1 : - h'[~~~~~~~~~j~~~~'I' .- V 2:: N ¼> Am;: -Xk~2'* .~uentaI1y SustaI~bIe I~eveI K',r~ N Environmentally Sustainable Development Series Titles Proceedings Series: Culture and Development: Proceedings of an International Conference ESD Proceedings Series no. 1 (1994) (Also in French) Valuing the Environment: Proceedings of the First Annual International Conference on Environmentally Sustainable Development ESD Proceedings Series no. 2 (1994) Overcoming Global Hunger: Proceedings of a Conference on Actions to Reduce Hunger Worldwide ESD Proceedings Series no. 3 (1994) Traditional Knowledge and Sustainable Development Proceedings of the 1993 United Nations International Year of the World's Indigenous Peoples' Conference ESD Prcedings Series no. 4 (Forthcoming) The Human Face of the Urban Environment: Proceedings of the Second Annual World Bank Conference an Environmentally Sustainable Development ESD Proceedings Series no. 5 (Forthcoming) Studies and Monographs (formerly Occasional Paper) Series: The Contribution of People's Participation: Evidencefrom 121 Rural Water Supply Projects ESD Occasional Paper Series no. 1 (Forthcoming) aking Development Sustainable- From Concepts to Action ESD Occasional Paper Series no. 2 (1994) Sociology, Anthropology, and Developmentt An Annotated Bibliography of World Bank Publications 1975-1993 ESD Studies and Monographs Series no.3(1994) The World Bank's Strategy fir Reducing Poverty and Hunger ESD Studies and Monographs Series no.4(1995) Overcoming Global Hunger Ismail Serageldin Pierre LandelU-Mills, Editors Alice Dowsett Editorial Consultant Proceedings of a Conference on Actions to Reduce Hunger Worldwide hosted by The World Bank and held at The American University, Washington, D.C. November 30-December 1, 1993 Environmentally Sustainable Development Proceedings Series No. 3 FeSD The World Bank, Washington, D.C. U © 1994 The International Bank for Reconstruction and Development/The World Bank 1818 H Street, N.W., Washington, D.C. 20439, US.A. All rights reserved Manufactured m the United States of America First printing December 1994 This xeport has been prepared by the staff of the World Bank The judgments expressed do not necessarily reflect the views of the Board of Executive Directors or the govremments they represent ISBN: 0-8213-2883-2 Library of Congress Cataloging-in-Publication Data Conference on Actions to Reduce Hunger Worldwide (1993: American University) Overcoming Global hunger: proceedings of a Conference on Actions to Reduce Hunger Worldwide, hosted by the World Bank, Bender Arena, The American University, Washington, D.C., November 30-December 1, 1993 / Tsrnail Serageklin, Pierre Iandell-Mills, editors ; Alice Dowsett editorial consultant p. cm - (Environmentally sustainable development proceedings series; no. 3.) ISBN 0-8213-2883-2 1. Food supply-Congresses. 2. Starvation-Congresses. 3. Poverty-Congresses. 4 Sustainable development-Congresses. L Serageldin, IsmaiL 1944- II. Landell-Mills, Pierre, 1939- m. Title. IV. Series. HD9000.5.C6275 1993 363.8-dc2O 94-22194 CEP Contents Foreword v Acknowledgments vi Contributors vii Aconyms and Abbreviations ix Introduction 1 0 Session 1 Global Challenge Welcoming Remarks Elliott Milstein 5 Partnership to Fight Hunger lewis T. Preston 6 A Vision for a Hunger-Free Partnership Tony P. Hall 8 Participation of Nongovernmental Organizations Carolyn Long 10 Nothing Grows from the Top Down Atherton Martin 11 Conference Themes bsmail Serageldin 15 Session 2: Macroeconomic Reform: Its Impact on Poverty and Hunger Edward V KC Jaycox, Chair Macroeconlomic Reform: Its Impact o Poverty and Hunger Nancy Birdsai 21 Discussant Remarks Carlos Heredia 28 Workshop Spokesperson Remarks Shafka Nasser 3I Nancy ALe r 32 Floor Discussion 34 Special Address: The Scope for Public Action to Reduce Chronic Hunger Keumie Mi4sin 39 Session 3: Targeted Interventions: What Works Best to Reduce Hunger Caio Koch-Wese, Chair Targeted Interventions: What Works Best to Reduce Hunger FawziAl-Sultan 45 Discussant Remarks Ruth Bamela Engo-Tjega 49 Catherine Bertini 51 Workshop Spokesperson Remarks Christopher Dunford 53 Mildred Robbins-Leet 56 Floor Discussion 58 ili1 iv Contents Session 4: Lessons of Experience Joseph Wood, Chair Lessons of Experience Muhammad Yunus 65 Discussant Remarks Sekai Holland 69 Floor Discui;sion 72 Special Address: Ending Hunger A Global Concern Boutros Boutros-GCuhi 79 Session 5: The Political Economy of Hunger Shahid Husain, Chair The Political Economy of Hunger Amartya Sen 85 Discussant Remarks Marcelo Selowsky 91 Workshop Spokesperson Remarks Deepa Narayan 94 Barbara r. Bramble 95 floor Discussion 97 Special Address: NGOs and Intenational Organzations: Developing Collaboration to Fight Hunger Jimmy Carter 103 Floor Discussion 107 Final Session: Commitment to Action Needed: Food Security in a Hungry World J. Brian Atwood 111 Concluding Statement on Behalf of NGOs Carohyn Long 114 Closing Remarks Ismdl Seragddin 216 Appendixes 1. Overcomiing Global Hunger: An Issues Paper 127 2. Addressing Hunger. A Historical Perspective of International Initiatives 147 3. Lessons of Expenence: Twelve Case Studies 163 4. Ending Hunger Soon: Concepts and Priorities 203 5. Hunger and the World Bank An NGO Perspective 219 Associated Event The Ethical Dimensions of Global Hungern A Panel Discussion Opening Statement Ismail Serageldin 227 Statement JorgeMaridMejia 229 Statement David Beclknann 232 Statement Ibrahima Fall 236 floor Discussion 241 Closing Statement Ismail Seragelddi 244 Foreword That a sixth of humanity goes hungry in a world cial role. The empowerment of women is at the where food is plentiful is an abiding disgrace. That core of any sustained action to deal with poverty hunger persists despite the many conferences and and hunger. initiatives organized to overcome it is a profound There is widespread agreement that hunger hallenge to the development community must be tacked with a broad-based poverty The Conference on Overcoming Global Hun- reduction strategy, for it is extreme poverty that ger was inspired by the example of Tony Hall, is the main cause of hungei, and not insufficient who by fasting made us acutely aware of the need food production. Eradicating hunger and malnu- for renewed and more effective action. The con- trition is an attainable goal, but it depends on all sensus that emerged among the participants of us worlkng together for this common purpose. focused on the need for a more collaborative Eradicating hunger is an objective to which all effort on the part of the intemational community. decent human beings must be devoted. in the last With that came the recognition that the key to century, some people looked at slavery and said reaching the poorest of the poor was to assist that it was unconsciable and unacceptable. them directly to raise their eanring capacity They said it degraded the free as well as the slave, through participatory community-based pro- and that itmustbe abolished. Theywereknown as grams. Only by involving poor people direcdy in abolitionists. In this day and age, I say that hunger the design and management of programs can we is unconscionable and unacceptable. We must adhieve sustainable impiovements in welfare. become the new abolitionists. We must not fail Our challenge now is to ensure that this con- ference does not become an isolated event Ismail Serageldin Beyond a continuming dialogue, the need now is to Vwce President, agree on specific actions diat would benefit the Environmentally Sustainable Development, and poorest of the poor. Chairman, Most often the poorest groups are women. International ConferenCe The conference once again underlined their cru- on Overcomning Global Hunger v1 Acknowledgments We would like to express our profound appreda- John Mitchell, Michel Petit, Bill Stanton, Harry tdon to the president of the World Bank, Mr. Lewis Walters, and Aubrey Wllliams (World Bank). T Preston, who not ordy supported the conference, We would like to thank other Bank staff whose but gave his personal attention to the preparation dedication and hard work contributed to the and proceedings. His personal involvement was success of the event. We would like to acknowl- widelynoted and contributed much to the success edge in particulau, Richard Barrett, Fleurdelia of the event Likewise, the managing directors of Canlas,AnjaliChadha,BeniChibber-Rao,Metade the Bank gave freely of their time to ensure the Coquereaumont, Beni Devine, Alan Donovan, soundness of the Bank's position vis-a-vis the Elizabeth Dvorscak, Barbara Eckberg, Arlene issues under discussion. In particulair, Mr. Sven Elcock, Claire Evans, Kelly Forrest, Chantal Fox, Sandstrom gave unstntingly of his time and Catherne Guie, Julie Haris, Alicia Hetzner, energy to shepherd the various interelated Tomoko Hirata, Dean Housden, Sarwat Hussain, strands that made the conference possible. Heather Imboden, Vmcent Jayasuriya, Cordell Special thanks are due to the American Uni- McGnley, James McKinney, Adoracion Morao, versity and its president, Mr. Elliott Milstein, and Rene San Martin, Patricia Moran, Karen Osborne, theUniversity's Centerforthe Study of the Global Joyce Sabaya, Aissatou Seck, Rachel Sengers, South and its dimctor, Mr Clovis Maksoud, who Saydeh Shammas, Christine Stover, Fulvia graciously hosted the event and extended every Toppin, Rita Varanian, Luisa Victorio, Dayananda assistance to ensure its success. Weeralkkody, and Magdalen Zee-Wu. Special The planning and organization of the confer- tianls to Michele lannacci and his staff for pro- ence was a collective effort We wish to express viding all the pictures in this document In addi- our appreciation to the members of the confer- tion, we would like to acknowledge the staff of the ence steering committee for their time, contribu- Center for the Study of the Global South, espe- tions, and commitment to the event Nancy cially Ron Carlton, Patrick Grady, Dina Kasrawi, Alexander (Bread for the World); Richard Bissell Yasmine JChan, Katie Lukianoff, Susie Nemazee, (Overseas Development Council); Joanne Carter David Taylor, and Tony Vecchione. (Results); Vera Gathright (IFAD); Carolyn Long The editors also wish to express their appreci- (InterAction); John Morrill (Congressman Tony ation to Judith Nicholson for managing the par- Hail's office); Joe Muwonge (World Vision); ticipatory process throughout the planning stage Martin MacLaughlin (UJS. Catholic Conference); and for organizing the Particpatory Workshop, Charles Sykes (CARE); and jock Anderson, Alan which preceded the main event, and to Eveling Berg. John Clark, Timothy Cullen, Alan Drattell, Bermudez for her invaluable assistance in coordi- Siddharth Dube, Leslie Elder, James Greene, nating the conference and bringing this document Jeffrey Hammer, Roslyn Hees, Norman fEcks, to publication. Finally, we are especially grateful Valerie Kozel, Matthew McHugh, Oey Meesook, to our editorial consultant Alice Dowsett. vi Contributors Nancy Alexander, Director of Issues, Bread for Gaurav Datt, Consultant, Poverty and the World Human Resources Division, Policy Research Department, World Bank Fawzi Al-Sultan, President, International Fund for Agricultural Development Anne Marie del Castillo, Food Economics International, Ltd. Brian Atwood, Administrator, US. Agency for International Development Jean Jacques De St. Antoine, Senior Project Operatiorns Offlcer, Human Resources Jayshree Balachander, Nutrition Specialist, Division, Department 1, Latin America Human Resources and Poverty Division, Africa and the Caribbean Regional Office, World Technical Department, World Bank Bank David Beckmann, President, Bread for the World Siddharth Dube, Editorial Research Analyst, population Health and Nutrition Department, Catherine Bertini, Executive Director, World World Bank Food Programme Christopher Dunford, President, Freedom from Nancy Birdsall, Executive Vlce President, Inter- Hunger Foundation American Development Bank -raDeB Leslie Elder, Nutrition Consultant, Richard Bissell, Visiting Fellow, Overseas Population, Health and Nutrition Department, Development Council World Bank WE. Dr. Boutros Boutros-Ghali, Secretary- Ruth Bamela Engo-Tjega, Cofounder, Advocates General, United Nations for African Food Security Barbara J. Bramble, Director, Interational Ibrahiima Fall, Under Secretary-General, United Programs, National Wildlife Federation Nations Centre for Human Rights The Honorable Jimmy Carter, former President, The Honorable Tony P. Hall, Member, United States of America US. House of Representatives rites reflect positions held at the tine of the conference- vii Contributors viii Carlos Heredia, Director of International Anna Sant'Anna, Project Officer, Human Programs, Equipo Pueblo, Mexico, and Visiting Resources Operations Division, Department 2, Fellow, The Development Gap Latin America and the Caribbean Regional Office, World Bank Sekai Holland, Association of Women's Clubs Marcelo Selowsky, Chief Economist, Pierre Landell-Mills, Senior Policy Adviser, European and Central Asia Regional Office, Office of the Vice President, Environmentaily World Bank Sustainable Development, World Bank Amartya K Sen, Lamont University Professor, Kathy Lindert, Consultant, Agriculture Department of Economics, Harvard University Operations Division, Department 1, Middle East and North Africa Regional Office, World Bank Ismail Serageldin, Vice President, Environmentally Sustainable Development, Carolyn Long, Vice President, InterAction World Bank Atherton Martin, Executive Director, The Julia Tagwireyi, Director for National Nutrition, DevelopmentInstitute Ministry of Health, Zimbabwe H.E. Sir Ketumile iMasire, President, Botswana Laura Tuck, Senior Economist, Office of the Vice President, Europe and Central Asia Regional Monsignor Jorge Marid Mejia, General Office, World Bank Secretary of the Congregation for Bishops, The Vatican Alberto Valdes, Agncultural Adviser, Latin America Technical Department, World Bank 'Elliott Milstein, Interim President, The American University Isabel Vial, Associate Professor, Instituto de Nutrici6n y Temologia de los Alimentos, Deepa Narayan, Social Scientist, Enviromnent Universidad de Chile Department, World Bank Joachim von Braun, Professor, Institute of Food Shafika Nasser, Professor and Chairperson, Economics, University of Kiel Department of Public Health and Nutrition Faculty of Medicine, Cairo University Harry Walters, Food Security Adviser, Human Resources and Poverty Division, Africa Lewis T. Preston, President, World Bank Technical Department, World Bank Shlomo Reutlinger, Food Economics Patrick Webb, Research Fellow, Food International, Ltd. Consumption and Nutrition Division, International Food Policy Research Institute Mildred Robbins-Leet, PLesident, Triclde Up Program Muhammad Yunus, President, Grameen Bank Acronyms and Abbreviations AKRkSP Aga KChan Rural Support Program CAM Centro de Apoyo a la Microempresa CGC Caisse Generale de Compensation CFNP Community Food and Nutrition Program CFP Complementary Feeding Program CGIAR Consultative Group on International Agricultural Research CSIFP Children's Supplementary Feeding Program EGS Employment Guarantee Scheme FAO Food and Agriculture Organization of the United Nations FINCA Foundation for International Community Assistance FFHC Freedom-from-Hunger Campaign GDP gross domestic product GNP gross national product IDA International Development Association IDB Inter-American Development Bank IFAD International Fund for Agricultural Development IFPRI International Food Policy Research Institute IMF International Monetary Fund NGO nongovernmental organization PRAF Family Assistance Program TINP TamiI Nadu Integrated Nutrition Project UN United Nations UNDP United Nations Development Programme UNICEF United Nations Children's Fund USAID U.S. Agency for International Development WFP World Food Programme WHO World Health Organization ix Introduction Hunger is not a simple phenomenon that yields planned in close consultation with representa- to simple solutions. The means to overcome tives of NGOs who participated actively in the hunger cut across the whole spectrum of devel- work of the conference steering committee, as opment challenges: raising agricultural produc- did Congressman Hall's staff. InterAction, which tivity. developing hurnan resources, creatingjobs, has links with NGOs worldwide, coordinated and improving governance. Consequently, the the NGOs' contributions. World Bank, which exists to foster the develop- The tensions that arose from these two differ- ment of poor countries, has a central role to play ent perspectives were immediately evident at the in assisting countres to banish hunger. steering committee's meetings, which had to Recognizing this special responsibility, the make difficult decisions on the form and content Bank responded to Congressman Hall's call to of the conference. The NGO representatives were action by offering to organize a conference where interested in influencing the World Barn's coun- those most knowledgeable about hunger and try assistance strategies and the design of struc- malnutrition in developing countries could meet tural adjustment programs, while Bank staff saw to formulate an agenda for action. The objective the conference's main task as building a consen- of this collaborative effort was to (a) identify sus on spedfic priority actions to be taken at the major elements of an effective strategy to reduce country level and supported by all those agen- hunger and to generate the necessary political des-multilateral, bilateral, and nongovernmen- will; (b) build consensus on a priority action tal-active in the country concemed. These agenda to reduce global hunger; (c) assist the tensions persisted throughout the conference. World Bank in defining what it can do to help The conference was preceded by a one-day implement the action agenda; and (d) raise preparatory workshop attended by NGO repre- awareness about the seriousness of global hun- sentatives; researchers; and representatives of ger, the actions that can be taken to overcome it, bilateral and multilateral institutions, including and what the World Bank is prepared to do to UNICEF, the World Food Programme, the UNDP, reduce hunger. and IFAD, as well as the World Bank. The work- From the start the conference organizers rec- shop provided a forum for experts in food secu- ognized that two very different perspectives had rity and nutrition to thrash out the key issues and to be taken into account One was that of country present their ideas and proposals to the main con- economic managers, the finance and planning ference. The workshop participants divided into officials who devise countries' macroeconomic three groups to discuss the topics of the different and sectoral strategies. The other was that of sessions of the main conference: (a) the impact of local nongovernmental and community-based macroeconomic reform on poverty and hunger, organizations whose staff are in direct contact (b) the lessons learned from targeted interven- with poor families. Thus, the conference was tions to overcome hunger, and (c) the political 2 Introduction economy of hunger. Eadh group chose spokesper- pared an action agenda for deepening its support sons to summarize the group's views and con- for reducing poverty and hunger. clusions for the benefit of those attending the The analysis set out in the supporting papers main conference. prepared for the conference brings out the strong To assist the deliberations of the main con- link between hunger and poverty alleviation. ferences, four background papers were also pre- Countries such as Indonesia that have achieved pared. These reviewed the history of past rapidgrowthinpercapitaincomeshavealsoseen intemational initiatives to reduce hunger, a rapid reductioninthe number of families below sought to clarify concepts and priorities, sum- the poverty line. At the same time, however, rates marized the lessons of experience from twelve of poverty reduction differ considerably among case studies, and set out key issues for the con- countries with the same per capita income ference to address- These papers are induded in growth rates, and hence the extent of hunger alle- this volume as appendixes 1-4.The NGOs at the viation among countries. Moreover, the extent of conference prepared and circulated a statement hunger among countries at the same level of per which has been included in this document as capita income varies greatly. The reason for these appendix 5. differences can be attributed in part to differences Finally, a separate but related event was in the design and implementation of programs held-an evening panel discussion on the ethical directly targeting the hungry. dimensions of hunger. The main statements and The case studies illustrate a number of differ- a summary of the panel discussion that followed ent hunger alleviation programs that allow us are attached in a special conduding section. some insightinto whatworksbest Differences in The conference was well attended. At times the extent of hunger alleviation among countries as many as 1,200 people filled the conference with the same growth rate of per capita income hall, and requests to speak from the floor were are attributable in large measure to the varying numerous. The concern of the vast majority of results of the hunger policies and programs dif- participants was to find ways to move deci- ferent countnes have adopted. For example, sively from rhetoric to action. Over the years Chile's remarkable improvement in its social people have made so many speeches about the indicators contrasts with changes in the social disgrace of hunger in the world, and yet so little indicators of other Latin American countries with has been achieved to improve the access of the similar levels of per capita income. This is poor to food. because of the existence or absence of poliaes and What, then, has been the outcome to the con- programs explicitly intended to reduce poverty ference? First, the conference steering committee and hunger and their varying effectiveness. The has been reconstituted as a follow-up group and case studies show that specific interventions tar- has agreed to promote country-level consulta- geted to assist those who suffer from hunger- tions at which government officals and local especially the very poor-can have a significant NGO representatives could meet to review the positive impact. At the same time, they reveal the food securityandnutritionstrategies inplaceand ample scope for learning from experience to to identify specific additional actions that should improve the design and management of these be undertakeL Second, a donor group has been programs to target them better and to make them meeting to establish a consultative group aimed more cost-effective. at improving the earning capacity of the very The struggle to banish hunger worldwide is a poor. In the first instance this will concentrate on long one. There has been to much taLking and too expanding the provision of financial services to little doing This conference was yet another con- ffie very poor. Lastly, the World Bank has pre- tnbution to the debate Now is the time for action. Session One Global Challenge Welcoming Remarks Elliott Milstein The American University is very pleased and ship and trough their public service work, in honored that the World Bank chose our campus these kinds of issues throughout the world makes as the site for this major conference on world it particularly fitting that this conference is being hunger held here. Furthermore, as overcoming global Overcoming global hunger is an ennobling hunger is part of the agenda of our Center for the endeavor, besides being an issue of immediate Global South, which operates under the able concern and urget humanitarian priority diecon of Dr. aovis Maksoud, the conference Indeed, conceiving of an issue that is of more fun- reinforces our commintment to that center and its damental importance than this one is difficult. work in the south of the world. For this reason, our welcome to you on behalf of I am hopeful that this conference will open the university community is heartfelt- new avenues of cooperation and joint programs Your participation here comes at the end of between The American University, and particu- 1993, the 100th year of The American University. larly the Center for the Global South, our School During our centennialyearwewere able to reflect of Intemational Service, and the World Bank and on our own involvement in international human the NGOs, in their respective struggles to combat rights, international trade and economic devel- the root causes of hunger and to ensure a more opment, international environmental protection, equitable world order. humanitarian affairs, dispute resolution, and I wish you success in this conference and, international education. The involvement nf our more important, intheworkthatitwillengender. faculty and our students, through their s Lar- Welcome to American University. 5 Partnership to Fight Hunger a* Lewis T. Preston Like most of the organizations represented here Nations organizations, donor agencies, nongov- today, the World Bank-through its commit- ernmental organizations, and multilateral insti- ment to poverty reduction-has long been con- tutions also have important roles to play- It is cerned about global hunger. Congressman Tony encouraging to see this partnership strongly rep- Hall's fast earlier this year gave renewed and resented here today. dramatic attention to the issue and sparked the thinking that led to this event. I would like to Poverty and Hunger take this opportunity to commend Congress- man Hall on his efforts, and to say how Hunger in the midst of plenty is one of the most delighted we are that he is here today. difficult development challenges of our time- Aggregate food production continues to increase; Sense of Perspective yet hunger also continues to blight the lives of hundreds of millions of people. This conference does not take place in isolation. Hunger is sometimes caused by drought, dis- There have been many other confermces that- ease, or war, and a strong humanitanan response as you know-have set ambitious hunger reduc- is always needed in those cases. But the more tion objectives. The actual results, however- widespread and deep-rooted form of hunger is again, as you know-have too often fallen short caused by people having neither the capacity to of those objectives. We must ensure that our produce food nor the income to pay for it words during the next several days are matched Fundamentally, hunger is caused by poverty- by our actions during the next several years. We need to be realistic and view this conference as a Broad Spectrum of Actions step toward a stronger international effort to address global hunger and as part of a continuing If we want to reduce hunger effectively, we have dialogue. That does not mean, of course, that we to reduce poverty, and that requires a broad spec- will necessarily agree on everything, but it is in trum of actions, namely: everybody's interest to be open to different views * Supporting government policies that encour- and perspectives, age growth and employment for the poor and The World Bank has convened this confer- removing policies that discriminate against ence, but it does not act alone. Hunger can only agriculture and peasant farmers be effectively addressed through a partnership * Investing in people's capacities through edu- involving all those concerned. The governments cation, health, family planning, and nutrition and peoples who face the problem every day * Implementing better agricultural tedhnolo- are-ultimately-the key actors, but the United gies and research 6 PrEston 7 * Focusing on the vital link between environ- the lead in establishing a consultative mechanism mental sustainability and increased food that could focus not only on funding, but also on production the dissemination of best practices. * Expanding the participation of the poor in In the meantime, the Bank is ready to make development through increased access to the concept action-oriented. The Grameen Tiust, credit, land, and services. represented here today by its founder, Dr. The Bank, working with its partners, is deeply Muhammad Yunus, has already initiated a pro- engaged in supporting these efforts, but recog- gram to provide seed capital to some thirty to nizes that more needs to be done, both by the forty micro-credit schemes in various countries Bank and by its partners. during the next five years. A number of donors have already contributed to this program, and I Complementary Action am pleased to announce that the Bank is also will- at the Grassroots Level ing to contribute a US$2 million grant to help cover the Grameen Trust's startup needs. As you The discussion over the next few days ought to may know, the Bank does not generally provide consider how we can complement our ongoing grants. We are prepared to make an exception in efforts and reach the poorest of the poor more this case because the need is urgent and because, directly. as I indicated, we hope it might help to catalyze Micro-level credit schemes, such as those a broader response from the donor community. undertaken by Grameen Bank of Bangladesh, the Badan Credit Bank of Indonesia, and the Conclusion International Fund forAgricultural Development, have provento be highly effective at the grassroots Many other actions can and must be taken to fight leveL The basic idea behind these schemes is to hunger, and I emphasized earlier the importance help people help themselves by starting small- of embedding our efforts in the context of a broad scale income generation prcjects and businesses poverty reduction strategyIThe various organiza- They are a particularly effective way of reaching tions represented here have different comparative women, thereby helping to improve the incomes advantages, but we all share the same goal. More and well-being of their children and families. collaboration and a more regular, more open dia- The World Bank is willing to work with its logue can help us to achieve it If this conference partners to expand effective micro-level credit moves us further down that road, it will have schemes for the poorest of the poor, perhaps by served its purpose, and the millions who suffer in joiiing other donors who might be willing to take poverty and hunger will benefit. A Vision for a Hunger-Free Partnership Tony P. Hall St. Francis of Assisi said, "We need to preach the Looking back on it, I was amazed at the expe- gospel at all times and only if necessary do we rience. Ilooked on this actof fasting with the anx- need to use words." I believe he meant that we iety and dread that any man of habit feels when need not make speeches or talk so much, but suddenlyconfrontedwithadutythatcarriedwith rather act and demonstrate our love for our fel- it an action that is so unfamia, so out of his com- low man. I think action is a good word for us. It fort zone, that the details and results are not up to is not enough to come out of here with a good him, and are beyond his understanding and con- statement, a good direction. We must be people trol. Nevertheless the action, done in all humility, of action. Speak softly, but firmly, and let our was very powerful to me. It was a moving expe- actions speak for themselves. rience that I admitted to my wife I would miss. I I vrant to thank the World Bank, President felt I was inspired by God and I still do. At other Preston, Dr Serageldin, and especally my good times IthoughtIwould be labeled "the flake of the friend Bill Stanton, who had the vision and the year" I thought this was the end of my career, but love not only of this Bank, but of the issue of I was willing to give it up because I was so frus- hunger. I thank them for asking me to be part of trated and angry at the lack of response from my this most important conference and for respond- own Congress and my own colleagues. ing not only to this pressing issue, but to my By going twenty-two days without food, with twenty-two-day fast only watex, I felt what it was like for some chil- The reason for the fast was that I was fas- dren as they go to school, how they are tired, trated with my colleagues in the American falling asleep, sometimes dull, because they do Congress for their failure to focus on and empha- not have enough food to feed their brains. I felt size the importance of the hungry, not only in the very old when, in the aftenoon, I could not walk world, but in the United States as well. How can a block without being winded, and when I would we call ourselves leaders and yet not lead in the lie down to rest I did not feel I could get up most basic of human rights: the right to eat, the because I was so tired, without energy, and yet I right to food? How can we stand by and not make was not hungry anymore. I remember an experi- the children and the malnourished people of this ence I had in 1984 in Ethiopia, on the upper world a priority, especially when we have the plateau, where 50,000 people had come because resources and knowledge to end hunger, or at a they had heard-this was in the very early stages minimum decrease its prevalence substantialy? of the famine-that food would be available. But In reading the book of Isaiah, verse 58, about when they arrived, nobody was there There were fasting, I felt that I was on a path that I could not no medicines, no doctors, no blankets. There was turnback from, and thatwas to identify with the nothing. As I was relating this to my own fast, I poor and to raise people's consciousness about wondered how these people had walked so far. the hungry. How were they able to get to the site? Hall 9 What happened as a result of the fast, the pletely worked. Our ideas of what is best for the thing that is so unpolitical, was that thousands of people of Gonaives, Haiti might not be their idea people across the country, even in other coun- of what they need. I have seen whole communi- tries, wrote and asked, "What can we do?" Some ties defeat hunger They are like an oasis in a started programs. Some wrote and asked, "To desert of hunger. Their solutions work because whom can we donate our money?""Who iseally they come from the bottom up. We need to do fightinghunger?" Itwas amazing thatthesethou- everything we can to support solutions to hunger sands of letters and communications poured in that work, no matter where they come from. from all fifty states of my own country. hi his context, the NGOs deserve praise for Then Mike Espy, the secretary of agriculture, their programs and the arguments they put forth started a series of summits on domestic hunger in that incorporate a bottom-up approach and a the United States. He is very involved and very responsible mixture of short- and long-term solu- committed to this. In the Congress I have started tions. The NGOs' involvement in a hunger strat- a hunger caucus that has more than seventy egy is absolutely essential if we are ever to members, and I am starting an outside group, the succeed. More and more, NGOs are successfully Congressional Hunger Center, to follow up on convincing governments and multilateral groups the issues we will be discussing in the next few that they must provide both short-term and days. The center will have a hunger intern pro- long-term solutions to the problems of world gram, the Mickey Leland Hunger Corps, which hunger and poverty NGOs are driving home to will send young people out to various hunger world leaders the notion that solutions to hunger sites around the countryfor a few months, and on cannot be imposed from the top down. Progress their return they will share their experiences with can best be made when the poor are given the their colleagues or with the Congress itself. We opportunity to design solutions Lo their own are also inthe process of completing ahigh school problems. hunger curriculum that we intend to offer to hun- We must increase our aid and our resources dreds of schools around the nation, and eventa- andbesurethattheygettothepoorestof thepoor. ally around the world. I think the Bank deserves credit by increasing its We have here today in this room and at this lending to such sectors as health, nutrition, and conference the experts who know hunger issues education. The Bank is our friend, and we can all better than anyone else You live with it, you fight help our fiend by continuing to encourage it to it, and you are committed to doing something pursue economic growth that not only empowers about it. We have a chance to make a major dif- the poor, but enables them to participate. ference together Our conference should be like a grand bonfire One sensitive problem that has long plagued that heats a room during the winter months, and our fight against hunger is the long-standing while it bums brightly it provides warmth and debate about whether hunger can best be solved comfort, but if you separate the logs from the with a top-down approach or with a participa- sticks and scatter them piece by piece around the tory bottom-up approach Anotier major debate room, they bum out Some might continue to is whether we should aim our resources at short- burn, but they would not heat the room, they term relief or long-tem solutions. One of the best would not do the job. We need to wrrk together possible outcomes of this conference would be as a team, share our resources, and not reinvent agreement about the best approaches to take. the wheel We must commit to a plan and work We here in Washington have tned to end like that bonfire burmng bnghtly to give poverty for years. Our policies, developed apart warmth, comfort, and vision to a cold and hun- from the poor's everyday realities, have not com- gry world. Participation of Nongovernmental Organizations Carolyn Long When planning for this conference, the World regard to hunger. We felt it was important to Bank invited four NGOs to serve on the steering explain that at the beginning, because all of our comnmittee, and we accepted the invitation, not as actions in relation to the conference, the NGO cosponsors of the conference, but in a consulta- speakers we recommended and whom the Bank tive role, to provide recommendations and our agreed to put on the program will all look at this point of view. conference from the perspective of the World The NGOs' orientation to the conference has Bank and its role been somewhat different than the World Bank's. So on behalf of the NGOs, the -sticks in the The World Bank has perceived this conference bonfire" that Congressman Hall just taked and is working in this conference to consider about, I want to adknowledge the World Bank's hunger in the global context, which includes all staff for their willingness to indude the NGOs in institutions involved-governments, multlat- the planning of this conference and their open- eral agenaes, universities, NGOs, and the hun- ness to accepting many of our recommendations, gry people themselves-whereas the NGOs, even though they knew that we would be critical primarily because of the power uf the World of them. And I want particularly to thank Vice Bank worldwide, decded that they would focus President Ismail Serageldin, who in some ways exclusively on the role of the World Bank in has put himself on the line. 10 Nothing Grows , - from the Top Down Atherton Martin I am very pleased to have been chosen to repre- ated with the phenomenon of hunger, we simply sent the views of several hundred thousand peo- refuse to accept hunger as a feature of life on ple, who for obvious reasons could not be here earth. As NGOs we are convinced that an end to today, but who would insist that we remain faith- hunger is not only possible, but imperative. We ful to their realities, their concems, and their believe that for every person going hungry any- hopes for the future. where in this world, there should be a Tony Hall In the last 500 years, there have been four willing to go to extraordinary lengths to draw major threats to the survival of humanity slavery, attention to the shameless fact that we have the fascism, hunger, and environmental degradation. capacity to prevent that indignity. We salute the One of these has been overcome: slavery. To a courage and persistence of that U.S. congress- greater or lesser extent, fascism, hunger, and man who, when all else had failed, was prepared environmental degradation persist. Slavery was to resort to embarrassing the US. Congress, the overcome by the action of people in the South and U.S. public, and the world into paying attention the North who were outraged by the very to the tragedy of hunger. We also salute the thought of one human being owning another courageous people throughout the world and human being. The other threats to our humanity, inside the World Bank who have received that and in the context of his conference, hunger, message from Representative Tony Hall and await the action of people who, like Congressman decided to act on it Hall, are determined that the pain and indignity Yesterday, the representatives of southern of hunger and the horror of the starvation of even NGOs had a most interesting exchange with one human being will not be tolerated. senior Bank staff regarding the Bankrs role in con- The "champagne glass' of hunger and tnbuting to the causes of global hunger. We were poverty that is depicted in this chart accurately pleased to hear many of these staffers repeatwhat illustrates the brutality of the problem of hunger NGOs have been saying for several years about In summary, at the top of the glass the nchest 20 the important contribution of economic policies percent of the people receive, own, and control 82 and programs to the debacle of persistent poverty percent of all the income and wealth of the world. and its bedfellow, hunger. We were pleased At the bottom of the glass, the poorest 20 percent because the emergence of a common perspective of the people share 1A percent of the income and on the causes of hunger signal the possibility for wealth of the world. Together with the rest of us, partnership in the efforts to end hunger. We the World Bank is challenged to accept the chal- applaud these staffers and applaud the president lenge of changing the conditions that create and of the Bank for his support for this conference and sustain this horrendous human inustice. the resulting opportunity to have this dialogue. As the representatives of NGOs, many of us As NGOs we believe that we have a spedal from the countries of the world normally associ- role in this and other efforts aimed at drawing 11 12 Notlhing Crouwsfrom tile Top Down attention to the problem of global hunger. Simply The Bank would also need to agree to regular put, we are prepared to be the conscience of many interaction with those who work with and repre- people in rich and poor countries who see hunger, sent the poor, so that NGOs from the countries of reject it, and have decided to end it We are pre- the South together with their partner NGOs from pared to be the conscience of those who under- the North would provide year round input into stand the cause of the deepening crisis of global the process of transforming the Bank into an hunger as it relates to development policies and instrument for development that is responsive to strategies, many of which have been advocated the needs of the poor and hungry among us. and financed by the Bank and other international It is already clear from this that our perception financial institutions during the past fifty years. of economics places people at the center, and is We are prepared to be the eyes and ears of the mil- substantially different from the notion of eco- lions who are unable to be here, who are unable to nomics that is espoused by the Bank. Lest we be read your documents, who are unable to see the misunderstood, however, we wish to make it opulence of your work stations, who are unable to clear that NGOs recognize the need for interna- be here to tell you themselves what it means to go tional trade as one means of stimulating eco- hungry. We are your conscience saying no! nomic activity, but we in turn ask that the Bank Enough! Let us put a stop to this! recognize the need for trade arrangements that To put a stop to this means that we must notonlyearnforeignexchange,butmeetpeople's .change the way that we do business. For the needs for jobs, housing, health care, food, and Bank, probably the single most cntical institution other life essentials. relating to the issues of global economic activity In the same vein, if the Bank accepts the need in recent decades, this means changing the way for large industrial economies to protect their that things are done inside the Bank between the microchip industries and the intellectual prop- Bank and other financial institutions, as well as erty rights that go with them, we insist that it rec- between the Bank and its clientgovernments, and ognize the need for countries such as ours to most important, between the Bank and the peo- protect national and regional markets for our ple in whose name we combat hunger products, to protect our jobs, and to protect our Instead of administerng structural adjust- rich biodiversity and other natural resources. We mient programs to our countries, the Bank would note that such measures on the part of poor coun- need to focus on maling adjustments to its own tries attract the label protectionist and are operations that would allow it, for example, to referred to as unfair trading practices, and often establish procedures and mechanisms that allow result in economic retaliation. We also note that the experiences and the expertise of poor women, the Bank is often prodding the compliance of workers, farmers, youth, and others to inform poor countries with trade liberalization as a con- and shape policies and proams of the bank! ditionality for financing. The Bank would need to subject itself and its We note, however, that even when large coun- work to the scrutiny of those same groups who tries resort to direct cash subsidies to protect their are most affected by its actions, and to be respon- own producers, as is the case with rice, wheat, sive and accountable to the poor in whose name com, and many other commodities m the United it addresses the issues of hunger. States, for example, these measures are not con- The Bank would need to link its policies and sidered protectionist, they do not attract retalia- programs in such areas as trade, education, tory measures, and the Bank, among others, health, housing, nutrition, and other important remains silent on these blatant violations of the spheres of human life to the phenomenon of principles of free trade. A case in point the global hunger, and to insist on an integrated United States just this year used its PL 480 food approach to the design and implementation of aid program inJamaica to force Guyana's rice out Bank policies and programs. of that Canbbean market' Rice is a commodity The Bank would need to admit that the med- that attracts some of the highest subsidies in the icine of structural adjustent has not helped stop United States, and we have calculated that global hunger, which means that it should stop whereas Caribbean rice producers in Guyana trying to administer that potion to our countries. receive no subsidies, just one of the five rice sup- Martin 13 port programs in place in the United States pays The problem is that a Bank whose collective an average of US$50,000 per year to each rice corporate experience is light years removed from farmer. If this is the free trade that we are being that of those whom it purports to serve may be told about, it is no wonder that poor countries unable to craft policies and programs except cannot engage in free trade. We simply cannot those in support of cash crop production, export- afford it led growth, large-scale dams, and mega hydra- What does all this business of trade have to do electric plants, aU of which in their present form with hunger? Well, it is relevant when the Bank destroy the capacity for food production of pre- insists that we produce more crops for export, as viously self-provisioning communities, exposing that is the way we will earn foreign exchange that people to food shortages, and eventually to we can then use to buy cheap, subsidized food hunger. To set off on a new path, the Bank will from the rich countries and to service our inter- need to work losely with organizations and peo- national debt But do you understand that by ple who work with and represent local commu- insisting on this dependence on a narrow range nities in the poorer countries. The NCOs of commodities for export, you are destroying represented here at this conference, and the many one of the only safety nets that poor countries can others in whose name I humbly speak, are such afford, the diversity of mixed faming that organizations. We can help translate the criteria addresses some of our food needs? How many of for sustainable development into concrete you would invest all the money that you had arrangements that see the expertise and expen- saved up for your daughter's college education ence of people of the South directly applied to in one option on the stock market? Well, that is designing and implementing programs that exactly what you are asking us to do. attack hunger at its roots. Does the Bank have any alternative? It cer- It is good and noble that Congressman Halls tainly does. The conditions attached to lending fast has brought us here today. Let us not forget the Bank's resources can be tied increasingly to that his fast was about hunger. Hunger here, rewards for efficient management of scarce hunger there, hunger everywhere, even in this, resources; to food security based on local produc- the richest country of the world! Let us also not tion; to the effective involvement of women in the forget, however, that it has taken a twenty-two- production, preparation, distribution, and trad- day fast by one U.S. congressman to bring the ing of goods and services; to the processing and World Bank to the table to eat of the food of real- manufacture of goods that use local raw materials ity, but the suffering and death of thousands, and foster linkages between different sectors of hundreds of thousands, even millions, of African the economy; to the creation of jobs for the armies and other children, women, and men from lack of of young people that populate our rural and food was not enough to do that. urban areas; and to other such indicators of a This conference should not, therefore, be seen development that is sustainable, equitable, partic- as the definitive response to the congressman's ipatory, and self-reliant. Such indicators as these fast or to the pain and suffering of those who have become known as the central features of sus- expenence hunger around the world. This con- tainable development and should become the ference is instead a chance for a fresh beginning major conditionalities governing the Bank's pol- of our campaign to put an end to the sound of icy, programnming and lending. "bubbles in bellies" once and for alL This confer- The practice of providing loans for develop- ence is our wake-up call to the fact that people in ment projects, yet insisting that most of the the countries where hunger persists know what money be spent to purchase high-priced equip- is wron& and know what must be done to end the ment and personnel from the rich countries of the indignity of poverty and to eradicate its uglybed- North, defeats the purpose of national self-suffi- fellow, hunger. Through this conference, the Bank aency and regional integration and undermines can send a signal to the world that the sound of any chance that we might have of developing the bubbles has been heard for the last time. The South-South trade or the capacity to become Bank can let it be known that from today, the globally competitive. This can be stopped. So, of knowledge, skills, and expertise of people from course, the Bank can change. the South and the North will be mobilized and 14 Nothinig Growsfrom tJie Top Down focused on diagnosing, treating and curing the experience, and the commitment to play a critical global malady of hunger. role in the campaign to end hunger. One more decade of structural adjustment We are here to tell you that the only chance and business as usual, and there will be so many that the Bank has to be part of this campaign to hungry people all over the world, so much degra- end hunger, once and for all, is to ensure that the dation of our soils, so much pollution of our needs of those with the greatest stake in ending waters and our air, such complete destruction of hunger, the hungry, become the centerpiece of the our forests, so much debt, so much inequitable Bankls imperative for action. The NGOs, by trade, such widespread disease, such a break- virtue of our evolution into institutions that down in family and community cohesion, such know and understand these needs intimately, civil conflict, that even the actions of a trans- have the unique capacity to facilitate this new formed World Bank would be to no avail. Now is partnership, this new contract for survival, this the time! Now is the time to change the partners, new grand alliance for a world free from the hor- to change the process, to change the tools of diag- ror of hunger. The Bank, for its part, is challenged nosis and analysis, to prescribe and administer a to be a sensible, flexible, and reliable partner with different treatment to an earth and its people that the people, especially those in greatest need. are urgently in need of intensive care. If the horror of global hunger forces the Bank We, the NGOs, are here to tell you that this to do one thing, it should be to change the terms conference must be that signal for change. We are of engagement and to do all that is necessary to also here to tell you that this will be so only if the make it possible for local people, poor people, Bank and others, including the U.S. Congress, are hungry people to accept the Bank as a partner in big enough to admit that change is needed. Big this quest to end hunger. Our message to the enough to admit that the Bank's staff, as talented Bank, therefore, is simple, "Come to terms with as many of them are, do not have a patent on the the fact that the standard prescriptions for skills of economic analysis, planning, and man- growth have not ended poverty or hunger. The agement for growth and development. The Bank chance for a change begins and ends with the must also be big e-nough to admit that there are people on the ground, because very simply, noth- people, even in the countries where hunger and ing grows from the top, down, not trees, not starvation are endemic, who have the skills, the economies, and certainly not people." Conference Themes Ismail Serageldin It is indeed invigorating to hear the eloquence in so many domains not to be taking the neces- with which Atherton Martin puts forth his case. I sary actions to remove this blight from the face of feel comfortable that it is not disagreements on the earth. All the more shameful because so much the objectives that may divide us in this group of the problem is avoidable. today, but perhaps on fine-tuning the contribu- Taking the actions needed to reduce hunger is tions of each of us to establish more firmly the what this conference is aUl about. But-and in this common ground on which we can act. This fine- I join my colleagues who spoke before me today, tuning will be our responsibility in this coming induding Mr- Martin and Congressmanr Hall- day and a half, to determine how we can keep the goal of this conference is more than that. The Congressman Hall's bonfire going to provide us abolition of hunger in our lifetime is a task to with the necessary heat and visiorL which all people of good conscience must reded- Perhaps I too can share with you the feelings icate themselves. of outrage that so many of us in the World Bank, Mr. Martin mentioned slavery, and I believe and in the development communitv at large, feel that like slavery 150 years ago, hunger today is about the problem of extreme poverty and its unconsconable. Let us be the new abolitionists, ugly corollary, hunger, in the midst of a plenti- those who from every location and every forum ful world. will do our utmost to address this challenge. We Every day, 40,000 people die from hunger- must do so because it is a moral imperative. But related causes. In the brief forty-five minutes of beyond the ethical issues, from an economic this opening session, one-and-a-half times as standpoint and from a political standpoint, we many people as are in this auditorium will have have no choice. It makes no sense to leave so died from hunger-related causes. Those who do many kindred souis living in misery and not die outright are deprived of the most basic wretchedness, barely on the brink of survival, attributes of human existence, and their children when they could be active contributors to the are stunted in their growth and unable to realize improvement of both self and society. the full potential of their genes. But wishing the problem away will not make From this perspective, hunger is surely the it disappear. It will require the systematic appli- most abhorrent physical expression of absolute cation of sound policies, a sustained commit- poverty, for it is imprinted on human flesh and ment to investment in human resources, and the bones. Furthermore, it is not only the poor who promotion of policies that support the em- are degraded by that condition. All of humanity powerment of the poor. It will require special is degraded by tolerating that one-sixth or more attention to the needs of women, for the em- of the world's population could continue to live, powerment of women is at the core of any sus- barely, in such conditions. It is shameful for the tained action to deal with poverty and hunger. It nations of the world that have achieved so much will require sustained conunitment and partner- 15 16 Conference Thlemes ship from the international community, includ- Indonesia or Grameen Bank in Bangladesh. My ing all of us here today. colleagues and I look forward to participating in You may well ask, "What is the World Bank such discussions with the donor community after doing to meet this challenge?" The Bank's com- this conference. mitment to fight poverty is grounded in a view of Mr. Preston spoke of the different comparative development that sees the ultimate measure of advantages of different institutions in the fight success in the improvement of people's well- against hunger. We fully recognize that ours is being. Mr. Preston has said many times that only one contribution among many. During this poverty reduction is the benchmiark against conference we must all seek the common ground which our success as a development institution that will enable each of us to make our contribu- must be measured. tion in a way that creates a whole greater than the We believe that sound economic management sum of its parts. How do we do this? The World that focuses on broadly based, employment-gen- Bank certainly does not have all the answers. We erating growth is a necessary feature of any effec- are here to listen and to learn from the experience tive attack on poverty, because real progress and expertise of others as much as to share what- occurs when the poor, the weak, and the margin- ever we have learned ourselves. This conference alized become the producers of their own welfare was structured so as to allow maximum interac- and bounty, not the recipients of charity or the tion and cross-fertilization of ideas, wliich brings beneficiaries- of aid. We also believe that these me to the mechanics of the program. policies must be accompanied by sound invest- The conference was preceded by a partici- ments, especially in human resources. Currently, patory workshop at which representatives of the World Bank is lending close to US$3.0 billion international agencies, goverunents, nongovern- a year for human resource development, of which mental organizations, and academic groups dis- US$1.6 billion is going for-education, with a spe- cussed the main themes of each of the main cial emphasis on the education of girls. In some plenary sessions to be held today and tomorrow. countries in the poorest regions that are most at macroeconomic policies, targeted interventions, risk, such as the Sahel in Africa, fewer than one and the political economy of hunger. The work- girl in four goes to school. shop participants designated rapporteurs from But beyond this double-pronged attack of the workslhop who willbe reporting in the plenary sound macroeconomic policies and investment in for each session during the conference. The main human resources, increasingly the Bank has been sessions are structured as panels with an invited supporting direct interventions to improve food speaker, a designated discussant, and the work- security and nutrition. Our support for nutrition shop rapporteur as the second discussant Bach set pr4rects, for example, rose from nearly US$20 of presentations willbe followed by questions and million or so five or six years ago to more than answers from the floor. US$680 million last year. Many of these projects On this occasion we hope that all speakers will have brought about sound improvements in peo- keep in mind the issues of equity, sustainable ple's lives. The Tamil Nadu Nutrition Project in development, and popular participation, which India, for example, managed to reach 20,000 vil- are the conmmon threads running through this lages and 3 million children, and significantly intricate tapestry. Again, as M. Preston men- improved the nutritional status of 50 percent of tioned, we know that there will be differences of those children. opinion and disagreements, but that is healthy, Today we heard Mr. Preston announce that because thesearedifferences inmeans, notinends. the Bank was willing to consider new ways of With good will on all sides, we all will leave here supporting complementary actions to reach the enridhed by thtis dialogue. poorest of the poor and to join with our partners The World Bank will be represented by many in exploring how we can systematically provide of our staff in the audience, and by four vice support to the kinds of micro-credit schemes that presidents in addition to myself, who will be the empower the poorest of the poor to pull them- chairs of the four sessions: Mr. Edward Jaycox, selves up by their bootstraps, whether it be the the vice president for Africa; Mr. Caio Koch- National Fadily Planning Coordination Board in Weser, the vice president for the Middle East Seraegdin 17 and North Africa; Mr. Joseph Wood, the vice ment can do to avoid hunger and famine even president for South Asia; and Mr. Shahid in the face of the worst drought in 100 years. Husain, the vice president for Latin America President Masire will be addressing us after and the Caribbean. the first session. Thus, in addition tothe central vice presidents *Secretary-Ceneral of the United Nations Dr. like myself and Mr. Michael Bruno, our chief Boutros-Chali, scholar, diplomat, and pro- economist, who is here in the audience right now, found humanist, who is actively working to we will actually have listening to this debate the orient the global United Nations system to four vice presidents dealing with the four regions balance military and political security con- of the world that are perhaps most affected by siderationswiththesecuritythatonlybroadly this problem. based development can provide when it I would also add that we are privileged to brings a decent living to the millions of peo- have distinguished world leaders join us in our ple currently deprived of it. deliberations, and by their presence lend their * Former United States President Jimuny Carter, support to the cause of ending global hunger dur- who by word and deed, both in and out of the ing our lifetimes. We are indeed privileged to White House, has shown how profoundly a have with us political leader can be committed to the cause IHis Excellency Ketumile Masire, president of of the poor and the -hungry in the world. He Botswana, winner of The Hunger Prize for will be addressing us tomorrow. 1989, chairman of the Global Coalition for All in all, it promises to be quite a gathering Africa, firstvice chairman of the Organization and an unrivaled opportunity to build that com- of African Unity, a true spokesperson not just mon ground and keep that bonfire alive, to retain for the people of Botswana, but for all of that sense of outrage that is necessary for all of Africa. His actions have demonstrated what us to go straight into action and not limit our- political leadership and a sensible govern- selves to talk. Left to right, Clois Maksoud, Di,ctor, Centerfor the Study of the Global South; Ismail Serageldin, Vice President, Environmentally Sustainable Dev- elopment, World Banlg The Honorable Tomy P. Hall, Member of the U.S. House of Representatives; The Honorable JinmW Carter, former President of the United States; EiottWALilstein, Interin President of theAmeria Unkersity;H.E SirKetumileMasire, President of Botswana; J. Brian Atwood, Admin- istnrtor, USAID; and Lewis T. Preston, President, World Bank - B Session Two Macroeconomic Reform: Its Impact on Poverty and Hunger Macroeconomic Reform: Its Impact on Poverty and Hunger Nancy Birdsall My former colleagues in the World Bank have * Second, that structural adjustment can and given me a tough topic and a challenging audi- has reduced poverty, induding in the short ence3 I am delighted to have the opportunity to run. Adjustment is not orly necessary, but is addressa group among whom are many with on- at times a major contnbutor to reduced the-ground experience m working in and man- poverty and hunger aging programs to combat hunger I see it as an * Third, that in reducing poverty and eliminat- opportunity to try to affect somewhat how you ing hunger, transfers and other compensatory think about the problem we all face. programs can help, but are not a substitute for I want to convince you of the centrality of adjustment and shared growth. economywide reforms for the reduction of poverty and the defeat of hunger. You and your Background: Poverty and Hunger constituents need to be involved in and engaged with efforts of the World Bank, my bank (the The relationship between poverty and hunger is Inter-American Development Bank), and other clear poverty is the root cause of chronic hunger, multilateral institutions in encouraging and and hunger probably contributes to poverty, for assisting governments in the difficult task of example,byreducingtheamountof energyavail- reforming their economies. able for manual labor As most of you know, I start from the premise that chronic hunger is South Asia and Sub-Saharan Africa, which have not a food production problem, but a poverty the highest percentage of poor, also have the problem. A strategy to combat chronic hunger highest percentage of hungry people. The rela- bcZls down to a strategy to combat poverty. tionship over time also holds. In Latin America I will talk about three points. Let me state and Sub-Saharan Africa poverty inceased them bnefly and then discuss each one. between 1985 and 1990, and these regions also First, the importance of shared growth to the experienced a rise (or no change) in hunger. In reduction of poverty. By shared growth I East Asia and South Asia, where poverty mean growth that benefits everyone, that decreased, so did hunger. lifts all boats, including the boats of the non- Poverty, in tum, and therefore hunger, are in elites. To reduce poverty, economic managers part a function of country income per capita. in most poor countries (and officials of the Cross-country statistical analysis indicates, not multilateral agencies that work with them, surprisingly, a dose relationship between aver- and members of the community of non- age per capita income and average per capita con- govemmental orgarizations) must worry sumption of calories. It is also true that no matter not only about growth itself, but about the what the level of average income, growth of aver- pattern of growth, and must aim for shared age income is associated with growth of average growth. per capita consumption. 21 22 Macroeconomic Refrm: Its Impact on Pouerty nd Hanger More interesting is that much of what is not aggressively used a variety of mechanisms: explained in the statistical analysis is due to dif- strong support for public education at the pri- ferectces among countries in the distribution of mary, and eventually at the secondary, level in all income: for any given average income, countries these countries; land reform in Korea and Taiwan with less equal income distributions have more (China); housing programs in Hong Kong and poor people, who are more likely to be hungry. Singapore; massive investment in rural infra- structure in Indonesia; and credit and export Managing Shared Growth: guarantee programs for small and medium-size Lessons from East Asia enterprisesinTaiwan(China),andsincethe1980s in Korea (where the shares of small and medium- This brings me to my first point managing size enterprises in manufacturing employment shared growth. Income distribution within a and value added had nsen to 51 and 35 percent, country is the result of initial conditions at some respectively, by 1988). past time and economic and social policies since In addihton, these countries avoided the false then. Policies of shared growth over time can conflation of social policy with labor policy and make a difference to income distribution, and worker entitlements. In Korea and Singapore, through distribution to poverty and hunger. and to some extent in Malaysia, the govemment Why doesn't growth m some counties lift all actively managed the labor movement to sup- boats? Why did growth reduce poverty so much press radical political activity, and in Thailand more in Indonesia tian in Brazil? I believe we and Indonesia labor unions were routinely sup- shouldbemorecynicalinthinkingabout thisques- pressed out of fear of communism. As a result of tion. Let us start from the premise that where the rapid growth and rising productivity, wages rose, eites have political as well as economic power, in generally in line with market forces, but not the absence of managed efforts government poli- ahead of market forces- The governments did not cies are likely to favor eelites Often such policies allow the mechanisms that elsewhere permitted contravene the market A prime example is import a group of privileged workers in the formal sec- substtution policy. Import substitution policy tor labor force to reap huge rents through union- helps industnalists and those who get privileged ied pressure or interest group politics to be access to foreign exchange, and via overvalued created. This suppression of labor rights had high exchange rates permits cheap imports of consumer costs, of course, in terms of loss of human rights. goods for the urbanmiddle class, but it reduces the The lesson is not necessarily that such rights local currency proceeds of the exports of rural should be suppressed, but that wages above mar- farmers and reduces demand for the labor of poor ket rates, need to be avoided if the benefits of urbanworkers Giventhepowerful combinationof growth are to be broadly shared. political and economic power among elite groups Three aspects of shared growth in East Asia in many developing countries, including in the seem to have been key: first, that there was active poorest, a triclde down laissez faire approach to management (usually to supplement, catalyze, or growth is simply not Ikcely to reach the non-elites. strengthen market forces not to override the mar- To offset this tendency, a policy stance we can ket); second, that the emphasis was not on direct label shared growth is criticaL Active manage- transfers, but on improving opportunities (this ment to reach non-elites was key to the phenom- was not a populist approach); and third, that the enon of shared growth described in recent work distinction was not between the poor and the rest, by the World Bank on East Asia3 In Hong Kong, but between the elites (which elsewhere in the Indonesia, the postwar Republic of Korea, developing world include privileged public sec- Malaysia, Singapore, Taiwan (China), and Thai- tor and public enterprise labor as well as indus- land new regimes faced a formidable challenge trialists and large landowners) and the rest. In from the communists, either externally, inter- East Asia, the elites were also attended to, but not nally, or both. The need to build legitimacy with to the exdlusion of the non-elites. the worling class in both rural and urban areas The programs noted above were not necessar- was no doubt pressing To ensure the continuing ily the core economic ingredients of shared support of the working class non-elites, leaders growth, however. Three ingredients of the East Birdsall 23 Asian growth experience were fundamental to reinforced the tendency to rely heavily on labor, shared growth and the rapid reduction in the most plentiful factor of production, and to poverty: a relatively level playing field for agri- minimize the antilabor bias associated with pro- culture, an export push that created high demand tecting capital-intensive industries. Equally for labor, and a universalist approach to public irnportant for shared growth, demand for un- social and infrastructure investments. skilled labor has been relatively high, in Korea in In the fast-growing economies of East Asia the earlier decades, and more recently in Malay- direct and indirect taxation on agriculture has sia and now in Indonesia and Thailand. Com- been lower than elsewhere in the developing bined with a rapidly increasing supply of skilled world. In the last ffiree decades, many govern- ments in other regions favored manufacturing Figure 1. Intervention and growth in the agricultumi and hurt agriculture by overvaluing their curren- ector, selected East Asin countries and decades cles and protecting domestic industries that man- ufactured agricultural inputs and the goods rural K, i - ; households purchased. The exchange rate that Republic of resulted from restrictions on manufactured - . imports reduced the domestic currency proceeds Malb3I of agricultural exports. Industrial taxation acted ; as a hidden tax on agriculture, raising the price of ThmbW agricultural inputs to subsidize industry Figure 1 compares the taxation of agriculture in selected East Asian countries. Taxation has been higher Pj= .. I i for tiree decades in Pakistan, the Philippines, . 19605 and Sri Lankathan inKorea (where agriculture is 1970s now protected) or Malaysia. Thailand's level of PMippires L agricultural taxation was relatively high in the : - -, 1960s and 1970s, but was reduced in the 1980s, Sr Lanka while taxation in the Philippines rose Low taxation of agnculture has been associ- I t O 0.6 ated with high growth. If we compare agricul- -0.6 -04 -2 0 02 0.4 0.6 tural growth rates across regions for the period Leptpee 1965 to 1988, we find that agricultural income and productivity have grown fastest in EastAsia, one rarma percentage point or more every year for twenty- Rpbr- o, five years, than in other regions. Increases in pro- , , ductivity contributed to and reinforced relatively Malaysh Tr slower rates of growth of employment in agricul- ture, as workers moved into even more rapidly . R _r, expanding manufacturing and other employ- ment. Other factors, of course, also contributed to : ' , success in agriculture in East Asia, but the policy Pakdun - I of not penalizing the farmers was clearly key. 1960s The second key ingredient of shared growth . 1970t was East Asia's export push. Complemented by - *95 5 would have benefited from less adjustment The Boikia, 1981 72 9 answer is almost cerainly not In Lima, Peru, the BraziL 1981 >95 19 poor suffered disproportionately between 1985 C6te CIdWeA 1981 93 20 and 1990, when President Garcia attempted to uberia 1982 86 4 reactivate the economy by stimulating consumer Senegal. 1982 83 12 demand, raising minimum wages, reducing Soure World sank mhe East As M Wo. taxes, and postponing external debt payments. Birdsull 25 After an initial spurt of growth, the lack of adjust- reducing the rapid inflation that erodes real ment led to an estimated 55 percent decline in wages, adjustment policies may actually prevent average consumption, and a 60 percent decline a worsening of poverty and hunger among the poorest 20 percent of households. Lack of adjustment is also associated with Poverty increased from less than 1 percent of the import substitution facilitated by trade protec- population to more than 17 percent3 tion and overvalued exchange rates. The combi- In Latin America throughout much of the nation tends to lead to capital-intensive 1980s, lack of adjustment was associated with industialization,whichlimitslabordemandand high and rising inflation. While inflation stabi- weakens the incentives for the productivity gains lization usually means more unemployment and that help drive up wages. If labor demand is lower real wages in the short run, accelerating weak, there is little hope for improvements in inflation also reduces real wages and increases employment or the wages of the poor. As I men- poverty- Using data for 1977 to 1989 for seven tioned in invoking the experience of East Asia, Latin American counties, Cardoso found that growth in labor demand is a critical component real wages fell by about 14 percent when inflation of shared growth that benefits all groups. doubled. She concludes that while there were Unfortunately the best evidence for the effects years in which real wages declined in response to of lack of adjustment on the poor and on poverty stabilization polcy, the dedline caused bya lack of and hunger comes from Africa. Africa's poor policy and the resulting high inflation totally growth performance in the 19BOs and the failure dominated the scene between 1977 and 1989. This to reduce poverty were caused by many factors, is particularly significant given the findings of including severe terms of trade shocks and low Morley and Alvarezft In their study of the 1989 initial levels of human capitaL. However, lack of recession in Argentina, they conclude that the adjustment also played a role: exchange rates decine in real wages caused by inflation was one were consistently overvalued (in countries with of the most significant contributors (much more flexible rates), resulting in high black market pre- so than unemployment) to the rise in poverty dur- miums, and trade regimes were highly distorted ing this perod. Similarly, in a subsequentstudy of with high nontariff bamers (see figures 2 and 3). Brazil,Cardosoreportsihatrealwage losses inthe High black market premiums reflected govern- 1980s hurt all groups incuding the poor (they mertts' efforts to defend overvalued exchange hurt the middle dass the most), and that increases rates by restncting access to foreign exchange. It in the minimum wage worsened inequality, prob- was the poor who suffered the most from result- ably by reducing formal sector employment6 By ing higher parallel mnarket prices for imported goods and from lack of access to highly rationed Figure 2. Premnium on the paraffll market investment and consumer goods. for rorein exchage. 1974-91 Of course, structural adjustment is almost A4Bn always recessionary in the short run, implying 1974-80 _ | j | * Fgure 3. Outward onientation of selected countrygroups, 196545 19814B6 1987-91 0 50 100 150 200 250 300 Pftrlt Sub-SahrnAfrica El sub-seem *Jsthgco flsexidble exchange mtesi i i-i i i i 0WVXW)W0tO.D 0.5 1.0 1.5 .2.0 2.5 3.0 35 hdersas IVc TheWpemifmxiscilaedasthe parf.mratmduMige rieu the d5iM exdhage rae [rn esetrrneny atdte eid drhe period4 NoteMA hjp sare comesx to nmre ouwrd arianL ff%Adp6ed b ICO. 9ocae Xrid Be Aqnnet inAfrrRefrn. Rest aR die R)od Aheod SmsmIrwemtbnarencyh4 h c and hnta iabona Mtary Fund datLa Vbdtr D CtWMdd Dar Iordlmnh). 26 Macrocnomic Refornm Its impact on Poverty and Hunger employment and wage declines and reductions have not necessarily risen, because limited sup- in public services. The poor may be affected by ply kept parallel market prices so high in the these changes, and even if they are affected pro- preadjustment period. In Tanzania, real con- portionately less than other groups, they can least sumer prices for maize, rice, and beans all fell afford any losses. However, initial conditions in sharply between 1985 and 1987, when food crop the world's poorest countries, where chronic marketing was first being liberalized, and even hunger is great, and the nature of adjustments in 1992 were below the levels of the early 1980s. needed in those countries imply that the poor lose At the same time, the rural poor-the poorest in relatively less than we might think, and can have most countries and the most likely to suffer from offsetting gains as a result of adjustment reforms. chronic hunger-are relatively insulated from Let me suggest at least four ways in which adjust- rises in the official prices of some consumer ment can help the poor goods following depreciations, if only because First, adjustment polices, especally devalu- they often rely heavily onnontraded food goods ation and real deprecdation of the exchange rate, for their own consumption and because they raise the producer price of agricultural trad- had no access to cheap, but rationed, food ables. Among economies with the largest num- imports before. bers of poor and hungry are those with large Finally, one effect of adjustment, often agricultural sectors producing tradables, and decried, is probably neutral m its effects on the within economies, many of the poorest house- poor. Cutbacks in spending on social programs holds are in the agricultural sector. Morley of the do not hurt the poor, at least in the poorest Inter-American Development Bank points out economnies, for a simple reason: the poor bene- that although recessions in Latin America hurt fited relatively little from them in the first place. the poor, in at least one case, Venezuela from None of this is to say that we should be san- 1981 to 1986, rural poverty declined during a guine about the design of adjustment programs. recession, and that during the adjustment-led Adjustment programs can and should be better recoveries the decline in rural poverty has gen- designed so as to maxinize their effects in reduc- eraly been greater than the decline in urban ing poverty. Where general food and energy sub- poverty (p. 12).7 They also note that in Costa sidies are cut, the resulting fiscal resources can at Rica, even though per capita income in 1987 was leastinpartbe directed toward targeted food pro- still below its preadjustment 1980 level, poverty grams for the poor Where social sector spending had declined because the rural poor gained from is cut, the cuts should come from reductions in adjustment reforms. the types of social services that benefit the rich, Second, elimination of subsidies to owners of and from reductions of redundant and politicized capital through directed credit programs and employment rather than from reductions in through preferential access to rationed foreign expenditures on drugs, fuel, books, and the other exchange means the poor may gain access to ser- complementary inputs that ensure adequate vices and goods they could not obtain, and may quality for the poor and others. More emphasis enjoy lower prices for those services and goods. on reducing deficits by enforcing broadly based In Africa, where rationing was most severe, the and progressive taxes and by eliminating exemp- urban poor benefited quicldy from the elimina- tions and loopholes that favor elites and less tion of such subsidies. emphasis on cutting public investment in rural Third, stabilization and adjustment reduce roads and schools is clearly in order inflation, which, as I mentioned earlier, is associ- These aspects of better design imply strength- ated with declining real wages, and especially ening the adjustment process, not weakening it hits the urban poor. Think of adjustment as a difficult political and Fourth, in Africa, deregulation of the public social process of taking away privileges enjoyed sector monopolies of marketing boards raised by the elite, such as special access to economic rural incomes by eliminating the large taxes on favors and to social subsidies. In this light, better producers extracted by the marketing boards. At design of adjustment simply becomes another the same time, consumer prices of food staples aspect of what I have called shared growth. Birdsall 27 Transfers Cannot Substitute for I don't pretend it is an easy task, but I do see Shared Growth and Adjustment reasons for optimism. In Latin America, for example, the recent efforts of government leaders Finally, I come to my third point During the in Chile, Costa Rica, Mexico, and Pern represent adjustment process, transfers and other compen- thebegimnings of a new consensus about theneed satory programs to redistnbute income to the to ensure that all groups benefit from growth. To poor can also make sense and should certainly be build on those efforts and to extend them to other tried, especially because even a small drop in regions, the international financial institutions income during a recession can take the poor can focus more on the need to develop some across the line into chronic hunger However, social consensus. A technocratic approach is not transfers, trgeted employment, and other short- enough. And commumity and nongovernmental run safety net programs cannot substitute for a organization groups can focus more on the real- political shift to shared growth and the develop- ity that economic reforms, including structural ment of a new social and political consensus. In adjustment reforms, are politically difficult to the short run, such programs are easy to mount undertake precisely because they take away the because they do not require contesting the e- elites'pnvileges,andrecognizingtdis,inghttake nomic position of the elites, especially given that up anew the mandate to represent the interests of intemationalresourcescanusuallybegalvanized the poor in pushing for such reforns precisely for these attractive clearlypro-poor programs. (In because the poor stand to gain from them. fact they are not easy to mount all that quicldy.) However, without a new consensus, widely Notes shared, they will be difficult to sustain fiscally, and thus politically, and to the extent tW com- 1. The views expressed here do not necessarily pete with scarce local administrative, technical, reflect those of te Inter-American Development Bank and political resources or of its members. A note on which these remarks are and political resourcs for implementing more based, including technical references and sources, is universal programs, they present some tradeoff available fiom the authoc for those concered with a frontal attack on the 2v World Bank, T East Asn Mmdc Econmc Grwt causes of poverty. and Public Policy, especally chapter 4 (Washgtn, DC- Oxford Uriiversit Press, 1993). Concdusion 3. Paul Glewwe and Gillette Hall, The Poor in Latin AComeca durng Adfustment. A Case Study of Peru, 1985-90, World Bank Living Standards Measurement Study, Let me conclude by restating my main objective: Working Paper No. 86 (Waslhington, D.C: World Bank to convince you that you cannot ignore the need 1992). foreconomic and adjustmentreformsif youwant 4L Eliana Cardoso, -The Maaoeconomics of Poverty to eliminate hunger Transfers and brgeted p in Latin America" (Boston: Tufts University and Na- Pro- tional Bureau of Economric Research, 1992). grams can help, but they are not a substitute for 5. Samuel A. Morley and C. Alvarez, "Recession and the fundamental challenge of developing a new the Growfh of Poverty in Arena" (waaingn, D.C2 consensus around the idea of shared growth and Inter-Amecan Development Bank, 1991). Procesed. the need for struchtral adjustment 6. Eliana Cardoso, "Cyclical Variations of Eamings Reasonable people with reasonable skeptiasm Inequality in Brazil," Revista de Emomia Politica (forth- will askc how can we propagate the idea of shared 7. un l A Morley Strucual Adjufstment nd the 7. Samuel A oly tdlAjsmn n h growth in settings where it hasn't take hold? Determinants of Poverty in Latin America (Washington, After all, in East Asia, shared growth emerged as D.C.: Vanderbilt University and Inter-American Devel- a reaction to specific events after the war. opment Bank revised Marh 1993). Processed Discussant Remarks Carlos Heredia As Dr. Birdsall has pointed out,highgrowthrates tions of civil society cannot afford to deal orly are not enough to tackle poverty and hunger In with social policy, while the economic and polit- 1993 a greater percentage of the population of ical elites, the establishment, make all major dec- Latin America is struggling with hunger and sions about macroeconomic policy. It has been misery than in 1980, despite the claims by the said, and it cannot be repeated enough, that a governments and by multilateral institutions good social policy starts with a sound economic that the right policies are in place. We have coun- policy, and our definiton of the latter is one that tries like Venezuela, in which rates of annual benefits all groups of society, not only those that growthof the gross domesticproductof9 percent have political clout or economic might. In Latin do nothing to alleviate the poverty of the major- America four out of every ten people are suffer- ity of the population. ing hunger as we speak. Where are their voices in We can no longer bear with this increase of this debate? The World Bank, despite daims to misery and social degradation. This is why civil the contrary, appears to have a laissez-faire atti- society is mobilizing, through its institutions and tude toward hunger in the same fashion that a organizations, to take care of the problems that military president of Brazil said in the 1970s, governments are unable or unwilling to tackle. "Brazil is doing fine. It is the people who are The World Bank's poverty alleviation programs doingpoorly." do not attack hunger at its roots. Rather, World Let us listen to the people to find out what is Bank-supported macroeconomic policies tend to really happening and what people really want. polarize our societies by concentrating income The people I work with in peasant communities and resources m the hands of the few, and nar- in rural Mexico want credit, available in a timely rowing economic and social opportunities fbr manner and in sufficient amounts to enable them the poor. to finance their small-scale productive opera- Social development programs compensate for tions. They donet want charity, they don't want the damage done by structural adjustment only aid. They want credit What they actually get is to a very limited extent Civil society cannot and reduced credit for the production of basic goods will not remain idle in the face of widespread and basic grains and for regions considered to be hunger, and yet hunger is not the only challenge less productive, and a preferential targeting of we face. We must also grapple with the mono- scarce credit funds to agnbusiness. lithic nature of World Bank policies and opera- What small farmers want is to stay and work tional procedures, which serve to shut down the on their land, but they are being forced to voices of cvil society. migrate to cities, or in the case of Mexico, to the A strategyby civil societyto combathunger is United States, because agribusiness controls not not merelyanissue of economic policy Itis above only the land, but the resources needed to make all a political issue. NGOs and other organiza- it productive. 28 Herdia 2g People want food security, by which they Contrast this with the fortunes of Carlos Slim, mean the ability to either purchase or produce the whose assets grew by US$1.5 billion thanks to his food they need. But under World Bank policies, purchase of Mexico's state-owned telephone more and more countries are pushed to increase company, which was recently privatized. This their agricultural exports while increasing num- amount is roughly equivalent to the 1992 budget bers of their people, including their farmers, go for the social investment fund to address the hungry. needs of 17 million Mexicans Living in misery. People want long-term job creation programs It is because of women like Maria Martinez and income-generating activities, and they want and men like Carlos Slim that we must not only to earn a decent living from their work. But what address the immediate consequences of hunger, they get is so-called poverty alleviation pro- but also the urgent need to come up with new grams, which are often, as in the case of Mexico, development alternatives that, unlike structural controlled by political elites who choose the ben- adjustment, put up front the needs of millions of eficiaries on partisan grounds and are immune unemployed, underemployed, hungry, and land- from any democratic means of accountability. less people in our countries. We are not only talk- They also get wage suppression as a condition for ing about the countries of the South. Millions of foreign investmen.L For industrial workers in people are also hungry in Europe and in North Latin America, this led to a 35 percent drop in America, which also struggle with the enormous wages between 1980 and 1991, according to the contradictions in these societies. International Labour Organisation. The best development strategy for a given People want to break out of the cycle of society will be the one that, first and foremost, poverty. Instead, poverty is on the rise. In Brazil, derives from the population's expressed needs the world's third largest food exporter, where per and priorities. The basic criteria for assessing the capita income is now US$3,000 per year, the soundness of any strategy should be the follow- United Nations says that the number of people ing.Whatisitscontributiontoendingmniiseryand living on less than US$1 per day increased by 40 decentralizing power? What is its enviromnental percent during the 1980s. That is why the core of sustainability? To what extent are governments Brazil's hunger problem is not food supply, but and multilateral agences held accountable under purchasing power. this strategy, especially to the poor, who are sup- Let's go beyond the numbers and look at the posedly the beneficiaries of these policies? This human dimension of all this. And remember that approach implies a direct involvement of small these effects are not separate, not discrete. They producers, in agriculture, industry, and services, combine to overwhelm individuals and commu- that allows for economies of scale and technolog- nities. Let's take the case of Maria Martinez, an ical advances to work, while being flexible Indian-Mexican woman in the state of Oaxaca in enough to permit the creativity of each producer the south. Maria has to work sixteen-hour days to flourish. Strengthening small and medium- while the men of the household go to the United size business at the regional level is extremely States as migrant laborers, because as small important, because that is the basis for economic farmers they cannot compete with cheap food and political decentralization. imports. She has no voice in local affairs because Unfortunately, what Josue de Castro said elections are stolen. She has had to pull her two aboutBrazil fifty years ago-and fifty years is the older girls out of school to help her with her lifetime of the Bank-not only remains true work on the farm. She has no access to credit, to today, but applies to an increasing percentage of health care, to education. The communal land the population in countries of both the North and she lives on and around which her cultural and the South. He said, "Brazil has a population of religious life revolves is now for sale to the high- insomniacs-those who cannot sleep because est bidder, thanks to World Bank privatization they are hungry, and those who stay awake out of schemes. Her family canbarely survive, and she fear of those who don't have anything to eat." is one of the 17 million Mexicans that according Hunger is a human, not a technical, drama. It to World Bank statistics earn less than US$350 affects us all one way or another. The Bank has to per year. look beyond the statistical characterizations of 30 Discussant Remoarks poverty and wake up to the call of the poor. There independent judiciary; we do not have clean, fair is no reason, no argument, no theory that can jus- elections. So when people are not free to express tify the persistence of hunger. We are out of time, their will to change the govemment, little can be and we will accept no more excuses. The Bank has done to attain shared growth. to change. And the third reason is that economic policies I will now briefly address some of the points have been designed largely, supposedly, to Nancy Birdsall raised. I found her approach of address the issue of poverty and poverty allevia- shared growth interesting, although it is unfortu- tion, but they have fallen far short of most peo- nate that in my home country we have not been ple'sneeds. Weare told thatthey will mature over able to witness that. I am being educated about time, and that the benefits of adjustment will be economi zs in Southeast Asia by friends in the found at the end of the road. Bank and by friends in the NGO community in When one of the top Mexican bankers was that part of the world, but in Mexico, we have not asked, "When do you think the benefits of adjust- had that kind of growth. In fact, we are having ment from 1982 to 1992 will materialize for the very low growth now, despite pledges and poor?'-we had asked the Bank the same ques- promises that with structural adjustment, which tion and Bank staff said maybe five years-this has been ongoing for more than ten years now, we banker said, "Well, maybe twenty-five years." would have higher growth. The rate of growth in We have asked the Bank to work with us on Mexico for 1993 is projected at 1.3 percent, and it this. We wrote a paper, a research report, on struc- was supposed to be 6.0 percent to cope with an tural adjustment in Mexico, and we are dis- increasing work force going into the labor market. cussing it with the Bank. We invited the Bank to We have not had that kind of growth because go and visit the communities with whom we of three main factors. The first factor is because work in Mexico, and they said, "Fine, we'll go, we have had a deliberate strategy to suppress we'll visit the communities." That was in wages, a deliberate strategy to suppress labor October. Today, what do I find on my desk? Ifind rights-and this came up during the North a fax from the Bank telling me that well, the Bank American Free Trade Agreement (NAFTA) missions will visit more communities, but only debate-precisely because the Mexican govern- after close consultation with the Mexican gov- ment refused to include labor rights, industrial ernment, and not necessarily through our NGO. organization, collective bargaining, and the right So I put forward the challenge again to the to strike in the NAFTA side agreements to lock in Bank. Are you afraid of facing the poor, face-to- the high productivity/low wage model. face, ina setting in which you can exchange views The second factor is that we do not have a about your programs? What is wrong with doing democratic system in place. We do not have a that? What is wrong with taLking to the very ben- checks and balances system; we ao r.ot have an eficiaries of your policies? Workshop Spokesperson ~~Remarks Shafika Nasser Ifind myself inavery awkward position, because the year 2000, with people's well-being, the being a physician and nutritionist speaking to investment in human beings, measured not only economists, we are always at a disadvantage. Yet by progress, by economic development, by mon- in the world of today we always believe in, and etary measures, but by social development crite- we are trying to push forward, the idea of ria. The human development index should interdisciplinary approaches, particularly to a include measures of nutritional status. When the problem that affects a lot of people today, and that United Nations Development Programme has is the problem of hunger. been trying to put forward various indices that A few years ago, with the green revolution, could be used for longevity, life expectancy, edu- with our knowledge of nutrition, we thought the cation criteria, and monetary criteria, but I think world would get rid of malnutrition, as we call it nowadays we have to concentrate on nutritional technically. But today we are seeing more malnu- criteria. tition, more starvation, and more deaths from The third vision is that by the year 2000 we starvation than ever in the world. would like the progress of countries to be mea- Thegroup that metyesterdayto discuss macro- sured correctly, taking into consideration natural econonic reforms came up with about eleven resources that have been depleted. items, but then we decided that we could put them The fourth vision is government priorities. We together in fewer visions. The first of them would would like to see that the burden of debt is faced, be the vision that by the !ar 2000 we will have because when govenmments decide they want to moreparticipationbypeopleindevelopingmacro- cutback, they usually cut expenditures on health, economic reforms that affect their lives. These peo- education, or subsidies of essential foods. We ple have to be informed to be able to discuss and have to reach a consensus as to how much of this choose what is best for them, because it is going to could be included or not induded in an adjust- affect them. As a ohysician , I ronsider this as a sort ment program. of informed consent. We have to develop the tools The last vision is equity. By the year 2000 we and medanisms and refine them, instead of deny- would like to see macroeconomic reforms ing that it is feasible. Participation should be not directed to address gender equity between men only by the poor, but by all sectors of civil society. and women, inter-regional equity between peo- Mr. Preston has said that he wants to ensure par- ple a .ud children, and designed so as to create ticipation of the poorin the development as well as more opportunities for people. the implementation of projects. This is a very big In short, we would like thesevisions tobe coy- statement, and we hope it will be fulfilled. ered in our reflections, and I was glad to hear The second vision is that we would like from Dr Birdsafl that some of the visions-at macroeconomic reforms tobe people-centeredby least the first one-were part of her intervention. 31 Workshop Spikesperson -> Remarks w 4' Nancy Alexander The workshop group asked me to highlight areas role inshapingpolices thatbenefitpoorandhun- of agreement and disagreement gzy people and protect the environment. The First is the issue of particpation. Mt- Preston resources of other donor agencies with a strong has called forparticipation to be the nonninBank knowledge of and experience in reducing pov- projects, but there is a great silence about partici- erty and hunger, such as the United Nations pation in macroeconomic reform policies. As it Children's Fund and the United Nations Devel- stands now, only a handful of government offi- opment Fund for Women, should regularly be dials, principally the finance minister of a coun- called upon. I understand that this is not cur- try, shape economic reforms with the donor rently the case institutions. However, our workshop thought The second issue is equity. Our recommen- that representatives of local communities, dation is that the Bank and borrowing country unions, farmers, women's groups, envirormen- governments do more than minimize the ad- talists, consumers, and so on should have a voice verse effects of adjustment by integrating relief in shaping the economic reforms as well as the measures, which are often too little too late, into projects that shape their destiny, reform packages. The Bank and governments NGOs generally felt that such participation should ensure that poor people, especially was vitally important in relation to the tans- women, benefit parency and accountability of Bank-funded oper- Although economic growth is important for ations. Many Bank staff felt otherwise. This is the reduction of poverty and hunger, the nature puzzling to me- Bread for the World works to and pattern of growth is critical. The Bank and shape the United States' adjustment program governments should promote a development every day: its tax policies, its deficit reduction strategy based on the prnciple of equity, with a strategies, its fiscal priorities, and so on. Clearly goal of ensuring that the productive capacity of the United States has a richer infrastructure in all people is fully realized. democratic institutions than, for instance, Mali The group was strongly in favor of the follow- But it would seem to be a necessary goal to build ing declaration from the International Conference the capacity of communities and organizations to of Nutrition: "Our priority should be to imple- shape economic reforms. This can only happen if ment people-focused policies and programs that adequate information about proposed programs increase access to and control of resources by the is available to them. Currently, information is not urban and rural poor, raise their productive generally available to the people or to the repre- capacities and incomes, and strengthen their sentatives of aU the stakeholders. capacity to care for themselves." We want to see Information should also be made available to Bank policies that do that. Specifically, the Bank government ministries-other than the finance needs to emphasize strategies to eliminate gender ministry-in a way that ensures that they have a bias, promote land reform and secure tenancy, 32 Alender 33 reduce massive income differentials, and give pri- lateral debt People from developing countries ority to hunger prone groups and regions. stressed that these heavy burdens make them Policy dialogue between governments and vulnerable to and too dependent on the condi- civil society and between the Bank and govem- tionality imposed on their governments by the ments should result in adjustment packages pro- international financial institutions. They also dis- posed to the board that are explicitly designed to agreed about the imnplications of a double stan- invite participation, to meet targets that can be dard relating to the enforcement of adjustment monitored during a specified time frame, and to conditionality, one standard for rich countries, give feedback to ensure that mid-course correc- anoher for poor counties. For example, the tions are made as necessary to achieve goals. United States, while still the world's largest econ- These goals should include human develop- omy, is the world's largest debtor, has the world's ment and quality of life criteria, not just eco- largest militarybudget, and is the world'slargest nomic criteria. arms merchant Like many other powerful The third issue is government policies. There economies, the domestic U.S. subsidies, espe- was some agreement tfhat progressive taxation ially agricultural and textile subsidies, and other policies that are actually implemented should protectionist polices make for an unequal global help rectify skewed, unjust patterns of growth playing field. and income. The participants also agreed that Bank officials contended that poor countries excessive military expenditures should not be should continue to liberalize their economies allowed to sap resources that could otherwise despite the vagaries of external conditions. Many be used for investments in people and produc- NGOs argued that an emphasis on servicing five capacity. ficlde demand in rich countries must be balanced Most participants in the workshop agreed that with the need for self-reliance. relieving debt is important so that it does not cre- The United States considers the production of ate an unreasonable burden in relation to the size certain crops and manufactured goods as essen- and dynamism of an economy However, the par- tial to its national security, and some NGOs tcipants were unable to agree on how to relieve argued that the standard of security should be debt, including the growing proportion of multi- afforded to developing countries as weLL Floor Discussion A number of partidpants commented from the for; percent in real terms in the manufacturing sector then the speakersr rponde between 1988 and 1992. The rural sector has decined, largey because it was heavily subsi- Partidpants'Comments dized, and total aedit to the private sector inreased by 12 percent in real termsn First floor participant When the World Bank Regarding Nancy Birdsals point about pro- attempts to implement stmctural adjustment in tection for the private sector, Mexico opened its any country, this is viewed as interfering in the economy, but left its agricultural sector virtuaRy country's natural sovereignty This intrusion is close& For example, the price of maize was tolerated only if the assistance is sufficiently almost twice the international price until very badly needed. Therefore, the Bank should revise recendy, and this shielded the poor from some of the methodology for having the poor participate the consequences that rapid opening would have in discussions with governments so that this brought abouL More recently, the government becomes standard procedure replaced the price subsidy with an income sup- port scheme, so now Mexico has the best of both Second floor participant: Carlos Heredia, what worlds in that the rural poor are protected, but at country in the world, at any point in time, would least agriculture has the right incentives. you hold up as amodelfor the type of policythat Finally, the Mexican govemment is aware of you were advocating? the problems of income distribution, and in recent years expenditures in the social sectors Third floor participant: This moning Ismail have bee increasing faster than any other com- Serageldin suggested that we keep in mind ponents in the budget, and according to a recent equity, stability, and participation, and many budget proposal, in 1994 total expenditure in the other speakers raised these same issues I wonder socal sectors will represent more than half of if we looked not only at equity, but also at stabil- total programmable expenditures. ity and participation, whether there would be such a model. Speakers' Responses Fourth floor particpant In reference to Carlos Carlos Heredia: I do not hold up any one coun- Heredia's statement on structural adjustment I try as a model to be imitated or to be taken as a would point out that a recent study by the United blueprint for any other country What we are Nations and Mexico's Department of Statistics advocating isasetof policiesthatputpeoplefirst shows that poverty declined from 18.8 percent in The way a particular country implements those 1989 to 16.1 percent in 1992. Wages have notbeen policies is subject to that country's particular suppressed. Real wages in Mexico increased 30 political and geographic conditions. 34 Floor Discusion 35 In regard to the proportion of the population That is something we can all agree with in Mexico that is living in extreme poverty, However, I would see the issue as one not of according to our case studies and regional statis- whether economic reform and adjustment are tics, poverty has worsened, even during the last necessary, but of improving the design of eco- three years- Wages have been and are being sup- nomic reform and adjustment pressed in Mexico. Let me give you an example. IF we start from the premise that adjustment Ford Motor Company wanted to increase wages takes away privileges the elite enjoy, it is easier in 1992 over the wage ceiling fixed by the gov- for us-both those from nongovernmental orga- erinent and strictly enforced. There was a 9 per- nizations (NGOs) and those representing inter- cent wage ceiling, and Ford wanted to raise national financial institutions-to arrive at some wages from between 12 and 15 percent Mexico's sense of common vision about the need for and secretary of labor called Ford to say that Ford design of these reforms if we are to overcome could not go above the wage ceiling. hunger.Forexample,wherefoodandenergysub- Now as for the decline in the rural sector, I do sidies are cutbecause of adjustmentprograms, let not take the rural sector as a whole. I consider the us ensure that the new fiscal resources are tar- rural sector by looling at small producers and at geted to the poor, if necessary, through food sup- agribusiness and big producers, and I do see a plementation programs. Where social programs strong bias in the policies induced by the Bank are cut, let us ensure that the cuts come from and those adopted by the Mexican govenmuent those programs thatbenefit the rich, and not from toward big business, agribusiness, and big pr- the basic education and health services that ben- ducers-I do not thiink it is acceptable to take over- efit the poor Where deficits must be brought all figures and then say that more money is going down, let us work together to ensure that more of into the countryside, so there will be more pro- the success in bringing down deficits comes from duction and people wBi benefit That is not true. developing broadly based, progressive taxes that We have to look at the aggregate figures for par- do actually tax the relatively rich, and not only ticular subsectors of the rural population and se from cutting public investments in schools, how they are firing And I have to say that the roads, and so on that benefit the poor. statistics have been manipulated in Mexico in Now the question about East Asia. All these such a way that even the Financial Times, which countries are not a model for everything. On sus- cannot be accused of populism or leftism, came tainability, I think we can take heart that many of out with an article that stated how unbelievable the countries in East Asia, especially in the last it is that the Mexican government claims that the five years, have vigorously adopted programs to unemployment rate in Mexico is 3.3 percent Not deal with natural resource degradation, pollu- even the people who compile those statistics tion, and other urban problems, in part because believe that incomes are rising. On participation, dlearly different models Ismail Serageldin: In connection with the ques- exist We may not believe that the model in East tion on equity, sustainability, and particpation, Asia makes sense for other parts of the world. the point Carios Heredia made is important, that Nevertheless, we have to recognize that the like- evenif things maybe improvingin the aggregate, lihood of people being more involved in both they maybe worsening in certain areas, and there political and economic decisions increases in may be pockets that need special attention. It is those countries whose approach is along the lines not acceptable if while many things are improv- of what I called shared growtlh not taxing agn- ing, for the few or the not so few things continue culture, pushing exports, not closing up eco- to be bad, and even less acceptable if they are nomies, and so on- worsening. What I see in countries such as Costa Rica and Chile, and especially and increasingly in Mexico, Nancy Birdsall: One of the speakers said that is an eagemess, and certainly a willingness, on there must be some participation through civic the part of powerful political groups to extend the society or civil society- in the discussion of eco- difficult economic reforms they have undertaken nomnic policy reforms in developing countries. to embrace larger social reform as well. We have 36 Floor Discussion to recognize that shared growth and a social developing countries can be strengthened. It is agenda are also extremely difficult from a politi- here that we need to take President Masire's cal point of view, and so these governments can words to heart because he has had remarkable benefit from and need the support of their citi- success in Botswana in maintaining an uninter- zens in a particpatory way in changing things. rupted, multiparty, parliamentary democray Thisiswherelseetremendouspotentialformuch that has respect for human rights and pluralism, more constructive dialogue between the multi- that is refocusing toward social benefits, and that lateral institutions and those of you who are con- is achieving universal primary education and cerned with these vital issues. reductions in infant mortality; and he stood today before us and said that there has to be a role for Ismail Serageldin: The real answer to the issue of NGOs. With leaders like that, with that kind of particpation by the poor in the design of adjust- openness in a country, and with a civil society ment programs is not whether a World Bank del- actively affecting the policies of its government, egation will somehow go and pick some the voice that will be heard in the debate and the representatives of poor communities at random discussion will be a pluralistic voice that wil from around a country and involve them innego- enrich the discussion. We must not set aside the tiations about the money supply or the interest invisible poor those who are hungry and who rate, but whether or not the civil society in most have no political voice. Special Address The Scope for Public Action to Reduce Chronic Hunger Ketumile Masire ne Scopefor Public Action to Reduce Chronic Hunger Ketumile Masire .1~~. Our purpose in gatherng together here is not only an economic problem, but is also a political simply to talk about ways of reducing g-! al problem. hunger, but to seek consensus on concrete act..' s Aswehaveheard, chronicpovertyaffectsmore that can be taken now that will make a difference. than a billion people. Perhaps a better term to I hope this conference will be a turning point in describetheirhungerisashidden,becauseitisless moving in that direction. obvious tan the acute hunger of those suffenng The response to the World Bank's initiative in from famine, and consequently tends to be a orgaruzing this gathering-inspired bythe exam- neglected issue. Food is the most basic of our ple and leadership of Congressman Tony Hall- needs. It is regrettable indeed that despite so much is heartening. I am encouraged by the active affluence in the world, so many people go hungry. participation in this conference of representatives Let me explain what I mean. Other speakers of so many NGOs that are directly iLvolved in have rightly distinguished between acute hunger activities aimed at overcoming hunger Their caused by short-term emergencies and chronic presence is a further sign of the growing cooper- hunger or long-term "endemic deprivation," to ation between international development agen- use a term favored by Professor Amartya Sen. cies, governments, and citizens' movements. This Taldng the case of acute hunger, I am convinced could be a powerful coalition. that there is no famine that we cannot overcome if The task we face is a formidable one, but I am we have the political will to recognize the onset of confident that by working together we can make famine conditions and to mobilize public and pri- real progress toward our ultimate goal of ensur- vate resources, locally and internationally, to deal ing that no one, however poor, anywhere in the with it. We demonstrated this last year in south- world goes to bed hungty. Hunger is not just a ernAfricawhenwefacedtheworstdroughtinliv- problem the developing countries face. The hun- ing memory, and overcame it. In South Africa gry are found everywhere-in the North and m alone, which is the largest producer of food in the the South-and this need not be so. We have regionr, cereal production fell from about 8.0 mil- enough land and we possess the technology to lion tonnes in a normal year to 2.6 nillion tonnes. produce enough food to ensure that everyone has Thrughout the region about 18 million people enough to eat. In short, the problem is essentially were short of food. Yet no widespread deaths one of policies and purchasing power. The chal- occurred, and in some places children were even lenge is to find effective ways to provide house- better fed than in years of plenty. This was the holds with food and economic security. result of improved food distnbution by the I have not come to this meeting as a nutrition famine relief programs mounted in the region. expert, or as a food economist, or even as a When Botswana achieved independence in farmer, although I am one. I am here as a politi- 1966, it was emerging from another terrible cal leader, because I recognize that hunger is not drought Its effects remain embedded in our col- 39 40 The Scopefor Public Action to Reduce Chronic Hunger lective memory. Through cash-for-work pro- task that I believe is so important forthe future of grams and targeted feeding for school children, our continent infants, and lactating mothers we managed to The suffeing from famineis deeply etched in avert a disaster. At the height of the drought we our conscience because of the high media atten- were feeding almost one-third of our population. tion it is given and because of the large numbers It can be done. It was done. affected. Estimates indicate that at any one time Notall famine situations are acts of God. Some between 40 and 50 million people around the are man-made, such as those caused by civil world are affected. Nonetheless, Ibelieve that we wars. Such man-made tragedies derive from should give most time during this conference to political misdirection, and their solution is, by discussing ways to lessen chronic hunger, the definition, a political one. We, the political lead- form of hunger associated with poverty By that I ers, should always resort to peaceful resolution of mean a household's inability to produce enough conflict rather than the violence that is now food or to obtain the income to buy enough food afflicting the people of Angola, Burundi, Somalia, for the family Chronic hunger deserves most of the Sudan, Bosnia, and Georgia. our attention because it affects such a vast num- The international mechanisms put in place ber of people, and because we seem to have been after World War I1-the UN system, the Secuity less able to taclde it Although it is more deeply Council, UN peace-keeping forces, and the High entrenched, it is not intractable. Commission for Refugees-cannot cope with the With political determination governments terrie consequences of the breakdown of civil candovastlymorethanwhatisbeingdonetoday order occunrring within member states. to reduce chronic hunger. We know this is true Today the world faces a crisis that has grown because countries at the same level of per capita to fightening proportions. The end of the East- income vary significantly in the proportion of West ideological conflict has lessened political their population that suffers from hunger. controls in some parts of the world, but has also During the 1960s and 1970s Sri Lanka showed unleashed an outbreak of ethnic conflicts. The us how a developmg country could successfully UN system was designed to take care of conflicts administer a food voucher program that greatly between states, but that is not the main problem reduced malnutrition throughout its population. facing the world today. We need new initiatives, Costa Rica has much less malnutrition than its new thining, and a new political commitment to neigbbors in Central America. Since 1950 China dealmoreeffectivelywiththe civilstifethatnow has also achieved remarkable improvements in threatens all societies. I look forward with keen nutrition, even though it also suffered the worst interest and concerntoDhearing the proposals that famine in human history in the late 1950s. In Secretary General Boutros-Chali may make later Africa we can draw similar lessons from the expe- today on thesematters.However,Iampersonally riences of different counties. Overall, however, convinced that above all else we must seek to the number of people in the world suffering from strengthe, and not to weakent, the UN systemL chronic hunger-roughly one in five-is regret- We must give the secretary general the resources tably high and unnecessarily high. We can and and the full mandate to assist effectively coun- must do a much better job of targng assistance tries that are in domestic turmoil. to those most in need. Regional organizations have a role to play too. At the conclusion of the International Con- One of the in-itiatives of the Global Coalition for ference on Nutrition in Rome last year, govern- Africa has been to explore ways to strengthenrthe ments committed themselves to preparing role of the Organisation of African Unity in con- national nutrition strategies. It is quite tempting flictresolution More active mediation is one pos- at such international events to make commit- sibility.Apan-Africanmechanismformobilizing ments that are no more than declarations on peace-keeping forces is another. The key ingredi- paper, and so manynational strategies and action ent for success is imaginative and constructive plans are being called for, such as environmental political leadership. I would like you all to note strategies, poverty strategies, sustainable devel- that as co-chairman of the Global Coalition for opment strategies, AIDS strategies, women-m- Africa, I will continue to dedicate myself to this development strategies, health strategies, and Masfrr 41 water resource management strategies. Govern- public works programs whereby people can ments risk being overwhelmed. For this reason I eam a wage; distributing food rations to fear that the call for a national nutrition strategy selected pregnant and lactating mothers, chil- may be forgotten. Let us therefore try to focus at dren under five, and those at school; and issu- this meeting on a few pority areas that govern- ing food coupons to the destitute. This is in ments could act upon and that are more lilcely to addition to our efforts to diversify income and make a -eal impact on reducing hunger. employment opportunities in manufacturing, - Acceptance of the hunger present in our soci- tourism, and other sectors of the economy. eties is akin to an acceptance of poverty, and in * We intend to maintain a strategic food grain that lies a great danger. We see poverty as a reserve equal to at least three months of con- long-term problem that countries will only over- sumption to cover future drought emergen- come gradually as development takes place. The cies, which seem to befall us for three or four danger is that we will treat hunger in the same years in every ten. way, accepting it as a condition of underdevelop- Despite these measures, between 10 and 15 ment, but that is a mistake. Hungry children percnt of the population suffers from malnutri- become disadvantaged adults with low produc- tion- That is low for Africa, but not low enough. tivity. This perpetuates the state of underdevel- We recognize that we need to improve the target- opment. We can break this vicous cyde of ing and management of our food programs. I poverty by targeting our efforts to reach those hope some of the priorities identified by the most in need. experts here today will help us to achieve this. S Some have argued that for poor countries the I started this address by emphasizing the polit- only way out of the hunger trap is to become ical dimension of hunger. I recognize that in self-sufficient in food. Sometimes people even mounting public programs to combat hunger, dif- argue that countries that piomoted the expansion ficult political problems must be faced. While I of cash crops did so at the expense of food crops, believe that over time the benefits of economic and in that way mcreased the prevalence of growth do tridde down and that poverty is hunger. I do not subscribe to those views. In reduced, as East Asian countries have dramati- Botswana for years we subsidized production of cally demonstrated in the past ten years, it is our staple food crops heavily, even though the nonetheless a slow process. If we are to reduce the farming conditions we face as a semi-arid coun- numbers who are hungry in the short and medium try are largely not favorable for cultivating food term, we can only do so by transferring income crops or achieving food self-sufficiency on a sus- from the better off to those in greatest need. tanable basis. The soils are sandy and rainfall is Charity begins at home, and each country erratic both over time and space. It is for this rea- must play its part. My own country spends some son that our policy now is to adcieve food secu- US$14 million each year on domestic food pro- rity and not food self-sufficiency. The revised grams. The US. government, I believe, allocates policy gives farmers the latitude to produce crops nearly US$40 billion each year for such programs. of their choice, including cash crops, depending However, for the poorest of the developing coun- on the suitability of their land. tries, external aid, especally food aid, is vitally This food security policyhas three components. important The Urnted States has been a major * At the national level we follow our compara- supplier of food and we are grateful to them for tive advantage in producing livestock and that. I am told that the U.S. Congress appropri- drought resistant sorghum and other crops ated US$1.5 billion for food aid in 1993, but that such as cowpeas and sunflowers. We finance at the same time US$35 billion went for military the importation of food to meet our food aid. In the post-cold war era, I would hope that deficit by exporting minerals and manufac- these two figures might be reversed. To put these tured products and by promoting tourism. figures in the context of Africa, let me remind you * At the household level our goalisto ensure that that total external food aid to all of Sub-Saharan every family has sufficient basic income to buy Africa is no more than US$1 billion per year. the food it needs. This means helping the food The domestic food programs are orly short- insecure groups by providing labor-intensive term measures. The ultimate goal, as I have 42 rTe Seope for Pubtic Action to Rduc !Chronic Hunger already stressed, is to raise the incomes of the environment for its growth is preferable in the poor. The challenge for political leaders is to sup- long run. Private voluntary associations and port programs that enhance their citizens' ability community-based organizations also have a to be self-reliant. In developing countries this major role to play. means supporting programs that include land As I said at the beginning, I am delighted to reform and targeted credit for the poor who can see so many NGOs participating in this confer- offer no collateral, for example, along the lines ence. The growth of NGOs strengthens civil soci- pioneered by Crameen Bank in Bangladesh ety and buttresses the growth of democracy. By Above all we must work harder to overcome promoting a partidpatory approach and actively the discrimination women face. Regrettably, they involving the beneficianes in hunger programs, and their children constittute the bulk of the hun- NGOs foster sustainable development and gry. In southern Africa 80 percent of the rural self-reliance. They can achieve an impact beyond poor are women with no land, no access to credit, that of governments. NOOs have a vital role to and usually no coverage by public services such play that is complementary to the role of govern- as agicultural extension. ment. I am much aware of the important contri- I believe that a heavy responsibility rests on bution that such organizations have made in the shoulders of political leaders to adopt poli- providing emergency relief operations in Sub- cies that will help the hungry, but governments Saharan Africa. For example, during 1987-90, on cannot shoulder this task alone. They need to average, 20 percent of bilateral cereal food aid to work with the private sector. In this context, let Sub-Saharan Africa was channeled through me underline the importance of well-function- NGOs. In the case of noncereal food aid, about 30 ing markets. In developing countries the private percent was channeled through NGOs. sector is generally reluctant to invest in remote The experiences gained from our recent and rural areas because of the lack of infra- drought have demonstrated that hunger is a mul- structure. Governments under such circum- tifaceted problem. I am convinced that we have stances are forced to establish agricultural to act proactively to reduce the vulnerability of marketing parastatals to encourage agrcultural our populations to food shortages. The impera- development by purchasing and selling pro- tive need to ensure that no one dies of hunger is duce. For most small farmers this service is nec- a challenge that confronts all humanity Our abil- essary for some time until the private sector is ity to meet this chaUlenge will succeed only if we fuly developed. Unfortunately, experience has focus our efforts and share responsibilifies. The shown that such parastatal organizations tend alleviationofpovertyisalong-termobjective,but to be inefficient, wasteful, and costly. Thus pro- the reduction of hunger is an immediate chal- moting the development of a strong and com- lenge that we must take up and win. Let us all petitive private sector by creating a conducive rededicate ourselves to that goal. Session Three Targeted Interventions: What Works Best to Reduce Hunger Left to right, H.E Sir Ketumiie Masire, President of Botswana; H.E. Dr. Boutros Boutros-Ghali, Secretary-General of the United Nations; and Lewis T. Preston, President of the World Bani 44 Targeted Interventions: What Works Best to Reduce Hunger P-= Fawzi Al-Sultan This conference truly represents an opportuiity credit, training, or techrnology. There are also risks to generate the political will to end hunger. I am of adverse effects on the poor during the transi- here to comnmit IFAD fully to collaborate in that tional periods of adjustment programs. We must effort Today, more than 1 billion human beings make sure that the poor do not fall through the are absolutely poor, most of whom live in rural cracks in the matrix of reforn areas, and three-fifths of whom are women. To combat hunger, therefore, we have to be These groups live with hunger as a constant com- more direct in our approach. But trying to deal panion, with the threat of famine looming when- with -hunger as a matter of welfare is simply not ever drought or other adverse events occur financially feasible for most developing countries. Hunger is not the only international problem, but IAD's fifteen years of operational experience in in human terms it is perhaps the largest, and one 100 developing countries suggest that the only that represents a major challenge to hopes for a sustainable response to hunger as a mass phe- new period of economic expansion and democ- nomenon is to enable smallholder farmers, the ratic transformation. landless, and poor rural women to improve their Let me offer a simple observation: rich people own productive and income-generating capaci- do not go hungry. The problem of hunger is basi- ties. Empowering the poor with the resources nec- cally a problem of the inability of a large number essary to pull themseives out of hunger would not of poor people-mosily in developing coun- only have a direct impact on hungez it would also tries-to command access to sufficient food. The contribute to national growth by increasing the question is, how do we improve that access and supply of food and other crops and widening the make it more secure? .market for manufactures. However, resources are For some the challenge is to increase the over- scarce, and to make the maximum. impact on all supply of food. For others it is general eco- hunger we have to ensure that our support has an nomic expansion. However, these sorts of explit beneficiary orientation and is as carefully macroeconomic developments are difficult to targeted as possible to the hungry to minimize engineer While the general expansion of employ- leakages to other groups. ment and increased global food supplies are good In what follows, I will principally be referring objectives, they are blunt-and slow-instru- to solutions to chronic poverty. However, EFAD's ments for addressing the specific problem of work in drought stricken areas shows that the hunger, because seldom do resources intended development of more resilient production sys- for general agricultural or rural development tems can significantly reduce the impact of nat- reach the poor and the hungry. The impact on ural disasters. Moreover, actions taken during the hunger of broad-brush support for agricultural course of emergency operations can become the development has often been disappointing: the seeds of resumed and sustainable development poor akud hungry still have little access to land, in the future. Working with the World Food 45 46 Targeted Itlernenfiouns: Wliut Works Best toRediuce Hunger Programme, for example, we have found that extension systems that respond to their needs. Yet food aid provided through targeted food-for- another is a focus on small-scale water conserva- work schemes can be made into a development tion and control methods and on the crops and resource that supplies immediate needs and animals poor farmers raise. Other forms of target- strengthens future production capacities. ing are also important. Apart from food-for-work Unfortunately, some misunderstandings about schemes, employment guarantee schemes and the idea of targeting still exist. Some economic strengthening health, education, and nutrition purists believe that targeting represents a misallo- services in poorer regions have proved effective. cation of resources into areas that would not be In our view targeting means focusing on issues served under free market conditions because of that are of special and unique concern to the poor, lower returns.The reality is, however, that in many which requires both resources and a willingness of the rural areas in which the hungry live and to give these issues the necessary priority. WFAD operates, markets are weak and monopolis- Targeting has to be complemented with elicit- tic, and sometimes virtually nonexistent. In these ing t e full participation of the intended benefi- circumstances untargeted resources do not neces- ciaries, offering the hungry the means to choose, sarilv flow to the highest return areas; they tend to and to benefit from, the productive services and flow to the most socially powerful. Apart from institutions they need to change their situation. market failures, there are also significant govern- The benefidaries' involvement in project design merit failures, including weak government insti- and implementation often lowers the costs of tutions, that fail to reach the poor and respond to implementation and improves the project's sus- the priorities of the socially powerful. A dear ori- tainability. In the IFAD-supported Niger project, entation toward poor beneficiaries and effective which we are presenting as a case study, for targeting can foster particpatory grassroots insti- example, the involvement and contributions of tutions through which the poor can express their the beneficiaries to development work has low- needs and obtain productive services. Rather than ered the cost of irrigated land in the project to less creating distortions, targeting can thus help to than US$1,800 per hectare, one of the lowest in overcome institutional failures, both in markets the country. Access to small-scale irrigation and in govercunents, in their capacity to reach the allows the villdgers to produce a highly profitable poor. green pepper crop, with significant and lasting TIhe type of targeting I have in mind involves increases in their incomes. in the other case study, identifying the specific obstacles the hungry face the project in Indonesia, the target group has been in raising their incomes and food production and offered the means for self-reliant development seeking to eliminate these corstraints in a sus- through a group-based credit scheme that has tainable way. Naturally this necessitates better given them access to bank financing. As a result identification of who is hungry and at risk. We the beneficiaries have increased their incomes by also require a better understanding of the xunder- as much as 50 percent in three years. Moreover, lying causes of why people are hungry. This sort an institutional structure for poverty alleviation of understanding of the who and the why of has been forged that is both cost-effective and hunger leads to a positive type of targeting. One sustainable, as well as being capable of country- example is credit. Targeted credit using group wide replication. guarantees to replace collateral requirements that There is now, I believe, enough experience of builds, where possible, on traditional informal effective interventions at the iicroeconomic level financial institutions, can sharply reduce transac- and macroeconomic policy adjustment programs tion costs and offer the poor the means to use pur- to provide the basis for a coherent approach to the chased inputs to improve their productivity. In challenge of hunger. It is evident that well-con- IFAD projects we have found that the repayrment ceived macroeconomic and sectoral policies are of rates of the poor, especially women, are extremely critical importance for underpinring the process high. The poor are bankable. of development. We are certainly not saying that Another powerful form of targeting is to they should be abandoned: experience shows that encourage research to emphasize technologies targeted hunger projects have the most sustain- suitable for smallholder farmers and to develop able results when developed in a supporting Al-Sultan 47 macroeconomic and sectoral framework. To over- projects initiated by IAD. This mayhave been jus- come hunger what we have to ensure is that the tified for a certain period by the preoccupation of function of targeting the poor is performed, that it the major international financial institutions with is adequately funded, and that it is supported by macroeconomic rather than poverty issues. But it the right policies and programs at the sectoral and is no longer justified. I have instructed my staff to macroeconomic levels. raise significantly the level of collaboration with This does not mean, however, that all devel- other multilateral and bilateral development opment institutions should be doing the same finance institutions in the coming year by every thing. Each has accumulated different experi- means we can devise. ences and has different comparative advantages. A proper attack on hunger requires a real part- Take the example of macroeconomic policy for- nership to deal with the obstacles the hungry face, mulation. While many institutions have sought principally as producers, for the poor are rarely to claim expertise in macroeconomic policy for- simply poor, they are poor farmers, poor fisher- mulation, it is the Bretton Woods institutions that men, poor herders. And it involves changing our have the operational experience in and practical own style. It means reducing the drive by all insti- responsibility for these issues. What is true of tutions to seek to address everything, while macroeconomic programs is also true of targeted simultaneously making exaggerated claims to hunger eradication projects. Experience in and policy uniqueness. It also means moving toward responsibility for targeting resources to the poor more practical collaboration that really draws on and hungry do make a difference, and we should the strengts of each institution. recognize and build upon this as we organize our Talking about targeting and collaboration campaign against hunger. I would also say that if would not be very useful without referring to the comparative advantage and experience should role of the single most important global develop- better govem the division of labor among multi- ment institution, the World Bank. The Bank's lateral institutions, it should also affect the way comnmitment to resolving the question of hunger we deal with NGOs. NGOs have a unique capa- will be decisive, and its sponsorship of this con- bility of leading innovation at the local level. ference is a clear reflection of this commitment. They are the pathfinders who seek out means of The poverty assessments the Bank is undertaking getting people to participate and test options in a number of countries to identify the causes of without huge investments. Professor Yunus' poverty is a further indication of that commit- Grameen Bank in Bang*ladesh, for instance, is an ment May I express my hope that these assess- outstanding example of a local initiative that later ments can be made a more collaborative exercise could be scaled up into a large, national-level from which all of us could benefit. endeavor. We in IFAD are proud that we were We also have to reflect upon what sort of com- among the first to recognize and give outside mitment to hunger will make the crucial differ- support to what Professor Yunus is seeking tu do. ence. First, I believe that what we should aim for The general need for a greater focus on the hun- is not the reduction of hunger, but its elimination. gry and more cooperation has often been verbally This offers a clear target to aim for, a yardstick by acknowledged. I would like to make a more con- which to measure progress during the coming crete gesture of intent on the part of IFAD. I am years. Second, and again reflecting the need for therefore committingHJADtoshiftingits resources visible and quantifiable commitments, I believe toward the most direct possible delivery to the that the World Bank and other multilateal finan- poor and hungry To that end, I am working for cial institutions should consider earmarking spe- WFAD to reduce its own costs in the project devel- cific and adequate resources for targeted attacks opment cycle by more than 20 percent next year on hunger, funds that are large enough materially while maintaining the same level of financial com- to reflect the magnitude of the problem. These mitment to projects and programs for the hungry funds should be available for supporting the pro- and poor We are also seeling stronger collabora- jects and programs of institutions that have tion with other development and financial institu- demonstrated their ability in the area of targeted tions. During the last decade, the trend in IEAD has and sustainable interventions against hunger. been toward a higher and higher percentage of Such institutions could include IFAD and other 48 Targeted Interventions: What Works Best to Reduce Hunrger development agencies specialized in this area, as A third form could involve a sort of subcon- well as national institutions, NGOs, and private tracting, if I may put it like that, by the World voluntary organizations. Bank to institutions that have special experience To remind you of my earlier remark, legiti- with participatory efforts to alleviate poverty. mate universality of concerns does not necessar- Interventions in marginal areas with large num- ily imply equal experience in all areas of concern- bers of poor, scattered beneficiaries need a sin- Experience at the macroeconomic level is not eas- pler, more flexible, and more responsive project ily and immediately translatable into expertse in cyde to deal with the informal associations and local-level, targeted operations. This is why our organizations of the poor, the NGOs, and other collaboration must emphasize and draw upon grassroots institutions. Approaches that are the unique capacities of each of us, and must appropriate for large-scale infrastructure projects ensure that the materials are available to make may not be cost-effective in these areas, and this the most of them. This coUlaboration could be could provide a strong logic for a subcontracting developed in at least three different forms. At type of collaboration. present, thevolume of resources devoted to over- We have aLl been receiving signals that busi- cominghungerissiumplytoomeagercomparedto ness as usual is not enough. People are expecting the scale of the problem and the number of the somethingnewand concretefrom this conference. hungry IFAD, for example, can only finance one I think they want a new and specific focus on the project every two or three years even in countries elimination of hunger as a legitimate and separate where large numbers of people suffer from objective. They want sufficient fumds explicitly chronic hunger. It would be relatively easy and and separately allocated for this purpose. And cost-effective to replicate these projects elsewhere they want to see those funds used by those who in these countries and have two projects a year can use them best for the purpose: "universal" there instead of one every second year We all multdaterals, speciahzed interational agncies, need to use our influence to assure that inceased NGOs, and national-level institutions, with al of levels of resources are devoted to eliminating them acting in a mutually supportive fadhion. hunger. It is now within our power to satisfy these A second form could involve complementing expectations and make real inroads into hunger, the sectoral and large-scale infrastructure invest- soon. What is needed is the willingness to invest ments financedbythe WorldBank and other mul- in hunger eradication and to target the hungry, tilateral financial institutions by having other not to the exclusion of everythng else, but as institutions, like my own, undertake components part, and an important part, of our regular activ- and activities thatlnk these infrasucture invest- ities, with quantifiable targets and quantifiable ments to initiatives to reach the poor and hungry and separate means- This conference hall is far at the village and grassroots levels. We and the from the world the poor and hungry inhabit, but Bank are looking right now at exactly this kdnd of if we show the commitment to launch a process collaboration in Armenia. Such a collaborative of concrete programs and collaborative actions, linkage would give World Bank sectoral invest- we can translate the rhetoric here into meaning- ments a greater beneficary orientation, and thus ful changes in the daily lives of the hundreds of increase their impact on eliminating hunger. millions of the world's hungry. Discussant Remarks Ruth Bamela EngoTjega I represent the Advocates for African Food This perspective ensures that the index of Security, a coalition of more ftian thirty non- local food security will be higher than the index governmental organizations, representatives of of dependency on extenally provided food, and United Nations bodies, governments, and inter- the presence of a national strategy ensurng that governmental organizations worlcing together on the right to food is addressed at the highest polit- the issue of food security, with a special focus on ical and planning levels the role of women food workers. To ensure the implementation of these three The work of this umbrella group, created in targetediterventions,theAdvocatesforAfrican 1986, is built on three targeted interventions. The Food Security have initiated a process with three first one derives from each human being's basic specific functions: the debate function, the advo- right to food, but in this case the right to food is cacy function, and the need to build antihunger not, as usually perceived, a right to receive food structures within the continent of Africa. passivelyorarighttobeassisted,butratheraright The debate function's objective is to clarify to merit one's own food. It is an active right that ideas concerning food security and hunger; creates a responsibility to its holder and duties to ensure that major aspects of various definitions the country and the international community and strategies pertinentto these issues are under- expected to provide an appropriate environment, stood at the international, national, and local lev- The second targeted intervention of my orga- els; and that the roles and duties of each group or nization focuses on women who are the main level are well defined. This is important for nego- food providers, with a world of experience in all tiation and for planning purposes. the stages of food system. This intervention This debate is relized t ugh the Advocates' entails the recognition and support of women yearly symposia and their participation in meet- who are involved in food activities so that their ings like this one. The debate function has helped productivity will eliminate hunger in their com- the Advocates to come up with their own defini- munities. One aspect of the support they need is tion of food security, which initially was "food a reduction of their burdens so that they have locally produced, procsed, and stored, available enough time to invest in ending hunger in their year after year despite natural or human-made communities. famine." The debate function also helped us to The third targeted intervention of the Advo- measure the limitations of our first definition as we cates for African Food Security is the need to recognized that all foods oDuld not be locally pro- understand what we are aiming at and to define duced. This debate also helped to communicate to food security. indeed, food security for the advo- audiences like this and to individual countries that cates means food produced, preserved, pro- foodisnotawoman's issue, butacommunity issue cessed, stored, and distributed as dose as possible that needs to be part of macroeconomic planning, to where it is consumed. whether itbe at the international or country leveL 49 50 Discussant Remarks The debate function finally helped to spell out national levels, so that they can comprehend the states' internal and external duties, which range magnitude of the problem and understand the from providirng land, credit, training, and other need to work with others. executive, legislative, and administrative mea- Our last three symposia were held in Ghana, sures onrented specifically toward the realization Tanzania, and Cameron In Ghana (1991), in a of food security, to ensuring that international village with a deficit of food, the symposium led policies on food do not place people of certain to women traders getting a vehicle from a rural countries in a state of perpetual dependency. bank to ensure that instead of spending four The Advocates' second fumction is an advo- weeks searnhing for food to be sold in the vilage, cacy function. The widespread concern to over- theywould only use three days. InTanzaia land- come hunger has not led to concrete actions. We lesswomenfarmerspreparedadocumentforpre- realize that hungry people, as we have all sentation to the local government that explained repeated in this conference, do not have a voice. the importance of the link between food security Our advocacy therefore started at the interna- and land ownership. In so doing they became the tional negotiating level m 1986 with the negotia- voice of the hungry, the advocates within tion of the United Nations Program of Action for Tanzania. In Cameroon the focus was on the qual- African Economic Recovery and Development, ity of street foods used by the majonrty of hungry through the LDC Program of Action adopted in people in urban areas, reminding all of us that Pains in 1990, and lately with the New Agenda for food securty must, from thebeginnimg, deal with the Development of Africa in the 1990s adopted both quantity and quality. in 1991. Our involvement in these negotiations In conclusion, ladies and gentlemen, I will was to ensure that resources flowing to Afica share the following expience with you. When will consider food securty as one of the priorities we were asked yesterday to give our v¢ion of in a continent where 168 million of its 650 million, food security in the year 2000, my vision was, inhabitants go hungry "that African palaces will eat the food of their In this advocacy process we leam that food land happily, and will make the whole continent security strategies are expensive and necessitate feel happy and proud to do the same." Iwas alit- important infrastructurs, such as storage, tle bit destabilized when my neighbor on the research, and so on. We learn to encourage the right was shocked by my level of unconscious- international community and institutions like the ness, that I could be here at this conference and World Bank to address these expensive aspects not understand the urgency of the problem and thatAfricancountriescannotyetaffordinsteadof be incapable of understanding that I needed to distnbuting food. We also leam to highlight the contribute three to five words toward a strategy danger created by industrial countries that flood that will work right away. He actually left the African counties with surpluses of their subsi- group, and I missed himr This event made me dized food, discouraging local production, think and helped me state something that is very changing patterns of consumptiont and elihinat- close to my heart visions are abstractions that are ing many possibilities of employment, thereby so dear that you can actually touch them.L Vsions encouraging migrations. need to be extremely clear and detailed so that we Building antihunger structures m Afica con- can, withno difficulty, put them into life. But dear stitutes an action that gives a purpose to the visions have something a little bit spiritual that Advocates' debate and advocacy functions. One generally comes through a long experience of aspect of this work has been to bring African wantandhope.Itisadreamof afuturethatisnot women food -workers to many of the interna- present and that may never come, but its impor- tional and national debates. This gives them the tance remains opportunity to. clarify their own positions; to Mypleaforallofushungeractivistsisthatwe know what they stand for; and to understand the should spend some time listening to the visions key role they play, not only in their families and of the hungry. It may help our interventions to be communities, but also at the national and inter- more targeted. 17- 0, Discussant Remarks - - L Cathierine Bertini In bringing us together, the World Bank, the criteria. Depending on the nature of the problem, largest provider of financial assistance in so many the criteria for intervention can be defined to countries, is going to help raise all of our expec- address either the needs of a particular category tations about what might be done to alleviate of people, for instance, pregnant and lactating hunger throughout the world- We certainly all women, or people in a particular area afflicted by share a common ground and the common pur- the same crisis, for instance, victims caught in a pose of eradicating poverty and hunger. war zone. Atso manyof these conferences we can talk for The second area is the administrative feasibil- hours and days, but what we ultimately have to ity and costs of targeting. Sometimes the excellent do, as Mr. Al-Sultan said, is to act together, to act scenarios envisagedbytargeted interventions fail together within the United Nations, witiin the because they cannot be admnistered on a regu- intemational financial institutions, through the lar and sustainable basis. We must ensure that the governments, and with NGOs on behalf of and basic ability to continue administrative support is with hungry people so as to make a difference. present IntheUnitedNationswetalk oftenabouthow The third area is participation by the affected we are working together to develop country groups: the poor and the hungry. We can overcome strategies. We need to expand that work, not just many of the difficulties of intervention programs within the United Nations agencies, but with each if the poor themselves are involved in their design, government and with the international financial in their implementation, in their evaluation. institutions and the NGOs, so that together we can The final area is the transfer of resources. Any develop our strategies, together we can establish intervention is most likely to attain its objectives the appropriate directons, and together we can when the resource transfer is appropnate and the pool our resources to make a difference. method of transfer is direct Regarding what works in targeting, we have Of course, when we talk about targeting, we similar questions at the WFP to those that have also talk from the perspective of food aid. Before already been presented today. Who are the hun- we can talk about sustainable inprovements, gry and the poor? Where are they located? How sustainable development, sustainable differences many people are in each location? What kinds of in people's lives on the basis of their own food dharacteristics define these particular people and security, sometimes we have to talk about just their needs? And ultimately and most important, helping people to exist from day to day. So many what can be dcne to empower these people and emergencies, almost aU man-made, take our to put them on the path of sustainable improve- resources away. They take away the resources of ment in the quality of their lives? the donor community and of NGOs because we, We have noticed several areas concerning tar- as a people, must help people survive, help peo- getinginwhichwe could concentrate. One is the ple live. As a result, we find that many of the 51 52 Discussant Remarks resources that could otherwise be used for long- Thus food as a resource becomes especially term sustainable development and for helping important in development over the long term, people make a difference in their lives are actu- whether it is food for work, whether it is for pro- ally used to help feed people in Somalia, espe- jects that feed vulnerable groups, or whether it is cially women and children, because the men are monetization. The use of food becomes cntically shooting at each other; help feed people in the important in helping to reach those people who former Yugoslavia; help sustain people's lives in are targeted and to help them become self-suffi- southem Sudan or in Angola. That is one reason cient over the long run. why President Masire's comments about the I am pleased to note that the WFP puts a high need for political solutions were so important, priority on triangular transactions in the pur- and why the commitment of political leaders is so chase of food in developing countries for distrib- critical to be able to solve these problems. ution in developing countnes. Having spent We can see many successes. We can see suc- more than US$250 million last year, the WFP is cesses now in almost all of Somalia, for instance, the largest purchaser of food for this purpose. where the work is now primarily on rehabilitation Fawzi Al-Sultan said that the rich do not go hun- and development, and where we are making sig- gryI That is true. However, one thing that I have nificant strides in helping to improve the country found when I worked on hunger issues in the We see a great success story in the drought that hit United States, and nowworkinginthe international southem Afica that could have affected 18 million community, is that even the ndih understand hun- people. Because of the commitment of the donor get Theyunderstand hungernotlikesomeonewho community,becauseoftheinteractionbetweenthe is near starvation and not Slke Congressman Hall countries in the region, the SADCC, the United after his fast, but even the rich understand what Nations, and NGOs we were able to make a sig- being hungry for a day or two days is lie, even if nificant difference and avoid tragedy in southern some may not understand what being poor is like. Africa. The WKorld Food Programme was pleased As a result, I believe there is a major commitment and honored to be in a position to be able to caor- among the people in the United States and among dinate that effort But even though we are com- thepeoplearoundtheworldtohelppeoplewhoare mitted to development work, whether it is hungry,whedun itis people from the UnitedStates building schools in El Salvador, providing crops sending surplus food or people from Bangladesh and animals in SomaIia, or planting trees in sending a contribution to the flood victms in the Bangladesh, we still find that we must have a Midwest of the United States People around the major commitment from the political leadership to world understand what it is to be hungry make a difference, to end the man-made disasters. Thus I think all of us committed to helping to We can concentrate on development if we alleviate world hunger have infront of us the great have peace and stability If we have peace and sta- dhallenge of reaching out to our publics, reaching bility we can concentrate on the process at hand, out to our constituencies in the United States and helping people help themselves to become self- around the world, and making sure that people sufficient and self-reliant and this is where food understand not just the tragedies that hqey see on aid also becomes criticaL television about Somalia or the former Yugoslavia, Some of the negatives have been mentioned in but understand that hunger unfortunately affects this panel and in others, but there are so many so mnany people throughout the world. We must positives as well. One of those positives, in addi- communicate the difference that we can make by tion to the ultimate objective, which is helping increasin-g our resources, whether they be food people become self-reliant and self-sufficient, is resources, cash resources, or people resources, to that the donor community-we see this in the help alleviate hunger around the world. United States and in other counties around the Working together with organizations such as world-understand the comintnent of food, the International Fund for Agricultural Develop- understand the use of food, understand the ttans- ment, the World Bank, the NGOs, the govern- fer of food from a wealthy country to poor peo- ments, and the multilateral institutions we can ple in a poor country, and understand the moral make a significant difference. We owe the poor obligation to make that transfer and the hungry nothing less hian our best AL ~Workshop Spokesperson 1 - = Remarks 4> 8Christopher Dunford An intervention can be targeted on those who The dominant vision that emerged from yes- need it most and also on what works best On the terday's workshop is participation. It has become onehand,wecanfocusonthosemostinneed,not a major theme throughout this conference for just the poor, but the poorest of the poor, espe- good reasons. I am talking about participation by cialy women, those most vulnerable to hunger. those most vulnerable to hunger (I want to On the other hand, we can focus on those actions emphasize that over and over again) in the that are the most cost-effective. We have to ration design, implementation, and evaluation of pro- scarce resources to make sure that we use them grams that respond to these people's specal effectively for those who need them most needs for empowerment empowerment of the Theimageryoftargetedinterventioncorjures poor, especially women. This can be done up an image of armed police brealing down the through education; increased income and sav- door to round up "the usual suspects." This kind ings; improved nutrition and health, induding of aggressive terminology may reflect one of the family planning; and for those with access to land basic problems of the international development and natural resources, agricultural and natural communty, our attitude and the way we work resources research and extension that supports with the poor A better image might be a joint the food security of the poor, not just a focus on venture between development institutions and commodities, but on the farming systems of the those most vulnerable to hunger the poor, espe- poor. cially poor women and their children. Beyond the ideological and ethical reasons for Some assumptions underlay the workshop's encouraging particpation by the poor, there is a results. One is that poverty is a fundamental practicalreason.Programsforthepoorworkonly cause of hunger. A second assumption is that the with the willing involvement of the poor. This World Bank and other development institutions willingness comes only when they know that want to reduce poverty. Echoing Mr. Al-Sultan's their voices are heard, that their concerns are point, let's not just talk about reducing poverty; given consideration at least equal to the concerns let's talk about eliminating poverty. He used the of the investors in or donors to programs, and term hunger, but let's go evenfurther. And third, that they are trusted to make decisions that con- perhaps most debatable, is that poverty reduc- trol resources. Thust and control of resources are tion depends ultimately on long-term, broadly the biggest problems with participation. based economic growth that canbe sustained by Saying that we know how to foster partcipa- the Earth (a major qualifier). Given that this last tion is fashionable; that all that is needed is the assumption is true, there are still other actions will to do it. However, it is not that simple, espe- by, with, and for the poor that we need to take cialy given that we are concened with hunger. now to create by the year 2000 a future that we We need participation by the poorest of the poor, can live with. who are often margnalized even from the asso- 53 54 Workshop Spokeperson Remarks ciations in their own communities. How do you The third is to provide training and technical invoke their particpation? assistance to community-based organizations. I was reaily very pleased yesterday, at the Regarding family income, the workshop par- dose of our workshop, by the comments of the ticipants felt strongly that the World Bank and World Bank spokesperson: that the Bank is com- other major institutions could do a lot to channel mitted to learning and trying promising tech- more resources to micro credit schemes, particu- niques for promoting participation by the poor- larly through NGOs, which have shown an However, the spokesperson did not mention the unusual capacity to manage mico credit schemes fact that during the last two decades the research for the benefit of the very poor There should also and development for findmg successful tech- be a concerted effort to link the poorinto the main- niques has been done mainly by the NGOs. Why stream financial systems at some point in the do major development institutions not take this future. Itshould not always be the case that a fund experience more seriously? Speaking personally is set aside for credit for the poor. Eventually, the now, I think the reason relates to scale. NGOs poor themselves can and should have direct have been very effective at encouraging the par- access to the mainstream financial systems. ticipation of the poor, even the very poor, in pilot The workshop recognized that income is not programs that reach a few hundreds or thou- enough. A family can have adequate food, and sands of people, but it is rare to see major-scale some family members can still be malnourished. involvement of the poor by NGOs. This is why Many health- and behavior-related problems there is so much excitement about the few lage- can cause malnutrition, and therfore need atten- scale examples of micro credit programs, in par- tion. We urge the continued search for delivery ticular, which are found especially in Asia The systems that work best Delivery of what? Pri- Grameen Bank is only the best known. mary health care, of course, is very important One of the things bedeviling the Bank and also maternal and child health care, including other major institutions is that they often simply reproductive health and family planning; cost- consult people outside the mstitution and call it effective nutrition education, not just attadhed to participation. You know: we talked to an NGO health programs, but to other programs that here, or we talked to an institution there, and that deliver financial and education services; micro- is participation. That is not We have to be careful nutrient supplementation schemes; and, where to maintain the discipline of sticking to the pur- needed and as needed, mother and child supple- suitofrealparticipation. Wecan'tbe content even mental feeding, not as temporary programs, but to just consult NGOs that are close to the poor We as programs that are always there to help those have to find ways to allow the poorest people to who get in trouble nutritionally. control at least an important part of the program Our final point is that even if food production or project resources. is sufficient now (there has beena lot of talk about The most general reason to pay heed to the how the world has plenty of food), we have to NGOs is that they have a wealth of experience in look to the future, locally and internationally. The giving the poor a voice in decisionmaking and in future is threatened by 2nvironmental degrada- controlling resources. We sfil have much to lear. tion, degradation of the very resource base that We still have a lot of experimentation to do. But produces food and other commodities. So agri- the NGOs are for the most part where the cultural and natural resources research and researchand developmentis ocring, not in the extension needs to be strengthened and focused 'puzzle palaces" of Niew York, Washington, on tle commodities, crops, and farring systems Rome, Geneva, and so on. (livelihood systems) of the poor. Specifically, in support of participation, the In summary, the World Bank, the Inter- workshop recommends three actions for the Bank national Fund .'jr Agricultural DeLvelopment, the and other institutions. The first is to create an World Food Programme, the Food and Agri- enabling environment, including the legal, culture Organization of the United Nations, the administrative, and policy frameworks, tat is U.S. Agency for Intemational Development, and aimed at reducng hunger The second is to dele- other major institutions can help reduce poverty, gate control of resources to the targeted groups. but only to the extent that they can truly believe DunfoJd 55 that the poor are their clients. The Bank, other hunger, but we know that commitment is only development institutions, and govenmments are credible if the Bank accepts that the participation really supposed to be the fiduciary intermedi- of the poor is going to involve fundamental aries between the investors and donors on the changes in the way it designs, implements, and one hand, and the poor on the other Investors evaluates programs and projects. Meaningful and donors are there usually with the support of change in this respect involves organizational grassroots taxpayers of whatever countries are pain, and therefore real leadership. providing the donations or the investments. The sovereignty of nations is often given as a These ordinary people want to see the poor major reason why the Bank and other lending helped, and it is the job of the Bank and the bor- institutions cannot really make things happen at rowing governments to see that that is what hap- the national level. Well, as I've seen it, one of the pens, d iat the poor are helped, especially to help most remarkable developments in the last decade themselves. This objective requires development or two is that only invading armies could have institutions to act much the way commercialbusi- had more impact than the expert missions of the nesses do. Getting close to their clients or cus- Bank and the Interational Monetary Fund. If tirmers is the key to success. The institutions Iam you can get national govermments to swallow the talking about need to be closer to their clients- need for structural adjustment, you can g them the poor-not just the irnvestors and donors. to accept the need for te poor truly to participate The NGOs, who have made a serious com- in theLr own development A committed Bank mitment to getting close, know what a funda- has an obligation to educate investors and the mental transformation it requires in the way you borrowing governments, and to take a good dose do business We welcome the Bank's commit- of its own medicine: internal structural adjust- ment and that of other institutions to fighting ment. Physician, heal thyself! Workshop Spokesperson Remarks Mildred Robbins-Leet Our vision about gender equity recognizs that We envisioned a redirection of resources to women are central to realizing the goals of this ensurebasiceducationforall, and to providegen- conference for overcoming global hunger and der neutral curricula, including an adequate poverty We have heard this in extraordinary fash- focus on family planning, health, and nutrition. ion from evety one of the conference speakers. f When we talk about empowerment, it is the you noted, this morning the men on the platform people's participation that is involved. One of the made excellent speeches What was extraordi- means is dthough groups such as Ruth Engo- nary, and a change, was that every one of them Ijega cited when she talked about the Advocates underlined the importance of women as a natural for African Food Security, This international and essential component for erasmg hunger and NGO has worked smce 1986, and was initially poverty That is a change. Men and women are concerned with lessening the burden for women moving in the right direction. Now we are taling and increasing food production. It is currently words. But perhaps the words at this conference involving people in exaniinmg their programs, will soon be transformed into actions. working toward community-based decisions. It Some of the actions that emerged from the is building antihunger structures in Africa. The group discussing targeting interventions to programs to alleviate poverty should be commu- reduce hunger included, for both the national nity-directed and should start with people find- andinternationalcommunities,tlhedesignofpro- ing out what works, what doesn't work, and grams that will help women to overcome con- moving on from there. straints, and for the World Bank to give greater The other vision that I would like to talk attention to women in their economic and sector about is employment, because people are hun- analysis as well as in their poverty assessments. gry, they are poor, and there just are not enoulgh Women should be an integral part of the pro- jobs in the world. In whatever country we visit, gram, not an add-on. there is unemployment and tiere is underem- Onto the nextvision, the empowerment of the ployment. Let us hope that we can have full poor. All our visions relate to people, their par- employment That is a goal, a really big goal. We ticipation, and their resulting empowerment are saying that one of the ways to achieve that is When we talked about empowerment of the poor, by self-employment, that is, to try to develop we recognized that providing disadvantaged cost-effective mechanisms that provide opportu- groups, especially women, with greater access to nities for the poor to earn more income to reduce information and education was imperative. For their hunger and to move them up and out of these disadvantaged groups we determined that poverty by doing it themselves. They help them- this was one of the critical elements that could selves by creating businesses of their own. It is help people move up out of poverty. through such self-employment that women pro- 56 Robbirs-Leet 57 duce much of the food that susains life for low- And thenra shorter-term goal, which we heard income people. cited earlier today, the focus on food-for-work We had two long-term actions to suggest in programs.They do work, sometimes, in the short regard to employment One was to increase the term. There is a difference of opinion about this. availability of worling capital, trainin& and tech- Ultimately, all people, women and men, nical assistance to the unemployed and underem- should be involved in policy, planning, decsion- ployed, or, as we nught call them "economically making, and working. Together they just night active poor" Another long-term goal was to give be able to stay the course for humanity and make greater support to those sectors where the poor life better for more people, while employing the are predominately employed and that are often principles of equity, sustainable development, overlooked in programming. and democratic participation. Floor Discussion A number of participants commented from the floor; institutions are wifling to chadi e their approach to tihen the speakerssrponded. agrculture to a more sustainable one, we cannot share the World Bank's assurances that the food Particpans' Comments supply will always keep up with population. Mr Al-Sultan, in the vein of what you said aboutbusi- First floor particpant It seems as though in the ness as usual not being enough, do you believe past, there was a certain amount of disagreement that IFAD and the Betton Woods institutions are about wrhether or not poverty had actually been willing to work with NGOs in combating hunger alleviated in Mexico or in other places because of by promoting sustainable agriculture? World Bank interventions. In this connection, what are the indicators tiat show that poverty is Third floor participant In the late 1970s, tageting being alleviated, and how will World Bank lend- assistance to the poor was a principal focus of ing officers in the field be given the incentives to attention In 1978, half of the resources from the make the lknd of loans thatwill make a difference IDBs Fifth Replenishment were supposed to be for the poorest people? Won't they have to have targeted to help the poor in Latin America. In 1981 their whole psychology changed about the kind Congress enacted legislation that urged the World of loans we need to be making to end poverty? Bankandtheothermultilateraldevelopmentinsti- tutions to emulate the stated objective of the IDB Second floor particpant tFawvzi Al-Sultan said byputtinghalfoftheirresourcesintohelpingpeo- that it is the rich who have food, but even the rich ple who were absolutely or relatively poor After eat potatoes and rice that were grown from soil, 1981 other issues were emphasized. Are we now not from fields of dollars. Because of the economic going back and picldng up where we left off, and focus of this conference, we have thus far largdy essentially dropping this whole twelve years orso iginored environmental problemns associated with of emphasizing economic policy reform in bor- agrculture that are now beginning to threaten our rower countries, or is this something we are now food supply, such as erosion, desertification, salin- factoring in as we are trying tc taet assistance to ization, deforestation, overgrazing, and the deple- the poor? Do we look at econormic olicy reform as tionof aquifers.Alsoof concemaremonocropping limiting our capacity to target as;istance to the and diminishing genetic resources, as well as the poor, or is itanother factor that we keep in mind abuse of chemical ferfilizers and pesticides, and as we try to target assistance? potentially catastrophic are the as yet unknown effects of the destruction of the ozone layer and Speakers' Responses global wvarming. These trends are all exacerbated by agribusiness-onented, capital-intensive pr- Caio Kodh-Weser The first question was about grams frequently pushed by multilateral aid insti- the indicators on which we can base the argu- tutions such as the World Bank Unless these ment that poverty has been alleviated. The pic- 58 Foor Discussion 59 ture is mixed. In some countries poverty has teach the poor new techniques of intensive agri- dearly been alleviated and poverty indices culture that use natural fertilizers. We have to reduced. In other countries the situation is much teach them terracing, which is a form of more less clear. We could even argue that the crisis of intensive agriculture. We have to do research on adjustment in many countries in the 1980s led to the varieties of the foods that the poor grow and a demonstrable increase in the incidence of eat There is also intercropping. In Nigeria, for poverty. instance, we are growing cassava with coffee, and When it comes to measuring how we have in the highlands they have been growing plan- done, in a number of countries, Morocco, for tains with coffee and some other crops. So at this example, we have established, together with gov- stage we should focus on this type of sustainabil- emments, careful systems of household survey- ity, particularly using techniques similar to what ing, of measuring living standards, that give us a the farmers already know and understand, while much better idea of the incidence of poverty than at the same time trying to solve the problems of we had some years ago. These measurements environmental degradation. show that in Morocco, ten years of successful Fundamental to almost all IFAD's projects is reform and adjustment, which had its social researchthat goes into the types of cropsthatpeo- costs, have reduced the incidence of poverty from ple grow. To take Nigeria as an example, cassava 21 to 13 percent In some other countries, Egypt, was a small investment, less than US$1 million. for example, the situation is much less dean We were able to develop a variety of cassava that However, we also have to ask ourselves what produced almost three times as much. Almost would have happened if no reform policies had ovemight we had a food that made almost every been introduced. We have to do much more work poor home self-sufficient in the basic crops that on measuring poverty, on having benchmarks, the family ate, and families even had surpluses. and on having governments accept then, but Another issue is that you need resources. We overall we are on the right track can only go so far at the basic beneficiary level As to how committed to poverty reduction with the resources that we have. When we talk Bank field officers are, and can we really expect about participation, that is not talking to govern- them to do a good job unless attitudes change, I ments. It is talking to the beneficiaries, forming believe that the vast majority of Bank staff is truly groups in much the same way Grameen Bank has committed to the Bank's central objective, which been doing. We get the womren together, we get is to red' .t poverty. How to achieve that is a the men together, and we understand from them much more complex issue. I would point to one what they want. important area here, the traiing and sensitization One constraint that we have in common with that takes place in the Bank across departments almost every multilateral organization is that we and across regions based on years of experience, have to work through governments. We would all so thatwe leam, say, what China has done orwhat like to be able to deal directly with the beneficary Morocco has done for the Egyptian case or the groups, but then you cannot really complete pro- Yemeni case. This cross-ferilization, training, and jects in the sense that you have to have infrstruc- sensitization needs further strenenng. We are ture, forwhich you have to talk to the govenmment not doing enough yet, but we are doing it. Particlpants' Comments Fawzi Al-Sultan: IFAD's projects are essentially at the level of the poor beneficiaries. Sustain- Fourth floor participant: We speak of the poor abilityis thekeyelementinprojectdesign. Letme and the very poor and the poorest We have to be give you a couple of examples. One is the-high- aware tiat if we do not have the specific will to lands in Central America, where the predomi- reach the poorest, we will not reach them. Most nant technique of the poor is to slash and burn to of our programs often not only do not reach the get access to more land so they can feed them- poorest, but contribute to increasing the gap selves. The land has very low productivity. This between the poorest and the rest is a major environmental disaster that takes place My second comment is about wonmen. It is true on a daily basis. What we first have to do is to that women are central for overcoming hunger, 60 Flwor Discussion central for overcoming poverty, but it is not sometimes, but the United States and other coun- always true to say that women are the poorest, or tries also make a conscious effort to make specific that we can work with women and this is almost budgeted pledges to help the poor throughout enough. Just look around Washington, D.C., look the world. around this country. Who is in the street? Who is - Some countries give primarily cash. Japan, for in jail? It is not the women. It is the men. This is instance, which does not have a food surplus, not lque to the United States. It is something purchases food. Some countries like Sweden you; nd in many countries. We need to work with have gone much more to giving cash, which we families, and we need to work with women in a use to buy food. The WFP is the largest purchaser way that will not reinforce the breakdown of fam- of food for triangular transactions in the world. ilies and the disappearance of the men. Last year we spent US$200 million buying food in developing countries for distribution in devel- Fifth floor participant I am encouraged that the oping countries. WFP is beginning to take a more integrated For all of us in this business it is important to approach to food, agriculture, and long-term try to ensure that food is not used either to keep development. However, I found one comment people dependent or to disrupt the local market- disturbing, and that was that it seemed to be place. Sometimes the wrong kind of food or too ahright to rely on wealthy nations to send food as much food gets to a place, but it is critical for us food aid. The problem with this is that it feeds in such situations to move the food, to make a dif- into a system of chemically-intensive overpro- ference, rather tian just keeping an earlier com- duction in the United States and Europe that mitment that might now actually be harmful to destroys small farmers, rural communities, and the local economy. the environment Some sustainable agriculture To sumup,wearestronglycommittedtohelp- and farmers' groups around the world are begin- ing to improve the local economy in the country ning to look at alternative ways to provide what we are attempting to help. Our absolute priority is dearly needed in terms of food aid. This gets is to help people become self-sufficient and self- back to food security being based on food pro- reliant We want to use food as a tool, whether it duced, processed, and stored as close as possible is food that is contributed by donor countries or to where it is consumed, and this also applies to whether it is food we have purchased for con- food aid. So I wonder to what extent the WFP is sumption in the developing country. looking at ways of not necessariy providing food aid from wealthy countries, but from neighbor- Participant's Comment ing countries or regionally. Is it examining the possibility of international grain reserves that Sixth floor participant Fawzi Al-Sultan said that would be used only for humanitarian aid, and to IFAD, as a multilateral agency, has to work with which all countries could contribute, thereby goverunents, but you also said that IFAD dis- eliminating the ;ustification for overproduction? cusses projccts from the beginning with the potential beneficiaries. You have also worked in Speaker's Response the World Bank Can you offher the Bank some suggestions? The Ban lseems to have difficulty in Catherine Bertini: The food aid that we provide getting into dialogue with beneficiaries. is prcvided prirnarily, but not exclusively, by the weaLhy donor countries. Contributions come in Speaker's Response from around the world. The major donors, like the United States, the European Community, Fawzi Al-Sultan: Earlier we outlined different Australia, Japan, Canada, and others, contnbute approaches whereby the Bank could move closer either food or cash or both depending on the sit- to beneficiaries. One of them is where you repli- uation in their country; and naturally domestic cate an activity that has already worked. This can priorities, politics, and interests in the donor be done quickly- A second is subcontracting, countries govern what kind of aid they con- working through NGOs. The key is how to tribute. We and others are given the surpluses change the way we do business, not just ear- Floor Discussion 61 marking more resources, but using a much sim- pointed out, we must trust local commurities and pler project cycle, recipients to make decisions about the use of resources. We now have an opportunity for joint Caio Koch-Weset As Fawzi Al-Sultan has complementary action guided by a vision of food pointed out, there is no tradeoff between sound security, a coherent approach based on comple- macroeconomic policies and adjustment on the mentarity, on the relative strengths of the various one hand, and well-designed, targeted interven- actors, and on division of labor. tions on the other. Good macroeconomic policies A number of people have suggested that the will also produce the robust growth that gives Bantk, WAD, and some other international finan- asset and income distribution and redistribution cial institutions should do business differently, a better chance. These are complementary actions, become committed to learning the techniques not alternatives. appropriate for participation, not just consulta- We have heard a call for renewed political tion. The poor have to become our real clients. commitment on all sides, recipients and donors, This requires establishing the legal and policy to a food security vision and concept for the environment for participation, delegating local future, and we have discussed participatory control of resources to community-based organi- approaches that stress empowerment, particu- zations, having components in our lending larly of women. These participatory approadhes addressed to women that are not yust add-ons, are a necessary, though not a sufficient, condition. and encouraging self-employment by providing By participation we must mean not just hearing working capital and training in a cost-effective and consultin& but, as the NGO representatives manner. Session Four Lessons of Experience Lessons of Experience _ Muhammad Yunus It has been a memorab'le experience to participate Grameen Bank and the World Bank. Remarks I in this conference. I have been feeling outraged have been making about the World Bank and the by the behavior of the financial institutionLs way it does its business may make my friends at around the world for the past many years. the World Bank feel very unhappy. This would Coming here, hearing the Bank's vice president not surprise me at all, because that's the same way Dr. IsmailSerageldli saying on behalf of the Bank we have been feeling about the World Bank, too. that the Bank is feeling outraged by the poverty But we can work together, we can take joint action situation that exists in the world, for the first time to work out of the unhappiness on both sides and I felt slightly relieved about my own outrage. get the job done. Tfhe big job before us is the are- Now that this outrage is felt at the flagship of ation of a planet totally free from poverty. This can all financial institutions in the world, I am hoping be done if we work together single-miindedly. that something will happen to change the exist- Hunger is the worst form pf deprivation of a ing situation. Finandial institutions have treated hunmanbeing. Although inability to access food is the poor with complacency and with indiffer- the immediate cause of hunger, the real cause in ence. They have continued to operate with a caste most incidents of hunger is lack of ability to pay system that they created for miankind, categornz- for food. If we are looking for a way to end ing the poor as untouchables Of course, instead hunger, we should be looking at ways to ensure of using a rude word like "untouchkables," in their a reasonable level of income for all. Hunger is a polite language they describe the poor as "not symptom of poverty. If we can root out poverty, being creditworthy." Now, if an outrage is felt in we root out the systemidc cause of hunger. the World Bank, and that is translated inrto action in outrageously unconventional ways, maybe the Poverty Is Denial of All Human Rights caste system will be forced out of existence. Coming to this conference, I feel like I am in a In other words, hunger should not be viewed as dream hearing the Bank talldng about "con- a feeding problem. It is a much bigger problem science," not internal rates of return, not all those thLan that- I see it as a problem of untying people numbers, but "conscience." [ hope conscience has from chains and barriers created by the societies been firmly installed in. the Bank, and that con- around them. These chains and barriers have science is at the driver's seat at the Bank. I hope disabled people, crippled them, refused them Congressman Tony Hall will not have to repeat access to work and income- This situation is his hunger fast again n-ext year to convene described as poverty. Poverty is not the creation another conferentce to talk about poverty- of the poor. It is the creation of the "system," I was inivited to talk about Grameen Bank. which is made up of concepts, theoretical frame- While doing that, I end uptalWking about both works, policies, and institutions. If we can 65 66 Lessons of Experience change the system appropriately, we won't have The World Bank Needs to Be Changed poverty left on this planet. Poverty is the denial of all human rights, but For the World Bank to take poverty reduction we don't feel concerned about it because that's seriously, these two issues have to be resolved the way the system makes us look at it The pre- in favor of poverty reduction. This may require sent system promotes the look of indifference us to goback to the drawingboard, to design the toward poverty, not that of concern. More than a Bank from scratch. We shall also have to design billion people around the world are deprived of a theoretical framework in which poverty their human dignity, and the world is deprived of reduction will have a central place. We shall their creativity, ingenuity. and productivity This have to define goals in terms of measurable should be enough cause for concern for anybody. reductions of poverty each year, for each coun- Each human being is endowed with unlim- try, and set a date for freeing the world from ited potential, but the existing system allows us poverty once and for alL We shall have to design to unleash only a small part of it. The poor never methodologies and work habits that are get a chance to explore their potential at all. pro-poor, and hire people who have the ability Their potential remains unknown to them for- and commitment to do the job with all the seri- ever. The poor keep on suffering miseries and ousness it deserves. indignities all their lives because they never get Until this restructuring of the World Bank is a chance to use their capabilities to change their done, to achieve its poverty reduction goal the lives. This happens because those who design World Bank could immediately create a window the system and run the system do not care to give (like the Interational Development Association) them these chances. All they offer them are pity with an exclusive mandate, managed by people and handouts. hired exclusively to achieve the goals set in the mandate. Poverty reduction should not be mixed The World Bank's Mission up with the usual World Bank projects. The new windowshould formulate its ownbusinessprac- The World Bank was not created to end hunger in tices rather than follow the existing procedures, the world. It was created tohelp development To which are not conducive to poverty reduction the World Bank development has meant growth. efforts The hallmark of this window would be Single-mindedly it pursues growth to the best of that it would not claim to have all the answers. It its ability until it is distracted by other issues like would have the humility to learn, expenment, hunger, women, health, the environment, and so and continually seek better answers. on. It tries to adapt itself to these considerations It is very important that we change the World without giving up its basic goal. It adopts the Bank to create a poverty-free world. The World rhetoric of all these issues pretty easily and Bank is the flagship of all the development banks quickly, but it cannot easily translate that rhetoric in the world. All regional development banks, into action. Conservatism at its core makes doing specialized development bandks, and national this extremely difficult development banks follow the lead of the World Two things may have contibuted to this con- Bank. Even nonbank development institutions servatism. First, the World Bank does not have follow the World Bank without ever raising a any compulsion generated by the theoretical question. Its influence is global and total. Unless framework within which it operates. This frame- we change the course of this flagship we cannot work does not assign any urgency or primacy to change the course of the ships charting their own poverty reduction. As a consequence, Lts pro- courses behind it. nouncements about poverty reduction get trans- All these changes can come about only if we lated only through humanitarian add-ons, like find poverty totally unacceptable, if we believe safety nets and so on. Second, people who work that poverty can be eliminated at an affordable at the World Bank were not hired to eliminate cost, and if the basic technology to eliminate poverty from the world. They were chosen for poverty is known to us (and we can improve on qualities that may not have immediate relevance it as we proceed). We need unshakable political for poverty reduction. will to end poverty and hunger Yunus 67 Grameen Bank: A Bank for the Poor 98 percent Besides income-generating loans we also give housing loans. A typical housing loan is Current conceptualizations of povertjr provide US$300. We have given more than 220,000 hous- no help in the alleviation of poverty These con- ing loans so far with a perfect repayment record. ceptualizations arebased on the assertion that the Studies done on Grameen tell us that the bor- poor are responsible for their poverty They are rowers have improved their incomes, widened poorbecausetheyarelazy. Theyarepoorbecause their asset base, and moved steadily toward they lack skills, or initiative, ambition, or entre- crossing the poverty line and toward a life of dig- prenteurial qualities. They are poor because they nity and honor Studies also tell us that the nutri- suff;er from cultural badkwardness or they have tion level in Grameen families is better than in bad habits (drinking drugs, and so on). Working non-Grameen families, that child mortality is on this conceptulization we produce programs lower in Grameen fimilies than in non-Grameen and projects to make the poor give up their "bad families, and that adoption of family planning habits" and acquire "skills" and "attitudes" that practices is higher in Grameen families than in we think they should have. Obviously, we don't non-Grameen families All studies confirm the make much headway through these efforts visible empowerment of women. because of the wrongstarL All these facts only add up to say that if we In Bangladesh we run a bank for the poor We had changed our banking system the poor would think ofthe poor differently. We think theyareas have had a chance to change theirlives. If we can capable and as enterprising as anybody else in change our development banks, this would make the world. Circumstances have just pushed them poverty reduction happen much faster to the bottom of the heap. They work harder than anybodyelse Theyhavemoreskillsthantheyget We Do Our Business Differently a chance to use. With a supportive environment they can pull themselves out of the heap in no In many ways we do our business differently time. We offered tiny loans to the poorest people than other banks, indcuding the World Bank. For in one village in 1976. People showed how good one thing we don't blame our borrowers if things they were in using the money to earn income and don't go right Instead we blame ourselves. We pay the loans back. But that's not how conven- train our staff to find fault with themselves, not tional bankers look at the poor To them the poor with borrowers We tell our staff "Things will go belong to the class of untouchables. Encouraged wrong only if you don't do it right" by the results we expanded our work to two vil- We take quite a bit of time preparing our bor- lages, ten villages, one distnct, and then five dis- rowers to learn how to make decisions within tricts. At no point did we have any problem their five-member groups. We raise questions getting our money back. But all along conven- concerning their reactions should one of them fail tional bankers told us that what we were seeing to pay his or her weeldy installment We repeat was not the real thing. The "real thing' is that the the following advice many times to them so that poor have no vill to work, they have no ability, they will remember it when the occasion arises: they will never return your money. "Please never get angry with the person who can- For a while you feel confused. What is real? notpaythe istallment Please don'tputpressure What you hear about the poor or what you expe- on her to make her pay. Be a good friend, don't rience with the poor? We relied on our experi- turn into an enemy. As a good friend your first ence. We kept on expanding. Today Grameen response should be, Oh myGod, she is in trouble, Bank, the poor people's bank in Bangladesh, we must go and help her out." We advise them: operates in 34,000 villages, exactly half of all the "First find out the story behind the nonrepay- villages in Bangladesh. Grameen Bank currently ment From our experience we can tell you that lends money to 1.7 million borrowers, 94 percent most often there is a very sad story behind each of whom are women. The borrowers own the case of nonrepayment When you get the full bank. We lend more than US$30 million eadc story you'll find out how stupid it would have month in loans averaging less than US$100 each been to twist her arm to get the money. She can't The repayment record of our loans is more than pay the installment because her husband ran 68 Lessons of Expeience away with the money. As a good friend your encourage our borrowers to make their own deci- responsibility will be to go and find her husband sions. When a nervous borrower asks a Grameen and bring him back, hopefully, with the money. staff member '"Please tell me what would be a "Itmayalso happen thatyourfriend could not good business idea for me," the staff member pay the installment because the cow that she knows how to respond to the request He or she bought with the loan money died. As good is trained torespond in the followingway.'"Iam fnends you should promptly stand by her side, sorry, I am not smart enough to give you a good give her consolation and courage at this disaster. business idea. Grameen has lots of money, but no She is totally shaken by the shock of the event business ideas. If Grameen had good business You should cheer her up and prepare her to pull ideas also, do you think Grameen would have herself together. Ask Grameen to give her given the money to you? It would have used the another loan, and reschedule and convert the pre- money itself, and made more money.' vious loan into a long-term loan.' But it is quite different with the World Bank. Grameen reminds its staff that no borrower They give you money. They give you all the ideas, should, at any time, get a feeling that she has expertise, and everything else Your job is to fol- added to her misery by joinig the Grameen low the yellow lines, the green lines, the red lines, group.Weareinthebusinessofreducingpeople's read the instructions at each stop, and follow miserywe tellthem,notincreasingit Ifwearenot tlem. The World Bank is eager to assume all the capable of doing that, we should dose down our responsibilities. They don't want to leave any shop and find something else to do for a living responsibility for the borrower, except the responsibility for the failure of the project The Poor Suffer Because The World Bank approaches its borrowers of Countries' Debt Burdens through a string of powerful missions. The mis- sions are so plentiful that at no point are you too Stories that we hear about the enormous debt far away from the next World Bank mission. burden accumulated by a large number of coun- Despite all the arrogance of expertise, supervi- triesaroundtheworldandthemiseriescausedby sion, and money, the projects don't always work the structural adjustment programs imposed on out It is not fair to blamethe borrower for failure themby theWorldBank make us feel that our two of projects and make the poor suffer for it banks work quite differently. When we hear about how countries are made to pay these debts We Need the World Bank on the Side through the nose, surrendering the bulk of their of the Poor importearnings, leasing outvaluable resources at throw-away prices to make extra income, saci- Banking can be done in a humane way, in a ficng socal and environmental considerations to pro-poor way. We must make serious efforts to earn enough to repay their huge debts, we find it find this way and put it into practice. The World difficult to accept tiis as banling. Causing mis- Bank is the most powerful financial institution in ery to people and to nations cannot be banking. the world. To eliminate poverty from the surface At Grameen we follow the principle that the of the earth we must learn to bring the full force borrower knows the best Of course, the World of tiis institution behind this effort This needs to Bank follows a very different principle. We be donewith the utmosturgencyand seriousness. Discussant Remarks Sekai Holland p.. -s The Association of Women's Clubs (AWC) is household- However, persistent droughts, the forty-three years old this year Founded by a AIDS pandemic, the prolonged global recession, school teacrher, Helen Vera Mangwende, the AWC the collapse of the communist bloc inEurope cou- has 40,000 members, 80 percent of whom live in pled with the flight of aid from Africa to Eastern rural Zimbabwe, organized around 1,789 projects Europe, the nse of racism and sexism despite the and dubs. The AWCs focus is on skills training current popular positive rhetonc on the African for disadvantaged women to equip them to woman's burden on the work front, and the intro- improve themselves and the performance of their duction of the Economic Structural Adjustment duties in the household and in community devel- Programme (ESAP) are some of many factors that oppment Since 1986 the AWC has operated pro- have hindered progress. Organizations sudh as grams in the five Mozambique refugee camps to the AWC have therefore been forced to restructure teach women refugees the same courses available to meet their members' needs in this new situa- to local AWC members. Retuming refugees and tion. The AWC has also incorporated a Drought groups in other Southern African Development Preparedness,Food,Nutrition,andHealthProject Community countries have requested that the as an integral part of its new Five-Year Pro- AWC come to their countries to assist them to set gramme (1992-97) to ensure that when the next up similar development structures. The AWC and drought strikes, its members do not suffer as they women in Manica Province, Mozambique, have did the last time. one project they are now implementng jointly. The AWC's Drought Preparedness, Food, Although Zimbabwean womne were fully Nutrition, and Health Projectis a direct result of involved in the sixteer-year War of Liberation for members' experiences during the recent drought, independence, thirteen years later, while the ESAP, and the present steady spread of the Zimbabwean women have made significant legal AIDS pandemic throughout Zimbabwe. The gain, they have lost on many fronts in the house- AWC has 1,440 small agricultural projects that hold, in the community, and nationally. For include gardening, piggeries, rabbit and goat rear- example, there were women who were full cabi- mig cattle fattening, and poultry production. In net ministers in 1980, but now there are none. the new program these are divided into two cate- Women have lost their ministry, which is now a gories along with water and sanitation projects. In department in the President's Office. Women are the first category members are trained to grow no longer a pressure group in Zimbabwe. These crops and raise animals and poultry for daily losses have intensified the need for strengthening domestic consumption, and in the second they women's NGOs. develop their activities into business ventures. Since 1980 the Zimbabwean government has For example, with a US$100 donation, mem- made every effortto ensure the adoption of sound bers of the Zvishavane Agricultural Women's food security strategies to end hunger in every Training Centre bought 150 day-old chicks, feed, 69 70 Discussant RemiarJks and medication. The chickens were sold at eight vide them with skills training to equip them to weeks and some profit made. The proceeds were carry out their diverse activities. reinvested into purchasing 200 more chicks, and The experence of working irough donor- the cycle continues. In tius small way the centre financed projects and having accounting systems modestly embarked on the Food, Nutrition, and that were different for each donor led to the AWC Health Project. The Training Centre is in the dry becoming accountable to the donors and not to its belt, where such projects are part of the district's memrtbers. The AWC has now developed internal food security. The members are now developing systems to make it accountable to both members this small project into a business venture and and donors. The donors must also accept that plan to set up a modem chicken factory to thereisapolicychangebytheAWCfromthewel- slaughter and dress chickens supplied daily by fare type of project previously favored by donors each member. to the new AWC, which has a development pro- The AWC also had a successful Mother and gram whereby projects are being developed for Child Care, Family Planning Project with the specific regional, distnct, and dub siLtuations and Marie Stoppes Foundation, a British-based orga- needs over the next five years. nization, and other partners that trained 200 There is a saying in rural Zimbabwe that you locally based AWC area trainers in reproductive can tell AWC members' families because they health and child care. ThenewAWC AIDS Aware- are the healthiest and best looking, best dressed, ness Project relies on this resource. Zvishavane and best fed in the village. The homes of mem- members have long requested the setting up of a bers are the cleanestin every village. Their crops clinic focusing on AIDS, hence the "Health" in and animals are the healthiest and best looked their Food, Nutrition, and Health Project at the after. Songs and drama by village youths, male Training Centre- One hundred and eighty AWC and female, and by members all revolve around AIDS shelters are planned to provide members the importarnce and successes of dubs' work in with information and education. rural Zimbabwe. As a model for ambitious business ventures African women have always been partners in members are inspired by an AWC club in development, although they have not been Masvingo region that has built its own candle regarded as such since colonialism. For example, maling factory. This club decided to diversify when the country was occupied in 1890 by the its business mterests from handicrafts, agri- Pioneer Column, the leader of the tough resis- culture, and other activities associated with tance they faced was an African woman, women's work, and has so far succeeded in real- Nyakasikana Nehanda. When NGOs were first izing its dream- It has created jobs for its corn- started in the 1920s, women took this opportunity munity in. Masvingo. to found their own NGOs to improve society. - The AWC story is one of grassroots women's African women refused to dissolve their organi- struggle, courage, and the resilience to open up zations and chose to restructure and adjust them space for women's participation in development to changing envirornments as illustrated by the at all levels of society for more than four decades AWCs restructuring exercise. Yet these brave by strengthening the operations of their organi- efforts have not significantlyimproved women's zatiorL In reviewing the past we realized the status in Zimbabwean society- value of reinforcing the gains already made. Despite the Zimbabwean govermment's brave The AWC taught the women self-reliance efforts to explain the benefits of the ESAP, AWC mechanisms such as electing a committee and members continue to be increasingly hard hit by selecting one trainable person among them with it The average per capita income of AWC mem- leadership and literacy skills, that would be des- bers is Z$33 per year. Retrenchment of workers ignated as an area trainer and would be trained has devastated members as many are affected by each year. Its new structure is decentralized so as the loss of reaiittances from relatives working in to provide an organization for rural women run towns. The removal of subsidies without altemna- by themselves in their own viages and for their tive measures to support those least equipped to own benefit to provide an envirorunent for help themselves has brought hunger back into the women to socialize with one another, and to pro- streets and homes of Zimbabweans and has intro- Holland 71 duced the new element of street kids everywhere. grassroots level. The AWC, a community-based Girls have been removed from school and many organization, has relied on members' participa- pushed into prostitution in this AIDS pardemic to tion to produce a comprehensive, people-cen- eam income to help meet their families' needs. tered program based on the needs of 40,000 The list of negative drastic changes caused by the African women who are among the poorest of ESAP grows daily with the reintroductionof med- Zimbabwe's poor. The AWC needs seed money ical and sdhool fees. The number of Zimbabwean now for the new program to take off. The World women dying in childbirth has doubled since the Bank will hopefully listen, study, and learn from introduction of the ESAP. AWC members believe the experiences of the AWC and other NGOs and that the ESAP has prevented their new program introduce policies and programs that will have from full implementation to date. people-centered adjustment programs based on The North says that major funding should be participation of the world's poorest to improve directed to NGOs and African women at the them and their socieftes. Floor Discussion An exchange between the speakers and discussants than 80 percent. The terms for the repayment of followed. It was initiated by Ismail Serageldin's IDA credits are forty years, with ten years of commentary. grace, zero interest, and only three-quarters of 1 percent administrative charge. So exploitative Ismail Serageldin: I am surprised to hear today repayment conditions are not the Bank's mode of a description of the World Bank that is very dif- operation- ferentfrom theBank thatIknow and workin. My There is a big difference, however, between colleague here at the podium was telling me that working with governments and working directly we need to know more about how the World with the beneficiaries. The Bank is an intergov- Bank works, and my brief discussion with ernumental organization. Our mandate, our sta- Muhammad Yunus yesterday about his state- tutes, are to lend to governments for the purpose mentalso revealed thatpeoplemayneed toknow of promoting development. The examples that more about how the World Bank really works. Muhammad Yunus gave do not work well in In some ways, we are very much like dealing with governments because the people GrameenfBankiin the sense that the less you have, who have gone directly to governments and said the higher priority you get, not the more you to them, "Here, we will lend you money and you have, the more you get The latter is not the pol- know how to use it, were the commercial banks icy of the Bank. In fact, every time a country in the 1970s. They created the debt problem achieves a certain level of development, it ceases because they kept lending more and more money to be a borrower from the World Bank. We auto- to governments without any regard to how this matically say, "You now have no business with money was being used, whether to build lavish the World Bank." new capital cities or to purchase luxury items. When I first started working in the Bank we This was known as sovereign debt We all know were working on Greece, Ireland, and SpairL what happened to those loans because giving These countries all have graduated, and the directly to governments is not the same thing as Republic of Korea, Thailand, and others will giving directly to beneficaries. probably be following suit very soon. We exert Twomorepointsneedtobemadeaboutwork- ourselves for the poorest countries by our ing with and through governments. Itis our expe- unremitting efforts to obtain the concessional rience-and I am honored to say ftis in the funding they need, by mobilizing support for presence of a most notable African leader Presi- IDA. By providing IDA support, far from forcing dent Masire-that whenever a national govern- countries to pay through the nose for debt, IDA ment, a national leader, has articulated a vision, provides tremendously generous grants- The the Bank and others have tencded to support it. grant element in IDA is calculated by the Where differences have existed, they have been Development Assistance Committee at more technical differences. The success stories invari- 72 Floor Discussion 73 ably come from people who say, "'This is what we The way the World Bank does this, and I am have done. This is our program," and the Bank not saying this in a spirit of hostility, is to send a supports it. mission to find out what you, the country, needs, It is unfortunate that in many otier situations, and tells you what you need. And then it sends a government officials tend to blame the conditions project preparation mission, because you do not on outsiders. Governments do not discuss all the know how to prepare your projects, and says, contents of their programs sufficiently with their "We will do it for you." Then the preappraisal people They do nothave the kind of dialogue with mission comes, the appraisal mission comes, the civil society that is necessary to create a broadly inception mission comes. This is how the projects based consensus on "What is our situation, and are prepared. how are we going to solve it?" In such cases, when lIE were the World Bank I would say, "You do confrontedwithdifficultiesmanygovernmentoffi- your programming. If you need assistance in dals find it expedient to blame it on the Bank or on terms of money to pay for experts of your choice, the International Monetary Fund or on some inter- tell us, and we'll give it to you, but you prepare national entity, but pointing to others is not the it If you want us to come and comment on your same as dealing with their own problems- When programming, we'll do so. This is your project governments do take responsibffity, not only does You prepare it." If the government does not pre- success come to them, but the donor community pare the project, it does not own it. and everybody else will support them. I can give you an example. When we were With tremendous modesty, President Masire preparing a Grameen Bank proposal for what we taked today about what has been achieved in wanted to do in the next three years, IFAD sent Botswana. What other country has had to launch one of their staff. He introduced himself by say- special programs to feed as much as 30 to 40 per- ing '"FAD sent me to prepare your proposal." I cent of its total population? Would it have had the said, "Who is FAD to prepare our proposal? We dialogue to build the consensus with its people shall prepare our own proposal.' IFAD had not that Botswana achieved? And on top of this, even bothered to tell us that they were sending President Masire said that he wants to engage the somebody to prepare our proposal. I said, "We nongovernmental organizations and the civil don't recognize you." So the poor IFAD repre- community more actively in this debate. This is sentative was hanging around, sending faxes the kind of action that I salute and to which we back to his Rome office. Fmially, a formal letter should dedicate ourselves. came to us, and I said, "I don't recognize this let- People talk about the World Bank as if it were ter, because this letter has to come from the gov- the bogeymarL This is not true. If we listen to the eminent" So he could not do anything, and he discussions we have been having here, we could went back, but before he went back, he tried to build a better understanding of one another's explain to me, "You tell us what you want, and strengths and comparative advantages and see Il1 write the thing in the language of IFAD." I how we could help one another achieve that said, "I will write my proposal in my language. If objective to which we must all commit ourselves IFAD does not understand it, IFAD has to hire an and dedicate ourselves: the abolition of hunger in interpreter to understand what I wrote, because our lifetime. this is my proposal, and it is up to IFAD whether or not to give money." Muhammad Yunus: Concerning the difference This kind of thing happened not only once, betweenborrowers as individuals and borrowers but all the time when we created the Grameen as governments, I stil think the relationship has Bark. At that time, we were receivmg funds from a lot more similarities han dissimilarities. If I IFAD, but project execution was by the Asian were lending to a government, I would rather Development Bank. Each mission that came from wait for it to formulate what it wants the money the Asian Development Bank caused us night- for, because just as we do not tell our borrower mares. They hated us for everything we did. what she should be borrowing money fr, I Whenever we heard that the FAD tehnician was would not tell the government what it should be coming we spent sleepless nights, as if we were borrowing money for. doing something criminaL When we became a 74 Floor Discussion bank, the mission that arved in Dhaka was fui- What we are doing right now is trying to ous. They said, "You have no right to convert into understand the different policies of the different a bank." I said, "We struggled very hard to make donors. While we are doing that, the 66 workers a bank. Now you tell us that we have no right of the Association of Women's Clubs servicing Who has the right?" He said, "Without the per- 40,000 women have been working voluntarily, for mission of IFAD, you cannot do this? I said, no pay, for 12 months. I do not know how many "Who is FIAD thatI have to get their permission? times we have been told that the World Bank has If you don't want to give us the money, keep your US$10 million for women, the USAID has US$10 money. We will find other money' million for womerL I am sick and fired of hearing For another example, the World Bank pres- about how women are a priority and they ought sured the government of Bangladesh about mak- tobe supported, yetwhen we produce sometiing ing up its mind about a credit programn The the donors give us every excuse as to why they president formed a high-level committee and cannot put money into the Association of asked me to be part of it In the committee meet- Women's Clubs, and they have done so even ing I said, "In this program, 60 percent of the though we have asked them for a financial comp- money will be used for technical assistance, troller to come for two years to train us in how to which means that experts will come to look after money. Bangladesh to tell us how to run a credit program. So the point about the World Bank that I found They are also saying how they are so impressed outyesterdayis thatitis ourbank, and Ifound out by the Grameen Bank So they do not need to that the people I oughtto be fighting with are the send people from Washington or anywhere else. Zimbabwe govemment But I find that hard to We are here, and we do not need any money to believe, because the same problem that we have tell you how we run a credit program." met in trying to get a revolving fund to finance our So the minister of planring asked me to wnte 1,780 clubs must be the same problem our gov- Up the project and gave me a deadline of twenty- ermnent is facing with the World Bank in getting four hours. At a meeting the next day the com- money into Zimbabwe, because the problem in mittee reviewed the proposal and approved it, Zimbabwe is that there is no cash to do anything- but the World Bank continued to pr us. It insisted that the new foundation I had suggested, A number of participants commentedfrom thefloor; which would receive funds from the government then the speaker rsponded. and make them available to any NGO that was interested in lending money to the poor at 2 per- Participants' Comments cent interest, had to receive US$75 million from the World Bank. We said we did not need the First floor partcipant I know that Muhammad money and the World Bank insisted that we come Yunus has a wonderful story to tell about how and negotiate a US$75 million loan. Fmally, by Grameen workers find the poorest when they going to the president of the World Bank and then start a new group, and I would like to ask him to sending a negotiator to the Washington meetins, share that story with everyone here. we managed to convince the Bank that we really did not want their money for this project. This Second floor participant Statistics reveal that in was not a pleasant experience, and what Iam try- many countries persistent structural hunger is ing to say is that we can do business differently. more an urban than a rural phenomenon. I was recently in Kenya for a meeting with representa- Sekai Holland: I wanted to respond to the com- tives of the United Nations Children's Fund, and ment that we do not have enough information this is what they have found in Kenya. Yesterday about the Bank. The reason InterAction asked me I spoke with a colleague from Brazil. Brazil is 80 to come and speak is because we produced a five- percent urban, but according to his figures about year program in March this year and we came 75 percent of the hunger in Brazil is in urban here in a desperate effort to get some funding in areas. So what we are calling for is assistance to the United States. To this day we have not the urban poor to produce their own food in the received one cent from one donor. way Ruth Bamela urged us. Floor Discussion 75 Now bfore anyone thinks this is rather far- Speaker's Response fetched, a .ent survey carried out in Moscow found that two out of three families in greater Muhammad Yunus: On the question of how we Moscow are producing food. A survey in Kenya find the poorest person in the village, we follow found that three out of five families in Nairobi are two basic principles. One is that people should producing food. In most countries, urban agri- not come to the bank, but that the bank should go culture is women's agriculture rather than men's. to the people. Our staff travel around and meet I was recently in Uganda, where the women- people to talk to them about their needs. The sec- headed families leave the villages and move to ond principle is the reverse of the banking prin- the city. lnthe city they have to produce their own ciple that the more you have, the more you can food. So urban agriculture in many countries is get, so if you don't have anything, you can't get women's agriculture, anything. We say that the less you have, the Virtually no research or development assis- higher your priority. So we try to identify those tance has been devoted to urban food producers, who have nothing at all. yet we all know that within a few years half the During our staff traing we explain things in world's population will be urban. So I call to your this way. When you explain that you represent a attention the need to empower the poor in cities bank that lends money to poor people, every- and towns to achieve food security by producing body around you is likely to turn into a poor per- their own food, which means that they have to son. Anybody who says, 'I am a poor person, have access to credit, to land (which government give me the money," will surelynotbe a poorper- gels involved in), and to water This will also help son, and you can ignore that person. You should ities become more environmentally sustainable walk around and try to find out where the poor- and less polluting. est person in the village lives. If a man comes up to you and claims to be that person, accompany Thirdfloorparticipant Ihavebeenanadmirerof him to where he lives, and that way you can see GrameenBank formanyyears.Thebankdoesnot how well orbadly he lives for yoursel£ only lend money, it contributes very effectively to Once you get in the house and you find out health, nutrition, education, and welfare in gen- that he has a relatively decent house and a few eraL How does it do tlis and wlhat is the rela- possessions, then vou tell him, "Look, you say tionsiip between the bank and the govermnent you are a poor person, and maybe you are, but concerning these social services? don't you think there are people who are not as lucky as you in this village, wvho are maybe worse Fourth floor participant: We are an international off?" Then he will admit that he knows several private voluntary organization, and in the last people who are worse off thanhe is. Thenyousay, fifty years we have built up a program that is now 'Would you please accompany us to show us who a US$200 million program worldwide, but we is the poorest in your estimation?" So he becomes built it up community by community, through a guide to take us to the poorest person. And if participation. My question is, how does one you see that this is a house in name only, and that reverse the process with the Bank, whereby you all the owner and her children have is maybe a start with multimillion dollar loans and then get couple of pots and pans, a few bottles hanging to the community level? from one comer, and some rags, then you will know you have found the poorest person. Fifth floor participant The US. Congress, espe- Then you explain what Grameen does and dialy President Clinton, is in the process of slash- how she can borrow from GrameenL And after a ing foreign assistance, including foreign while, when you ask for her response, she will assistance that goes to the poorest countries and say, "Oh, no, I can't take money, and I dont need to poverty-focused programs. I understand that money. What can I do with money?" And you Muhammad Yunus met with President Clinton know nght away that she is the person you are and had an opportunity to talk with him about lookingfor.Sofromnowon,youhavetobuildup that problemrL I would be interested to hear his herconfidencebecauseshehasnotgottenanoffer impression of President Clintorns interest of help before, so naturally she is suspicious. So 76 Floor Discussion you have to build up her confidence so that one min deficiencies is by eating plenty of vegetables. day, maybe several weeks later, she will say, "Yes, So we explained this to them, they discussed it, let me try to find some friends to form a group." and they decided to grow vegetables year round, So this is how we try to find the poorest per- and Grameen took the responsibility of selling son, and the first few groups that Grameen forms vegetable seeds at cost to the borrowers. Today in a village have to be made up of the poorest peo- Grameen sells more vegetable seeds than the ple, because otherwise we will keep moving up government agency responsible for selling veg- to a higher level, and we will never come down etable seeds. to the poorest Our approach is the same whether Another example of a decision is that we shall we are in an urban or a rural area, a hill region or send our children to school and help them to earn a plain region, and the causes of poverty and enough to pay for their education. One of the hunger are the same, institutions that deprive the ideas that emerged during our discussions was poor of a fair chance at access to credit that if you plant enough vegetables so that you As for producing food, all poor people do not can sell some in the market, you can use the have to produce food as long as they have the money to buy all the stationery that your child income to buy it from a job. I do not see how a will need in schooL And growing vegetables is poor person can La engaged in food production ftm for children, who would also enjoy raising in an urban situation. chickens to earn money to pay for other necessi- In the case of social services supplied by the ties, while at the same time learning how to do government in Bangladesh, not too many of these things for themselves. services are readily available to the poor Our About the meeting with President Clinton, health service is free, because it is aimed at the one of the things we discussed was the USAID poor- However, anything that is free only serves and the foreign aid situation, and I expressed my the interests of the rich, because they have the views about foreign aid. In the foreign aid situa- power to capture it, and most of these benefits tion, the donor country writes the check, but will be in urban areas, where the powerful and gives the wrong address. In the case of the rich tend to live. If the benefit ever get to the Bangladesh, it says US$100 million to Bangladesh rural areas, the same thing will happen. So all under the assumption that Bangladesh is a poor these services like health and education do not country, so everybody there must be poor. What really go alL the way down to the poor. In happens is that the richer people in Bangladesh Grameen's case, we try a different approach to grab that check and use it for themselves. You see if these bencfi;s can be provided through the have to address the check to, say, the poorest 50 Grameen groups. percent of Bangladesh's population, so that the We have something called sixteen decisions. officials who are responsible for it now have to These are decisions that the people themselves find these people. have arrived at through intensive dialogue I also mentioned to President Clinton that within their Grameen Bank groups about their when I had visited the USAID on previous occa- problems and what they can do about them. From sions, I felt as though I had entered enemy term- these discussions over the years, we now have a tory, but this time I felt at home. Everybody was list of sixteen decisions, for example, we shall not spealing the same language that I spoke. I take any dowry at the time our sons marry and thanked him for making this happen, especially we shall not give any dowry when our daughters the change in policy on microeconomic lending. I marry. Giving a dowry is a killer for poor people said, "I wish you could use your influence to and can lead to even deeper poverty and to debt dcange the World Bank in the sar-e way." with the moneylenders. Finally, I delivered a letter from many of the Another example is that we shall grow veg- NVGOs who are represented here today that asked etables all year round, eatplenty of them, and sell him not to make the planned reduction of about the surplus. Malnutrtion is rampant in Bangla- 50 percent in aid money and poverty reduction desh, and one of the ways people can improve on funds. He read the letter and said, "I'll make sure the nutition situation and alleviate certan vita- that there is no cut.' I hope he remembers. Special Address Ending Hunger: A Global Concern Boutros Boutros-Ghali Ending Hunger: A Global Concen Boutros Boutros-Ghali The topic of this conference should not be con- related crises. India provides an example. There, troversial. No one seriously disputes that hunger an efficient system of early warning, drought is an evil that should be eradicated. Nevertheless, relief, and food distribution has been established- hunger exdsts despite our consensus that it Southem Africa gives us the example of the should not, and despite all our efforts. Many famine that did not happen. In 1992, when 18 rmil- famines still afflict our world, and in some parts lion lives were at risk, governments of the region of the world, whether harvests are good or bad, mobilized their own resources for food and emer- hundreds of millions cannot afford the food they gency aid, and the humanitarian program need. Population trends raise the specter of an launched by the United Nations (UN) attracted increase in hunger and malnutrition in the com- timely support Tragedy was avertedc ing decades. However, famines are not caused by natural We are here to discuss what should be done. disasters alone.They arise all too often from man- Before we can do that, we must be dear about the made causes. War and civil unrest are the most causes of hunger. Basically, there are three: common causes of large-scale hunger in many of • Hunger that arises during a sudden crisis the humanitarian crises in which the United * Endemic hunger that comes from poverty Nations is involved. Often entire populations are * Ilunger caused by an imbalance between displaced from their homes or seek refuge in population and food supply. neighboring countries, and sometimes famine is The world now produces enough food to feed used as a weapon in civil or ethnic conflict. its population. The problem is not simply techni- When populations are displaced or forced to caL It is a political and social problem. It is a prob- flee, food production suffers. Military operations lem of access to food supplies, of distribution, often target the most fertile areas of a country. and of entitlement. Above all, it is a problem of They leave barren desert where once green fields political will. and farms provided food for thousands. Once- The most obvious manifestation of hunger proud food producers crowd in makeshift camps comes with a sudden crisis, when large numbers awaiting international aid. However, aid is often of people are deprived of access to food. The cri- stopped by the second scourge of wan attacks on sis could be a drought or a flood, or it could be a ports and food collection centers, and on food military confrontation or a dvili war. relief workers themselves. In Somalia nearly half Weather-related famines are -iot new, but a million people, most of them children, died because of population growthi, many more people because food relief was not able to reach them. are affected today, and modem communications United Nations food convoys, as well as those of see to it that we are all made aware of each crisis nongovernmental orgariizations, were impeded more vividly than before. Many more countries by brutal gang- Anarchy reigned, and the weak today have thle capacity tc cope with weather- suffered the most. But today even the most unfair 79 80 EndingHungerA Global Concern critic of the United Nations can testify to the fact United Nations is central to this task because the nobody dies of hunger in Somalia. solutions must be comprehensive. Food security The second cause of hunger is endemic requires an across-the-board effort. Its political, poverty If hunger caused by crsis requires emer- social, economic, and technological factors must gency relief, hunger caused by poverty should be all be involved and integrated. Above alL food the target of developnment efforts. Here a great security must be guided by a political consensus deal has been achieved. Let us take heart from the on the need for action, as well as on its nature and fact that the number of hungry people in devel- scope. oping countries has been falling during the last Often, in responding to hunger the dividing fifteen years. As a proportion of the world's pop- lines between relief and development work have ulation, fewer people are hungry today than at become blurred. Some agencies are involved on any other time in history. Except in Sub-Saharan both sides, others only on one. The General Africa, nutritional trends have improved in all Assembly, in its Resolution 47/150 of March 31, regions of the world. 1993, dealt with the issue of coordination. It This brings me to the third cause of hunger: an affirmed the critical importance of establishing imbalance between food requirements and food the most effective arrangements for managmg production. Hunger is often the result of devel- and coordinating the UN response to world food opment models that tended to favor the urban and hunger problems. Within the United Nations economy and life style at the expense of the coun- Secretariat the responsibility for coordinating tryside and agricultural production. In some work on humanitarian crises rests with the cases, the priority given to the production of Department of Humanitarian Affairs; responsi- export crops to generate hard currency caused bility for developing policy and coordinating food production to decline. Because of falls in action on poverty, hunger, and malnutrition rests commodity prices and the resulting decline in with the Department forPolicy Coordination and export revenues, many countries are now vul- Sustainable Development. nerable to food shortages and crises. In situations of humanitrian crisis, the The answer is to raise agricultural productiv- United Nations system has responded to some of ity. Farmers should be given the incentive to the worst manifestations of hunger in recent invest in food production. However, attempts to years. The World Food Programme (WFP), the raise production at all costs may be counterpro- High Commissioner for Refugees, the United ductive. In many countries, food production is Nations Children's Fund (UNICEF), the United endangered because of damage to the environ- Nations Developmert Programme (UNDP), the ment. Land degradation, water scarcity, and a Food and Agriculture Organization of the UN growing vulnerability to stress are real threats to (FAO), and the World Health Organization are food security. Agricultural development should involved in this effort I pay tribute to the dedi- therefore be sustainable. cated men and women who work for the relief of Careful attention should be paid to the mar- hunger, often risking their own lives. ket for food, and hence to the price of food. To attack endemic hunger, we must address Economic reform, which includes the removal of its underlying causes. The reaL answer to hunger bureaucratic pricing mechanisms, is necessary lies in measures to eradicate poverty. The system In the short to medium term, however, the result is therefore targeting endemic poverty, low agri- can be prices higher than most people can cultural productivity, and. deficiencies in food afford. When this happens, hunger and mal- production and distribution. The FAO, the Inter- nutrition may appear among lower-income national Fund for Agrcultural Development, the groups. Adequate safety nets for the poor are, UNDP, and UNICEF, among others, are working therefore, an essential component of any eco- to these ends. World Bank lending for agriculture nomric reform program. and rural development, for antipoverty pro- Hunger is a global issue. Its existence violates grams, and for social development plays a central that most basic of human rights, the right to sur- role. vival, and it is our responsibility as an interna- The World Food Programme-the food aid tional community to guarantee that right The organization of the United Nations-provides Boutros-GOhali 81 relieffood aid to victims ofnatural and man-made * Methods of relief delivery must take into disasters. It also supplies food aid in support of account the need to ensure a continuum from development in general. During the past three relief to rehabilitation, reconstruction, and decades, the WFP has invested approximately development US$13 billion, which included more than 40 mil- *Hunger is not a single, uniform scourge. lion tonnes of food, to combat hunger and pro- Several types of hunger can be identified. One -mote economic and social development The WFP solution will not solve them all, but all of them now handles more than one-quarter of all food aid are easier to pursue in a growing economy. moved globally Most of the food is donated by * Although economic growth is necessary to industrial nations or is purchased forn develop- eradicate hunger, it is not sufficient Greater ing countries. WFP assistance is specifically tar- attention to poverty alleviation, health, educa- geted to projects assisting the poorest people in tion, and human fertility is necessary. If solu- the poorest countries, with the objective of long- tions are not to produce added hardships, term improvement in their lives, but the balance taking the social factor into account is essential. between development and emergency assistance * Many problems of hunge, including famine, has altered considerably in the past three years as require building sound institutions-particu- conflict and civil strife have inaeased throughout larly at the community level-for food produc- the world. tion, storage, and distrnbution. Food security at The United Nations Development Program is the household level must therefore become a following an integrated approach to hunger The guiding prindple for agriculturl policies and UNDP seelcs to address all aspects of develop- antipovertyprograms. ment that have a bearng on food and hunger. Action must be taken in good time All too These inlude providing drought relief, helping often the mternational communityhas reacted in disaster mitigation, halting desertification, at avery late stage, when a famie hasreached taclding crop disease, promotng agricultural catastrophic proportions. Similarly, malnutri- self-reliance, and improvig the infrastructure tion can be swifty reversed by targeting aid required to move farm products to the people. toward vulnerable groups: children, women, The focus of the UNDP's work is on building and the aged. national capacities in all these areas. Today, some 800 million people suffer from . UNICEF is another major actor in this sphere. insufficient or poor nutrition. We have the expe- At the World Summit for Children in 1990, heads nence and the resources to feed them alL We do of state and government made important not always have the political will to do so. pledges. They accepted far-reaching goals, to be However, I am most encouraged that the political achieved by the end of this decade, to reduce will is emerging. I have just received a letter from hunger drastically and to mitigate its impact on President Carlos Menem of Argentina He sug- children's nutrition. The world's children are the gests settng up an international volunteer corps world's future Today, UNICEF is carrying those for the fight against hunger This is certainly an goals forward trough its three-way concept initiative that merits serious consideration. household food security, the health envirornent Economic growth and prosperity will help and health services, and care for the well-being of eradicate hunger. the next generatiorL Peace and stability will help eradicate hunger. From the experience of the past and the im- Institution building will help eradicate hunger. proved study of the present, some lessons emerge: Targeting assistance will help eradicate hunger Coordination at the field level and at head- Sustainable development policies will help quarters is of the essence. The need for coordi- eradicate hunger. nation is particularly acute where relief We have the understanding, we have the operations are conducted in conflict situations. means, we have the tools to remove the shame of Hunger relief efforts must have safe access to hunger from the world. With political will we populations in need. can, together, do so. Session Five The Political Economy of Hunger Hunger Conference attendees included acadmnicians, development practitioners, U.S. Congressional staff, and rep resentativesfrom more than 250 NGOsffiim developing countres and the United States. 84 The Political Economy of Hunger Amartya K. Sen The modem age is not short of terrible and nasty plagued the world for a long time. Thomas happenings, but the persistence of extensive Robert Malthus' dreary pessimism was a good hunger in a world of unprecedented prosperity is example, and it was aimed at the optimism of surely one of the worst Famines visit many coun- some of the leaders of European erlightenment, tries with astonishing severity, "fierce as ten such as Condorcet and Godwin, who saw social furies, terrible as hell" (to borrow John Milton's problems as being solvable by rational delibera- words). In addition, massive endemic hunger tion and cooperative action. The rationalists did causes great misery in many parts of the world, not assume, as is sometimes suggested, that debilitating hundreds of millions and killing a unlimited population growth was no problemr sizable proportion of them with statistical regu- Rather they believed, as Condorcet put it, that larity. What mnakes this widespread hunger even "the progress of reason" will make people recog- more of a tragedy is the way we have come to nize that "if they have a duty towards those who accept and tolerate it as an integral part of the arenotyetborn,thatdutyisnottogive themexis- modern world, as if it is a tragedy that is essen- tence but to give them happiness," so that they tially unpreventable (in the way ancient Greek will on their own choose to restrain family size, tragedies were). "rather than foolishly to encumber the world with useless and wretched beings."' In contrast, Defeatism and Fear Malthus announced that 'there is no reason whatever to suppose that anything beside the dif- I shall argue that not only is the problem of world ficulty of procuring in adequate plenty the neces- hunger decisively solvable, but that one of the saries of life should either indispose this greater greatest barriers to achieving that solution lies in number of persons to marry early, or disable the widely shared skepticism about such a solu- them from rearing in health the largest families."2 tion, the defeatist and baseless fear that we shall He theorized, therefore, that misery was not succeed against so big a challenge. Jimmy inevitable, that population would be persistently Carter, who is addressing us later on in this ses- outstripping our ability to grow food, which sion, has spoken against defeatism in many would be followed by famines and disasters, fields, and I hope he will do so again in the pre- which in tum would raise death rates and returm sent--exceedingly momentous-context. One of the population to a smaller size. Jimmy Carter's illustrious predecessors, Franklin Roosevelt, had said that "the only thing we have Reasoning and Participation to fear is fear itself." That applies very well to the world's attitude tD persistent hunger. The defeatist and cynical attitude reflected by Defeatismoftenmasql,uerades as hard-headed Malthus and his followers continues to dampen realism, and the tendency to take that view has the prospects for a reasoned solution of the 85 86 The Political Economy ofHunger world's problems, and the tendency to attribute While Malthus thought that population greatness and vision to the Maltfhusian approach growth would speed up indefinitely with pros- by some contemporary authors can misguide l c perity and had to be kept downbyrnisery and the in many different fields ranging from famine compulsion of so-called "positive checks," popu- relief and economic development to population lation growth rates are now very low indeed in policy itself. The debate between the two sides countries with economic and educational devel- was not one between smugness, on the one hand, opment and remain high mainly in regions of and realism, on the other, as it is sometimes por- misery and underdevelopment, such as Sub- trayed now, but between working for a reasoned Saharan Africa and parts of south Asia Of course, and participatory solution of identified prob- many problems are still connected with popula- lems, on the one hand, and defeatism and com- tion growth, but they do not arise from issues. pulsory hardship, on the other. stressed by Malithus. The solution to them dearly It was Condorcet himself who had identified, lies in bringing reason and cooperation to bear on before Malthus, the possibility of population them including, as Condorcet had noted in an growth being too fast, and Malthus quotes immensely far-sighted reference, the exploration Condorcet in presenting his own theory of popu- of "methods of preservation and economy" lation. Where they dffered was in Condorcet's belief, and that of many other rationalist thinkers Causes of Hunger of that period such as Adam Smith, that by rea- sorting about the nature of solvable problems and As far as hunger is concerned, there was a great by understanding the appropriate actions to be deal of it (combined with widespread general undertaken to avert these problems, we can pre- deprivation) in Malthus' own times-propor- vent their occurrence, whereas Malthus saw no tionately much more than now-but Malthus' such hope and spoke instead of the need for com- opposition to relief and his hostility to Poor Laws pelled suffering on the part of much of humanity. and charitable hospitals was based on his belief Indeed, Malthus went on to integrate his pes-i m the inevitability of-and some religious merit simiism wit his ruthless religiosity nIt seems, in-sufferings of this type. While we should take however, every way probable that even the some comfort in the fact that we live in a less ter- acknowledged difficulties occasioned by the law rible and morally less harsh world, I must now of population tend rather to promote than turn to the question as to why so much hunger impede the general purpose of Providence." 'A still exists. There is something to discuss here uniform course of prosperity" would, he given the immense productive abilities and gen- asserted, "degrade" rather than "exalt the char- eral economic prosperity in the contemporary acter."3 This is a fundamentally different attitude world. from that shared by Condorcet and Smith, which I have argued elsewhere that hunger is best seeks reasoned identification of problems and seen in terms of failure of people's entitlements, voluntary action to deal with them. that is, their failure to establish command over an adequate amount of food and other necessities.5 Development and Population Growth Rates A person may have little means of commanding food if he or she has no job, no other sour -is of The history of the world since Malthus' times has income, and no social security The hunger that not given much comfort to his bleak cynicism-4 will result can coexist with a plentfu-l supply of Population has increased sharply since Malthus' food in the economy and tle markets. Famines days, and yet the availability of food per head has have occurred in situations of high food avail- grown rather than fallen, death rates have steadily ability, sometimes even peak food availability.6 declined, average longevity has expanded to lev- els that very few could enjoy inthepast, and much Essential Requirements as Condorcet expected, birth rates have come for Famine Prevention down with education (especially female educa- tion, on which Condorcet had particularly Effective famine prevention has three essential focused) and economic development aspects: scientific, economic, and political. Sen 87 Famine Prevention and Science Economics of Famine Prevention The first aspect concerns the scence" of famine, In preventing faiines, the economic policies the need to understand the real causes of famine needed to recreate the lost entitlements are not and not to identify the prospects offamine with the hard to identify. While some countries have misleading figures of food supply per head. tended to favor direct food distibution, and Famines result from particular sections of the pop- indeed a case for going that way exists in many ulation-typically some occupational groups- situations, there is the possibility of much greater losing their ability to command food, for example, use of public employment programs to generate because of loss of employment, falling real wages, income and security. By offering jobs to the desti- and so on. The Malthusian focus on food supply tuteatawageinanareathreatenedbyfarmine,the perheadcanbeverymisleadinghereingenerating potential famine victims can be empowered eco- a false sense of security based on the belief that so nomically to command food. They can then buy long as food output per head is high enough, no food inthe marketand redress theirloss of a share problemexists.Whilewehavetended todebatethe of total food availability. This can be combined merits and flaws of Malthusian pessimism, what with adding food to the market, but a more equal maybe called Maltusian optimism has kiled tail- sharing of the available food as a result of the lions. Policymakers sticldng to a false theory of newly regenerated purchasing power of the famiunes have seen no need to take preventive potential victms, m itself tends to prevent action when food output per head is high and faminesY8 Such policies have been tried out with plenty of foodis available n the market, whilelarge great success in many countries, including India. sections of the population have been forced to This kind of strategy involves a combination of staivebecauseof theirfailureto command apartof state and market intervention and is put together the food that is available? by an informed analysis of what causes famines The entitlement theory of famines does not and how reasoned public programs -can over- deny the importance of food output. Many peo- come these causes. plecommandfoodbygrowingitthemnselves,and Such programs need not be too expensive, the price at which others can buy food is favor- even for very poor countries. The proportion of ably affected by a larger food output. Scientific people threatened by famines rarely exceeds 5 advances and changes in public policy in pro- percent of the total population, and their share of moting more food production, especially in the national pie wo'uld typically be no more than regions where it has stagnated or declined such 2 or 3 percent, given that fiey are normaRly quite as Sub-Saharan Africa, canbe a significant part of poor even before the threatened famine. To recre- the protection of entitlements of potential famine ate all their lost income and to offer them their victims. Also, it is extremely important for famine normal share of the national food supply does relief to have some food available inpublic hands not, therefore, require an inordinately large for distributing among victims or for releasing in amount of economic resources, even for a poor the market to break spirals of food price rises. country. This is, of course, not an argument for One of the practical problems relief organizations other, richer countries to refrain from helping, but face today is the decline in food made available it is certainly an argument for the poor countries for international relief as a result of programmed threatened by famines not to wait helplessly for cutbacks in food production in Europe and the aid from abroad. United States. The production of food and its availability m crucial areas are indeed important Politics ofFamine Prevention for any entitlement-based analysis of famines. What that approach does deny, however, is the ln addition to the scientific and economic aspects adequacy of concentrating only on food output of famine prevention, there is also a political and availability. It is a kuller economic under- aspect. A government may be capable of under- standing of the process of commanding food on taking an effective famine prevention policy, and which sensible famine prevention policies yet not do it. A further factor, therefore, is the depend. political influences that make famine prevention 88 The Political Economy of Hunger imperative. I have tried to argue that democracy Etemal vigilance is the price not only of liberty, and a free press are great forces in that direction, but also of conquerng deprivation and hunger. because a government has to respond quickly and convincingly if it has to face re-election; if it Markets and Cooperation cannot censor out the terrible facts of starvation, disease, and death that go with famines; and if it The importance of politics opens up the possi- has to face strong criticism from opposition par- bility that prejudices of one Idnd or another can ties and newspapers.9 It is not surprising that stifle intelligent use of our available knowledge. even though famines have happened in colonial This is indeed not an empty fear Some organi- economies and in modern authontarian states, zations are well known for havng, in general, a never has a famine occurred in a democratic pro-market and a pro-capitalism bias. Our host country with a relatively free press. institution, the World Bank, has certainly had to This applies not only to the richer countries in listen to that charge (though the wisdom of my the world, but also to very poor ones that happen years tell me not to undertake a full frontal to have a democratic state and a largely uncen- examination of the truth or falsity of that charge sored press. The contrast between India's avoid- right now). Other public bodies, not to mention ance of famines since independence in 1947 (the political groups, are more inclined toward direct last famine there was in 1943, which killed public intervention whenever possible. Both between 2 and 3 million people) and the huge predilections have their pitfalls. On the one famine that occurred in China in 1958-61, which hand, recent experiences of the world provide killedbetween23and30millionpeople,isimpor- plenty of evidence of how dreadfully wrong tanttonotein thatcontexLTh.efactthatChinahas state intervention can sometimes be (th,e Khmer been otherwise much more successful than India Rouge's Cambodia is an extreme example of a in expanding health care and social security more geneal phenomenon). On the other hand, makes this contrast even more significant there is also much evidence of suffering caused Similarly, democratic Botswana and Zimbabwe by excessrve reliance on the market, by attempts had major food problems related to droughts in to "adjust' too uncompromisingly to the sup- the early 1980s, and nevertheless escaped with- posed "right prices,' and by the failure of the out any famine because of quick public action, government to do those supportive things that whereas dictatorial Sudan and Ethiopia suffered it can do very well. enormous famines during thatperiod with much What is really needed is not in general a pro- -smaller declines in food output0 mnarket or a pro-state view, but to see the two types of institutions as having different functions Particpation, Cooperation, and Criticism and ioles that can be mutually supportive and complementary. They both fit into a general view The importance of political response based on of participation and cooperation. It is not sur- democratic and pluralist critiques has to be seen prising that Condorcet and Adam Smith, who in terms of the general importance of participa- unlike Malthus argued in favor of social help in tion and cooperatior in solving the problemis of remedying individual misery, also saw the mar- hunger in the modern world. Participation has to ket as a grea area of social cooperation. Indeed, be interpreted at diffeent levels in distinct ways. it was that identification of coordinated mutual It involves working together, which can be gain through market transactions that canbe seen extremdly important, and I was happy to see that as one of Adam Smith's principal contributions to the statement of the nongovemmental organiza- the economics of market processes. The fecundity tions to this conference has emphasized the sig- of market processes in generating economic nificance of that route. But it also involves being growth and-prosperity has been widely demon- politically active in influencing public policy in strated across the world, not least in east and the right direction. Democracy and a free press southeast Asia, and more recently in China. A open the way to that, but the opportunities cre- reasoned solution of the problem of hunger in the ated have to be actually seized, and thus political modern world has to acknowledge the impor- activism is ultimtely immensely important tance of well functioning markets without deny- Sen 89 ing other forms of participation through political corresponding period, and later, somewhat pro- and democratic processes, through public action visional, statistics suggest that China's further and influencing state policies, and through coop- fall in the birth rate in very recent years (esti- eration between individuals and socal institu- mated to be 19 per 1,000 by now) has continued ions of different types. to be matched by Kerala's decining birth rate (calculated to be 18 per 1,000 by 1991). The respec- Family Planning and Compulsion tive fertility rates are similarly comparable. Kerala's achievements are not based on com- Ittumfinally to the issue of populationpolicy. The pulsory birth control or the violation of any indi- focus on cooperation in my presentaLtion may be vidual liberty to decide on these matters, but by thought to be particularly unsuited to the need thevoluntaryexerciseofthefamily'srighttofam- for forceful action to curb fast population growth ily planning. As the death rate has fallen and fam- rates in the developing world- Many people ily planning opportunities have been combined admie China's policy of compulsion in cutting with health care and the desie of Keralan down the population growth rate through such women-more educated as they are-to be less measures as the one child policy and through shaclded by continuous child rearing has become maldng basic social security and economic rights prominent, the birth rate has tumbled. What has (such as housing) conditional on following the also played a part is a general perception that the government's rules about the number of births. lowering of the birth rate is a real need of a mod- The birth rate has certinly fallen in China quite em family; a conceptualition m which public sharply. The last systematic calculation put it at education and participatory discussion have around 22 per 1,000, considerably lower than been very effective. India's 30 per 1,000, not to mention the average The argument for compulsoxy birth control figure of 38 per 1,000 of poor countries other itan relates to pessimism about voluntary restriction India and China of family size and the eagerness to institute state It is very tempting to go on from there to rec- compulsion instead. That gap can lead to deeply ommend some forceful use of family planning to disturbing results. While China has ended up deal with the population problem, but the com- with a similar birth rate to Kerala's, one result of parison requires more scrutiny. For example, the compulsion has been a much higher mortal- China's bith rate is not lower than that of the ity rate among female infants and children. The state of;Kerala in India, a sizable state of 29 mil- traditional "son preference" in China seems to lion people rather larger than Canada. There are have contributed to extreme reactions to compul- widevariations inbirth rates withinIndia related sory birth control measures, mcluding possibly to diverse social and economic factors, including infanticide, and certainly a tendency to neglect life expectancy and mortality rates, education female children, yielding higher rates of female (especially female education), health facilities, mortality among infants and childrerL No such and the availability of means of family planning tendency can be seen in Kerala, where family and medical help- Kerala does wel in all these planning has been achieved not by compulsion, respects, and the birth rate in Kerala has fallen but by participation and social reasoning.?2 sharply during the last few decades, from 44 per Gender bias is, of course, a widespread prob- 1,000 in the 1950s to 20 per 1,000 in the late 1980s. lem that applies to India as well as to China. The While Kerala's per capita income is no higher bias seems to be remarkably less in Kerala, possi- than the Indian average, it has the highest life bly because of its long history of female educa- expectancy in India (more than seventy years, a tion- In contrasting China with Kerala, it is little higher than China's) and the highest literacy instructive to note the general statistics that the rate for general and female literacy (higher than ratio of females to males in the population, which that in China as a whole and also, for the rural is substantially higher than unity in Europe or population, higher than that in every province in North America, is still as Iow as 0.94 in China China, particularly for female literacy).n The (rather like India's average of 0.93), whereas the Keralan birth rate of 20 per 1,000 is certainly no ratio in Kerala is 1.04, and even after adjustment higher thar she Chinese rate of 22 per 1,000 in the for emigration, the ratio is still much above unity, 90 The Political Economy of Hunger roughly where the European ratio would be but change" (Essay on the Principle of Population," chap. for the lasting effects of higher male deaths in XVII in the Penguin Classics Edition, 198-99). recent wars.13 3. Malthus, A Summary View of the Principle of Population, "Essay on Population," chaps. XVII and XDt, 206,209. A Concluding Remark 4. On this general issue, see Gerald Piel, Only One World (New York: Freenan, 1992). No matter whether we look at ways of prevent- 5. Amartya Sen, Poverty and Famines (Oxford, U.K: ing famines, reducing undemourishment, pro- Clarendon Press, 1981); Jean Dr&ze and Amartya Sen, moting general economic development or Hunger and PublicAction (Oxford: Clarendon Press, 1989). motmggencouragingfamilyplanning,theadvantagesOf 6 Ts occured, for example, in Bangladesh in 1974; encouraging fay planning the advantages of see Sen, PoErty and Fanmne, chap. 6. See also M. Alamgir, policies based on reasoning, participation, and Famine in South Asia (Cambridge, Mass: Oelgeschlager, cooperationwould seem to be enormous. Neither 1980); and Martin Ravallion, MAar*ts and Famines (Oxford: defeatism nor the use of forceful compulsion pro- Clarendon Pess, 1987). vides a viable alternative without the greatest of 7. Sen, Poverty and Famines; Drvze and Sen, Hunger and Public Action. 8. Dr*ze and Sen, Hunger and Public Action, especial- I have argued tat public action can help to ly chap. 8;jean Dr&ze, "Famine Prevention in India' and eradicate the dreadful and tenacious problems of -Famine Prevention in Afica," The Political Economy of starvation and hunger in the world in which we Hunger, eds. Jean Dr&ze and Amnartya Sen (Oxford: live, but that for this to happen, we must see pub- Clredon Press, 1990). c action in a broad perspective-involving not 9. Aartya Sen, Resources, Values and Development (Oxford: Blackwell, and Cambridge, Mass.: Harvard just the government, but also the pblic itlf-in Univesit Press, 1984); Dr&ze and Sen, Hunger and Pubic aRl its manifold economic, social, and political Action, N. Rarn, "An Independent Press and Anti-Hunger activities. The public is, above alL the agent of Strategies The indian Experience," The Poutial Ewnomy of change, and not a patient to be looked after and Hunger, eds. Dreze and Sen; Amartya Sen, "The ordered about. It makes a big difference how we Economics of Life and Death," Scientific Anm (May see each other- 1993). 10. Drze and Sen, Hunger and Public Adion and The Political Economy ofHunger Notes . 11. Jean Drbze and Minalini Saran, "Primary Edu- cation and Economic Development in China and India: 1. Marie Jean Antoine Nicolas de Caritat, Marquis de Overview and Two Case Studies," Discussion Paper Condorcet, Esquisse d'un Tableau Hitorique des Prog?s de DEP-47 (London: London School of Economics, 1993). !'Espnt Human (1795). For later reprints of this volume see 12. For further discussion of this issue, see Amartya Oeuvres de Condoret, vol. 6 (Paris: Firmin Didot Fr&es, Sen, "Population and Reasoned Agency: Food, Fertility 1847 and Stuttgart: Friedrich Fmrnmann Verlag, 1968). and Economic Development" (Paper presented at a con- English translation by June Barraclough, Sketch for a ference of the Beijer Institute and the Royal Swedish Historical Picture of the Progress of the Human Mind Academy of Sciences, Stockholm, November 11, 1993). (London: Weidenfeld and Nicolson, 1955). 13. The average ratio is around 1.05 in Europe and 2. T. R. Malthus, A Summary View of the Principle of North America, but this is somewhat inflated by a high- Population (London: John Murray, 1830, and Penguin er rate of male deaths in past wars. However, even Classics, 1982), 243. Elsewhere he argued that "the per- when the influence of wars is taken out, the ratio petual tendency in the race of man to increase beyond remains considerably higher than unity, and relates to the means of subsistence is one of the great general laws systematically lower age-specific death rates of females of nature which we can have no reason to expect will than males. Discussant Remarks AMarcelo Selowsky I will focus on Latin America, the region I know * And who do you ffiink benefited from the best butIbelieve the lessons from LatinAmerica underpncing and rationing of credit and for- are relevant to other countries. eign exdchange? Definitely neither poor farm- Latin America today can both improve its ers nor small entrepreneurs. economywide policies-which are fundamental * Governments expanded money-losing public for long-run growth and the sustained reduction enterprises, fmancingthembyprintingmoney of overall poverty-and simultaneotisly under- (the so-called inflation tax). And wLo paid that take radical public finance measures to immedi- tx? Obviously not the higher-income groups ately and sharply reduce the worst manifestations who could protect themseves by investing in of poverty There need be no tradeoffs here. Both foreign currencies. goals can be achieved. The issue is one of political All these policies that economic liberalization will and commitment And in addressing it, I now aims to correct neither promoted growth nor -want to make just two basic points. encouraged equitable sharing of the fruits of such My first point is simple, but still not fully growth They were politically expedient policies understood. economic liberalization and macro- that responded to short-term pressures from the econoiuc stability are essential for growth and most vocal urban groups. sustained poverty reduction. In the long run, only And this is why reform has not been easy. It growthwilleliminatepoverty. Butpasteconomic has been carried out in the fae of opposition practices have militated against growth and from interest groups that stood to profit from the poverty reduction. Let me give you some exam- rents created by rationing and the lack of compe- ples of such practices and suggest why they are tition. Thus, it is not surprising that most reform so popular among politicians- programs have been initiated by young tech- * Underpricing food was good for urban con- nocrats with little connection to old wealth. sumers, butbad for farmers and rural employ- Now let me tum to my second point, the ment It forced countries to import food at importance of refocusing the role of the state. Such higher costs. The political gains came quickly. refocusmg is crucal (a) to increase the "shared' The winners were vocal urban groups. The nature of the growth being triggered by economic costs came later and were spread among many liberalization, and (b) to reallocate public expen- but less vocal losers. ditures radicallyso as to eliminate in the short run * Industrial protection created quick urban theworst aspects of poverty. Increasing the shared employment while again taxing agriculture, nature of growth will be the natuml by-product of which had to pay for expensive domestic a modem state with modern responsibilities and industrial inputs. Again, the political payoff functions. The reformed state will no longer focus came in the short run, while the true costs were on price controls; the management of state air- only felt indirectly and in the long rurL lines; and the production by public enterprises of 91 92 Discunt Remarks fertilizers, steel, or armaments. Instead it will also have significant potential for raising tax rev- focus on property rights; rural extension; public enues by improving tax collection and eliminat- infrastructure; and investments in health, educa- mig loopholes and exemptions. Cost recovery in tion, and training. Such investments not only services usually provided fiee to middle- and accelerate the sharing of growth. Because of their high-income groups is another potential source high rates of retrn, they also accelerate growth of revenue. itself. As I said before, tiere need be no tradeoffs. What is the cost of nutrition programs well However, even shared growth will take time targeted to the most vulnerable groups? A World to benefit the most vulnerable groups. They need Bank study, Feeding Latin America's Children, to be supported now, which brings me to the which compares the experiences of 100 programs theme of this conference, hiuger, perhaps the in 19 Latin American countries, provides some most disturbing manifestation of poverty. And I information. School feeding and take-home sup- want to focus on the most shocking dimension of plementary feeding programs for preschoolers hunger. hunger and malnutrition among young can be successfully implemented for less than children. US$75 per child per year A program in a country In Latin America some 10 million preschool with a per capita annual income of US$750 could children, almost one-fifth of all children in that therefore benefit 10 percent of the population at a age group, are undemourished. The regional cost of 1 percent of COE. If per capita annual average, however, masks significant differences income were US$1,500, the cost would be one- across countries. Low-income countries such as half of 1 percent of GDP. Even if these costs were Haiti and Guatemala have an incidence of 50 percent higher, they are still small relative to preschool malnutniton in the range of 35 percent, the resources Latin American countnes could while in Chile and Costa Rica the figure is less obtain by restructuring their public sectors and t-han 5 percenL However, per capita income lev- improving their tax systems. Such targeted pro- els do not necessarily dictate malnutition levels. grams can replace the past practice of using gen- In BraziL with a per capita income significantly eral food subsidies as the vehicle to protect hgher than that of Chile and Costa Rica, 30 per- nutrition. General subsidies either misallocate cent of preschool children are malnounshed, six resources when financed by taxing farmers or are times as many as in the other two countries. The unsustainable when financed by te budget. ability and willingness of governents to reallo- To summarize and condlude: in Latin cate and target social services to the most vulner- America, protecting the health and nutritional able groups appear to be more important than a status of the most vulnerable groups is perfectly country's overall level of resources. compatible with economic liberaliztion and sta- Economic liberalization implies decontrol of bilization. However, it requires strong reform in prices and exchange rates. In the short run, some public finances and in the role of the state. The of the most vulnerable groups may gain-those state must stop subsidizing particular industries associated with agriculture and exports. Some through credit, tax exemptions, weak tax collec- may get hurt-those living in urban areas and tion, and procurement practices that unnecessar- working in sectors that contract during the ily burden public finances. 'Prestige" project adjustment But the best way to protect the wel- must be eliminated. The use of public enterpriscs fare of these groups is not by modifying or slow- and p ovincial governments as employmen- cre- ing down basic reforms essential for growth. The ation agencies has resulted in an enormous bur- appropriate vehicle is a sharp reallocation of pub- den on public finances. Reforms in this area could lic expenditures to thesegroups, a strategy that is release significant resources in relation to the particularly important for Latin America. amounts needed to finance well-targeted social In Latin America, the poorest 20 percent of the programs. An important part of the Bank's work population receives about 4 percent of GDP. Pub- today is to assist countries to restructure the state lic expenditures account for between one-quarter to release th-se :esources. and one-third of GDP. Thus, a modest realloca- However, we also need to strengthen the insti- tion of the budget can substantially increase the tutions in charge of delivering these services. In level of consumption of the poor. Many countries the past, the staff of these institutions have been SeIjSk 93 neglected. Salaries have lagged behind those in This overall strategy requires strong commit- other government agencies. This should be ments and initiatives from country leaders. reversed. These institutions should be able to International institutions can support this process attract the best managerial talent in society. Why through technical assistance and financing. But not let their salaries match those paid by the cen- progress will ultimately depend on the deteni-- tral bank or the state petroleum company? nation of governments to take decisive action. Workshop Spokesperson Remarks Deepa Narayan In trying to distill the key messages emerging would like to see would have the following dhar- from several hours of discussion in the working acteristics. They would be accountable to the group on the political economy of hunger, we poor and hungry; would look, listen, and learn; ended up posing the following question. If the would be transparent; would open up and share World Bank vision, as defined by us, was to play information; would trigger the release of funds a role in endirng hunger, what would the World dose to the ground; and would notjust count the Bank be like, what would it look like? poor, but would count on the poor, that is, bank The practical vision that we defined was on the poor for economic development to end empowerment of the poor to end hunger" Note hunger and poverty. that the word is empowerment and not participa- The last area thatwe thoughtwas importantin tion, because the hungry are not in a good place gerating the political will across countries, all to participate. Empowerment, because the pow- countries, was constituency building and organiz- erfci have assets and are not hungry, and it is the ing pro-poor constituencies in all countries, in the poor who have few assets and who are powerless. North and South. We had a lot of discussion about We were amazed at the consensus that mechansms, how this would actually happen, at emerged in the group, but we also knew that the the local level, atthe nationallevel, and atthe inter- moment we got into strategies and allocation of national level, Many issues were raised about the resources, that the apparent consensus would need to work simultaneously at different levels dissipate very quicldy. And so we also suggest The most important point is the. linkages that this goal of empowerment of the poor to end between micro and macro actions. We put the hunger be the overriding goal and the indicator community at the center of focus because large of success against which impact and performance institutions tend to focus on the macro level and be measured. forget to trace back the impact at the community We then moved on to leadership and the key level or the micro level. Both are important, and role of leadership in generating the will and the by ignoring one, action at either end is ineffective comnmitment to end hunger This has to be a two- to end hunger. pronged approach. The first is to start now. We Last is the issue of gender, and first is the issue need to create the political will to address the of gender and empowerment of women, and we problem on an urgent basis. We need to move did not know where to put itin. We felt it needed beyond being depressed and overwhelmed at the to go in everywhere, but there is also a fatigue enormity of the problem, and move to committed with gender issues. In the end we decided to put action now. However, we also recognize an a G from the top to the bottom, from the practical important second prong, which is to focus on vision down to the mechanisms and at the com- solutions that last, and this whole area has to do munity level. And then I forgot. And so my last with institutional IefornL The institutions that we message is let's not forget again. 94 : r . Workshop Spokesperson - ~ ~ Remarks-: a ; Barbara Bramble I am going to describe the practical recommen- The next step is to act on the recognition that dations that arose from this vision that Deepa has participation is the only path to development just described. We did not want to dissipate our success. That means stop temporizing and move energy and time in the workshop on the political forward with implementing the recommenda- .economy of hunger, so we focused our recom- tions of the Bank's own Participation Learning miendations on the actors that are here, the ones Group. At a minimum, many countries have that we can affect by our discussions this week, national women's organizations, and wherever and those are, of course, the World Bank and the they exist, starting now, pledge to involve them national leaders and the people of the United in all stages of Bank operations. States. So I will limit my comments to those Next in the area of trnsforming the agenda is actors- leadership, and I think that could be first or last. We took as our beginuing assumption that the This is where the emphasis needs to be. The Bank World Bank is making, here and now, a commit- has a significant influence on governments and ment to play its part as a leader in ending world on international institutions. So use it Put elimi- hunger To accomplish this goal it will have to nation of hunger at the top of the discussion make a radical transformation in at least four agenda with these bodies. areas, namely, its agenda, its competencies, its The second area of transformation is in the operating procedures, and its structure. From our Bank's own competencies. Alot of us have felt for discussion in the workshor believe that the a long time that the Bank is unsurpassed in World Bank can make the _ - rmations we amassing resources, but has some problems in recommend within the existing Artides of figuringouthowtospendthem. Sofirst,buildthe Agreement, so there is no hiding behind prob- skills of listening. As we all agree that participa- lems in that area. tion and participatory development should now First let us consider a transformation in the be the centerpieces of Bank operations, hire peo- Bank's agenda The most important point can be ple who know how to do it encapsulated in the phrase "first do no harm," Next, the skills mix has to change. Sociologists and that involves macroeconomic reforms that and anthropologists simply mustbe part of every must be designed with the poor and the hungry Bank policy review and operation- in mind. So our recommendation is for the Bank Then open the door to NGOs in reality. The to ensure that measures to compensate the poor Bank should be xequired to show evidence of the and the hungry, at the very least, are in place involvement of representatives of affected people before Bank-promoted macroeconomic reforms in all policy dialogue, sector work, and project are initiated. We believe that NGOs can be formulation. We had a specific recommendation enlisted to monitor compliance with this particu- to others from our workshop, which is to estab- lar recommendation. lish a permanent representation of southern 95 96 Workshp Spokeperson Remai* NGOs in Washington to facilitate this involve- ending it, but the one individual nation that can ment of local people and NGOs. So to the Bank, make the most difference is still the United States. when that happens, when it comes, use it. Therefore we call upon our own people and Finally in the area of competencies, there really our own leadership to do three tiings: first, sup- cannotbeanymoreexcusesforusinginternatioral port realistic assistance, that is, foreign assistance consultants when local experts are available in the form of putting people first, something we The hird area is transformation of operations. have heard a lot about in the last couple of years. To begin with, indicators of success must be It applies both at home and abmad. Now that we linked to actual impact, and we recommend that understand so many of the causes of and solu- the relevant indicators in the area of hunger are, tdons to extreme poverty and hunger quite well, quite fanlrdy, very simple: one, fewer hungry ths would be the saddest moment for the United people; two, an increase in the quantity and qual- States to cut its support for the kinds of programs ity of assets of the poor; and three, an improve- we know would help, like participatory pro- ment in the status of women. grams for women's education and healt, small- Next, the incentives for the staff must be scale credit and child nutntion, and famine linked to these indicators of success. prevention. Finally, we can see an important new role for As many of you know, current administration the Bank in supporting community capacity plans call for cutting US. development assistance building, specifically in two aspects. One, a sig- by perhaps as much as 50 percent in next year's nificant percentage of loans and credits should be budget. We, the people of this country, must channeled through decentralized relending become an organized constituency for realistic mechanisms, such as community banks and targeted assistance to eliminate hunger, or else women's banks, providing micro credit and we will forever be shelling out more moneywhen training to the very poor Two, a small amount of television pictures of famine periodicaUy shame grant funds would be appropriate, to permiit us into action that is too little and too late. NGOs to become seriously involved in research The second action is participatory research. It and debate with their national govemments and is something we all know about, and both NG0Os with the Bank but that money must be channeled and govemment bilateral programs must actu- ffitugh intermdiaries to preserve the NGOs' ally start supporting and learning from the com- autonomy. munities that we are trying to help. The fourth area of transformation is in struc- The third action is to build a sense of commu- ture, and here there probably are several other nity around this issue of hunger and poverty aspects, but we emphasize two. One is to get to Hunger realy is the same all around the know the people that you are affecting, and to us world We cannot forget that we have a Third that means establish a serious field presence. World within our own country, and the same Experts flying back and forth from Washington kinds of participatory self-help programs that we cannot accomplish the agenda tha we are setting want for our own inner city neighborhoods and out here at this conference. The second is to prac- our rural areas are exactly what we are talking tice what you preach by maldng the Bank's own about here this week. Foreign assistance actually structure more participatory and tansparent is not so very foreign after all The second major objectve of our comments So to all the NGOs here, the church groups, is aimed at the leadership and the people of the the labor groups, the universities, and others we United States, as I mentioned earlier We do rec- recommendthatwecommitourselvesheretoday ognize that many otheractors are equally respon- to maling our colleagues, our students, and our sible for the current unacceptable prevalence of members aware that the ongoing disgrace of mas- hunger and poverty, and mary others whose sive hunger all around this world of riches does actions would make an important difference in not have to continue. Floor Discussion A number of participants commented firom thefloor; Third floor participant The comment that I have then the spakr responded. to make concerns the distunction between the development of countries and the development of Partidpants' Comments their people- We have experienced in this country and we have seen around the world how nations' First floor participant: I see a real change in what economies can improve, while the well-being of the World Bank is doing now, not just in devel- their people does not A two-pronged approach, opment, but in ending poverty. My question is, a the furtherance of countries' economic develop- year from now, what will the World Bank look ment and the empowerment of people at the bot- like? What changes will it have made to make torm of the economic scale is what is required to itself a tool for ending poverty? What indicators see a world without hunger and poverty. The will it have to indicate that it has made a differ- Bank tends, Ibelieve, to look at countries first, but ence for the poor? I think it needs a shift in priorities. Second floor participant: The World Bank was Fourth floor partcipant It is time for the Bank to orginally founded to encourage and create devel- move ahead on partidpation- You have had two opmentinthedevelopingworld,andithas largely years of studying, you have done a great deal of accomplished that mission and has established a expenmentationL Now the participatory method foundation upon which to build in the next thirty should not involve consulting people about what years. It has accomplished that miission largely by bankers do, but should be about people being the operating from the top down. But from the com- principal actors in anyffiing that involves com- ments from participants, it is dear that this needs munities or households. The Bank, whidh is the tobeweddedwithabottom-upapproachbothin princpal way of getting money when bilateral terms of its projects and structural readjustments. donors are reducing their contributions, must So it seems that we are dealing with a new move ahead and mainline partcipatory activity. approach that is using the best of both worlds, the Take some risks. We will support you. There will top-down macroeconomic approadh through be some mistakes, but move ahead now. development projects wedded with the bottom- up putting people first approach, which realy Fifth floor participant My question concers a reaches the poorest of the poor, those that have practicalexpressionofparticipation. WhenIthink not benefited from the economic growth of the of the political power of participation of a last thirty years. So I look forward to what the women's handicraft collective or of a fishermen's Bank can do to use both methodologies together association, the first and the most practical place to leverage its power and its influence. where participation could occur is in local gov- 97 98 Floor Discussion ermnent, and there has not been mudh discussion and a steady-state model. I would urge the World of local government. I know that Professor Sen Bank to incorporate these ideas and use its influ- has looked a great deal at the relationship of ence to help national govemments begin the democracy and hunger, and I want to ask him absolutely vital shift in economic measures and whatheseesarethepracticalmeanswherebygov- in the system of national accounts to reflect the emnment reforms, economic reforms widtin the depletion of natural resources and the potential puleiic sector, could empower democratic partici- of human resources. Perhaps the World Bankstaff pation in local govemment how the transfer of could address what a shift to such a model of eco- resources to local governments could make a dif- nomnic accounting would have on world hunger ference in participatory and more flexible and on povet alleviation. approaches to ending hunger As Marcelo Selowsky did mention local government, I would Eighth floor participant On behalf of the south- like to ask how the World Bank has succeeded or em NGOs, I want to say that we are going to call failed in brnging about this transfer of resources upon people like Tony Hall, Jimmy Carter, and meaningful power to local government Boutros BoutrosChali, and others to work with us to hold the Bank directly accountable to the Sixth floor participant During this conference I statements of support and commitment to a dif- have heard criticism of the World Bank that sur- ferent approach that have been made here during prises me. I want to take some excepDtion, with due this conference. We are going to ask these people respect for the spirit of this audience. I refer to the and others to monitor every single step and field of nutrition. I think that the Bank has done a action that the Bank is taidng or not taking to greatjob inthis field, and thatwithoutitwewould ensure that the proposals contained in Barbara be worse off. [am not referring to the phenomenal, Bramble's report become reality. exponential increase in the amount of money Wemightwanttoexaminewhyitisiimportant being invested. I am referring to the increasing that some of these proposals come to life, and in number of mothers and children that are being this regard I want to share with you a few obser- served through goverrunments and nongovemnmen- vations about the comments from the two speak- tal organizations. In reducing malnutrtion these ers There is a constant harping on the fact that if organizations are avertmg death and improving people have more money to purchase food that health and resistance to disease. Although we will lead to an end to hunger I know you are not have learned that hunger has so many different saying that is the only thing, but to many of you faces, and therefore so many different demands, I it is probably the most important thing. We must hope that the Bank continues this trend in nutri- question this overemphasis on income being the tion that it has done so well so far Without it, the critical element, because it runs the risk of avoid- international community will never be able to ing some of the underlying factors that are being reach the goals it is currently reaching. put aside by the model of growth being perpetu- ated by the Bank, other intemational institutions, Seventh floor participant I think the World Bank and many prominent thinkers in the area of has done a lot of valuable work in the past, and I development These underlying factors include, am encouraged bywhat seems to be awillingness for example, the fact that in poor societies and to investigate new directions. But at this confer- communities, income is not only cash. Income is ence, so far we have only heard about ways to goods, income is services, income is natural improve the lives of the poor. We have had little assets, imcome is intellectual property and local or no discussion of the earths limited ability to knowledge, income is the unpaid labor of sustain this linear growth model indefinitely, women. If economists do not have tools that can especially given current levels of resource use measure these forms of income, that is no reason and waste production. Robert Ropetto at the to exclude them. What we, as NGOs, can do is to World Resources Institute, the World Bank's own contribute new tools, new skills, and new means Herman Daley, and other worthy and reputable of diagnosing the underlying causes of hunger economists have proposed other models, indud- that would allow them to be factored into the ing a drcular or cyclical model of resource use response to hunger. Floor Discussion 99 Another reason why cash income must not be about their importance. The active agency I was allowed to assume center stage in this matter is discussing in my talk is very much the local gov- because in poor societies, when money is made einment, in particular, the local govermment's available, and maybe this is true of countries in role is paramount in the spread of education, the Caribbean and Latin America more than else- especially female education. One way to under- where, money does not always get spent on food. stand why a state like Kerala could have such a Poor people spend it on televisions, video cas- completely different record from the rest of India sette recorders, designer jeans, drugs, guns, and -is to understand something about the nature of so on. So the key to eradicating hunger is not just local government there. a question of income. The issue of local government is central, even in the context of the West For example, why do Ninth floor participant: Having served on the different. European countries have different World Bank NGO Committee for five years rep- expressions against immigration, different racist resenting Interaction, I have observed that for feelings? Consider, for example, Germany, programs or new directions to take hold within France, and the United Kingdom. One of the the Bank it requires not only a strong commit- great advantages from a British point of view was ment from the top, but operational directives, the accdent of commonwealth. As soon as the which are the Bank's mechanism for establishing immigrants arrived they automatically had the new objectives. Often, the argument I have had vote, which meant they took part in local elec- with the Bank is that the staff are ahready over- tions, and that has probably been the strongest loaded, and that the focus on poverty alleviation factor operating against the growth of Nazi-like wril take care of the problem of hunger. But if you parties in the United Kingdom. lookback at the operational directive on the envi- Iquiteagreewiththegentlemanwhosaidthat ronment, it took years to drum it into the Bank's income is not all. It is not the case that all econo- process. It is going to require a commitment mists think that income is the only vanable to within the Bank that goes way beyond simply look at I would like to suggest you read an arti- having a conference, no matter how good this cle I wrote on exactLy that subject in Sientific conference is, on overcoming global hunger. American in May 1993 called "Economics of Life A second point is that we always hear that the and Death." Bank is the instrument of governments, and that I also agree with the importance of political the leadership of the Bank, as the world's largest will and the role of organizations like Grameen and most influential development instrunent, Bank. These organizations have played a key requiresittoexertmorepressure ongovernments part in the changes that are taking place in to use loans and to have more conditionality tied Bangladesh. to their loans. Unless the Bank not only recom- mits itself as the recommendations suggested, Shahid Husain: Let me underline some of the but also uses its power to bring the same force to basic points that Amartya Sen raised before I bear on the governments that it is lending to, I respond to some of the comments on the World fear that the role of NGOs and the strengthening Bankanditsprograms. Iwouldparticularlylike to of communitygroups will simplynotbe affected. stress his point that experience since Malthus shows thatthe pessimism abouttheinevitability of Tenth floor participant I have a question for hunger was unfounded, but at the same time the Amartya Sea- What is the basic message to availability of food can coexist with hunger. The nations to end hunger, because at the end of the key issue is whether the poor, the hungry, have the day a change of political will among countries' income and the resources to command food or not leadership is a must? Amartya Sen underlined the importance of both state action and the market as important Speakers' Responses ingredients in combating hunger and poverty, and particularly enlightening was his compari- Amartya Sen: One of the questions was about sonbetween the experiences of China and Kerala, local governments, and I could not agree more which showed how in the democratic, participa- 100 Floor Discussion tory and basically enlightened state of Kerala, Bank and counties have to work simultaneously indices of fertility, birthrate, literacy, longevity, on specific approaches that take economic oppor- and nutrition have been achieved that many tunitiestothelessprivilegedInthiscontextmineco- assumed could have been achieved only in a nomic adjustment programs we now routinely totalitarian and repressive society He went on incorporate measures to safeguard socal expendi- from there to advocate an increasedparticipatory tures and to increase the availability of resources approach, one that takes into account the impor- for them by stimulating and supporting the orga- tance of people not simply as subjects of govern- iizatonal change, incorporating MNOs in tlhs ment policy, but as actors and decisionmakers. work, and encouraging decentralization. About the World Bank, I am sure most of you Simultaneously, World Bank lending has are aware that it has been changing radically. We shifted toward lending forbasic education, health, do not argue that hunger and poverty can be and the environment under the conviction that solved simply by economic growth, but we do ultimately the people who suffer most because of believe that economic growth is essential, and environmental degradation are the poor and hun- that goes back to Sen's point, that unless you cre- gry. In Latin America 30 to 40 peaent of our ate jobs, you cannot achieve a sustainable reduc- resources are now going into these areas. tion of poverty and hunger. We fully agree with those who suggest that an Let us look at the World Bank¶s approadhes in institution such as the World Bank cannot func- Latin America as an example. We are worling on tion simply on the basis of disembodied eco- three or four basic approaches. Retuming to the nomic aggregates, that ultimately behind these point that without economic growth, a country economic aggregates is a variety of institutions, at cannot resolve the issues of employment, hunger, the central level, at the local level, at the non- and income, we are promoting and stimulating govermental level. If economic and sodal pro- economic growth. We have stimulated a funda- grams are going to be worthwhile and if they are mental reform of the state based on the premise going to produce results, then people must par- that a bankmrpt state cannot do much to alleviate ticipate in administeing these programs through poverlty and to create jobs. A state whose subsidies local governments and through NGOs. have little or no direct impact on the poor is not We have a mission and our mission is to aLle- equipped to alleviate poverty and reduce hunger viate poverty. However, we recognize that we are Therefore, one of the basics in our work on the but one actor in this drama, and that the princi- reformofthestateinLatinAmericahasbeentocre- pal actors are people and governments in the ate the state's capacity to redirect its resources to actual countries. While from the outside we can areas such as basic education, basic health, nutri- stimulate, we can finance, we can provide techni- tion, local work programs, and the divestment of cal assistance, we can provide some expertse, all both resources and responsibility, particularly in these efforts will be of no avail without political the social areas of local government. In countries will and participation, and that is why we are such as Argentina, Bolivia, Jamaica, and Mexico encouraged by the growing democratization of and. in the countries of Central America this the developing countries and the growing possi- approach is beginning to bear fruit bility of broader participation by the people of However, we also agree with the theis that eco- developing countnes in the development nomicgrowthbyitselfisinsufficient Therefore,the process. Special Address NGOs and International Organizations: Developing Collaboration to Fight Hunger Jimmy Carter NGOs and Intemational Organizations: Developing Collaboration toFight Hunger Jimmy Carter The sponsorship of this conference by the World not comnunicate or cooperate with other agencies Bank is truly admirable, and we at The Carter with the same goals, and at times even competed Center have found the Bank's most recent World with each other. They came to The Carter Center, Development Report, which correlates sustainable and the Task Force for Child Survival (now with developmentwithhealthandnutrition,tobepar- 'and Development" added to its name) was ticularly.innovative and helpful. formed. Within the next five years, with little I speak today not as a former president but as increase in total funding or personnel, the portion the leader of an NMO, one of hundreds that are of the world's children immunized against polio, deeply committed to resolving the problem of measles, and other common disss increased hunger. Like many NMOs, The Carter Center is from 20 to 80 percent! free to try new ideas and is eager to cooperate This has been an exciting and gratifying suc- with others. In some ways special, we have cess. The sad fact is, however, that except in the almost unequaled access to top leaders in the field of health and in the holding of elections, we news media in all nations and in the international have found it almost impossible to cooperate community, and also unlimited opportunities to with any major official agencies. Along with visit farms and villages that are afflicted with other NCOs, we have been excluded from the poverty or disease. Despite these special advan- development of team efforts to deal with hunger tages, our center is inadequate to resolve major and other crucial issues. Almost all agencies, problems when forced to work alone. including the World Bank (and perhaps even The We have many projects, several dozen in fact, Carter Center), jealously guard their turf and hes- most of which are in African nations. We know itate to admit failure or that the participation of that people suffering from starvation are more others could improve their effectiveness. likely to erupt into civil war, and that in a war- There have been many hunger conferences tomsociety starvation is almost invariably preva- like this or even on a more global scale, with lent. The afflictions feed on each other. We have admirable motives. However, grandly stated found that peace, freedom, demnocracy, human goals are rarely met, and most new agencies cre- rights (including the right to food), and the alle- ated soon fade away or, perhaps worse, become viation of human suffering are inseparable. lethargic bureauaacies that sap away and waste The next point is, perhaps, the most important scarce funding and qualified personnel. lesson to be leamed today. About eight years ago, Howcanthespecific problem of hunger among the major health organizations involved in child the poorest people be overcome? Can food pro- immunization acknowledged that despite their ductionbeincreasedintimeof war? Canpoorgov- best efforts, they were unsuccessful actng indi- emient policies be voluntarily modified? Can vidually. The World Health Organization, the technology be introduced without destroying the United Nations Children's Fund, and others did native culture? How can the importance of health 103 104 NGOs and International Organizations Developing Collaboration to Fight Hunger and nutrition be emphasized? We must find the inadequate. Nobel laureate Dr. Norman answers to these and many more questions. Borlaug says that under pressure from their Many generic problems exist. The following parent organization, the Consultative Group are about a dozen of them: on Intemational Agricultural Research, the Major agencies are reluctant to change basic international agricultural research centers are policies, even in the face of failure. Although now concentrating excessively on basic global per capita food production has research and less on applied research, and are increased, few successes have occurred in therefore less effective than they were five to Africa, where the number of hungry people, eight years ago. Partially because of this, currently around 200,000 (40 percent of the many agricultural programs in developing population), is still rising dramatically. The countries are weaker now than a decade ago, number has almost doubled in the last twenty and are getting worse. years in Africa, while remaining about the * Program managers are moved around too fre- same in the Near East and in Latin America, quently. I know of no country in which one but approaches rarely change. person is responsible for the long-term suc- * There are too many fragmented, uncoordi- cess or failure of an aid project to reduce nated, even competitive programs within a hunger given nation. Some, like Kenya, with pleasant * NGOs are mostly exduded from participation living in Nairobi, are flooded with agencies. in a comprehensive approach to alleviating President Moi told me that more -tan 200 hunger, either in its conception or its consum- were devoted to health, spealdng with con- mation. Also, coordination among the major flicting voices, and whose representatives his national and international agences is inade- health officials could rarely even meet Other quate. For instance, I understand that while nations, much more destitute, are almost the World Bank is rapidly increasing its bereft of assistance from these same agencies. emphasis on nutrition, the US. Agency for Local leaders, oft-n first or second generation International Development is relegating it to a guerrilla fighters with little training in eco- lower priority because of serious budgetary nomics, health, agriculture, long-range plan- constraints. ning, or management, are confused by the * Public interest in hunger has waned because cacophony of advice, entreaties, threats, and globally there is enough food. Inadequate offers of assistance, and tend to grasp at attention is given to the critical problem of straws. Sometimes isolated from the voices of unequal distribution of food either interna- their own people, they are induced to make tionally or wiffiin nations. poor decisions to receive desperately needed * We fail to acknowledge that disease is still the grants or loans. greatest cause of malnutrition. Increased * Programs need to be country specific and com- emphasis is needed on health and on the prehensive, linldng such disparate factors as impact of river blindn ess, Guinea worm, and soil fertility, govemment subsidy policies, other parasites on tbe production and use of food distribution systems, and import equre- nutrients. Realizing that people can eat ments. A cooperative task force approach is enough and still be malnourished, the recent needed, both among donors and within the conferences at Bellagio and Rome have recipient country, that involves official agen- emphasized the importance of such crucial cies; NGOs; and representatives of women, dietary elements as vitamin A and iodine. farmers, and envirornmentalists. This is diffi- * Protectionism in rich nations is a cruel and cult, but not impossible. most often ignored affliction on starving peo- *In the evolution of any major project, a top pri- ple. Officials of the General Agreement on ority should be the local people's develop- Tariffs and Trade estimate that the annual cost ment of the sustained capacity to meet their of protectionism is US$300 billion, compared ownneeds. with total aid levels to the Third World of * The relationship between research emphases US$55 billion. Theexportof highlysubsidized and practical needs in the developing world is and surplus grains to developing countries Carter 105 tends to kill domestic food production. Borlaug learned during the green revolution in Artificially low prices for domestic grain India and Pakistan. reduce incentives for production: in Tanzania * Top national leaders must share responsibility it now takes four times as much maize as it did with the donors. We meet personally with the just five years ago to buy a given package of nation's president and the ministers of necessary imports. finance, transportation, agriculture, health, Deforestation is rapidly becoming the most and education. A memorandum of under- critical issue in many poverty stricken areas. standing is negotiated and signed that speci- Mothers and their children need more and fies the roles that we and the local government more time each day to find enough wood for will play. On subsequent visits by me and Dr. cooking, and in many co-mmunities the last Borlaug, these officials are invited to visit the trees are disappearing as more people seek fields and test plots with us. Local people are fuel. given maximum credit for successes. * Perhaps overriding all other issues in the long * We always emphasize self-reliance. Habitually, run is population growth. Even if a country we provide only one or two agricultural could sustain a 2 percent annual increase in experts per country, while the government fur- food production, continuing starvation is nishes the dozens of extension workers who almost inevitable with a 3 percent growth in are then trined to work with assigned groups population. Women must be educated, infant of farm families. We place a time limit on our mortality must be lowered to convince par- participation, and require that farmers gradu- ents that they will have support in their old ate from the program after a couple of years to age, familyplanningprograms mustbe devel- permit our limiting the scope of our effort oped and supported by political leaders, and while extending its coverage to more and more practical contraceptives must be made avail- communities. able. There must be some better coordinated * The poor pseople are directly involved, and do worldwide approach to this highly emotional more than any others to shape the final pro- subject Because of its political sensitivity, gram in their villages.The degree of participa- NGOs might play a special leadership role in tionhas been amazing. I went to one Sudanese a global family planning effort- community south of Khartoum for a two-hour Most of you in this assembly know more sorghum production workshop, where we about the hunger issue than I do, but we at The expected about two dozen farmers. More than Carter Center have recognized the crucial prob 1,000 came, some having walced 20 miles, and lem and have tried to address it in our own way. they insisted that the session be expanded to Let me be presumptuous and describe some of an entire-day. In Benin and Togo I have visited our efforts, often in the face of previous failures farm families at harvest time who were care- and a sense of pessimism. fully weighing their maize; storing it in com- In 1986, under the tedhnical leadership of Dr. mon bins where rodent, insect, and moisture Norman Borlaug and financed by private donors, damage is minimized; and having their notably the Japan Shipbuilding Industry Founda- accounts credited. Each group had already tion,we launched a program to increase the quan- accumulated net profits of more thanUS$6,000 tity and quality of food grains produced in a few from previous crops. With this money they couatriesinAfrica.Webeganwithtwoeachinhe were renovating homes, buying oxen, and northern and southem hemispheres. Necessarily, improving their village water system. We are these efforts have been narrowly focused and lim- all concerned about employment, but we ited in scope. Since then, we have had 150,000 should remember that a successful farmer has farm families in seven nations in this prgram a good job. One Tanzanian farmer, who lived We have leamed a lot, sometimes the hard near the base of Mount Kilimanjaro, was way. Whenever possible we have combined our proud of his harvest of twentyix bags of efforts in health, nutrition, and agriculture. In maize, comparing it with his previous high general, for food production alone our approach yield of six or seven bags on the same fields. has been based on the following lessons Dr. He told me that his two sons, who had moved 106 NGOs and International Organizationw Devloping Collaboration to Fight Hunger to Dar es Salaam to seek a livelihood, would an agricultural program was initiated this now be returning to the farm. year.) I have already mentioned other results, We promised to place a heavy emphasis on and we produce complete reports annually. women. In one country, for instance, I was * By requiring maximum local responsibility, invited to visit a master farmer, honored for limiting our bureaucracy to one-agricultural twosuccessiveyearsforhisachievements.The expert in a country, using modest quarters, entire village was assembled, his two plaques and with tight control over vehicles and sup- were prominently displayed, and he wel- plies, we have had minimal costs of about comed me in a shiny black suit. During lunch, US$800,000 per year per country- served by his wife, I asked to visit his crops, Despite these positive results, expanding and he reluctantly agreed. When we arrived at them appreciably or building on them is impos- his superb field of corn, I asked him what vari- sible without greater correlation of efforts with ety he used. After some hesitation, he turned other official agencies and NGOs. Also, we know to his wife and learned the answer The same that while we are still working in a country and procedure was followed concerning fertilizer, exerting our -.iuence, the farmers are more frequency of cultivation, and other questions. likely to get good seed and proper fertilizer on It was obvious that his wife had beer. the out- time, have access to needed credit, and receive standing firmer, and tat the award winner adequate prices at harvest time. When we leave, was only familiar with the family's few cattle. conditions are likely to deteriorate. * We try to make a minimal impact on the peo- Perhaps our cumulative ideas at these ses- ple's culture. Most families still plant their sions can be tried in a few places, just to prove smail crops with sharpened sticks and culti- somewhere that they are good ones. Ethiopia, just vate with hoes. Only as a community group recovering from thirty years of war and with a are they likely to advance even to a few oxen receptive government, might be one of the good for brealdng land. places to start * We introduce advanced technology when Recognizing that development aid in general appropriate, however, with the finest seed has been relatively ineffective, United Nations available, the planting of large numbers of Secretary General Boutros-Ghali and I cochaired plants in- contour rows to control erosion, a a conference last year, sponsored by Carnegie moderate amount of the proper fertilizer, and Corporation, to assess what might be done. The adequate storage of harvested crops using World Bank and other major agencies attended, local materials. In Ghana we helped to intro- and we derived the final conclusions from them. duce Quality Protein Maize, a high-yielding One proposal that is being initiated is called a variety developed in Mexico that is tasty, has "global development initiative." First in Guyana .a good texture, and contains all the amino and then in one or two other countries, we will acids that are missing in all other maize. attempt to forge cosely coordinated task forces of Hundreds of aces have now evolved from the donors on the one hand and recipients on the few pounds first provided. It is our hope that other. The lessons learned can be applied inmany these seeds will be distributed to all nations. other countries. * Inannual meetings involving top government Hopefully, we can develop a more effective officials, agricultural experts, farmers, and way to alleviate hunger using some of thepninci- others we franklyassess our successes and fail- pies outlined by all of us here in these sessions. ures. We have seen some tangible results. On Although past experiences make me skeptical, I the average small farm, yields have been hope that this conference will result in common tripled. In Sudan, despite the ongoing war, action, and not in just another beautiful report wheat production was increased from 150,000 and the creation of another agency. We are eager tons in 1987 to 850,000 tons in 1992, our final to cooperate, adding our small capabilities to an year. In Tanzania alone, 437 extension workers overall effort Success or failure in reducing were trained, along with 32,691 farm families. hunger worldwide will depend on all of you- (Our experthere has moved to Ethiopia, where and on me. Floor Discussion A number of participants commented from the floor; where a comprehensive approach to alleviating then the speaker responded. hunger and malnutrition might be tried. Another thing is that we generally go into Participant's Comment those countries that are most in need, the ones that ate suffering more. We have programs, for First floor particpant: I would like to put in an instance, to eradicate guinea worm. Obviously appeal. Tribalism in Africa is very destructive. we do notneed to go to countries that do not have The present government in Ethiopia htas intro- guinea worm. We have never had a program in duced tribalism in a big way. I think perhaps the Botswana, by the way, because Botswana does Carter Institute should look into it very carefully not need help. Botswana, because of its inspired and find out what its impact is going to be. leadership, is able to help others. Putting pressure on people to build up. political So regardless of the political environment, we parties along tribal lines in a society that has been do try to go in and give assistance. nationaList for about 1,000 years or more is not going to help the development process.Thesigns Participant's Comment already suggest that conflict is likely, and that Ethiopia may go the way of Somalia. Second floor participant Some of the concerns expressed during the last two days revolve Speaker's Respovse around the issue of popular partcipation in the creation of macroeconomic policies, and you Jimmy Carter In our own programs in Africa alluded to the North American Free Trade and elsewhere, like the World Bank, we try to deal Agreement debate here in the United States. with the needs of the people in the country Many people feel like me that the popular will regardless of ihe ciharacter of the govenmment, or and expression of the people was not reflectedby even of how popular the government might be, Congress' passage of agreement because quite oftae, under the worst of dictator- We find this happens often with the partners ships or in the midst of a horrible war, as has been that we work with in the South. No matter what the case for the last eight years in Sudan, the peo- people do to express their will about the nisuse ple tend to suffer more than in a stable govem- of macroeconomic policies, about foreign inter- ment that has an attractive leadership. vention in economic policies, no matter what This is one reason we went into Sudan in the they do to try and speak up to protect their liveli- middle of the war to increase the production of hoods and their lives, they are not listened to. I sorghum and wheat. I hope that in the case of would like to ask you all how you will help cre- Ethiopia, whether you agree with the govern- ate an economic system that is responsive to the ment's policies or not, this mught be a situation needs of the poor. 107 108 Floor Disrussion Speaker's Response Speaker's Response Jimmy Carter. I am not qualified to answer that Jimmy Carter In one of the addresses at the question, except to say that there is no clear delin- World Conference on Human Rights in Vienna eation between microeconomnic and macroeco- last spring I emphasized this topic of female cir- nomic approaches to hunger. As former Speaker cumcision. I hope it is something that does con- of the House flp O'Neill said, all politics is locaL cern everyone here. The macroeconomic policies that are trouble- some in a country almost invariably relate to the Participant's Comment individual family and to the village, so what we do is have. our scientists work directly with the Fifth floor participant I understand that there is, extension workers and the farmers, and they on average, 0.6 acres of land per person. Yet the report directly to me and to Dr. Borlaug, inde- industrial countries have 1.1 acres per person for pendently of the government, because quite often consumption, and this could be explained by their the governrment's policies are totally contrary to meat-intensive diets. I wonder whether develop- those of the village or of individual farm families. ment will inaease a transition to a Westem diet But to answer your question, how to put and what that means for global food security. together a combined microeconomic andl macro- economic policy in the entire world to eradicate Speakers Response hungeris averychallenging issue,whichIamnot qualified to answer. Jimmy Carter: When I was president, I had a presidential task force on hunger, and one of the Participants' Comments main issues addressed at tat time was the extreme waste of energy used to transfer grain Third floor participant There has been a lot of through an animal into food for human beings. It talk about participation in the solutions for over- costs about seven times as much for a given level coming global hunger, and I would like to of nutrition if you feed a sheep or a goat or a cow encourage everyone to continue encouraging and then eat the animal. dialogue among many groups, induding talking This change you mention has happened in with young people, students, and women all over some countries, and the one with which I am most the world. I would like to take this opportunity to familiar is Egypt Egypt used to be self-sufficient invite you to the Student International Con- ingrainproductionwhenitconcentratedongrain. ference to be held next June. The theme is science A few years back I went up the Nile River, and and technology for the twenty-first century to alongside the Nle few people were growing grain meet the needs of the global community. for human consumptioiL They were growing grass to feed goats to eat or to sell. They were tak- Fourth floor participant I would like to speak ingUS.program480wheatandmakingbreadout about a rather taboo subject and encourage you of it, and sometimes they were maling bread to to speak out on it, and thatisfemale circumcision, comply with the law, but were feeding the bread which is being done to 8 million little girls across to their goats so they could eat the goat meat Not Africa. All of us in this room, men and women, only is eating red meat not good for the health, but can help stop this maiming of women across it is a tremendous waste of an arable acre of land Africa that causes unbelievable pain in childbirth or the productivity of a farmer, no matterwhat size and huma: . degradation. the landholding. This is a good point Final Session Commitment to Action Sr.~~~~~~~~~~~~~~~~~~~~~~~_ I - 5 7 4e- v Kst- K it iI?r C A , -, u ,9c,, - . nzzi3i bs --en, ~~~~ ~~vr 1,00 cojrec attendees. -__ TheAmeicn University's Bender Arena, host to over 1,000 conference attendees. 110 Needed: Food Security in a Hungry World J. Brian Atwood Overthelasttwodays,onemessagehaspermeated nal health, high rates of infant mortality. and the proceedings here: we cannot distnce ourselves the disempowerment and illiteracy of women, from the problem ofhunger Mostofus understood the very factors that drive up birth rates. this when we convened yesterday, and I hope that. * Hunger is a health issue, because persistent the news media will convey this message to the malnutrition makes people vulnerable to en- people of the United States and the citizens of the demic disease and epidemic infections, and industial world. Food is themostbasicmeasure of condemns them to unhealthy and unpxoduc- empowerment, and the hunger and-malnutrition tive lives- of perhaps a quarter of the world's population * Hunger is an envirornmental issue, because threaten the industrial world and its economies, its food insecurity drives people to explo, mar- interests, and its moral stature. ginal lands, misuse water supplies, exhaust tinder the Clinton administration, the United soils, and deforest the land. States Agency for International Development *Hunger is a democracy issue, because empty (USAID) has made the pursuit of food security a bellies make freedom difficult to sustain, and strategic goal. We believe that food insecurity is because the availability of food and access to part of a larger danger that the World Bank and it say much about the consolidation of democ- the international community must address. the racy in nations that are emerging fom state phenomenon of failed states. Societies implode domination. because of persistent poverty, because of unsus- Our approach is profoundly simple: tainable population growth, because of abuse of * We believe that prevention is the most inex- the environment, and because of autocracy and pensive investment we can make. oppression. In every one of these causal factors, * We believe that conserving and building on hunger plays a role, and its consequences must be existing economic assets and systems is seen in this larger context cheaper hian rebuilding themL - Hunger is an issue of broadly based economic * We believe that by helping people achieve growth, especially among the very poorest, food self-reliance, we can help. them unleash because when people are uncertain whether their productive energies in a hundred differ- they will eat that day, they cannot be. eco- ent ways. nomic participants, except in desperation or Progress has been made. In many parts of the as supplicants. world agriculture is being conducted in ways that * Hunger is a population issue, because as better address the quality and quantity of food pro- Lester Brown has noted, the quantity of food duced. Inanumber of nations agriculturalincomes in the world is stabilizing, but the curve of have increased, hunger and malnutrition have populationgrowthisstillgoingup.Poornutri- declined, and rural society has been stabilized. In tion is intimately connected with poor mater- Central and Eastern Europe and some of the : - ~~~~~~~~~111 112 Needed: Food Security in a Hungry World republics of the former SovietUnion the benefits of We believe that economically advanced privatization are becoming evident. In Indonesia, nations and the donor community have a respon- the Republic of Korea, and Thailand sustained sibility to strengtien agrarian economies and development has produced real food security. enhance food security in the developing world. On the subcontinent hunger remains a prob- This is in our own interest, for we can help arrest lem, but India and Bangladesh have steadily economic migration and political turmoil, help reduced the threat of famine. Progressive poll- nations achieve broad economic growth, and cre- cies, flexible planning, -and liberated market ate markets for our products. forces have given them a margin of resilience. Because food issues are critical to overall In Central Amenca high value agricultural development and often determine the extent and exports, which draw on broad participation by recurrence of famine, the USAID will structure its small farmers and business owners, are increas- programs-especially in agrarian countries that ingly significant. Their impact is evident in the are subject to famine and other disruptions of the faces of rural and urban children who are better food supply-to encourage the establishment of fed, among farmers who now have disposable flourishing agricultural sectors. We will do this incomes, and among an emerging middle class. by addressing policy issues, marketing factors, In Guatemala it was these people who under- and farming practices and technologies, the ele- stood that forward-looking policies depend on ments that determine whether local capacity will the survival of democracy, and who last summer increase or decine. came into the streets in democracts defense. Our programs will focus on the factors we In the Dominican Republic, Tanzania, and believe are pivotal in agricultural success and TIhailand simple food preservation technologies building local capacrity3 market-oriented pricing have made food rich in vitamidns available year and trading policies; access to inputs, such as round. These programs, which emphasize com- seeds, ferilizer, credit, technology, information, munity partieipation, simultaneously increase and land; access to domestic and export markets; food production, access, and consumption and crop production and marketing choices; inte- household incomes. grated crop and livestock management; progres- In southern Africa we can speak of the sivehusbandrypracticesandveterinarycare;soil 1991-92 famine that never was, the thousands of and water conservation through improved tilling lives thatwere not blighted, the tens of thousands practices, erosion planning, and control; inte- who were not displaced. We can speak of this grated pest management; reductions in the use of phantom famine not because drought did not pesticides and in fertilizer and pesticide runoff, occur-it was one of the worst of the century- efficient design and management of irrigation but because the nations of the region cooperated systems; and protection of aquifers and inte- as never before, used their particular strengths, grated water resource planning. We will continue and attended to the concerns of their neighbors. to support agricultural researk. work that has I am proud that the USAID made a contribu- had a global impact and is indispensable to devel- tion to this famine that never was. We will build oping new methods and tedhnologies that on this legacy. Yet despite the progress, more than enhance growth and food security. a billion people still go to sleep each night and Our long-term programs to build food security rise each morning with food paramount in their will address food availabifity income and distri- mninds.Abillionmoresufferfromhiddenhunger, bution issues that affect access to food; issues of the lack of sufficient vitamirns and minerals in harvesting, storage, and processing; and health their diets. Throughout the world food insecuimty and nutrition issues that affect food use and con- has a devastating effect on child mortality, pro- sumption. We wfll also continue our efforts to pro- ductivity, and economic development vide technical assistance to help countries Hunger is not an abstraction. It is a profoundly eliminate hidden hunger through the Opportuni- human issue, and it demands our attention. Food ties for Micronutrient Interventions project security and famine are two sides of the same coin, Intemational economic policy is also part of and if we are to address the issue of hunger in the this equation. We must all work together-devel- developing world, then we must focus on the fac- opment agencies, multilateral development tors that determine whether people eat or starve. banks, and international financial institutions- Atwood 113 to ensure that structural adjustment lending wherewithal of entire societies, and will tax the strategies improve food security and do not skills and resources of the donor community to undermine it. the limit Under the Clinton administration our efforts Our ultimate success will require partner- will focus on people who are mired in poverty. shipswithhostnations,withthepeopleweassist, Yesterday you heard Muhammad Yunus, presi- and with each other At this time of critical need, dent of Grameen Bank of Bangladesh, speak of the willingness of the industrial democracies to his remarkable efforts to help poor people, support and invest in foreign assistance is at a mostly women, to empower themselves econom- low point Curiously, the worst enemy faced by ically and politically. By textbook definition the donor community, by private voluntary orga- Professor Yunus's clients were destitute. Their nizations and nongovernmental organizations, primary need was the wherewithal to acquire by universities and professional associations, suffcient food, a modicum of assets, and access maybe our own parochialism: about distinctions to markets so that they could join the productive between hunger, nutrition, andhealthl about spe- economy. Grameen Barnk provided tem with an cific programs; about earmarks in appropriations answer, one whose starting point was to help bills; about organizational prerogatives; and them feed themselves and their families. A key to about prjects, programs, and grants. Last the success of Grameen Bank was its integration month, I spoke to Interaction, one of the groups of nutrition education and literacy activities. represented here today, and I told them some- Grameen Bank has had a profound influence thing that bears repeating: on the development community and on the USAID. Its participatory aspects are especially We need each other The role of foreign important to us, because the bank not only lends aid as an instment of policy will be thepoormoney,but involvesthemineveryaspect redefined this decade, and what we say of its operations. Village and neighborhood banks and do-as a community-will deter- do much the same thing, and this contnrbution to mine if our nation and its allies care to the community's sense of itself is one reason why respond to the challenge of development, these enterprises succeed in reducing extreme and can respond. So we must stand poverty and the hunger that characterizes it together, each of us here, as a community, WLth this in mind, the USAID will direct or we will find ourselves standing for resources toward microenterprise development very little . . . [And] we must stand and the instruments to support it, induding together, not only for ourselves as a com- poverty lending. We are convinced that this is an munity, but for the advocates of foreign effective way to address the overriding, daily assistance in other industrial nations, concerns ofthe verypoor,andinsodoing,tohelp who are facing precisely the same pres- them become economic and political partidc- sures that are confronting us. pants. These programs become even more effec- tive when they are linked with literacy programs Even as we strive to help feed a hungry world, and improved access to nutrition and health we must reinforce each other We must coordinate information. at every stage of the development process, assess- We will mount programs that address related ing problems and the threats they represent, shar- issues, such as infectious diseases, sanitation, ing responsibility, allocating resources, pooling water supplies, and rural institutions, because our financial resources where appropriate, shar- each of these has a measurable impact on food ing our technical resources and expertise, trans- and hunger In essence, we will follow an inte- ferring insights about methods and results, grated approach to food security collaborating at the institutional level, and com- Most important of all, we are convinced that municating in the field. our efforts must stay the course. Assistance will This is the ultimate challenge posed by a hun- be of little value if it follows development fash- gryworld to maintain the capacity to care and to ions or the political needs of the moment The act This is the ultimate challenge we confront, pursuitoffoodsecurityis along-termenterprise. and I am hopeful that for the betterment of the It involves the social, political, and economic millions who look to us now, we will meet it. Concluding Statement on Behalf of NGOs Carolyn Long Iwant to commend the Bank for its willingness to for changes in intemal operations. Is the Bank listen here to some very ftank exchanges about the now willing to accelerate dramatically the way the Bank does its business and how it should institutionalization of participatory processes change If we as NGOs had allowed ourselves to so that the poor can engage in the planning be scrutinized to-the same extent, I wonder how and design of policies, programs, and projects we would feel right now. Now that Bank staff intended to benefit them? I know that there are have listened for two days, maybe we'll do some "participation pioneers" (as I like to call then) self-examination the next time we get together As toiling valiantly within the Bank already to uhis conference ends, I ask myself, what does this alter the way in which the Bank develops pro- mean? Is this a turning point for the Woxld Bank jects and policies to incorporate participation, and for the rest of the people working to end and even to do socil mobilization to find the hunger? Or will it have been just another confer- poorest, as Dr. Yunus talked about yesterday. ance that will fade in our memories as one more These are great efforts, but such work needs to time when great ideas were proposed about erad- be institutionalized throughout the Bank so icating poverty and hunge4 but nothing really that systems change and methodologies sup- dhanged? port these efforts. The NGOs issued a press release and a state- * At present, staff are rewarded for moving ment yesterday with recommendations for the money and for getting projects approved Bank as to how it needs to dhange to put people at within certain time frames. Is the Bank now the center of the development process. rd like to willing to change the incentive system so that draw from that statement to pose five or six ques- staff are rewarded for effectively incorporat- tions about what the Bank might now be willing ing partcipatory methodology into the to do to make this a turning point, and make a design of programs, or for carrying out other couple of points about what NGOs mnight do too. innovations that refocus Bank programs and The Bank has had a leaming pmcess onpopu- operations more directly on the poor? lar partiapation for almost thiree years, with a * Currently, some very good work is being done core group of staff examining how the Bank in central vice presidencies of the Bank to might alter the way it does its business to ensure, for example, that environmental safe- involve the poor effectively in the design of guards and other sustainability factors are projects and policies. Bank staff have con- incorporated into Bank programs. But usually sulted with NGOs, they have worked with decisions about projects are madein the coun- academics who specialize in researching par- try departments, where rates of return, mov- ticipatory methods, they held a major work- ing the money, and maintaining cordial shop on the topic eighteen months ago, and relations with major borrowing govemments they have deveoped many recommendations axe more important, and much or a}l of the 114 Long 115 important innovations in programming get Now for the NGOs. We re-commit ourselves left out. Would the Bank be willing to commit today to work toward building a pro-poor con- itself to interdepartmental decisionmaking so stituency in the United States to provide the nec- that the innovations are actually approved? essary grassroots support for changes rin US. In terms of equity, although Nancy Birdsall government policies and international policies so said yesterday that in implementing the right that they work for the poor in developing coun- shared growth macroeconomic policies, "all tries and not against them. boats rise,' all boats in factdon't rise. Some lit- Second, NGOs also commit themselves today tie ones get flooded and sink, some light ones to collaborating with the World Bank in its efforts break apart, and some getstuckin the mud. To to transform its policies and operational prevent this, is the Bank willing to commit approaches to put the poor at the center of the itself to strategies to eliminate gender bias, development process. This could be in areas promote land reform and secure tenancy, whereNGOshaveparticularexpertise,suchasin reduce massive income differentials, and give participatory processes, sodal mobilization, and priority to hunger prone groups and regions? targeted interventions. * The IDA-9 agreement dits the Bank to give Brian Atwood, the new administrator of the pnonty in its allocation of assistance to coun- USAID, is in the midst of transforming that insti- tries with a demonstrated commitment to alle- tution to put people at the center of the develop- viate poverty NGOs havebeen asking the Bank ment- process, and the United Nations for four years how this commitment to poverty Development Programme, under the leadership is being defined in order to implement this of Gus Speth, is making similar important directive. Is the commitment to poverty being changes. The USAID, the United Nations defined as something other than adherence to Development Programme, the World Bank, orthodox strucural adjustment measures? NGOs, and others all need to work together to * Yesterday, Atherton Martin proposed that put poor people first NGOs from poor countries have a base in In Bill Cinton's successful campaign for the Washington where, together with Northern presidency, they had a war room run by the NGO colleagues, they would have the oppor- famous James Carville We wouldn't want a war tunity to make year-round input into the room at the Bank, but how about a pro-poor task process of transforming the Bank into an force or a campaign headquarters to end poverty instrument for development that is respon- and hunger, a group that would seize on the sive to theneeds of thepoor and hungry. Is the urgency of this need and make it happen? Bank prepared to endorse this idea and help At the beginning of this conference, Dr. makeithappen? Serageldin talked of being the new abolitionists * To eradicate poverty, there is need for struc- in the fight against hunger The old abolitionists tural adjustmnent in the North to create a level took risks, many risks, and struggled in a cam- international playing field for developing paign to end slavery in the same way that Libera- countries. Although the World Bank cannot tion groups in southern Africa and across the press such reforms, we ask that the Bank at world have struggled for freedon. If we all are to least monitor the damage done to developing be the new abolitionists, we need to work with countries by the highly selfish policies of the that same sense of urgency. NGOs are ready to United States and other Northern industrial work with the Bank, the USAID, United Nations countries, such as protectionist trade policies agencies, and others to move forward and win and agricultural subsidies. the new campaign to end poverty and hunger. Closing Remarks Ismail Serageldin Friends, it is never easy to bring to a dose some- soon.We are trying to move participationbeyond thing as nch and enridhing as the discussion we the pilot stage toward the mainstream stage. have been having together for the last two days. How do we do this dramatically? This year we Norisiteasytotrytosunmarizethevastamount have quadrupled the number of operations that of information, experience, expertise, and insight contain participatory elements and put in place that was exchanged - during these discussions. special incentives for staff in the country depart- Yet, as it is my duty, I will try to pull tog ther ments to undertake these kinds of activities. some of the strands of this dialogue into a coher- This leads naturally to the second point about ent whole. incentives for World Bank staff, which are alleged While many points were made, some of the to be biased toward moving large amounts of questions raised by our critics deserve to be money As Ilook atmy owncareerin theBank, I answered here because this is a dialogue, an somehow have never been associated withpush- enterprise in which we are involved in mutual ing large amounts of money I have been associ- learning iwhichweshare experences andopen ated with a fairly large number of controversial ourselves up to learning from each other. These issues, but I am happy to say that my career did questions were summarized by Carolyn Long in not suffer too much from that. The president of her statement, in longhand and inperson, and by the Bank has repeated time and again that he Barbara Bramble earlier wants staff to focus on issues of implementation First was the question about the leaming and quality. I do not know how to emphasize group on participation. It is not just a matter of a more forcefully the Bank's policy to staff and to learning group anymore. The Bank now has a outsiders alike than to have the president of the group of people working in a formal division of Bank dedare the policy and have senior man- the Environment Department called the Social agers reiterate it. We can only continue to repeat Policy Division, who are preparing a handbook that we attach great importance to having our for the use of staff dealing with participation staff focus on implementation, participation, and issues, similar in outline and format to the hand- quality and to keep encouraging ffiem to look at book on poverty assessments, the Poerty these issues. Reducton Handbook I want to'address another important issue that .In addition, we have been piloting a tool kit came up in Barbara Bramble's comments, for participation programs put together by Deepa whether the Bank intends to employ sociologists Narayan and Lyra Snirivasan-who says we use and anthropologists. The answer is yes, we are only northern consultants?- excellent profes- probably going to double the number of sociolo- sionals who have prepared a superb tool kit on gists and anthropologists in the Bank within the how to engage local communities in participa- next eighteen to twenty-four months. I am work- tion, and we are hoping to produce this pilot very ing with Michael Cernea, who is in my vice pres- 116 Semgeldin 117 idency and who is also the chair of the social tnies and the country staff at the Bank to look for science staffing group. That is the group that the kinds of data that they may not have looked identifies and screens candidates for potential at before. This has already generated the kind of recruitment at the Bank. Here when we refer to demand for information and questioning of pol- social scientists we mean noneconomists. He has icy that many of us in this room feel is necessary. a mandate to go out and find the best, especially Poverty assessments are the key instrument from the south. that the Bank increasingly relies on to deal with How about environmental standards and these issues. As a result of this conference, I can safeguards? Carolyn's third point and Barbara's say that in prepanrng future poverty assessments fourth-it could be called Barbara's first-is to do we will also try to focus on looking at the ques- no harm. The answer is we do have a loan com- tion of extreme poverty and hunger, not just the mittee structure through which vice presidents level of poverty, not just how many people or express their views on any operation. LWe do have households are below a certain percentile of the a review process through which different points income distribution. But how can we come to of view are expressed. But ultimately what we grips with the issue of hunger and extreme want is not a situation in which environmental poverty? For surely, the eradication of poverty is reviews are the purview of somebody and social at the heart of thinldng about the problem of reviews belong to somebody else, and if some- development, especially the worst kind of how we can obtain the seal of appmval from poverty, that which is associated with hunger. those specialists in environment and sociology, How about southern NGOs opening a repre- we can go ahead and do whatever we want sentative center in Washington? I think that it Rather, experience has shown that this bifurca- would be great Who would represent them and tion of responsibilities is not the best way to bring how they would organze their selection is really about profound institutional change in the way up to them, but we would welcome increased day-to-day business is done. Experience shows dialogue with southem NGOs. We have, in fact, that this comes about only when each person in increasingly engaged in such dialogue through the organization internalizes the issues of con- the World Bank-NGO Committee, which has an cern, not when internal inspectors assume increasingly important proportion of southern responsibility for ensuring that these issues are NGOs among the NGO representatives. I hope addressed. When an intemal inspectorate is set that we will do more of this. up, experience shows that people become inward There is more to be said. You talk about looking and learn how to address the issues to putting participation at the center of our work satisfy the inspectors instead of being outward and changing the attitudes of Bank staff and the oriented, toward their clients, and focusing on competencies of the Bank You ask whether the their cients' problems and how to solve them in Bank's management is listening to your concerns. the field. You have had in this conference the president of What we want is to ensure that the kind of dia- the Bank, who has been here almost continuously. logue that has been launched here-which I per- In fact, you have seen him coming up on the sonally and my colleagues have found so podium frequently. Even when he was not with enriclling, and wehave had alnostall the senior us in the halhe was here, because he was up on management of the Bank here-and its content the balcony waiting for one of the dignitaries, and permeates the institution to the staff who are he was listening. You have had the regional vice responsible for these operations. That is what we presidents here during the various sessions. You should be shooting for. have had in this forum the chief economist of the The next issue is how to allocate International Bank and the vice presidents in charge of human Development Association resources in propor- resources and of private sector development We tion to the country's efforts in reducing poverly. have had among us Alan Berg, our lead nutri- We are now systematically addressing this tionist; Michel Petit, the person in charge of agri- through poverty assessments, and we have set culture; and so many others from the Bank who out a new methodology to do this. Interestingly, have participated in preparing this conference it is forcing both the statistical staff in the coun- and listening. 118 Closing Remarks All of this I cite not just to prove that we have comes of this conference, he was willing to com- been listening, but more important, to satisfy you mit himself to the objectives of this conference, to about another important point, namely, is this a the dialogue that I have reaffirmed now, and he one-shot affair? I think not It is not an isolated gave us two major openings. These are not event It is not the end of the road. It is-the begin- merely a continuation of dialogue across the rning. This large an event is a milestone in what board, but a recognition that grassroots action could and should be an enriching and fulfilling and targeted intervention to the poorest of the dialogue, not for us Bank staff and management poor are important and necessary complements to be intellectually enriched, but enriched in our to the kind of broadly based action that the Bank ability to have a real impact on the reduction of takes, and that the Bank would be willing to meet poverty. We are all impoverished by the continu- with its partners, the international donor com- ation of this scourge, by the complacency that munity-which, of course, will involve the affects governments and the international com- USAID, the UNDP, and others-to explore ways munity alike, and we are all enriched by the by which we can systematically provide support reduction in poverty and hunger We would all, for such actions. as human beings, be infinitely worthier of the To show that these were notjust empty words, name if the scourge of hunger was abolished from he did something exceptional that the Bank never the face of the earth. I have said so earlier in these does, which is to make a gift. Banks make loans, proceedings, and I say so again. In the last cen- but we in this case made a gift to the Grameen ury, some people felt that slavery was uncon- Trust as a signal of the value the Bank places on scionable and unacceptable, that it degraded not the kinds of micro-credit schemes that were so just the slaves, but all those who countenanced its eloquently presented by Muhammad Yunus here continued existence. Theybelieved that the objec- yesterday. tive should be the abolition of slavery from the So we have an opening and a serious issue to face of the earth. They were caUed the abolition- discuss with the intenational community. Where ists. Today, I say that hunger is unconscionable do we go from here notjust using only the instru- and unacceptable; that it degrades not only the ments that now exist, but amending them, if nec- hKungy. who are denied the most basic of human essary, to create new ones to ensure that the kind needs, but also all who would look upon such a of action that complements the essential macro- state of affairs with complacency. Let us indeed economic and sectoral approaches by directly be the new abolitionists, who will from every reaching and empowerng the poorest of the poor platform and in every forum fight for the elimi- is maintained, and enforced, and replicated on a nation of hunger from the planet grand scale across the world. All the countries of So, what about this conference then? Is it just the world should have the support needed to an isolated event? No, this is not an isolated event launch actions that enable the poorest of the poor It is the beginning. It is an opening. What I can to pull themselves up by their bootstraps. commit myself to right now is an outline of what But I would be remiss in my summation here this process will be. Iam not going to tell you that today and in my response to the many comments in three months, in six months, or in a year from and criticisms that we heard if I did not also now something will happen. I will say that next address the question of the substance of what the week, December 8, at 2 o'dock, we have a meet- Bank normally does and what is currently part of ing of the steering committee that helped put the development paradigm. together this conference. We will meet to see We started this conference as a dialogue and wherewegofromhere. Thisimmediatefollow-up we said that there are some things on which we reflects the urgency, the sense of commitment, the will disagree and others on which we can agree. sense of dedication that has permeated all our Perhaps the time is appropriate to also take stock preparations for the conference and all our hopes of how far we have come. Where we stil disagree, and aspirations for the process that must follow it. perhaps it is appropriate for both our critics and Will there be new operings in what the Bank our friends to spend more time thinldng about does? In his opening address, the president of the the issues and educating us on their points of Bank said that without prejudging the final out- view. Serageldin 119 In terms of substance, we can do a lot right theWorldBankand soughtsupportforanutrition now with the promotion of broad-based eco- project and was told that the Bank does not have nomric growth to generate income-earning oppor- money for nutrition. I know of no country thathas turnities for the poor. This was part of Nancy come seeking the support of the World Bank for a Birdsall's message, although we got tied up with population program and was told that we do not the questions of whether macroeconomic stabi- have enough resources for that. I know of no lization has a negative impact on the urban poor country that seeks to improve its health system or or the rural poor or specific pockets of poverty, its education system and gets turned away. and whether social safetynets are anafterthought The willingness is there on our part. I invite or shlould be an integral part of the design. you to share the same concerns that you share These elements in the discussion have really with us with the governments who are our bor- taken us a bit away from the heart of the matter, rowers, as well as our shareholders. We will do which is that today, despite the fiscal crises that our part in discussion and dialogue. We will do are affecting the governments of the world, they our part when we talk about gender bias, when are the most important source by which hun- we talk about the education of girls, when we tell dreds and hundreds of millions of dollars can be the governnents in the Sahel that it is unaccept- reallocated toward the services that most benefit able that only one girl in four goes to school, that. the poor. This can be done through fiscal reform unless this situation is changed rapidly they are and the reorientation of public expenditures preparing a generation in which 75 percent of the toward those who really need it, through remov- women will be illiterate, and that something ing subsidies from fancy hospitals and university must be done now to avoid that. structures, as we have seen in some places, to pro- We will do our part, but we invite you to do vide basic textbooks in primary schools or fund- yours, so that collectively we can really build the ing for preventive medicine for health care units. broad national consensus that translates into The UNDP's Human Development Report has esti- action. I do not mean merely the direct action of mated that this kind of realignment is of great a project here and a project there by this NGO or importance in meeting the needs of the poor and that NGO, important as that may be, or this loan the disadvantaged. There is tremendous room to or that loan that may be funded by the World reallocate within g&,rarnments' public expendi- Bank or by the Inter-American Development ture frameworks. Bank or by the African Development Bank or by To realize this potential,Icansay thattheBank some bilateral agency, but to bring about pro- will increasingly use the instrument of public found change in govemments' spending pat- expenditure reviews and public investment terns, which is the key by which broad-based reviews and emphasize the centrality of the needs changes occur. of the poor to country decisionmakers. Education, Why did Botswana succeed? Because it had health care, social services, and nutrition are all revenues from mineral resources? So do many essential ingredients of the package that must be other countries. It was the use to which the gov- emphasized. This reorientation of public expen- emient put those resources that made aU the dif- ditures will be away from militarism and fancy ference: achieving universal primary education, prestige projects-the creation of a new capital avoiding hunger and famine despite the city, a monument to the party, and other su'lh droughts that hit that country with regular sever- ways of public spending-because, after all, the ity. Since 1966 when the country gained its inde- money for public spending comes from taxing the pendence it has been hit by these severe people of the country, and most of the time those droughts. Botswana succeeded because its gov- who get taxed are the poor and the lower-middle emient adopted a pattern of spending, a pattern dass. The elite, we know, most of the time escape of priorities, that others could supporL taxation, whatever the books say about tax rates. I was teasmg former President Carter when we We also want to say that the resources of the were outside and he was talking about choosing World Bank will be made available for the kinds Ethiopia or some oiher country for this more har- of priorities that are at the heart of your concerns monized approach to assistance. Isaid, "I wish you and ours. I know of no country that has come to would choose Botswana. The president is right 120 Closing Remarks here and we could agree and I am sure he would is a dear expectation that our work in these areas have no difficulty implementing the program." will be intensified. President Carter said, "Yes, butthe problem is that Nevertheless, differences still abound, espe- Botswana is not the one that needs our help." cially on the issues of structural adjustment, trade, Most important, much common ground was and exports. But most important, differences still identified between the Bank and its critics. The exist in the link between the macro and the micro, following points were the basis of an emerging the role of governrments, and the appropriate bal- consensus: ance between regulation and incentives. The problem of hunger was closely identified Indeed, this is part of what I am tafldng about. with extreme poverty rather than with the The-government's attitude is at the center of how production of food, although it was largely public spending is configured and how priorities understood that we could not be complacent are set in the country. Where the government is about the necessary support to agricultural responsive to its people's needs and is accountable research, a sine qua non to maintain the high tothem,theprioritiesarelikelytobetherightones, level of food production in the future. Thus and we should all be working in support of them. the attack on hunger is an integral part of an Having said that, I do not deny that the Bank a -§0overty strategy. has a role to play, through its advocacy and ana- ne promotion of broad-based'development lytical functions, in influencing govermnent deci- is recognized as the essential condition for sions and influencing the attitude of the world reducing poverty on a large scale. This reaf- about where the priorities lie. And I can assure firmed the importance of sound macroeco- you, all of you here tocday, that we will take these nomic management, labor-intensive growth, responsibilities very seriously, that we will be and sound investments in human resource engaged in promoting income-earning opportu- development, with a special emphasis on nities for the poor and in removing anti-employ- addressing issues of gender equity. mentbiases in trade policy or market regulations, * In addition, there is a recognition that com- in looking at tax regimes and at financial sector plementary action at the grassroots level to policies. We will be involved in all these things reach the poorest of the poor is essential. Such and stake out our positions with a view to bring- targeted interventions, however, should be ing about changes in the lives of the poor and the channeled toward production and not just destitute, the vulnerable and the hungry. consumption. Micro-credit schemes were A friend in Africa told me that"over the last ten identified as one of the key elements in such years the World Bank has made the private sector interventions. respectable in Africa, because ten years ago we * The link between health and hunger is now used to consider them as pirates, and now we better understood (a point that was well artic- think of them as business people. We used to think ulated in our World Development Report 1993), of them as exploiters, but now we think of them as and accordingly, certain types of interven- investors.' That has taken ten years of discussion. tions, including vitamin A, iodine, and iron I think that we have a similar task in changing supplementation programs, which cost very the priorities and the focus, not just on poverty, little and have a profound inpact, should be but on extreme poverty and the issue of hunger, promoted. and I sincerely hope that, with your help, it will * Policies that increase the access of the poor to not take ten years to change those attitudes. assets and to the factors such as credit and Beyond these two key points, the follow-up in extension, which increase the returns to assets terms of substance is really just to intensify some held by the poor, should be promoted. This areas of current Bank work that are part of the will, in certain cases, involve the issue of land emerging consensus I described. This would reformL include the following points; All these points are within the Bank's current * Poverty assessments should address hunger framework for poverty reduction, and therefore issues more explicitly in relation to the ultra- do not constitute departures from the existing poor and the vulnerable, especially during policies and practices of the Bank, although there periods of transition. Serigelin i21 * The Bank should support some actions that reach those who are in most severe need, espe- are of immediate applicability and proven cially in hunger and food insecurity situations. effectiveness. Such support may be just by Many methods are in place; and we have heard insisting on their importance in the context of about many of them today. Some are more effec- public expenditure reviews, consultative tive and some are less costly than others. Here, we groups, and other forums, and does not nec- need to find the most cost-effective schemes pos- essarily imply that we should finance such sible. We need to explore such schemes and apply activities ourselves. These actions include: them wherever they are needed. * Cheap direct actions: vitamin A and iodine We need to make better use of food -aid, an supplements, immunization against cholera important sourceof supportfrom many countries and other childhood diseases, and treatment but one that, where inappropriately used, brings of parasites. All of these are simple, low-cost, about very sad results in undermining local food and affordable, even in the most constrained production and local farmer production. We need budget situations. to make sure that, in addition to food aid, the . Other direct actions: give food coupons to Bank supports ways of improving incomes for children and mothers at health clinics, mone- the poor, including the targeting of incomes for tize food aid and use the revenue for targeted the poor. feeding programs, and mtroduce food-for- We know that improving incomes forte poor work schemes. and hungry works in a number of ways, the most - Protecting the poor during structural adjust- categorical and direct of which is that those who ment: Maintain social expenditures, improve have no assets should have access to assets. the composition of social expenditures to tar- Where there is a land distribution problem, as get the poor and the very poor better, and exists in many countries, we should be collec- introduce public works job programs (for tively willing to tadcle the issue of land reform. it example, such as the Maharashtra Employ- is not an easy issue. Politically it has proven ment Guarantee Scheme). extremely difficult to do. Most of us here are - Targeted schemes to raise incomes: reduce active in the United States. We know that where regulatory constraints to the activities of the rent control has been imposed it has been very informal sector, promote better access to micro difficult to remove. Where strong, politically credit, promote better natural resources man- vested interests support existing legislation, it agement, and promote agricultural research stays in place. En the same way land reform is a targeted on the needs of small farmers. difficult task, but I believe the time has come for All these points are already being tackled suc- all of us to tackle it. cessfully in various Bank-financed operations, Access to assets for those who have no assets and should be more recognized as the best prac- also means access to the factors that increase the tices that should be mainstreamed. return on assets that are held by the poor. In the Some of these are very simple, basic things, case of rural farmers, or even of farm labor, as we and there is no excuse today why they should not discussed with Muhammad Yunus in connection be done immediately. I can tell you that the Bank with Grameen Bank, it means access to credit. But will systematically look at that in every country -access to assets is also access to extension ser- with which we speak. And when a country sub- vices, and we need to address that as well. We mits a program for us to fund, we will ask, "What need to address access Lo fertilizers and seeds and are you doing about these interventions?" I think make sure that all these activities are possible to I can vouch for the fact that none of my colleagues increase the return on assets. will accept an answer, "We haven't got enough For most of the poor, the biggest asset they have money for it." For the basic, simple actions is their own labor, and therefore, the returns on money is not an acceptable excuse. labor have to be maximized. These returns are But beyond the simple, basic, and cheap things maximized by mvestment in nutrition; in reduc- that must be done, some of the more complicated tion of hunger; in improvement of health, educa- schemes I just mentioned, some of the more tion, and traininm and in the opening of expensive and direct actions, are also needed to opportunities for self-employment trough the 122 Closing Remarks respect that must be given to the informal sector That, my friends, was twenty years ago, not now, that functions in most countries, and is unfortu- not in response to criticism from the outside, but nately criminalized by the legislation of most coun- in the Bank's continuing efforts always to explore tries. We need to tackle this set of issues as welL the most ngorous ways of dealing with the most We need equally to recognize that technology difficult problems. is critical, and I was happy to hear Brian Atwood So social weights were intended to treat affirm support for agricultural research Because income to the poor as more important than while we cannot be and should not be complacent income to te rich. It is not equal, and it should not about the problem and the presence of hunger and be equal, and in our view, both twenty years ago poverty, we should also not be complacent about and today, we have to take the income distribu- the continued trends in agricultural research that tion aspect into account Iherefore, I would be have made food abundant in the world today. wifling on behalf of the Bank to say that yes, we What we need to do is to continue the kind of pre- believe that sound macroeconomic policies are ventive investment-investment in research that essential, we believe that, on balance, things are is sustained, nonpolitical, not subject to fads, not improving in the aggregate, but I also accept the subject to year in/year out changes-that has point of view-the experience of the NGOs-that been the key to the success of the Consultative despite that fact, conditions in some, possibly Group on Intemational Agricultural Research, many, places are not only not improving, but they whi was able to pursue increases in production may even be getting worse. systematically, receiving supportyear in and year The question then becomes how we can work out for manyyears. So there is a set of actions that together to maintain the gain to the aggregate and must be carried out, and again it will be difficult remove the loss to the specific. This is a real chal- to mobilize the political support for them, but that lenge. It is a challenge that we will have to address is one of the things that we need to do. together to find ways of integrating the micaoeco- Let me then go back from these actions to the nomic and the macroeconomic. In this sense we most controversial of all, and I will not duck it, have much to learn from everybody, and I hope which is the issue of structural adjustment that we will learn that in the coming parts of this Cearly we have a disagreement There are dif- dialogue. ferent views of what happens under adjustment, Outside this conference and in parallel with it, and I suspect that part of that difference arses we had a separate panel composed of Monsignor because while things may-I emphasize the Jorge MeFla, a representative of the Holy See and word may-be improving in the aggregate, it is the vice president of the Commission on Justice quite possible that they are getting worse for and Peace of the Vatican; David Beckmann, pres- some people, and getting much worse for some ident of Bread for the World; myself, and initially, people in particular locations. This in and of itself Ibrahima Fall, the United Nations assistant secre- should be inadmissible. tary general for human rights, who, although he Itis not enough to say that, on average, condi- was detained at the last minute and could not tons are getting better. It is important that we say come personally, sent a text The title of that panel that conditions are getting better for everybody, was "he Ethical Dimensions of Global Hunger;" and that particularly they are getting better for because we wanted to address hunger not just as those who are the poorest of the poor. That has to a technical issue, but as a human rights issue, as be the stand of the new abolitionist! It makes sense an issue of ethics, as an issue of public morality from an ethical point of view, as well as from a (see Associated Event section). welfare point of view. Strangely enough, for some Frarndy, I feel so strongly about this that I will people here, I will even mention something that add the papers from that panel to the proceedings was done in the World Bank almost twenty years we will have of this conference. Even though the ago, the- Bank's much attacked methodology of proceedings are not the main outcome of this con- benefit-cost analysis, explored and worked with ference, I think it is important to integrate the the idea of sodal weights, which was in fact to say papers of the etbical dimensions panel with those that a dollar earned by the pooxest person is not from this conference, of which you will all be equal to a dollar earned by the richest person. receiving a copy- Scrageldin 123 In the end, if we are to be the new abolition- and reinforced fashion, in an enriched fashion ists, we need to reinforce ourselves with the right immediately as of next week when we meet with degree of outreach, the right degree of anger, the the steeing committee. right degree of commitment, that it is inadmissi- Let this conference be a milestone from which ble that we should allow hunger to persist amidst we all start to respond to the fears and the aspi- plenty in a changing world. rations expreed by former President Carter For this to be more than a slogan, I commit when he asked, wil there be actions to suit the myself before you here today that I will create a words? I am willing to say that for my colleagues focal point for follow-up of this discussio within and me at the Bank-and I am sure I can say that my vice presidency at the World Bank, tat the for all of you here-there will be follow-up. How dialogue that we have started here today will not fast it will come we cannot predict, but I can say end here today, that we will start again in a new that it will not be for lack of trying. Press conference (left to rTight, IsnwiL Serageldin, Lewis T. Preston, imnmy Carter, Tony P. Hall, and Carolyn Long). 124 Appendixes Appendix 1 Overcoming Global Hunger: An Issues Paper The problem of hunger can be broadly * To help the World Bank rethink the actions it divided into two types, viz., (1) famines, is taking and define the actions it is prepared and (2) endemic deprivatiorL If fimines to take to reduce hunger kil millions through starvation and epi- * To raise awareness in North America about demnic diseases, endemic deprivation can the seriousness of global hunger and the affect hundreds of millions through de- actions that can be taken to overcome it. bilitation and illness, ceasing mortal- Thispapersupports the goalsof th conferenceby ity rates and shortening people's lves. e Reviewing the experience of previous hunger One of the problems that makes the initiatives to identify what we have learned task of the prevention of famines and from them and why, even though progress has hunger particularly difficult is the gen- been made, they have not resulted in actions eral sense of pessimism and defeatism commensurate with their objectives. Hunger that characterizes so much of the discus- has notbeen overcome. sion on poverty and hunger in the mod- * Clarifring the issues involved so that we can em world. undeistand the efforts to overcome hunger in There is, in fact, little factual basis for the short, medium, and long term within the such pessimism and no grounds at all for larger political, economic, and social contexts assuming the immutability of hunger withinwlichspecificactionsneedtotakeplace. and depnvation. Yet those unreasoned * Identifying the actions the World Bankc is tak- feelings dominate a good deal of public ing that contribute to the reduction of hunger, reaction to misery in the world today. and the actions thatthe Bank could take to sup- Amra Seni port a larger effort to overcome hunger - * Identifying an action program that has rea- The Objectives sonable prospects for success. * Highlighting some major issues this confer- The Conference on Overconiing Global Hunger ence could resolve. set four goals: * To identify the major elements of an effective The Larger Perspective strategy to reduce world hunger and the politi- cal, economic, and institutional actions needed The conference is not taking place in a vacuumL to inplement it Many earlier conferences with similar objectives * To build a consensus on the priority actions have preceded it. Some established bold goals, that would form the core of such a strategy such as the World Food Conference in 1974, This paper was prepared by Harry Walters with assistance from Richard Bissell. 127 128 Appendix I which propsed to eradicate hunger and malnu- While these elements define hunger, food tnition within a decade. WFhile such efforts have security, as defined by the BLank and discussed in achieved a great deal, they have fallen far short of a companion paper by the International Food overcoming hunger. Many governments and Policy Research Institute (IERI), is "access by all organizations-the United Nations (UN) and people at all times to enough food for an active bilateral and nongovernmental entities-are con- ant healthy life."3 cerned with overcoming hunger. Major research Among the chronically hungry or undernour- institutions now work actively on hunger issues. ished three useful distinctions are important for These combined efforts have contributed signifi- policy and action. The largest subgroup among cantly to the reduction of hunger in some parts of the chronically undernourished consists of small theworld,butmanycomplexissuesremainunre- farners, landless rural workers, and urban non- solved. These range from the level and kinds of professionals. In normal times people in this actions needed to incaease food production to the group subsist They typically spend the bulk of size and types of programs needed to improve theirincomes onfood,soariseinthepriceof food food consumption and nutrition. These in turn or a fallin their incomes deepens their food inse- involve even more complex economic, sociaL and curity. Another group among the chronically political considerations. Because some countries undemourished is the unemployed. Adults may have made remarkable progress in overcoDmng work when employment opportumities exist, but hunger while others have not, overcoming their incomes are not sufficient to satisfy their hunger dearly depends on decisions made at the famflies' dietaryrequirements. Frequentillnesses national level, and also at the loal, community, further limit their employment capacity. A third and household levels. However, other decisions subgroup is the chronically ill, the aged, the crip- need action internationally. While there is a pled, and the orphaned, who are still less able to shared concern to overcome hunger, diferent earn enough money to support themselves. groups havedifferentperceptionsaboutwhichof People in the first group can take part in the the multiple issues that influence hunger deserve economicdevelopmentprocess.Theunemployed, priority, particulaly about how the larger eco- thesecondgroup, remain atthefringeof economic nomic, social, and political factors impinge on development Poverty marked by chronic under- hunger.- nutriton, poor health, unsanitary drinklng water, Sen has juxtaposed famine and endemic large families, and cowded housing increases deprvation as the two essential dimensions of tieir vulnerabflity to infectious diseases, stifles hungern Famine is acute and dramatic, but their* motivation, and reduces their capacity to mvolves a relatively small proportion of the hun- work and study. For tiem, development at the gy: tens of millions. Endemic deprivation is aggregate level offers little relief. An increase in largdy hidden, but accounts for most of the totalfoodproductionmaynot improvetheirnutri- world's hungry: hundreds of millions. To this we tionalstatusbymuch,becausetheywouldstillnot can add malnutrition caused by specific nutrient have enough money to buy the food. People in the deficiencies and a lack of knowledge about nutn- third group will have to rely on directhelp, indud- tion. Thus hunger has three elements: ingsuchbasicassistanceas free food, housing, and a Staruation a life-threatening condition caused health car4 by insufficient food that is generally assoc- ated with acute situations like famine. How Many People Are Hungry? * Chronic hunger or undernutrition: a persistent lack of calories (food energy) that may impair Estimates about how many people are hungry the ability to lead a fully healthy and active differ, but more for reasons of methodology and life. definition than disagreement about essentials. * Otherforms of malnutritiwor a pathological con- The Food and Agriculture Organization of the dition resulting from the inadequacy (or United Nations (FAO) has calculated that in 1988 excess) of calories, protein, and micronutrients, to 1990, 786 million people faced chroric under- often in combination with diseases, parasites, nutrition in developing regions, or 20 percent of and inadequate knowledge about nutrition. tueirpopulations (table 1). Most of these people- Ovrooming Global Hunger An ssues Paper 129 Table 1. Prevalence of chronic undernutition in developing and absolute numbers in the Near East and Latin regions, selected yuan America are relatively smaller In both regions the Or- * uaxwnuuidsi proportion has decined frmm near 20 to 12 and 13 Totl AVonn of percent but the u numbers have remained popitin wdpcqxio Nurner relativelyunchanged. Re&n Paw uL'oru) Inec (Erls) The figures cited represent the lower limit of Mirica 1969-71 288 35 101 the. hungry. Hunger in the industrial world and 1979-81 384 33 128 1988-90 505 33 16 in some seventy-two countes with populations FarEast 1969-71 1,880 40 751 of less than 1 million is exluded, as is the impact 1I97981 2,311 2 648 of famine. The upper limit.is indicated by the l.atiArneuica 1969-71 281 9 528 World Bank's estimates of poverty (table 2). In 1979-81 357 13 47 1989 1,133 million people were poor at a poverty NearEast :9691 433 22 5S line of US$1 perdayperperson. The geographi- Near asL 169-71 160 22 35 1979-81 210 12 24 cal distribution of the poor is similar but larger 1988-90 269 12 31 tian that of the cronically malnourished for Tda 1969-71 2.609 36 941 197981 3,262 26 844 obvious reasons: hunger is a prime reflection and 1908-90 3,938 20 786 indicator of extrEme poverty. a. Seventy-tvfsoweun swithapopuiacndlessthan I mikonareexcduded ifmtesetao&ThecombnedpopubcaftihescouniesrepresentO6 Why Are People Hungry? pe e i tftfe tot population of the developig countriei Sh A StaDi m o n. VVrUFaod5 wsa id de ft ececfCtrovc Undonurr i DsehpingvRe asAsessadin 1992 (Pome 10.1992) Thereasons whypeople are hungry diffenIEPRs companion paper suggests a conceptual frame- 528 million-areinAsia.The nextlargestgroup- work thatintegrates a number of these factors and 168 million-is in Africa. The FAO's calculations portrays the long-termr relationships between root suggest a significant drop in the proportion and causes and symptoms of hunger Poverty, for absolute number of dhronically unde mourshed example, including natural and man-made people in developing countries: from 36 to 20 per- shocks, is a root cause of hunger. The famework cent and from 941 to 786 million since 1970. The also depicts the broad interactions betweenpolicy most dramatic decline was in the Far East from failures,.resource poverty, disasters, and the pop- 751 to 528 mIllion people, and from 40 to 19 per- ulatia±L transition that impact on hunger Within cent of that region's population. In Africa, despite this context, the main reasons why people are a small decline in the proportion of malnour- hungryarelackof assets and resources toproduce ished, the absolute number has risen dramati- enough food, lack of income to buy enough food, cally, from 101 to 168 milliorL Both the proportion and lack of specific essential nutients and knowl- Table 2LEsntates of the agritude and depth of poverty in the developigworld, 1985 and 1990 Nwnerof poor (mbs) Hea*mdcmmrkkx ,pEr) Fwertygop kdex@rcenr) Regon 1985 1990 1985 1990 1985 1990 Aggte 1,050 1.133 305 29.7 9.9 9.5 EasAsiaandthePadic 182 169 13.2 11.3 33 2-8 EsemEurope . 5 5 7.1 7.1 14 1.9 LatinAmerim and the Caribbean 87 108 22.4 252 . 8.7 10.3 MidcleEastardNorth Aica . 60 73 30.6 33.1 13.2 14.3 SouthAsia 532 562 51.8 49.0 16.2 13.7 Sub-Saharan r Afri 184 216 47.6 47.8 18.1 19.1 Nate The poverty estimates are for eif,-s,c counuies represent about 90 percentofthe popalion of developing counties They hae been updated fiom fthe used in the 19YO Wrfkl Oevepmt Report and are based'on raional household sample survys frrn ity-ne countri represnt rugldy 80 percent ofthe popubion of deveoping cutries, and on an econometic model to etrapole poverty estiraes to the refing fifty-ive couties. The estimates do not inude Indoina or the former Soviet Union. The poerty ke is US$31.23 per person per month at 1985 prices. It is derived from an intatinal survey ofpoverty lines and reprset the ypia consLumption standard of a number of low-inorne counries. The poverty line in local currency is dwsen to have constat purhsing power parity aoss counties based on 1985 purdaing power bew the poverty line The poverty gap index is the mean cnce bebwthe poverty line (zero forthe nonpoor) eqp>esseds a pecetage of the poverty ne See Martin Ravaion. Gain Dat. and Doniriqe an de Wi 'Qu ingAsute Poverty in the DeopirgWd. Review offnome nd V*eh 37 (1991): 345-61. fordetilsoffte methodoloc The updated esimates are docrnented in the smrce pubaialion. S9rce World Bait krpnert4 the Wodd&na¶s Sbutoew Re Fw vawgon. D.C.: obrd Bitt 1993). 3-7. 130 Appendix I edge. These conditions are in turn affected by the * The relationship between the need for efficient naturalresource environment and the economic household, local, and national food self- and social environment in which the hungry live. relace relative to the need for an efficient These influence the level and distribution of assets and smoothly functioning world market. and incomes; the level and nature of employment; The concern with global hunger is most often and the availability of social services, especially stimulated by short-term phenomena .such as health, housing, water supply, and education. famines, which activate people's humanitarian They also influence the degree to which people concerns, or by disruptions in the world food participate in government and economic deci- supply, which spark Malthusian anxieties of a sionmakg, induding decisions relating to how world running short of food. While these are hunger can be overoDme. important elements of the hunger problem, they Solutions to overcome hunger thus encompass are in a serse transitory When the anxiety dimin- a wide array of issues and possible actions. At the ishes people tend to feel that the problem has most direct level these include the following been solved. However, the major cause of hunger * Actions to deal with droughts and other dis- is what Sen calls endemic deprivation, for which asters that can lead to famine. the solutions have less to do with global food pr- * Actions to provide essential nutients such as duction and more to do with poverty and vitamin A and iodine and the education to be inequality economic and employment growtk aware of the need for these vital elements m and distribution within countries and in the the diet world as a whole. These issues involve a much * Actions to increase access to food through more complex set of considerations- Among improved incomes, employment, technology, groups concerned with hunget. however, there and so on, and through food transfers or other are strong, divergent views on these issues, measures that increase entitlements to food. which affect policy recommendations and action * Actions to increase and sustain food produc- proposals. tion in the world, within countries, and at the Recently, some other concerns have become household level These actions influence the prominent on the same agenda as overcoming total supply and price of food for all con- hunger The following paragraphs discuss these sumers, and the supply of food availale to issues- hungry people (if they are farmers or farm The global food balance looks adequate in the worKers). Most of the world's hungry are aggregate and points to a progressively improv- farmers, farm workers, or others in rural ing food situation i the industrial and develop- areas. Their direct access to food and to ing world through 2010 for those with an effective incomes is thus closely linked to increased demand for food, thatis, the resources to produce food and agricultural production, it or the income to buy it6 But this masks the peo- At a more complex level are such issues as: ple who are chronically ourished and lack * The functioning of the world economic sys- the essential elements of an adequate diet As the tem and its impact on equity, that is, on WorldDevelopmentReportof 1990recopgnizes:The income, asset, and food distribution burden of poverty is spread unevenly-among * The functioning of the world food system and the regions of the developing world, among coun- its implications for food production, con- tries within those regions, and among localities sumption, and trade in and betweenindustial within those countries."7 Two issues are involved. and developing countres, and thus for hunger One is recognition that greater equity in the dis- * The balance of resource allocation and use tnbution of assets needed to produce food or between industrial and developing countres, income would result in less hunger This view indluding the relevance of industrial country focuses on the redistribution of existing resources consumption pattems ife styles), both as as a means to overcome hunger The other issue they currently affect global food and income emphasizes that raising hungry people's com- distibution and their implications as a long- mand over food through more productve term guide to future growth and consumption employmentandhigherincomes wilraisepeople patterns out of poverty and reduce hungera which focuses Overcoming Global Hunr An IhsUmS Paper 131 on the future. Each approach has strong propo- not only central to the preparation and distribu- nents. Overcoming hunger now and in the future tion of food within households, but in many parts requires greater attention to equity in people's of the world, especially in Africa, they are the access to food and the resources to produce it, and major producers of food. Often the key- entry to measures to enable them to escape from pointin targeted food and nutritioninterventions poverty Proponents of each approach will need to is through women to their children. Fnding ways find ways to reconcle their differences if a consis- to enhance women's participation in food pro- tent approach to overcoming hunger is to be ductionisequallyimportant Legalissues,aswell achieved. as issues of access to land, credit, and other Sustainability. has become an increasingly inputs, are involved not only to produce food, but pressing concern for viable approaches to devel-. to generate other sources of income, and to share opment, and is particularly important for, over- fully in the marketing and distribution of food coming hunger The prevalence of hunger among These larger concerns with equity, sustain- poor farmers and their families, often in environ- ability, participation, and the role of women need mentally fragile regions, makes dear the link to be seen in two perspectives. Each is an objec- between unsustainable natural resource exploita- tive inits own right, and the reasons for pursuing tion and meeting household food needs. The 1992 each go well beyond the concern with overcom- World Decvment Report highlighted this lirt ing hunger. Each also has dimensions that relate "Alleviating poverty is both a moral imperatrve directly to overcoming hunger Identifying these andaprerequisiteforenvironmentalsustainability. direct and indiLect lirns and clarifying how they The poor are both victims and agents of environ- help reduce hunger is essential, and should be an mental damage.' 8More important, however, is the important objective of this conference. The issue dependence of the incomes, and hence of the com- need not be one of tradeoffs or of confrontation mand over food, of most of the wold's hungry on between liese concerns and the goals of over- agriculre, often in the most environmentally coming hunger, but should concern integration stressed areas. Thus environmental degradation is and phasing. Some of these concerns can only be an important hunger (and poverty) issue. Actions adequately addressed in the longer term. Others to achieve sustainable development and reduce are directly relevant hunger have to reinfrce one another if the world Two other elements of the larger perspective is to achieve a sustainble reduction of hunger and need to be darified. One is the political nature of a sustainable environment in the larger sense the hunger problem; the otheris the practical pos- Overcoming hunger- will not be achieved sibilities for action. solely by donors, governments, or concened out- People often see the hunger problem in its siders. The poor who are hungry must be key direct food production or nutrition dimensions, players, not only as recipients of assistance, but as but it also has important political dimensions. producers. The poor are disenfranchised in every People are hungry because they are .poor, and sense, whichmeans a global agenda to overcome because they are poor their participation in the hunger will have to find ways to enable the poor political process is weak.9 At some point, all solu- to produce their own food or the income needed tions for overcoming hunger, no. matter how to buy food. This inevitably involves questions of seemingly technical, must face the reality that human rights and the development of civil soci- -transfers of income or resources, either to con- ety- Ensuring that the poor participate in the sume or produce food or to gain access to other design of programs and projects to alleviate their sources of income and social services, are needed. own hunger is far from commonpractice. As anti- Access to these economic and social opportunities hunger efforts increasigly focus on people who are ultimately issues of the functioning of politi- are excluded and marginalized, the issue of par- cal systems. Proposals for overcoming hunger ticipation and empowerment becomes increas- often call for political will, but how to achieve this ingly crucial to their success. is left vague. This conference can seek to clarify Securing the full participation of women is how to develop a basis for political action at the also essential to overcome hunger Women and national and intemational levels that is commen- children suffler the most from hunger Women are surate with the objective of overcomig hungr 132 Appendix] Despite this huge package of issues that obvi- The green revolution and the mid-1960s ously impinge on hunger, and must in some way emphasis on expanding food production and the be resolved, overcoming hunger also involves availability of agricultural inputs such as fertil- many practical actions that can be put in place izer worldwide, which these initiatives con- even if larger social and political factors can only tributed to, resulted in dramatic global food be changed slowly. These actions form the basis surpluses by 1970. Real world food and fertilizer of the action program discussed later. prices were at historcal lows in 1970 and food seemed abundant These global food surpluses Previous Hunger Initiatives led to dramatic cutbacks in production by major industrial food producing countries by 19713 Overcoming hunger has been a recurring theme These cutbacks coincided with sharp, mostly for decades. The paper Addressing Hunger: A weather induced, shortfalls in food production in Historical Perspective of Internation Initiatives the former USS.R., Africa, and Asia in 1972 to (appendix 2), reviews some of these. Progress has 1973, and with the first oil crisis. This combina- been significant Global food production has tion of events, which caused a nearly 200 percent increased faster than population, and food con- increase in world food and input prices, short- sumption has improved (see section, "lme ages of internationally traded food supplies, and Frame for Reducing Hunger"). Hunger has been a dramatic drop in food aid, resulted m the world reduced both absolutely and proportionately in food crisis of 1972 to 1974. many developing countries, but the goal of erad- The World Food Conference, held in Rome in icating world hunger remains elusive. Why? November 1974, was the culmination of world- wide concern with the world food crisis. It Earifer Hunger Initiatvesi brought together leaders of 130 countries, offi- cials of the major UN and bilateral agencies, and Overcoming hunger was a central issue at the representatives of concened NGOs. It gave rise time of the establishment of the FAO in 1945, to the most comprehensive effort ever to address when a proposal was made and rejected to estab- the global food and hunger problem. Its twenty lish a world food board to ensure adequate food major resolutions covered nearly all aspects of for alL, world food production, consumption, and trade. Concern with slow food production growth in The conference adopted the Universal Dedara- developing countries and food shortages in South tion on the Eradication of Hunger and-created the Asia, China, and the former USS5R in the mid-. World Food Council, the International Fund for 1960s led to a number of major conferences held Agricultural Development (WFAD), and the Con- in the United States concerned with food and sultative Group on Food Production and Invest- hunger. Among the more significant were the ment. The world food cisis also spawned a new Strategy for the Conquest of Hunger by the generation of NGOs, such as Bread for the World Rockefeler Foundation (1963), The World Food and the Hunger Project in the United States. The Problem by the U.S. President's Science Advisory International Food Policy Research Institute was Committee (1967), and Overcoming World also created at that time. Hunger by the American Assembly (1969)30 Despite the comprehensive framework of rec- These resulted in detailed studies of the causes of ommendations and institutions put in place by hunger and related food problems and proposals the World Food Conference and the network of to overcome these problems. These undertakngs new hunger- and food-centered NGOs and contnrbuted to some degree to the green revolu- research centers that emerged, the intense world- tion, which produced dramatic increases in food wide concern with the food and hunger problem productionandreductionsinhungerinSouthand subsided as the global food supply improved Southeast Asia and in Latin America in the 1960s after 1974. The newly created UN institutions and 1970s. The FAO also established Freedom lacked effective support, and most were gradu- from Hunger nongovernmental organzations ally abandoned or margnalized. W:AD is one of (NGOs) in the 1960s with networks that continue the few surviving entities. The major recommen- to operate in Asia and elsewhere. dations, especially the Universal Declaration on Oemoig Globai Hunger An Issues Paper 133 the Eradication of Hunger, became dead letters. duction and consumption have increased and Progress hasbeenmadeon many fronts,butmore world food pnces have declined. Even more outside than inside the framework created by the important, hunger has been reduced. Fift, they World Food Conference, and the goal of eradicat- have clarified the causes of hunger and how it can ing hunger had clearly not been achieved. be reduced. During the past thirty years many Recoging this, and concemed that acton be countries, such as Indonesia, Malaysia, the initiated on at least the most serious hunger prob- Republic of Korea, and Tailand, have demon- lems, two confens were conveled. The 1989 strated how an emphasis on gowth using the tal- Bellagio, ltaly, conference proposed a Sharply ents and resources of the poor, with strng focused objective to reduce hunger by one-half in rein ng socal services, sharply reduces the1990shiroughfour"achievablegoals,"namely, poverty and hungeri Other countries, suci as to (a) eliminate deaths from famine, (b) endhunger Chia, Sri Lanka, andparts of India, have demon- in half of the world's poorest households, (c) cut strated ffiat even though people remain poor, malnutrition in half for mothers and small chil- reducing hunger significantly is possible. dren, and (d) eradicate iodie and vitamin Adefi- Intemational agencies have also devised dences.'2 The Intemational Confence on approaches to development that shift the focus Nutrition, held in Rome in December 1992 and toward poverty reduction or address specific attended by representatives of 159 countries, hunger-related problems, for example, the Wbrld adopted the World Dedaration on Nutition, Bank's ointation toward poverty reduction,4 which also had as its central element the pledge to the United Natifos Childrenes Fund's (UNICFs) eiminate, before the end of hius decade, (a) famine program of oral rehydration,'5 and IFAD's efforts -and fane-rated deaths (b) starvation and to alleviate rural poverty and target specific nutrional defiency diseases in commurnties hunger groups.' A large number of grassroots affected by natural and ran-made disaste, and instiutions and NGOs are also now in place that (c) iodine andvitminAdeficienciesn 3 direcdly help the hungry and seek to empower them to solve tieir own food problems17Al these Accomplshments of EalerwrHunger Intittes efforts show that hunger can be reduced through multiple measures: growth thatis well distibuted The earlier attempts to overcome hunge have and uses the resources of the poor, public action resulted in a number of signficatt accomplish- that assures adequate socal services even where ments.First,theytestifytothecontinuingconcem growth is constrained, and actions trgeted of many people, governments, agencies, and directly at the hungry. - NGOs to overcome hunger. This concern waxes Despite tiese successes, however, the goal of and wanes, however, and ways have yet to be overcoming or eradicating hunger remains elu- found to -galvaize it into effective and sustained sive. Why the hunger gap persists despite world action to eradicate hunger Second, they progress is the central ssue. Some of the reasons rflect a conviction that overcoming hunger is for this lie in the dcult lessons that have been achievable. For some this should be through more learned from past initiatives. equitable distribution of existing "adequate" food supplies, with the emphasis on equty and redis- Difficult Leso Leanedjium Earlier Initiaites tribution of existing world iesources, incomes, and food, because food is a basic human right or The first lesson learned from past initiaies is ahunitarian obligatioL For others it is because that there is little support for such global mecha- of a belief that what needs to be done and what is nisms to reduce hunger as either a world food needed to do it is reasonably well understood. board or a world food council. The reasons for Third, they have generated a large body of analy6 this deserve careful thought They probably have sis on how to identify who is hungry, why, and less to do wihi the lack of support such mecha- what can be done, and a number of strong nisms received, although this is one fictor, tian research and NGO groups have emerged to sup- the fact that multiple and complex issues are port and expand tius effort Fourth, they have involved and decisions need to be made at many adievedreal progress. Percapitaworldfoodpro- levels. Expecting a global mechanism to bndge 134 Appentdix I this gap is probably unrealistic, and therefore the countries have failed to grow very rapidly, but goal of erad:;ating hunger through such mecha- have achieved significant improvements in nisms is not taken seriously. Nevertheless, a vac- health and in hunger reduction, for example, Sri uum exists at the intemational level if a global Lanka.3 effort is to be mounted to overcome hunger and The fifth lesson is that despite the improved an outstanding issue remains: what mechanism knowledge about who is hungry and how hunger is needed and can work that will focus the multi- can be reduced, many differences persist among ple efforts of others to overcome global hunger? practitioners and policymakers. One reason for this The second lesson is that hunger problems are is that the concern about hunger often centers on country specific. Within countries they also have food as "the staff of life." Like water and air it is regional-, community-, and household-specific essential for life. Food is a basic human right and elements. At the country level issues range from therefore on equity and humanitarian grounds it national economic and social policies to details should be provided to everyone."This is a power- such as land ownership and distribution, agri- ful driving force behind many hunger initiatives, cultural techniques, and the types of social ser- and was the basis forthe World Food Conference's vices that are needed to reach the hungry. dedaration to eradicate hunger. In practice, how- The third lesson is that many problems have to ever, food is a commodity. Access to itis largdy a be resolved at multiple levels. Some of these prob- function of income and asset distribution, as well lems are large and complex: governance, equity, as of the functioning (or malfumctioning) of food approaches to development Others are technical, production and marketing systems From this per- but often complex as welL which actions produce spective, access to food is governed by the same the best results in the specific circumstances? factors that govern access to any other commodity. The fourth lesson is that overcoming hunger It is for this reason that hunger and poverty are so is dlearly nota one-dimensional problem. It is not closely linked. The vision of global hunger, which simply an issue of food and its allocation. Many seems so dear in terms of the basic human right to different approaches to overcoming hunger are food, quicldy balloons into a larger settee of politi- relevant and work How fast growth takes place cal, economnic, and socdal issues that go to the very and how equitable it is are major factors. Hunger heart of political and social systems, and on which has been reduced quicldy in those countries in there is less agreement There are important differ- East Asia where growth has been rapid and has ences between approaches to overcoming hunger usedtheresourcesofthepoor,wherethebenefits that rely on the redistribution of existing food, have been equitably distributed, and where income, or assets and those that stress the need to social services such as health and education have enable people to earn enough to afford the com- been supported.?8 The proportion of East Asia's modity food. population living in poverty fell from a third to a Another major issue separates those who tenth between 1970 and 1990. Although the pop- emphazefoodself-reliance atthelocalornational ulation increased by40 percentinthese countries, level and those who stress the role for a well-func- the number of poor decreased by 60 percent The tiorningworld marketfor food. Resolving this issue absolute poor in six East Asian countries num- involves a major effort to reconcile the advocates of bered 380 million in 1970 and 150 million in 1990. two valid approaches. Not only were 230 million poor lifted out of The final lesson is that global action on hunger poverty, but another 425 million people were requires multiple decisions at many levels. added to the population and are living above the Unless governments put in place mechanisms to poverty line. By contrast, Africa's hunger and identify the hungry and initiate actions to reduce povertyproblemsaregettingworse,inlargemea- hunger, little can be accomplished. At the same sure reflecting the lack of growth. time, unless the international community is pre- However experts recognize that growth by pared to support national efforts and to address itself is not enough. Some countries have expei- those hunger issues that are influenced by inter- enced rapid growth, but its distrbution was not national action, national efforts will be con- equitable and it was not supported by growth in strained. Currently, mecianisms focused on social services, for example, Brazil, whereas other overcoming hunger are weak at both levels. Overcoming Global Hunger: An Issues Paper 135 rime Frame for Reducing Hunger that elements of both long-term and short-term actions are not part of the solution, and inevitably How one deals with reducing hunger depends on shifts the balance of concem toward equity, enti- the time frame within which this objective is tiement, and intervention solutions. sought. If, as the World Food Conference pro- posed, the intent was to eradicate hunger in a Long-Tern Measures decade, then a high priority would have had to be placed on direct interventions and equity -Three things are of overriding importance for actions. Actions would also have had to include overcoming hunger in the long term: proposals for dealing with some extremely diffi- * Sustained economic growth works when it cult situations, such as what to do inwar and con- uses the resources of the poor and is equally flict situations, what to do in cases where distributed. government support and policies were lacking, * Public policies that support human resource and what to do in the most intractable hunger development and expanded social services areas. If the intent is to overcome hunger eventu- (poverty reduction or support-led security) ally, as part of a broadly based growth strategy, also work. then a broader array of tools is available, but * Sustained increases in food (and agricultural) many people would remain hungry production work. There axe three broad, overlapping approaches Growth. Examples of dynamic growth-led to reducing hunger: (a) through economic growth, poverty reduction in Asia have already been (b) through poverty reduction, and (c) through cited. Clearly growth by itself is not enough, but public provisioning. Drize and Sen have reduced it is nevertheless essential. Why does economic these to "growth mediated security" and "support- growth matter? Growth reduces hunger to the led security."21 In practice, all these approaches extent that it (a) reduces income poverty, that is, have had their successes and failures.?2 The fol- the poor are active participants in the growth lowing section describes how the World Bank process; and (b) is used to finance public support approaches the reduction of hunger through these in key areas where markets work poorly, notably, three approaches. Here we axe concemed with the in the provision of basic health, nutrition, and issue of a time frame to overcome hunger in the education services. Such an approach is more short, medium, and longer term directly linked to concerns with empowerment Table 3 illustrates the relationship between the and equity than might appear on the surface. short-term, medium-term, and long-term actions While growth alone does not ensure the reduc- needed to end hunger. tion of poverty or hunger, there are many exam- Such a time frame brings into focus the degree ples of where it has, Asia being a notable one. to which the effort to reduce hunger needs to be Africa is an example of where lack of growth has incorporated into longer-term concerns with impeded progress in increasing food production, growthandpoverLyreduction.Whileitrecognizes in generating more employment and higher that some elements of hunger reduction can only incomes, and in providing public revenues to beachievedbylong-term solutions,itconcentrates support improved social services. attention on the actions needed to reduce hunger Poverty reduction and support-led growth. tothe maximum extent well before long-run solu- Evidence also exists that in countries such as Sri tions are achieved. However, this does not mean Lanka or in parts of countries such as Kerala, India, where incomes are low and growth has Table 3. Continuum of actions to reduce hunger been slow, but there is a high degree of equity or r,tegory -m-nen -oods Pavryenxno targeted social programs focusing on food, health, and education, hunger has also been reduced and Tre scale Immediate 1-10yearsnear I 0-50 years, bngtrm h lf g3 A i to medhime human ue greaey extended.3 Actons i nese Location Feedingcent herable areas Whole ountry areas include those health, education, nutrition, Fbkdes Distibu.ionof 'of ee axducd reormc and other social services that sustain human life food aid diectfl- growth. pi andbuild human capacity to enable people to par- _ vefltn reduction ticipate in the development process. 136 Appendix I Increasing agricultural andfood production. One have helped large numbers of the poor achieve important factor in the reduction of hunger in the food security in recent decades, and their continued past three decades, and also an indicator of the decline will underpin much of the anticipated future, is the longer-term development of the progress in future decades. It is the lowered real supply of and demand for food. The World Bank price of such basic energy-supplying food com- recently reviewed the pattem of food production modities that provides the simplest market-related and consumption over the past thirty years and means of reducing hunger, even if it adds to the eco- the outlook to the year 2010. The analysis shows nomic viability challenge faced by small-scale agri- that growth in food production continued to cultural producers who derive some of their cash exceed population growth during the past thirty income through the sale of such grains. World years. World per capita cereal consumption has cereal consumption is projected to grow by about increased by 20 percent since 1960, and in devel- IA percent per year, with developing countries oping countries it increased by 36 percent Cereal increasing their cereal consumption by 2.2 percent yields continue to increase faster than population per year. To achieve these consumption levels, how- growth, while the amount of land used for cereal ever, cereal imnports bythe developing countries are production has declined: since 1950,90 percent of projected to increase from 87 million tons in 1990 to the increase in cereal production has come from 210 million tons by 2010, continuing the trend yield increases. toward increased imports that started in the 1960s. The analysis also found that the demand for These are simply projections however. They food is not growingas fast as in the past, and as a do not deal directly with those who are lefthun- result, the period of greatest stress on the world's gry nor do they take account of the random ele- food production capacity may have passed. Dur- ments that contribute to food insecurity, and they ing the 1970s, world cereal consumption increased raise other issues as well. by an average of 2.7 percent per year, but during First is the need for sustained support to agri- the 1980s it slowed to 1.7 percent per year despite culture, including inceased support to the Con- a decline in real world cereal prices of more than sultative Group on Iernational Agricultural 40 percent. By 2010 world cereal consumption is Research (CGLAR) and to national research cen- expected to slow furiter as incomes grow, con- ters (see box 1).24 sumption patterns change, and world population While the pattern of past and possible future growth slows. growth underscores the contribution of sustained Diets in developing countries have also agricultural growth to overcoming hunger, the changeddramaticallyduringthepastthirtyyears. projections also raise long-term issues. One is the Per capita calorie supplies in developing coun- implied underlying pattern of future growth, tries increased by 27 percent with nrsing real which ieflects devel.ping countries'adaptation to incomnes and declining commodity prices. Asia, the consumptionpatterns of the developed-world. which accounts for 59 percent of the world's pop- This ads clearly happened and is projected to con- ulation, has seen the greatest improvement in tiLnue, but many argue that such a growth pattern diets, while Africa, which accounts for 12 percent is not sustainable. Where does the truth lie? of the world's populaticn, has had the fewest Another concen is that projections of grow- gains. World population growth slowed from 2.06 ing for,d consumption in developing countries percent per year during 1965-70 to 1.74 percent in indicate increases in imports from the industrial 1990, and is projected to fall to less than 1 percent countries. While this reflects a more fully devel- by 2025. The countries being left behind present oped world market for food, some question the greatest challenge. Most of these countries are whether it is feasible, sustainable, or desirable. in Africa and tlw problems are economywide. These projections argue strongly that it is. Others The prices of basic staples such as cereals are argue that it is not. expected to continue to decline relative to other consumer prices and relative to incomes. By 2010, Short-Term Measures real wheat prices are projected to decline by 33 per-; cent, real rice prices by 31 percent, and real maize Much of the concern with hunger is focused on pricesby2lpercentThedeclinesinrealfoodprices short-term problems: droughts, floods, natural Overoming Global Hunger: An Issues Paper 137 disasters, and civil and militay conflicts. Both the ing in place early warning systems, supporting Bellagio conference and the International Con- traditional coping strategies, ensuring against ference on Nutrition proposed that ending death loss of assets, and, most important, sustaining from famine should be a specific near-term goal. entitlements (see also the accompanying IFPRI These conferences provide good examples of paper, Ending Hunger Son Concepts and ways to address the problems of people experi- Priorities).25 Many NGOs are actively involved in encing these disasters. Ending death from famine such relief efforts. The outstanding issues remain should be an essential short-term component of a how to deal with famines driven by conflict and hunger reduction strategy how to overcome national policy neglect. In recent years, many, including l)r&ze and Traaditionally the Bank has viewed iese prob- Sen and IFPRI, have undertaken major research lems largely as relief efforts for which otherUN and on how droughts affect those who expenence bilatea agencies are better suited. This position is them and how their impact of these events can be changin4 although the pre-inelnce of. otier kept from resulting in famines. The World Food agencies is recognized. In Africa, where famine Programme (WEiP), the FAO, and many bilaterl remains a serious recumng event, the Bank is agencies are also well equipped to act quicldy. rtinking its approadh to the problems of drought The basis for actionto avoid famineincludeshav- as a guide to new policy and lending actions. Box 1. Research to sustain long-term food production Another recent World Bank study finds tat meeting the doubled food demand that is anticipated by 2030 seems feasible, but that given the incemasingly constrained resourcebase, supporting agricilture will require substantial productivity gains. Fundamental to meeting the challenge of increasing agricultural productivity will be better application of existing (but underused) knowledge about resource management, and the development of new agri- cultural technologies and knowledge. Among the incentives that would encourage faxmers to adopt improved technologies and methods,none is more important than the allocation and protection of property rights. In addition, as technologies become more sophis- ticated, educating farmers and strengthening extension systems is essential, notjust to increase production, but to find better ways to use increasingly scarce water supplies. The spread of practices such as conservation tillage and integrated pest management demonstrates that environmentally fienLdly and economically attractive technolo- gies offer practical alternatives to regulation and subsides in controlling the-environmental costs of agricultura Even if existing knowledge is fully exploited, the availability and quality of land and irrigation water will be insufficient to meet demand. Plant genetic resources and climate change are less immediate constraints on increas- ing global output. Further expansion of cropland by perhaps 25 percent and of irrigated land by 50 percent may be possible, but will have high environmental and other costs. New knowledge wil be necessary. - Experience over the past few decades has demonstrated that the generation of new knowledge is the most potent and least costly way to improve productivity. The expansion of knowledge thirough research and development will need to encompass human capital, institutional innovation, and new technology. New and higher-yielding culti- vars of plants will be needed, along with farming systems research that focuses on integrating livestock and crop activities as wel as forest and aquatic resources, and on modifying the physical environment in which plants grow, for example, measures that conserve soil moisture and permit more continuous cultivation on the infertile, acidic soils common in many tropical areas. Deliberate and sustained investment in agricultural research and development has never been more important Yet expenditures for agiculurl research an stagnating or shrinking, both nationally in most parts of the world, and intemationally. Research must address the inceasing constraints posed by the environmental consequences of agri- cultural development. The Consultative Group on International Agricultural Research (CGIAR) is placing much greater emphasis on agricultural resource systems and on relatively neglected areas, such as forestry, pest manage- ment, and soil conservation and irrigation, to complement the more traditional focus oncommodityprograms These changes by the CGIAR need to be reinforced and matched by comnuitments to strengthen national research systems in these and more traditional directons. Such investments feature long gestation periods, yet have yielded high rates of returnL Itwill onlybe through continued investmentin the agricultural knowledge (education, research, and exten- sion) systems of tie developing counbies that long-term food security can be safely approaced and achieved. Sour=. Crosson and Anderson, Resoursc and Globl Food Prspects Supphl and Demandfor Cemas to 2030.. 138 Appendix ! The response to the 1992 drought in southem which may. have a more direct impact on hunger, Africa illustrates that action to deal with but not necessarily a greater impact The reason droughts, famnes, and other disasters need not why economic growth matters was discussed ear- wait on further research The combined efforts of lier. While appropriately designed growth strate- countries and international agencies to respond gies alone do not ensure the reduction of poverty to that drought is a good example of how effec- or hunger, there are examples where they have tive action can forestall the famine consequences done so. When done well, economic growth that of a major drought Without these efforts, a major uses the resources of the poor not only empowers famine could have been expected in southern them, but also enables them to participate. Africa in 1992-93. That it did not occur was a The Bank has long recognized that growth major achievement. alone is not the sole measure of development In The fact that war and other conflicts are a the early 1970s the Bank shifted its efforts toward major cause of famine poses important issues for poverty reduction, particularly through its rural the Bank and other organizations. Often Bank development and health and human services pro- operations are halted in such cases. Other agen- jects. By the end of the 1980sthese efforts had crs- cies and NGOs have been on the leading edge in tallized into a decisive , shift toward poverty dealing with the food problems of people facing alleviation. By means of such publications as the these conflicts, but these conflicts still impede World Deveopment Report 2990, Assistance Sidte- action in most cases. ges to Reduce Poerty, and the Povert Reduction Handbook the Bank has demonstrated that "the Medium-Term Measures basic mission of the World Bank and the core of its assistance program is the reduction of poverty="2 WVhile long- and short-term approaches to over- The Bank's strategy is based on supporting labor- commg hunger are essential, arealisticattemptto absorbing growth and systematic investment in overcome hunger must concentrate on actions the development of human resources, especially that complement these long- and short-term ele- among the poor It also indudes supporting well- ments, but focus on action that will have a large targeted transfers and sodal safety nets. These are impact in a relatively short time. Many such actions that'reduce hunger actions exist, and they are discussed in the sec- Recognizing that action at the country level is tion, "An Action Agenda to Overcome Hunger." essential, the Bank is committed to preparing country poverty assessments in all developing Cunrent World Bank Actions countries, most of which will be completed in to Address Hunger 1994. These assessments provide the basis for developing the two-part strategy described ear- Actions by the Bank address hunger in the three lier They analyze and make recommendations ways cited earlier, that is, through (a) economic on the following: growth, (b) poverty reduction, and (c) public pro- * Extent and nature of poverty in each country visioning. Bank approaches also include specially * Effectiveness of economic management (short targeted actions to address such issues as nutri- term and long term) in generating growth that tion, food security, gender, and safety nets- makes productive use of labor A long-standing focus of the Bank has been to D Adequacy of government efforts to provide support countries' economic growth by financing basic social and infrastructural services to the productive mvestments (oans and International poor Development Association credits). Whether for * Extent, effectiveness, and affordability of infrastructure, industry, agriculture, power,, and social safety nets. so on, the objective is to increase the production Based on these poverty assessments, the Bank potential and the growth of incomes in developing is designing assistance strategies to support countries, and thereby contibute to the reduction poverty reduction thatwill shape both the volume of poverty and hunger Over time, Bank lending and composition of its lending. The volume will has spread to other sectors, such as healtlh, educa- be linked to a country's efforts to reduce poverty, tion, nutrition, urban housing, and water supply, and the composition will support these efforts- Ovrcomng Globld Hunger An Issues Paper 139 Simultaneously, but within the context of its all times to enough food for an active and healthy poverty reduction strategy, the Bankhas initiated life," a condition that some 200 milLion Africans a number of other programs directed at reducing lack today3'The initiative set outa five-point pro- hunger, impro ving nutrition, or adhieving food gram of action. security *Pxeparng specific actionprograms to promote food secuity in each Sub-Saharan country Nutrition Inkmenions G Givingpnrortytoprojectsandpoliciesthatraise the incomes of the food insecure and dampen Nutition projects axe one of the main direct ways fluctuations in food prices and supplies the Bank acts to reduce hunger and malnutrtion, . Strengthening the institutional capabilities of specificaly targeting nutrition services (includ- African govementsto manage food security ing food) to the poorest and most vulnerable ele- programs ments of populations. In tese projects women i Increasing the effectiveness of food aid, play a central role both as beneficiaries and as which includes improving the preparation project providers or administrators. Nutrhion and coordinabon of responses to emergeny lending has increased exponentially smice 1987. food situations Total project resources mobilized for nutrition in * Maldng more systematic efforts to identify the Bank-financed projects incraed from US$49 people at risk of food insecurity- million in fiscal 1987-89 to US$894 million in fis- The iniativealsoproposed thatapartnership cal 1990-9 Projected nutrtion lending in fiscal be formed among donors, NGOs, and African 1993-95 is US$12 bfllion goverments to support comnprehensive policies This rapid growth in nutrition lending reflects and p for food secmuity research findings that show the negative conse- Asaresultof this initiative theBarkhas learned quenc o malnuttio he Bank recognizes that much about the hunger problem and what can be while econm c growth is essetial to long-term doneaboutit Ithasalsolearnedsomeoftesober- growth and poverty reduction, for most cotrs ing lesonscussed earlier- The Bank has camed to achieve significant progress for the lowest- out food securty studies in a dozen Afican coun- income groups through grwth alone wEil take ties, from which have emerged a numberof food more tian a generation. More direct support is securty strategies. The Bank has also supported neded. Inaeasing incomes, even among low- food security projeds in six countries: Benin, inmcomegroups,isalsoinsuffidentA seriesofPPRI. Burina Faso, Cameroon, Madagascar, Mozam- studies demonstrates tat behavioral issues and bique, and Rwanda (seebox 2). Depending on the health and envirnmental factors are also criticalin spefic crm safs of each country, tiese pro- determiing nutitional status. Awareness that the jects inlude incoie-generating components tar- Bankneeds to considerthe c of adjust- geted on the food iscure, such as public works; ment operations on nutrition and to provide com- nutrition interventions targeted on the food inse- pensatory programs to the most needy has also cure; support for early warning systems; capacity played a role?' After some years of exnmenta- buildingtoiden*ti efoKodinsecureandtodesign tion, the Bank has supported successful models for programs and projecs to reach them; agricultural nutritionproects with a demonstrated impact; for actvities targeted on the food insecure; and example, the Tamil Nadu Integrated Nutrition improved uses of food aid fo food security. Many Project, which has reached 2 million women and of these projects involve reliance on local commu- children in 20,000 vilages, has reduced the preva- nity action and NGO support The Bank has also lence of severe malnutrition by 55 perct undertaken an analysis of food aid in Africa with the WFP and an analysis of droughts as they affect Food Security people and economies From thee efforts the Bank has learned a number of lessons. The Bank has directy addressed hunger in Africa While food security strategies are essential to through its food security initiative launched in identify problems in specific counties and to 1989. In The ChallengeofHungerin Aftica, the Bank make proposals for action, they can be costly if defined food security as "access by all people at done well, have often lacked national or benefi- 140 Appendix 1 cary inputs, and do not by themselves result in at the same time to fund the analysis needed to action29 The resources devoted to sudi strategies go further. within the Bank and within countries must com- pete with the resources devoted to other strate- An Action Agenda to Overcome Hunger. gies environmentaL agricultural, forestry, and so on. Given the currentoverwhelming demands on Overcoming hunger requires action in the short, staff and resources, the feasibility of launching medium,andlongterm,atmultiplelevels,inmul- separate food or hunger strategy studies is lim- tiple directions, and by many actors. Gover- ited, and thus the needed analysis may need tobe ments must take the lead, complemented by included in poverty assessments NGOs and supported by external agencies. The The greatest impact on food security, given followingagedfocusesfirstonimmediatesteps the Bank's operational orentation, is achieved that can be taken that ill have a high payoff, and when analysis is combined with the design and then considers priority longer-term actions that implementation of food security projects- Such are needed to improve small farmer output or projects focus the attention and resources of both raise the purhasing power of the poor govemments and Bank staff and managers on the issue of food security, and they are the vehicle Drmught-Rated Famin through which concrete results can be achieve& Projects also provide the Bankc with the possibil- The response to slow onset disasters (for exam- ity to support developments on the ground and ple, drought) that result m famines should be Box 2.7The Rwanda food security project The food crisis in Rwanda is the result of the interaction between scaice land and a gowing population, which is leading to exhaustion of the soil, smaller farm size, poorer harvests, and mceased incidence of plant dsleases. Income eamed fom coffee, whic varies with the world market pice, also shapes the magnitude and mtensiy of the food crisis- Population density is among the highest in the world, with 300 people per square kilometer Inceased fragcmen-. tation of the land is taking place.and is also making high demands on agriculture (intensification and specaliza- tion)- The aborforceisgrowigby90,O0peopleperyear, themajority ofwhomwill have to find tirmainsource of income outside agriculture, but nonagrcultural jobs are scarce. Rwanda has rached a stage where virtually all tillable land is cultivated. Hence, increased production is dependent on mtensification to increase yields. The isSue of food security in Rwanda wfll be increasingly dominated by the overwhelming need to create jobs and inCmes outside family agriculture. Food availability in Rwanda has increasingly depended on coss-border imports from neighboring countries Bumnmdi, Tanzania, and Uganda. Food is available in the region and much of it is beng officially and unofficiany imported into Rwanda- The food security action plan for Rwanda recmmended (a) harmonizing economic poli- cies among neighboring countries to mcrease the efficiency of interegional trade, (1) imprvmg the performance of the small enterprise sector (formal and informal) to broaden the sources of employment and income creation, (c) developing a nutntion policy, (d) supporting mtensive agriculture and policies to haltfurther fragmentation of the land, and (e) stegthenig early waming and emency prepaedness systems- In support of this action plan the Bark has financed a food security projectwith (a) food aid and nutrition com- ponents, (b) labor-based public works components, (c) microenterprise and development components, and (d) social surveys to enable improved targeting of future interventions. The o1jectives are to improve the food secu- rty and social welfare of the poor, improve the govement's capacity to moniotor food security, and initiate a long- term poverty alleviation strategy: O-Oter World Bank-supported food security projects indude the following * Republic of Cameroon Food Security Project February 1991 * Burkina Faso Food Security and Nutrition Project,June 1992 * Madagascar Food and Nutrition Pioject, February 1993 * Republic of Mozambique Food Security Capacity Building Project April 1993 * Benin Food Security Project, appraised June 1993. SoDr World Bank, Ruwf Food Srity md Scial Adc Prnoect (Washi DZ: World Bank, 1992). Oweaming Global Hunger An hsues Paper 141 substantially improved. A more collaborative stamps, free ration cards, or vouchers (see, for effort by the UN agencies, international financial example, the Chile and Honduras case studies) institutions, and NGOs is needed to: unless direct food supplements can be shown to Integrate a drought response strategy into the be move effective and efficient Food assistance country assistance strategies and project delivered to undernourished mothers and chit- designs of drought prone countries or regions. dren at health posts combined with nutrition and * Strengthen counties' capacity to prepare for health education Is particularly effective, espe- and mitigate drought This will reduce the cially as the impact can be dlosely monitored (see need for emergency reief and smooth the Chile, Tamil Nadu, and Zimbabwe case studies). transition. from drought to recovery . Close collaboration in these interventions is * Improve lending instruments to provide needed between UNICEF, the WFl, the World greaterflexabilitfor foreignexchangerequire- Bank, and community-based organizations and- ments associated with famines. NGOs. Food aid is a valuable tool to overcome hun- Immediate Actions to Address Chrnic Hunger ger, and it is often preferable for. it to be mone- tized, and the counterpart fimds made available As a follow-up to the World Deelopment Report to finance food entitlements. These interventions 1993, the goals of the September 1990 WorldSum- should be supported by assistance for nutrition mit for Children, and the December 1992 Inter- education and the provision of micronutrients national Conference on Nutrition, countries need and health services. The WFP and contributions help to prepare, implement, and finance action frombilateralfood aid donors are essential in this plans for negistic, low-cost, hunger-reducing effort The Committee on Food Aid Policies and health and nutrition interventions. A few specific Programs is one institution through which to low-cost interventions are relatively easy to develop such programs. implement and can have an immense impact on Where the potetial for income generation is the health and nutritional well-being of poor peo- poor, help can be provided to finance employ- ple, especially women and hildren- These ment generation programs along the lines of the incdude the following: - Botswana Food-for-Work Program or the largely * Reducing vitamin A, iodine, and iron defi- self-targetingMaharashtra EmploymentGuaran- .dencies through fortification, supplementa- tee Scheme-- tion, and dietary modification Exp anding childhood immunization cover- Actions to Address Chronic Hunger age from 80 to 95 percent in the Aedium Tern * Implementing low-cost programs for control- ling parasitic infections that cause anemia and In developmentprojects, and especially inadjust- * malnutrition- . ment lending itis essential to encourage employ- These services should be linked to nutrition edu- mernt-intensive growth as the most powerful cation through community-level delivery- Such approach to reducing poverty in the medium to action plans would be sharply targeted on the long rurn. Governments should be encouraged most cost-effective interventions similar to the to undertake measures that successfulUNICEFprogram onoralrehydration. * Promote macroeconomic stability and open- There is no reason why all developing counties ness of the trade regime should not achieve comprehensive coverage of * Eliminate direct and indirect taxation of the their populations within five to seven years. farm sector to encourage domestic food pro- Targeted food assistance programs should be duction and rural income and employment mounted that provide food entitlements to chil- growth dren and to entire famiies whose children and - * Eliminate anti-employment taxes and credit mothers have been identified as malnourished in subsidies health posts, schools, or other social programs * Reduce the extent of direct and indirect labor through growth monitonng Entitlements should taxation and increase cost-effective, labor- preferably be provided in the form of food intensive infrastructure construction- 142 Appendix I Countries should be encouraged and assisted to nonfam economy. In some countres it is being mount income generation programs in rural and tested in an urban settig. Such credit, however, is urban areas, including following specific key more difficult to manage in more sparsely popu- actions. lated and highly nsky agrodlimate zones such as Much can be done to focus govemment exten- the semi-arid tropics. Nonetheless, informal credit sion and research on the needs of small farmers mechanisms that could be fostered exist even in to help overcome hunger, both to produce more these areas (see Indonesia case study)- food and to generate more income to do this. Specifically this includes Actions to Achieve Sustained Long-Tenr Poverty • Continued emphasis on small farmer exten- Reduction sion and other agricultural programs targeted at the poor Reform measures to reduce fiscal and monetary * Strong support for national agricultural imbalances, reduce market distortions, and pro- research systems, with special emphasis on mote efficient public management are essential to the farming systems characteristic of the poor foster economic growth (see World Developnent * Intensified support for the CGIAR to under- Report 1991 for a detailed exposition of successful take research on food commodities that are development strategies)?3 Development practi- particularly important in the consumption tioners recognize that such measures may have a and production of the poor, and on policies short-term negative impact on the poor and the and programs intended to help small farmers, hungry unless special compensating actions are and especially poor women farmers. undertake Consequently, it is imperative that Within the context of overall financial sector every effort is made to protect and help such vul- reform, increased attention should be given to nerable groups (see box 3), includingv policies and programs that provide small loans to * Protecting primary health, nutrition, and tar- the rural and urban poor, particularly women, geted food assistance programs from cuts along the lines pioneered by the Grameen Bark * Increasing targeted compensatory expendi- in Bangladesh, and more recently by the Founda- tures for vulnerable groups through safety net ton for International Community Assistance actions, including social funds and public. (ENCA) in Latin America and the Freedom- works employment programs, where basic from-Hunger Campaign (FFC) in Africa. food prices are likely to nse Programs of the Grameen type combine credit *Improving the targeting of food subsidies to withthe provision of advice and public education the poorest and most vulnerable groups on sound nutrition and health practices, family *Introducing cost-effective strategies and planning, and sanitation. External aid agencies financing plans to stabilize the prices of the should encourage the exploration and establish- most essential staple foods under conditions ment ofprograms that address the creditand sav- of large temporary international price shocks ings needs of the self-employed poor. In * Expanding the access of the poor to credit to particular, donors could enable them to acquire assets so as to become * Explore the possibilities for establi hing fund- productive. ing mechanisms to support micro-credit For the rural poor, who comprise the largest schemes. Onebeneficiaryofsuchsupportcould segment of poor people in the world, the key to indude the program for establishing and sup- income geation is getting land, because they porting Grameen Bank replicators, FINCA's have no assets other than their labor. Having land village banks, or their equivalents worldwide not only allows them to produce income and food (see FINCA and FFHC case studies). for themselves, but also allows them to tap com- * Provide grants to NGOs that are experiment- mercial bark credit and to be integrated into ing with new ways to reach the poorest and broader social networks, thereby allowing them hungriest people. to withstand droughts and other shocks better By Group-based microa-eterprise credit is often shifting assets to poor rural people, we can give most appropriatefor situations of high population. them a buffer Moreover, in low-wage countries, density, landlessness, and a thriving urban or rural large farms tend to have lower productivity and Orcoming Globd Hunger An us Paper 143 to employ fewer workers than small farms- There are critical areas in which the line Therefore land reform can improve the effiaency between hunger and environmental sustainabil- of agricultural production and help absorb ity is most sharply drawn. hI such cases too com- increasing labor forces (see World Development munities need special assistance to tadclde their Report 1990) 37 Land reform in countries with critical natural resource management problems highly unequal land distribution can use market- (see the Niger case study)- assisted programs to make agricultural land available to the landless. The African National Issues for Discussion Congress is considering;such a land reform option in South AfAica, where the party proposes to Widespread agreement exists that persistent transfer land to the vicbms of apartheid during a chronic hunger is primarily a consequence of five- to ten-year period extensive continuing poverty The experiences of Box 3. Addressing hunger in structural adjustment Oneof the mostsensitive areaswherereducnghunger and achievinggrmwth impinge concerns structural adjust- m ment operations Esuring that the macroeconomic environment is nght for sustained growth is important for the long-term development of a country, but this concem with the long term must not edipse actions urgently needed today to overcome hunger. An important principle in adjustment operations is that, at a mintimuIn, there should be no net losers among the hungry. How this iught be done in two key areas of adjustment is descrbed below. Maximizing Benefits * Stress the creationof employmentforunsidEledworkersinhungerproneareasand seasons (theremaybeoppor- tunities for incentives to encourage investment in such schemes). *Pwvidevocational trainingprograms, extensionservices, and crecit thatwould help the ultra-poor take advan- tage of the opportunities in cases where devaluation has increased the opportunities for domestic production] * Ensure thatwhere agricultural incentives are improved, that margnal farmers also benefit through special pro- grams introduced to overcome constraints (for example, access to credit, labor constraints at critical seasons). This particularly applies to women farmers. * Gear agricultural extension and other services toward helping improve household nutritional status. * Ensure that when adjusting relative prices, goods produced or consumed by the poorest are favored. * Ensure that priority is given to provision of primary health care in hunger prone regions, that services are free to the ultra-poor, and thatadequate stress is given to appropriate nutrition education and to reducing diarrheal disease ffrough such measures as improving sanitation when restructuring health services * Ensure that stress is given to improving vocational education, adult literacy, and other programs that develop human capital, and therefore the income-eaningcapacityof the ultra-poor when restructuring education servces. *Ensure that agricultural services give priority to extension services that are of special value to marginal farm- ers, particularly women farmers- P'rotecting the Hungry from Shocks * Adjustment programs should include monitoring of the impact of reform measures on the poor and, within tiis, focusespeciallyon the nutritional status of vulnerable groups and on the incomne levels of the ultra-poor. *Whenever an adjustment measure might create hardships for the ultra-poor, the cost to specific population groups should be calculated and studies conducted to identify the most effective mechanism for ensuring that at least an equivalent benefit is provided. Such a study should involve consultation with the vulnerable groups themselves, who should also be involved in the execution of the compensatory program to ensure minimum leakage to local elites and others. * When cuts in subsidies are required, they should be concentrated on those subsidies enjoyed mostly by the bet- ter off (for example, those provided for rail and air travel, energy, and certain kInds of foods). *When subsidies are cut, those used significantly by the ultra-poor should be retained wherever possible. * When expenditure cuts require reduced services, those that benefit the hungry should be retained, and when adjustment prog-ams lead to increased food prices. additional measures are required to ensure that the poor are compensated. 144 Appendix 1 the past twenty-five years indicate clearly which particular country's circumstances? 1Tn general, developmentstrategies have been successful and answeing these questions will require a sys- which have not, both in raising per capita tematic economiuc and social evaluation of incomes generally, and in achieving a reduction these interventions and a knowledge of coun- in poverty specificaly. These were discussed in try conditions that can only be acquired some detail in the world development reports for through household surveys like those now 1990 and 1991. The persistence of considerable being undertaken in Africa as a follow-up to poverty in many countries is caused not so much the Soial Dimensions of Adjustment Prgram, by a lack of knowledge about what measures and the living Standards Measurement Study need to be adopted, but rather by a failure to surveys being carried out elsewhere. How can adopt sound ecoonomic and social policies and to this process be accelerated? implement them with persistence and determi- * A division of opinion exists between those nation. The reasons for this are weak institutions who stress growth and poverty reduction as and capacities, political blodcages and disagree- the best means of addressing poverty, and ments, and poor governance. A lack of natural advocates of direct interventions that stress resources and a harsh climate are drawbackcs, but empowerment, equity, and the right to food. not insuperable obstades, as the Republic of Both groups are working in the same direction Korea has dramatically demonstrated. to a great extent Are these two options alter- Even though economic growth does result in natives or complementary actions? a reduction of poverty, and hence of hunger, - If hunger reduction in the short term involves growth alone will not be enough to overcome food or cash transfers to the poor, what share malnutrition and food insecurity, as can be seen of government and international budgets from the expenence of Indonesia Specfic tar- should be devoted to this goal? geted interventions are also needed to address * Howcanexistingknowledgeabouthowtopre- chronic hunger, protein and mincronutrient defi- vent famines be applied in Africa, and espe- ciencies, and transitory food shortages. dially to avert slow-onset (drought) disasters?. To achieve a rapid reduction in global hunger, * Given that in a number of countries poor gov- a number of issues need to be resolved.- enance leads to a lack of leadership concern * Countriesneedtoestablishafocalpointtoini- about hunger, what can be done to give tiate and coordinate a well-articulated strat- hunger alleviation greater priorit in govern- egy for overcoming hungec Because hunger ment agencies in those countries? reduction is mnultisectoral, such a focal point * Because food is both essential to sustaining must succeed in coordinating actions that are human life and a commodity, how can these the responsibility of several sectoral rnin- concerns be brought together? The first istries, which is inherently a difficult task emphasizes social and political analysis, the Where should such a focal point be located to latter economic analysis. Important method- be effective? ological differences as well as value judg- * Exteral agencies have a major role to play in ments are involved. How can each concern providing food and financial aid to countries inform the other? with hungry populations. To be effective they * How can the need for empowerment, which too need to establish a focal point capable of places a high priority on household, commu- achieving a coordinated and pro-active nity, and national food self-reliance, be more response How can thev best do this? effectively linked with the equally important * How can a global program to overcome need for an expanding and well-functioning hunger be given sustained global support? IE world food market? Both are essential for a world food board or world food council is overcoming hunger worldwide. Both need to not the answer, what is the answer? be efficient sustainable, and equitble * A great range of direct interventions is possi- * What is the place of overcoming hunger in the ble, but resources are inevitably limited. Which context of development and poverty reduc- interventions are the most cost-effective? tion? If overcoming hunger is to have a high Which set of interventions is best adapted to a priority, how can this be realistically achieved? Ovnoing Global Hunger An Issues Paper 145 Notes 15. UNICEF, Child Malnutrition: Progress toward the Worid Sumitfor Children Goas (Ceneva: UNICEF, 1993). 1. Amartya Sen, Public Action to Remedy Hunger 16. IFAD, The State of Rurl Poverty (New York New (Londoin The Hunger Prpject. 1990). York University Press, 1993). 2.Sen, Public Action to Remedy Hmger. 17. Bread for the World, Hunger 1994; United 3. World Bank, The Challenge of Hunger in Africa Nations Development Programme, World Development (Washington, D.C: World Bank 1988), 3. The compan- Report 1993 (New Yorkl UNDP, 1993). ion paper referred to is Ending Hunger Sor Concpts and 18. World Bank, The East Asian Mirack (Oxford: Priorities, in this volume. Oxford University Press, 1993); Frieda Johansen, Povrty 4 P. Berek and D. Digman, Food Security and Food Reduction in East Asia, World Bank Discussion Paper 203 Inventories in Developing Countries (Wallington, (Washington, D.C.: World Bank, 1993). Oxfordshire, U.K. CAB Intemational, 1993). 19. World Bank, World Development Report 1990, 5. In part this dedline reflects ite indusion of comun- chap. 3. ties, in particular China, that were not included in earli- 20. UN Decaration on Human Rights. er FAO estimates. If exduded, the prportion of the mal- 21. Jean Dreze and Anay Sen, Hunger and Public nourshed would have fallen from 31 to 21 pecnt, but Polcy (Oxford: Oxford University Press, 1989). t'he number would have increased frm 536 to 579 nil- 22. World Bank, World Development Report 1990, lion betweea 1970 and 1989. FAO, State of Food and chap. 3. Agrictre (ome: FAO, 1992),2L 23. Amartya Sen, "The Economics of Life and &6. Donald 0. Mitchell and Merlinda D. Ingco, The Death," Scentiflc American (May 1993); Drze and Sen, World Food Outlook (Washigton D.C: World Bank, 1993). Hunger and Public Policy, chap. 10. 7. World Bank, World Development Report 1990 24. Pierre Crosson and Jock R. Anderson, Resources (Washington, D.C.: World Bank, 1990),2. and Goal Food Prspects: Supply and Dmand fir Cereals 8. World Bank, World Development Report 1992 to 2030, World Bank Technical Paper no. 184 (Washington, D.C.: World Bank, 1992). 7. (Washington, D.C.: World Bankr, 19)- 9. See Bread for the World, Hunger 1994 (Silver 25. Jean Dreze and Amartya Sen, Thi Political Spring, Md-: Bread fo r the World, 1993) Ecnmy of Hunger, vol. 11, Famine Preion (Oxford: 10 Sterling Wortman and Ralph W. Comnmigs, Jr, Oxford University Press, 1990). To Feed This World (Baltimore, Md_ Johns Hopkins 26. World Bank, World Development Report 1990; Univrsity Press, 1975), 85. Wold Bank, Aiance Sttegis to Reduc Povertw World f.L US. Department of Agrinculture, The World Food Bank, Poverty Reduction Handbook The quote is from Situation and Prospects to 1985 (Washington, D.C: US. Assistan Strategies to Redwce Pory, 5. Department of Agricultue, 1974). 27. Joy Miller Del Rosso, Investing in Nutrition 12. The Bellagio Dedaratiorr Overcming Hunger in (Washington, D.C.: World Bank, 1992). the 190s (Bellagio, Italy, November1989). 28. World Bank, The Challenge of Hunger in Africa 13. FAO and World Health Oganization, Intrnatiol (Washington, D.C., 1988), 3. Conference on Nutriion and Plan of Action for Nutrition 29. The FAO has also prepared a number of food (Rome: FAO and World Health Organtion, 1992). secunity strategies in Afrn cuntries, namely, in Chad, 14. World Bank, World Development Report 1990; Niger, Tanzania, and Zambia. World Bank, 1990 Assistance Strategies to Reduce Povrty 30. See Wold Bank, World Deveomnt port 1990. (Washington, D.C.: World Bank, 1991); World Bank, 31. World Bank, World Development Report 1991 Poverty Reduction Handbook (Washington, D.C: World (Washington, D.C.: Wbrld Bank, 1991). Bank, 1992). 32. World Bank, World Devopmet Reprt 2990. Appendix 2 Addressing Hunger: A Historical Perspective of International Initiatives HXunger has been the focus of intemational policy tions and recommend remedies for its eradicationL pronouncements and conferences for a long time. Often, however, actions are selectively applied to DevelopmentinsttutionssuchastheWorldBank, only the more readily taclded forms of hunger the International Fund for Agricultural Develop- While this is understandable and maywell be the ment (lMAD), the World Food Programme (WFP), cost-effective thing to do, one must be on guard the Food and Agriculture Organization of the that this should not become a -"smoke-screen" Uimted Nations (FAO), and the United Nations (unintentional or otherwise) thatobscures thefail- Children's Fund (UNICEF), along with govern- iure to act on ihe most difficult manifestation of ments and nongovermnental organizations hunger, chronic undernutition. (NGOs), have emphasized the hunger focus of The world has made progress toward eradi- their assistance programs. This cursory review of cating starvation and some forms of malnutrition, the history of hunger initiatives can only touch on but less (and some might say very little) toward some of its highlights. It attempts to explain why alleviating chronic hunger and- food insecurity some dimensions of hunger have been more suc- The reason is that one can address starvation and cessfully addressed than others and some institu- malnutrition through relatively short-term super- tional frameworks have worked better than ficial interventions that do not significantly alter others. prevailing economic and power structures. The There are three basic manifestations of hunger alleviation of dhronic hunger, by contrast, requires and malnutrition: (a) starvation, which is a life- politically far more difficult solutions. Chronic threatening condition caused by insufficient food hunger is a reflection of poverty, and therefore of that is generally assocated with acute situations the existing distribution of wealth and power like famine; (b) chronic hunger or undernutrition, within a country which is caused by a long-term intake of calories Hunger initiatives are directed toward differ- that is insufficient to cover nutritional needs; and ent audiences. This review covers primarily ini- (c) pathological conditions, which result from tiatives emerging from institutions or conferences inadequate consumption of calories, protein, and mtended to provide bluepnnts for action. This nmicronutrients, and are often found in combina- selective emphasis on action-oriented initiatives tion with infections and inappropriate nutrition- does notimplythatwe underesimate thevalue of related behaviors. hunger initiatives. that reach out to the much Major conferences, such as the World Food broader audience of public opinion. Conference or the World Nutrition Conference, as Without support from public opinion and well as development organiations and donor. political pressure, both in rich and poor nations, govemments, deplore hunger in all its manifesta- the implementation of specific action initiatives This paper was prepared by Siomo Reutinger and Anne Maie del Castflio. D147 148 Appendix 2 would have little chance. Thus, many of the con- all people, including the hungry, live. They ferences and organizations covered in bis review include measures that are intended to increase or may well have made important additional contri- stabilize global and national food supplies by butions through their impact on creating public promoting food production, trade, and stock- awareness. -Media events" directed exdusively holding. They also include measures to increase to broader audiences are of immeasurable value. the wealth of nations. These include such events as Live Aid, Band Aid, The second group, poverty-oriented solutions, and the less glamorous, but perhaps even more emphasizes.the inadequacy of purchasing power influential, continuous educational work of (often and attempt to improve directly the present living church-related) NMOs. Such humanitarian-or- conditions of people who are hungry either by ented initiatives increase the availability of enabling them to earn higher incomes with which resources from private and public sources for to procure more food, orby enabling them to pro- relief aid and give governments an incentive duce more food, or both. Efforts generally rely to act upon ways to increase poor households' access to In recent years developmental and humani- more adequate and higher-uality diets, primar- tarian orientations have converged noticeably. ily through gains in income from all sources, but Humanitarian-oriented efforts, properly admin- also through nutrition education and nutrition- istered, do increase resource mobilization signif- related health programs. icantly. Authorities are increasingly aware that Agricultural or supply-oriented solutions development is a prerequisite for the prevention view hunger as a symptom of inadequate perfor- of future, more severe emergencies. Those con- manceby the agrcultural sector either globally or cerned with development now recognize the in particular nations. Those solutions that con- need for remediall action or safety nets for those centrate on increases in GNP view hunger. as the families sufferng from hunger today. result of poor performance by national economies Many different proposals for addressing the as reflected in national per capita income. hunger problem have been made. These can be Preventing starvation arsing from natural or classified into two broad headings as shown in man-made calamities or eliminating a particular table 1. The first group is the macro solutiors, malnutrtion problem usually calls for direct which aim at changing the environment in which delivery (ast column of table 1). The solutions to Tkle 1. Classifiation of hmger solutions .' ,U~~ ~ ~~oov . 'w- iend : -itnmandol Nodond- hou :d Food Increasing supply Inaeing supply Inaeasingcorsumption * Researh and extension * Production and researh E Ergency and dught rlief * Canservabo of naeural resources * Imports - Feeding and nutrion progwms - Stdas - Subidzed d rafionm * Pbsfhrvestfood bss Jmsiution Sablizing supp StabTbig supply Improaing nutrition and wel-beirg * Stods - StaDtS . Infnnation and educadion Earywarning Trade MKronutiertspplemnts * Reseadr Earlwarring * Access to adeqate water and sanation --Incea*igcDnssnVpion and improvingdistbution - Food macet intervention Income -Leve ofincome hireaskng production - GNP growth Smalifanrer - Aid in moey or in kiid Resour-preons v Employmertprogm Stabilt dfincome Hurmn resouce develpment - Food amratouyfman&cigo1fes - Grain reservs icome disbbon - ' ' ~~~~~~~~~~~~~~~~~~~~~~~ocioal secuiL v Unempbymer insuran - Food subsides orvoudiers Addrssing Hunger A Historical Perspewtir of Internalional ltIitiatiuer 149 taclde chronic hunger are much less obvious and RediefAgencies, Early Warning Systems; will be duly noted later. and Food Aid Starvation, Famine, and Emergency Relief Several international agencies are involved in relief activities. Since 1992, the United Nations The number of people affected by famine, an esti- (UN) Department of Humanitarian Affairs, under mated 15 to 35 million, is small compared with which the Office of the UN Disaster Relief Coor- the close to 1 billion people who suffer from a dinator and the UN Disaster and Rehabilitation more chroic form of hunger. Since the 1950s the Office operate, has been responsible for coordinat- incidence of famines has shifted from Asia to ing intermational relief and assisting countries Africa. One estimate suggests that the population with disasterpreventionand preparedness. Under of countries reported to be affected by famine has its authority is a revolving fund of US$50 million declined from a peak in 1957-63, with a yearly and a register of stand-by worldwide capacities to average of 788 million people, to.264 million in ensure rapid and coordinated response by the 1978-4 This downward trend continued during organizations of the UN system. the next seven years (1985-91), when the popula- Effective early warning systems at the inter- tion of famine-plagued countries averaged 141 national, regional, and national levels have million. In 1992 famine was reported only in averted or mitigated the effects of naturl disas- Somalia and the Sudan, with combined national ters, especially those caused by local harvest fail- populations of 35 million? ures. The FAO's Global Information and Early International and national emergency relief Warning System, an international information efforts to combat starvation and famies have network that relies on such sources as satellite- been extensive and relatively successful Natural conveyed data and reports provided by NGOs, disasters used to claim millions of lives. Today, anticpates and assesses severe food shortages outside of Africa, with few exceptions only peo- throughout the world. Itprovides assessments on ple who are subject to ruthless neglect or actve a regular and an alert basis, largely in terms of pursuitbytheirowngovernmentsarelhreatened national food balance sheets and food import with starvatiorL Intolerance of famine caused by gaps oriented to provide information to food aid natural or man-made disasters is one of the most donors. The Famine E-arly Warning System, striking accomplishments in the international funded by the US. Agency for International community's struggle against hunger Development, provides detailed agricultural With the important exception of Africa, information, but geographic coverage is rela- famines resulting from natural causes have tively limited. The System d'Alertes Precocoes, become less frequent and severe, but not because established by the European Economic Com- clmates and food production have become more munity and implemented by an NGO, has been stable. More efficient transportation and better particularly effective in Chad and Mali A num- communications have improved international ber of separately funded early warning systems and domestic preventive and relief operations. In now exists in Africa. addition, the greater effectiveness of trade as a Emergency food aid is the primary means by stabilizer and stronger international and national which the international community responds to solidarity, backed up by public action, have disasters. In 1990, approximately 32 percent of reduced the ravages of famine. food aid for emergency purposes was provided In Africa, by contrast, drought-related disas- through the WFR. In addition, the WFP made pro- ters are occurring with greater fiequency and curement, transport, and monitoring services impact Estimates of deaths inAfrica during the available to bilateral donors, whose contibutions 1980s range from 400,000 to as high as 2 to 3 mil- accounted for some 15 percent of emergency food lion for the 1983-84 drought alone. In 1991, 23 aid. Food aid distributed by the NGOs from their million people were seriously affected by own resources and from those of the bilateral drought in Africa?2 Indeed, between 1987 and donor programs accounted for more -than. one- 1989 nearly 58 percent of all food aid for disaster third of the total. Other multilateral programs rdief was shipped to Sub-Saharan Africa. distributed the balance. 150 Appendix 2 The International Emergency Food Reserve, . ger or undernutrition, and the pathological con-. established in 1975, is a reserve for which partic- ditions resulting from inadequate consumption of ipating donor countries pledge in advance to calories, protein, and micronutrients, often in make grain available when the WFP alerts them combination with infections and inappropriate that such aid is necessary to avert starvation in nutrition-related behaviors. One of the essential the face of nonrecurring natural disasters or wars. characteristics of the latter is that while it is often Itis the only international mechanism specifically symptomatic of poverty, some of its effects can be designed to respond to food emergencies. Relief dealtwithquiteeffectivelywithmodestresources for long-term refugee operations is handled andwithoutmajorimprovementsintheeconomy. under a special fund separate from the Inter- Indeed, Alan Berg writes: national Emergency Food Reserve. Although malnutrition is dosely linked Response of the World Bank and NGOs to a country's level of economic develop- ment, nutritional improvements need not Since its earliest days, the World Bank has await development ... Addressing the responded to emergencies by providing advice underlying causes of poverty remains a and financial assistance, mostly through emer- vitally important development objective. gency recovery loans, the modification of existing But the time required to reach the most loans (notably the reallocation of funds to critical impoverished and the immediacy of the investments of the Bank's existing lending pro- malnutrition problem argue for a contin- gram for the country related to emergency relief), wing direct attack on nutrition deficien- or bothl Bank policy specifies that all emergency ciesasweL... Efficacious and affordable recovery loans and, when appropriate, other measures are at hand.4 investment operations in disaster prone countries, should include disaster prevention and mitigation The remedies for malnutrition can cure some components, suchas the installation of earlywarn- of the effects of the lack of access to an adequate ing systems and studies to prepare a disaster pre- diet and circumvent the causes. Malnutrition vention strategy and develop the institutional interventions, frequently financed with interna- framework best suited to implement it3 tional assistance, indude highly targeted food The importance of NGOs in intemational distibution and supplemental feedingprograms responses to famine is unparalleled. The nature of for mothers and children, food supplements, for- NGOs has permitted them, at times, to side-step tified foods, and nutrition education. These mea- some of the thorny issues of national sovereignty. sures are efficacious, and they are sometimes The role of the private voluntary agencies, partic- supported by powerful national interests pre- ularly CARE in Somalia, is a dramatic example of cisely because the measures reduce human suf- the growing commitment to eradicating starva- fering, yet do not threaten existing political and tion and of the sophistication of modern relief economic structures. efforts in terms of capacity to distribute large vol- umes of food quicldy in a hostile envirornment In Foreign Assistance Agencies many countries, particularly in Africa, the author- ities see the NGOs as effective in the responsibili- International attention to the problem of malnu- ties that they assume, namely, targeting food trition in large populations led to the establish- distribution to vulnerable groups, engaging in mentof the Sub-Comrnittee on Nutrition, a forum emergency water and sanitation activities, help- in which all UN and bilateral aid agencies mg displaced people, and supporting the recov- exchange information and issue pronouncements ery of agriculture. about the nature and causes of and remedies for nmalnutrition. Alleviating Malnutrition In the forefront of supporting measures to alleviate malnutrition over the years have been Earlier we noted the three basic mnanifestations of UNICEF, the World Health Organization (WHO), hunger and malnutrition starvation, chronic hun- the FAO, and several bilateral assistance agen- Addressing Hunger: A Historical Pen pective of Intiernational Initiatives 151 des, particularly the US. Agency for Intema- successful, the governments lacked the resources tional Development.5 In recent years, the World to extend these programs nationally. Bank has also become an active participant. In the 1960s nutritional rehabilitation and Oneof the earliest successes of nutrition inter- mothercraft centers, with their emphasis on vention was the promotion of salt, iodization, nutrition education, came into vogue. Com- which began in the 1950s through organizations munity weight-for-age surveys were conducted such as the WHO and UNICEF. While the prac- to determine which children were suffering from tice has been adopted throughout the world, moderate to severe malnutrition. Supplementary political indifference has prompted lack of com- feeding was combined with mateinal education. pliance, and in many developing countries Antedating all other nutritional interventions, endemic goiter remains a serious problem. supplementary feeding programs have been by Iron deficiency is the most widespread nutri- far the most prevalent. iood aid made readily ent deficiency in the world.6 Despite the recogni- available from large donor surpluses supplied tion of its contribution to morbidity and mortality these programs. UNICEF, as well as CARE, CAR- from infectious disease, its damage to effective- ITAS, and other private voluntary agencies, pro- ness in education, and its direct effect on work vided food aid to school feeding programs and productivity, consensus on an appropriate, easy mother and child feeding centers. Despite their technology to prevent it is lacking. As interven- relatively.high counterpart costs in terms of stor- tions to prevent iron deficiency have held a low age, transportation, and personnel, host govern- priority on national and international nutrition ments usually welcomed these programs. agendas, the fortification of foods, including bev- erages, salt, and sugar, is rarely adequately World Bank Nutrition Initiatives implemented. Attention to the significance of vitaminA was Nutrition became an object of World Bank atten- previously limited to the severe ocular manifes- tion in the 1970s as part of its basic needs tations of xerophthalmia and keratomalacia, but approach. At the time, Bank staff were concerned recent research has established a relationship about the potentially harmful effects of malnutri- betweenvitaminAstatus andmortalityandmor- tion on the mental development of hundreds of bidityin young children from infectious diseases. millions of childrnL While there was much The WHO and UNICEF have strongly promoted uncertainty about what could be done, arguing the distribution of vitaiin A palmitate to all chil- that malnutrition should not be a central concern dren up totwoyears old in countries at risk of vit- for a development agency became difficult. amin A deficiency. This program has been well Later, a new professional consensus estab- administered and aggressively pursued, and has lished that often malnutrition is not caused by met with considerable success. However, success inadequate protein intake, as earlier studies had has been limited by the extremely poor infra- emphasized,but by insufficient food energy. With structure in some risk areas and the possibility of this understanding, malnutrition could no longer incomplete protection because of the difficulty of be regarded as just another disease that could be ensuring that children receive adequate dosages. cured by administering the appropriate medi- The major nutritional intervention efforts of cines or vaccines. Furthermore, the work of two the 1960s were the FAO, WHO, and UNICEF Bank economrists-Selowsky and Reutlinger- applied child nutrition programs. The three exter- showed that even if the cost of increasing poor nal agences collaboratedin sponsoringprograms people's food consumption to meet caloric that would involve the ministries of education, requirements were not low, hghly targeted subsi- health, and agrculture and included school and dized food programs could show positive eco- home gardens, nutrition education, and supple- nomic benefit-cost ratios. Discrediting the notion mentary feeding. In at least fortyi countries, that there was necessarily a tradeoff between demonstration communities were carefully growth and poverty alleviation justified the selected and external resources were provided to implementation of policy interventions that pro- supplement those available from the government vided minimum adequate food, health, educa- While the pilot programs were for the most part tion, and shelter for specific groups. 152 Appendix 2 In the mid-1970s the World Bank began to subsequently endorsed at the WHO/FAO 1992 explore how it might contribute to the improve- International Conference on Nutrition. These ment of nutrition. A learning-by-doing approach goals included reducing iron deficiency in was adopted for large nutrition projects in BraziL women by one-third of 1990 levels, virtually Colombia, India (the state of Tamil Gnat), and eliminating iodine deficiency disorders and vita- Indonesia. Each included components for institu- min A deflciency, promoting exclusive breast- tion building, a food subsidy program, and nutri- feeding for the first four to six months of a child's tion education. Later the Bank decided that it life, and reducing severe and moderate malnutri- should try to incorporate nutritional concems into lion of children under age five to one-half of 1990 agricultural and rural development projects, and levels. that improvements in nutritional status should become an objective and part of the design of Chronic Hunger and Undernutrition health projects. The thrust of the Bank's nutrition and Food Insecurity programs concentrated on its particular advantage in drawing officials' attention to problems, assist- Chronic hunger persists: nearly 1 billion people ing in plannminfurthering the development of pro- silently suffer from chronic hunger. Today about ject analysis, and providing enough resources to as many people as in the 1970s do not earn make significant interventions possible. Recent enough money to secure an adequate diet? Pro- years have seen the development of a sizable port- gress in alleviating hunger has certainly fallen folio of nutrition operations in the Bank short of the targets set by numerous forums that have been convened to give expression to the Recent International Conferences global community's abhorrence of the persistent presence of dhronic hunger. Tobe sure, there have Recently, several major conferences have con- been dramatic success stories, particularly in cluded by endorsing targets for reducing malnu- Asia. Unfortunately, hunger has become more titiorL While having little direct bearing on severe inmanyothercountries,predominatelyin reduang malnutrition as such, development prac- Africa. titioners see target setfing as useful in establishing Chronic hunger has been the target of many intemational priorities, providing a yardstick pronouncements and initiatives. It is not our against which to measure progress, and influenc- intention here to evaluate whether all or any of ing the budgetary allocations of intemational and these initiatives have been effective in reducing national donors. Substantial efforts would be hunger. Sorting out the positive and negative needed toaduievethese goals.Accordingtothe UN consequences of deliberately pursued policies Admiistrative Committee on Coordination/Sub- and actions and of uncontrollable factors in the Comnmittee on Nutrition's Second Report on the environment on the observed outcome would be World Nutrition Situation 1992, the rate of improve- a major undertaking. The best we can hope to ment in the nutntion situation is generallv far accomplish is to record the approaches that have below that needed to meet internationally agreed been tried and to speculate why, in our opinion, goals. some haveworked better than others so as to dis- The nutrition goals of the World Food till some lessons. Council's 1989 Cairo Declaration, later incorpo- rated into the UN international development The World Food Conference and Its Aftermath strategy for the 1990s, called for, among other things, the elimination of major nutritional defi- The World Food Conference held in Rome in'1974 ciencv diseases. The Bellagio Declaration of 1990 is widely daimed to have been a major milestone proposed nutrition goals, including the eradica- in drawing attention to the hunger problem in tion of iodine and vitamin A deficiencies, along developing countries. However, did this confer- with cutting hunger in the poorest households by ence put the train on the right track or actually de- haLf in ten years. rail what could have been a promising begiuting? The UNICEF 1990 Childrenrs Summit also set Although subsequently billed as a- major nutrition goals to be achieved by 2000 that were hunger initiative, the World Food Conference AddressngHunger A Histoncal Perspect of Intermation Iniiatives 153 was actually convened as a reaction to a sharp - relationship between hunger and poverty was rise in world food prices (together wit the prices only tangentially addressed. of many other commodities), which were misin- The Consultative Group on Investment in Food terpreted as an indication of an impending sup- Production. The Consultative Group on invest- ply scardty. At the same time, the framers of the ment in Food Production went out of business Club of Rome formulated their pronouncements soon after it was founded, but not because of a vf doom. Managers of the economies of the lack of interest in investment in food production. industrial as well as the developing counties To the contrary, by that time the World Bank, become concerned about the inflationazy effects under the leadership of its activist president of food pnrces and their political consequences. Robert McNamara, had already reshuffled its With Malthusian fears in the air, the conference portfolio of investments and otherwise expanded identified inadequate food production in the theresourcesgoinginto.agricultureandfoodpro- developing counties and flaws in the intema- duction. Moreover, once IEAD was funded, the tional commodity markets as- major contributors consultative group had little reason to exist tohungerItsresolutionsweredesignedtoaddress The FAO Committee on Wor1d Food Security. these culprits. In so doin& the conference The FAO Committee on World Food Security endorsed much of the supply initiatives that dom- was set up to assess the world food security sit- mated intemational hunger dialogue in the ensu- uation. During the early years of its existence, ing decades. Despite the adoption of the Universal one of its major preoccupations was monitoring Delaration of the Eradication of Hunge, which the level ofworld cereal stocks as compared with prolaimed that'everyman,womanandchildhas consumption. The committee considered that the inalienable nght to be free from hunger and stocks equivalent to 17 to 18 percent of con- malnutrition in order to develop filly andc main- sumption were the minimum level required for am their physical facilities," the fate of the poor world food security. In addition, during its people afflicted with hunger was not central to the annual meetings, at which delegates convene to conference deliberationsr discuss the world food situation and measures to The first resolution of the conference report address hunger, the committee is presented with declared that agricultural production in develop- reports for its consideration on various FAO ini- mg countries should grow at an annual rate of 4 tiatives with more or less relevance to hunger percent Tosupplementinadequateproductionin and food security. developing countries, the conference recom- In recent years, the committee has given much mended that food aid donors -provide com- attention to the FAO's Food Security Assistance modities and/or financial assistance that will Scheme and the Global Information and Early ensure in physical terms at least 10 million tons Waning SystenL The Food Security Assistance of - as food aid a year, staring from 1975."9 Scheme provides developing countries with tech- As a means of increasing stability in the world nical and financial assistance to design and gra- market, the conference endorsed the estab- implement food secunty strategies. This assis- lishment of an international coordinated system tance frequently includes improved data and of national grain reserves, the provision of addi- information networks, food stodcs, and pro- tional assistance to developing coEntries to estab- grams to inaease production. & lish these reserves, and the conclusion of In 1985 the FAO unanimously approved the international negotiations for a reserve system World Food Security Compact, which reaffinned agreement. "a moral commitment to achieve the ultimate The conference also established three interna- objectiveof ensuringthatallpeopleatalltimes are tional organizations to deal with the hunger in a position to produce or procure the basic food problem: the Consultative Group on Investment they need.'40 The compact marked an important in Food Production, the FAO Comiuttee on departurebytheFAOfromits earlier definitionof World Food Security, and the World Food world food security, with its emphasis on global CounciL All these organizations were either food supplies and stocks,to one that focused more meant to address food supply issues or ended up on the victims of food insecuity. By 1991 the FAO doing so for a good part of their existence. The Council had endorsed the foliowing 154 Appedir 2 Food security was becoming less a prob- By the early 1980s, when it became dear that lem of global food supplies, overall sta- countries would not be able to agree to an inter- bility and global stock levels as such, but nationally coordinated system of grain reserves, more a problem of inadequate access to the council finally turned its attention to an ini- food supplies for vulnerable groups tiative more dosely related to the hunger issue: resulting from, inter alia, lack of purchas- the poverty of nations. Following up on the writ- ing power? ings of severl economists at the World Bank and the International Food Policy Research histitute World Food Council The general assembly in the late 1970s, the council asked the Inter- established the World Food Council as a coordi- national Monetary Fumd (MF) to establish a nating mechanism for initiating policies perti- cereal financing facility?12 nent to food production, nutrition, food security, An extension of the IMF compensatory financ- food trade, food aid, and related matters. The ing facility became operative with the 1981 IMF council was to review, guide, and coordinate the CerealDecision,whichenabled theMvF toprovide conduct of food and hunger actions by multilat- assistance to members to finance temporary eral agencies, national governments, and the increases in the cost of cereal imports- Its purpose international community as a whole and to act as was to protect domestic food consumption levels a politcal advocate forthe world's hungry poor. in the face of shortfalls in domestic food produc- Bynominating ministers of agriculture as del- tion or increases in world cereal prcesn As it egates, govenmuents had in mind a council that turned out the extended Ceral Funancing Facility would link agncultural development, as the pri- was not used much for various reasons, mainy its mary instrument to reduce hunger, to economic unfavorable caedit tenms, the extensive availabil- and social policy and political considerations. ity of food aid on better terms, and.the inviolabil- While its mandate was to promote initiatives to. ityofupperlimitsonthe MF'scountryallotments. reduce hunger, the council primarily discussed One of the most significant World Food policies that met the interests of agricultuml pro- Council proposals was to establish national food ducers in both the industrial and developing strategies in the developing countries The strate- countries, for example, how to expand markets or gies were premised on the belief that regardless how to make production more profitable. of the possible losses in economic efficiency, a Proposals centered on food aid and food stocks country could eliminate hunger within its bor- and on how to promote greater self-sufficency, ders ordy by producing enough food domesti- even at aih economic cost cally to. meet its food requirements. The For years the council supported the need for strategies, which the UN General Assembly larger, internationally agreed, nationally held endorsed in 1981, were intended to be a means stocks. This was a dubious proposition from sev- "by which a country can actieve food self-suffi- eral perspectives, particularly as the proposals ciency through an integrated effort to increase never confronted the issue of mismatches in costs food production, improve consumption and and benefits to participating nations. Most of the eliminate hunger."n3 They were intended to link proposals implied large benefits from additional consumption needs more directly to production stoks for food importing nations, while tilefood obives, emplize the integration of policies exporting countnes were to bear the costs of hold- and proect activities, sustain adequate priority irg the stocks. However, an even more important. for the food sector, facilitate national decisions wealknessoftheseproposalswasthatglobalstocks related to the food sector, and increase and coor- would have done very little to alleviate hunger, dinate international assistance. because the primary causes of food shortages in While some of the studies underlying the low-income, drought prone countnes are badhar- preparation of the strategies are valuable addi- vests within their own borders and a shortage of tions to the understanding of countries' food ys- foreign exchange and purchasing power in the tems, the central perception underlying the hands of many of their households. The final cot- strategies-that hunger can be eliminated lapse of the discussions contrbuted to the erosion through food self-sufficiency and that importing of the councils credibility and prestige food while exporting agricultural commodities is Addressng Hunger A Histaia Prspectiw of lnktwnahizitiis 155 bad for food security-was flawed. Fortunately, poverty and the requests for resource transfers the council did not have the resources or author- yielded only declarations. Agriculture ministers ity to implement these strategies, but the plans had neither the interest, the expertise, nor the embodying them made it more difficult to authority to implemet such actions. Proposals develop and fund plans that would have genm- such as the use of vastly expanded food aid pro- uinely addresed hunger grams to provide short- and long-term assistance Beginnig in the mid-1980s, the council to the hungry, as originally proposed in the attempted to redirect the focus of international Cyprus Initiative, were rejected. Food supply initiativesfromsupply-orientedactions to actions considerations formed the basis for the opposi- that directly addressed poverty-related hunger tiontotheseproposals,thatis,wouldthefoodaid throughtheBeijinmCairo,andCyprusinitiatives. be harmful to exporting countries supplying Theperceptionthatstuctualadjustmentand commercially transacted food? Would the food stabilization programs were having an adverse aid be harmful to the producers of marketed food impact focused renewed attention on the vulner- surpluses in recipient countries? ability of the food security of certain segments of With its narrow focus on food supply and the population. Atone of the consultations called market lissues, the council was never able to by the council dunng 1987, the participants con- become a true advocate of initiatives broad sidered a proposal to compensate 50 million of enough to encompass the problem of hunger the poorest households in countries undergoing structural adjustments. Half of the package's esti- Food Aid and the World Food Programzne mated cost of US$5 billion could have been funded with food aid (equivalent to 15 million The World Food Progamme plays a unique role tons of cereals). The partcpants further sug- among agencies concerned with the alleviation of gested that part of the cash component be -uchric hunger. It promotes its own brand of obtained through partial debt forgiveness by strategies, prmarly in its role as the convener of donors and multilateral banksr While little the Committee on Food Aid, while at the same progress was made toward implementing this time it has command over sizable resources to proposal, it did galvanize thinking about the implement a great variety of programs. As effects of economic adjustment and stabilization alreadynoted, the W1F is the front-line agecy in programs upon the very poor and the need to implementin emergcy hunger relief pro- provide interim compensation to protect them grams and, together with UNICEF, is also sup- from deeper poverty andi greater hunger and porting many programs designed to reduce malnutrition, malnutrition. But what has been its contribution The council's Cyprus Initiative emphasized and, more generally, what has been the contribu- the urgnt need to protect the poor and vulnea- tion of food aid to the alleviation of chronic ble from the specific hardships posed by struc- hunger? tural adjustment programs and their associated Contrary to what mightbe inferred from pub- fiscal constraints. The view emerged.that lic pronouncements, a relatrvely minor share (23A percent in 1989-90) of food aid is used in The elimination of hunger, malnutrition child feeding programs, income transfer, or and poverty requires pecial policy atten- employment programs. For the most part, food tion; and that neither economic growth, aid is used for balance of payments assistance (57 important as it is, nor market forces by percent in 1989-90) and, to a lesser extent, for tlhemselves will spread the burden of emergency relief (19 percet in 1989-90).The fail- adjustment and distribute the benefits of ure of food aid to make a more significant contri- development in the equitable way bution to the alleviation of chronic hunger is needed to protect the poor and improve disappointing for a number of reasons. their situation in the foreseeable future.14 While conceived primarily as a means for sur- plus disposal, political support for continued Unfortunately, the calls for effective programs food aid derives increasingly from organzations to alleviate the twin predicaments of hunger and advocating the alleviation of hunger Seen in this 156 Appendix 2 context, itis disappoiting that the WFP (or more cific sodal and economic circumstances. It has precisely, the Committee on Food Aid) has not leamed, through considerable field experience, been able to provide more leadership to turn food thatinvestment for the poor is a good investment, aid into a major instrument for aleviating and that it can have a larger economic as well as chronic hunger. social impact than if deployed elsewhere6 The low utilization of food aid for programs T.he World Bank's approach to hunger has that directly contribute to the reduction of evolved over the years in response to changing chronic hungeris disappointing given thatdevel- external conditions and institutional factors. Not opment practitioners now widdy accept that surprismigly, the Banlks actions often reflect more food aid can be, and under many ircumstances than one approach. should be, monetized. With monetization as a In its early years, the World Bank primarily viable option, money derived from the sale of promoted policies and projects to increase the food aid could be used, for instance, for granting growthin nationalproduct The assumptin was credit to peasants in locations and seasons in that national authorities could subsequently which it would have been useless, or even coun- attend to poverty and hunger according to their terproductive, to transfer food to themL Now that own political philosophies. Also, based inpart on food aid can be used effectively for programs its expeience withthe reconstruction of war-tom specifically designed to benefit the poor, there is European economies, the Bank-initially stressed little justification for untargeted food aid.' the development of the industrial sector and related in-fastructur- Developmn7t Agencies: IFAD and the World Bunk Wit the arival of Robert McNamara in 1968, the Bank's pnonties rapidly shifted into new The impact of development agencies, such as the directions. For one, McNamara, with much sup- World Bank and FAD, on the alleviation of world port from his chief economist Holis Chenery, hunger is less a consequence of what theysay and promoted a quantum jump in lending This strat- more of what they do or fail to do. However, this egy was consistent with the then popular growth does not mean that their influence is exdlusively, models, which suggested that slow growth of or even primarily, related to the relative success developing country economies could be "fixed" of their investment projects. The World Bank, for by -transferring more resources to close the instance, attempts to influence macroeconomic "resources gap." and microeconomic public policies and actions Concurrently, the Bank began to pay more through its annual World Development Report and attention to the agricultural sector because of numerous economic and sector policy papers- industry's limited capacity to expand rapidly, the One of the most promising initiatives of the renewed flair-up of Malthusian scares about food FAO World Food Conference in 1974 was the and population growth, and the promising founding of the International Fund for reports about tecnological breakthroughs in Agricultural Development because it rested on agriculture the green revolution. As a result, an explicit understanding that hunger should be lending to agriculture increased significantLy in addressed by focusing financial assistance on the Bank's portfolio, and the Bank led in the eslab investments that directly benefit the hungry lishment and administration of hie Consultative IFAD became operationalin 1977 "to finance pro- Group on Intenational Agricultural Rearch, jects primarly for food production in the devel- which by all accounts turned out to be one of the oping counttes-'4 Unfortunately, an excessive most successfl international technical assistance concern with the food supply during the first ventures. The phenomenal growth in grain pro- decade of IAD's eistence probably limited its ductityhas certaindymade a major contribution effectiveness in terms of combating hunger. to the abundance of food in markets and the Later, IFAD's original mandate was more observed decline in foodgrain pnces during broadly interpreted to encompass investments recent decades. This growth in productivity is that lead to the alleviation of rural poverty. linked to sustained investment in international W:AD's experience taught the fund to aim at the and. national agricultural research relevant to productive potential of the poorest in their spe- basic food production. AddressingHunger A Historical Perspctive of Intrnaional rniiatives 157 Thus the Bank, kle the World Food Con- public investments. This skepticism, which coin- ference, confronted hunger with measures that cided with worsening economic conditions in the promoted agriculturalproduction to ameliorate a industrial countnes and hence reduced growth in potential food supply shortage. Yet the impera- the Bank's resources, sharply decreased further tive to expand agriculture quickly led the Bank to funding for inteated agricultural projects. realize that increasing food production in devel- In the 1980s development theories tended to oping countries is highly complex, because it advocate greater reliance on market forces and requires increasing the productivity of a multi- less on planrnng and government interventions. tude of poor peasants. As for agriculture, development experts recog- In the early 1970s the Bank initiated its inte- nized that reducing the implicit and explicit tax- grated rural development projects, which were ation on the sector practiced in many countries primarily intended to increase the agricultural could be far more beneficial to the sector than productivity of peasant famers through the pro- large public investments. Bolstered by the suc- vision ofimproved agricultura inputs and ofnew cess stones of a few (small) countries in East Asia, extension and social services. This was consistent the decade opened with renewed optimism about with the basic needs approach To carry out these the potential for rapid growth that would sweep projects, the Bank commissioned numerous pol- away poverty and food shortages-B icy and research papers on employment, land Some in the Bank were less optimistic about reform, low-income housing, population and ihe rapid transformation of counties into well- health, nutrition and education, and extension. functioningmarketeconomies and the unfolding From the outset it was dear that the inte- of unprecedented,highgrowthrates.Inaddition, grated rural development projects would not therewas evidence thateconomicgrowthtrickles directly benefit the landless or near landless, but down so slowly that even under the most opti- the Bank expected them to benefit from increased mistic assumptions of growth in national income demand for labor and from better access to basic and food production, poverty, and hunger would social services in rural areas. The basic needs not be swept away for a long time. These con- approach did not significantly alter the Bank's cems, reflected in a 1986 Bank policy paper, that conviction that projects, including integrated neither increased national economic growth nor rural development projects, designed primarily ample food supplies at the global or national lev- to benefit the rural poor should meet the usual els would elimirnate poverty, were not new?9 As cost-benefit criteia. Whle this approach facili- early as 1956, an economist with the FAO wrote tated program implementation, it became dear, in a paper discussing food stocks: '"alnutrition at least in hindsight, that the criteria may have is a chronic problemr. The main cause of under- restricted the flow of benefits to the poorest nutrition and malnutrition is poverty, lack of con- The concept of integrating multisectoral pub- sumers' purchasing power."20 lic services under the umbrella of a single rural Amartya Sen captured most eloquently the development project turned out to be orgariiza- dichotomy between the same emerging perspec- tionally unworkable. The activities intended to tives and those perceptions to which many inter- enhance human capital were frequently foregone national organizations continued to adhere: "The when line ministries of education, health, and so relentless persistence of famines and the enor- on were reluctant to be "integrated' into pre- mous reach ofworld hunge, despite a steady and dominately agricultural projects. Hence, the con- substantial increase in food availability, makes it tribution of integrated rural development to the imperative for us to reorient our approach away alleviation of hunger, even in rural areas, from food availability and towards the ability to remained at best modest. 7 command food.m Another reason for the early demise of rural Reutlinger and Selowsky had also previously development projects was the growing realiza- drawn attention to the relationship between mal- tion that development generally was not well nutrition and poverty in preparing quantitative served by a complex, centralized planning estimates of the.extent of hunger: '"That under- approach that relied for its implementation on a nutrition is a function of absolute poverty is self- smoothly functioning bureaucracy and large evident But estimates of the global magnitude of 158 Appendix 2 calorie deficiency in the developing countries The Bank's focus on Africa in the late 1980s have usually been made by reference to highly confronted it with the hunger problem particu- aggregated per capita data." larly forcefully. Here was a continent in which In its policy paper on poverty and hunger, not population growth exceeded the growth in food only did the Bank demonstrate unequivocally production without compensating growth in the the relationship between hunger and the lack of purchasing power of people and nations. For a adequate purchasing power, but it also asserted while some of the food deficit was made up by emphatically that the long-held belief that in- food aid, but it became dear to all that the grow- creased domestic production would lead to ing dependency of countries for their physical greater food security had to be discarded and survival needed to be addressed with urgency- replaced by polides that addressed the plight of The Barks prognosis and prescriptions, writ- the poor. The document states: ten up in a special report, The ChaUenge of Hunger in Afric A Call to Action, were discussed prior to Although far too many people eat too lit- and during publication in several ad hoc intema- tle, the energy deficit in their diets repre- tionalmeetingshostedbytheDutchgovernment sents only a small portion of the food The recommendations for specific actions energy consumed in most countries. induded the following: Increasing the food supply would not *Preparing specic actionprograms to promote eliminate this problem, since it would not food security in each Sub-Saharan country necessarily improve the incomes and the * Giving priority to projects and policies that purchasing power of the poor. This is why raisetheincomes of thefoodiinsecure anddam- internationalsupportshould focus onpoli- pen the fluctuations infood prices and supplies des and investments that would improve * Strengthening the institutional capabilities of the distribution of benefits by raising the African governments to managefood security real income of people facing chronic food programs insecurity and stabilizingaccess tofoodfor * Increasing the effectiveness of food aid, indud- people facing tansitory food insecurityn ing improvingpreparation and coordination of responses to emergency food situations The document concludes that the lack of food * Makingmoresystematiceffortstoidentifythe security is a lack of purchasing power that is not people at high risk of food insecurity,5 necessarily eliminated with food self-sufficiency. The Bank is now putting these recommenda- In the long run chronic food insecurity is elimi- tions into practice, buc with far fewer resources nated through economic growth, and.in the short than are requiredL A particularly noteworthy fea- run through measures to redistribute purchasing ture of this initiative was the active dialogue power to those who are undernourished. The between the Bank, other international organiza- document stresses that searching out only the tions and government-to-government aid pro- most cost-effective measures for implementation grams, and NGOs. The positive outcome was to is essentiaL. demonstrate that suchmeetings, held in an infor- Consistent with the view expressed in the pol- mal atmosphere, can establish a useful encounter icy paper on poverty and hunger, the World between people working on hunger in widely Bank's World Development Report l990 and Poverty different institutional settings. Reduction Haindbook emphasized the need to Implementation of-the envisioned active col- maintain macroeconomic policies that placed a laboration among the many agencies concerned high priority on creating employment, introduc- with hunger in Africa fell short of expectations. ing measures to increase the participation of the The lesson might be that expecting too much col- poor in growth and to reach resource-poor areas, laboration is unrealistic. Work on hunger ties in delivering social services to the poor, and pro- with a host of other agendas that are quite diffier- viding special income transfers arLd safety nets.4 ent for each organization. It is perhaps natural - The BankJs present lending portfolio and eco- that each organization should pursue, and be nomic and sector work are beginning to reflect. seen to pursue, those strategies that appeal to these perceptions. . their own particular constituencies. AddrssingHunSger A Histadzwl Pspctie of Interatianal Iniuatiuhs 159 Nongovernmental Organizations ity, and (c) empowering the poor. In particular, the summit recmmended dissemintingnowi- Apart from their irvaluable role in intenational edge and support services to increase food pro- feeding programs (involving approximately duction so as to ensure household food security. US$2.5 billion of food annually), the NGOs, The World Declaration on Nutrition, adopted because of their on-the-ground presence and by 159 participating counties at the FAO/WHO first-hand knowledge of the needs and the inter- International Conference on Nutrition in ests of the poor, have been extremely important December 1992, stated that "there is enough food in keeping the focus of development on the hun- for all and that inequitable access is the main gry. NGOs demonstrate a variety of approadhes cause [of hunger and malnutritioni] ... Poverty to addressing hunger and poverty The adminis- and the lack of education, which are often the tration of food aid programs, including food-for- effects of underdevelopment, are the primary work and nutrition programs, continues tube the causes of hunger and malnutrition." primary commitment of some of the largest In the opening address of the conference, the NGOs, such as CARE and Catholic Relief Ser- secetay-general of the United Nations judged vices. Others provide services for developing food and nutritional security to be the most cru- small and micro enterprises. Inspired by the cial issues for world peace and security. He Grameen Bank of Bangladesh small-scale credit placed nutrition in the forefront of national programs have become popular among NGOs strategies that put human beings as individuals andtheirdonors. Stil others are heavilyinvolved at the center of the development process. The n advocacy and education, and are directing UN's role would be to mobilize international -heir attention more toward policy and macro- awarness and concern and contribute to techni- economic issues. cal efforts. Ln addition to channeling sizable voluntary TheluNConferenceonEnvironmentand Dev- contributions (about US$2 billion each year), the elopment held in Rio de Janeiro in 1992, high- NGOs' advocacy work has been important in lighted the international concer for sustainable increasing foreign assistance flows to the poorest development and environmentally sound man- of the poor. The NGOs have leamed from field agement of natural resoures. According to experience that food reief is not the answer to "Agenda 21," which sets out ihe aims of the con- chronic food insecurity. As a consequence, Bread ference, sustainable agriculture, haracterized by for the World and other NGOs have become political will; proper economic analysis of envi- champions of assistance targeted directly to the ronmental impacts; appropriate incentives, such poor Their strong advocacy of peasant agncul- as prices, share nghts, and effective participation; ture has at times obscured their appreciation of Lnstitutionalflexibility;andcomplementaryinfra- the role that domestic and international markets structure, such as transwort, storage, credit, and couldplayinefficientlyproviding and stabilizing research, are needed to address world hunger. food supplies. Today awareness is growing that Chapter 14 of the agenda, which concerns national food self-sufficiency may not, in all food security, states that increases in food pro- cases, be a reasonable goal. duction improve food security only if they are sustainable. Policies to foster sustainable agricul- * Major Conftrenc of the 1990s tural growth should include provisions that avoid fragmentation of landholdings; develop Recent conferences, including the UNICEF and tran4fer appropriate technologies; and Children's Summit (1990), the Rio Conference on improve harvesting, storage, processing, distrib- Environment and Development (1992), and the ution, and marketing, Voicing a concem fre- International Conference on Nutrition (1992), all quently raised by the NGOs, the agenda called addressed hunger and endorsed recommenda- for strengthening rural organizations to decen- tions and targets for its elmination or reduction. tralize decisionmalcing- Chapter 32 maintains The UNICEF summit introduced new concepts to that a farmer-centered approach is key to attain- the dialogue on hunger that included (a) provid- ing sustainable agriculture in the developing and ing services to the very poor, (b) building capac- industrial counties. 160 Appendix 2 Concluding Remarks Lpoor Intermational assistance should be sufficient to combat chronic hunger effectively without Starvation from natural disasters has virtualy waiting for economic development to eradicate disappeared from the face of the earth, although poverty in some counties people still die from hunger because of the actions of ruthless governments. Notes intemnational awareness and efforts have been responsible for the progress made in elminating 1. Robert Chen and Robert Kates, 'World Food Sec- outright starvation. Advances in transportation, rityl Prospects and Trends, Climate Changes and World communications, and mass media have f.,.li- Food Security" (Unpublished manuscipt, July1993). communications, and mass media have Sli- 2. Edward Clay and John Bortn, "Food Secuity and tated intemational responses to fimine. Disasters m Africa: A Framework for Action" (Unpub- Modern medicine and the effective, ioard ished paper wntten forthe Wbrld Bank June 1991). work of a dedicated cadre of intemational civil 3. Clay and Borton, -Food Security and Disasters in servants and otier professionals have made Africa. some progress in reducing the prevalenc4. Alan Berg, Malnutrifion: What Can Be Done? -some P ess in redu g the prevalence of ml (Baimoe Johns Hopkins University Pr 198IW), t nutrition caused by micronutrient insuffidencies, 5 me:g, Iraiion. lack of awareness about nutrition, and poor pub- 6. Nevin Scrimshaw, Effects of Food and Nutriton lic services and social infrastructre Assiance to Developing Countrie (thaca: Cornell Food However, not enough has been accompLished and Nutition Policy Progra, 1990). to reduce undernutrition or chronic hungero flij ;7. Robert Chen, M. Datt, and Martin Ravallion, Is to rcluc undmuttionor crom huner. his poverty Increasing in the Developing World? Policy is not because of a lack of growth in national Research Working Paper-no. 146 (Washington, D.C. products or food production. In most countries World Bank). Strctly speang, the estimates re to an these have grown at the same or higher rates than income cntenon. Yet, if income propely reflects changes populatior, in themselves laudable accomplish- in real income, these poverty measures are a good esti- ments. Chronic hunger persists for two reasons. mate of the chrnically hungry, because food wresents Some would place all the blame on lack of politi- a high share of expenditures. 8. Thomas Weiss arid Robert Jordan, lhe Global Food cal wilL Measures to overcome poverty do fail in Confne and Global Problem Soling (Lordon: Praeger part because of the inherent resistance to dis- Publishers, 1976). mantling and rearranging the prevailing legal .9. Confrenc Report Resolultion XVII. For most of and economic power stuctureswiina country the decade, the 10-million-ton goal was not achieved, But we believe that another important reason for but since 1984 food aid has exceeded the target, readcing the failure has been the dearth of workable and nearly 12 mnlUion tons in 1992. However, under the Food Aid Convention, donors remained commiitted to 7.6 mil- cost-effective ways to reach the poor. Many of the lion tons. past hunger initiatives failed to confront the 10. FAO, Report of the Conference of Council of FAO, problems poor people face with practical and Twenty-Tiird Session, November 9-28, 1985 (Rome realistic solutions. FAQ, 1985), 3S-39. Consesus s groing hatpoertys huner's 11. FAQ. Report of the Council of FAO, Ninieti-Nnth Consensusisgrowingthatpovertyishunger's Session, (FAO Rome, 1991), 21. root cause and that governments need to deliver I1 Stiomo Reutliger, "Food Insecwurit Magnitude social services to the poor, not only to improve and Remedies," World Develtmen 6 (1978): 797-811. their present living conditions, but also to 13. World.Food Council Nationl Food Stfaiet To empower them to shed their poverty However, Emdioe Hunger (Rome World Food Councl, 1982) 14. there is much less agreement on the appropriate 14t World Food Counc Thm Cyprus Initi aganst Hunger in the World, WFC\1989\2 (World Food Councdb mix of resourceS-food, water, land, credt, Roe, 1989),2. improved technology, training, markets, and so 15. Resolution Xm of the conferece report. on-and on how to transfer these resources to 16. ldriss Jazairy, A Alamngir, and T. Panuccio, The enable the poor to augment their ability to acquire State of World Rural Poery (New York: New York Press, or grow the food they need. -1992).. Thero chae f .o .the nter 17. Operations Evaluation Department, Rural The d_age forthetrln Development: World Bank Experience, 1965-86 is to leam new ways of providing assistmance, con- (Washingt D.C. World Bank, L988). sonant with the decentralization process many 18. World Bank, World Development Report 1986 countries are undergoing, directly to the very (Washington D.C.: World Bank, 1986). Addressing Hunger: A Historical Perpective of Interntional Initiatives 161 19. World Bank, Poverty and Hunger: Issues and Islam, Nurul. 1989. "Undernutrition and Poverty: Options for Food Security in Developing Couintries Magnitude, Pattern and Measures." Paper presented at (Washington, D.C.: World Bank, 1986). the World Food Conference, Iowa State University, 20. Gerda Blau, Functions of a World Food Resert Ames. Scope and Limitations (Rome FAO, 1956), 5. McNerney, J.J. 1978. Developments in International Food 21. Amartya Sen, Hunger and Entitlement (Forssa Poliry. Conmnonwealth Paper no. 9. London: Common- United Nations University, World Institute for Develop- wealth Publisher rment Economics Research, 1987), 17. Ravaflion, MartirL 1987. Markets and Famines. Oxford:. 22. Shlomo Reutlinger and Marcelo Selowsky, Clarendon Press. Malnutritfon and Poverty: Magnitude and Policy Options . 1989. E; Undennutrifton Responsie to Camges in (Baltimore Johns Hopkins University Press, 1976), 3. Incomes? World Bank Working Papers WPS 303. 23. World Bank, Poerty and Hunger, 17. Washington D.C.: World Bank. 24. World Bank, World DECelopment Report 1990 Reutlinger, Shlomo, and Pellekaan van Holst, 1986. (Washington, D.C.: World Bank, 1990); World Bank, Poverty and Hunge Issus and Optionsfor Food Security Poerty Reducton Handbook (Washington, D.C.: World in Developing Counlries Washington D.C: World Bank Bank, 1993). Schiff, Maurice, and Alberto ValdEs. 1990. The Link 25. World Bank The Challknge of Hunger in Africa A btwee Pov and Matutritiovn A Houseld Thoei Call to Adion (Washington, D.C.: World Bank, 1988),2. Approach. World Bank Working Papers WPS 536. Washington, D.C:-World Banlk Selected Bibliography Sen, Amartya. 1977. "Starvation and Exchange Entitle- .ment A General Equilbrium Approadc and Its Appli- Anderon, Jock, Robert Herdt, and Grant Scobie. 1988. cation to the Great Bengal Famine." ambridge Jounal Science and Food: The CGIAR and Its Partners. ofEmonmics 1:33-0 . Washington, D.C.: World Bank - 1981. Poverty and Famine An Essay on Entitle- Brown, Lester. 1991. Saving the Planet How to Shape mn nen and Deprivatio Oxford: Oxford University Press. Environmentally Sustainable Global Econmy New Yorkc .1985. Poverty and Hunger. Research Memoran- Norton Publishers- dum, no. RM-102:1-3L New York Williams College, Cohen, Marlk, ed. 1993. Hunger 99tT- ransrming the Poli- Center for Development Ecoomics. tics of Hunger. Silver Spring. Mdt. Bread for the World. Simon, Arthur. 1975. Bread for the WorhL New York FAO 1973. World Food Pgme, A Story ofMultilateral Pauist Aid, 3rd ed. Rome. Talbot, Ross1 1990. 'he Four World Food Agencies in - . 1979. FAO Principes of Splus Disposa and Con- Rome." PhD. diss. Iowa State Unrversity. sutaive Oblgations ofMemberNations. Rome. World Food CounciL 1979. World.Food Security for the 1985. Food Aid for Deveopment: Tkre Studies. 2980's: Report by he Excutive Director WFC/1979/5 Rome. Rome. . 1990. Towards BeHer Nutrifion for AlL Prepaing . 1987. Cmsultation on the Impact of Economic Ad- for the International Conference on Nutrition. Rome . justnent on People's Food Security and Nutritional Lev FAO Comnittee on World Food Security. 1974. "Draft m Developing Countri Trteenth Ministerial Session Evaluation of World Cereal Stock Situation." CCCPTGR in Beij4g. WFC/1987/2/Add. 1. Rome. 7 4/11. Rome. . 1989. The Cyprus Initiative against Hunger in the 1 1979. Outcome of the Negotiating Confernce for a Workl WFC\1989\2. Rome. New International Grains Arrangemenk ImpIications for .1989. The Views of the Non-Gonhmetal Organi- World Food Security and Pposals for Implementing the zations as Presented fo the World Food Council.- Irationa Undertaking. CS: 79/8. Rome. WFC/1989/2(Part Il/Add3). Rome. * 1979. Action Taken to Adopt a Natnl Creal Str- . 1991. Focusing Devlpmnt Assisance on Hunger tegy. CFS79/4. Rome. and Poerty Aleviation. Rome. 1983. Assessmt on the World Food Seurity Situa- World Food Programme. 1977. Assessment of Food Aid tion and Stock Situation and the Short-Tenn Outlook CF5: Requirenents and of Food Aid Targetsfor Cerwls: Possible 83/2. Rome. Approaches. WFP/CFAk3/7-B. Rome. Goreux, L.M. 1977. "Compensatory Financing: The .1978. Interim Report on the Assessment of Food Aid Cydical Patteem of Export Stortfalk IMF Stff Papers Requirements Including the Question of Food Aid Targets. 24 (Novenber):633. WFP/CFAM 55-B. Rome. Appendix 3 Lessons of Experence: Twelve Case Studies 163 164 Appendix 3 Contents Indonesia: Economic Growth, Equity, and Hunger 166 El Salvador: Village Banldng 167 West Africa: Credit with Education for Women 169 Palastan: The Aga Khan Rural Support Program and the Empowerment of Rural Women 171 Indonesia: Rural Credit for Marginal Farmers and the Landless 174 India: Maharashtra Employment Guarantee Scheme 177 Tunisia: From Universal Food Subsidies to a Self-Targeted Program 181 Honduras: Food Coupons 184 Chile: Targeting and Decentralizing Health and Nutrition Programs 186 Zimbabwe From Relief Feeding to Food Production 190 India: Tamil Nadu hItegrated Nutrition Project 193 Niger: Komadougou Small-Scale Irrigation Project 198 . a a L-ssons of Experience: TveCase Studis 165 Introduction respects women are the most important actors in improving the health and nutrition of their The twelve case studies presented inlthis paper rep- chldren, and thus that imvestments in educa- resent only a few of the broad range of public pol- tion, health, and nutrition for women have a icy interventions available to governments and strong multiplier effect. Virtually all the case other actors that could effectively reduce poverty studies show that programs directed at and hunger Some obvious interventions are not women work effectively, and that women are repesented here, such as those addressing food central players in- reducing hunger and insecurity. Many different types of interventions poverty Moreover, far more women than men are available to reduce the burden of hunger and are below the poverty line. In the rural areas poverty the choice depends on country and of South Africa, for example, 80 percent of the regional conditions. The success of the examples population live below the poverty line, and of cited here illustrates the enormous scope for those, 80 percent are women.For this reason, expanding the use of such interventions globally, many of the credit and miroenterprise particularly employment guarantee sceesm schemes focus on providing crehit to women, credit and microenteprise programs, nutrition for, example, Freedom from Hunger's credit programs for women and children, and food sub- with education scheme, the Foundation for sidyandfoodcouponschemnestargetedatthepoor. Intemational Community Assistance village Despite the diversity of the examples selected, banrking program, and the Aga Khan Rural all the case studies illustrate several basic condi- Support Program. High repayment rates, suc- lions for success, namelr- cessful development of microenterprises, * Political awareness and a willingness to com- increases in income and savings, and the mit resources social empowerment of women characterize * Multisectoral colaboration from the minister- all these projects. Programs do not have to be ial to the district level exdusively focused on women for them to * Community participation and ownership of participate fully, as illustrated by the the program. Maharashtra employment guarantee scheme, Obviously, in some areas and some countnes where between a third and half of thepartic- these elements play a stronger role tian in others. pants are women. Four important features of successful inter- * Achiving sustainabiity. A major objective of al ventions emerge from these case studies: programs to assist the hungry must be to pro- *Targeting. The Tunisian food subsidy program mote sustainable improvements in income- and the Maharashtra employment guarantee earning capacity so that poor communities can scheme both underscore the merits of self-tar- become more self-reliant In many comuni- geting mechanisms. In the former, targeting ties the key to this is providing people with has been achieved by directing subsidies at small loans to p'uhase productive assets and "inferior goods" that are bought dispropor- support microenteprises. A remarkable - tionately by the poor. In the latter self-arget- expansion of village banking is occurring ing occurs because of the manual nature of the across the developing world, in part inspired work and the low wage rates. hiboth cases the by the remarkable achievements of the interventions are designed as a safety net for GramenBankinBangladesh, whose methods the very poor. The Honduras food couponpro- arenowbeing replicated elsewhere. This paper gram illustrates how geographical and anthro- cites several other examples. These credit pro- pometric criteria can be used for targeting. In grams show that poor communities can suc- fhis case, in schools with an incidence of mal- cessfully use and repay loans at market rates of nutrition of more than 60 percent all mothers credit. Programs can be low-cost and sustain- automatically receive food coupons. able if they build pragmatically on existing * Focusing on women. Today development prac- community structures, as illustrated by the titioners increasingly accept that in many International Fund for Agricultural Develop- Thme case studies were compiled and edited by Leslie Elder and Siddharth Dube based on contributions from the authors and organizations as indicated for each case. 166 Appendix 3 ment's income-generating project for marginal sharply from 54 million (roughly 40 percent of the farmers and the landless in Indonesia. A com- population) to 27 million, just over 15 percent of mon element is the reliance on the solidarity of the population. These figures reflect success in small groups, which ensures a high repayment reducing poverty in both rural and urban areas. rate. As the Freedom from Hunger credit pro- The percentage of poor people in rural areas fell grams show, village banking can go well from more than 40 percent in 1976to roughly 14 beyond the provision of credit to, -'compass percent in 1990, and in urban areas from just and facilitate a range of public edudtion and under 40 percent to about 17 percent Moreover, community development activities that are since 1978 severe malnutrition among preschool mutually reinforcing. children has fallen substantially. Doing better with what one has. The case studies Development practitioners generally agree illustrating targeted health and nutrition that Indonesia's success in reduc.mg hunger and interventions underscore the considerable poverty is rooted in the following: possibilities for improving families' nutri- *Policies that havefostered rapid economic growtht. tional status at existing levels of household Duringthe oilboom of the early 1970s the econ- income or food consumption. This is achieved. omy grew-at an annual rate of more than 1l per- primarily by reducing the burden of ifection, cent, but growth dropped to roughly 5 percent improving feeding and care patterns for per year between 1982 and 1987 because of oil infants and young children, and enhancing shocks and global economic crises. Since the basic knowledge about nutrition. introduction of structural reforms in the late The purpose of ftiis paper is merely to be 1980s the economy has -grown at an average indicative. There is a wealth of experience to rate of 7.5 percent per year- Consequently, per draw on. Although few programs have been as capita income has increased more tian tenfold rigorously evaluated to determine their cost- during the past two decades, from US$50 per effectiveness as decisiormakers might wish, year in 1967 to US$570 per year in 1990. enough has been done to show the way. We hope T* he high prorty given to increasing agricultural thatthe case studieswillbe aninspiration fornew andfood output. Not only has agriculture been a initiatives, but we should remember that the suc- prime contributor to the economy's growth- cess of any scheme depends largely on adapting agricultural output grew at an average annual a promising design concept to specific local rate of $7 percent between 1969 and 1990-but social, political, and cultural circumstances. Indonesia's. success in keeping food output Experimentation and structured learning from. ahead of the population growth rate of 21 per- pilot schemes, accompanied by rigorous evalua- cent means that today Indonesia boasts the tion and effective dissemination of the findings, -highest daily calorie supply-2,675 calories per must be encouraged. capita per day-of all low-income countries. Yet until the late 1970s Indonesia was the Indonesix Economic Growth, Equity, world's largest rice importer, spending a quar- and Hunger ter of its foreign exchange revenues an rice imports. Rice self-sufficiency was one of the Indonesia's remarkable success in reducing the primary goals of the country's economic dev- incidence of hunger and poverty during the past elopment plan, and this was successfully fifteen years stems from. policy objectives to achieved in 1985, when rice imports fell from 2 ensure that the population at large .tared the million tons to only a few thousand tons. gains of rapid economic growth * "Pr-poor polic such as the heay subsidis placed on rice for consumers. The government The Strategy held rice prices constant in real terms for about twelve years, from 1974 to 1986. As a result, Between 1976 and 1990, the number of Indo- withrisingincomnes rice consumptionperper- nesians in poverty-defined as those unable to son increased by about 30 percent, from 100 purchase about 2,100 calories per day and a mm- kilograms per person per year in the late 1960s imum amount of essential nonfood goods-fell to around 145 kilograms in the late 19BOs. LessonXs of Experience DativeCasStudies 167 This miix of policies has been effective in oping anextensive network of village banks since sharply reducing the number of hungry and poor. 1991.2 The program has evolved into the largest Today hunger is concentrated in particularly vul- credit program for the poor in Central America. nerable households. Chief among these are The village banking network provides small households that rely on seasonal wage labor and loans to self-employed borrowers, 95 percent of suffer from shortfalls during the slack period, whomarewomen. and poor households that are espeally suscepti- ble to hunger during periods of drought or other Background factors that lead to low agricultural output. Despite the large gains made in raising The peace process in E Salvador has only just incomes and reducing hunger, however, infant begun after nearly twelve years of civil war. While mortality rates remain high and childhood mal- large portions of the population are excluded nutrition is still widespread. This reflects the per- from full particpation in the national economy, sistent burden of diarrheal diseases, acute the country cannot aspire to lasting peace. Today, respiratory infections, malaria, micronutrient tens of thousands of Salvadoran families remain deficencies, and suboptimal breastfeeding and trapped in severe poverty with their children weaningpractices.VitaminAdeficiencyhasbeen threatened by malnutrition and disease. In the eliminated as a public health problem in all but aftemath of the civil war, FINCA has sought to two of the fifteen provinces, but iron and iodine build a national credit pam that could con- deficences remain widespread. The country's tribute to the reconstuction of the country. infant mortality rate of 64 deaths per 1,000 live FINCA is a network of nongovernmental births is well above that of other Association of organizations (NGOs) that operate village bank- Southeast Asian Nations countries and of such ing programs in Latin Amenca and Africa. In low-income countries as China and Sri Lanka. April 1994 the FINCA network comprised 2,058 village banks worldwide. These banks, which are Lessonzs Leaned entirely managed by the borrowers, process more than 22 million loan payments a year at an aver- Indonesia's development policies combining age repayment rate of 97 percent. growth, increased food availability, and poverty In El Salvador FINCA's Centro de Apoyo a la reduction have been central to the substantal Microempresa (CAM) began its village banking reduction in severe malnutrition. However, con- operations in June 1991 with a seven-year grant tinuing high rates of moderate and mild malnu- from the US. Agency for International Develop- trition, both of which have serious developmental ment The objective of the village banldng pro- implications for young children, and the persis- gram is to provide extremely poor families with tence of micronutnent deficiencies, indicate that self-employment loans ranging from US$50 to economic growth is necessary, but not necessarily US$300. CAM, which is an affiliate of FINCA suffcient by itsel to eliminate malnutntion as a International, was created as an independent hindrance to development NGO whose board of directors comprises repre- Despite its remarkable achievements in recent sentatives from El Salvador's private sector and years, Indonesia still faces huge challenges: it is a local NGOs. low-income country, living conditions need to be improved for the 15 percent of the population Operations that lives below the nationally-defined poverty line, pockets of hunger persist in some regions, By April 1994, after less than three years of oper- and large public investments are needed to ations, CAM was operating 975 village banks improve health and nutrition standards. serving 29,550 families, or more than 150,000 peo- ple. The program has encountered a seemingly El Salvador. Vilage Bankdng limitless demand for village banldng services among poor communities. CAM now offers vi-- In El Salvador, the Foundation for Interational lage banling services in all 14 geographic depart- Community Assistance (FINCA) has been devel- ments, including 45 of 109 municipalities within 168 Appendix 3 the former war zone. It is currently expanding its mines how it will use the savings deposits. Most coverage at a monthly rate of 48 new village village banks decide to keep an emergency banks, or 1,250 borrowers. El Salvador has anesti- reserve and on-lend the balance of their savings mated 600,000 extremely poor people, and by to bank members. This practice allows commu- 1998 CAM aims to provide services to more than nity net savers to finance net borrowers at inter- 90 percent of them. est rates that the membership sets. These rates are In April 1994, CAM's village banking portfo- generally higher than those FINCA charges. lio totaled US$2.7 million, with an average loan Savers thus realize a substantial dividend on size of US$90. The repayment rate was 99.4 per- their deposits. cent. Borrowers are charged interest and training CAM's delivezy system is organized as fol- fees at a flat monthly rate of 3 percent of the loan. lows. Each CAM promoter typically services ten Savings deposits in the village banks amounted village banks. Promoters work as members of a to US$1,140,917. At the close of the first quarter field office team. The team services from 60 to 240 of 1994, CAM was operating at 102 percent self- banks. Regional bank offices, of which four now suffidencyg operate in. E Salvador, supervise the field offices. The central office in San Salvador is charged with Program Design overseeing management, trainingr and adminis- tering the flow of funds through the system The borrowers' participation in managing the CAM collects cost and revenue data at each orga- credit systemnis one of the most important features nizational leveL of FINCAfs village bank model. Village banks, whose membership ranges from twenty to fifty Inpact individuals, function as autonomous informal credit associations that manage all loan transac- According to CAM sample surveys, most bor- tions- A democratically appointed management rowers are single mothers, many of whom lost committee governs each village bank At the out- their husbands in the civil war. A borrower typi- set, the memberslip determines the by-laws for cally supports four or five dependents and has the operation of the bank using guidelines pro- less than three years of education. Most borrow- vided by FINCA. The bank's members meet ers live in a one-room dwelling without electric- weeldy to conductloan transactions, discuss busi- ity Water is usually head-carned for distances of ness matters, and give each other moral support. up to a kilometer At the outset of the project, the FINCA "promoters" or extension workers visit family income of most participants was less than weeldy to provide training to both the manage- US$2.33 a day. ment committee and the borrowers and to over- According to a recent extenal evaluation sur- see operations.- vey of 386 borrowers conducted by the US. Village banks have two sources of capital. The Agency for International Development, the aver- first source is from outside the community. Local age increase in sales and income was 160 percent FINCA intermediary institutions extend group and 145 percent, respectively, among borrowers loans to the village banks in four-month loan who had participated in the program for more cycles. Borrowers make weeldy instalimeat pay- than one year. More than 70 percent of surveyed ments that are coRected at viilage bank meetings. borrowers reported that they had increased their -The installments are calculated as a quota or purchases of medicines and food since joining lump sum that compnses payment on loan prn- the program, and 60 percent reported that they cipal. and interest and a savings deposit In the were making significant contributions to family case of CAM, the first group loan is equivalent to decisionnmalcing- US$50 multiplied by the number of borrowers. In In the words of Franciscan Rajas, one bor- subsequentloan cycles CAMincreases the line of rower. "When you have been as poor as I have credit to the bank in direct proportion to the accu- been, there is a lot of shame. Even when I was a mulated savings deposits. child, people wouldn't look at me. I guess they A village banks second source of capital is were afraid Iwould ask themfor sometiing. I feel comununity savings. The membership deter- safer now. Isleep calmly at night because Iam not Lessons of Experiencc Twdve Case Studies 169. so woaffed about how to pay back a moneylen- West Africa: Credit with Education der I don't have to prostrate myself to anyone." for Women Lessons Learned Freedom from Hunger's3 review of formal research studies and program experience shows Some of the key issues that FINCA faces indevel- that a combination of financial resources and oping CAM and other vilage banking programs nutntion and health education provided to very can be summarized according to the different poor women has the most direct impact rr organizational levels of its program. chronic hunger and malnutrition among womuiL Borrowers. Empact evaluation data show that and children) Credit with Education is a pro- average village bank borrowers substantially gram strategy designed to provide integrated increased their income and empowerment from financial and educational services to bolster the participation in the program. FINCA programs self-help capabilities of women inverypoor rural need, however, to analyze better how borrowers areas. Because of the high levels of food insecu- can continue to grow. The issue of integrating rity and malnutrition, most programs supported nonfinancial services such as marketing and by Freedom from Hunger are in West Africa. production assistance needs more scrutiny as the number of borrowers expands and borrow- Program Design ers increase the level of sophistication of their businesses. Credit with Education uses a village banling Vilage banks. There are areas where the bank approach, which is a decentralized version of operation model can be improved. Techniques poverty lending well suited to reaching dis- for helping members manage their savings need persed communities in rural areas. Credit is pro- to be constantly reviewed and refined. The evo- vided to self-managed credit associations of lution of the banks as they mature after several approximately thirty women as a four-month years of operations needs to be more dearly group loan that can be rolled over and increased defined so that they can adapt their services to the in proportion to members' savings. The women changing needs of their membership. take out individual loans to carry out income- Intermediary organizations. The most important generating activities of their choice to mcrease challenge FINCA intermediary organizations their personal and family incomes and savings. such as CAM f-ace is balancing their need to pro- Weeldy meetings of these credit assocations pro- vide quality service with their need to expand. vide a forum to address credit association man- CAIM experienced the most rapid expansion of agement, basic microenterprise development services in the history of microenterprise imstta- problems, and hunger-related issues. Learning tions in Latin America. Such an expansion places sessions on health and nutrition address five extraordinary pressure on internal management important issues: (a) birth spacing, (b) breast- and financial control systems. The growth in feeding, (c) infant and child nutrition, (d) man- CAM's portfolio has sometimes outpaced its agement and prevention of diarrhea, and (e) development of such systems. CAM's manage- immunizations. Baseline surveys, focus group ment has now learned to strike the right balance studies, and the nonformal problem solvmg tech- between expanding its services and introducing niques used during the weekly learning sessions adequate systems to support the expansion. draw attention to specific barriers to change. Also, as FINCA intermediary organizations FLeld staff provide credit association members expand, they need to identify new sources of cap- with information and counseling as they facilitate ital at a time when bilateral foreign assistance is problem solving. decreasing. For this reason, FINCA intermedi- aries are increasingly accessing loan capital from Impact commercial bankls and international financil institutions. FINCA intermediaries need to In early 1989 Mali became the first field program develop new systems and skills to manage lines site in which the Credit with Education strategy of credit from such sources. :was introduced. In the last four years, the program 170 Appendix 3 has lent approxinately US$300,000 to poorvillage members indicated that their incomes and sav- women living in two arrnndissenents southeast of ings had increased, that they had learned about Bamako, the capital city In 1991 the program's 99.9 the appropriate timing of weaning, and that they percent loan recovery rate and clientele of more were empowered and enjoyed greater bargaining than 1,000 poor rural women convinced the power in their families. Eighty-five percent of the Banque Nationale de Di-veloppement Agricole to members felt that the health and nutrition of their provide loan capital to the program at a conces- preschool children had improved. sionary interest rate of 6 percent without requiring. A Credit with Education program that started a reserve fund. As of June 1993, 1,762 members in Honduras in .1990 produced similar results. were organized in 65 credit associations with an Other Freedom from Hunger Credit wi-i Educa- outstanding loan portfolio of US$51,413 and an tion programs are operating in Bolivia (1990), average loan size of US$34. The smal average loan Burkina Faso (1993), Ghana (1992), and Thailand size reflects the extremely low per capita incomes (1989). Of the households reached by this program. Figure 2 presents survey results using a larger Nutritional assessments in the Mali program sample conducted by Freedom from Hunger in area indicated a widespread tendency for late the Credit with Education program iri ThailandP introduction of weaning foods and high levels of Credit association members demonstrated supe- malnutrition among weaning-age children. For rior knowledge and adoption of steps to prevent this reason, the nonformal health and nutrition and manage diarrheal episodes. Program partic- learning sessions facilitated at credit association ipation also seemed to provide some protection meetings have stressed good infant and child during a recent drought, because credit associa- feeding practices, particularly during weaning. tion members were less likely to report a deterio- Evaluations of the Mali program have demon- ration in their families' diets, and per person strated a positive impact on the participants' weeldy food expenditures were greater in mem- quality of life. Figure 1 provides summary results bers' families than in nonmembers' families from a survey conducted in conjunction with an despite their comparable socioeconomic status. independent evaluation that highlight the pro- In 1993 Freedom from Hunger and the Credit gram's diverse benefits.5 Credit Association Union Network of Burkina Faso started to repli- Rigure 1. Results from the Mali evaluation Figure 2. Results from the Thaiand survey N I nebers(n=15) * Credit aocation menbers (n=50) []Nonmbs (n=MY) * Credilt oaon merb (n=68) Fet that the healt and nuition of tr prol did had irved Give oral rehydration salts to children with diarrhea I 40961 50%1 Knew the proper age for introducing solid food to an infnt Knew what coLid be done to prvent diarrhea Felt that theirfaniles istened to them more (one sign of inreased Gave te fwstantbody-rih brestmik(colostoun) to teir nborrs paeonal empowerment 6 Diet did not deteriorate alker a widespread drought Reported more sayings (which can be used to measure adequate food suppies during the hungry season) - I - ' - - 1 27% - A-erage fmnily eqxnditur on food per farnly nmber during the previous week Reported increased income in the pastye US 501 1 27%1 I an d MkNe. free&hmnm ws NewswCir-LedAW0d: Wo Sm-e MkNyWW and Wash. kpEoa&n cfRdom E HwsCdt MJuJLar Writ Edi== Acn,n inm Thvibx. LEssonsof ExperiencE: Twelue CaseStdits 171 cate and extend the model developed in Mai regionalofficewllcoveritscostswitminsixyears. Credit with Education is being added to the ser- Similar projections for the Mali program show a vices provided by exsting financial institutions much slower approach to self-financing, reflect- (credit unions) to achieve quick, cost-effective ing the differencebetweenworklingwithanNGO implementation as well as a network for rapid focused solely on delivering Credit with Educa- expansion. Figure 3 shows the organizational tion versus a financial institution that adds Credit structure of the programs in Burkina Faso and with Education to its services. Mali for comparisrt. Note that existing financial The self-financing feature of the Burkina Paso institutions (not guaranteed by Freedom from program allows the Credit Union Network (and Hunger) are the sources of credit for all Credit its funding partners) to start up Credi; with with Education programs currendy operating in Education in many credit unions around the West Africa. country without accumulating a massive fiscal burden. By becoming financialy self-sufficient, Lessons Lamed each field unit relieves the regional office and the central office of the responsibility for endless Freedom from Hunger is demonstrating that funding of recurrent costs. Credit with Education can be scaled up to a high performance level, creating an increasingly self- Pakistan: The Aga Khan Rural Support financing mechanism that cost-effectively Program and the Empowerment serves growing numbers of peoplea Credit with of Rural Women Education is designed to cover expenses with revenues from the iterest and fees collected The mountainous northerm regions of Pakisain, Table 1 shows the projected expenses and rev- populated by about 1 million people, are climat- enues for a single credit union (caisse popzdfe) ically extreme, ecologically fragile, and scarce in in the Credit Union Network in Burlina Faso- natural resources? The population is of mixed and the regional office that supports a cluster of etnic and religious origin and speaks a variety cedit unions. of languages, ranging from Wakhi, an arcaic Financial self-sufficiency can be achieved Iraniandialect,to BaltiaTibetandialecLThe peo- usingrealisticgrowthscenariosforthenuniberof ple of the region are farmers who depend on credit associations and borrowers, the volume of glacial melt to irrigate their small fields carved loans, the service fees collected, and the costs of out of the mountinsides. Until the 1970s the operating the program. Projections indicate that region was ruled by small, princely states that each particpating credit assocation will become survived largdy by levying taxes on the farmers self-financing within four years and that each or on caravans traveling the Silk Route; igum 3. Credt with educaton partneips in Burkina Faso nd Mma |redom fim HumVer |ational Ainitunge Develrnent Bank Centefor Ecoxnoic_ and Nutitional Cred&tunoinnetwork Support for Vtmen Credit Crilt Credit Seld .e eid i uniOns unions unio_s t eam team tea Cred Credit Cedit Credi Credit Creied asoa s ions asoia atioas assoI ations 172 Appendix 3 Background them to realize their strengths and capacities by particpating in women's organizations. Mem- In 1982, a time when the old social order was in bers of the 600 women's organizations feel that disarray, the Aga Than Rural Support Program the AKRSP's most significant contribution has (AIRSP) was established in nortiern Pakistanh been the savings program initiated for women. The AKRSP's objective was to fill the institutional Having their own money has increased their sta- vacuum created by the dissolution of dozers of tus, and has led to increased personal ppnde and tiny states by mobilizing rural populations into power. village-level organizations. These have since Village women form women's organizations been instrumental in.helping communities plan to save money and to learn skills from the their own development Today the AKRSP has AKRSP in agriculture and related fields. The almost 3,000 village and women's organizations program's provision of agricultural and live- in its program area, coveing a population of stock inputs has led to improvements in more than 90,000. women's nutritional status as well as in their For the women of northern Pakistan, the incomes. In northern Palistan women's diets A1KRSP has changed their lives sigriflcantly. The depend not only on the seasonal availability of women of the region have a difficult life, bearing food, but also on cultural practices prevalent in up to 10 children, often working harder than the the region. Although women are responsible for menboth on and off the farm, andwith only 3 out all activities related to food, they are also the of every 100 being able to read and write, last to eat meals, having served the children and Women's lives revolve either around the house- men first Food taboos for women are common. hold or the village. Cultural constraints prevent Women are often anemic because of frequent women from being able to sell produce in the child bearing, and a large percentage of women regions few markets or from owning property- consume less that 70 percent of the recom- Consequently, they have little power in making mended daily nutntion requirement The open- decisions pertaning to land use and fncial ing up of the region to the rest of the country resources. through the Karakoram Eighway and the resul- The AKRSP's aim is not only to help women tant expansion of local markets has also meant increase their agricultural and related produc- that farmers place more emphasis on selling tion, but, perhaps more important, to enable produce than on producing the food necessary Table 1. Burkdi Fma Credit with Education progran, findal sary and sbc-year projecons at two organizational evels, fiscal 1994-99 Level - cl 1994 Fiscal 995 Fcal 1996 Fscl 1997 Fisc 1998 FIl 199 lbtl credtassodatiom 10 25 40 55 70 70 btal bormowers 300 750 1.200 1.650 2.100 2-100 Loans made iadh year 16.092 90.767 180,391 299.680 458.451 624,060 Loans outstandml end oydear 12.372 36.988 69.750 113.357 171.397 228,130 Interest kxme 372 6,616 14.763 25.609 40.041 56.733 Talcosts 6.020 14.772 21.178 25.025 26.538 29.191 Netsuplus(deried (5.648) (8.156) (6.415) 584 13.503 27.542 bpenses overedbyincome 0.06 0.45 0.70 1.02 151 1.94 Cost perdobr lent 0.37 0.16 0.12 0.08 0.06 0.05 ReA- Totalcissespopiiuhes 3 6 12 18 24 24 Tomlaredtassodatiom 30 105 255 495 825 1.140 Total borrowers 900 3.150 7,650 14.850 24.750 34.200 Loans nadeeachyear 48.276 320.577 910.026 2.081,367 3.997.893 6.672.561 Loamsousaning. endofyear 37.1 16 148.110 394.506 845.601 1.569.102 2.519391 Intee xrmie 1.116 20.964 66.369 163.044 327.456 572,250 ibtalcosts 18.060 62.376 181.905 28&189 431.840 560.901 Netsurplusderidt (16.944) (41.412). (115.536) (125,145) (104.384) 11349 Bqenses covered by income 0.06 034 036 0.57 0.76 1.02 Costperdollar[at 037 0.19 020 0.14 0.11 0.08 Sowcc Freedom .tm k_hm da. Lessons of Experience: Twelve Cae Studies 173 for a balanced diet. This reflects both women's show a 94 percent increase since the inception of lack of knowledge about nutrition and the pres- the program compared to 26 percent for the rest sure they face in meeting household require- of Pakistan. Over the year's the women's organi- ments through their incomes. zations have saved PRs 19 million. Today *omen Two major activities that the AKRSP has are much more involved in making decisions emphasized are training women in vegetable relating to land use and the allocation of financial cultivation and poultry rearing, including the resources. They are realizing their strength by provision of improved inputs. In the past ten being members of women's organizations and years the cultivated land area has increased a experiencing significant personal and collective total of 6 percent, with an increase of more than growth. 100 percent in the amount of land under veg- llustrative of the change in society's attitude etable cultivation- The land has been developed toward women are the shifting distinctions and bytheconstructionofwaterchannelsbuiltbythe boundaries in occupations traditionally viewed village organizations. as male. The transfer of accounting skills to Poultry rearing is also a traditional women's women and the fact that women are managing activity and is increasingly becoming the region's the affairs of their organizations are positive signs main source of meat Women's organization of their enhanced capabilities and their potential members have been trained in poultry disease to plan for their own development control and improved management practices. Ten years ago the average .number of poultry Lesons Leamed birds per farm was 5.1. During the past ten years this number has increased to 123, representing -The change in the status of women in traditional an increase of 141 percent areas such as northem Palistan is not rapid. The One of the most significant changes in the program has .encountered resistance by men to lives of members of women's organizations is the concept of organiingwomen into strong and that they are now eating many more varieties of vocal groups The womerns organizations of vegetables and consuming more poultry prod- northern Pakistan still have a long way to go ucts than they were ten years ago. Whereas they before they: develop capacities that will enable only used to grow two vegetable vaieties, they them -to make decisions completely indepen- now grow more than fifteen types of vegetables. dently of menL Income generation has been the Similarly, the increase in the number of poultry first step toward women's empowerment. In birds has meant that they are consuming more most women's organizations participants are ftian double the amount of poultry and eggs. using their money for productive activities, and Impact statistics do not capture the essence of are thus increasing their capitaL However, the AKRSPs message and its success, which is a women are also demonstrating an increasing result of the strength of the women's organiza- awareness of mivfstments in the soaal sector and tions. There are sinpler and perhaps more effi- are paying for education and health services for cient ways to increase consumption and improve their daughters. nutrition. However, the AKRSP's investment is The large village-level network of commu- not only in vegetable seeds or in poultry birds, nity-based development organizations has lent a but in the 600 women's organizations of northern form of cohesion to activities undertaken by the Paldstan More than 10,000 village specialists villages of northernPakistan. Vilagers'increased trained by the AKRSP are independently provid- ::apacity to design and implement their plans in a ing services to villagers, with more than 90 per- democratic manner has been the strength of these cent of them being paid by the villagers organizations. The "development partnship" themselves. Women have set up poultry enter-'. that the AXCRSP offered to the people of northern prises and are contributing to the education and Palistan has given them the confidence to taclde improved health of their children through many of their problems on their owrL The goal increased household incomes. They hold regular must be to invest in building up the capacites of meetings of their organizations and they are sav- poor communities. Then village organizations ing money. Real per capita incomes of the region will be able to carry on the process. 174 Appendix 3 Indonesia: Rural Credit for Marginal Farmers Thus, while the project had envisaged that 20 per- and the Landless cent of all groups would be women's groups, in practice the figure is 35 percent. The objective of the Rural Credit for Marginal Above all the project has succeeded in target- Farmers and the Landless Project is to increase ing the poor. Rigorous targeting of the beneficia- the incomes of the rural poor in r¼ provinces of ries has been undertaken to ensure that no IndonesiaYIt is also intended to provide the rural household with an income equivalent of more poor with a mechanism and institutional frame- thian 320 kilograms of rice per person per year work for accessing available government and (the poverty yardstick) is included. This is ven- other services, such as the agricultural extension fled by a survey of preselected poor villages and system and the formal rural banking sector, by households. These sceening processes have suc- orgarizing them into groups. ceeded in identifying the poor, although not After tbree years' operation, the project has always the most severely impovenshed. succeeded in the following- The progect's intent was that group members * Increasing the incomes of the poor by 41 to 54 should undertake one common income-generat- percent ing activity, although up to three are allowed. *Training and building up groups to enable Although this has raised practical difficulties im them to gain access to credit, services, and the some locations, working together on a coimmon means for self-reliant development enterprise has induced greater group confidence * Forgnmg an institutional structure capable of and cohesion, and has facilitated economies of continuing the poverty alleviation program scaleininputsupply, production,and marketing. on a cost-effective and sustainable basis The members of 83 percent of the groups under- * Linling groups of the poor to a bank with a took a common activity, but carried it out on an wide network of rural branches and provid- individual household basis, while the remaining ig credit on terms that are both replicable and 17 percent of groups used their access to credit for sustainable joint enterprises. Many of the groups also under- * Providing a cost-effective model, methodol- tooksocialserviceactivitiesasagroup,whichhas og5 and institutional framework for poverty advanced their standing in their communities. alleviation that can be replicated nationwide The- project has also been effective in training * Increasing the beneficiaries' empowerment, both beneficiaries and project staff. Field-level confidernce, and self-reliance. extension workers train the beneficiaries in the Roughly 2,000 villages from 53 districts in the skills they need to manage their groups and 6 provinces were selected to participate in the microenterprises, while the extension workers project More than 15,000 groups of the poor have are themselves specially trained for this purpose. been formed with an average membership of 10 The mid-term evaluation of the projectfound that or 11 households each, which amounts to a total the training was quite strong in all fields except of 160,000 families in just three years. Given the nonfirm, microenterprise development, in which project's strong performance, it is likely to meet the field-level extension workers lack expertise. its target of forming 32,750 groups within the next Another major factor accounting for the pro- two years, covering around 327,500 households ject's success is its institutional foundation. The or approximately 2 million rural. poor people. field-level extension workers set up the groups and trainm tem, while their parent agency, the Project Design and Implementation Ministry of Agriculture, is responsible for project management At -present, only 21 percent of the The project's aim is to form small groups that are extension workers in the project locations have socioeconomicallyhomogenous. These are used as been drawn into project work, and they are sup- focal points for training, credit, and income-gen- posed to devote only 30 percent of their time to erating activities.Ithasbeenrsuccessfulincreating such activities. This decision to base project relatively strong groups with internal dynamics staffing on the pattern of an existing agency with and personalities of their own. Most women were a vast field network (Indonesia has more than found to prefe women's groups to mixed groups. 30,000 field-level extension workers) implies that Lessons of Expert nae Twelve Case Studies 175 project activities can be expanded and replicated their recent origin (all of them are less than one or at relatively low cost. Moreover, as project credit two years old), the success of these associations, is provided through the normal banking system, especially in the field of financal intermediation, project expansion or replication is unlikeLy to face has been impressive. For example, many of the any great costs or difficulties. associations collect the loan repayments of their member groups in advance and re-lend the funds Project Impact to members mainly as short-term loans at interest rates of up to 5 percent per month, chiefly for petty An important achievement of the project has been trading. This has resulied in high rates of profit its ability to instill a sense of self-reliance among and savings. Thus the Association Sinar Harapan the members of poor rural groups and to demon- in Lombok-in existence for only one year-has strate their creditworthiness. They have already already generated interal savings of more than accumulated Rp 700 million in compulsory sav- Rp 1,088,500, and through profits from loans for ings. Moreover, all of them have accumulated petty trading has accumulated a fund of Rp 2.5 additional voluntary savings totaling more than million. For reasons of institutional viability and Rp 300 millioiL economies of scale, these associations may well Credit is provided by the Bank Rakyat develop into the main service organizations of the Indonesia, the largest rural bank in the country- As poorproviding the institutionalbase for credit, for the executing bank, it lends to the groups without services, and for self-help activities. demanding collateral at the near-market rate of In heavily populated poor villages, where in 21.15 percent peryear. Lending packages and pro- some cases more thtan 90 groups have been ceduxes have been tailored to the poor, while staff formed in a single village, each with a member- have been trained by the project for banling with ship of more than 1,000 people, the social and the poor. The repayment rate of 99.5 percent (after institutional impact on the community is bound thee loan cycles) makes this the most successful tobe strong over time, especally in those villages credit program in the country, if not the region. where associations have been formed. Thus, the The groups and individual beneficaries are project may be said to be empowering the rural given assistance in mnicroenterprise development poor to a significant-extent to boost their economic activities. Here the results In terms of its sociopsychological impact, the have been niixed While many groups have set up beneficianes claim that for the first time they are profitable enterprises, especially in trading, agro- recognized by the community, are approached processng and handicrafts, many are still stag- rather than overlooked by local government func- nating in low-paying activities such as fattening tionaries, and, most important, feel that they can livestock. One reason for this is that the field-level improve their lives through their own efforts as a extension workers trained in agriculture are not group. The individual and group savings of the equipped to help the groups with their nonfarm poor have helped to give them this greater sense activities. Another obvious reason is the difficulty of confidence as well as collateral for credit in the of findmg profitable nonfrm income-earning future. Indeed, the Bank Rakyat Indonesia has activities in poor rural areas with an undifferenti- confirmed that it would be prepared to continue ated economy- lending to the groups without collateral (at market Of the groups receivingcredit, 367haveformed rates of interest) even after the project was over associations. This two-der system seems to evolve The project envisaged that credit would be more natully in areas with high concentrations disbursed only for activities approved in the of the poor, where many groups are formed in a group business plans..-However, in practice the single village, as in West and EastJava and on the loans havebeenused to finance anumber of other island of Lombok. The-main reason for the emer- small income-generating activities, and even for gence of the associations seems tobe toimplement consumption purposes. The beneficiaries have particular activities that exceed the capacity of the also been using their second and third loans to groups Such functions fall mto three main cate -.:;.-t additional new activities, thereby adding to gories: (a) financial intermediation, (b) purchase and diversifying their income streams. Although and supply of inputs, and (c) marketing. Despite loan repayments are being made in full and on 176 Appendix 3 time, they do not necessarily originate from the emient interest in such programs is high by. activity financed by the lon Thus in practice the means of its creation of groups of the nrual project is financing a portfolio of.activities by the poor. poor (including consumption), but with excellent *The project has shown that an agricultural results in terms of credit repayment and exteision agency can, with some trainin; pro- increased incomes. Consequently, the project vide a widespread institutional network to. may switch to portfolio lending for the poor sustain a countrywide poverty alleviation pro- based on their actual cash flow and their 99.5 per- gram. This also implies that the program can cent loan repayment rate. be doubled or tripled at short notice, and at lit- Similarly, project credit has tended to fow tle additional cost mainly into nonfarm- or nordand-based enter- * The project has had an institutional effect on prises, mainly because the beneficiaries have lit- the largest rural bank in the country, which tle or no land. When credit is targeted to the rural has changed its attitudes toward and rules poor, they will inevitably channel the funds to and procedures for lending to groups of the those activities that are the most feasible and poor, and has now accepted that lending to the profitable for them. Hence, when the poor are poor atmarket rates of interest isboth feasible accurately targeted, the credit activities also seem and profitable. to be automatically targeted. In this case, 97 per- Concerning the project's economic sustain- cent of the activities financed by project credit are ability, many of the microenterprises are stllU at a of a nonfarm nature (We have icluded livestock stage of low productivity, but many others are rearing by the landless, with the livestock fed pmfitable and have obtained access to higher lev- from fodder cut from the commons, and the few els of technology and higher value markets. It is cases of sea fisheries as nonfarm activities.) in the area of microenterprise development, how- Some 82 percent of the groups claimed that ever, that the project still has a long way to go. they had increased the volume of their produc- Other technical resources will have to be brought lion as a result of projct credit, while 65 percent in to ensure better performance in this field. said that the quality of their production had With respect to financial sustainability, the improved. In some cases these changes were cost per beneficary is estimated at only US$1 accompanied by diversification, differentiation, per month. This cost will decrease as the num- expansion, and modernization of production. ber of groups increases and they become more Moreover, 79 percent of the groupsnoted indirect self-sustaining. The estimate excludes credit effects on production through improved input costs, but given that credit is to be at market supply and marketing There are also some cases rates of interest (at the conclusion of the project), of a change. in production relations. Many this will not pose a financial problem for repli- respondents stated that whereas prior to the pro- cation or sustanability. ject tiey had been wage laborers, they were now As a result of the groups' excellent credit per- self-employed. formance, the executing bank is now prepared to Given the difficulties in measuring improve- expand credit to groupsof the poor in other areas ments in income, the data reported here must be on the sane terms. It is also prepared, in the viewed as a rough approximation. The mid-term future, to continue providing credit to te groups evaluation estimated income -increases per (without collateral) at the market rate of interest household at41 to 54 percent This is asignificant prevailing at that time. Credit should, therefore,. increase considerng that project credit has only besustainable,becausethepoorhaveprovedthat been available for three years. The extent of the they can operate under these conditions. increase in incomes has varied according to the different locations. Lessons Learned With regard to institutions, the project has had a profound impact at three levels: The prject's organizers learned a number of * The project has pioneered an essential institu- valuable lessons. First, it is possiLble, and indeed tional building block for poverty alleviation necessary, to organize the poor into groups to prgrams in Indonesia at a time when gov- help themselves and receive services. Second, Lens of Epeince Twlve Cas Studies 177 these groups can be financed by providing credit with the exception of the last few years, the without the need for expensive handouts Third, scheme's scale has been sustained for nearly two the poor are creditworthy and have a better. decades. Since 1990, the EGS has been substan- repayment record than other credit recipients, tially reorganized to focus on integrated devel- and therefore credit is sustainable Fourth, exist- opment at the village leveL It is also being inginstitutionalstructurescanbeusedtoprovide coordinated with other programs on watershed a low-cost and effective means to organize and development, horticulture, and well construc- train the poor. Fmally, the means are available to tion. IHowever, little is known about the effects of makesuchaprogramofpovertyandhungeralle- these recent dcanges, and this account refers viation relatively cost-effective, replicable, and mostly to the period up to about 1990. sustainable. Second, EGS projects are designed to be highly intensive in their use of unskilled labor. Labor India: Maharashtra Employment Guarantee costs have typically accounted for more than two- Scheme thirds of variable costs, even higher than the stip- ulated minimum of 60 percent (see box 1). Among developing countnes, the best known Third, the EGS has also been an important and by many accounts the most successful exam- avenue of employment forwomen Their share in ple of direct public efforts to reduce absolute total participation has ranged from about one- poverty in rural areas is the Employment third to a half, with a median of about40 percent Guarantee Scheme (EGS) in the Indian state of Several factors have contributed to this, includ- Maharashtra9 ing the close proxmity of work sites to villages, the provision of basic child care (often employing Overview an elderly woman from among the participants), and the fact that EGS piece rates do not discrimi- Initiated in response to the severe drought in nate between the genders (although differenials Maharashtra in 1972-73, since the mnid-1970s the in time wages remain because of differences in EGS has aimed at provLding unskilled rural the type of work and because women often work employment on demand, as embodied in its slo- fewer hours than men). gan magel tyala kam (whoever asks for work will Fourth, and perhaps the most strildng feature getit). EGS projects create ormaintainruralinfra- of the EQS is its guarantee of employment, structure through small-scale irrigation, soil con- although the legal guarantee is restricted to the servation, reforestation, and rural road building. provision of unskilled manual work within the Wages are set in the form of piece rates stipulated for a number of specifc tasks, such as dig,Tie 1 brealcing rocks, shifting earth, and transplanting.- Given the attention it has received in devel- - r.e ktr Gpeoe swey r * - - ~~~~~~~~~~~~~e;1p17wt rrxek tbbw pv=f cky VW in opment policy debates, it is surprising that the (na&ou of otexnce (MSat 1990- weal casS. common perception of the EGS as a successful -tr peson dcj Cenrj 91 prices) (pJoi: poverty alleviation program is backed up by rel- 1978-79 163-5 433 11.11 79.6 atively little careful searh. The basis for this 1979-SO 205.4 41.0 11.54 81.9 perception is perhaps to be found in several dis- 198142 15760 373 1337 77.7 tinctive and promising features of the scheme as 198243 128.0 369 17.48 76:2 desmibed in the following paragraphs 198384 164.5 393 17.11 753 described in the following paragraphs. 1984-85 178.0 37.9 1926 63.7 First, the scale of the EGS ispressve aver- 1985-86 189.5 42.1 20.55 66.9 age monthly participation during 1975-89 was 198647 187.6 52.9 1736 63.4 about 50,000 people. In an average year during 1987-89 8133 345. 173.62 663 the latter half of the 1980s, at a cost of aboutUS$1 1989-90 77.7 33.1 2327 72.4 per day, it provided about 130 million person- 1990-91 62.6 - 24.00 70.6 days of employment in a state with a rural work -iaMabbk force_inluding CultivatorS-of about20 million a Pefe to thetfinM r choth AptG5M abr on %rom Ccrnpied fiom mm"tH prcgess reports an teE "hdb (see table 2). Anoffier notable achievement is that th Pkn OtDeparmerateGoveemmenofMuarata. Bonmta. 178 Appendix 3 district (see box 2). The district covers a large area: ciple that the benefits net of costs of participation apart from Greater Bombay, Maharashtra has are such that onl the poor would wish to partic- twenty-nine districts with an average area of ipate. In the EGS self-targeting works bycombin- about 10,000 square kilometers. En general ing- a low wage rate and a manual work though, the EGS has sought to locate work sites requirement. Brealdng rocks or performing simi- within the same panchayat samiti area (typically a lar physical labor for a low wage is unlikely to be small cluster of contiguous villages). attractive to anyone but the poor. Finally, the employment guarantee is closely linked with another attractive feature of the EGS, Impact The EGS and Poverty Alleviation namely, its ability to operate as a self-targeting scheme. This avoids the costly, and in some Since the mid-1970s absolute poverty in instances infeasible, altemative of means testing. Maharashtra has declied more rapidly than in Self-targeted schemes work on the gneral prmn- India as a whole While this may be consistent Box 1. How the EGS works: the main provisions All adults living in villages and small municipal towns of Maharashira are guaranteed employment under the EGS. The guarantee is only for unskilled manual work within the distric Transport facilities or expenses are tobe provided if the worker must travel more than 8 kilometers. There is also provision for on-site facilities such as potable water, creches, and first-aid. Those looking for employment must register for work under the EGS with the locally designated official. Employment is to be provided within fifteen days of demand, failing which the state is obligated to pay a nomii- nal unemployment allowance. New works canbe started at the authorization of the district collector if at least fifty laborers become available for work and they cmnotbe absorbed by any ongoing works. With the exception of some canal works involving mrck cutting, EGS works are required to have an unskilled wage component of at least 60 percent The EGS is financed in large part through a number of special taxes levied mainLy on the urban sector, including a professions tax, an additional tax on motor vehides, an additional tax on sales tax, a surcharge on land revenue, a tax on irrigated agricultural land, and a tax on nonresidential urban lands and buildings. Additional funding comes from a matching contribution by the state government equal to the net collection from the specal taxes. Box 2. Does the EGS guarntee employment? The statutory guarantee is for unskilled manual work within the district At the district level the guarantee has probably been honored, but given the size of most districts, this does notimply that ECS employment is necessar- ily accessible to all those who need it. More challenging for the EGS is to accommodate the demand for locally accessible employment, for which travel costs (pecuniary and nonpecuniary) are not prohibitive. One cannot assume that this stronger, and ultimately more meaningful, form of guarantee has always been metL Indeed, there are several documented instances of labores' orgaizations having to agitate (with varying success) for the initi- ation of EGS projects in specific areas. In recent years the guarantee aspect seems to have come under particular pressure. This is in the context of the doubling of the piece rates paid by the EGS in May 198B in line with a doubling of statutory minimum wage rates in agriculture. During the year following the wage increase, employment actually fell by about one-third, even one might have expected higher wages to draw more laborers to the EGS. Careful econometnc modeling of monthly labor attendance during the preceding thirteen years revealed that contrary to offical claims, the good crop year of 1988-89 accounted for only a small fraction of the fall in employment More than 80 percent of the decine could be attributed to the rationing of EGS employment, and in the twelve months following the wage incease the E1S met only two-fifths of the demand for local employment Statutorywage increases canbe politically attractive but without an accompanying comnitbment of the necessarybudgetary resources to sustain assured employment they may not be in the interests of the poor. For a detailed discussion see Martin Ravallion, Gaurav Datt, and Shubhbam Chaudhun "Does Maharashtra's EmploymentGuaranteeScheme GuaranteeEmployment?Effectsof thel988WageIncaease,- EcwonicDeelopment and Cultual Change 41(2) (1993). LessonsofExpeence:.TwlveCaseStudies 179 with expectations, how much of the decline in three-quarters of their gross wage receipts. poverty in Maharashtra can be attributed to tl Factoring in other costs, notably materials and EGS is not known. The critical issue in assessing supervision, the study found that about half of the performance of the EGS is its cost-effective- the gross budget disbursement directly reaches ness in alleviating poverty relative to alternative theparticipants,mostof whomwouldbedeemed policies supported by the same gross budget poor by any reasonable standard. However, the Even within the narrow dimension of income or impact on poverty is no greater than what could consumption poverty, this is a difficult question, be expected from the same gross budget dis- and one that the literature has not addressed ade- bursed as uniform (untargeted) cash handouts to quately. However, some evidence is available. all households.10 The povertr alleviation impact of the EGS Indfrect benefts. The evidence cited above sug- depends on (a) the scheme's success in screening geMts that in the case of the ESG poverty allevia- the poor from the nonpoor among potential par- tion depends on the indirect benefits. The same tcipants (targeting), (b) the size and distribution study cted above estimates that indirect benefits of net income gains to the participants, and (c) equal to about 40 percent of cost, if uniformly dis- indirect benefits. tnbuted across all households, would be enough Self-targeting. Recent evidence on the to tilt the scale in favor of the public works scheme's performance in reaching the rural poor scheme over untrgeted uniform transfe Thus, is available from the National Sample Survey for conventional benefit-to-cost ratios well below 1987-88. The survey asked whether or not any- unity would still ensure that the EGS was rela- one in the household had participated in a rural tively cost-effective in alleviating poverty- public works project (mainly, but not restricted The two most important sources of indirect to, the EGS) for sixty days or more in the last year, benefits from the EGS are through asset creation and asked a similar question about participation and induced effects on agricultural wages. Since during the previous five years im the hitegrated its inception until March 1991, a staggering total Rural Development Programme, a scheme ofr of 195,000 EGS works had been completed. To subsidized credit targeted to the poor on the basis date their benefits have not been systematically of an income means test Figure 4 plots participa- quantified. A 1980 studyby the Programme Eval- tion in public works and the credit program against consumption per person. Consistentwith e 4 P in publi works versus subsidized previous information about the EGS, it shows credit programs, Maharashtl 1987488 that participation in rural public works in 20 -Pubk work Maharashtra tends to be gr.atest for the poor. - Subsizedcndit Self-targeting seems to work for the EGS (while r, the means-tested credit program is strikingly . 6. untargeted). 14- Net income gins to partic pating households. Net income gains to participating households are 2 - more difficult to measure than the scheme's tar- lo geting performance. Foegone income is the main m 8 cost involved, which may be significant even in situations of relatively high unemployment It 6 depends on how partcipation in the EGS dis- 4t places other more or less productive household activities. Evidence from a detailed study of two villages in the Sholapur and Akola districts of 0 , * . 0 100 200 300 400 500 600 700 800 900 Maharashtra found that foregone incomes are positive, although quite low. The bulk of the dis- C-tXpIonIeLLn (Rterm) placement in time allocation is in unemployment sbm Mam RawEa and Gain Da (1994; .Irstinrg dtmi a k for men and leisure or domestic work for women. E Soi EuldsecI Rural We.'a n CDomiqae van de VAll The net gains toead(edt.).p reprcsdte abu fi Bak r heP deger TIhe net gains to participanLts represented about WAtM Bw.t fowke 180 Appendix 3 uation Organization of the Planning Commis- September. tirough November and cotton, the sion, Government of India, and the Directorate of principal nonfood crop (sown in June through Economics and Statistics, Government of Maha- September), are harvested by about March. rashtra, did provide some information about a Similarly, some evidence indicates that EGS range of benefits from the assets created by sixty- attendance responds positively to shocks in tie six completed works spread over four districts of agrcultural sector. For example, during 1979-80, Maharashtra. It listed a total of 2,051 households, when MWharashtra was hit with a drought in the or 31 households per completed work, who ben- central and western (Madhya Maharashtra and efited in different ways from EGS assets, includ- Marathwada) region, and later a flood in the east- ing 1,427 households who reported an increase in em (Vidharbha) region, labor attendance increased their farm production, 335 who repaid outstand- sharply. The same happened during 1985-87, when ing loans, and 558 who were able to create new drought conditions led to a roughly 30 permnt assets from increased earnings. The study also drop in foodgrain output. reported an enhancement of the employment potential of the area around the completed Lessons Learned works, with farming households reporting greater use of both family and hired labor. It is, Desnite its popularity, the EGS remains contro- however, difficult to say how far these findings versial in some respects. The scheme has often can be generalized (see box 3). been criticized, with some justification, for creat- During the nid-1970s to the mid-1980s, the ing low-productivity assets with po6r subse- realwagesofagriculturallaborersinMaharashtra quent maintenance and little complementary increased substantially,-with increases ranging investment Some people also argue that while from 50 to more than 100 percent depending on the EGS provides short-term income supple- - the region. Again, how much of this can be attrb- ments to the rural poor, it has notimproved their utedi to the EGS is not known. However, even if long-term income-earning capacity to the extent the EGS's contribution was relatively small, the that they no longer need the EGS. According to overall benefits could be enormous, because a this view, a truly successful EGS should have wage icrease benefits not just the 500,000 EGS been self-liquidating. Several considerations are participants, but the entire work force of 8 million relevant when assessing the merits of thiL argu- agncultural laborers. Note that maintainig the ment First, there is scattered evidence of long- scheme's guarantee aspect is an important factor term income gains in some areas. Also, the in the realization of these benefits assured success of the EGS needs to be judged against employment allows workers to make credible - - - - threats during wage b g in local labor markets. Box 3. Induced income effects of EGS assets: Stabilization benefts. The EGS can claim a cer- Ralegaon Shindi tain measure of success in stabilizing the incomes s . r s s w . . ~~~~~~One of the best known examples of induced income and consumption of the poor, both within a year ga m the EGSis that of Ralegaon Shmd,, a vil- and across good and bad years. The evidence lage in the dought prone district of Ahmadnagar in here is indirect, and is based mainly on the pat- central Mahamashtra. ln this village, EGS funds (sup- tem of labor attendance at EGS projects (figure 5). plemented with other pubLic funds) have been suc- First, EGS atbendance seems to be responsive to cessfullyused tohamess scarce water and todevelop the seasonality of labor demand in agriculture. social forestry Asa result, the village harvests two or Monthly labor attendance typically peaks during three crops a year and has enough wood orbionmass March to May and is at its -lowest during fueL Ralegaon Shindi claims to have eradicated March to May and iS at its -lowest duing unermployment, and the EGS is no longer needed in September to November. This is consistent with - Maharashtra's crop calendar. The major food crops (owar, rice, bajra) are grown in the kharif Sorelr Sartdi Acharya, The -Mahmrshtr Employment (monsoon) season, with sowing inJune to August Guante Sdemc A Case Study uf Labor Market btervation (New Delhi: Intraonal Labour Office, Asian Regional and harvesting in October to December. Evert the Team for Empklyment Promotion 1990) . rabi (post-rainy season) food crops (sown inx Lessons of Experience: 7ioelve Case Studies 181 Figure t Average monthly attendance tecting the poor. A central theme of the Tunisian at EGS projects, 1975-89 reform program, which was introduced into the BOO 1975-80 wa Eiglth Development Plan (1991-96), has been its 198D-85 average reliance on existing institutions. Rather ffian - 1985-89 average switching to an entirely different metiod of 4k7O0 . , ,transferring income to the poor, tie government has sought to fine-tune the existing framework of t 6w vfy/-\ price subsidies by shifting subsidies to those food products that are primarily consumed by lower- * incomegroups. With this approach, a type of self- targeting, subsidized products are stiU available to all, but the subsidized commodities selected are of the kind that the rich choose not to con- sume. For a summary of the program and c - - - - / selected indicators, see table 3. Jan Feb rar Apr May Jun Jul Aug Sep Oct Nov Dec : Mah - ~~~Impactof the UniverlSubsidy Program Sa CoredC fnmr plgress repors o pubhedbyhe Since its inception, the central objectives of the ibng Dqment rft Coemm>ent d Mahmh Bombay CCC subsidy program have been to redistbute alternative antipoverty programs or policies. In income in favor of the poor and to protectthepur- general, targeted poverty alleviation programs chasing power and nutritional status of low- cannot substitute for a sustained broadly based income groups. To some extent, the universal growth process, but they can often be a useful subsidy program succeeded in meeting these component of an overall development strategy goals. It was progressive in relative terms, con- to help the poor. In that context, there will tributing some five times more tu the purdcasing arguably be scope for public works employment power of the poor than of the tich as a share of programs such as the EGS, particularly in a set- total expenditures. This is not surprising because ting of surplus labor, unstable incomes, and poor the bulk of CGC subsidies were on food products infrastructure- that generally constitute a larger share of total spending by lower-income groups than by the Tunisia: From Universal Food Subsidies more well-to-do. Indeed, subsidies on food items to a Self-Targeted Program covered by the program have been very impor- tant to the poor. In 1990 they contributed more Trough the CGisse G6nAnlede Comsatiun (CGC), than 11 percent to the total expenditures of the the Tunisian government has subsidized the con- lowest income group. More tian 74 percent of sumption of basic foodstuffs and a variety of other total caloric intake by the poor and dose to 44 per- items since 1970u The benefits have been available cent of their protein consumaption were derived to anyone who chooses to purchase subsidized from subsidized products.?3 commodities in whatever quantity the desire. Despite these benefits, by the mid-1980s it was clear that the universal subsidy program was Overui-.w inefficient and costly. It was inefficient because it subsidized abroad range of products available to While CGC subsidies made a substantial contri- all Tunisians regrdless of need. The wealthiest butiontothelevel of consumptionbythepoor,by income group achually benefited twice as much the 1980s it was apparent that the universal sub- from the program as the poorest inmcome group in sidy program had become too costly for the gov- absolute (per capita) terms. The program was emmnent. The government was faced with a costlybeca.use itclaimedalargeshareofgovem- common policy dilemma in reforming its univer- mentresources: by 1984 outlays on subsidies hov- sal subsidy program: how to reduce budgetary. ered at around 4 peroent of GCP and 10 percent costs m a politically acceptable way while pro- of total governmentexpenditures. 182 Appendix 3 Alternative Courses of Reform suffered from substantial leakages to the nonpoor and have exduded eligible beneficianes. For The program's high and rising costs combined these reasons the Tunisian government has not with inefficiencies and substantial leakages to the considered individual assessment schemes, such nonpoor made an overhaul of the universal sub- as food stamps, to be feasible replacements for sidy system an urgent priority. In the early 1980s the food subsidy program. Tunisian policymakers began exploring ways to The govemment has also explored other tar- reform the program. An initial attempt to reduce geting approaches, but these have not proved to the CGC's budgetary costs was made at that time, be suitable for reforming the food subsidy pro- and subsidies on several food items were elimi- gram either. For example, the authorities rejected nated, effectively doubling their prices. However, geographic targeting, because in many areas dis- the violent riots that erupted in response to these tinctions between neighborhoods are too obscure efforts forced officials to rescind the measures to make it effective. and delayed the adoption of significant reforms until the end of the decade. -The Reform Progranm From Universal Subsidies Rather than eliminating the transfers, which to Sef-Targeting was no longer politically feasible, or continuing with the costly existing program of universal pro- Given political, economic, and administrative con- vision, Tunisian policymakers examined several straints, reforms thatreduce costs and improve the alternatives for better targeting of transfers to the equity of subsidies are obviously preferable to poor. In practice, correctly identifying eligible those irequinng anenlirely new institutional struc- people can be difEicult because of incomplete ture. In this context, a reform program was incor- information about individuals' economic status. poratedi into the Eighth Development Plan This problem has plagued assistance programs (1991-96) with the primary goal of reducing CGC begun in Tunisia in 1986 to ease the pressures of expenditures while protecting lower-income structural adjustment on the poor."4 These pro- groups- The primary components of the reform grams rely on individual assessment (means test- program include (a) improving the targeting of the ing) to screen potential beneficiaries. However, CGC intervention, (b) adjusting prices gradually administration of these programs has proved to to reduce and eliminate subsidies on certain prod- be difficuilt and eligibility lists are rarely updated. ucts, and (c) reducing unnecessaryproduction and As a result, the direct assistance programs have distribution costs for subsidized products. Table 3. Consumer subsidy reform and selected indicatoms, selected years Nunberofintedided teariaies Pborstquinde ofthe popuation (I.6 million in 1990) Per capita GNP OJS dolbr) 1280 t9a5 190- 1.280 1.180 1.440 Percentage of poor indiviu 1 19 12.9 7.7 6.7 Perntg of inividuals estimated to be bod imseare SpeercfeLm not mailable. in 1985. the Food and Agrickure Orgmanization of or unable to meet mininum caori requirements tie United Nations estimated tht daily energy requrerrnts in Tuinisia were 2.103 cabries perpcson. In 1990. 18 percent ofthe population (15 mnilaon people) consumed a daily average of 2.125 cabries pe person or less, and 13 pert (I . I million people) consumed a daily average of 1,953 cablries per person or less. Percentage of individuals belw the BMI cut-off pcint - 80 1985 (c1853) for enery deridencyb Male 4.1 2.9 Femriale 4.8 3.6 Total 43 - 3.3 costs of susidy program per benefdary (US. dolbrs) 19811 1985 .1990 44.3 43.8 44.6 a. Accordingto thdclidal poverty ne which s based on anriimun dailyintakeof I .870 caories perperson in urban areas and 1.830 calories per person in luBw areas. --- '--- - ' : b. BMI is the body mass index (teieight:8) S1on Per capita GNP: World Bank, * Tables (Wsingo D.C: Arld Bank. 1993); all ot-er data frorn the Nationrl statiscs Oice and tie iriryof the National Econaom. Lessons of Erience TWelve Case Studies 183 A particularly innovative aspect of the maintaining benefts to the poor, the authorities Tunisian reform program is its reliance on self- have libealized the sale of higher quality versions selection mechanisms to improve the targeting of of these goods, whicih are sold at cost.and are subsidies. Self-targeting occurs when benefits are bought by wealthier consumers, who then con- available to all, but the program is spedfically sume less of the subsidized products. designed so that the nonpoor elect not to partici- 'The second method for extending self-target- pate. While other targeted programs require some ing, a variation of the inferior goods approach, sort of explicit screning medhanism (suchdas indi- involves differetiating goods within a particular vidual or group assessment) to determine eligibil- product line through different types of packaging ity, withself-targeting the decision to participate is and the use of generic ingredients. The products nmade by individuals themselves rather than by packaged in the lowest quality cartons or con- social workers or other govemment agents. taming generic ingredients are subsidized. These The principal device used to promote self- perceived infieior features discourage consump- targetig in Tunisia is quality differetation. tion by upper-income groups, although the Designing a self-targeted food subsidy program intrinsic quality of the subsidized products using quality grading involves eminin house- remains good. hold expenditure data to determine wheier sig nificant differences exist in consumption across Impact of the Rom income groups. IE the poor consume a different basket of goods than higher-income groups, this The two mutually reinforcing tehniques for self- basket can be targeted for subsidies. Using exist- targeting described above have been successfully ing survey data to identify goods for subsidies implemented in Tunisia. Data on CGC spending allows self-targeted programs to economize on indicate that the reforms have reduced costs information costs by avoiding the cumbersome significantly outlays on the subsidyprogram were task of assessng individuals' inoDme levels to cut from over 4percentof GDP and close to 10per- determine Eligibility. In practice, however, con- cent of government expenditures in 1990 to 2 and sumption patterns may not differ significantly 6 percent respectively, in 1993. While data for an across income groups. This does not mean that extensive quantitative assessment are not yet avail- self-targetingisnotfeasible,butthatitmayrequire able, anecdotal evidence suggests that the rich are some creativity to invent "iferior' subsidized indeed shifting consumption toward superior goods that are unattractive to higher-income goodsineachsubsector,whereastheinferiorgoods groups and to encourage unsubsidized high qual- created under the reform program appear to be ity alternatives to siphon off demand by the rich, well-targeted toward the poor (To analyze the As a first step inuimproving the targeting accu- results of sef-targeting efforts more rigorously, racy of the Tunisian program, the government data arebeingcollectedinasmall-scale surveycur- eliminated subsidies on goods dearly consumed rently under way in Tunisia and the results will be e'isproportionately by the rich. Efforts were then available inan upcoming study.) Despite these evi- extended further to indude two additional meth- dent successes, analyzing the impact of price ods of self-targeting in the cereals, milk, cooking increases on lower-income groups reveals mdxed oil, and sugar subsectors. results: simnulations show that any increase in the The firstzmethod,thesuperior goods approach, real prices of subsidized goods has an adverse involves easing govenunent controls to allow the effect on the welfare and nutrtional intake of the private sector to market high quality, unsubsi- poor Targeted price adjustments, which reduce or dized products that appeal to high-income con- eliminate subsidies on products consumed dispro- sumers as alternatives to their subsidized portionately by the rich, dampen these effects. counterparts. In general, the quality of the subsi- However, price increases on such products still dized products is reasonable, but not exceptional. hurt the poor because even these goods are con- Because markets have been tightly conirolled by sumed to some extent by low-income groups. This state marketing boards in the past, the subsidized dilemma reflects a genuine tension between the product has often been the onlv quality available goal of reducing the CGC program's budgetary on the market To reduce subsidy costs while costs and that of protecting the poor 184 Appendix 3 Lessons Learned then coordinate monitoring of the standard of living of this group. Political considerations, imperfect information, The Tunisian case provides a useful example and the importance of food subsidies to the poor for other countries that are contemplating similar limit the tools available to Tunisian policymakers reforms, but that are concemed about the practi- in reforming the universal subsidy program. The calities of implementing self-targeting reforms. three-pronged reform program adopted by the Note that Tunisia's self-targeting efforts are part Tunisian authorities makes use of available infor- of a reform program. Self-targeting via quality mation and existing institutions developed by the differentiation is appropriate in Tunisia precisely universal subsidy system. This approach has also because a system of food price subsidies was proved.to be a politically acceptable way to cut already in place. The aims of the self-targeting budgetary expenditures while protecting the component are to modify existing institutions to consumption of the poor. While the results of the reduce leakages to the nonpoor, to cut the scope reform efforts since 1991 are impressive, particu- of the program, and to protect the welfare and larly their successful reduction of budgetary consumption of the poor. Self-targeting may not costs, there is still scope to improve the effective- be suitable in cases where the institutional frame- ness of the reform program. work of food subsidies. did not previously exist Self-targeting. Self-targeting efforts in Tunisia In cases where self-targeting does seem appro- should be reinforced. Laiberalizing government priate, the tedhnicalities of the program, such as controls on supenor goods and allowing unsub- the particular quality features of the targeted sidized goods to enter the marketthrough private products, are likely to be specific to the region or channels to siphon off the demand of wealthier country in question. The Tunisian experience consumers should be intensified in all subsectors. offers an example of one way in which such Tlhe inferior goods approach should also be reforms were implemented, and provides the strengthened by further tailoring the selection of - information necessary to design an effective self- subsidized goods to the consumption patterns of targeting reform program- the poor. Price increases. In general, price increases Honduras: Food Coupons should be gradual, but should at least keep pace with inflation to control budgetary costs. These Widespread poverty in Honduras was aggra- increases should be focused on goods consumed vated during the economic crsis of the late 1980s, disproportionately by higher-income groups. resulting in a significant increase in the incidence While targeted price increases are not as detri- of undernutrition, particularly among young mental as indiscriminate subsidy cuts, the gov- children15 The proportion of children under five emiment needs to pay dose attention to their years of age exhibiting symptoms of severe and impact on the poor. It should simultaneously moderate malnutrition increased from 38 percent introducecompensatingmeasureswherefeasible. in 1987 to 46 percent in 1990 according to the Data requisrement and monitoring. The infor- Ministry of Health's national health survey.- mation necessary to design a self-targeted sub- Chronic malnutrition (stunting or low height-for- sidy program indudes household expenditure age) among school-age children averaged 40 per- data. The governunent should seek. to collect this cent in 1986. Nutrition deficiencies among poor information regularly to monitor the progress of pregnant women was a factor behind the high the ongoing reform program. This could be done incidence of infant mortality (50 per 1,000), low using frequent small-scale surveys as opposed to birth weight, and high rates of maternal mortal- the larger, five-year surveys currently being ity that reached 221 per 100,000 in 1991. used. In addition, marketing studies that te-st The traditional nutrition assistance programs consumer acceptance of self-targeted products . that existed in Honduras prior to the creation of should be conducted prior to widespread intro- the Family Assistance Program (PRAF) involved duction of new targeted goods. Moreover, poli- distributing food through various channels. All cymakers should seek to establish an explicit, these traditional programs carried high overhead consistent defiriition of the target group, and costs and suffered from serious logistical prob- L.ssons of Expaiwe TTwelve Case Studies 1B5 lems. Limited coverage and faulty trgeting con- eight departnents. To maintain eligibility, chii- tributed to thidr failure to reach those most in dren have to attend school. need. Weaknesses in their education efforts The coupons for the Maternal Child Coupon included failing to communicate adequately Prgram are admin rd through health centers information about breastfeeding, weaning prac- targeted to low-income children under five and tices, or adequate diets for children and women. pregnantandlactatingimothers.This programcur- Neither did they provide incentives for the poor rently benefits approximately 104000 poor moth- to use eisting health care and education fidli- ers and children in ten departments. The program ties. Reliable evaluations of program outcomes provides coupons every month equivalent to were not conducted, and a policy framework for US$45 per year for each eligible child and modter. integrating and consolidating nutrition assis- The intervention is cocentrated on the earliest tance efforts was missng. stages of infancy and childhood, and includes To address these issues, the government assistance to pregnant women to improve the decided to testa new strategy of income transfers chnces of reaching children before malnutrition in the form of food coupons targeted to the most causes permanent damage. To maintain eligibility, vulnerable groups. It created the Family beneficiaries must meet health surveillance Assistance Program in July 1990 to expand the requirements. Together with the coupon, benefi- coverage of nutrition assistance while improving darisreceiveinformationonbretaseedin&wean- targeting and reducing the administrative costs ing practices, and adequate diets for women and of program implementation Operated initially children.. lntensve supsion at both coupon through the primary school system in the poorest delivery sites ensures against-lealmge to noneligi- departments, the authorities intduced a pilot bleindividuals. program in 1991 to test delivery of food coupons Theprivatesectoris involvedinallstages of the through the basic health network The pilot pro- program, with the commercial banldng network gram proved effective, and implementation of an participating directly by distributing coupons and expanded PRAF program with improved target- redeeming thien from local merchnts. Local mer- ing -and parallel strengthening of preventive-: chants particpate by accepting the coupons in healthcareandpnmayeducationservicesbegan payment for food' and other basic goods. in early 1993. Successful communication about the program has resulted in close to 100 percnt acceptance of nplemetato coupons by merchants. Potential problems of cor- ruption on the part of shopkeepers have been Under the first PRAF food coupon program avoided by the willingness of local commercial (Women Head of Household Coupon Program) banks to redeem coupons directly, leaving no coupons are distributed tihough the schools to roomformerhantstodemand"servicingfeesfor poor mothr and their children attending grades redemption of the coupons against goods. one through three in primary school and shown Beneficiaries can redeem the food coupons to be at riskof malnutrition.Expansion of this pro- through commercial establishments Tcmduding gram covers children entering the first grade of private banks) within four months of their issue, primary school at risk of malnutrition as identi- with redemption not contingent upon the pur- fied by the annual nutrition census (height/age). chase of food. In practice, beneficiaries use the In addition, at partcipating schools where the bulk of the coupons (88 percent) at local stores to results of the- annual nutition census show an' purchase food, and spend the remainder on incidence of malnutrition equal to or higher than essential items such as school supplies, shoes for 60 percent, all first graders become beneficiaries of their children, and medicine. Commercial banks the programL The food coupon, distributed three redeem the coupons' at the Central Bank of times a year, is equival-et to US$37 per year,'and Honduras. Used coupons are canceled at the is estimated to cover 20 peraet of the value of the Controller's Office. The authorities have not individual food basket of the benfidaries. As of adjusted the coupons' face value because infla- October1993,apprximately205,000mothersand fton rates have declined, but they reviewed this children were benefiting from. this program in issue in early 1994, and'plan to make an adjust- 186 Appendix 3 ment in- 1995. The costs of using health care staff linkage with primary health and primary educa- and prmary school teachers for distributing tion services. coupons to the beneficiaries has not been sys- ternatically measured, but the PRAP intends to Chile: Targeting and Decentralizing Health do this as part of its monitoinng and evaluation and Nutrition Pmograms activities. PRAF's food coupon expenditures amounted Ensuring that subsidies and services meant for to US$72 million equivalent in 1992, induding thepooradtuallyreachtenemandarenotdiverted 3A percent administrative costs.These costs are to the less needy requires a constant effort16 lower than those programs that distribute food Targeting and decentalizing programs to allevi- in-kind generally incur. FRAFs success in reach- ate poverty is essential to make the most of scarce ing target groups has convinced the government resources, butis an extraordinarily complex insti- that the food coupon program should be contin- tutional, administrative, and political task. ued over the medium termL Existing programs and institutions often have to be restructured, complex legal issues have to be Program Impact addresed, and targeting and d ation faces considerable resistance from powerful An evaluation of the pilot experiments indicated groups thatin the pasthave captured much of the that the program was cost-effective in alleviating subsidies. poverty and was more efficient than other nutri- Chile's innovative reforms in the social sector tion assistance programs. There is widespread during the 1980s and early 1990s-in education, acceptance and support of the program by bene- health and nutridon, housin& and social ficaries, implementing agencies, participatng secuity-represent a success story of effective, retailers,andbanks,leadingotherdonoragencies well-targeted reforms that have broad and rele- to consider monetiAng existing in-kind food aid vant lessons for other countries. These reforms programs as they reach their completion, partic- have produced record gains in social indicators ularly as the food coupon programs have not had such as life y ,ectncy, nutrition, infant and child inflationary effects. mortality rates, and birthweights.7 - n addition, the PRAF program provides its beneficiaries with incentives to use preventive. Backgrund health services and prmary schools. Enrollment in participating prmary schools rose by 12 per- From 1960 to 1991, Chile's infant mortality rate cent, while the number of consultations atpartic- fell from 119.5 to 14.6 per 1,000 live births; the ipating health centers increased by 131 percent child mortality rate dropped from 9.1 per 1,000 to during 1990-91. only 0.8; the percentage of low birtiweight new- borns declined to 5.7 percent, a decrease of Lessons Learned around 45 percent since 1976; and life expectancy at birth increased by more than 13 years, a world The key elements contributing to the PRAF's suc- record gain. The greatest reduction in infant and cess are (a) the use of coupons as opposed to in- maternal mortality has taken place in poorer kind nutrition . assistance; .(b) the simple and rurl areas, wheremortality rates were the high- standardized elighility cntena for beneficiary est The declie was achieved by improving. selection; (c) the high frequency of coupon distri- access to health services, potable water, and butiop. (in the case of the Bono Matemno Infantil sewage disposal systems. Program), which increases the probability of This remarkable improvement in social indi- coupon use to purchase food; (d) the simple coor- cators m Chile dunng the last three decades dinating mechanisms between PRAIj the Central occunred in a highly unstable and difficult eco- Bank, private banks, the Ministry of Health, the nomic siLtuation for the country as a whole. As Ministry. of Education, and merchants;, (e) the shown in table 4, GDP growth was highly unsta- annual recertification of beneficiaries, thatis, the ble,evennegative,insomeyears;unemployment exdstence of clear exit criteria; and Of) the direct was high during the early 1980s; inflation was Lessons of Experience Twelve Cas Studies 187 extraordiarily high during the early 1970s; and With the creation of Chile's National Health government real expenditures on health pro- Systemin,1952, the authorities redefined the food grams declined. Given these circumstances, why distribution,programs, integrated them with the did the social indicators continue to improve at provision of health services, and expanded the rates even faster than in the past? CFP to cover children under six and pregnantand Chile has a long history of combined health lactating women.As a result, the entry point into and food distribution programs, the most impor- the integrated health andnutrition programs was tant of which are the Complementary Feeding dunng pregnancy, and contnued until the child Program (CRP), the School Feeding Program, and was six years old. In primary school, the school the Day Care Food and Education Program. The lunch program provides on-site food rations for food distribution programs that gave birth to the low-income school children linked to school CFP started as early-as 1936 with the distribution attendance. of milk to children from birth to age two . Since The mainobjectives of the redefined CFPwere then, the CFP has constituted an important part to prevent malnutrition among the most vulner- of Chile's welfare system, lasting through many able groups and to promote health through regu- different political regimes The reason why these hr Lvisits to health clinics, immunization, and programs have survived numerous and radically education on the use of health services among different political regimes is that they were initi- low-income families. Food distribution involved ated to ameliorate malnutrition from a tedhnical not just providing free food, but was used as a perspective, and werenot perceived as part of the device to attractbeneficiaries to health and nutri- political platform of a specific party Smce their tionservices. Thiswas.accomplishedbychannel- initiation both government analysts and univer- ing the distribution of milk through health cincs sity- academics have particpated in the debate and rural health posts. about the design and implementation of the Because the food distribution program was health and nutrition programs. conditional on the beneficiaries having regular health check-ups, this required a nationwide infrastructure of health clnics to meet the -I.h,4. Gnrwth rates in GDP and gowi ,mc spending, increased demand for preventative and curative 197090 . services. Consequently, during the 1960s the gov- n eencuNe eminment expanded its investments in physical as h-~~~~~~~~ak . . Sod CW. GDP U lMhl ( - well as human resources. in GDP Unevnpb,- Dr4lofrm (ndbou eiqrdktrs p&cov ena rates crte 'f 98 (as petage *ar Oare& (pern OPer) do&rs) of GOP? Refirm of the Soca Sermces' Deliuery System 1970 0C. - 34.9 342.5 13.0 1973 -7.1 - 508.1 553.6 170 During the 1970s the govemment reoriented its 1974 -0.7 - 375.9 429.5 15.8 1975 -14.4 14.7 340.7 3113 14.7 efforts to impov the targeting of health servies 1976 1.8 12.7 1743 2621 14.2 and food distrution to the needy. To mcease effi- 1977 8.0 11.8 63.5 301. 15.0 cdencyintheprovisiont of services, service delivery 1975 6.4 13.8 303 314.8 14.5 1979 6.5 10.4 38.9 2984 13.1 was decentralized to the local level (municipali- 1980 7.8 10.5 312 384.1 14.6 ties), and the responsibility for manufacturing milk 1981 5.5 1L.4 9.5 406.5 16.2 1982 -14.1 19.6 20.7 384.3 22.4 produ was trasfeed bo the private secm In 1983 -0i 143 23.1 3173 21.9 this way, the government was able to expand and 1984 63 13.9 23.0 313.7 22.3 improveprimaryhealthservices,givingprioityto 1985 2.4 12.0 26.4 .281.1 21.6 1986 5.7 8.8 17.4 261.1 2(2.8 mothers and children of low-income households, 1987 5.7 739 193. 259.0 17.4 and to expand coverage in rural areas. Bette fwd 198B 7.4 63- 14.7 2703 16.5 presentatior was emphasized, and industies that 1989 10.0 5.3. 17.0 262.9 13.9 199D 2.1 5.7 26.0 - - - produced the milk for the program were required -Notwalabbie -bto sell the same product they sold in the supermar- a. Octbeth Decenber each year kets, threby elimiating the image of "a product b.SOeceflC=lkm 0dtdehd sOchre&dseaNiedU"td n £"for the poor" For the preschool population (chl- swa CenVeBarkpofatChic. - dren age two to six), the authorities.introduc&d - ore -en . ar . oV.Chi.e. .: . 188 Appedix 3 milk-cereal mixtures instead of powdered milk to that govermment spendig should subsidize the incease the childrenrs intake of vitamins and mn-- demand for and not the supply of social services. erals, diminish food leakages within the famfly, That is, subsidies should be given directlyto ben- and use cheaper raw materials (for example, soy- eficiaries rather than to providers, and should be beans). Finally, as a preventivemeasure,in1983the given in the form of direct subsidies (vouchers) govemment initiated a renfoced program that rather tan indirect subsidies (suci as subsidiz- provides additional food and more fiequenthealth mg the price of commodities). care for low-weight pregnant women, undernour- Decentralizing service provision was another ished children, and those nutritionally at xisk A imporlantcomponentofthereformsbasedonthe sale that measures weight increments is used to view that municipalities and the private sector identify the children nutritionally at risk. rather than the central government should Dro- Tables 5, 6, and 7 present various quantitative vide social services. Local governments or insti- indicators on coverage and goverunent expendi- tutions are closer to the beneficiaries, resulting in tures on health and nutrition programs. Table 5 improved quality of services, better targeted pro- shows coverage and the implicit income tradnsfer grams, increased enroUllment of low-income from the three principal programs, table 6 pre- households, and more effective administration. sents the annual cost perbeneficiary of the same - The authorities gave high priority to the devel- programs, and table 7 shows the coverage of opment of an effective information system, which potable water and sewerage services. wasseenaskeyforplanningthereformsandintro- In October1993,based ontheresults ofarecent ducing targeting. One of the mai instruments for evaluation of the criteria for taugeting the rein- targeting sodal programs was the poverty map, forced program (see table 6 for an explanation), preparedin1974,andlatercomplemented byaliv- the program directors decided to use weight-for- ing standards measurement instrument called the age and weight-for-height as key indicators in Committee for Social Action Index Systm The defining the target populationL These changes are latter has become a useful tool to help the local expectedtoreducethepopulationpartcipatingin authorities (municipalities) identify the target the reinforced program by some 30 to 40 percent population for a wide variety of social assistance This result shows the need for constant review of programs, suchas subsidies for housing and pen- the targeting cnteria and the operation of the sion assistance. health and nutrition programs, so that adjust- The CFP uses health and nutrition informa- ments canbe made inaccordance with the current tion gathered montily at the health clinics to situation and are not historically based. make decisions at the local, regional, and central levels. Tne regularity of the information.permits Some Features Underlying the Social Rejbrms the local staff to assess health and nutrition trends, thereby permitting timely modifications A common principle underlying the orientation of ongoing programs and assesments of the of social reforms in Chile during the 1980s was short-term needs for a new interventiOn. TableS. Caveag and impricit income owanser frni dte principal food distibution programs - 0 D0dth*inconie Dmmn*' RWo~RamS Coage as a pectage cfhushold incwme Complentary Feeding Pm 7% ofttal populaionurxder6 I 6for-ihepoorestldedcle 6:7% for the second poorest dedle Sdiol Feedirg Prgrarn 80% of the expenditures alocated to poores quLes; 32.0% for the poorest dedle.- . -th . . - dze progranm cwers 52% ofte dhilen in qtintle I ard 13.3% for tie second poorestdecle 26% in quirtle Pb Day Camreood and Eduation Fogram 40.OO hildren in tetwo poores quinties in 1978 and - - - -72.OOD 1991 -NotavailbLe, a A.ual coveragebythe pubcheal stem s 78 pentofthepopublion between one and lessftan twoyears od and 70 peretofthe popuWaion beteen two and fwe. b. Of didren attending priary school in urban and rural areas. So-w Isab" Va Rosa Cahi. and Carlos Castilo nd kabel Vial and Antoo Inft. Fron Plaodwes to PRuctici Tauet Sodiof gms in Latin AMe-x ed. M. Gosh (fashiwoon, D.C:World Banrk 992). Lmm of Expeiecn=Tweve Case Shabae 189 TahI L6 Am.a cmt per b.ndldwy for the aic and advances and strngthered institutional capadty, ruorcmi CFP 9A9 the sdol feedingpram, I m the local governments have been able to improve (i5 *A) the systems while decrasing thir costs. Bod e Ih, h*cedCFP Aside from the issue of targetirng, an impor- Oten - - 81 107 ta curent i concernng socal progrms in COwe ap 1-<2 32 105 Chile is how to reorient the subsidies from the ChJrenage 2-5278 havo VQenf <44 78 supply side to the demand side and the extent to which this should be done. This is particularly complex in the provision of health, where a large Bued. I -. percentage of the target population depends o a Totl 71.6 centazed national health system. Discussons = Oldeiconsorte CFI 810 pMt2ore fit dicodaem are currentlyoriented to the design of mixed ser- 17.2 pacet ws deiwy s dti bcd lwd. ad 1A perct pays lbr vice prvision, whereby the beficiary will be mF*oraedweoI riSidFee*PnaUhzn.95Pc nstdws pay(ciie hoad rinaid 5 peutzasmkiiiS*.e;. allowed to select where to seek service, which La. RMOCIV iC -and ivdLdb kwill be paid (totally or partly depending n the b1Pvk di andnilrvowtma 0iX b-enexCiary's icmelevel) directly to tie irstitu- SalwVot C*w, ad C*a it F;i PWJWif timo providing the service- lSbl.7 Coimage club., .l p.i abI.bw _A major reason for the effectiveness of the scNt wwq,sd SW .M -govemments social programs is, tipresence of &wmtefal xadokh) a leading institution for policy change, Chile's . . . -Ufb National Planng Office, which took the klader- * d - shibp role in designig the impleenation of the economic and social principles and policies 1960 5 - 2 9. - appliedbythenewgovemmnt Suchleadership 1965 54 25 12 1970 - 67 3' -included developing methodologies for cotb- "75 74 4- 35 effecivenessanalysistobefollowedlbyallpublic 1911> gg5 .915 - 67 4 -agencis and designing and implementing an 97 :3 66 informainsystenfortargetingso calassstanc p ams. Targeting to the poor and improvig saru Sweth de Deusyo y A sosin. se cw e budwo the coordination of soial projects implies the use psr b Ia P~ (Sm~ Seardinb de De5110 exi'' of twotypes ofinformationsystems: one to iden- tify beneficiaries and the other to evaluate the Antr information system designd to mea- socialprograms. Thelatberis akeyinrstumentfor sure theeredisbutiveimpactof socdalspend-mgis desgning policy and for establishing priority ffiheUvingStandds ur emenSurwey, acom- needs and p r prehensive nationa household survey that con- impor eature of the refornis has taims imforfat on all the st*sdiesprogrmthe been the trainig of senior and midlevel officials. govefentcurrittlyrsltvesarpresenta- The authorities achieved this by creating a schol- tive sample of o ate 20,000 households arip po sndstudents abroad to y tlat was first obtaihned in 1985 and subsequently in several disciplines and by developing well- stdied in 1987, 1990, and 1992. These suvys designd training programs in Chile. They also have provided reliable information on. the effi- provided training to municipal officials of the cency of the targeting in the various programs, twelve regions. The result was a core of well- presenting imforationonthessubsids the differ- taned professionals, distributed nationwide, ent income grn4xps have received, and allowing that faiclitated the govennmes preparation, plnners to make corrctions where needed. planning, and implementation of the reforms. Developing the infoimation systems has been cosdy, and at the beginning they reprsented anr. fssos arned additional burdenfor ihe muicipalities, particu- larly during the fist stages of the decentraliza- In summary the main lessons that have emerged tion proacess. However, because of technical from Cile's e areas follows: 190 Appendix 3 Strong leadership is needed that can articulate * Local institLtions like municipalities and the a clear set of objectives and a strategy. To private sector can play a significant role in achieve the objectives requires a solid blend of poverty alleviation strategies by providing economics and technical skills so as to be able health and nutrition services in coordination to communicate effectively with the govern- with other programs. This will avoid the ment's economic team-L For effective targetng duplication of programs and benefits. the government must be able to identify and * Two types of information systems are needed capitalize on the complementarities among fortaretingandforimprovingthecoordination the various programs. of social projects, one to identify beneficiaries * The design and implementation of targeting and another tD moritorthe inpactof socal pro- takes time. Decentralization and "municipal- grams.Thelatteriskeyfordesigningpolicyand ization" requires legal changes and bud- for establishing priority groups and programs. getary adjustments. Efficiency and equity problems cannot be resolved with quick, Zimbabwe From Relief Feeding superficial fixes. Instead they often require to Food .Production large institutional changes that result in new roles for central govemment bureaucracies. Zimbabwe, while able to show improvements in and changes in the way social services are children's nutritional status since the 198s despite financed and operated. economic setbacks and drought, remains.a coun- in primary health care, the authorities should try with unacceptably high levels of shmting (low emphasize linlkin maternal and child health height-for-age)?8 This is particularly disappoint- programs with growth monitoring and food inggivenits earli±r status asafood exporter innor- supplementation measures, paying special mal agricultural years. Factors contributing to the attention to the group at risk. These interven- continued levels of malnutrition include individ- tions, coupled with a significant increase in ual household poverty, seasonal food shortages the coverage of potable water and sewage andconcomitantpreh,rvestincreasesininfectious handling facilities, were key factors behind disease, a declie in per capita maize production, Chile'srecorddeciesininfantmortalihtyand heavy work loads for women, lack of exclusive morbidity, undernutrition, and maternal breastfeeding among infants six months and mortality younger, and lack of knowledge about optimal Continuity in the reform process is impor- feeding patternsfor young children. tant Chle's success is a result of strong gov- In response, two of Zimbabwe's most impor- eminent conmitment to overcome setbacks tant nutrition initiatives have been the national and pressure exerted by interest groups . Children's Supplementary Feeding Program Reforms are difficult and in Chile's case (CSFP) and the Community Food and Nutrition required considerable negotiation, trial and Program (CFNP). The government started the error, and corrections. Children's Supplementary Feeding Program in Targeting of social programs and decentraliz- 1981 to provide emergency relief to children in ing their implementation is bound to raise drought prone areas. The CSFP attempted to strong resistance among those currently avoid some of the dependency-creating aspects employed by the sstem and will probably of most supplementary feeding programs by involve higher fiscal costs in the short term using locally grown food and including nutrition Some employees wil be. made redundant. education. Inan even larger step in this direction, others will be asked to relocate; and many will the phasing out of the CSFP and its replacement become employees of a municipality, facing by a program designed to enhance local growing an uncertain future with a totally new set of of the supplementary foods, the CFNP (originally employers at the local level The government called the Supplementary Food Production might have to pay for early retirement by Program), was started by 1982. However, during many employees and for the relocation costs the 1992 drought the authorities reinstated the of others. CSFP on a much larger scale than before. Lesn of Epience. Telzve CasE Studies 191 Children's Supplementary Feeding Program comnimittees at the national, provincial, and dis- trict levels. The authorities further streamlined The CSFP was a cooperative effort between gov- the work of these committees by establishing a eninental and nongovernnental agncies oper- task force of relevant miisters under the chair- ating under the umbrella and direction of the nmanship of the vice president and creating a ful- Ministry of Health. A national working group time secretariat to oversee the day-to-day was set up with representatives from relevant running of the program. Six worldng groups ministries and voluntary organizations. In the were established to facilitate program planning provinces the provincil medical officers of and implementation that were responsible for the health set up committees with inteecrtoral rep- following activities (a) nutrition program moni- resentation from wifhin the Ministry of Health toring and evaluation; (b) traing; (c) conmmu- (for example, environmental health, health edu- nity mobilization; (d) infornation, education, cation, maternal and child health, nursing, and and communication; (e). procurement and nutntion) and other relevant sectors, such as resource mobilization; and (f) transport and lands, agriculture, and water development, and logistics. NGOs operating in the area. At the district and Impact. Evaluation of the feeding program in village levels, the CS(P relies heavily on conmmu- 1981 documented a weight gainbychildreninthe rity participation, with local . committees progam twice that of cildrenina controlgroup, composed of health workers, school teachers, and with children that obtained thirty or more community development worklers, and women's supplementary meals having a threfold weight advisors. Parents in the villages where feeding increasewhencomparedtotheircontemporaries- points are established select a feeding point- Perhaps more imnportant, the number of families committee to run the program, with the commit- who stated their desire to grow groundnuts for tee responsible for developing a duty roster to home consumption in the following agncultural ensiure that feeding occurs on a daily basis and season almost doubled, from 45 to 80 percent of that the work load is shared. During the 1992 families. In addition, the establishment of the drought the authorities developed a manual to Community Food and Nutrition Program mnini- enable extension workers (particularly village mied growth falterng after the feeding program health workers) to help the community imple- was terminated. ment the programL More recent evaluation of the program's Implementation. Following the selection of impact during the 1992 drought indicated that high-need areas based on a variety of nutrition while the incidence of malnutntion in children surveillance data, one- to frve-year-olds are cho- under five increased in 1992, six months after the sen for supplementary feeding using-mid-upper feedgprogrambegan the levels of malnutrition arm drcumference measurements (ircumfer- had decreased in all the provinces. In October ence of less than 13 centimeters). Meals are based 1992, 2 percent of children had severe malnutri- on local foods-maize meal, beans, groundnuts, tionand5 to7percenthadmoderaternalnutrition and oil -and are planned so as to provide based upon m-iid-upper am crcumference mea- approximately one-half of the daily energy surements. When the survey was repeated in requirements of the one- to two-year-olds and April 1993, a nondrought year, the levels one-third of the daily energy needs of the three, remained the same. More than 70 percent of chil- to five-year-olds. The cost per beneficiary per dren under five were receiving supplementary month is approximately US$1.45. meals at the time of the second survey. During the 1992 drought, the country was Among the strengths of the program is its pro- divided into three zones based on clinical malnu- gression from a focus on relief efforts to an tntion and crop forecast data. This categorization emphasis on education, along with its capacity to facilitated the early targeting of assistance reach even the most remote areas and feed chil- resources to the most needy areas. The program dren at, or dose to, their homes. Structurally, the rapidly reached more than 1 millionbeneficiaries flexbility of building upon grassroots organiza- because of the estence of CSFP intersectoral tions at the district level provided the greatest 192 Appendix 3- degree of personal commitment and manage- the program, with the long-term objective being ment responsiveness. to develop a villae-vlevel capacity to identify and correct the cause. of malnutrtion, particularly Lcssons Learned among children age five and younger Experience with the CSFP demonstrated that the Program anagmet following program elements are required to imple- ment emergency relief activities successfuUlr A major emphasis of the program has been dlose * Ensuring political commitment and being attention to project management Chaired by the willing to mobilize resources - Ministry of Agriculture Extension Service, the 0 Implementing intersectoral collaboration and intersectoral National Steering Committee for coordination using existing structures Food and Nutrition.provides leadership for the * Encouraging community participation in and program. At povicl district, and ward levels, ownership of the program similarly composed food and nutrition manage- - * Providing dearly defined program imple- mentcommitteesareresponsibleformanagingthe mentation guidelines and training and orien- program. At all but the national leve, these com- tation for all key implementors at all levels mittees have been institutionalized as develop- *Instituting appropriate collection and use of ment subcommittees, and serve as an entry point - food security and nutrition status data for tar- for placing nutntion on the development agenda, getng purposes at least in the pvines. Incorporating community coping strategies IThesecommitteeshaverunwellbecauseofan into future preparedness plans early definition of the roles of each sector in the - Recognizing the crucial role of village com- program. A management handbook describes munity workers in mobilization, program these agreedroles,andisused asthebasictoolfor implementation, community training, and interectral training of the committees- As it is program monitonng . now viewed as an integral part of each sector's a Conun.unicatingthebasicmessageaboutlocal work plans, the CFNP does not disrupt other availability of food commodities for provid- duties- At the ward levei, contact with villages is ing children with adequate nutrition. maintained through a nutrition coordinator No development committee exists at the Community Food and Nutrition Program national level, although the State Planning Agency may eventually fulfill this role. In the The authorities implemented the CFNP to meantime, the National Steering Committee for address chronic malnutntion by mobilizing vil- Food and Nutition lacks executive powers and lagers to grow nutrtious foods (groundnuts, must depend upon the good will of each sectoral beans, and vegetables) in community gardens minstry and the personal commitment of the and rainfed plots or by raising poultry or rabbits committee members- in areas where water is a constraint In many cases, projects are linked to day care, growth Proect Implementation monitoring, and special feeding sessions for chil- dren identified as malnourished. The authonties The authorities use data from cinic-based nutntion have initiated more than 3,000 CFNP projects, surveillance (weight-for-age) and other nutrition with 10 to 200 participants per project. surveys and reports and informtion from otier The CFNP effectiLvely makes more land avail- setors to identify communities withlhigh levels of able to the poorest farmers and places them in malnutrition and poor household food security. working contact with more successful farmers for Extension workers discuss the situation with the the transfer of firming techniques. The govern- leadership of each community and explain thepr ment extension service is attracted to the commu- gram's objectives and how ihe vilagers can Xntyplotsbecauseworkingwithexistingcohesive actively participate in addressing malnutrition. groups is efficient Community decisionmalkng The community, with the technical advice of the and collective self-reliance are twopnrmaryfoci of agriculturl extension worker, decides on the pro- -~~~P0 Lessons ofbEenrc ¶llvelc Case Studies 193 ject it wishes to undertak The request for inputs a management system, in raising awareness of is tbnsniitted through the district to the province nutrition issues at all levels, and in securing com- Families in the village work together to pro- munity support for and participation in projects. duce food communally, primarily to be fed to Further achievements of the program include the children under five. The production package con- following: sists of groundnuts and beans for rainfed plots h Increased awareness of the potential role of and gardens. and small stock . The fimilies sectors other than health in alleviating mal- appoint a committee that plans the work roster nutrition. and manages the group's activities. Parents orga- *Greater involvement by staff in key develop- nize the group feeding of children under five in ment sectors such as . agriculture in the project and those referred by the clinic or out- Zimbabwe's nutrition programs. reach sites five times a week. * Enhanced integration of nutrition issues in The key messages communicated to project other development activities. For example, participants are as follows: the Water Development Program systemati- The importance of food preparation, hygiene, callypromotessmall-scale gardensatprimary and storage. water points in rural areas, and the Agi- * The importance of using energy dense food in cultural Department is incorporating basic each meal. foodrequirementsforafamilyof sixinitsland * The group feeding: meal. is a supplement to, use planning exercise. not a substitute for, other meals provided at * Heightened appreciation by key poliymak- home. ers of the need for a national food and nutri- * The child needs to be fed at least four times a tion policy to .institutionalize intersectoral day with cereals, beans, groundnuts, oil, and coordination and collaboration. vegetables. * Increased promotion of community aware- . The mother should continue breastfeeding ness of food and. nutrition problems and the until the child is at least eighteen months old. potential for addressing them using local - The child should be fed during illness. resources and limited exteral assistance. * The child with diarrhea should be given salt * Strengthened community self-reliance and and sugar solution and continue to be fed. reduced dependence on direct food aid. : The child should eat from his or her own sep- arate plate. India: Tamil Nadu Integrated Nutrition * The child should be weighed regularly to Project assess growth. The nutrition education messages are integrated If hunger is the worst consequence of poverty into the training of all extension workers at the vil- and malnutrition is the worst consequence of lage level, and they are expected to relay this mes- hunger, then according to Liptonl the fight sage to project members withinthe contextof tidr against poverty is. "first and foremost a fight sectoral activities. Practical demonstrations have against nutritional risk."" Projects that address been encouraged as the best method of education. hunger therefore have to steer resources to the An ongoing monitoring system is in place, very poor, avoiding triclde up, and ensure that with standardized assessment forms completed their extra income is converted into calories for foreachprojectthatcontaindetailedinformation, those at risk of malnutrition. The Maharashtra including the number of recipients, the types of Employment Guarantee Schemedescribed ear- projects, and so on. Each province submits quar- lier is one of the best examples of a project terly and annual progress reports that are the designed to do both- However, income gains. basis for the disbursement of funds. reaching the poorest families may still fail to raise the calorie intake. of the two groups most Impact vulnerable to nutritional stress: children under two and pregnant and breastfeeding women.. A 1989 evaluation of the previous four-year .The Tamil Nadu Integrated Nutrition Project period found significant progress in developing (iNP) typifies a highly tareted effort to reach 194 Appendix 3 those in the vulnerable groups at demonstrable Thus, the government's main concern was to risk of malnutrition. design. a program that would avoid. these com- Tamil Nadu's poor nutritional profile is not mon pitfalls of nutrition. peograms. The large commensurate with its relatively better position numbers to be covered and the potential difficul- among Indian states in,respect of many other ties of broad intersectoral collaboration necessary indicators of development Although the state for a large project were daunting. Project activi- has comparatively lower birth and infant mor- ties were confimed finally to .those components tality rates and a higher literacy rate, it is among the government thought were liely to have the the worst off states in terms of average calorie greatest impact on; nutrition status: health ser- consumption (table 8). vices and nutrition education with a core of nutri- In the late 1970s about twenty-five different tion services, induding growth monitoring and nutrition programs were operating in Tamil selective nutrition supplementation. Nadu at an annual cost of Rs 162 million (approx- imately US$15 million). However fewer than 10 Project Goals percent of the groups identified as the most vul- nerable were actually receiving benefits from The TINP's overall goal was to improve the nuti- these programs. The reasons for the programs' tionandhealthstatus ofpreschoolchildren,espe- limited success are as follows: cially those under three, and of pregnant and They did not reach the intended beneficiaries nursing women. Its objective was a 50 percent because feeding was done on a drop-in basis reduction in the prevalence of severe and moder- rather than aimed at those who were identi- ate protein-energy malnutrition, estimated at fied as being at risk about 60 percent among preschool children. In * Most programs did not cater adequately to addition, the project aimed to reduce the infant the nutritionally most needy group, those mortality rate (then 125 per 1,000 live births) by under thiree years of age. 25 percent, reduce the proportion of children * The food distributed tended to substitute for under five showing signs of vitamin A deficiency rather than supplement food normally con- from about 27 to 5 percent, reduce the prevalence sumed at home. of nutritional anaemia among pregnant and nurs- F* amily members usually shared take-home ing women from about 55 to 20 percent and ratons, thereby diluting the impact on the increase the provision of antenatal services and intended beneficiary. trained attendance at deliveries from about 50 to * Most programs placed little emphasis on 80 percenL- nutrition education even though food habits were a major determinant of nutrition status Prject Coverage in Taiil Nladu, particularly of children being weaned, whose growth faltered dramatically The TINP covered about 40 percent of the state's across all income groups.- rural population, 17 million people living in 10 of * Eisting maternal and chiid health services the state's 22 districts. After an initial year-long were inadequate. trial in one block (an administrative unit with a Table S. Indicawtors for selected stats, various yeas kDor MDrtity ro Amw1 per Di' perc S khrawt- 1989 1m9(deat per Fneme racyre. . apita ince. cablie hto. Stow (.rt per 1.0Ope) 1.00 Five bi) 1991 (fren 1987 (Rs) 1988 (koi AndhraPradesh 26 70 34 2.333 2.401 Gurt- 29 72 48 3,636 2,608 Kamatalm 29 71 -44 2.B02 2.592 Ierak 20 17 87 2-371 2.203 Orisa 30 123 34 1,983 2,700 Tami Nadu 23 67 52 2.980 1,910 Scrce OFlc ofthe RistrarGeneral. Vital Slfistics Division. fPpcti ofkdo 1991: Cow Peumend QndiOfce of tRegsrrGeneral. 1992); Naional Nurtidon MonWitgBilureau,'Interirn Rr of PepeatSurvey 1988-89 (Hyderad: National IrsfituteofNut,ition. 1992). Lesso of Experience Tahvc Case Studies 195 population of about 100,000 people), the project gain adequate weight during this period were expanded at the rate of 35 blocks per year to cover referred for medical evaluation and treated for any a total of 173 blocks at the end of five years. A illness detected. community nutrition center housed in a rented Pregnant and nursing women were also dwelling was opened in every village of approx- selected for feeding on the basis of any of the fol- imately 1,500 persons. A total of 9,000 such cen- lowing objective criteria: ters were opened, each staffed by a community * Having a child enrolled for supplementary nutntion worker and a helper. hey were respon- feeding sible for monitoring growth; selecting children * Lactating simultaneously with pregnancy for feeding; distributing the nutrition supple- * Being of fourth or higher parity ments; organizing people to participate in health * Having edema activities; and providing nutrition education * Being a single mother through demonstrations, house visits, and the * Carrying twins. organization of women's groups. These women received food supplements daily during the last trmester of pregnancy and the Nutrition Services first four months after childbirth. Nutrition services, the core of the project, cen- Health Care tered around monthly growth monitoring of chil- dren. Short-term supplementary feeding was Health care was intended to back up the nutrition provided for those found to be malnourished, effort It inluded antenatal registration and care, those showing signs of growuth faltering, and tetanus toxoid immunization, deliveries by selected pregnant and nursing women. All chil- trainedpersonnel,child imuruzation,and exam- dren under three received deworming medicines ination and medical care of children found sick or and a mega dose (200,000 international units) of not gaining adequate weight Coordination vitamin A twice a year Daily iron folate tablets between health and nutntion workers was con- were provided to pregnant women for three sidered particularly important for malnourished months. Intensive counseling was given to moth- children who failed to respond to therapeutic ers to improve the home care and feeding of chil- feeding. drenL Education on the home-based management Under the project the authorties strengthened of diarrhea withiluids and feeding was an impor- the- existing rural health system to provide tant component of the nutrition strategy. improved maternal and child health services and Children were enroled in the supplementary preventive care. The supply of drugs and medi- feeding program only if they were at risk, that is, cines to the block-level primary health centers iftheywereidentifiedasseverelymalnourishedor was also augmented. The project. constructed if their growth pattern faltered, indicating incipi- some 1,300 subhealth centers in the villages, each ent malnutntion?' While children in Grades mI - with an outpatient clinic and a place for the mul- and IV of malnourishment were admitted to feed- tipurpose health worker to live. Training facities ing immediately when their malnutrition was for multipurpose health workers were created or detected, those losing weight or failing to nimproved. As the government of Tanil Nadu had weight in Grades ILI, and normal) were admitted rejected the central government's community to feeding only after two successive weighings health gwdes' scheme, there was great potential (thirtydays)inthesix-to twelve-monthage goup, for using comnmunity nutrition workers to and four succssveweighings (ninety days) in the improve the spread of primary care servces, twelve- to thirty-five-month age group. Enroll- which were estimated to be reaching only 30 per- ment in feeding was accompanied by intensive cent of villagers. education about nutrition for the mothdrs of these childrerL The project provided feeding for a lim- Communications ited time (ninety days) only?' Those who had gained at least 500 grams over three months exited Communications were designed to familiarize from the feeding progranL Children who did not families with and involve them in the project's 196 Appendi& 3 goals, encourage them to accept services, and suggest the causes of and remedial actions for fal- influence them to perform activities at home to tering, and would follow up with home visits to. improve the health and nutrition of mothers and continue the mother's education. Graduation young children. The interpersonal. communica- from feeding provided ample demonstration of tion skills of nutrition and health staff were the effect of extra feeding on growth that could strengthened by traiing.- They were provided actuallybeseeno thegrowth card. Selective feed- communication materials for use in the field and ing was, therfore, a key communication strategy. encouraged.to produce materials of their own. A staff newsletter informed and motivated them. Monitoring Mass media campaigns reinforced interpersonal communications. Films, radio spots, wail pasters, The project design included a monitoring system, advertisements, and folk theater were used.. planned evaluation,' and the conduct of. special. V-llages were prepared to receive the project studies. The management information system by having its objectives and design explained.to was designed tomeasure projectbenefits in tems village elders and opinion leaders. Communica- of improved matemal and child health and nutri- tion materials were used to descbe the activities. tion and to document the process by which these. . In the lastweek of the communitynutritionwork- gains occurred (or did not occur). ers' training, joint trining with the multipurpose The monitoring system was based on three health worker was aimed at informing the com- important principles: munity of and involving it in initiating the com- * Collect only what information is needed, not munity nutrition center. what is possible. A key to winning community support were the * Devolve responsibility for data interpretation women's working groups. These were groups of and remedial action to. the lowest possible fifteen to twenty women identified by the level. - community nutrition worker as progressive, capa- * Manage by exceptioi. ble ofworking togeiher, and interested intheactiv- ities of tie communitynutrition center The groups TINP's Achievements met once a month at a cooldng demonstration where the community nutrition workers demon- lndependentmid-termandfinal evaluationsofthe skrated nutritious and easy to make weaning food project found an impressive improvement in chil- recipes. The community.nutrition workers gave dren's nutrtion status. Severe mnalnutrition had the women health and nutrition training, and beenreducedby25to55percentindifferentblocks some of the women became quite proficient in depending upon the duration of the projecL There using flip books and flanel graphs to spread the had been a corresponding shift in the proportion health and nutritica messages to their neighbors. of cidldren in the better nutrition grades, indicat- To sustain the interest of women's worldng group. ing an improvement in the entire population of members, the project recently experimented with children from newborns to age dthet The propor- a community self-survey and with the "adoption" tion of children in feeding at any time (children of several families by each group member fed/children registered) declined from 40 percent Another recent innovation in the communica- to 25 percent On average, 80 to 85 pecent of chil- tions effort was the formation of cildren's work- dren entered feeding for at least one nirnety-day ing groups. The facility with which children period. Fully one-half of these required only a sin- communicate and the enthusiasm with which gle period of intervention to maintain healthy they learn and relay project messages through growth. Some 40 percent required two or more. poems, songs, and skits has made this a highly penods of supplementary feeding and a group of successfuil activity. from 5 to lOpercentrequired almost constantfeed- A crucial communication strategy was the ing, never emerging from the lower -grades of monthly growth monitoring session. Children's undernutrition. growthpatternswerediscussed and mothers were IThus, each child in the community received complimented for good growth. In the case of fal- personalized attention and supplementary feed- tering, the community nutrition worker would ingwhenrequired,ata cost equivalent to feeding Lessons f Experien: Ttvcvl Case Studies 197 only 25 percent of children at any one time. Some in the rest of Tamil Nadu. There was a clear 2.4 million children participated in the TNP pro- decline in hospitalization for diarrheal illness, ject. The total cost of the project, including food, which seems-to have been associatedwithearlier salaries,.construction, and administration, was and better use of home sugar-salt solutiorL US$26 per benefiadry or roughly US$9 per child Tmmunization levels climbed to more tian 80 per year. Of course, this notional calculation does percent throughout the state, associated with the not consider the extensive benefits the program national Universal Immunization Progranm provided to other children in the community. Other health services were found to have had Evaluation also found the nutrition benefits of rather low coverage. Coverage of children with the project were long lasting. Children in the biannual deworming was estimated to have thirty-seven- to sixty-month age group who had been nearly 50 percent, while vitamin A supple- been in the project enjoyed better nutrition status ments reached only one-quarter of children. This than their counterparts in other communities too was initially the responsibility of the health who had not The final evaluation estimated that worker and was plagued by an uncertain supply the project had reached 77 percent of childreni. of the liquid vitamin. It will now be given on a The shortfall in coverage was caused by the com- regular basis by the community nutrition munity nutrition workers not covenng outlying worker. The referral of chldren to the primary hamlets ini less accessible areas of their villages health care system if they failed to gain weight adequately. This error is being addressed in the during supplementation was poorly imple- follow-on project (TINP-Il). mented and remedial actions were rarely, if ever, The monthly weighings had been carried out taken. regularly with a high degree of participation. The communications component was evalu- More than 90 percent of enrolled children were ated largely through qualitative techniques.- Sub- weighed each month, and participation in feed- stantial improvements were noted in mothers' ng was almost 97 percent of those eligible. The knowledge and home treatment -of diarrhea as proportion of children participating in feeding well as in their appreciation and acceptance of who were actually ineligible was 2 percent immunition. Unfortunately, little information Almost all mothers interviewed stated that the was collected on the frequency and -timing of food supplement was palatable and readily breastfeedingoronweaning althoughchildfeed- acceptable to their child. Most reported little ing practices appear to have improved through- sharing of the supplement or substitution of out the project area. Workers acknowledged the home feeding. This was probably because of the usefulness of the wide range of attractive and dose attention paid by the community nutrition appropriately targeted communication materials. workers; the on-site feeding; and the provision of The training of project functionaries in communi- the food supplement in the form of ladoos, a tra- cation skills was particularly noteworthy. ditional snack. Among the project's disappointments was Lessons Learned the poor enrollment of pregnant and lactating women in supplementary feeding only 50 per- The project demonstrated that it was possible to cent of those eligible. This low enrollment has have a substantial impact on malnutrition within been attributed to the inconvenience of daily a context of low economic levels and with the feeding and to the fact that the health worker assistance of community-based nutrition work- was made responsible for selecting pregnant ers. At a cost of US$9 per child per year (and an women for supplementation. Cultural factors effective transfer to the household of about US$3 undoubtedly also played a part The follow-on on average per child per year), the relative cost- project allows selection by the community nutri- effectiveness of the project's approach as com- tion worker and take-home feeding for eligible pared to direct transfers to the household maybe mothers. called in question. However, a number of stud- .Evaluation also showed that while infant ies have confirmed that the income elasticity of mortality fell throughout the project period, this demand for calories is less than one even in the was no more significant in the TINP areas than lowest income groups. Furthermore, the evalua- 198 Appendix 3 tions did not find that calorie adequacy at the per year in the 1980s. The rainfed millet, which houzehold level was an acceptable proxy for was once the main food source of the local Manga calorie adequacy of individual preschoolers, and Mober populations, is now a highly uncer- although it might capture major calorie deficits tain crop. During the last twenty years the district inpregnantandbreastfeedingwomen. Thuspro- has suffered from intermittent drought that has grams that improve income alone may or may sometimes wiped out the millet harvest.Depend- not adequately reduce the risk of malnutrition in ing on the amount of rainfall, this crop now pro- vulnerable groups. The TINP approach is suc- vides no more than 20 to 40 percent of the annual cessful in capturing this target group, although it cereal requirements of farm households in the reaches them in households both with and with- Komadougou valley. A number of farmers living out energy deficits. by te river have even gone so far as to abandon dune millet cultivation altogether. Simulta- Niger. Komadougou Small-Scale Irrigation neously, a reduction in the level and duration of Project the river flow has also affected the traditional cul- tivation of floating rice. Consequently the 3,000 to The objective of the Komadougou small-scale 4,000 hectares of small-scale irrigation is now the irrigation project, funded by the International most important and secure farming activity in the Fund for Agricultural Development as part of its valley Special Country Program in Niger, is to reduce Irrigationpermittedamajerevolutionarystep the vulnerability of agriculture to drought and in the local faming system with the introduction deserffication.3 The project has been successful of green pepper (Capsicum anuum) cultivation in in alleviating hunger This is all the more remark- the 1950s and its subsequent expansion in the able given the difficult implementation condi- 1980s. By 1990 the area given over to green pep- dons of rural development projects in Sahelian per production covered some two-thirds of the countries in recent years 24 total inigated area. This cash aop has a large demand in the urban centers of Nigeria and Background Niger, and thus enjoys a good market pice. As the cultivation of green peppers has spread, so The Komadougou Valley Program owes its suc- farmhouseholdsin the omadougouvalley have cess in large part to the rapid expansion o aprof- increasingly met the structural cereal deficit by itable cash crop: the Diffa green pepper Like purchases from Nigeria financed by the sale of many other success stories in African rural devel- the cash crop.- opment, the project builds on locally initiated In this context, poverty and hunger are development processes that have been further directly dependent on access to irrigation facili- supported and enlarged through people's partic- ties. Farmers encounter three main constraints to ipation. the development of irrigated agriculture: first, The Komadougou iver, which flows from the recurrent drying up of ponds before the end July to December and feeds a complex system of of the vegetative cycle (the river frequently dries sixtyrponds andsecondarybranches along its val- up in December and most of the ponds dry up in ley, marks the border between Niger and Nigeria January, whereas the green pepper fructification 150 kilometers upstream of Lake Chad. lasts until the end of February), second, the lack Approximately 30,000 inhabitants of the district of credit facilities to purchase motorpumps, and of Diffa live along the northern bank of the third, the intermittent infestation by pests and Komadougou River and around the ponds, diseases. - where they practice a mixed rainfed (millet and cowpeas on 1.0 to 4.0 hectares perhousehold) and Project Desig- irrigated (green peppers, wheat, corn, and cow-. peas on 0.2 to 1.0 hectares) agriculture. Formulated in the mid-1980s, the project has The area has suffered from a drastic reduction aimed at countering some of the most deleterious in the level of rainfall, from an average of 350 mil- effects of drought conditions through a twofold limeters per year in the 1950s to 225 millimeters physical target Lessons of ErperHintc ¶elm Case Studies 199 To improve forty-one natural reservoirs fed by creditprogram has allowed access to motorpump the Komadougou River, including construct- ownership by about 1,000 farmers in 26 villages. ing one or more retention dikes, deepening Until now, the reimbursement rate has been 100 naturalfeeder canals, andbuildinginletstruc- percent, a remarkable result in the context of tures. Irrigation infrastructure around these Sahelian Africa, and.the demand for new motor- reservoirs would include individual. small pumps is still increasing. pumps, shadouf (person-operated traditional Fourteen collective irrgation schemes with water-liftingsystem) irrigation, and collective concrete coveredcanals,mostofthempumpingini schemes that would irrigate a tOtal of 870 the improved reservoirs, have been developed on hectares, including an incremental area of 100 a total of 165 hectares (average size of schemes is hectares. 12 hectres) benefiting 640 farmers with an aver- * To rehabilitate twenty irrigation schemes age plot size of 025 hectares. These self-managed pumping directly from the Komadougou schemes are cultivated with green peppers, River and providing a complementary sup- paddy, or wheat, depending on the soils. The ply of groundwater through boreholes. management performance contrasts with that of These schemes would serve principally as a the state-owned and cooperative schemes. The test to determine the feasibility of ground- average investment cost for the eleven schemes water irrigation, exploiting surface water in the ponds is US$3,500 -The total of improved or incremental irr- per hectare, a reasonable cost for these kind of gated areas would amount to 950 hectares. works. The cost of the pumping devices has been These works would be complemented by exten- reduced considerably in the last two years by sion services and credit delivery for irrigation replacing large diesel motorpumps, which were- equipment and agriculture inputs. Altogether, difficult to maintain because of the lack of spare estimates indicated that some 2,400 farming partsonthelocalmarketandwhichcostUS$1,800 families (1,760 individuals) would benefit from perhectare,withsmallgasolinepumps,whichthe the project -famerspreferandwhichareeasytomaintainand replace, at a cost of US$300 per. hectare. Given the Project Implementation lack of banking institutions in the area, the finan- cial amortization of big collective pumping Five years after start-up and one year before com- devices is difficult and farmers'. groups have pletion the 35 villages where some 2,300 farmers begun to buy small pumps to replace such equip- live have directy benefited. The number. of indi- mentpmgressively. rect beneficiaries, sudh as traders and herders, is The idea of providing a complementarysupply unknown, but is probably significant Twenty- of groundwater through the expermental bore- seven pond systems have been developed. The holeshas beenabandoned after thebuilding of six average unit pnce of the reservoir developments boreholes on three schemes because of the prohib- has been less thanecxpcted,lageybecauseofpar- itive investment (US$14,000 per hectare) and oper- ticipation by. the beneficianes in the earth moving ating costs of this techique. works on a volunteer basis. The irrigated area orig- Although the potntial of the reservoirs' devel- inally covered by the reservoirs was estimated at opmenthas not yet beenfully realized, the overall 520 hectares of individual plots, but has increased effect on irrigated area expansion is, nevertheless, by more than 50 peraant in the last five years. The greaterithanexectTheLnetinceaseinirrigated average investment cost per hectare for his incre- area is estimated at 300 hectares of individual plots mental pnvate irrigated area (water retention con- and 100 hectares of collective schemes. This total aete infrastructure provided on a grant basis, of about 400 hectares of irrigated land expansion small motorpumps and mobile pipes on credit) is exceeds by far the initial objective of 180 hectares. less than US$1,800, among the lowest in Niger The individually irrigated area is rapidly increas- The project has delivered 350 small gasoline ing because of the net increase in water availabil- motorpumps and 1,960 mobile pipe elements to' ity in the reservoirs after the fall of the water level individuals or small groups (of between two to in the river and the supply of motorpumps and five members) on a three-year credit basis. This pipes to individual farmers on credit. 200 Appendix 3 Project Impact Although this small irrigation development subprogram is not yet complete, it shows the fol- A visible effect of the rapid expansion of motor- lowing clear signs of success: pump adoption is the complete disappearance of * The beneficiaries have participated actively in the shadouf in participating villages. The credit the development works. programforprovidingthesmallmotorpumpsnot * The collective schemes are self-managed and only permits an increase in the irrigated area, but functioning relatively well. also reduces the percentage of farmers renting * The farmers are supporting full operating pumps, the poorest category of farmers in the val- costs with the exception of heavy infrastruc- ley. The cash incomes of motorpump owners are ture amortization. actually three to four times higher than those of * The incremental irrigated area has surpassed farmers renting theirequipment(therentalcharge initial objectives and has proved to be cost- is a third of the harvest). A survey conducted in effective. 1990 showed that the average net cash incomes * The farmers continue to demand new reser- from green. pepper production varied from voir developments, credit facilities, and col- US$911 per year for farmers that owned their lective schemes. pump to US$293 per year for farmers that rented * The credit provided is being fully repaid. their pump As the project provided most pumps * The farmers' cash incomes have increased sig- to small groups averaging three farmers, and nificantly and could be higher still. assuming that most of the 1,000 buyers were pre- viously renting their pumps or using a shadouf an Lmons Learned average cash income icease of 100 percent after credit repayment appears to be a reasonable esti- The project's achievements are partly due to a mate of the effect onthis poorest category of ben- particularly favorable context for the develop- eficiaries. nment of irrigated agriculture the quality of the In most reservoirs the duration of water avail- water and soils, the access to a large market in ability has been increased by one to two months, Nigeria for the sale of outputs and for input pur- irrigating some 940 hectares and allowing com- chases, the favorable relative prices, and the pletion of the green pepper vegetative cycle,; widespread knowledge and tradition of small resultinginanincreaseinyields.Progressinyield irrigation in the area. In this context, the willing- terms is, however, difficult to evaluate, and -is ness of local farmers, the appropriateness of the probably inferior to expectations because of the subprogram's design, the quality of the local poor quality of the extension services in the area staff, and the overall participatory and flexible and the lack of a pest control programL However, approach adopted have resulted in remarkable on the collective schemes rice yields are good at progress toward food security and a better stan- 4.7 tons per hectare. dard of living in the Komadougou valey. Ir. terms of food security, and given the avail- The irrigated production systems still have ability of cereals on the nearby Nigerian market, plenty of potential for improvement, especially in green pepper production appears to be the best terms of improving green pepper yields through. . option for the farmers of the-Komadougou val- controlling pests, improving cultivation tech- ley. For example, on a single hectare of irngated mnques, applying ferlizer, and. so on; improving land, and given average yields and production marketing practices through better exploitation of costs, the net return for cereal production is esti- the seasonal price variations by providing credit mated at 1.0 tons for wheat and 2.8 tons for for storage and marketing; diversifying irrigated paddy (1.8 tons of rice). The net cash income on crop production; and developing transport facili- the same area cultivated with. green peppers ties, for example, through providing credit for ox amounts to US$ 1,000, corresponding to more carts and upgrading secondary rural roads. than 4.1 tons cf millet at the average Nigerian The interim evaluation underlines three sub- market price. Estim ates indicate that local house- stantial issues that must be considered if a second holds purchase at least 50 percent of their cereal program is to be undertaken to consolidate. and requirements. build uponwhathasbeenachievedtodate,namely: Leson of Experiancc; Ttrelve Case Studifes 201 * The aedit deliveryservice is still-dependent on Evaluation of Fmedm from Hunger's Credit with Education the program staff. A local credit and savings Progrm in 7ailand (Davis, Calb* Freedom from Hunger, instibLtion should be developed. 1993). 7. This section was provided by The Aga Khan * Pests and diseases, inc:luding nematodes, may Foundation, 8-Aga Khan Road, F-614, Islamabad, continue to breed if noting is done in terms of Pakistan. diversifying crops and facilitating access to B. The International Fund for Agricultural Develop- pest control inputs. meat provided thissection * The sheer profitability of greenpepper cultiva- 9. Gaurav Datt prepared this section. tionmightlead to vewkploit of the water 10. Martin Ravallion and Gaurav Datt, "Is Targeting tdrough a Work Requirenent Efficient? Some Evidence resources in exAsting reservoirs as the number for Rura India," Public Spending and Ihe Poor: Incidence of private InotoXpumps increases. Vilagm and Targeting, eds. D. van de Walle and K. Nead should be clearly informed about the total irri- (Washington, D.C. World Bank, forthcoming). gation capacity of each pond and adopt rules 1L Laura Tuck and Kathy Lindert wrote this section. to avoid exoess pumping. 12. Population is ranked by expenditure per capita quately per year, which is used as a proxy for income through- Provded that these issues are adeoutl Provide that thee iout the analysis. In 1990, the poorest income group, with addressed in the years to come, one can conclude arnual per capita ependitures of less than D 250, repre- that this subprogram has ameliorated the food. seated 13 pent of the population, while the richest security of the poorest households and lessened induded those 13 percent with an annual per capita the risk of hunger in the project area. The pro- ccpnditure greater than D 1,200. overall rate of return and the replical.i.... 13- Institut National de la Statistique, Household ject's oealrtofrtr aa& elG -Expenditure Survey (Tunis: Institute National de of such a program need to be carefuily assessed la Statistique, 1985). Intake is derived from purchased before any final conclusions can be reached. subsidized products only and excludes on-farm Furthermore, the effects of pond development consumption. on the river discharge should be monitored to 14. Direct assistance schemes include the Needy avoid a negative impact onfloodrecession crops Families Program and the Union Tunisienne de downstream. Solidarite Sociale, which is responsible for low-income food ration programs and cash transfers to the elderly and handicapped. These programs are small compared Notes to the CGC program and could not cDmpensate the poor for an elimination of food subsidies. 1. Siddharth Dr-be wrote this section based on 15. Anna SanrAnna and Jean Jacques De St Antoine Soekiman and others, "Economic Growth, Equity and wrote this section- Nutritional Improvement in Indonesia' (A United 16. Isabel Vial and Alberto Valdes wrote this section. Nations Administrative Committee on Coordinationf 17. For information about these programs see T. Subcommittee on Nutrtion (ACC/SCN) country case Castafieda, Combating Poerty: Innovatize Social Refonns study for the XV Congress of the Intemational Union of in Chile during the 1980s (San Francisco: ICS Press, Nutritional S ciences, Adelaide, Australia, September 1992). 26-October 1,1993); United Nations ACC/SCN, Second 18. Julia Tagwireyi wrote this sectiorn. Report on the World Nutrition Situation, vols. I and It 19. Michael Lipton, Poverty, Undernutrition and (New York, 1993). Hunger, World Bank Staff Working Paper no. 597 . 2. This section was provided by FINCA Inter- (Washington, D.C.: World Bank, 1985). national, Inc., 901 King Street, Suite 400, Alexandria, Va. 20. Jayshree Balachander wxote. this section, which is 22314, U.S.A. reproduced in part from Jayshree Balachander, 'Tamil 3. This section was provided by Freedom from Nadu's Successful Nutrition Efort,' Reachig Heath for Hunger, 1644 DaVmci Court, P.O Box 2000, Davis, CaL All, eds. Jon Rohde, Meera Chatterjee, and David 95617, US.A. Morley (eBt- Oxford University Press, 1993). - - 4. Barbara Kennelly, Literature Review of the Impact of 21. Severe malnourishment onds to Grades Income-Generating Activities on Household Nutrition m and IV in the lassification of the Indian Academy of (Davis, CaL: Freedom from Hunger 1988). Pediatrics, which uses the Harvard weight-for-age stan- 5. Cheryl Lassen and Barbara MkNelly, Freedomnzin dard, that is, 81 percent and above is media to normal, Huzger's New Credit-Led Approach to Alleviating Hunger. 71 to 80 percent is Grade 1, 61 to 70 percent is Grade II, Is It Working? Mid-term evaluation by the US. Agency 51 to 60 percent is Grade III, and under 50 percent is for International Development Partnership Grant, Grade IV. Cooperation Agreement no. OTR-0158-A-00-8147-00 22. Children younger than 24 months received a (Davis, Cab Freedom from Hunger, 1991). -food ration containing approximately 140 calories and 6 6. Barbara MkNelly and Chatree Watetip, Impact grams of protein a day. Those between 24 and 36 202 Appendix 3 months, severely malnourished children, and mothers 24. It is worth mentioning in this respect the recent received double this amount daily. decision by the US. Agency for International Develop- 23. This section was provided by the International ment to help the Government of Niger meet its counter- Fund for Agricultural Development, part funding obligations. Appendix 4 Ending Hunger Soon: Concepts and Priorities At least 700 million people do not have access to issue. Low labor productivity and limited pur- sufficient food for a healthy and productive life? chasing power impair the ability of hungry ndi- This is despite the exdstence of sufficient global viduals to capitalize on the benefits of many food supplies to cover their minimum needs.- development investments. This, in tum, compro- The world now produces more food per capita mises the success of such investments. If con- than it did a decade ago. Of course, even if cur- straints to the production of and access to food rent supplies can, in theory match current mii- are different for different groups of people, then mum needs, the adequacy of future supplies is policy and project interventions should be tai- not assured. Seeldng to match the food supply lored to the location- and income-specific needs with the demands of a fast-growing world popu- of such groups. It is therefore useful to separate lationis a huge task. However, the problem is that. out and address the issue of hunger as a major hunger is not just about the food supply. Trying element (boh a symptom and a cause) of broader to guarantee a minimum diet for today's hungry problems of poverty and food insecurity. even when the food is available is just as great a This paper begins by presenting a conceptual dcallenge. framework for understanding the linkages Hunger exists because poor people cannot between hunger, poverty, and food insecurity at gain access to available food. This occurs at all both macro and micro levels. This is followed by levels: food may be available at a global level, but a review of the characteristics and causes of individual countries can go short; sufficent food hunger Finally,the paper considers priority poli- may be available on the market at national or cies and programs for reducing hunger and -for regional levels, but some households go hungry bolstering household efforts at coping with because they cannot purchase it; sufficient food hunger and food insecurity. may be available at a household level, but some individuals go hungry because they do not have Conceptual Framework access to it Hunger is therefore as much about access as it is about supply. Undernutrition and Acleardistinctionmustbemadebetweenhunger starvation can occur in the midst of plenty. and food security. Hunger-largely an advocacy While hunger is thus first and foremost a rather than a scientific term-is defined here as humanitarian concern, it is also a development an individual's inability to eat sufficient food in This paper was prepared by Patrick Webb and Joacbim von BraurL The authors are grateful to Lynn Brown and Rajul Pandya-Lorch for their substantive contributions to the paper, and to Per Pinstrup-Andersen, Harold Aldemnan, Jock Anderson Alan Berg. Schlomo Reutlinger. David Steeds, and Stephen Vosti for constructive reviews of an earlier draf. 203 204 Appendix 4 terms of calories and nutrients to lead a healthy on household "coping," the cost of which usually and active life. Hunger is a reng feature of includes suffering.4 Limitations to effective mar- absolute poverty that has long-term (chronic), ket-based actions against hunger in many famine short-term (acute), and seasonal (transitory) prone countries and/or those undergoing policy. dimensions. Food insecurity leads to, and is often reforms suggest a continued need for improving charactenzed by, hunger, but food security is not' the role of public action.5 just the absence of hunger. It is about the absence of risk relating to adequate food consumption. Poverty, Policy, and Hunger Food security can be defined as secure access by all people at all times to the food required for Figure 1 portrays some of the long-term relation- them to lead a healthy life.3 While food is the ships between causes and symptoms of hunger. defining focus of the concept, the risk of individ- Poverty, including the associated vulnerability to uals and households not being able to secure natural or man-made shocks, is a root cause. of needed food is key. The risk of constrained access hunger. Yet poverty and its dynamics may-be to food can arise from many causes, such as seen as an endogenous outcome of limited absolute shortages in the supply of food, which resources and flawed policies. Endogenous and are often the result of climatic vagaries or natural exogenous relationships are conceptualized at disasters; . inaccessibility of available food different levels of analysis. The figure traces because of political (war) or economic disrup- broad interactions between root causes such as tions; or massive income collapse associated with pocy failures (including war), resource poverty disruptions in labor or food markets. and climatic disruptions, and population growth Hunger is perhaps the most obvious manifes- . and outcomes in the realm of macroeconomic tation of food insecurity resulting from a complex activity and household strategies. For example, combination of these factors, compounded by the top row of causal factors represents economic institutional and policy failure. In other words, it strategies and policy interacting with sodal dis- is a combination of the degree of poverty, the crimination, conflicts, and military conflict; degree of risk of failing to secure local food and resource endowments and their relationship to income, and the chance of receiving external climate or disasters influencing levels of poverty assistance that defines food insecurity. and food availability; and population growth. Istitutional capabilities and the capacity of These elements directly affect both the design policy to respond in a timely manner to crises are and the success of policy and project interven- essentialtopreventhungerfrommaterializingon tdons, such as subsidies and distibutional poli- alarge scale. It is afailure of policy to deal appro- des, that influence input/output relationships, priately with demographic, environmental, pro- and thereby influence domestic food production ductivity, and political pressures that makes levels and stability. some segments of socety and some regions more Other polcies, such as wage policy, and pro- vulnerable to hunger fian others. Wars and civil ject interventions, such. as paid labor-intensive unrestmaybecomepartially endogenousto these public works, interact at the level of capital, labor, detemuinants of vulnerability over time. Strate- and. output markets. These relationships deter- gies for ending and preventing hunger must, mineprices,andhencetherealpurhasingpower therefore, build on a recognition that institutions and terms of trade of the poor. Severe deteriora- and their policies (and their constraints) play a tion in, or rapid fluctuations of, purchasing key role, and that long-term forces are as relevant power and terms of trade among the poor can. as short-term forces. have a strong impact on nutrition. It is in such The most inportant institution at the micro instances that income and consumption failure level-the household, with its complex internal become most severe and result. in extreme- organization and diverse macro-level linkages- hunger, and that the failure of household "enti- must figure prominently m the analysis of tlements" becomes evident hunger, especially where state institutional capa- Analytical discussion on any one of these bilides remain weak. However, the failure of pub- interactions should be pursued with a recogni- lic action must not lead to advocacy for reiance tion of the upstream/downstream and short- Ending Hunger Soon: Concepts and Priorities 205 term/long-term linkagesbetweenindividual ele- low human capital, and a high risk of income and ments. Recognition of the compIc city of these consumption instability or collapse. For example, relationships is crucial for effective action aimed children inpoorsmallholderhouseholds thathave at curbing and eliminating hunger. limited income diversification may be severely affected if their household experiences a bad crop Sources of Risk or loss of employment, and they are located in an area of civil unrest Food-insecure households can be found in differ- To improve household food security, location- ent socioeconomic and demographic groups specific risks need to be identified so that effec- depending on factors such as agroecological tive risk reducing actions can be implemented. characteristics, access to land, diversity of income The risks associated with hunger have short- and sources, and the state of development of the econ- long-term dimensions. Some of the more com- omy. Different types of risks affect various groups mon risks are briefly discussed below. of food-insecure households and their members War and oppression. The impact of civil unrest in different ways (table 1). and armed conflict is not limited to the area The most severe hunger problems affect par- directlyaffected 6Whenwars erupt, oftenbecause ticularly high-risk demographic groups in rural of perceptions, real or otherwise, that the policies and urban households characterized by low and of the. central authorities discimninate against variable household incomes, liminted asset wealth, peripheral groups, the poor in deficit areas away Figure 1. RPaionship among variaNsesp onsble for hunger in developing countries …~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ __--- - -- - - ------------ - -- - r--~~----------------------- ------ r--- -- -- -- -- * ~ ~ Pb Iiit Resource &oe~dnate sthocs Eal misontsn a Dcrinan6aton. i R Pees-ie ww poky War of( clknue t~~~ransWon. * Iu . - - --a I - 1 1L….' 4 l L- L -- - La -~~~~~~~~~~~~~~~ m- t Hr i. y kar.cAdqtedfumT.Td&4. van Bras, an E. .d CrVa ad Faate Rekirhj in Wm Fbtybrqkufn Rusadc RepotSS CNahWei D.C. In.emad Food PIty-y R I Istraw,r. 1-9 1). 206 Appendix 4 from the front line are affected through rapidly productive assets owned by, and poor nutritional dedlining food supplies and rising prices. As condition of, many returning refugees means that conflicts continue crops are not sown, farmers production gains from a larger cultivated area and abandon their lands, and longer-term production potentially higher yields will not materialize in declines. This adds to the strain on the food sup- the near future without considerable assistance. ply chain in areas that may already be at risk. Investments will therefore be required in seed dis- Unable to secure a living or feed their families, tribution and cultivation technology, as well as in vast numbers of the poor migrate to neighboring defusing land mines, to return formerly culti-' countries or to more peaceful areas of their' own -vated lands.to previous levels of productivity. country. In the early 1990s more than 5 million: Natural resoures and hunan resources. Esti- Africans were classified as refugees or asylum mates indicate that half of Africa's poor farmers seekers, with another 35 million living outside already live in environments characterized by a their own countries in search of employment7 natural resource base highly vulnerable to degra- Anotier 10 million orso were to be foundin otier dation, while in Latin Amenca the figure is closer parts of the developing world. Such dislocations to 80 percent.' The resource environment affects create problems of increased food insecurity the nutrition and food security of hungry people among the displaced poor, a concentration of job mainly through impacts on crop choice and crop seekers in urban areas of already high unem- h yields. Food insecure and poor households do ployment, and resistance to the assimilation of not deliberately degrade their resource base with- newcomers among many host populations. out thought for the consequences. Ihey are often Even when peace retums to an area people confronted with a choice: short-term satisfaction contintue to feel the impact of years of war. Food of food needs with consequences for long-term production in Mozambique has yet to recover environmental. degradation, versus short-term from the displacement of more than 1.5 million hunger with fewer envirorunental demands. people (about 10 percent of the population) dur- Much environmTental destructior, such as defor- ing fifteen years of civil war The result in 1992-93 estation and soil erosion, canthereforebe ascribed was that the total fDod crop area planted was far to the. struggle of the poor to feed themselves-1 below the long-term average.8 What is more, Growing family size and deepening poverty 1 million refugees may soon retunL The lack of forces farmers to cultivate marginal lands and Table 1. Sources of risks of hunger and affected populations Ri.ks Househol peopfe at risk ifhlmger Poldcs ard poky failur Houseolds in war zones and areas of cil unresc * Households in areas of low potential that are not connected to gowth ceters via roads orother means of comumicatios Crop production risks * Smaliholders with liWe incoe divKation and mrted access to imprved tedhnology - pexts. drougt etc.) (br example, inproved seeds, fretTzer irrigation, pest ont L andlesstfrm -ox- AgriwLiku trade riks * Smarlhoeds who are lighty spedaked in an export crop (disruption of exports or imports) - Small-scale pastrat * Poor households who are high dependent on irported food * Urban poor Food pice risks * Poor, net food purchasing households (arge,_sudden price rises) Employment riss a*ge earing houshlds and informal sector erployees in peri-urban areas and, when there is a sudden crop pducton fim in rural ars Health risks * Ertire communfties, but especially tise households tiat cannot aird preventive or curative cre as wel as (infectious dseases. fcr ees , vinerable menbers ofthese households resulting in bor produiv decine) Demographk risks * brnen, especidaly when they have no access to educatio individual riks affecting large groups) Feale4heded househos wibws, abandoned wormen * Children atweaning age * The aged Sowe:kdapted from von Brau and others, Lpirtg Rood aoty ofthe Fbao Ending Hunger Soon: Concepts and Priorities 207 reduce fallow periods. It also forces the landless have been those with more pluralistic politics and and the unemployed (as well as farmers and pas- open channels of communication and criticism.2 toralists) to cut trees for fuel and fodder, but envi- While China made great postrevolutionary ronmental damage, such as tree loss through strides in terms of eliminating endemic hunger, charcoal production, becomes a direct constraint the population was still vulnerable to famine in on fuhture expansion of food harvests. Failure to the late 1950s. By contrast India, with its open address hunger issues leads to productivity journalism and adversarial politics,was relatively losses today, directly trough reduced work time less successful in reducing endemic undernutri- because of illness, and indirectly through time tion, but has avoided famine. Starvation deaths spent caring for the sick. and extreme deprivation are newsworthy, where- Failure to address hunger issues can also lead as increased morbidity and mortality rates from to further environmental degradation and deep- endemic undernutrition are not. ening problems inthe future. Children's cognitive The absence of political opposition and free development and school performance are speech have contrib ted greatly to famine vulner- impaired by poor nutrition and health, with con- ability in Africa today. Many autocratic African sequent losses in productivity during adulthod. governments have recently been challenged by Nutritional deficiencies play a large part in poor mounting social anger at the increasing poverty of school enrollment, absenteeism, early dropping large segments of society However, if fledgling, out, and poor classroom performance in develop- transitional democracies are to survive, they must ing countries. The education factor is particularly quicldy satisfy the needs and demands of those important for girls given its role in lowering later whobroughtthemtopower Thisrequirespositive fertility, and thus the population growth rate. support by the international community. Demo- Eradicating hunger would therefore have a cracy is vulnerable where extemal debt, disease, beneficial impact not only on human productiv- hunger, and poverty are commonplace.1' Oppor- ity and well-being, but also on the environment. tunities for investment aimed at stabilizing fragile Improved adult nutrition leads to higher farm. economies, even where democratic institutions productivity, improved productivity in the labor may yet be imperfect, should be seized whenever market, a Ilkely reduction in population growth, they appear and reduced depletion of natural resources for short-term gain- Setting Priorities for Ending Hunger Governance, participation, and demoaacya A key factor in eliminating persistent hunger and recur- . While the dimensions, causes, and consequences rentfamines ispublic action. This involvesnotjust of hunger differ widely from country to country, governmental initiatives in the delivery of and even within the same country, substantial resources to target populations, but active partic- numbers of hungry households and individuals ipation by the public, both as individuals and inhabit practically all low-income and many through grassroots nongovernmental orgarniza- middle-income countries. tions. Public participation can have positive and powerful roles both in collaborative and in adver- Incidence of Hunger sarial ways with regard to govermnent policies. Collaboration is essential in public.health cam- Hunger is. concentrated among certain demo- paigns, such as nutrition education, and in fimine graphic and socioeconomic groups, as well as geo- relief operations, which require. cooperative graphically. For example, hunger in most efforts to ensure their success. However, the pub- countries is concentrated among the very poor in lids adversarial role often brings problems to the both rural and urban areas, households headed by government's attention and demands resolution. women, the displaced and dispossessed, the The demand for action through political elderly and disabled, and among certain cate- activism, journalistic pressures, and iformed gories of infants and children. At the same time, criticism can help to identify both persistent moreofthepoorandhungryarelocatedinregions hunger and famine risk. Itisnoaccident thatthose of the developing world that are poor in natural, countries most successful in famine prevention infrastruchtual, and institutional resources. In 208 Appendix 4 Sub4aharan Africa, for example, almost 40 per- content tht is, that th Include fruits and leafy cent of the population can be csasified as poor, a green vegetables; supplementing people's diets share that is coincident with the proportion that tuhough feeding programs; organizing food forti- does not eat a minimum diet'4 Approximatelyi5 fkcaton, such as iodine modules in water supply percent of Africa's poor Inhabit semi-arid tropical projects or the provision of iodized salt; and con- regions that have poo0 physic infrastructure and trolling disease. services, and depend on low and variable rainfall It also calls for reducing the constraints disad- for food production. As a result, local diets are vantaged groups within certain households face dominated by low-yielding coarse grains (millet in gaining access to the benefits of development and sorghum) that have shown limited potential initiatives. Communities and households are not for lap productivity incmases.s neutral media through which development The proportion of the total population not eat- resources flow evenly. While hunger is not solely log a minimum diet is 25 percent in south Asia a function of adequate global food suppUes, the and 16 percent in southeast Asia (ACC/SCN issue of individual acosss to resources has impli- 1993).1 In south Asia one again finds more than cations beyonid income and purchasing power. two-thirds of the absolute poor (who are absoci- Addressing hidden hunger therefore requires ated closely with hunger) in the driest agroeco- attention notjust to hesith cre, water supply, and logical zones of warm tropics)' In this instance education, but also to the distnbution of these their dietisdominated by cereas such as rice and and other resources within the household. wheat, with coarse grains and cassava an impor- Hunger can exist in households that are not poor tant complement. While rice and wheat ware the by local standards. star performers of the green revolution, the driest Hunger is therefore a problem of great cam- areas of the subregion benefited relatively less plexity as well as of scale. But in a world of Sim- from the new technologies thaan did the moister ited resources for development in poor oDULtries, tropics and subtropics. this raises the quesdon of whidc hungry people Ihe proportion of South America's popula- should be taken care of first Given wide vari- tionnotconsuming a minimum diet is 25 percent- ability in the causes and manifestation of hunger, with the largest number of poor again located in no general blueprint for setting priorities can be the driest agroecological regions, as well as in sought. Eadc country will always address its urban conurbations.?' problems according to the prevailng demands of political economy and to the perceived osts and Hidden Hunger benefits of alternative investments. Nevertheless, the issue of setting priorities for While the total number of hungry people in all investment initiatives has received insuffident regions may eceed 700 milion, milliors more attention Justasthe sequencing ofpodicyreforms peopleworldwide ae sulecbttochdonic micronu- maybe crudal to the success of the overall pack- trient deficienies.1 Aca' hunger may relate not age of reforms, the sequencing of polides and only to catasirophic calone coonsumption defi- programs to address hunger can be important denies, but also to transitory fluctuations in Long-term initiatives independent of short-term calorie supply, mironutsient deficienies, diet actions maybe unsustainable, while the converse diversity problems, and also to maldistribution of is also tnh Priorities need to be set for coordi- resources within household units. For example, nated action among donors, govements, and estimates inhdicate that 40 million preschool chil- ommunities to be possible. dren are suffering from chronic vitamin A deft- We argue here that coordinated action should dencq and that between 200 and 300 million focus on the worst symptoms of hunger first in people worldwide are experiencing endemic the context of a strategy for long-tern interven- iodine deficiency goitern' tions aimed atremoving the root causes of hunger Addressing these forms of hidden hunger This suggests a primary focus onproblem areas of requies a multifaceted approach, including pro- Africa and Asia with priority attention to the viding nutrition education; ensuring that food acute problem of famines, which are the worst supplies have the appropriate micronutrient case ofentitlementfailure associated withallU three Ending HunSerSon Conpts and PTIorities 209 root causes of hunger laid out in figure 1. The sec- initiatives against acute hunger? While a reduc- ond focus is the much larger problem of chronic tion in long-term poverty and stimulation of pri- and transitory dietary deficiencies-of maaonu- vate sector economic activity-two of the key tients and micronutrents-in rural areas of aims of structural adjustment policies-serve to Africa and Asia, particularly those areas that are reduce the risk of famine, action by public agen- resource poor and ecologically fragile. A third des remains necessary, at least in the medium focus would be chronic dietary deficiencies run, to protect vulnerable households that lack among the urban poor, with an inceasing empha- the resources to protect themselves. sis on Latin American problems alongside those Successful preparedness and mitigation of other developing countries.?. depends on a public commitment to intervene effectively and on time. This has the advantage of Famine Prevention and Mitigation offering high returns in reduced hunger relative to the resources invested. Also needed are the Govemments and donors should give the highest conditions that prevent hunger from recurring on prionty to addressing famine The world cannot the same scale and at the same intensity as before afford to let the worst cases of hunger go Such conditions. include building institutional untreated. With high population growth the capacity at regional and local levels, detecting absolute number of people becoming vulnrabie and diagnosing indicators of distress in close col- to famine continues to grow. In the early 1990s the laboration with affected communities, preparing number stood at roughly 30 million people in programs and projects for vulnerable regions Africa? This catastrophic hunger has profound ahead of time, and executing appropriate inter- inplications for economic growth in affected ventions in times of need?4 counties, let alone for their longer-term human The successful eradicationof fmine, as wel as capitaldevelopment,as wellasfordemandsmade the removal of nutrient deficiencies, depends on on more developed nations for food and other successful. economic growth. Unless gro*th assistance. The longer the social and econo mic underpins appiopriate trgeted interventions, malaise associated with faminepemsists, the harder short-term mitigation of acute hunger cannot be and more costly it becomes to eradicate. sustained. Thus, in countries with a large agricul- This calls for a swift and effective response to tural sector, a key contribution to famine preven- famne set within a framework of actions to tion must come from an employment-creating remove the underlying causes. Free food aid to agricultural growth strategy from which hungry severely malnourished individuals will not alone populations reap a direct benefit, an issue taken solve the problem. While temporary solutions to up in more detail below. acute hunger are often achievable in a short time at relatively low cost, hius does not make them Agricultural Growthfor Sustained Hunger sustainable in the longer run. Reduction Famines are extreme, regionally concentrated shortfalls in food consumption that result in ris- In most developing countres, there is little ques- ing undernutrition and death rates. They do not lion that policies for enhancing economic happen suddenly Famines result from an accu- growth, particularly in agricultural productivity, mulation of events that progressively erode the must provide the bedrock for future develop- capacity of poor households to deal with short- ment, including the elimination of hunger term shocks to the local economy- Shocks often Agriculbral growth can address hunger not take the form of environmental extremes, but the only by increasing production, but also by gen- conditions that promote household vulnerability eratingrural employment, and therefore income. to extremes develop over long periods, typically Yet with population growth rates in excess of 3 in the context of inappropriate economic policies. percent per year in much of Africa, and growth Famines should therefore be recognized as in agricultural output during the 1980s rarely national and interational policy failures. They surpassing 2 percent per year in many countries, signal a lack of preparedness and political com- even outside Africa, the challenge to agrculture mitment to prepare for and implement public is daunting. 210 Appendix 4 While opportuiities for bringing new land This decline is unfortunate on several counts. under cultivation have compensated for slow First, investigators documented high rates of yield growth in the past, continued attempts to return for investments in agricultural research expand agricultural land will entail ever lrger duringthel980sandearlyl990s,eveninAfficaYI investments, accelerated deforestation and land Second, there is a time lag between agriculhtral degradation, and ultimately, falling yields. Pro- research and increased production. The ade- ductivity increases must be sustainable. The issue quacy of cunrent food supplies is a testimony to is one of finding a way to meet growing food past investments in agricultural research. For the demands without compromising the ability of the impact of new technologies or support services to total stock of resources, both natural and human, be realized in the agricultural sector could take to meet even larger demands in the future.?5 ten years orlonger. To facilitate yield increases in developing -Improved crop technology need not be countries higher investment in agricultural restricted to the production of staple food crops. researcb and technology is urgently needed, par- Growthinthe staple food sector and growth inthe ticularly for those crops most important to the cash crop sector are not mutually exclusive. The poorAb population and food demand continue to complementarity between the production of tra- grow, failure to develop and implement appro- ditionalfood crops and of cashcrops is often over- pnate production and marketing technologies looked. Longitudinal studies in many parts of will lead to either more food insecurity and. Africa show that the real income poor smalhold- hunger, for which.the current generation of poor ers earn from cultivating cash crops is generally people will pay, or to further degradation of our converted into food calories for consumption in a natural resources, for which future generations similar manner to income eamed from subsis- wifl pay?6 tence food productiorL3n Appropriate policies for. The tradeoff between meeting future food technological change, input supply, pricing, mar- demands and maintaing production capacity keting, and infastructural growth benefit both can be avoided and sustainability in food pro- sectors andare crucialforgrowthinboth. Inother duction can be assured only if (a) investment in words, the attainment of optmal food security appropriate research and tedhnology is acceler- shouldnotrelyongrowthinthefoodsectoralone, ated; (b) relevant extemalities, including those but on the development of the most productive related to resource ownership and user rights and agricultural resource, wlich may be an export the needs of future generations, are either taken crop. into account in production and consumption Appropriate policies not directly related to decisions or effectively dealt with by government agriculturearealsorequired Theuseofnewtech- policy; and (c) poverty is significantly reduced or nology alone is not sufficient. Investment in rural alleviatedP7 roads, institutional change, and appropriate poli- Because of the risk of irreversible degradation cies are needed to facilitate farmers' access to ofnatural resources and the urgent need to assure modern inputs, improve farm management, sustainable production to meet future food develop a marketing system capable of assuring demands, understanding why investment in the sufficient food for rapidly growing urban popu- most promising solution, agriculturl research lations, provide the necesary production incen- and technology, appears to be decreasing is diffi- tives, promote economric growth in rural areas, cult For example, US. assistance to agriculture in and enhance -the exchange of commodities developing counties in 1990 was less than one- (indludinglabor) and servicesbetweenurbanand half (in real terms) what it had been in l988.2 The rural areas. Attention to the removal of insttu- World Bank showed a similar, though less dra- tional and policy barriers to dynamic factor mar- matic, decline of 25 percent in assistance to agri- kets continues to be needed. culture during the same period. In 1994 funding Without effective markets, more food will not for the Consultative Group on InternationalAgri- be within the reach of rural and urban net con- cultural Research-the driving force behind the sumers of food, including the landless and the green revolution-4s likelyto be 27percentbelow unemployed. Agricultural production increases its level of funding for 1990 in real terms.29 alone are inufficient to achieve food security if Ending Hznger Soon: CncEpts and Priorites 2l hungry individuals cannot secure that food. Thus of child bearing age. The targeting of feeding pro- a precondition for sustainable agricultural devel- grams is aed through various means opment is economic viability, both at microeco- depending on nutritional needand the programs' nomic and macroecononuc levels. Increases in objectives?I Geographical targeting works well agricultural production must be combined with when a high prevalence of hunger is identified in employment creation, higher incomes, and price selected areas. School feeding programs can be stability if growing populations are to have access used to target school-age children. Means tests to enough food in the future. and vulnerability tests are also used. General food distribution is rarely cost-effective because Policy and Program Options of leakages, but the administrative costs of tar- geting can overwhelm certain feeding programs. A range of policy instruments is available to Feeding programs rarely increase the food improve access by the poor to. the income and intake of those targeted by 100 percnt of the food food required to alleviate hunger. A combination given because of sharing of food with household of instruments is required so that short-term members or substitution with home produced goals are achieved in tandem with long-termn and purchased food. The income elasticity of development The portfolio of actions taken. food expendihtues tends to beless than unity, and should focus narrowly on the achievable and on not all the increased expenditure goes to increas- the cost-efficent both measured in terms of the ing calorie intake, but also goes to improving the effectiveness of resource ansfers-be they calo- quality of the diet in temis of the taste and con- rnes, income, or technology-to target popula- veridence of the food.34 However, such programs tions. Key instruments to be considered include are often politically and socially acceptable as a the followingv means of transfering income. - Targeted food distribution and subsidies Food stamps and other income tsfers. Interest - Employment creation (resultinginrural roads in food stamp programs as a means of providing and resource improvements) a food-mediated income transfer to low-income Institutional strengthenin& such as providing households and as an alternative to food subsi- credit for the poor dies has picked up in recent years. Food stamp P Pnce and trade policies for stabilizing con- programs are expected to display the higher con- sumption sumptioneffects of food-based income, as well as H Human capital investments. to reduce the administrative burden and costs imposed by food handling and transport Tiargeted Distribution and Food Subsidies Yet experience with food stamps is mixed. For example, in Zambia large-scale counterfeiting Food transfers, which are income transfers in comprmised such programs. In Sri Lanka the Idnd, are widely used as a means of alleviating income verification procedure excluded wage food insecurity, but they have come under attack earnmg workers on tea plantations even though for their potential adverse effects on markets, for they appeared to be a nutritionally needy group.?5 their high fiscal costs, and for their perceived These problems are not unique to food stamps; inconsistency with stuctural adjustment poll- tey are also encountered with m-kind trafers. cies.?2 In the current climate of structural adjust- The questioniswhichapproachismoreefficientin ment there is additional pressure to eliminate trsferng its resource to a taret population such transfers except where justfied on strong within the confines of accepted leakages. humanitarian and/or developmental grounds. Fixed, nominal value stamps do not protect This section considers three types of programs: consumers from price fluctuations, even when targeted feeding programs, food stamps and periodicallyadjustedforinflation.Tobecost-effec- otherincome transfers, and food price subsidies. tive, the targeting of food stamp p s has.to Targieedfeeding programs. Exceptinthe context be based on narrow criteria associated with need. of emergency relief, feeding programs are gener- Thisisnotperfecteven intheUnitedStates,which ally aimed at those people most vulnerable- to uses means testing, and is especially problematic. malnutrition, usually children and poor women mi poor countries- If food stamps. programs. 212 Appendix 4 employed the methods used for targeting feeding which used to be major food aid recipients, no programs they could pmbably be more effective. longer depend on such aid. Evidence of disine- Food price subsidies and rationing. Consumer tives for agriculture at the microeconomic level in food price subsidies are widespread and have countriessuchasEthiopiaandNigerisalsoslim41 been introduced in most low-income countries. In other words, the actual effects of food aid are They can take the form of generalized price sub- very much a funcion of recipient countres' food sidies or rationed access to a commodity at a price and agricultural policies. below market value. Generalized prce subsidies are more costly in terms of fiscal and economic Employment andIncome Generation Program costs than limited access subsidies, and are also more regressive in the distribution of economic Besides programs and policies oriented toward benefits.?'X agriculturalproduction,otherprogramsintended Household food security is a goal of certain to diversify employment and income can reduce subsidy programs. Food subsidies incease the rsks for hungry households. These other income real incomes of households with access to the generation programs, which can be comple- subsidies. In a number of programs surveyed, mented by other non-labor-based interventions, food subsidies accounted for 15 to 25 percent of differ from programs oriented toward food pro- therealincomeofpoorhouseholdsreceivingsub- duction in that they stimulate or stabilize the sidies?F Food price subsidies also gneraly demandforfood,butmaynotdirectlyexpandthe increase household food consumption. Furtier- supply of food. more, subsidy programs have a positive and sig- labor-intensive public zworks progrms. bor- nificant effect on food consumption by preschool intensive public works programs can address children, although they may result in. decmased four - key problems facing many Low-income consumption of other foods and leakage to other countries today: food insecurity, growing unem- household members may occurs38 ployment, natural resource degradation, and Programs that provide rations in fixed quan- deficient physical infrastructuhre Public: works tities have, in general, succeeded in reaching the are, in general, public prgrams that provide people to which they were diected. However, employment and generate public goods, such as experiences in Egypt, the Philippines, and Sri physical and social structure. Food aid can Lanlka underline the difficulty of achieving uni- be, directly or indirectly (monetized), a-compo- versal household food security throu& -ationed nent of the wage payments. distributions and targeted income transfer goods The food security effects of employment pro- in a single program in a cost-effective manner?9 grams are a function of program designYL3 For Self-tagetng can be achieved through com- instance, a short-term project may result in modities that better off consumers consider infe- expenditure patterns by the poor that treat pro- nor, and that are therefore used more by the poor. ject income as "windfall profits." A small food kfraditionally, food aid has been used to sup- consumption benefit from the Barngladesh food- port food subsidies, an action often viewed as a for-work program hints at thatbehavio4 In con- mixedblessing.Bypromotingfoodsubsidies,food trast, long-term benefits from improved rural aid has beern perceived as inhibiting gowth in roads produce more secure income flows and domestic food production in the short run, and as substantial consumption improvements for the misallocating resources, both public and private, lowest-income households. in the long run so as to create a dependency on Good public investment through public works externally subsidized food. Yet the empircal evi- programs, and thus the creation of productive and dence does not support such a generazation, at sustainable assets, needs to be emphasized inpol- least for Asia40 The so-caled disincentive effects icy. Note, however that income effects derived of food aid on domestic agriculture have been from works programs can also have favorable pri- exaggerated, and many countries that received vate savings and investment effects that improve high levels of food aid subsequently achieved household food security, as observed from experi- above average agricultural growth. For example, encesinBaneladeshandGuatemala.45ncountries India, the Republic of Korea, and Taiwan (China), such as Niger and Ethiopia, income from public Ending Hunger Soow Gonepts and Prbrities 213. works has contrbuted more than 20 percent of Grameen Bank. CGroup loans for poor households total income to the poorest households, who have without collateral can be an effective mechanism reinvested some of this income in agriculture.4 that ensures repayment as long as the group Strengthening financial institutions for the poor in remains small and peer pressure can operate.tm tandem with public works progrms is suggested Access to credit is an important food security in order to foster these positive effects. mechanism, both in the short run and in the long Public works programs can be a viable numLIntheshortrunitenables the poortoweather instrument for famine prevention as demon- shocks without selling productive assets, which strated by the Employment Guarantee Scheme would render them even more vulnerable to in Maharashtra, India. The employment guar- future shocks. In the long run it enables them to antee feature of the scheme, which generates adopt new technologies and farming methods unlimited empioyment to adults at a fixed wage, that increase yields and production without caus- also triggers -relief works" automatically at local ing enviromnental degradation and natural levels3 This enabies small crises to be addressed resource depletiorn through local action, an important lesson for Development practitioners increasinglyunder- dealing with the problem of loclized fmines in stand that production fluctuations, market infra- Africa. Note, however, that public works pro- structure,govemmentpolicy,location,andsectoral grams cannot address the immediate needs of diesification are important determinants of a hungry ndividuals who are unable to participate countys demand for stbiliation of food avail- in the schemes. Other complementary programs abilty and prices. Stabilization mustbe attbmed to are required for households that are poor in labor a country's specific production risiks (for example, as well as in income terms. whetheritis prone to droughts orfloods) and trade Properly designed public works programs risks (forexample,wheheritislandlocked)zThe have a unique feature in favor of poverty and response of local- and farm-level storage to public hunger alleviation with low administrative costs policiesisan important consideration, especiallyin and effects: self-targeting. At appropriate wage c where possharvest losses are signif- rates, the working poor identify themselves by icant and where local market disruptions occur offering their labor. However, the self-targeting frequendtly feature only operates effectively with an appro- Price stabilizationhas bothbenefits (induding priate (low) wage rate policy and a flexible in terms of food security) and costs. It is expen- absorption of applicants without rationing work sive. Frequently, low-income countries cannot places.48 The issue of whether to pay in cash, in afford it financially or administratively- Recentt kind, or a combination of the two is related to the research into domestic price stabilization widerproblemofwageratedeterminationandto schemes in developing countries suggests that the risk of market failure.49 governments can minimize the costs of stabiliza- Providing credit to the poor for stabilizing tionbyrelyingonmarketmechanismswhenpos- consumption and for self-employment through sible, avoiding schemes that require physical private investment is an important mechanism handling of the commodity, not trying to stabilize for improving food security in the growing and prices too much, and attempting to mimic prices diversifying rural economies of many low- that would be established in a feely functioning income countries. Many innovations occurred in market.54 the 1980s and early 1990s.Y' T.hese programs are Food market and trade interventions are wide- most likely to succeed in areas where agricultural spreadnotonlyinlow-income countries, but to an growth is proceeding well and that have good even greater extentinhigh-income countries.The roads and market activity stabilizationpolicies of high-income countries can The most successful programs in generating destabilize world markets. The extent and level of self-employment for the poor and stabilizing con- intervention in low-income countries vary and sumption are those that combine small-scale the late 1980s saw considerable steps toward the credit with group motivation, technical advice, liberalization of the agriculture and food sectors and other forms of assistance such as nutrition in these countries. This does not indicate a - ,d health programs, for example, Bangladesh's reduced concern for food security on their part 214 Appendix 4 Humanapital investment Long-run enhance- following points from the table deserve high- ment of the labor productivity of the poor requires lighting: that botchronic energy deficiencies and hidden *Crop production risks are best addressed hunger be addressed directly through investments directly through technological change and in improved health and human resources. improved commercialization of agticulture in Inproved investment in primary healcare facil- the long run In countries with high risks of itiesandservicescouldsignificantlyreduceunder- food unavailability and price fluctuations, nutrition and malnutrition in many regions. The joint promotion of technological change in sta- improvement of potable water supplies also ple foods and an appropriate incentive envi- remains a long-tern priority. ronment for agrcultural commercialization is At the same time, improved education is called for. Hunger is often best addressed not needed. The upgrading of human capital, with a by self-sufficiency goals (be it at household or positive emphasis on female education, has strong at national levels), but by food security goals multiplier effects in income growth, technology that seek an efficient balance between higher adoption, and the cortrol of population expan- domestic production and trade. sion- All are crucial to the enhancement of long- * Short-term food availability and related food term food security price risks canbe addressed bymeans ofa large array of options, induding policies at the Combining the Options: Targeting Risks macroeconomic level; stockholding; trade and of Food Insecurity aid policies; and programs such as public works, provision of consumption credit, food Thepolidesandprogramsbrieflyreviewedabove subsidies, feeding programs, and income address the risk of a household becoming food transfers that strngthen the entitlements of insecure, and therefore hungry. These risks can food-insecure households. Agricultural pro- originate from different sources and the effective- duction policies address these rsks in the long ness of policies and programs can vary. For exam- run. ple, a program tiat raises crop yields may not * Employmentandincomeriskscanbetaddedin have an impact on household food security in the the long run through agicultural production short run, whereas a short-term feeding scheme poliaes, and in the short run fthough entitle- on its own may not have a measurable impact in ment strengffening as indicated. Labor-inten- the long run. Table 2 links the nsks of hunger with sive public works would have both short- and the policies and programs discussed above. The long-run nsk reduction effects, the latter by cre- Table t Hunger risf and policy choices Crp Avobiaby tnd a mpfventaxd Pdicyd choies producikn risks preriscs ioerisks Health riss Tedmogical dcage II DI HI Comrnrdairaon. dinrion . 11 -1D xnoon of behxo rdnge.dte n du n Owi icome ond emnplmntgeun porices FLrcwds ss. sss E Credrcoit1 55 555 Mac9soeanmpolkies ssi Ss' s.I Subsdimanduw*osflerp* Feeg parnms sss 55s ss.I Food stamp6s (incu-ngtransfers) Ss 5Ws sj Food price subsidies. riorig s ss Ss Sl1 ioo trade, fod aid poiies sssl- s Bdent cf posibv iffpadt 1, t M1 S5m modate. high long,temi irpacL S. sss Some. mode-Ae Ngh shon-tern irnmpc sJ Mixdshaxt- and long-term impact Soww Mwzed from van Bran and ohers. Impming Food SKUwq o(fthe Fboc Ending Hunge Sworn Concepts arnd Priorities 215 ating assets that would generate future income provide social security will contribute to lowering streams- fertility rates by (a) reducing mortality rates, (b) Food security policies alone-with the excep- reducing the number of births required in a family tion of those feeding programs that have to ersure a given number of surviving children, strong ties to health care-have only a limited and (c) reducing the demand for surviving chil- impact on the mitigation or prevention of dren. This will reduce the pressure on the food healthrisks,wbichtogetherwithfoodsecurity supply chainL Many of these goals, howeve, can risks establish nutntional tisks Other polices only be achieved in the long run and programs are needed in conjunction with Given the close relationship between agricul- food security policies. Promoting behavioral. tural production and the livelihood of the poor in change twough nutrition education can have rural-based economies-partly mediated via favorable effects for dealing with most of the price, wage, and employment effects-it is in the risks.Long-runbenefitsresultfromthehuman agricultural policy area that a number of countries capital enhancement effects of short-term sub- can most rapidly contnbute to social securitywith sidies and transfer policies. growth5t5 Inproved agricultural technology and The typical problem of combined chronic and roads, combined with an effective foreign trade -transitory food security problems of poor house- policy, contribute tobasic social security byreduc- holds requires a well-designed portfolio of food ing the impacts of production fluctuations. security poliqr actions. Such a portfolio builds on assessments of the nature of risks and of the Conclusions instruments available, which are influenced by institutional capacities. Throughout this review, a The absolute number of hungry people is likely to number of complementary actions that need to be continue to growwellinto the twenty-first century underakLen in conjunction with food security Successes in reducing hunger in parts of Asia, and policiesandprogramshavebeenidentified. These even in parts of Afica, should not be overlooked; complementary actions include the development they are signals that certain policies, projects, and of an adequate marketinfrasucture and policies practices can work However, the donor conmu- that do not impair trade The rapid development nity and the govemments of poor countries have of rural financial markets open to all individuals, finite resources for investment againsthunger, and whiich permriits the smoodting of consumption, is the problem has no easy or inexpensive solution. another complementay action.. This requires developing country policynak- ers and intemational donors to focus on key poli- From Hunger Response to Social Security des and programs that will not only raise the food supply, but will also improve food access by the A long-term view of hunger alleviation needs to poor. This calls for three major priorities withback- be established and institutionalized. Policies ward and forward linkages as illustrated in the aimed at household food security mustbe seen as conceptual framework presented at the outset, basic to social security policy, achievable by an namely: appropriate division of laborbetween the private * First, the focus must be on tadding the worst and public sectors. Such a division of labor hunger where it exists today. Thi- requires depends - on country- and community-specific effective famine mitigation and preparedness capabilities. It also depends on more than ensur- activities in Africa's most vulnerable countries. ing an adequate supply of food to countries with * Second, well-targeted investments are a severe hunger problem. required in rural areas to taclde chronic and A key component in the pressure on the world hidden hunger. Potential actions include to feed itself is that many regions sfill exhibit high employment creation programs aimed at rais- and rising population growth rates. Lage families ing and stabilizing the incomes of the poor, are a means of social security for the poor. In the improved institutional credit programs, tar- nexttwodecades2billionpeoplewillbeaddedto geted food distributions, and effective price the world's population, the lagest population and trade policies, coupled with appropnate increase ever in a twenty-year period. Efforts that education, nutrition, and health investments 216 Appendix 4 Third, the first two priorities shouldbe under- Notes written by longer-term investment in agricul- tural growth, which benefits the poor directly, 1. Per Pinstrup-AnderseL. "World Food Trends and andiow They May Be Modified" (Paper presented at the supported by agrcultral research, trade, and Consultative Group on International Agricultural well-functioning factormarkets. -Research (CGIAR) International Centers Week, Success in the third priority should, over time, Washington, D.C, October 25-29, 1993). reduce the need for investments of the first and 2. Food and Agriculture Organization of the United second kInds. Investment in agriculture over and Nations (FAO), Food Outlook8/9 ome: FAO, 1993). above investment in emergency interventions 3 J. von Braun and others, Impmrving Food Security of yields ftiree important gains: (a) a net increase in firPr: Concept, Polia PR (Wshintn D.C.: International Food Policy Research Institute~, 1992). the aggregate food supply, (b) a net savmig in the 4. Patrick Webb, "Coping with Drought and Food - olume of relief activities required, and (c) a net InsecLuity in Ethiopia," Disasters 17 (1) (1993): 33-47. saving in relief costs because of improved effi- S. Jean Drize and Amartya Sen, Hunger and Public ciency of delivery. Quantifying these savings in Action (Oxford: Clarendon Press, 1989); J. von Braun, T. absolute terms is a complex task, but one that Teklu, and Patrick Webb, "Famine as the Outcome of of .ettmg .vef Political, Production, and Market Failures," IDS Bulletin would better guide the process of seg ivest- 24 (4) (1993): 73-78. meat priorities. The longer decisions are made on 6. Patrick Webb, J. von Braun, and Y. Yohannes, an uninformed ad hoc basis, the longer hunger Famine in Ethiopi Policy Impicatins of Coping Failure at will persist - National and Household Levels, Research Report 92 For success in the fight against hung inter- (Washington, D.C.: International Food Policy Research national coopertion toward food securitI fr all Institute, 1992). cooperation security fr .- 7. R. S. Chen, -Hunger among Refugees and Other must be mistitutionalized by means of appropnate People Displaced across Borders,- Hunger 1993: Uproted incentives. Given the nature of political and Peopk, ed. Bread for te World Institute on Hunger and .administrative process, the recogrnzed need for Development (Washington, D.C.: Bread for the World cooperation and coordination among agencies Institute on Hunger and Development, 1992); S- S. - and ministries, for example, thse concerned with Russell, K. Jacobsen, and W. D. Stanley, International Migration and Devdepment in Sub-Sahaan Africa, vol 2, -agriculture and health, must be ontinuously rein- Country Analyses, World Bank -Discussion Paper 102 forced. The related United Nations' agences, sudh (Washington, D.C- World Bank, 1990). aS the Food and Agriculture Organization of the 8. Bread for the World Institute on Hunger and United Nations, the World Health Organization, Development, ed., Hunger 1993: Uprooted People the United Nations Children's Fund, the World (Washington, D.C.: Bread for the World Institute on -~~~~~~~~~~~~u th , .H ,unger and Development, 1992). Food Pr-ogramme, the Intemnational Fund for HugradDvlpet19) 9. H. J. Leonard and contributors, Environment and Agricultural Development, and other develop- thecPoor: Development Strategies for a Common Agenda, ment agences, as well as the Consultative Group U.S.-Third World Policy Perspectives 11 (New on Intemational Agricultural Research, the World Brunswick, N.J: Tranaction Books, 1989). Bank, and the International Monetary Fund, have 10. T. Reardon and S. A. Vosti, 'Issues in the a key role to play in setting good examples and in Analysis of te Efects of Poliy on Conservation and fsteringsuch cooperation at country and inter i- Productivity at the Household Level in Developing Countries,' Quarterly Journal of International Agriculture T i tion al levels. t 31(4) (1992): 33-34: -Tlhereis noexcuse for the conLtinuedoourxerice 11. S. A. Vosti, "Reprise of Rio: Survival's Sharp of hunger in today's world. Public policy actions Edge," Diversity 8 (4) (1992): 380-96. based on partnerships between communities and 12 Drze and Sen, Nserand PublicAcion. pubhc agenaes can taclde hunger effectively This 13. Von Braun, Teklu, and Webb, "Famine as the publc agncie cantadd huner efectvely '~ Outcome of Political, Production, and Market Failures," calls for an improved understanding of local con- 73-78.. straints and needs. With its complex origins, 14. United Nations Administrative Committee on hunger requires appropriate multisectoral solu- Coordination/Subconmmittee on Nutrition (ACC/SCN), tions that focus on a narrow set of achievable pri- Second Reprt on the World Nutrition Situation (Geneva: - orities. Local - conditions - will- dictate thBse ACC/SCN, 1993); S Broca and P Oamm, "Study on the prioxities,w. chmustbeweU oordinated,r.ot Location of the Poox," Report prepared for the Technical priorities, wbichmustbewellcoordinated,notjust Advisory Committee of the Consultative Group on among intemational players, but also among local International Agricultural Research (Washington, D.C.: communities and teir governments. Inbemational Food Policy Researc Institute, 1991). Ending Humger Soon: Coneeps and Proties 217 15. J. S. Davis, P. A. Oram, and J. G. Ryan, Assement London: The Johns Hopkins University Press for the of Agricultural Research Priorities: An International International Food Policy Research Institute, 1988). Perspective (Canberra: .Australian Centre for Inter- 33. E. T. Kennedy and .1 H. Aidennan, Comparative national Agcriultural Research in collaboration with the Analyses of Nutrtional Effecieness of Food Subsidies and International Food Policy Research Institute, 1987). Other Food-Related Interventions (Washington, D.C.: 16. ACC/SCN, Secnd Report on the World Nutrition International Food Policy Research Instihtte, 1987). Situation. 34. Kennedy and Alderman, Conpatrde Analyses of 17. Broca and Oram, "Study on the Location of the Nutrtional Effectiveness of Fwod Subsidies and Other Food- Poor." Related Interoentions. 18. Broca and Oraa, "Study on the Location of the 35. Kennedy and Alderman, Compatie Analyses of PooL" Nutritional E4Qdtins of Food Subsidies and Other Food- 19. ACC/SCN, Secod Report on the World Nutrition Related Inkrventions. Situation; Per Pinstrup-Andersen, "Global Perspectives 36. H. Alderman, M. G. Chaudhry, and Ml Garcia, for Food Production and Consumption," Tidsskrift for Household Food Security in Pak-istan: The Ration Shop Lfndokonind4(December1992):145-69. System, Working Papers on Food Subsidies 4 20. World Health Organization (WHO), National (Washington, D.C: International Food Policy Research Strategies for Overcoming Micronutrient Malnutrition, Institute, 1988). Document A45/17, forty-fifth World Health Assembly 37. Per Pinstrup-Andersen and H. Alderman, 'The (Geneva: WHO, 1992). . Effectiveness of Consumer-Oriented Food Subsidies in 21. J- von Braun and others, Urban Food Insecurity Reaching Fatioring and Income Transfer Goals," Food and Malnutrition in Develping Countries Trends, Policies, Subsidies in Dewloping Counties and Research Implications (Washington, D.C.: Inter- 3 M. Garcia and Per Pinstrup-Andersen, The Pilot national Food Policy Research Institute, 1993). Food Price Subsidy Scheme in the Philippines It Ismpat on 22. 'Slow Famine Relief Imperils Millions" Africa Income, Food Consumption, and Nutritional Status, Rem very, June 3.1993. Research Report 61 (Washington, D.C.: International 23. Patrick Webb and J. von Braun, Food Secuity and Food Policy Research Institute, 1987); N. Lustig, '¶Fiscal Famine in Etiaopit Lessonsfor Africa (ondon: John Wiley Cost and Welfare Effects of the Maize Subsidy in and Sons, 1994). Mexico," Food Subsidies in Developing Contries. 2t T. Teldu, J. von Braun, and E. Zaki, Drought and 39Q K. Alderman and J. von Braun, The Effects of the Famine Retionshp in Sudaw Poicy mplications, Research Egyptian Food Ration mnd Subsidy System on Income Report 88 (Washington, D.C.- Intemational Food Policy Distribution and Consumption, Research Report 45 Research Institute, 1991); Webb, von Braun, and (Washington, D.C: Intemational Food Policy Research Yohanes. Famn in Etopi Poicy Impliations of Coping Instute, 1984); N. Ediisighe, "Food Subsidy Changes Faiture at National and Houshold Leuels. in Sri Lanka- The Short-Run Effect on the Poor," and lIL 25. Per Pinstrup-Andersen, "Socioeconomic and Garcia, "Food Subsidies in the Philippines: Preliminary Policy Considerations for Sustainable Agricultural Results," Food Subsidies in Developing Countries. Development" (Paper presented at the Thirtenth World 40. H. Singer and S. Maxwell, -Food Aid to the Bank Agricultural Symposium on Agriculture and Developing Countries A Survey'" World Devlpment 7 Envirounental Challenges, Washington, D.C., January (3) (1979): 225-46; J. von Braun and B. Huddleston, 6-7,1993. "Implications of Food Aid for Price Policy in Recipient. 26. Pinstrup-Andersen. "World Food Trends and Countries,' Agicultural Price Policy for Developing How They May Be Modified." Countries, eds. J. W. Mellor and R. Ahmed (Baltimore 27. Pinstrup-Andersen. 'World Food Trends and and London: The Johns Hopldns University Press for How They May Be Modified." the International Food Policy Research Institute, 1988). 28. Von Braun and others, Urban Food insecurty and 41. Patrick Webb, 'Food Security through Malnutrition in Developing Countries. Employment Creation in the Sahel: Labor-Intensive 29. This decline relates to the thirenintenational Programs in Niger, Report to the Deutsche research centers that existed prior to the expansion in Gesellschaft fir Technische Zusammenarbeit 1992. The CCIAR cunrrently compnses eighteen centers (Washington, D.C.: Intemational Food Policy Research 30. Pinstrup-Andersen, "World Food Trends and Institute, 1993); Webb, von Braun, and Yohannes, How They May Be Modified." Faine in Ethiopia. 31. J. von Braun and E. Kennedy, eds., Agrultural .42. International Food Policy Research Institute/ Commerciali7ation, Econoic Devlopment, and Nutriton Bangladesh Institute of Development Studies (IFPRI/ (Baltimore, Maryland; The Johns Hopkins University BIDS), "Development Impact of the Food-for-Work Pro- Press for the International Food Policy Research gram in Bangladesh,' Final report submitted to the Institute, forthcoming). World Food Programme (Washington, D.C.: Inter- 32. Per Pinstrup-Andersen, "The Social and national Food Policy Research Institute, 1989); J. von Economic Effects of Consumer-Oriented Food Braun, T. Teldu, and P. Webb, lsabor-lntnsi Publc Works Subsidies:- A Summary of Current Evidence," Food for Food Security: Expaienc in Africa, Worldng Papers on Subsidies in Developing Countries: Costs, Benefts, and Food Subsidies 6 (Washington, D.C- International Food Policy Optios, ed. P. Pinstrup-Andersen (Baltimore and Policy Researh Institute, 1991). 218 Appendix 4 43. M. Hossain and M. Mokaddem Akkash, Public ences in Employment Pattems between Districts," 7The Rural Works for Relief and Devlopment: A Review of the Econaomic Times (Bombay), May 31-June 2,1989. Bangladesh Experence, Working Papers on Food Sub- 48. M. Ravallion, G. Datt, and S. Chaudhuri, sidies 7 (Washington, D.C.: International Food Policy "Higher Wages for Relief Work Can Make Many of the Research Institute, 1993). Poor Worse Off: Recent Evidence fmm Maharashtra's 44. S. K. Kumar and 0. H. Chowdhury, The Effects Employment Guarantee Scheme" (Washington, D.C.: on Nutritional Status, Development Impact of the Food- World Bank, 1990). for-Work Program in Bangladesh," eds. International 49. Osmani and Chowdhury, "Short-Run Impacts of Food Policy Research Institute (IFPRI)fBangladesh Food-for-Work Programs in Bangladesh; Webb and lnstitute of Development Studies, final report submitted Kumar, "Ethiopia's Food/Cash for Work Programs." to the World Food Programme (Washington, D.C: IFPRI, 50. M. Zeller, C. Schreider, J. von Braun, and F. 1989); S. R. Osmani and 0. HK Chowdhury, "Short-Run Heidhues, "Credit for the Rural Poor in Sub-Saharan Impacts of Food-for-Work Programs in Bangladesh," Africa," Report to the Deutsche Gesellschaft fuir Bangladesh Development Studies 11(1 and 2) (1983): 135-90. Technische Zusammenarbeit (Washington, D.C.: 45. S. Kumar, S. 1988. "Rural Infrastructure in International Food Policy Research Institute, 1923). Bangladesh: Effects on Food Consumption and Nutrition 51. It Hossain, Crliefir Alleviation of Rural Povety: of the Population" (Washington, D.C.: International Food The Grameen Bank in Bangladesh, Research Report 65 Policy Research Institute, 1988); K L. Bell, R W. Hay, and (Washington, DC.C International Food Policy Research T. Martinez, "Consumers and Savers: Can Food-for- Institute, 1988). Work Stimulate Economic Growth at the Household 52. A H. Sarris, "Degree of Reliance on National Level?" (Oxford: University of Oxford, International Food Stocks and Imports,' World Food Seacrityjp Seected Development Centre, Food Studies Group, 1989). Themes and Issues, Economic and Social Development 46. Webb, "Food Security through Employment Paper 53 (Rome: Food and Agriculture Organization of Creation in the Sahek Labor-Intensive Programs in the United Nations, 1985). Niger"; P. Webb and S. Kumar, "Ehiopia's Food/Cash 53. Von Braun and others, Inmprmvig Fod Security of for Work Programs: Experiences under Joint Stress from the Poor. Famine, Drought, and Econoniic Policy Reform" (Paper 54 0. Knudsen and J. Nash, -Domestic Price Stabili- presented at the International Policy Workshop on zation Schemes in Developing Countries," Economic Employment for Poverty Alleviation and Food Security, Development and Cutural Change 38 (3) (1990) 539-58. Viginia, October 11-14,1993). 55. J. MeIor, C Delgado, and M. Bladcie, Accekrating 47. H. Ezekiel and J. C. Stuyt, 'The Maharashtra Food Production in Sub-Sakaran Africa (Baltimore: The Employment Guarantee Scheme: Its Response to Differ- Johns Hopkins University Press, 1987). Appendix 5 Hunger and the World Bank: An NGO Perspective An NGO Statement Presented to the World Bank Hunger Conference, November 30, 1993 Hunger is, in most instanes, a consequence of WethereforecallupontheWorldBanktocom- economic impoverishment and mar tion. mit itself to impleme the recommendations It is thus imperative that economic empower- presented below by the end of 1996 as its contri- ment form the core of strategies to eliminate the bution to the general effort to end hunger underlying causes of hunger These efforts must also include adoption of polices that build self- Participation reliant food security. Strategies aimed at economic empowerment flue participation is. assured only through eco- and self-reliant food security cannot be imposed nonic and politcal empowennent based on from the top. Rather, they must be identified, for- increased control of productive resources. There- mulated, implemented, and evaluated with the fore, the World Bank should make this empower- hll participation of those whom these strategies ment a cornerstone of its work with govenments are intended to serve. Such parficipatory strate- on programs, policy, and institutional reform. gies preclude a business-as-usual approach to This means maing a significant commitment to project and policy development and implemen- programs and policies thatwill increase access for tation, and will produce substntially superior the poor, especially women food producers, to all results than conventional practice. productive resources (such as land, capital, tedh- Given that strctural adjustment policies fre- nology, and markets) and skills such as literacy quendy have increased hunger in countries in Tluepartiapationalsorequiresfullrecogmition, which they have been implemented, NGOs are respect, and support for community rights and pleased to see this issue on the agenda for the social processes. These include the cultural rights conference. -However, for meaningful foilow embodied in the substantal contbutionf food through to the conference we believe that the preferences and practices to the cultural identity of Bank mnust initiate an open review of its role in mostpeoples.Those whopresume tohelp apeople designing and supporting macroeconomic poli- stngthen their food security have an obligation to cies that worsen the problem of hunger. It must avoid the arbitrary infringement of their right to then engage in a participatoryprocess of rethink- dhoose their own cultural food and other practices. ing and reformulating its prqects and policies The World Bank must revamp and democra- such that they address short-term poverty alle- tize the processbywhichitidenaifiesandsupports viation, as well as long-term economic empow- all development projects and policies, including erment of the poor. structunal adjustment policies. In this regard, we This statement was presenbed and distributed at the conferenc It is indluded here to present the views of the signa- tories, all particpants in the conference. 219 220 Appendix 5 applaud 1M. Preston's statement of April 28 about ensure that advancement within the institution is the importance of "ensuring the broad participa- linked to demonstrated commitments to and tion of the poor in the design as welU as the imple- skills in fostering popular partcipation in Bank mentation of projects. We want this to become the operations. This recommendation was embraced norm of our operations in the years to comea" We bylM. Preston in his 1992 meeting with the World affirm not only his recognition of the importance Bank-NGO Committee. The Wapenhans Report of involving the poor early on, but also his con- amply demonstrated how giving priority to get- mitment that this become the norm for all opera- ting project approvals and movig money has tions-programs as well as projects. impaired the quality of Bank operations. Our rec- At the same time, we are aware from our own ommendation for revamping incentives should fieldexperiencethattheparticipationelicitedfrom be at the heart of portfolio management reforns. the poor by multilateral agencies is often superfi- cial, may not be broadly representative, and the People-Centered Macroeconomic Policies results of consultations are often ignored. Many of these problems can be overcome by seekdng par- While we support efforts to fight hunger at the ticipationbythosemostvulnerabletohunger,par- grassroots, the Bank has long been an advocate of ticularly women. We recommend that the Bank the proposition that policies are key to develop- actively reach out to and incorporate the perspec- ment outcomes. We agree. If the policies are tives and recommendations of women's groups, wrong, hunger will persist in spite of the most community groups includg NGOs and other effective and committed grassroots NGO anti- actors in civil society in all Bank programs and hunger activity. We therefore urge the Bank to policies. We also call upon the Bank to strengthen make the economic empowerment -of the poor a and encourage NGO and community involve- fundamental priority-not only in projects, but ment in obtainng, reviewing, and respondig to also m its poliy reform efforts. information on all prospective World Bank pro- In particular, the Bank should give priority in jects and policy recommendations. policy and sectoral adjustment programs to poli- Full and meanineful pa'riipation is not pos- cies that will raise real incomes and reduce risks sible without access to relevant information. The for poor and hungry people on a direct and WorldBankisapublicinstitutionengagedinpro- immediate basis-as well as in the medium and viding public financing to public agencies for long term This includes policies that enhance public purposes. The public in whose name such food security, employment, and incomes in both financing is provided and which ultimately must urban and rural settings; and lead-to permanent repay the resultant financial obligations has a reduction in foreign indebtedness and increased right to full information regarding those obliga- self-reliance in meeting basic needs. tions. The World Bank's willingness to respect Furthermore, the World Bank must relinquish this right of the sovereign people and to require its insistence that free and open markets are an borrowing governments to do likewise will be a adequate vehicle for allocating available food. basic measure of its commitment to participation. The market is frequently not effective in equi- In order to monitor the results of its commit- tably or efficiently distnbuting food, as starkly ment to participation, we recommend that all revealed in numerous historical instnces of project and adjustment operations considered by famine amidst plenty. All policy initiatives must the board be accompanied by a full and gender take this into account through measures that disaggregated description of how poor and hun- assure the poor have the means to meet their gry people have been consulted, how they will basic food needs. dircdy benefit, and how actual consequences for For the Bank to continue to rely on triclde down them will be monitored using gender disaggre- economic policies and top down progam plan- gated indicators of equity (for example, distribu- ning is not consistent with a commitment to end- tion of income, distribution of land ownership, ing hunge Thiese policies are not only failing to access to credit, and other similar indicators). improve the-quality of life of the poor-especially Finally, we recommend that the management the ultrapoor-theyare increasingthesocialinse- incentive system of the Bank be revamped to curityandvulnerabilitytohungerof these groups. Hunger and the World Bank: An NGO Persweciv 221 Each adjustment operation or other policy We recommend that the Bank's definitions of initiative presented to the World Bank's board development impact and project quality give sub- should be accompanied by a description of how stantial weight to an operation's anticipated and that operation or initiative will benefit the poor actual contibution to equity, environmental sus- as aprimary focus-not simply as the objects tainability andparticipationgoals.Suchguidelines of the safety net programs that often supple- should ensure, for instance, that the Bank commits ment World Bank/IMF structural adjustment to funding only projects and programsthat actively operations. and directy increase sustainable on-site livelihood opportunities for disadvantaged people in the Project Quality localities in which they presently live. Personnel evaluations should include assess- Now that the Bank is attempting to become a ments of contributions to development impact more client govemment-centered institution, it and project quality so defined. is essential that it do more to ensure account- ability to the poor, who are the people most Poorest of the Poor affected by the Bank's policies and programs. As the Bank reoranizes centrally and in the field to The Program of Targetd Interventions (O11) upgrade its portfolio management, the modali- would target investments toward the poor, ties and locus for enhancing popular participa- broadly speaking. We recommend that in the next tion should be unambiguous, and above all two years, the percentage of IDA PTI lending- country specific. We recommend that this be especialy lending focused on the social sectors- done directly with NGOs, community-based be increased from 40 percent to a minimum of 50 organizations, cooperatives, and other actors in percent, and that combined 1BRD/IDA PTI lend- civil society. We recommend that the Bankwork ing be inceased from 26 percent to a minimum of with governments and NGOs to develop spe- 45 percent. cific guidelines to ensure that operations are We also recommend that the Bank include in viable at all stages from a sustainable develop- all poverty studies, social impact assessments, ment pomt of view The portfolio management and project appraisals a gender disaggregated reform process is giving more emphasis to assessmentofthespeificandcdistinctiveneedsof ensuring development impact as well as eco- the ultra poor (the poorest 10 to 20 percent) and nomic performance. Unfortutely, for the make specific provision to imvest in members of Bank, the meaning of "development impact' this group and to expand the livelihood opportu- remains cloudy. nities available to them. T-his statement is endorsed by the following or: Chuck Woolery Binta Sarr Alliancefor Child Survival Assodation pour la Promotion de la Femnme George Porter SOWgalAPROFES, Senegal AoteariTow Zealand Councilfor Inerntional David Beckmann Development Nancy Alexander Antonio B. Quizon : Bread for the World Asian NGO Coaltion for Agrarin Rejbnn and Dr. Philip Johnston RZural Development (ANGOC), The Philippines CARE Edwin Zablah Cathy Shepherd Asociadon Latinoamericao des Organizacions de Caribbean Associationfor Feminist Reserch and Promocion (ALOP) Action /Women Workingfor Social Progress Sekai Holland James E. Hug, S.J. Association of Women's Clubs, Zimbabwe Center of Concern 222 Appendix 5 Georgina Ashworth John Miheve CHANGE Inter-Church Coalition on Africa Safieton Diop Jim Bell Collectif des Femmes pour la Ddfense de la Famille, Interfaith Impactffor Justice and Peace Senegal - . - - Mensah Todzro Jeremy Hobbs Les Amis de la Terre, Togo Community Aid Abroad, Australia Maryknoll Fathers and Brothers justice and Peace Rodney E. Leonard Office Community Nutrition Institute Wendy Gordon Michael Hansen Mothers & Othersfor a Livable Planet Consumer Policy Institute Akin Mabogunje Consumers Union of Japan National Boardfor Community Banks, Nigeria Development Action Group, South Africa Rev. Mutava Musyimi Douglas Helliniger -National Council of Churches of Kenya The Development GAP Lynn A. Greenwalt Lori Udall. National Wildlife Federation Environmental Defense Fund Networkfor Safe and Secure Food and Environment, Carlos Heredia -apan Equipo Pueblo, Miixco Chuck Kaufman Anano Mwenegoha Nicaragua Network Education Fund Evangelical Lutheran Church, Tanzania Rita Clark Food Irradiation Network, Japan - Nicaragua United States Friendship Office Mazide N'Diaye fKathy Lawrence Forumfor African Voluntary Developrnent NGO Working Group on Sustainable Agriculture Organizations (FAVDO), Senegal No! to the Harmonization Action Committee, Japan Foundation EL TALLER, Tunisia George Porter Rupert Scofeied 0 0 Pacific Institute of Resource Management, New Foundationfor International Community Assistance Zeal Edwin Zablahi David Kortenr Fundacion Augusto C. Sandino, Nicaragua People-Centered Development Forum Ridhard Bumgarner Monica Moore Global Food and Nutrition Alliance Pesticide Action Network North America Bev Greach O - Graeme A. Reid Group for Environmental Monitoring PMNACT,SouthAfrica Joan Holmes Alison Clarke The Hunger Project - -.Politics of Food Program T Ben Turok 0 : Caleb Rossiter . Inst it ute for African Alternatives, South Africa Project on Demilitarization and Democracy Mark micite ~~~~~~Luis LopezUlera M. Mark Ritchie -Li x Institute for Agriculture and Trade Policy Pro mocin del Desarrollo Popular, MAico Gonzalo Tapia Public Interest Research Group, India Interamercan Network of Agriculture and Allen M. Arnstrong Democracy Rangpur Dinajpur Rural Service, Bangladesh Hunger and the World Bank. An NGO Perspefllve 223 Karin Nansen Bella Abzug REDES-FOE, Uruguay Susan Davis Joanne Carter Women's Environment and Development RESULTS Ognization Rudolf Buntzel Merle Hodge Rural Development Education of the Evangelical Womm Worngfor Social Progress Church in Germany Peter Mann Susan Shure . World Hunger Year Shure Communications Philip J. Hunt HoraceLevy: 0 - - World Vlision Austrlia Jennifer Jones Joe Muwonge Social Action Centre, Jamaica World Vision International Mildred Robbins-Leet J. Patrick Maddenr Trickle Up Program World Sustainable Agriculture Association Susan C. Peacock United Church Boardfor World Ministries This statement is endorsed by the following individuals (organizations listed for identification purposes only): Tariq Banuri Rev. Douglas B. Hunt Sustainable Developnment Policy Institute Church Center.fr Sustainable Community - Omega Bula - 0 - United Church of Christ, Officefor Church All Africa Conference if Churdns - Cri5tOJ~heX~ Th~orcl Tmtmie Jensen Christopher Dunford- ureJrn Freedom From Hunger Chol Chol Intern3tionl Karen Fennell - -Kathy Lawrence Amenercan College of Nurse Aviui s -Citizen's Network-for Sustainable Development Thomas Forster Carolyn K. Long NGO Working Group on Sustainable Development IterAction Learnne Grossman Erich D. Matiias Joint Ministry in Africa Office of the Disciples of Christ and the United Church of Christ John Gershman Institutefor Food and Development Policy/ Paul Nelson Food First Church World Service /Lutheran World Relief - Mark W. HaPison Carla Roppel General Board of Ckurch and So*ety, The Unid OXFAM, Global Agriculture Prqject Methodist Church Pablo Stone Rev. Dan C. Hoffmanr Disples Peace Fdlowuship Joint Ministry in Africa Offie of the Disciples of Susan Dralce Smith Christ and the United Churck of Christ ApproprWte Tedmology International Associated Event The Ethical Dimensions of Global Hunger A Panel Discussion This panel discussion was held at the World Bank on the evening of November 29, 1993, preceding the opening of the Conference on Overcoming Global Hunger. Opening Statement Ismail Serageldin We have worked hard aEl day at tie preparatory the efhical dimension-that it was profoundly workshop for tomorrows intermational confer- inadrnisslblethathumnbeingscouldliveinsudh ence on "Overcoming Global Hunger' and some degradationand thatslaverydegradedithosewho of you have been working on these issues in accepted it and were willing to tolerate its contin- preparation for the conference for nany weeks. I ued exstence-that eventually overtured the am delighted that you could be with us tonight insttution of slavery in this country. Although this panel is not on the formal pro- In this spirit I have also retained the words gram of the conference, itis an essential part of it that my friend, John Cark, used earlier today, l am particularly pleased that it is being held on thatwe should have a sense of anger about global the World Bank's premLses, because I believe that hunger Iwould use the words "sense of outrage emphasizing the ethical dimensions of hunger that such a situation could continue to exist from inside the premises of the World Bank is a Whilewewillnotbeabletoremnovehungertoday poit that needs to be made. or tomorrow, we must not quiescently accept its :The issues of hunger around the world are not continuation. We must, from all forums, from technical issues. Of course, there are problems of wherever we are positioned, challenge the con- technical design, of particular interventions, for tined existence of hunger in a world of plenty- example, whether iodine supplementation pro- Our world is plentifuL Hunger is not an issue of grams are better carried out in connection with food supplies. Even in the face of the worst health programs or with feeding programs, but drought in a hundred years, last year southem these kinds of issues are secondary. The core issue Africa avoided a famine by taking sound action. is an ethical dimension. I believe unabashedly It is this quiet acceptance that we can and that it degrades us all as human beings to know must now end, including the lack of resolve on that a billion people around the world are going the part of local and national goveernments, of hungry, that the most basic of basic needs is not international agencies, and of private groups, all beingmet of whom attend meetigs, make declarations, Earlier today I said that we should be the new and then do not suit their actions to their words. abolitionists, and I mean that Ibelieve that justas We need this dedicated outrage to keep the issue mithenineteenth century some people spoke up onthe frontburner and to carry us further inthe and said that it was unconscionable that people fight against hunger. should exist in slavery, in this day and age it is Sostronglydolfeelabout thispointthatlfelt unconscionable that one billion people should go that we had to have a discussion, at least among hungry We should commit ourseves based on the ourselves, on the ethical dimension of the fight same ethical movement Itwasnottheissue of the against global hunger before the official start of economics of the slave trade. It was not the issue the intemational conference tomorrow. A discus- of thepolitics of the slave trade. It was the issue of sionthatIhopewillhelp us to arm ourselveswith 227 228 Shial Dimensin of Glbal Thger that sense of outrage, to arm ourselves with the The hird paneist who was to johi us unfor- snethatthemostfundamentalofhumnrights -mnately sent his apologies, but he faxed his is violated for more than a billion people every thoughtful texk which wil be circulated. That day. If people are going hungry, we camnt'talk personismygood ftid,ebrahimaFallassistant anly about whether they have the rght to vote. secretary general of . the United Nations for Hunger is the most exreme form of deprivation Human Rights (not the asistant secretary gen- of human rights. eral for humanilarian relief).-What we are taldn Tontigtis the fomm that prvides the portu- abouthere ishumanrighF Fmudanalhuman nity to explore and discuss thes issues. I am priv- rights. Ibrahima FalU could not join us tonight fileged to say that we have two very distinguished because he has to repond tD questio of the guests. Let me fist intoduce Mmxsignor Jorge Third Committee of the Geral Assembly in Mejia of theVatican,whoisthevicepresidentof the New YorkL On his behalf, I wanted to edend his sio of Justc and Peace, butwho is here apologies to the group because he very much as the designated reprsenive of the Holy See. wanted to be here, and were it not that the Third He and I taled about the this confernc in Rome CoDmMittee of the General Assembly is the sover- some time ago, arid he challenged me by asking eign body tD which he has to report arid tey are 'How do you think you w get people to change questioning him on the progms that are being their pdicies? HOw wi you get govermene to done there, h certainlywould be here with us. I change their affitudesr I told him, "Monsignor, kncw that he is with us in spirit. there is only oneway toshameem into it Ours I know that a number of you also feel stoly is riot a political organizationbut mllctieyypub- about theseissues, and what we have plamled for Lic op has abig weigbt The mobiization of tonightisnotaseriesoflengthypsbut public opiIOn, the mobilizatio of the shmeful- alamucingof apanreldiscussionand a dialogu ness that is associated with the axninution of the hi this spirit I propose that each of the two pan- inadequatepolisthatperpetuateablpeople elists-Mri r Meia and David Beckaani- in hungeithis is what I iik it is allabou I am use ten mintms or so to make tluir open delighted thathe could be with us bonight comments, and thn we wil open the floor for On my right is my good fiiend David Beck- comments, questions and disussn There wil imamr whoforanumberofyeswasacoRleagu be occasio later to cimulate lengthier fomual in the Bank, and is now president of Bread for the papers for those who wish to do so. For myseI, I World.Inthe timehewasattheBankwehadmary wiL not make a formal presentation in the panel discsions aboutthe ethil dimnsons of devel- beyond these intro toy remarks. opment problems. David felt so strongly about 1 know that many of you are interested in these issues that he rsged from the Bank and voicing your thoughts beause three people have joned Bread for the Wold to work spefically on already signed up to speak after the paneists. I thehungerproblemn.Iamdelighg edthatheagreel will begn with them nght after the opening to be on this panel today. statements. Statement - - a Jorge Marid Meiaf The conference we are partidpatig in, tianks to sidered as awhole?1 The pointis therefore notthe the invitation of the World Bank, is significantly lack of food. Nor is it, according to another FAO entitled"AConerenceonActionstoReduceHun- study, the imbalance between agcultural food ger Worldwide." I emphasize the word actions. production and demographic growdi, which at Actions to reduce hunger worldwide are and this time appears to be stationary or tending to shoud be political actions, economic actions, and slow down2 even social actions if civil society is to be involved, The main difficulties, indeed the real obstadles- nationally and intemationally, as it ought to be, in the way of adequately producing, trading, and and if the hoped for results are to be not ordy true distributing food so that it reaches everybody, are results but also permanent ones. economic ard political Some economic and polit- However, actions of such different kInds are ical decisions, or again omissions, are responsible first of all human actions, individual human for the lack of a solution to the problem of hunger actions, even if they come from a givensocial con- Consequently, hunger is not a kind of unavoid- text and tend to transform that context. able necessity, a kind of curse hanging over the Now, human actions are of themselves ethical lives of so many people, a curse induced by fate. actions. That is to say they are actions that are It is sometimes said that if the political JwillH morally inspired; either good or evil. Because were there, at least some of the economic prob- omissions are as important as positive, actions lems regarding hunger could be solved. regarding the solution of problems such as global There is, therefore, an ethical question involved hunger,oneshouldbepreparedtoassessnotonly in global hunger Whether or not to put'some. actions but also omissions. mechanims in action depends on what crteria We are all agreed, I gather, that the problem of one chooses to follow in one's actions or inaction. global hunger, which is also and indeed primariy These criteria can be approached from differ- a problem of concrete individual persons being ent perspectives. If one believes that purely eco- hungry and having nothing to eat (men, women, nomic or even political considerations are first children,olderpeople),canbesolved. Putinother and foremost in determining a certain course of terms, it is not currently beyond the pale of the action, and not thehumanrights andduties of all human community to have people eat enough, those involved, then hunger might easily con- even in the most remote corners of the world. tinue unabated, or even extend and deepen. This According to recent data of the Food and wouldalso be true evenif thelack of enougeifood Agriculture Organization of the United Nations were not seen as the direct aim of actions or omis- (FAO) that were examined at the FAQs twenty- sions inspired by such criteria, but only as a seventh conference held in Rome during the past painful result two weeks, world food production is sufficient to Does this mean that solidarity and sharing meet the demands of the world's popi-lation con- should take the place of sound economic plan- . .~~~~~~~~~~~~~2 230 Ethical Dnmensions of Global Hunger ning and enlightened political decisions? To this tialimportanceofinterntionalcooperationbased question the answer is no. But we should add on free consent" Furte down in paragaph 2 it immediately that solidarity and sharing should says ".The State Parties... shall take individually also inspire economic and political decisions, and collectively and hirough international coop- especially in times of universal crisis, such as the eration, the measures, including spedfic mea- one we are going through now. sures,whichareneeded. Thesespecficmeasures Solidarity and sharing are, of course, ethical are thenspelledoutundersections a) andb) inthe concepts and ethically inspired actions. same Article 11. I do not need to read them out The problem lies deeper however Ishall now We all know themL The only pending question is try to approach it from the particular angle that to put them into practice. In a true sense, I am might prove usefut for our present discussion. afraid, they have been -awaiting implementation Peoplehavearighttobe adequatelynourished. since 1966. Human beings, acoording to the United Nations MoreovertheWorldDeclarationonNutrition 1948 Declarafion in Artile 3, have arightto life, as of December 1992, which emerged from the well as to liberty and secmty. And acrding to FAO/World Health Oranization International Article25,ahumanbeingalsohasarightto anade- CongressinRome,envisages notondytherightto quate standard of living "for the health and well- nutrition, but also recognizes "that access to being of himself and his family, including food." nutritionally adequate and safe food is a right of The Intemational Covenant on Economic, each individualr (Artice 1). In this sense, the Socal and Cultural Rights (1966) is yet more nght to nutrition implies adequate economiic explicit Artide 11, paragraph 2 states: "The State capacities and a safe environmenL Parties to the present Covenant recognize the fum- We have tius made the transition from right damentalrightof everyonetobefreefromhunger." to duty, and consaence has been mentioned in So, the right to be nourished is now seen as a relation to both, if we are to take John Henry tfmndamental' righ And let me add that since Newman's words seriously. The "ethical dimen- 1966 the declaration has become a covenant sions of global hunger" have appeared before our Now, a covenant implies obligations, as we shall eyes. soon see. If Imay now use a different perspective to I believe this is a very solid ethical basis for express the same reality, I shall say that the prob- assessing the problem of hunger worldwide, as lem of hunger, indeed of global hunger-but wel as for dtcding on the correct actions to be without forgetting what I said above about con- taken. crete individual persons who are hungry-is a Rights, in fact, exist to be respected and imple- problem of conscience, ethically considered. mented,andforthisreasontheygohandinhand Conscience, in fact, manifests to us what is with the corresponding duties. Indeed, according wrong and what is right, and in doing so toJohn HenryNewman (ALetter... to theDuke expresses what we are obliged to do or to avoid. of Norfolk): "Conscence has rightsbecause ithas It is the herald of moral obligation, as the recent duties." Papal Encyclical "Veritatis Splendor" has admni- For this reason, the covenant just quoted pro- rably explained. ceeds from the formulation of the fundamental In the face of the problem of global hunger, righttobefreefromhunger,toexpressingwhatthe conscience reacts and proclaims that there are state parties should do to implement this right and some concrete actions, whether economic, politi- what it implies. It goes from rights to duties; or, if cal, or social, to be taken, and other actions to be you wish, supports the nght with the correspond- avoided- When such actions are not decided ing duties. Otherwise, rights remain null and void. upon, or others are decided upon in their stead, In this connection, let me quote some sen- then the problem in question not only remains tences from Artide 11.1 of the 1966 covenant "The unsolved, but we become responsible for the fail- State Parties will take appropriate steps to ensure ure. We become responsible, according to the the realization of this right," (namely, the one to Covenant on Econormic, Social and Cultural an adequate standard of living, "indluding ade- Rights, which we have undersigned, before the quate food"), "recogizing to this effect the essen- international community; but also responsible ci Mia 231 before ourselves; and,of course,before thosewho That is why it is so important that values are are bound to remain hungry, or die of hunger. As held up, promoted, and defended among all of a Christian, I would add that we are responsible us. I mean, of course, true values. Values are before God, the Father of all. dosely interconnected with rights and duties. Conscence, it couldbe said, is a very personal The existence and real influence of values matter. Whose conscience, then, is or should be make all the difference. One could ask whether affected by the problem we are facing? the fact that global hunger still exists and is wors- My first answer to such a pertinent question ening is not a sign that some values at least are no would be: the conscience of whoever is nearer to longer operative, or rather, whether or not they the one who suffers. are considered values at all. The term 'near' in the comparative, should not If global hunger is an ethical problem, then we be interpreted locally. It might, of course, be read should askthis question, and face the consequences. so, because we are called, as fellow human beings, As a Christian, I am convinced that the prob- to share our food with whomever we see next to lem of global hunger, because it is ethical, affects us being a victim of hunger. This seems to be par- one's relationship to God. ticularly true when people are victims of hunger God not only commands us to feed our broth- because they are innocent victims of war, as is the ers and sisters, if they happen tobe hungry while case in more than one part of the world, as cur- we are not; but also, much more radically, says to rently in the former Yugoslavia, for example. us that where we did feed or did not feed those But, in a deeper sense, "near' means, in this who were hungry we did feed or did not feed context, whoever is able, by his or her actions or Him, as in the parable of the Fnal Judgment (Mt omissions, to alleviate hunger or to ignore it, 25:35-41). which always makes it worse Asitisherea question of ethical decsions, there Notes is no need to be more precse. Each of us knows, or should know, exactlywhere he orshe stands. 1. FAO, The State of Food and Agriculture 1993, Again, there is such a thing as a common con- Docxumt C 93/2 (Rome FAO, 1993), 20-10 science, or shared values in a given society, be it 2 FAO,:Agriulure Townrds 2010, Document C 93/94 national or international (Rome: FAO, 1993). Statement 1. David Beclna -nn In our era the most pressing ethical question Bread for the World related to hunger is how do we organize political will to end hunger?' Bread for the World is a church-based citizens' As thepapers for thisconference havepointed movement against hunger We have about 44,000 out, a series of conferences over many years have individual members and 1,000 affiliated local recognized people's right to food and outlined churches throughout the United States. We get feasible programs for getting rid of mass hunger moral and financal support from about fifty dif- in the world. The basic problem in carrying out ferent denominations all the way acoss the theo- those mandates is that we have not been able to logical spectrum, and we have some members mobilize the necessary political wilL who are not ChristianL Political will is also an issue within the We orgnize people to lobby the US. Congress World Bank The Bank has been committed to and the administration on issues that are imnor- poverty reduction as a primary objective for tant to hungry people in our country and around twenty years. McNamara made his Nairobi the world. Because of our active grassroots net- speech on rural poverty in 1973. The last two work, Bread for the World accounts for more than presidents of the Bank have consistently said half of all the lobbying done in this country for that reducing poverty is the basic objective of poor people in developing counties. We also the World Bank, but there are still many inter- have an influence on some issues that affect poor nal meetings in the Bank where the staff who are andhungrypeoplewihintheUnited States-Ithas most serious about reducing poverty and taken twenty years to build Bread for the World. hunger feel as if they are a beleaguered and ide- But it now provides practical links between the alistic minority high aspirations of people in South Dakota, Despite twenty years of real commitment at Arizona, or Colorado and policymaking in the level of the president of the Bank, doubts Washington that affects hungry people through- remain even among many Bank staff about how out the United States and worldwide. serious the Bank is about its stated intentions of Others have spoken about guilt and outrage reducng poverty and hunger The challenge for as motives for action to overcome hunger. But I the Bank, as well as for antipoverty efforts more suspect that most Bread for the World members generally, is to take steps that will establish the are more deeply motivated by a sense of abun- political will to actually carry out the rhetoric dance, of having been blessed, accepted, and for- I will speak from two areas of my experience: given. Christian faith in a loving God is what has the work I am doing now with Bread for the givenBreadfortheWorlditsstayingpower.Isus- World, and my fifteen years of work within the pect that mostpeoplewho activelywork to over- World Bank. come hunger are grounded in grace, shalom, 232 --- -.ckman 233 Islam, love of nature, or some other positive and domestic hunger. The US. government won't transcendent ethos. care much about what happens in Somalia or to Bread for the World's armual budget is less poor people in the Philippines or Brazil until it than US$4 milion, but almost every year we get cares much more actively about the plight of hun- the US. Congress to move hundreds of millions gry people in southeast WashingtonAppalachia, of dollars into programs that are good for poor or south Texas. Serious US. commitment to inter- and hungry people. Sometmes we help win nationaldevelopment,ifitcomes, willbefrothon broad shifts inUS. policy that are worth far more. a wave of domestic social concern. Bread for the World Istitute has just pub- Bread for the World has been able to get tens lished Hunger 199% Tranfong the Politics of of thousands of people worlkng on foreign aid Hunger Thisbookis astageinamultiyearprocess reform, pardy because we also empower them to of consultation and study on how to dhange US. work on issues that affect the 30 million peoplein politics as it affects hungry people in our countr dte Urnted States who face hunger. and around the world. We intend to help build a One final Bread for the World experience that I broad social and political movement against want to share is our work this year to iefonn US. hunger and poverty. If we want to make the US. foreign assistance. We call our campaign "Many govermnent a serious ally of hungry people, we Neighbors, One Eart. We anticipated last year need to transform the politics of hunger that the end of the Cold War would put the future I urge you to get Hunger 1994 and read it Let of U.S. foxeign assistance very muchin doubt US. me make just two points from Hutger 1994 here- foreignassisteisbeigdramaticallyievamped, Fh, to overcome hunger, people and o3gani- and no one can yet tell whether it will be slashed zations who are already working with poor and or mningfully reformed. So we have been cam- hungry people need to become more political. paigning to make sustainable development- That indudes official development agencies such especially reducing poverty and hunger in as the World Bank. The Bank's charter and sys- envonmentaly sound ways-e prmary pur- tems of governance have, atleastuntil now, made pose of post-Cold War foreign aid. We have also it almost impossible for the Bank to thiink straight been tryig to shift money from Cold War-driven about politics. Nongovernmental organizations aspects of the US. aid budget into programs that (NOOs) and oters who are trying to work with are focused on sustnable development About hungry people also need to get more politicaL 185 oranizations have worked with us on the The United States now has more fan 150,000 'Many Neighbors, One Eart" capaign, and private agencies passing out food to hungry peo- otier organizations have worked in various coali- ple. So there is no scardty of concern about hunger tions with us. and poverty, but most of it is apolitical Especially WhathappensattheWhiteHouse, twoblocks in the United States, we tend to be privately gen- away, will have more impact on world hunger erous and publicly stingy Nearly aU the 150,000 than any decisions here at the World Bank We private feeding agencies have sprouted up since should al be ftying to get President Clinton to 1980, during a period when public policies have focus on what is good for developing countries been harsh toward low-income people. The pri- and for poor people in developing countries. vate feeding movement, as fast as it has grown, Hungr and poverty-in other countries have not has not kept up with the spxead of hunger The been among the Clinton administration's priori- U.S. feeding movement is a clear demonstration ties. So foreign aid money has been cut The for- that people and organizations who are concerned eign aid policy bill was put off. A full year after abouthunger and poverty need to engage mor- President Clinton came to office, his admiistra- and more effectively-in changing the politics of tion has yet to appoint aUS. executive director to hunger. the World Bank. A second point from Hunger 1994, which Mysense is thatsenior managers of the World seems especially relevant for this conference, is Bankdonotallsharethe same Visionof its future, that US. political decisions about world hunger and that the Bank is unlikely to set any clear new will be significandy influenced by the politics of course for itself as long as its largest shareholder 234 Ethical Dimensions of Global Hunger government, at the highest level, really does not The mandate of the World Bank is to reduce care much what the Bank does. poverty, but its accountability structure makes The United States is important in the world the Bank always beholden to.governments. Its economy and in intemational decisions. So until board of governors are the folks who drive we can get the president of the United States to around in limousines at the Bank-Fund. annual provide some leademhip for interational devel- meetings. Finance ministers are not usually nasty opment and hunger reduction, we are going to people, butreducing poverty is seldom the high- haveaverydifficulttimemaldngprogressagainst est priority of any government hunger and poverty worldwide- The industrial countries' governments give The "Many Neighbors, One Earth" campaign inconsistentsignals to the Bank. In theboard they generated about 90,000 letters to Congress in may agree that the Bank should focus resolutely 1993. Constituents have told their representatives on reducing poverty Yet the next week the Bank that foreign aid that empowers and enables poor maybe making a decision related to fiancophone and hungry people is important and should be West Africa, and the French government has expanded.Almosthalf themembers of the House other interests it wants to push. Or the Bank is of Representatives and thirty senators have doing something in Egypt or VietNam, and the become cosponsors of the "ManyNeighbors, One US. govemment has priorities otier than what's Earth" resolution, which calls for a shift of policy best for poor people. and money toward poverty-focused activities. Similarly, developing countries' governments Partly because of this grassroots pressure, con- are seldom preoccupied with reducng poverty gressional leaders have been pushing the admin- and hunger, and they also often pull the Bank off istration to move forward with a foreign aid course. The World Bank has many wonderful, policy bilL committed staff, and they do a great deal of This discussion of Bread for the World's work important and good work. But again and again provides some practical illustrations of ways to the Bank's governance system does notback them build political will to overcome hunger We upwith consistent missian-driven political wilL shouldn't just hope for political. wi, waiting for Can we fix this problem? Even if we could some politician or jounalist to appear with the change formal governance structures, an institu- necessary conviction, vision, and persuasive tion that manages such large-scale finance will be power Buildg political will is a project that forced to work dosely with govemments. requires planning and work over many years-a The change in the Bank's information policy profoundly ethical project that is about to be implemented is a tremen- dously important reform. People all over the The World Bank world will be much better informed about what the World Bank and goverments are saying to Now allow me to reflect a bit on myfifteenyears each other and planning to do. GroupslikeBread at the World Bank. I did not leave the Bank for the World and the National Wildlife Federa- because I thought it was a horrible institution or tion, our counterparts in Central Amenca or that no good could be done here. On the contrary, India, and local community organizations and I think a lot of good is done here. But the World jounalists wilbeinabetter position to influence Bank has a fimdamental problem of political wilh Bank-related policies and projects. Knowledge is it is responsible to its shareholder goverments. power, and pro-poor interests will now have The industrial countries' governments domi- more possibilities for holding the Banrks feet to nate the Bank's board. What the Bank does thus the fire depends heavily on what the govenmments of the I applaud this measure that the Bank's man- United States, Germany, Japan, and the other agement and board have talcen NGOs have industrial countries want The Bank lends to pushed for years for a more open information developing countries' governments, and it feels policy The Banlcing Committee of the US. House pressure from them too. What the World Bank of Representativespushedhardforit Itisasmall, does in India depends profoundly on what the butsignificant,andalmostirrevocableshiftinthe Indian govemment wants. balance of power. For years to come Bank man- Beckmann 235 agers and staff will be under a somewhat die- pro-poor organizatiors make the agents of large- ent set of pressures. scale development activities more accountable. The next step should be to help groups who The Bank could give capadty building along represent pro-poor interests become involved these lines a tremendous boost forward. At this with the Bank and with Bank-financed activities, conference the Bank is indicating that it might They wil often criticize, but they will, in the help orgaize a consultative mechanism to assist process, help the Bank do a better job. and empowerhungry people: the ultra-poor This Commercial and other interests will also have proposed network of institutions should, in my more .information. More open, democratic view, strengthen pro-poor groups around the processes will not necessarily result in decisions worldtopuilthefBankandotherlargeofficialSys- that are better for the poor. Because the Bank's tems in the dirction of what is good for really mission is to reduce poverty, the Bank should hungry people. This would indude a stronger actively help poor people and pro-poor NGOs to social orientation in the design of macroeconomic engage in the planning of Bank-financed activi- policdesandmeasures to empowerpoorpeople to tis NGOs do notnow have the necessary capac- shape projects that wfll affect them. A consulta- ity. As president of a relatively large antipoverty tive network of institutions is a good model- advocacy group, I have gained a sharp sense of decentralized, but in close communication with how limited our resources are in relation to those one another It would include both governmental Of official agencies. It has been a stetch for US. and nongovernmental institutions, some already -NGOs even to participate meaningfully in the existing and some new. planiing of this conference. US. environmental Would the Bank ooperate in building this sort groups are large and sophisticated byNCGO stan- of network.? Why should the Bank strengthen its dards,buttheyhavehadtofocusonascoreofpro- critics? This conference shows that the Bank just jects to make their broader points about the need might do so. The Bank invited NGOs to help plan for World Bank reformL The Bank is churning out the conference, and the conference is indeed better more than 200 projects a year NGOs do not now because it includes criticism and dissent NGOs have the capacity to have even a minor influence here are saying thigs that some:Bank staff them- on most of them, let alone the hudreds of other selveswouldlike to say, but could notsaysoboldiy. maiorprojects and policy decsions that other offi- If pro-poor citizen groups become better able cial agencies and governments are developing, to become involved in specific and informed The Bankes new information policy makes ways, the Bank would need to face up to lots of NCO involvement more feasible. What is needed contrsy and make far-reaching, difficult now is a decentralized system of small grants and changes. The process would encourage the Bank other assistance to advoacy groups, especially in to be more consistently faithful to its antipoverty the developing countries, so that they can modify mission and, over time, would broaden political the pressures on Bank managers and staff as par- support for the Bank ticular decisions aemade. NGOs, especalw l- we financed industrial country NGOs, should shift Note more of their resources to advocacy Bilateral aid agencLw, pubh an p.at fondtis, an -oth- L. Until 1991, David Bedlsmann was on the staff of agencies, pblllIC and pivate foundations, and oth- the World Bank, most recently as the Bank's lead ers should also help with funding. In addition,lwe adviser on nongovernental organizations and popu- need a new institution or set of institutions to help lar participation. Statement Thrahima Fall Today, despite efforts reacing badk to the estab- to implement that strategy? Unfortunately, the- lishment of the Food and Agriculture Organi- preparatory documents I have been able to study zation of the United Nations in 1945, hunger, are silent on the human rights aspects of the fight malnutrition, and starvation remain a scourge to against hunger. Yet much has been done, and the a significant, and in some areas growing, part of human rights perspective has muchto offer to the the population of our planet This scourge is not goal of overcoming hunger -only one of developing countries Hunger and Is not human rights the very basis of the malnutrition,espeially among children, is ever United Nations work against hunger? In 1941 present and is even increasing, in industrial sod- President Roosevelt announced the objective of a eties. Nor is it a problem purely of economics or future world in which people everywhere would commodity distibution, because many of its enjoyfourbasicfreedoms: freedomof speech and causes are related to human rights, as are many expression, freedom of worship, fteedom from eleements essential to its solution. fear, and freedom from want Those four free- The background papers prpared for this con- domsarereflectedthroughouttheUnitedNlions ference dearly show that new diections, tech- Charter and are encapsulated in the preamble's nques, and methods and renewed political commitment to achieving "social progress and commitnents are required to face the challenge of better standards of life in larger freedom.' This worldhunger. Comprehensive efforts arerequired, objective has provided the framework for all our nationally and internationally, to change the eco- subsequent work in the field of human rights nomic, political, and social factors that contribute spanning some forty-fiveyears. to the maintenance of and increase in hunger and The fight against hunger, malnutritio, and malnutritionL Important future actions include fos- starvation from the human nghts perspective is tering people's partiipation in decisionmaking,. based on everyone's right to -a standard of living reducing inequalities, malkng efforts in favor of adequate for the health and well-being of himself women and the excluded, and establishing inpar- and of his family, including food, clothing, hous- tialandfunctioninglegalsysbtmstoprovidejuridi- ing and medical care," as laid down in the 1948 cal security for property and economic activity. Universal De-caration of Human Rights. Much But what of the human righbt perspective? more precsion is grven to this right by Article 1, What contnrbution can the United Nations sys- paragraph 2, of the 1966 hiternational Covenant tem for the promotion and protection of human on Economic, Social, and Cultural Rights, which rights make to the objectives of this conference, in recognizes "the fundamental right of everyone to particular, to an effective strategy to reduce be free from hunger" and provides for states hunger and generate the political will.necessary party to that treaty to take measures, individually Under-Seaetary Fall was unable to attend the meeting. This paper was distributed at the panel discusson. -236 Fail 237 and through international cooperation, induding Committee considers that it would be specific programs needed: desirable for States parties to take all pos- sible measures to reduce infant mortality (a) To improve methods of production, and to increase life expectancy, especially conservation and distribution of food by in adopting measures to eliminate mal- making full use of tehnical and scientific nutrition and epidemics. knowledge, by disseminating knowledge of the principles of nutition and by There can be no doubt that international law developing or reforming agrarian sys- dearly recognizes the individual's right to ade- tems in such a way as to achieve the most quate food and that states have duties and respon- efficient development and utilization of sibilities to protect that right, but what does the natural resources; (b) Talkig into account right to. adequate food mean, and what are the the problems of both food-importing and ways available to ensure respect for that right? food-exporting countries, to ensure an Centuries of attention by legal experts and politi- equitable distribution of world food sup- cal leaders has given much precision to such con- plies in relation to need: cepts as the ightto a fair trial, although even today we continue to discover new aspects of that right. More than 126 countries have accepted the The right to food has not benefited from this his- Intemational Covenant not only as a proclama- torical attention, but that does not mean it is not a tion of inrdividual rights for their people, but also basic human right. It does mean th-at we have to as a basic principle for state policy. make a sustained effort now to define that right A Alarge number of other international human and to find adequate means to implement it and to rights instruments dealing with such issues as measure the success of that implementatiorL women, discimination, armed conflict, refugees, In the mid-1980s the Norwegian expert Pro- and disaster relief, to name only a few, also expli- fessor Asbjom Eide carried out a study of the right citly recognize the right to food and the specific to adequate food as a human Iight Many of the protection of this right More recently, the 1989 concems, issues, and dilemmas we find in the Convention on the Rights of the Child, now rati- background papers for this conference were also fied by more than 150 states, recognizes chil- reflected in Professor Eide's study. In attempting des right to "a standard of living adequate for to give moreprecisionto the right to adequate food the Child's physical, mental, spiritual, moral and he proposed the following three guiding princi- social development," and provides for assistance ples. First, food must be adequate in terms ofnutri- and support programs for, among other things, tional quantity and quality, it must be safe from nutrition. adverse alien substances, and it must be culturally A final word about the international legal acceptable in the context of prevailing food pat- framework for the right to adequate food. The tems Second, food procurement must be viable, Intemational Covenant on Civil and Political that is, food must be available consistently along Rights recognizes every human being's "inherent with the procurement of other basic human needs right to life" and the Convention on the Rights of and obtaining it must not confi*ct with the need to the Child recognizes that "every child has the respond to other household necessities; Third, inherent right to life. The Human Rights access to food must be sustainable over time, that Committee, the body of independent experts that is, the physical and institutional environment oversees the Covenant on Civil and Political must be optimally used, protected from erosion or Rights, commented on the meaning of the phrase destruction, and restored or replaced as necessary- "inherent right to life": Professor Eide combined these three guiding principles with three levels of national or state The expression "inherent right to life" obligations in relation to the right to adequate cannot properly be understood in a food. The first is the duty to respect States must restrictive manner, and the protection of not interfere with the activities of individuals and this right requires that States adopt posi- groups, especially those based on exisfing food tive measures. In this connection, the pattems, in a way that would defeat their right to 238 Ethical Dimetnsionts ofGlobal Huinger adequate food. Second, states must act to protect the Committee on the Rights of the Child, whose the existing food pattem from distortion, to dynamic approach to its mandate includes th.e ensure food safety, or to counteract influences involvement of intemational organizations in the negatively affecting the existing food culture. committees' discussions of a country's reporr and, Here one th:inks of activities to limit the prona- more important, in considering practical ways and tion of breastmilk substitutes. Third, states must means of responding to a country's needs for assis- take a vanrety of measures to fulfill the rights to tance. This tripartite approach, government-com- adequate food, including correcting negative mittee-intemational development and assistance aspects of existing patterns of food distribution, organizations, grounded in the involvement of incorporating nutritional considerations in devel- nongovernmental organizations (NGOs), could opment activities, providing for national food well provide an imnportant framework for identi¶ security, and ensuring assistance where needed. fying problems and possible solutions and mobi- I believe that these considerations, while gen- lizing assistance where needed. eral in nature, provide a useful framework for These committees deal with countries from all discussion of the right to adequate food from a regions and all levels of development, and pro- human rights perspective. One of the responsi- vide an excellent framework for discussing bilities of the Committee on Economic, Social, hunger and malnutrition problems with coun- and Cultural Rights, a group of ten experts, is to tries that do not receive development assistance, monitor the implementation and respect for the and whose people consequently do not benefit right to adequate food as set out in the from the concern and attention of development International Covenant on Economic, Social, and assistance organizations. The committees base Cultural Rights. To doso it requests specific infor- their methods of work on dialogue and encour- mation from states on a wide range of matters agement to progress wheneverpossible, and over that are also of concern in the background papers time real and substantial results in policy evolu- prepared for the conference, for example, statisti- tion and actual practice can be and are achieved. cal data on the extent of hunger or malnutrition Sadly, certain situations of violations of among such especially vulnerable groups as human rights are of such a serious nature that the landless peasants, marginalized peasants, rural international community through the United workers, rural unemployed, urban unemployed, Nations has set up specific investigation mecha-. urban poor, migrant workers, indigenous peo- nisms -to carry out inquiries and report to the pies, children, elderly people, and other particu- General Assembly or the Commission on Human larly vulnerable groups.The request also asks for Rights. As necessary these reports deal with data on differences between the situation of men questions of hunger and malnutrition. In the late and women. In addition, governments are asked 1970s reports on the Lituation in Chile underlined to indicate measures they consider necessary to the iwnact of governnent policies on nutritional guarantee access to adequate food for each of the standards, and today many of the reports pre- vulnerable or disadvantaged groups and for the sented to the Asssembly and Commission contain worse off areas, and for the full implernentation such information, notably those on the situation of the right to food for both men and women. in the former Yugoslavia. In these situations we The committee reviews this information and must s:eek more direct and immediate means to discusses it with representatives of the concemed come to the aid of those whose right to adequate governments, often at the ministerial level, and food is being deliberately violated. then draws condusions and makes recommenda- Promotingandprotectingtherighttofoodasa tions. These may concen not only the govern- human right forms part of the United Nations ment, but also ir.'ernational organizations because overall effort to protect all human rights, eco- the covenant expressly recognizes international nomic, social, and cultural as well as civil and assistance and cooperation as one of the means for political, and dealing with extreme poverty and achieving respect for the rights it prodaims. exclusion is part of that effort. All are inter-related& Another committee of growing importance for The background studies for this conference show discussing issues of hunger and malnutrition with that participation, NGOs, and the role of women governments and international organizations is are important elements in a strategy to combat Fall 239 hunger. Studies by the Centre for Human Rights roles infighting hunger. They need to know more show, for example, that an impartial legal system about the complex hunger equation, and assis- is crucial to economic development. Here we can tance and development institutions could leam refer to programs designed to train paralegals for more about human rights standards. I would rural areas, whose responsibilities are to help small encourage the organization of a meeting between farmers, peasants, and shop owners defend their the chairs of those two committees and perhaps property, produce, and investments. This has a one or two other committee members specifically measurable effect on economic development. interested in the subject and development and Few, if any, United Nations activities do not assistance experts from relevant institutions, per- contribute to the Charter's human rights objec- haps with the participation of selected NGOs, to tives. Furthermore, respect for human nghts has study the committees' contributions to anti- much to contribute to attaining the objectives of hunger strategy. the United Nations in its other activities. Isolated I also propose that such institutions and action in one domain, as we have seen from our experts be more closely involved with the com- failures and successes, is not viable over the long mittees' consideration of reports, both before they termL are debated,for example, by providing conmments Acting together for common goals is the fun- or needed data, and afterward in the design and damental message of the WorIld Conference on implementation of assistance projects. Human Rights that last June, with the support of I also believe that the secretariats involved more than 170 goverments, adopted the Vienna have much to learn from each other Iwould wel- Declaration and Programme of ActionL This come thesecondmentof selected staff fromfinan- Declaration and Programme of Action called for cial and development institutions to the Centre United Nations bodies, organs, and specialized for Human Rights to share their knowledge and agencies as well as regional organizations and become acquainted with the human rights sys- international and regional finance and develop- tem. Similarly, I would welcome the opportunity ment institutions to work together for the promo- of sending staff from the Centre to such institu- tion and protection of human rights. It called for tions to learn and to provide information, and specific actionragainstdiscrimination; onbehalf of eventually traiung, on human rights. minorities, indigenous people, and migrant Reinforcing policy commitments to eliminate workers for the equal status and human rights of hunger will require the support of the NGO com- women; and for the rights of children and such munity and, in accordance with the call of the vuinerable groups as the extremely poor and Viena Declaration to associate both develop- socially excluded. ment and human rights NGOs more closely with At MVenna, the participants emphasized our work, we could envisage a joint meeting with strengthening the enjoyment of economic, social, grassroots NGOs active in human rights and in and cultural rights and seeking new and addi- development to explore concepts and action. tional ways to promote those rights. Here we The Centre for Human Rights administers a must stress the search for dialogue, the identifim- program of advisory services and technical assis- tion of problems, and the mobilization of assis- tance in the field of human nghts that helps gov- tance where needed over confrontation and emients to establish and strengthen democratic condemnation, while remembering that respect institutions and the structures of human rights for such classic rights as the rule of law and free- and to train and educate those involved in the dom of association are essential for long-term eco- protection of human rights on a national level nomic progress. and in public information and awareness build- I would like to make a number of suggestions ing. Many of the programs' specific activities for strengthening the understanding and cooper- could help address the problems underlying. ationbetweenhumanrightsbodies and organiza- hunger and malnutrition. We would welcome the tions . that deal directly with hunger and possibility of discussing our country programs malnutrition.. The Committee on Economic, with experts fromfinance and development insti-- Social, and Cultural Rights and the Conunittee on tutions to identify areas in which the Centre the Rights of the Child could both increase their might help. Conversely, the Centre's expertise 240 Ethical Dimensions of GlobalHunger could help assistance, finance, and development United Nations maintains a consistent and coher- organizations to identify areas in their programs ent position. Patient efforts over the years have where strengthening human nghts would enabled the United Nations to adopt and interpiet increase their chances of success. a broad range of standards in the field of human -The background papers of this conference rights. These are the standards states have dearly demonstrate the intimate connection accepted and to which they are held accountable between hunger, poverty, and exclusion and It would serve no purpose and would be show the main areas in which respect for human extremely counterproductive for some organiza- rights has an important role to play in corrective tions to develop theirownstandards and for states actions. Should we not look at these together? A to be faced with different criteia depending on well-prepared consultation on the role of devel- which organization they are dealing with. I give opment assistance and respect for human rights primeimportancetoworlcing doselywithallorga- in combating poverty and exclusion that would nizations and institutions to enable the United bring together experts from all fields might be Nations to speak on humanrights with one voice. useful- One result could be to identify types of Tfhe challenges to us all to eliminate hunger human rights assistance that could directy help and malnutrition are serious and difficult, and to solve those problems. success will depend on our combined efforts. I Close cooperation with the Centre for Human wish to take this opportunity to pledge the full Rights, and in particular its expert bodies, is cru- support of the United Nations human rights pro- cial to ensure that on human rights matters the. gram to that objective. Floor Discussion A number of pETfLip4mIs comumeted Jfum the floor, gle over the others, whether meaning to ot not. So then the speakers responded. for many years we have had very welli-meanLing people miaking decisions about whether projects Participant's Comment have failed or succeededl based. on whether the money was lent on time; whether the project First floor participant I work for the National stayed on schedule, as opposed to whether people Wildlife Federationt, which is not a church-based were actually helped; whether thieir quality of life organization. However, we have our own version improvedt whether hungry people had obtained of an ethic, and it cmonerns what happens to land, immuediate help; or whether the project had con- natural resources, and -people, especially futur tributed to long-range preservation of the planet generations. In terms of sustinability it helps to That is the struggle that I see the Bank gohing think in terms of a triagle that covers economic through now: trying to redefine project quality, viability, ecological viability, and social viability, trying to understand how to equalze the thiree Wihthin socilviabilitywe incude alltheissues con- corners of this triangle. However, unless that hap- cernedi with deqmorcy, public participationi, and pens, appropriate development decisions cannot help tDpo people,of which the mostextreme and be made, and all the people who are trying to do the most painftl to,deal with is the question of hun- good are being pushed to do something that is gry people- We do not tieglec-t the social aspect profoundlywrong. This lopsided measure of suc-. because we have the word "wildlife" in our name. cess is a failure of lonig-rnm efficiency. You end up I want to mention the business--as-usual, way degradinig productive resources and losiLng peo- in which decisions have been made for m-any ple's productive capacity- Getting the thiree coDr- years that violates this trianglei of what consti- ners of the triangle back into balance is obviously bites viable developmentIThe predominant part a profoundly ethical questiona of the triangle has been the economic viability part, making profits, rnaldng a project look like it Speaker's Response pays in some traditional way. From our point of view, no developmenit can be sustainble over the Ismail Serageldin: You wfi be happy to know long run if all three parts of the triangle do not that we are coreligionists. In the new Finance & have an equal, value. DeveLopmntn that is coming out in December, I So we have away of thinkingthat appliesto all wrote a lead article with that same equilateral developmenmt problems, in the most extreme cor- tringle, which I also presented at the First kinter- nier of which is hunger- Take an important actor national Conference on Environumentally Sustain- like the Bank, which has to decide how to measurce able Development, which is followed by pieces project quality, and through that poesends up written by leading peoiple in the Bank. So we are emhsiig n of the.three corners of the trian- maiking progress. 241 242 Ethicgl Dimensions of Gloa Hunger Participants' Comments hood disease by pmviding vacdnations. If we are going to discuss politicalrealities, how about a 10 Second floor participant No one should have to percent reduction across the board in military go hungy because of his or her religious orpolit- expenditures? ical affiliations. Whe one reduces it to the grass- roots level, most of the people who are hungry are Particpants' Comments not the ones maling the political decisions. Holding them to the decisions of those above Fourth floor participant I am happy to see that them seems unethicaL Ismail is introducing this ethical dimension, and Iwould like to suggest that next time he writes an Third floor participant I was dtinking of an arti- artide with the triangle he mentioned, he puts a de yesterday by Aleksander Solzhenitsyn on the cirde inside it with "ethics" dearly spelled out so op-ed page of the New York 7rns, which was an that everybody starts talking about fhis issue. excerpt from a speech he gave recently about his I would like to ask a question about the water observations on contemporary Russia. In the problem. Land is no good without wate and we days of central planning and gulags he was one need land and water to produce food Much of of those who brought communist socety to the the world is not endowed with enough water attention of the world and presented the moral The water that evaporates elsewhere because it is arguments against communrisL He has the same hot falls upon us, and we can live weUl and have fears about what he is seeing of the new market a lot of water and a lot of food. mentality cunrently being introduced in Russia, Now here in the United States we have our and argued tiatthe real needs of the latter part of west, which does not have water, and we feel it the twentieth century were to resolve the prob- absolutely natural and normal that we pay taxes lems of hunger and poverty, of planetary sur- and subsidies so that we can all share the same vival, and of war and peace, and that this new quality of life What about people elsewhere in system was not an altemative that would bring the world? We are talking about equity and this about It made me think of Karl Polanyi, who ethics, but what does that mean in terms of soli- around 1945 wrote an essay called Our Obsolete darity and sharing? Should we be thinldng about Market Mentality, whidh was a moral critique of managing waterandlandglobally? Whatkindrof market society and of capitalis. One of the institutions should we envisage? We have to issues we must seriously cnsider is that of the change our vision completely. ethicl nature of a market economy. Is this up for discussion? Fif-FfloorpartidpantLamstruckbythecontrast between the moral imperatives imposed on indi- Speaker's Responlse viduals' consciences, and the moral imperative of political action, whichhas to do with moral oblig- Ismail Serageldin: I do not think that anybody ations or the etlics of social, political actioi. today advocates dLe unfettered free market Eradicating global hunger is certainly a social, approach of throwing the baby outwit the bath and therefore a political, problem. However, wate What we are taldng about is that the ruth- there is a gap between the individual and the less efficiency of the market as an allocative sodal level. I know there is a whole literature on mechanism has got to be tempered by a nurtur- the topic, bitt I submit that we have a problem, mg and caing state. Justice that is not tempered because we have jumped too quicldy from indi- by mercy is not justice. It becomes legalisaLm vidual obligations to social action. I thinkthese are the kinds of things that we do My concern has to do with the ethics of our not have to spend too much time on because we obligation to future generations. There is enough aliprettymuchagee.WhereIamnotsosurethat food today, and as defined by the first speakers, we can easily make a case is in the military area. the etiical problem is the contrast of the hungry. I frequently talk about the level of military expen- ling among plenty. But the moral obligations of ditures around the world For the cost of a single past generat-ons have led to our having plenty, tankwe could save7 million children fom child- yet we are not sure that there will be plenty in the Floor Disussion 243 future unless we take action. I submit that this is ways in which the Catholic Church communi- a moral imperative, taking the necessary action cates with people and knocks at the door of con- so that there will also be plenty in the future. science, be it individual or socaL We are now prepanng a paper on hunger, which will be dis- Sixth floor participant Ethiopia is much affected tributed soon. We are also preparing a paper on by hunger I want an immediate answer; I do not the transfer of funds. When you talked about the care who is in power. What I want is that people price of tanks, I thought about this paper. The get the basic necessities, but thathas not occrred paper is not diectly about where resources go, in my country or inmost of the countries affected butitisacdear statement on the ethics of the trans- by drought or famine. The discussion here is at fer of armaments and weapons, particularly of such a high level for me because I come from an conventional weapons. area where the situation is verybasic WeVhave to Perhaps this discussion on the ethics . of come down to basics. I want to see some action, hunger should have taken place after the confer- such as the promotion of coping mechanisms in ence.Thenthemanyproblems thathave emerged areas where people have some resources and of here, and many others that have not emerged staple food production.. herebutwillbeequallyurgentwouldhavecome out and touched our consciences. Then perhaps Seventh floor participant Much of our discus- we could mneet again sometime and try to spell sion is about how we can get systems to restruc- . out exactly how deep the ethicl dimension of ture themselves so that we can evenhually get at this problem of hunger really is. the problem of hunger; or how we can get the-tri- angle to reshape itsel, or how we can deal with David Becknm: It seems to me tat what really the long-run problems. Because this is an ethical mowtvates inKdviduals so that. eventuaEly they question, what is so wrong with the president of change institutions and structures is generally not the Bank, and maybe the president of this country guilt, shame, outrage, or anger These feelig are and the leaders of a lot of ofther countries, making present and we are guilty. We should be ashamed. a comnitment that one of the first thngs we are We should be outraged. But I am convinced that going to try to do is to make sure that everybody what motivates most of us most powerfully is a IS adequately fed? sense of shalom, a sense of Islai, a love of nature, The tragedy of 1974 is thata nucleus of impor- ajoyinlife, or a sense of conviviality Ican say that tant people did not make the decision to do wS.at te World Bank ought to involve poor people in all they said they were going to do. There is plenty its decisions. But Bread for the World does not of evidence that had we tried to feed all the peo- interaction does not The National Widlife Feder- ple, they would have gone to schooL they would ation does not World Vision does not It is tough have leamed whatlkind of medicine they needed, to involve poor people in all our decisions. and they would have sorted out their develop- So when we look at our own life styles, our * nmentproblenms. own institutional structures, we have all got lots My question is, why can we not, as an ethical of things to feel discouraged about, and I think it point, take the position that in everything we try is this sense of God letting the sun shine on the todo,we will to makesurethatevenifweover- good and evi alike that gives me the capacty to run some systems, everyone has enough to eat? wake up in the morning and say, okay, the sun is shining on me. I did not do what I was supposed Speakers' Responses to do yesterday, but I will try again. I just think that this sense, which motivates us to share our Jorge Mejia: I have been asking myself what an abundance with hungry people, is really crucial. institution like the Roman Catholic Church does And that is the ethos that is most likely to make against hunger. Wetalk a lot, and this is one of the us succeed in getting rid of hunger. ClosingStatement Ismail Serageldin We could spend all evening discussing this sub- of coming to this panel, would consider a com- ject, and there are some here who could speak pliment This person was one of the real exte very eloquently, but who did not tonight ight-wing ideologues who believe that the only Muhammad Yunus will have an occasion to busness at the Bank should be tie promotion of address us in the plenary tomorrow. I see Alan the private sector- When asked what he thought Berg sitting in the back. I have sometimes called about the appointment of Lewis Preston to head him the conscience of the Bank on hunger issues, theWorldBank,thatpersonsaid, "Youknow,this and he has always been quiet but the quiet of the World Bank is a strange place. It doesn't matter wise Ithinkl He did not need to have anyone hold. where the president comes from McNamara his feet to the fire to result in his playing such a came from Defense. Tom Clausen came from the key role in which the World Bank's funding of commercial sector. Barber Conable came from nutrition went from US$20 million or US$30 mil- Congress. Now Lew Preston is coming froom Wall lion a year five or six years ago to some US$680 Street No matter where they come from, within million this last fiscal year It was his strong per- two weeks of landig there, they start talkdng sonalcommitmentandmotivationthatledhiinto aboutpoverty." do so. He is silent here, but I receive electronic I think this quote speaks well of the'inshtu- mail messages from him every night and they tiona I am glad that president after president of keep me going. There are many others here who the Bank has reaffirmed this istitution's goaL are equally committed. Second, I think thatwhat we all are seeking in Iwouldliketoendontwonotes.First,Idonot this conference and the spirt that we must take feel that the Bank is somehow inherently insensi- from tonight and the next two days is perhaps tive to global hunger or incapable of addressing best summed up in the famous words of Robert it. My career in the Bank speaks to the fact that I Kennedy. "There are those who look at the world did not suffer too much from my coniitment to as it is and ask 'why? while others look at the end poverty and hmger I cite a complaint about world as it could be and ask 'why not?'" We the Bank that came from a source whom I think should all be looking at the wodd as it could be mostpeople in this room,justbythe self-selection and asking why not 244 Dist,ibutors of World Bank Publications A.RGENTINA ECYFE, ARAB REPUBUC OF KENYA SAUDI ARABIA, QATARI Carlo.Hrsc SRL AlAlrAn Afica BookService (!A.) Ltd. JarirBookStore GCariaGuses AlGaSa Qmran HousMhf noSreet P.OBo:3196 FIorida16S,4th F1o1r-Oft4S3/465 Caro PD. Box45245 Edh 1171 1333 Buenas Aires Nairobi TIetAiddleEstObserver SINGAPORILTAIWAN, Ofidnadel brolserlnadonal 41,5hre(tSeut KOREA, REPUBLCOF MYANMAR,BRUNEI Alb=U4O Cahiro Pan rea Book Corporstin GowerAsis Padic Pte Ltd IOU BuenosAires P.D. Box 11 Kw a-gwhmn GldlenWherl Building FINAND Seoul 42 Kallang Pudding, I-D3 AU1STRALA,6 PAPUA NEW GUINEA. Akateemnndnrjauppe Singapare 2334 FUlLSOLOMONISLANDSI P.O.Boxm 1orean StockBook Centre VANUATU.AND WESTERNSAMOA SF-W10L HElsmnld 1 PDO B34 S0UTH AFRICA,UOTSWANA D.A I fnlatlun Servkes Yeoeido F- rsigfk li&r 648WhitdwhseRed FRANCE Seoul OxfordUhiversityPness MkldbamS3IS WlddBarPuablikaios .SoatbnAta Vicia 66,avenuedbIna MALAYSIA PD0 Bor 1141 75116Paris University ofMalaya Coopetive CapeTown 0 AUSTRIA Bohpliiked GedandICo. GERMAN P o I=Ja27.mPannFit Bam Fr .iL Graben3L31 UNO-VcIag 5970 Ka Lumnpur mntionalSabeaipSe A-lOllWien PeppusdocferAlleeS. PflBsc4109S -31-UssOz MEXCO Craighall BANGLADESH 'NICTEC J-han-es'urg2V4 Microirdusahieaflnelopnent GREECE Apartado Festul l-860 A..iasanSci5ety (MdDAS) - apasotirions.A. 14060D alpaMhindcoD.F. SPAIN HouseS,RoadI6 35,Stoumira Str. . idT.ibms,SA- DhRamondiK/Areas -106 ZAN Re Cllo HONG KONG, MACAO P.oGBox2M BIELGIUM Asia: ZIDL 7480 AEHaa;b _:gen Larrl IntemDSrLOUIAEDOS JeanDe Lanoy 4643 Wj)mdhaSlet Co-anseldeCent,391 Av.du ftoi20 WinnigCetre NEWZELAND 0009 Barceln 1060 Brussels 7th Floor ESSCONZ LIE Cral Homg Kog PrivaleMail BagSS9I4 SRI LANIA AND THEMALDIVES BRAZIL NewUMWiet Lake House Bookahap PublimcoesTecricslrnaios isL HUNGARY Auddand PD.BomZ14 RuaPfeiX10Gomide,209 FodabonfbrMadketEmsy IC00,SrChittampalamA. 01409 Sao Paulo, SP EoanbovafiUt17-19 NIGERIA GardinrMawatha H-U17Budapest UniversityPras Limited -C:o. nbo2 CANADA Mree Crowns BuildingJercho I.e Diffuser INDLA PrivateMalBagSOS SWDEN ISIABouL de Motng Allied Putbslhrs PrivateLtdL Ihadan For singie tis Boudll,Qy&ec 751 btaunt Roa FdtzsFadb&sbreageut J4B5E6 Madras -600002 NORWAY Rgagpatan2.Bo 16356 - - NarvusenInaeuliommC r S-llB27Stacholm hPb1ishingCO. INDONESIA Book Departent 1294 Apuga Road PtJIndira limited P.O. Bok 6125Eterstad ForsIESao CIwas otwaO ntario Jalanliorbud=r20 N-0020sb6 WennsWentWllliamsAu KICl3WB P.O.box 181 P.O. Boxi1 Jakar 120 ' PAKISTAN 5--17125Sol CHINA ..MialBoocAgency China Ftnmdal#rlcEcaanoic IRAN 65.ShahrhheQuaid-e-Azm SWiTZERLAND PublshingHouse Iowiab Publshers PD- Box No-729 Fwsingfr titkcs , Da ra Si DOngjie P-O Bm 19575511 LahreS40 Libririe Payot Beijng Teban Case postae321z2 PERU CH1I0 Lausaoe COLOMBIA IRELAND Editorial Desanolo SA bnuunace Ltda. GovernentSuppli-Agenry Apartado3824 hrsx * La ApaxtadoAeeo34270 4-5 H t Road ns a1 Librairie Pfyet Bogota Dy. Dublin2 Service desAbommenms PIIILIPPIES - Casepostale3312 COTEDlIVOIRE ISRAEL hTnensionallookCuenr CH 1002 Lausame Cente d'Edou et de Diffuson YeomotLiteratue Ltd. Suite DM,Cityland 10 Afriines (CEDA) P.Otlm56055 CondomXnhim Towerl THALAND 04 B2P. 541 Tel Aviv 61560 Ayala Avenue, IL.V duba Centrl DepamuntStore Abidjman04Plateau Costa Extension 306 Silos Road -rrALY MalMti Metro Mania Bagkok CYPRUS Lcossa Commisonaia Samoni SPA Center of Applied Rearch Via Duca Di Caabu1ia. 1/1 POLAND TRINIDAD &TOBAGO Cypu Cdlge Casella Pste 55Z ntemanal Publhing Sevice Systematcs Studie Unit 6,Diogenes Street. Engosi 50125 Peuze UI-Piew3l/37 #9 Watts Skeet P.O. Dx2006 00-- -Warszaw Curpe Iicosia JAMAICA TdrnidadWestlndies [an Randle PubUshert FL4ts DENMARK 206014lHopeRoad IPSJounas UNTEDCINGDOM Samkuud*Ukterar Klangston6 UL Clrezaa3 Mdicrunif LI. Rosenoern AIn 1 09SWasaw P.O. Dm3 DEK-1 rederlisbergC IAPAN Alton, HampshireGU342FG Eaitern Book Service PORTUGAL England DOMINICANREPUBLIC Hongo34home. Bonkyo-laz 113 Livearia Portugal EditoraTaler.C porA. Tokyo Rua Do Carmo70-74 ZIMBAJWE Restauradcn e Ibed la Catdr 309 1200 Lisbon tngman=Zmbabwe(Pvj)LdL Apartado deConeus 2190-1- Toudc Road, Adbeanie Santo ngo Pfl BoDr SF 125 - - ' - ~~~~~~~~~~~~~~~~~~~~~~~~Harame. . . . . . .~~~~~~~~~~~~~S,dfo . .~~~~Bu The World Bank Headquarters 1818 H Street N.W. Washington, D.C 20433, U.SA Telephone: (202) 477-1234 Fam (2021 477-6391 Telee MCI 64145 WORLDBANK MCI 248423 WORLDBANK Cable: Address: INTBAFRAD WASHINGTONDC European Office 66, avenue d'ilna 75116 Paris, France Telephone: (1) 40-6930.00 FacsimileI (1) 40-69 30.66 Telet 640651 Tokyo Office Kokusai Building I-l, Marunoucli 3-chome Chiyoda-ku, Tokyo 100, Japan Telephone (313214-5001 Facsimile: (31 3214-3657 Telet 26838 ISBN 0-8213-2883-2