"Hunger weakens immune systems, increases vulnerability to disease, and creates a platform for disability," said Jordan Dey, director of the U.S. Relations Office at the World Food Programme (WFP), at an event co-sponsored by the Wilson Center's Global Health Initiative and the Environmental Change and Security Program on October 16, 2006. In honor of World Food Day, the speakers acknowledged the 852 million people worldwide who are undernourished—more than 500 million in Asia, 203 million in Sub-Saharan Africa, and 52 million in Latin America, according to the WFP. "Hunger is the greatest public health problem in the world and it underpins—or undermines—a nation's development," said Dey. Yet, he stressed, "The causes of hunger are predictable, preventable, and can be resolved through affordable means."
The majority of the world's undernourished people are not living in natural disasters or conflict settings, but in chronic poverty. They are the people who are "never quite getting enough to eat," according to Dey. Over the last 10 years, aid agencies have resorted to a "firefighting" approach to meet immediate food shortages, rather than investing in multi-year agriculture and health programs that could promote sustainability, said William Noble, director of the Food for Development Program at Africare: "To improve food security, [we] must concurrently address several concerns. The objective is obviously not just to grow more food." Africare stresses a long-term, sustainable approach to increasing access to food: the process is "not something that can be done in six months and it's not something that can be done in five years," said Noble. Part of creating sustainable access to food, he noted, requires growing more nutritious food for vulnerable populations, increasing the amount of time food can be stored after harvest, and creating efficient agriculture markets that would allow people to buy food when it becomes scarce.
Noble also emphasized the need to build local capacity while directly addressing the risk of unforeseen shocks and the special needs of HIV-affected households. "Africans can make a positive contribution to their own food security with minimal outside resources," he said. Similarly, Dey noted that many immediate causes of malnourishment can be addressed through practical means: breastfeeding, micronutrient supplements, clean water and adequate sanitation, hand washing with soap, and deworming are all ways to prevent malnourishment.
Suneetha Kadiyala, a scientist at the International Food Policy Research Institute, argued that food insecurity—a situation in which people cannot get enough food to lead fully productive lives—increases the risk of exposure to HIV/AIDS through factors such as increased migration and transactional sex. Conversely, she said, HIV/AIDS can exacerbate food and nutrition insecurity: HIV/AIDS-related illness and the diversion of resources to AIDS treatment result in labor and capital shortages that threaten food supply. Additionally, AIDS deaths degrade formal and informal rural organizations, leading to a loss of farming knowledge.
In food-scarce areas, HIV-positive individuals are more susceptible to malnutrition, as HIV raises energy requirements by 10-30 percent in adults. Of the 25 countries with the highest prevalence of HIV/AIDS, 21 are receiving assistance from the WFP. Kadiyala noted that malnutrition is not only associated with a decrease in immune function, it also compromises effectiveness and increases toxicity of anti-retrovirals. Due to the strong connections between the prevalence of the virus and malnutrition, Dey said that food security should be a priority for donor organizations, specifically those with large AIDS funding arms. The 2007 budget for the President's Emergency Plan for AIDS Relief (PEPFAR), for example, exceeds $4 billion, some of which Dey believes should be rerouted to improving nutrition: "There is a growing body of literature that indicates nutritional support is a vital part of a comprehensive response to HIV/AIDS."
One attendee pointed out that USAID's nutrition and agriculture budgets were already miniscule compared to the AIDS budget, and asked, "How do we keep our food aid from being poured into the HIV/AIDS problem?" Kadiyala called for HIV programs to dedicate more effort to nutrition and food programs to prevent the unnecessary spread of the virus. Supporting her point, Dey invoked Dr. Paul Farmer's observation that providing medicine without also providing food is like washing your hands and then drying them in the dirt.
Drafted by Julie Doherty.