© 2006 thomson-wadsworth chapter 13 world hunger and food insecurity: challenges and opportunities

© 2006 Thomson-Wadsworth

Chapter 13

World Hunger and Food Insecurity:

Challenges and Opportunities


Learning Objectives

• Describe the current status of world food insecurity.

• List causes of world food insecurity. • Give reasons why women and children

are particularly at risk with regard to hunger.

• Describe the purpose and goals of recent international food policy initiatives.


Learning Objectives

• Describe the global public health issues related to world food insecurity that will continue to challenge policy makers and program designers in the twenty-first century.

• List actions that individuals might take to eliminate world food insecurity.


Introduction

• Some 2 billion people, mostly children and women, are deficient in one or more of these three major micronutrients: – Iron– Iodine– Vitamin A


Mapping Poverty and Undernutrition

• The Food and Agriculture Organization estimates that 18% of the developing world’s population suffers from chronic, severe undernutrition.

• Food insecurity is recognized as a problem of poverty with the present estimate of 1.2 billion people living in poverty.


Distribution of the Chronically Undernourished, 2000-2002


Malnutrition and Health Worldwide

• Nearly 30% of the world’s population experience some form of malnutrition.

• Worldwide, about 40,000 to 50,000 people die each day as a result of undernutrition.

• Worldwide life expectancy averages about 63 years.


Causes of Child Mortality, 2005


The vicious circle of malnutrition

Number of malnourished children (in millions)



• Protein-energy malnutrition (PEM) is the most widespread form of malnutrition in the world today.– Children who are thin for their height

may be suffering from acute PEM.– Children who are short for their age

may be suffering from chronic PEM.


Malnutrition and Health Worldwide – PEM

• PEM includes the classifications of kwashiorkor and marasmus.– Kwashiorkor is a protein deficiency

disease.– Marasmus is a deficiency disease

caused by inadequate food intake.


Malnutrition and Health Worldwide – PEM

• Children suffering from PEM are likely to develop infections, nutrient deficiencies, and diarrhea.



• Worldwide, three nutrient deficiencies are of particular concern:– Vitamin A deficiency is the world’s most

common cause of preventable child blindness and vision impairment.

– Iron deficiency is associated with decreased cognitive abilities and resistance to disease.

– Iodine deficiency is the major preventable cause of mental retardation worldwide.



• Effects of Malnutrition on Those Most Vulnerable– When nutrient needs are high (as in

times of rapid growth) the risk of undernutrition increases.

– Pregnant and lactating women, infants, and children are the first to show signs of undernutrition.



• Effects of Malnutrition on Those Most Vulnerable (continued)– Birthweight is a potent indicator of an

infant’s future health status. – Low birthweight (less than 5.5 pounds or

2,500 grams) contributes to more than half of the deaths of children under the age of 5.

– UNICEF regards the under-5 mortality rate (U5MR) as the single best indicator of children’s overall health and well-being.



• The Economic Burden of Malnutrition and Hunger– The burden of hunger includes both

direct...• maternal complications in pregnancy• poor health of babies• malnourished children

– ...and indirect costs.• lost productivity and income


Impact of Malnutrition on Productivity & Earnings


Food Insecurity in Developing Countries

• World hunger has several dimensions and is a problem of:– Supply and demand– Inappropriate technology– Environmental abuse– Demographic distribution– Unequal access to resources– Extremes in dietary patterns– Unjust economic systems



• The Role of Colonialism– The colonial era led to hunger and

malnutrition for millions of people in developing countries when European nations colonized the African continent largely to gain a source of raw materials for industrial use.



• The Role of Colonialism (continued)– This era was used to move minerals, metals,

cash crops, and wealth to Europe.– The era provided few opportunities for

education, disrupted traditional family structures and community organization, and greatly diminished the ability of the people to produce their own food.



• International Trade and Debt– Developing countries have seen the

prices of imported fuels and manufactured items rise faster than the prices they receive for their export goods on the international market.

– This has pushed developing countries into accelerating international debt.



• The Role of Multinational Corporations– Multinational corporations hire

indigenous people for below-subsistence wages to grow crops to be exported for profit.

– Leave very little fertile land where local farmers can grow food.



• The Role of Multinational Corporations (continued)– Natural resources are diverted from

producing food for domestic consumption to producing luxury crops for those who can afford them.

– Multinationals also contribute to hunger through their marketing techniques when they advertise cola beverages, snack foods, and infant formulas that are associated with Western culture and prosperity.



• The Role of Overpopulation– When people’s standard of living rises

the death rate falls.– In time, the birth rate also falls.



• The Role of Overpopulation (continued)– As the standard of living improves, the

family earns sufficient income to risk having small numbers of children.

• A family depends on children to cultivate the land, secure food and water, and provide for adults in their old age.

• Under conditions of poverty, parents choose to have many children to ensure that some will survive to adulthood.



• Distribution of Resources– Developing nations must be allowed to

increase their agricultural productivity and they must gain access to five things simultaneously:

• Land• Capital• Water• Technology• Knowledge



• Agricultural Technology– Governments can learn from recent history

the importance of developing local agricultural technology.

– The green revolution - the package of modern agricultural technology delivered to developing countries.

• Demonstrated both the potential for increased grain production in Asia and the necessity of considering local conditions.



• Agricultural Technology (continued)– Labor-intensive, rather than energy-

intensive, agricultural methods are more appropriate for most developing countries.


Risks vs. Benefits: The Debate over Genetically Modified (GM) Crops

• Potential Benefits– Increased nutritional value of staple

foods– Reduced environmental impact– Increased fish yield– Increased nutrient absorption by

livestock– Tolerance of poor environmental

conditions



• Potential Risks– Inadequate controls– Transfer of allergens– Unpredictability– Undesired gene movement– Environmental hazards



• A Need for Sustainable Development– Governments need to encourage and

support efforts at sustainable development.– Sustainable development - the

successful management of agricultural resources to satisfy changing human needs while maintaining or enhancing the natural resource base and avoiding environmental degradation.


People-Centered Development

• Development: – Enables people to meet their essential

needs– Extends beyond food aid and emergency

relief– Reverses the process of impoverishment– Enhances democracy– Makes possible a balance between

populations and resources


People-Centered Development

• Nutrition and Development– The United Nations views a healthy

nutritious diet as a basic human right.– Nutrition and health are now seen as

tools of economic development as well as goals.


Agenda for Action

• Focus on children• Make the world fit for children• Focus on women


Focus on Children

• Children are the group most strongly affected by poverty, malnutrition, and food insecurity.

• GOBI is a child survival plan set forth by UNICEF.– GOBI - an acronym that stands for growth

charts, oral rehydration therapy, breast milk and immunization.

• GOBI has made outstanding progress in cutting the number of hunger-related child deaths.


Focus on Children

• Growth Monitoring• Oral Rehydration Therapy (ORT)

– Consists of salt, sodium bicarbonate, potassium chloride, and sugar in boiled water.

– Prevents an estimated one million dehydration deaths each year.


Focus on Children

• Promotion of Breastfeeding– Until the middle of the twentieth

century, most babies were breastfed for their first year of life.

– Today only about half of all infants are exclusively breastfed to the age of four months.


Focus on Children – Breastfeeding Promotion

• A number of factors have contributed to the decrease in breastfeeding in developing countries:– Aggressive promotion and sale of infant

formula.– Encouragement of bottle-feeding by health

care practitioners.– Global pattern of urbanization and

accompanying loss of cultural ties supporting breastfeeding.

– More women working outside the home.



• The Baby-Friendly Hospital Initiative has fostered an increased awareness of the importance of breastfeeding worldwide.



• Replacing breast milk with infant formula may lead to infant undernutrition in developing countries for several reasons:– Breast milk is sterile and contains

antibodies that enhance an infant’s resistance to disease.



• Formula and undernutrition (cont.):– Formula in bottles, in the absence of safe

drinking water, sterilization and refrigeration, is an ideal breeding ground for bacteria.

– Feeding infants with formula prepared with contaminated water causes infections leading to diarrhea, dehydration, and failure to absorb nutrients.


Focus on Children

• Timely and Appropriate Complementary Feeding– The weaning period is one of the most

dangerous times for children in developing countries because infants may receive nutrient-poor diluted cereals or starch root crops.

– The most promising weaning foods are usually concentrated mixtures of grain and locally available pulses that are both nourishing and inexpensive.


Focus on Children

• Immunizations– Although current immunizations could

prevent most of the 2 million deaths each year, adequate protein nutrition is necessary for vaccinations.


Making the World Fit for Children

• UNICEF’s goals for nutrition and food security include the following: – A 50% reduction in the 1990 levels of

moderate to severe malnutrition among children under 5.

– A 50% reduction in the 1990 levels of low-birthweight infants.

– The virtual elimination of blindness and other consequences of vitamin A deficiency.


Making the World Fit for Children

• Progress Toward Meeting the World Summit for Children Goals– The number of malnourished children

in developing world declined from around 174 million in the early 1990s to 150 million today.


Focus on Women

• Women are more susceptible than men to food insecurity and undernutrition for a number of reasons.– Women have increased nutrient needs

during their childbearing years.– Women are responsible for the physical labor

required to procure food for their families.– Women may feed their husbands, children,

and other family members first.– Social beliefs may also limit women’s food

intakes.


Focus on Women

• Any solution to the problems of poverty and hunger is incomplete and hopeless if it fails to address the role of women in developing countries.

• Women’s nutrition during pregnancy and lactation determines the future health of their children.


International Nutrition Programs

• In developing countries, emphasis has been placed on four types of nutrition interventions:– Breastfeeding promotion programs.– Nutrition education programs.– Food fortification and/or the distribution of

nutrient supplements.– Special feeding programs designed to

provide vulnerable groups with nutritious supplemental foods.


International Nutrition Programs

• In many countries, there is mounting evidence of grass roots progress in improving agricultural, water, education, and health services, especially for children.


Looking Ahead: The Global Challenges

• We must face many new challenges if we are to meet the World Health Organization’s social target of “health for all in the 21st century.”

• Some of these challenges include:– The pandemic of HIV/AIDS.– An upsurge in cases of tuberculosis in the U.S.– The trend towards urbanization.– Rapid population growth.– Destruction of the global environment.


Personal Action: Opportunity Knocks

• Many individuals and groups are working to improve the future well-being of the world and its people through a number of national and international organizations.


Personal Action: Opportunity Knocks

• Individuals can do the following:– Work with others who have similar interests.– Follow current hunger-related legislation.– Call for change by writing and calling local

and national political representatives and expressing concerns about hunger-related issues.

– Support the overseas work of churches and synagogues to feed the hungry and support these efforts with monetary contributions.


Vitamin A Field Support Projects

• Micronutrient Operational Strategies and Technologies (MOST) project– $45 million program administered by

USAID for the promotion of activities designed to improve the micronutrient status of at-risk populations throughout the world, especially for vitamin A



• Dietary Diversification– MOST strategies include stimulating

the production and consumption of vitamin A–rich foods through: • Agricultural production• Home gardening• Food preservation• Nutrition education• Social marketing



• Food Fortification– Generally a large-scale undertaking– Effective only if the target groups can buy

and will consume the fortified product– Sugar is fortified with the vitamin in several

regions of Central America– Pilot trials with vitamin A–fortified rice are

under way in Brazil– Pilot program in the Philippines is currently

testing vitamin A–fortified margarine



• Distribution of Vitamin A Supplements– Most commonly, VAD intervention

programs periodically distribute high-dose capsules or oral dispensers



• Distribution of Supplements (continued)– Vitamin A supplementation programs have

reported a number of operational obstacles: • Low priority given to distribution of the

supplements by primary health care workers• Lack of community demand for vitamin A• Lack of awareness among policy makers of the

critical nature of vitamin A nutritional status

– Considered a temporary measure

© 2006 thomson-wadsworth chapter 13 world hunger and food insecurity: challenges and opportunities

Documents

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health worldwide pem

chronic pem

acute pem