Executive Summary

In the wake of the global food price crisis of 2008, a broad-based coalition of non-governmental organizations, advocacy groups, and faith-based organizations developed a document entitled the Roadmap to End Global Hunger that was endorsed by more than 40 organizations and became the basis for legislation introduced in the House of Representatives (H.R. 2817).  The Roadmap presented a vision for a comprehensive and integrated US strategy to increase global food security, including suggested levels of financial support for emergency, safety net, nutrition and agricultural development programs over 5 years. 

The Roadmap for Continued US Leadership to End Global Hunger reviews progress over the last three years toward the goals set out in the original Roadmap, and offers recommendations to ensure continued effectiveness of US global food security programs.

Why Address Global Hunger and Malnutrition?

Hunger remains one of the world's most pressing challenges, with almost a billion people — or one in seven worldwide — suffering chronic hunger.  In addition, each year up to 100 million more people may face acute hunger brought on by natural disasters and conflicts.  Women and children are disproportionately affected by hunger and malnutrition.  With population growth placing a strain on a limited natural resource base, and changing weather patterns creating more droughts and floods, feeding the world of the future presents a serious challenge.

Addressing hunger and malnutrition is the right thing to do. For decades, the US has been the moral leader around the globe in responding to humanitarian crises and development needs in order to make a difference in the lives of our world’s most vulnerable people.  These investments generate significant good will.

Addressing hunger and malnutrition is a smart investment.  Investments in nutrition programs can bring returns on investment as high as 138 to 1.  By contrast, malnutrition costs individuals up to 10 percent of lifetime earnings and may cost countries up to 11 percent of their gross domestic product in lost productivity.  Reducing hunger and increasing the economic well-being of people in the developing world — where 95 percent of consumers live — helps to create more prosperous and stable markets for US goods and services.

Addressing hunger and malnutrition is critical to national and global security.  In the wake of the food price spikes in 2008-2009, riots broke out in almost 40 countries around the world.  Volatile food prices and compromised access to food have led to social unrest, particularly in global security hotspots such as the Middle East and North Africa. It is critical to both our national and global security that the international community helps developing countries better manage destabilizing events like volatile food prices and natural disasters. 

 

The American people support smart investments in alleviating hunger and malnutrition.  Public opinion polls show consistent support from the vast majority of people in the US for programs to end hunger and assist poor people around the world in their efforts to reach self-sufficiency.

 

Progress in US Programs to Alleviate Global Hunger and Malnutrition: 2009 – present

 

Over the last three years, the US has demonstrated strong leadership, leveraging the support of the international community, host country governments, international organizations, civil society and the private sector for efforts to strengthen food security worldwide.  Emergency response has been improved through better early warning systems, more efficient supply chains, expanded pre-positioning of food, and enhanced nutritional quality of food aid.  In addition, the US has greatly expanded the use of local and regional procurement (LRP) in both emergency and development programs, increasing the efficiency and effectiveness of food assistance programs.  There has been tremendous progress on identifying the most critical nutrition interventions, with the US actively participating in efforts to generate the increased political will required to improve nutrition — particularly through the 1,000 Days Partnership and through active participation in the Scaling Up Nutrition (SUN) movement.  Finally, the US has catalyzed international investment in agricultural development, ensuring development of country-owned plans to spur agricultural development, particularly in Africa.  Within all of these programs there is increased recognition of the need to focus food security programs on the important goal of building the resilience of communities to withstand shocks and to build stable, self-sufficient livelihoods.

Recommendations

To continue to build upon this dramatic progress in US programs to address global hunger and malnutrition:

1.  The US should invest $5 billion annually in emergency, safety net, nutrition and agricultural development programs.  This investment constitutes just over one tenth of one percent of the US budget, yet would support increased food security for hundreds of millions of people worldwide.

2.  The US should ensure coordination and integration of food security programs by appointing a Global Food Security Coordinator responsible for overseeing development and implementation of the government-wide global food security strategy, with corresponding budget authority over all global food security programs.

3.  The US should increase support for programs that build resilience to shocks by making dedicated Development Assistance (DA) funding available to be jointly programmed by USG staff (including staff of all relevant USAID Bureaus, USDA, and other operational agencies) in countries at high risk of suffering crises.

4.  The US should support effective safety net programs and build the capacity of host governments to develop and deploy their own national safety net systems.

5.  The US should strengthen and institutionalize the focus on nutrition across all programs by establishing a high-level focal point for global nutrition as required of all SUN movement countries, defining the nutrition budget across initiatives and accounts, and developing a global nutrition strategy.

6.  The US should strengthen country-led development planning processes by increasing engagement of stakeholders, assisting governments in overcoming legal and policy constraints, and making criteria for selection of the countries and regions targeted more clear and transparent.

 

Hunger and Malnutrition: A Pressing Global Challenge

More than 925 million people suffer from chronic hunger worldwide.[1]  That's roughly one in seven people who go to bed hungry each night.  Despite progress in reducing the overall proportion of people affected by hunger from 20 percent of the world's population in 1990 to 16 percent by 2007, the overall number of hungry people continues to climb.[2]  High and volatile food prices have eroded the ability of poor households to buy adequate food and are threatening to drive millions of more people into hunger.  Malnutrition contributes to more than one-third of all child deaths — about three million each year.[3]  Virtually all of these deaths are preventable.  Hunger and malnutrition also have disproportionate effects on women and girls, who are often more economically, socially and physically vulnerable to food insecurity.  

The challenge of reducing hunger and malnutrition is only going to get tougher.  To feed an expected world population of more than nine billion people by 2050, agricultural output will have to increase by an estimated 60 percent.[4]  And this increased production must come while preserving the natural environment and adapting to changing climatic conditions that are expected to make some parts of the world too dry, others too wet, and many more prone to extreme weather events.  Shifting rainfall patterns and increasingly unpredictable seasons will challenge smallholder farmers’ ability to plan and reap a sufficient harvest.[5]  Oil prices are increasingly driving food prices.[6]  Demand is growing, the climate is changing, and the era of high and volatile food prices is expected to continue.[7]

Because there are compelling moral, economic and security reasons for funding global programs to fight hunger, US polls have consistently shown that the vast majority of people in the US favor doing so.  A 2010 public opinion survey by the Chicago Council on Global Affairs found that 74 percent of Americans support programs that offer food assistance to vulnerable people and help farmers in needy countries become more productive.  Likewise, the 2009 Alliance to End Hunger poll found that 69 percent of Americans agree that addressing problems like disease, hunger and lack of economic opportunity in the world's poorest countries can increase political stability around the world.

The Roadmap to End Global Hunger: Original Recommendations for Alleviating Global Hunger

The Roadmap to End Global Hunger — launched in February 2009 by a group of over 40 US non-governmental organizations, advocacy groups, and faith-based organizations —called upon the US government to develop a comprehensive, integrated response to global hunger.

Based upon the historical and strong bipartisan support in the US for efforts to address global hunger,[8] the Roadmap presented: 1) a set of overarching principles to guide US activities; 2) a detailed explanation of the elements of a comprehensive approach, which includes emergency, safety net, nutrition and agricultural development programs as integral building blocks for global food security; and 3) an overarching institutional framework to ensure coordination and integration of these programs.

Guiding Principles

Drawing on a series of studies, including reports by the US Government Accountability Office (GAO), the Roadmap called for the development of a comprehensive strategy to ensure that US support for global food security efforts reflects a balance between short-term emergency and longer-term development needs.  The Roadmap argued that to be effective, this strategy needed to be:

• Comprehensive: Inclusive of the broad range of activities required to combat global hunger, ensuring that gender and natural resource management principles are integrated throughout efforts;
• Balanced and flexible: Allowing emergency programs to continue to meet global needs, while increasing investments in longer-term development in order to build resilience to future shocks, helping to break the cycle of hunger;
• Sustainable: Increasing the capacity of people and governments around the world to feed themselves and be resilient in the face of hunger related shocks;
• Accountable: Grounded in clear targets, benchmarks and indicators of success;
• Multilateral: Able to incentivize robust contributions from other donor nations, and to encourage continued coordination through existing multilateral institutions such as the UN, World Bank and others.

A Comprehensive Approach to Addressing Global Hunger

Decades of research and action on global hunger and malnutrition have shown that there is no “silver bullet” for addressing this problem.  Rather, a comprehensive approach is required to build long-term food security.  For people to be food secure, adequate food must be available, households must be able to access sufficient food, the food must provide for their caloric and nutritional needs, and the system as a whole must continue to function despite economic shocks, conflicts, disasters and other disruptions.  By definition, people who are food secure are those who do not suffer from hunger and malnutrition.  Because hunger is a multifaceted problem, a broad range of programs must be effectively integrated to adequately address needs. 

Emergency programs are needed to address acute hunger following civil conflicts, natural disasters, and other types of crises to ensure short-term food security and to lay the groundwork for more rapid recovery.  To be effective, emergency food assistance programs must also incorporate best practices in the field of nutrition in order to guarantee that the right food is reaching the right people at the right time.[9]  For example, it is critical to understand the differential impacts of emergencies on girls and women — who are often at higher risk of malnutrition — as well as on men and boys. 

As with acute needs, combating chronic hunger requires an integrated approach that includes safety net programs and systems, nutrition programs and agricultural development programs focused on poor and food insecure people. The most effective food security programs combine these approaches to address the underlying causes of hunger. National safety net systems have proven highly effective at reducing chronic hunger.  Safety net programs like school feeding and food or cash for work programs have also generated strong positive impacts.

Over the longer term, agricultural development must be sustainable and resilient, protecting the natural environment on which productivity depends and ensuring the capacity of farmers and food systems to plan for variability in climatic conditions.  While agricultural development is essential to increasing the availability of food, if people are not able to equitably access the food produced — or if the food does not meet their nutritional needs — then increased production alone may not contribute to reductions in hunger and malnutrition. 

A comprehensive approach ensures that US assistance is as effective as possible at meeting the needs of all vulnerable people, as well as increasing the impact of interventions.  Expertise and experience drawn from civil society, including the business community, is essential to building strong comprehensive programs.

 

For this reason, the Roadmap suggested a comprehensive strategy, based upon four main categories of programs that are needed to guarantee food security: emergency response and management; safety nets; nutrition; and agricultural development.

Emergency Programs

Effective emergency response involves getting the right assistance — both food and nonfood — to the right people at the right time in order to save lives.  This requires strong early warning systems, effective and gender-sensitive mapping of vulnerabilities, advanced capacity for conducting rapid assessments and food assistance mechanisms that allow an appropriate mix of commodity and cash-based interventions with broad support of the international community. 

Emergency programs are essential for meeting basic human needs during times of crisis, when host governments are stretched beyond existing capacity.  For example, after the January 2010 earthquake in Haiti, emergency programs supported by the international community provided food to those in need at a time when the Haitian government had little capacity to assist the population.  The same has been true in many other countries, including countries vital to US national security like Pakistan, which has suffered massive floods for the past several years.  These crises are also caused by civil conflicts — like those in Sudan, Cote d'Ivoire, Somalia, and a host of other nations — which can provoke mass population displacements, disrupt agricultural production and cause food shortages for vulnerable people.  Emergency programs are vital to stabilizing countries in the wake of crisis. 

Throughout the last several decades, increases in extreme weather events and conflicts have placed millions more people at risk of acute hunger due to emergencies.  The historic trend in the reported number of natural disasters shows a consistent increase, with between 100 and 200 natural disasters reported each year during the 1980s, between 200 and 300 during the 1990s, and more than 350 natural disasters reported each year from 2000 to the present. ^[10]  Conflicts across the globe have led to dramatic increases in the total number of internally displaced peoples (IDPs), which rose from 17.4 million in 1997 to 27.5 million in 2011.  In addition, the number of refugees is at a 15-year high, with 80 percent of refugees now located in developing countries that are ill-equipped to meet refugee needs.[11]  In the last several years alone, crises affecting 13 million people in the Horn of Africa, 5.5 million in the Sahel,  and 3 million in Pakistan confirm a strong upward trend.  The estimated cost to address emergency food assistance needs rose from under $4.2 billion in 2005 to $6.8 billion in 2010.[12]

Safety Net Programs and Systems

Safety nets limit or mitigate the impact of shocks on vulnerable populations by effectively meeting the basic needs of chronically hungry and poor people, thereby reducing reliance on more costly emergency interventions.  Safety nets help hungry, poor people to maintain access to food and other assets to protect their livelihoods and to prevent them from falling more deeply into poverty, sustaining development gains during times of crisis.  Effective national safety net systems, such as Ethiopia’s Productive Safety Net Program [13] and school feeding programs,[14] can also be scaled up in emergencies to provide timely and predictable food assistance to vulnerable and chronically food insecure populations in order to protect livelihoods and productive assets.

Because safety nets help poor and vulnerable people cope with impacts of shocks, they are increasingly important given rising and volatile food prices.  The food price spikes in 2007 and 2008 led to protests and riots in 48 countries, [15] suggesting a close connection between food security and political stability.  In fact, international food prices are likely to remain high, with price volatility continuing. This is due to a number of factors including rising consumer demand fueled by larger and more prosperous populations, the use of food for fuel, high oil prices, resource scarcity, commodity speculation and increasing frequency of weather shocks.[16]  Effective safety nets help to ensure that higher food prices do not prevent poor households from having required access to food or contribute to inequitable access to food within the household.  In times of food price increases and volatility, for example, women often end up being the shock absorbers of household food security, reducing their own consumption to leave more food for other household members.

Safety net programs that provide food for work, cash for work or targeted assistance to particularly vulnerable populations can play a critical role in meeting the basic needs of hungry, poor people by maintaining their access to food and forestalling increases in poverty.[17]  Safety nets targeted to vulnerable populations on either a temporary or permanent basis can help save lives and strengthen livelihoods. Implemented through food and cash-based transfers depending on the context, they can prevent malnutrition that has lifelong consequences, prevent depletion of productive assets and reductions in education and health spending, build resilience to sudden shocks and promote longer-term development. Safety net programs can also help to graduate small farmers from assistance programs by increasing their capacity to integrate with market opportunities that allow them to sustainably escape hunger.

Increasing weather-related shocks, other natural disasters and the recent global financial crisis have underscored the urgent need for effective disaster risk reduction programs that build resilience and help governments and communities mitigate risk and reduce the impact of external shocks. In the absence of such programs, agricultural productivity gains, livestock and other assets that take years to build can be wiped out in a single moment, trapping smallholder farmers, their families and communities in a devastating cycle of poverty.  Safety net programs can help families offset the impact rising food prices have on the nutrition of their children.  They can build resilience to weather-related shocks by paying people in cash or food to construct irrigation and terracing systems that are disaster resistant, or to build other agricultural infrastructure to increase local productivity.  In Ethiopia, for example, a groundbreaking community program called MERET is restoring barren land for agriculture while increasing incomes and helping communities adapt to and prepare for weather and climate changes.[18]  This is one of many programs in the Horn of Africa where communities benefiting from this assistance experienced significantly less hardship as a result of the historic drought in 2011, showing that programs to build resilience can have a significant impact on reducing the need for costly emergency interventions.

Safety net programs also include efforts to reduce the negative impacts of natural disasters through risk reduction programs.   Disaster risk reduction includes a range of programs that aim to ensure that infrastructure is constructed to minimize risk and vulnerability to conditions that threaten food security, as well as planning for more effective responses so people are evacuated to minimize loss of life and communities are ready to respond immediately to impacts.

Nutrition Programs

Adequate nutrition serves as a foundation for lifelong health and development.  Nutrition programs ensure that the most vulnerable people have adequate access to the required calories and nutrients to develop properly.  Strong nutrition programs embrace a lifecycle approach — meeting the special needs of those most vulnerable to the impacts of malnutrition through maternal and child health, child and adolescent health and disease control interventions. They focus on children in the most critical window of human development — the 1,000 days from pregnancy to age two — and on specific interventions aimed at meeting the increased nutritional needs of people living with HIV and AIDS.  Nutrition programs include vitamin and mineral fortification, mother and child health and nutrition programs, nutrition education, sanitation/hygiene and improved access to clean water. 

Research indicates that it is critical to improve nutrition during the 1,000 days of life from pregnancy to a child’s second birthday.  During these 1,000 days, adequate nutrition has the greatest impact on a child’s cognitive and physical development.  Malnutrition during this period limits cognitive abilities, stunts growth and increases susceptibility to both chronic and infectious disease.  These consequences of poor nutrition have ramifications throughout adulthood and are passed on to the next generation when malnourished girls and women have their own children.  In addition, undernutrition costs billions of dollars in lost productivity annually and significantly increases spending on health care to treat undernutrition and its consequences.  The World Bank estimates that undernutrition costs individuals more than 10 percent of their lifetime earnings, and many countries lose at least two percent to three percent of their gross domestic product (GDP) percent to undernutrition.[19] A study by the United Nations World Food Programme (WFP) and the UN Economic Commission for Latin America and the Caribbean found that the cost of undernutrition amounts to as much as 11 percent of GDP — due to productivity costs, losses due to higher mortality, health costs and education costs — in Guatemala and Honduras.[20]  Malnutrition alone accounts for 17 percent  of the total global burden of disease,[21] with resulting costs for treatment that are far higher than estimated amounts for preventative investments.

Nutrition programs also focus on educating people about healthy eating habits.  At present, obesity — a form of malnutrition — is on the rise in developing as well as developed countries.  In addition, recent studies show links between adult obesity and childhood malnutrition.[22]  The rise in health problems like obesity, cardiovascular disease and diabetes that are directly linked to poor eating habits will place an increasing strain on already overburdened public health systems in many developing countries if investments are not made in preventative programs.

Despite the efficacy and cost effectiveness of nutrition interventions, the World Bank notes that historically, global investments in nutrition have been “miniscule given the magnitude of the problem”, even though five of the top ten most cost effective solutions for development focus on nutrition interventions.[23]

Agricultural Development Programs

There are more than 500 million small-scale farmers worldwide — most of them women — many of whom suffer from chronic hunger because they do not currently grow enough food to feed themselves or their families year round.  Together, these small-scale farmers feed more than two billion people, many of them among the world's most poor and hungry.  Because these small-scale farmers comprise roughly half of the population that suffers from hunger, the attention of the international community has been refocused on the importance of sustainably boosting their agricultural production capacity as a key strategy in addressing hunger.  While the innovations of “green revolution” technology have dramatically increased agricultural production in some parts of the world, the majority of small-scale farmers continue to lack access to the financing, information and agricultural inputs they need to significantly improve their own production.  For example, it is now estimated that if women in rural areas had the same access to land, inputs, financial services and markets as men, agricultural production could be increased and the number of hungry people reduced by 100 – 150 million.[24]

Effective agricultural development programs increase food availability and farmer’s incomes through more consistent use of agricultural best practices, increased attention to post-production handling, storage and processing and better linking of producers to various types of markets.  Agricultural development programs help ensure that farmers have access to the inputs — including seeds, fertilizer, training and financial products — that are required to increase production and market sales, and rely upon having the right infrastructure in place to transport products to markets.  Tapping business expertise in logistics, information and communications technology, as well as agricultural technology and science can be extremely valuable in building agricultural value chains.  Private sector involvement will help ensure that agricultural development programs lead to sustained investment that permanently links small-scale farmers to value chains and customers.

Successful programs give farmers the incentives, resources and information needed to be good environmental stewards and ensure effective management of natural resources through environmental assessments and the promotion of sustainable agricultural practices. They also build the capacity of farmers and their families to plan for an uncertain future with adequate, accessible climate information and adaptive strategies to help farmers cope with the anticipated impact of changes in climatic conditions.  Gender and vulnerability assessments are important for ensuring that programs promote gender equality, address disproportionate vulnerability of particular populations and capitalize on the unique contributions and roles of women and men.  In addition, these programs seek to ensure full integration of improved nutrition in program goals, design and implementation.  At the macroeconomic level, attention to international trade policies and national farm and food policies (including pro-poor policies) can contribute to an enabling environment for agricultural producers.  Programs also include capacity building to ensure that developing world farmers are able to meet relevant national and international standards for safety and quality.

Given the decades of insufficient funding for agricultural development at the time of the first Roadmap, the document suggested significant investments in programs to build sustainable, equitable agricultural production systems focused on improving diet diversity and on effectively linking small-scale farmers to markets. 

Institutional Structures for Coordination and Integration of Programs

While investment in all four categories of programs included in the comprehensive approach is required to reduce global hunger, the Roadmap also stressed the importance of integrating these programs to ensure that investments in one area are effectively leveraging US support for programs in other categories. 

To facilitate this integration, the Roadmap called for creation of a White House Office on Global Hunger and the appointment of a Global Hunger Coordinator to lead the process of Interagency coordination and program integration.  Because many US agencies — including the State Department, US Agency for International Development (USAID), US Department of Agriculture (USDA), the Millennium Challenge Corporation (MCC), President's Emergency Plan for AIDS Relief (PEPFAR), Office of the US Trade Representative (USTR) and others —are involved in portions of the overall US response to global hunger and malnutrition, this office was envisioned as a point of leadership, coordination and integration, as well as providing valuable oversight and accountability.

Likewise, because jurisdiction for hunger related programs and appropriations involves multiple Congressional Committees, the Roadmap also suggested that the Congress build upon the tradition of the House Select Committee on Hunger by restoring this Committee and making it bicameral.  The Committee was seen as a key resource in promoting coordination and integration of programs through the legislative and appropriations process.

US Progress on Roadmap Recommendations: 2009 – 2012

During the past three years, the US has mobilized the international community and has made remarkable progress to address many of the recommendations laid out in the original Roadmap.  The US has made significant investments in global programs to reduce hunger and malnutrition, has developed a strategy to guide future efforts that includes clear impact indicators and has made numerous improvements to existing emergency, safety net, nutrition and agricultural development programs based upon evidence from successful past interventions.  While additional time is needed to fully assess the impacts of these changes on the lives of hungry and malnourished people worldwide, this section provides a broad overview of some of the most significant steps that have been taken.

US Global Commitments

Since 2009, US efforts on global hunger have changed the playing field, creating a tremendous ripple effect with a range of other bilateral donors, multilateral development banks, international organizations, private sector actors, private voluntary organizations and other development stakeholders who have all joined the US in efforts to end global hunger and malnutrition.  From President Obama's references to addressing hunger in his inaugural address to the pivotal efforts to rally the international community at the 2009 G8 meeting, US leadership has played an essential role in galvanizing the global community to end hunger.  

At the 2009 G8 meeting in L'Aquila, donor countries committed $22 billion over three years to address the long-term underlying causes of hunger, as well as committing to maintain funding levels for emergency food assistance.  Donors agreed to provide sustained and predictable funding in support of comprehensive, “country owned” food security strategies.  To truly address food security, it was recognized that a comprehensive approach consistent with the Rome Principles was needed to address emergencies while simultaneously supporting “medium and long-term sustainable agricultural, food security, nutrition and rural development programs to eliminate the root causes of hunger and poverty, including through the progressive realization of the right to adequate food.”[25]  The US led the international community at L'Aquila, pledging $3.5 billion in new funding for agricultural development programs over three years.

Since L'Aquila, the US has made solid progress toward meeting this commitment.  Not only has the US nearly reached the $3.5 billion pledge of new funding for agricultural development programs intended to address root causes of hunger through Feed the Future,[26] but the US also has maintained funding for vital emergency programs, providing an average of $1.78 billion each year for Food for Peace commodity programs,[27] and $300 million for the Emergency Food Security Program funded through the International Disaster Assistance (IDA) account.

In addition, the US has demonstrated considerable leadership through improving the effectiveness of existing programs and launching promising new approaches to address hunger.  Since 2009, the increased US commitment and investment in food security has allowed for development of a range of new program tools that have the potential to meet global needs in cost effective and efficient ways, often through better coordination to ensure that different investments leverage one another.  

Progress in Emergency, Safety Net, Nutrition and Agricultural Development Programs

The following section highlights the progress during the past three years on emergency, safety net, nutrition and agricultural development programs. 

Emergency Programs

In the past three years, a number of improvements have been made to US emergency food security programs.  To decrease the time it takes for food from the US to reach people in crisis, USAID has modernized its supply chain management systems to allow commodities in shipment or storage for use in non-emergency programs to be redirected when needed more urgently for emergency response.  USAID has also expanded pre-positioning of commodities to include six sites: Texas, Sri Lanka, Djibouti, Kenya, South Africa and Togo.  This pre-positioning, combined with improved early warning systems speeds response.  For example, following the Pakistan floods in 2010, the US was able to respond to needs within three days: without these early warning, supply chain management and pre-positioning systems the response may have taken months. 

During the past three years, USAID also has developed robust capacity to utilize local and regional procurement (LRP) tools to address emergency food needs, allowing for food to be purchased locally when it is available, meets quality standards and markets are functioning.  Through an International Disaster Assistance (IDA) emergency food security program, USAID is now able to use cash to provide food assistance in addition to Food for Peace commodity-based programs, allowing for greater use of mechanisms like cash transfers and food vouchers that have proven to be highly effective methods for decreasing the cost and time of getting food to people in urgent need.  LRP tools allow for programs to be designed based upon local market conditions so that food assistance does not destabilize local economies, but instead becomes a key component of rebuilding markets following a crisis.[28]

 

Given the increasing frequency of deadly droughts and floods that can ruin crops and severely undermine food security, substantial need exists for systems that can forecast changes to planting or harvesting patterns.  USAID's Famine Early Warning System (FEWSNET) is an essential collaboration involving the US Geological Survey, National Aeronautics and Space Administration, National Oceanic and Atmospheric Administration and USDA in anticipating and better responding to humanitarian vulnerabilities and crises.  In the last several years, USAID has developed an innovative, remote monitoring strategy to provide early warning of significant changes to food availability using information on weather and climate, crop conditions and food markets.   FEWSNET also has developed a new resource — the Food Assistance Outlook Briefing — that predicts food assistance needs six months in advance, allowing for timely purchase and shipment of US commodities in response to emerging global needs.  Finally, FEWSNET also has significantly improved its market price monitoring capacity, which allows for more accurate forecasting of food shortages or price spikes that will make it impossible for poorer households to purchase food.  These global monitoring systems are essential to averting humanitarian crises and could also serve as a tool for improved surveillance and assessment of malnutrition.

Humanitarian organizations are also now able to benefit from massive investments made in communications technology by the US Government and private sector, allowing organizations to effectively locate and map activities and providing more timely data to facilitate communications with local partner organizations and donors.  Further, USAID has convened and facilitated ongoing discussions to improve monitoring and evaluation of all food assistance programs.  As a result, a new framework has been developed to fully integrate gender considerations into all Food For Peace (FFP) operations. 

Finally, USAID has utilized the emergency response to the drought and famine in the Horn of Africa in 2011 to develop a joint planning process that aims to more effectively integrate emergency and long-term development programs.  Within this planning framework, the joint goal is building the resilience of communities so they can better withstand future shocks and will therefore need less emergency assistance.  This kind of integrated planning and operations to promote long-term food security provides an excellent model for how integration of US global food security programs can increase the impact of investments.

Safety Net Programs and Systems

Progress on development of safety net programs and systems has lagged behind other investments over the last three years and is an area where more investment and progress is warranted.

The US approach to food security during the last three years has increased emphasis on country ownership: building the capacity of host country governments to develop their own national plans to achieve food security.  Since a primary goal of safety nets involves establishing national safety net systems to mitigate and respond to the needs of extremely poor and vulnerable people whose food security is threatened, this is a welcome advance.  The US has an important opportunity to leverage the country-led approach to encourage the development of formal mechanisms that ensure civil society, government and private sector interaction on the development of national plans to build food security efforts that include safety net systems.  Because the country planning process is still ongoing, there remains much potential for public partnerships between the donor community, international and local NGOs, private sector and national governments.  In addition, the examples where countries have made significant progress on food security while also upholding gender integration and natural resource conservation principles — countries like Brazil and Ghana — provide inspiration and best practices for other governments to follow.[33]

Safety net programs also can play an invaluable role in the development of national safety net systems.  A wide range of safety net methodologies developed by international NGOs and other partners over the past several decades with support of Food for Peace and USDA has created a rich body of best practices for the US, other donors and national governments to incorporate into the country-led approach. Programs that help subsistence farmers gain skills and embrace technologies to decrease seasonal hungry periods, village-run savings and loan communities and programs that focus on food security of mothers and children are just a few examples of the body of work developed by NGOs and other partners around the world. Increasing partnerships with the NGO community to scale up best practices can ensure that proven practices and successful new innovations effectively contribute to building strong national safety net systems.

For example, school feeding programs can become self-sustaining when host governments make political commitments to provide financing and build their capacity to manage the programs.  Purchasing food required for these programs locally, nationally or regionally brings added economic benefits by stimulating local agricultural production.  Over the last 45 years, more than 37 national governments have successfully taken over school meal programs launched by donor countries, NGOs and international organizations like the World Food Programme (WFP), including Brazil and India, which currently operate two of the largest school meal programs in the world.  Even smaller countries, like Cape Verde, have been able to successfully take over school feeding programs.[34]  In addition, school feeding programs promote improved nutrition and gender equality, translating into better health and educational outcomes for girls and boys.  Through the use of take-home food rations, school feeding programs have also dramatically increased the school enrollment rates for girls.

Safety net systems can be designed to be used as a platform for the delivery of related services. For example, many new insurance products are being developed to address and mitigate risks facing vulnerable people.  The Rural Resilience Initiative in Senegal (R4), a joint initiative of WFP, USAID, Oxfam America and Swiss Re, will develop mechanisms that extend the benefits of financial tools such as insurance and credit to the most vulnerable populations.[35]  Another promising example of recent work in this area  — called BASIS — is a USAID, UN, and research institution collaboration to design a new generation of index insurance contracts to improve technology uptake by farmers, increase incomes and attract lenders into rural markets.  These initiatives are a response to the overwhelming evidence that uninsured risk can drive people into poverty and destitution, especially those in low wealth agricultural and pastoralist households.

Nutrition Programs

During the past three years, the international community has made remarkable progress on identifying the most critical nutrition interventions,[36] estimating the total cost of delivering these interventions and also estimating the economic costs of malnutrition.[37]  The 2012 Copenhagen Consensus project identified a set of nutrition interventions aimed at pregnant women and children that can have the highest economic benefit of any development assistance investment aimed at reducing hunger and malnutrition. This bundle of interventions includes micronutrient fortification, nutrition behavior change and improving the quantity and quality of diet, which together can produce returns as high as $138 for each $1 invested.[38]  Nutrition investments could also save one million lives each year, and improve the health of 360 million children and their mothers.[39]

Within the last few years, political will to address nutritional needs has grown, thanks in large part to US leadership which has mobilized public and private stakeholders to invest in nutrition.  The US government has increased its support to country-led integrated nutrition programs that embrace a comprehensive approach to preventing undernutrition.  Through Feed the Future and the Global Health Initiative, the US is scaling up nutrition through new programs in countries like Tanzania, Bangladesh, Uganda, Nepal, Ethiopia, Ghana and Guatemala.  These programs focus on preventing undernutrition by improving infant and young child feeding practices, increasing access to diverse and quality diets, delivering critical nutrition services like micronutrient supplementation and community management of acute malnutrition, strengthening local institutions responsible for nutrition and mainstreaming nutrition into national agriculture, disaster, health and social policies.

The US is actively participating in the Scaling Up Nutrition (SUN) movement.  The SUN movement has been a key driving force behind coordinating and aligning the international community to take decisive action to address this core development challenge.  SUN supports countries affected by undernutrition to identify needs and priorities, encourage strong coordination between development partners and scale up proven nutrition interventions through a multisectoral approach. Donor and other development partner support will be essential as countries assess needs and capacities, develop detailed implementation strategies and seek investment in scaling up.  As mentioned above, returns on investment in scaling up nutrition will save lives and promote sustained development in participating countries. These valuable efforts to raise the visibility of the importance of nutrition investments should be continued, with the US continuing to provide leadership to governments all over the world to ensure success of the SUN movement.

Secretary of State Hillary Rodham Clinton helped launch “1,000 Days” in September 2010, to focus international attention on nutrition during the 1,000 day window of opportunity from pregnancy to a child’s second birthday.   The 1,000 Days partnership includes more than 70 organizations that agree with the importance of improving global nutrition and is mapping US NGO investments to prevent and treat malnutrition in key countries.[40]  Many are actively creating 1,000 Days programming.  Bread for the World created “Women of Faith for the 1,000 Days Movement” and has led church leader visits to Malawi, Tanzania and Zambia.  The Hunger Project’s board of directors established nutrition during the 1,000 day window of opportunity as a top priority within its 2012-2015 plan.  And CARE has educated members of Congress and key influencers about health, livelihoods and gender empowerment through the lens of 1,000 Days during learning tours in Ghana and Liberia.  Also, both World Vision and Save the Children are focusing international health and child survival campaigns on nutrition with an emphasis on the 1,000 day window. 

Governments also are investing in nutrition to target the 1,000 day window from pregnancy to a child’s second birthday.  In 2011, the Government of Tanzania announced six national nutrition commitments, including the creation of a nutrition-specific budget line, placing nutrition specialists in each district government, and finalization and enforcement of national food fortification standards.  Recently, the US government’s Millennium Challenge Corporation signed a compact with the Government of Indonesia.  This is one of MCC’s largest compacts to date and is the first to include a child nutrition program to reduce stunting.  This $130 million dollar investment in nutrition aims to improve long-term health, as well as to increase household income through cost savings, productivity growth and higher lifetime earnings. 

 

Integrated program approaches to improve nutrition are proving remarkably successful and cost effective.  The SHOUHARDO program in Bangladesh reduced the incidence of stunting and chronic malnutrition in children aged six months to 24 months old from 56 percent to 40 percent in just three and a half years.[41]  Likewise, nutrition education and community outreach programs have proven to bring high impact and return on investment, often dramatically improving nutrition.[42]   The YALLANDO KLEYA child survival project in Niger found the breastfeeding of infants increased from 55 percent to 85 percent after education programs were implemented.  Improving pregnant women's nutritional knowledge also led to reductions in anemia among pregnant women from 40 percent  to 7 percent.[43]

 

There have been tremendous advances in the treatment of severely malnourished children.  While therapeutic interventions for malnourished children previously required hospitalization and IV feeding, new nutritional products now allow families to administer high nutrient pastes from small packets to their children at home.  Nutritionally enhanced grain-based products for treatment of moderate malnutrition are also more widely available, allowing greater numbers to be reached more cost effectively.

Public-private partnerships are also providing a valuable way to bring these advances to people in need.  For example, PepsiCo is working with USAID and WFP on a project to produce chickpeas in Ethiopia: part of the production is exported to increase local incomes and part of it is converted into a fortified chickpea paste for therapeutic use with severely malnourished children.[44]  General Mills and Heinz are working in partnership with USAID in the Horn to build local capacity to produce similar nutritionally enhanced products.  USDA has supported universities, companies and NGOs to implement US-based micronutrient fortification food assistance projects in six countries.

Biofortified crops, such as orange fleshed sweet potato and high iron beans, have the potential of making nutritional impacts on a large scale through breeding higher levels of micronutrients directly into key staple foods.  HarvestPlus, an initiative that is co-convened by the International Center for Tropical Agriculture (CIAT) and the International Food Policy Research Institute (IFPRI), is a leader in developing biofortified crops through traditional breeding methods focusing on three micronutrients that are recognized as most limiting in diets: iron, zinc and vitamin A.[45]

In addition, in April 2011, USAID completed a two year process designed to enhance the nutritional quality of food assistance.  Recommended changes included nutritional improvements to the foods provided, increased use of ready-to-use products for certain target populations and improvements in cost effectiveness and monitoring of food.  These types of interventions will allow US food assistance programs to respond to the latest findings in nutrition science, especially regarding nutritional needs of women and children during the critical 1,000 day window between pregnancy and two years of age. 

Existing US programs have recognized the important links between food security, agriculture, nutrition and health, as documented in a series of publications by IFPRI.  These promising practices should continue for better health and nutrition outcomes, as integrating nutrition in all development programs increases impact and cost effectiveness.  An equal emphasis on nutrition in agricultural programs that were traditionally focused only on production allows people to grow more nutritious food for domestic consumption and encourages preparation techniques to ensure that micronutrients are not lost in the cooking process.  The inclusion of nutrition components in the PEPFAR programs has helped to successfully link health and nutrition interventions by addressing increased caloric needs of people living with HIV, AIDS and other chronic illnesses.

Despite the enormous strides the US has recently made in investing in nutrition, funding for nutrition programs remains very low given the high need, high impact and cost effectiveness of these investments.

Agricultural Development Programs

At the time of the first Roadmap, investment in agricultural programs worldwide had reached historic lows, with 500 million farmers worldwide suffering from chronic hunger.  In response, the Administration developed the Feed the Future (FTF) Initiative to help farmers in developing countries grow their way out of hunger and find a place as active participants in the agricultural economy.  The initiative aims to boost the incomes of agricultural producers by linking them to markets, while simultaneously leveraging these agricultural programs to improve nutrition (growing more nutritious foods, improving storage facilities and coupling agriculture and nutrition in extension programs.)  This type of value chain programming has proven highly successful at boosting the incomes of small-scale farmers.  For example, Catholic Relief Services’ ACORDAR program in Nicaragua was able to demonstrate a 44 percent increase in the incomes of farmers after just four years.  Projected sales for the five year project are more than $100 million.[46] As a major purchaser of staple crops,[47] WFP launched a program to purchase from small-scale farmers called Purchase for Progress (P4P).  The pilot program has trained 116,000 small-scale farmers in skills needed for full integration into markets, and has purchased 207,000 metric tons of food from them, valued at more than $75 million.[48]

Feed the Future also calls for the integration of environmental and climatic considerations, as a cross-cutting issue affecting the long-term sustainability of programs and outcomes. While this integration lags behind the integration of gender, USAID is making an effort to increase staff understanding on the importance of integrating natural resource management and climate change considerations into agricultural programs and to promote best practices.  Currently, much of the effort in the context of Feed the Future to integrate climate change is focused on research, though more robust integration at the implementation level is needed.

Feed the Future has committed to investing in country owned plans that support results-based programs and partnerships and that build upon country processes such as the African Union’s Comprehensive Africa Agriculture Development Program (CAADP). All twenty Feed the Future countries have developed implementation plans which have been reviewed and refined so that each focus country has a multi-year strategy to guide its Feed the Future implementation process.  Almost all of the country strategies include gender as a cross-cutting issue and commit to improving the livelihoods of both men and women farmers.  In Ghana, the Africa LEAD program has made effective use of the knowledge and skills of small-scale women farmers who are leaders by integrating them into the CAADP process and including their observations in the country plan.[49] Although FTF now includes agriculture programs managed out of Food for Peace in its overall framework, there is much potential to better integrate food aid agriculture programs that focus on small-scale and subsistence farmers into the larger value chain approach of the initiative.

In addition to catalyzing development of country strategies, Feed the Future also has developed a results framework to unify monitoring and evaluation procedures across projects and to ensure increased accountability for donor funds.  The US has developed a list of 56 performance indicators to measure progress through the results framework and also plans on undertaking impact evaluations to more fully understand the changes resulting from FTF programs.  Almost all of the US agencies involved in implementing food security programs now have systems in place to monitor program results across a set of common outcome indicators designed to measure program impacts.

While this progress is encouraging, significant gaps still exist in the selection of focus countries and regions, and in the integration of Feed the Future within broader US food security programs.  The list of countries originally selected for Feed the Future programs included some countries with both high levels of hunger and malnutrition, and opportunities for development of agricultural value chains.  As a result, many countries with chronic and protracted hunger crises have been excluded from participation in these programs.  Likewise, Feed the Future programs often take place in limited geographic areas within the countries selected.  For example, in Tanzania, USAID is focusing Feed the Future programs on more wealthy southern areas of the country, with insufficient attention to how the economic gains sustained there might translate into improved nutrition or food security for the poor and hungry who live in the north.  Finally, Feed the Future agricultural development programs will be most impactful when they are connected with and able to leverage other existing US program investments in each country.  For example, in Guatemala the USAID mission encouraged partners who were implementing existing food security programs to develop plans that make explicit linkages to Feed the Future.  Although households with incomes in the lowest 20 percent are generally not yet able to participate economically in the types of market development promoted by Feed the Future, early integration with other US programs that do target hungry poor people can help ensure that the Feed the Future approach in each country is responsive in some way to the needs of the most vulnerable.  Similar efforts at integration in other countries should be encouraged.

Because the vital role of women and girls in global agriculture was fully recognized by the Administration, gender has been fully integrated into agricultural investments.  For example, in an effort to understand how FTF is making progress towards gender equality, USAID has developed a Women’s Empowerment in Agriculture Index.  The Index aims to measure the changes in women’s roles and engagement in various agricultural sectors in both quantity and quality.  The Index has been piloted in three countries and is being scaled up in early 2012. 

Finally, Feed the Future is leveraging and aligning the resources of diverse partners, including multilateral institutions, civil society and the private sector.  Tapping the expertise of local NGOs, including farmer-based organizations, social accountability organizations and other civil society organizations, that are already implementing agriculture programs in poor communities will boost FTF success at ensuring that agricultural development is inclusive of poor individuals and communities. Similarly, it is important for national governments to create or strengthen mechanisms to provide support to local NGOs carrying out programs with subsistence and small-scale farmers. The creation of public-private partnerships for agricultural development in many target countries holds the potential to allow Feed the Future to actively incorporate the expertise, connections and resources of private sector actors. 

Institutional Structures for Coordination and Integration of Programs

The Administration has been committed at the highest levels to integrating global programs to end hunger.  From the start, the Administration prioritized coordination through an active Interagency process.  Leaders were identified at State, USAID, USDA and other stakeholder agencies to drive the process forward and to create greater synergies between US programs.  The Interagency process has remained ongoing and meetings are still held with regularity with strong participation of stakeholders.  There are now coordinating positions for food security at both State and USAID, with USAID designated as the lead implementing agency for Feed the Future.  To this end, USAID has created a new Bureau — the Bureau of Food Security — to spearhead efforts. 

However, despite these improvements, coordination of US food security programs has been hampered by numerous transformations over the last several years as well as frequent changes in leadership.  Fuller integration of US efforts remains a challenge, especially given the multiple agencies involved in programs, the multiple budget streams and the competing Congressional Committees with jurisdiction over global programs to fight hunger.

In addition, a number of improvements can be made to increase impacts of US global food security efforts.  The progress over the last three years has produced volumes of new evidence on the most effective approaches for reducing hunger and malnutrition, providing a significantly stronger base of knowledge to orient future policies and programs.  The following recommendations draw upon these advances to identify concrete recommendations to orient future US efforts.

 

Recommendations for US Policymakers

1.  Continue to lead the international community on global food security by providing robust support for programs

To continue to build upon the dramatic progress in US programs to alleviate global hunger, sustained investment is required.  To effectively address current and future global food security needs, we recommend US investments of $5 billion annually.  While this represents an increase of $1.4 billion over the average funding from 2009 – 2012, this would still constitute only 0.14 percent of the total US budget, or just over one tenth of 1 percent.[50]  It is clear that recent US investments in global health programs have generated significant impact: the same investment approach is needed to catalyze similar improvements in the state of global food security.  This level of investment will support all elements of a comprehensive approach, in order to effectively address acute hunger through emergency programs and the root causes of chronic hunger through safety net, nutrition and agricultural development programs.[51]

Emergency Programs:  An estimated 85 million people will require emergency food assistance in 2012, with a total cost of $6.5 billion.  A number of trends highlight the continuing need for strong emergency response.  The number of natural disasters has risen steadily from an average of 100 each year in the 1980s to more than 350 each year since 2000, with droughts and flooding threatening the food security of tens of millions of people each year. In addition, conflicts continue to rage on in many parts of the world, bringing the number of internally displaced persons to almost 30 million, and driving refugee numbers to a 15-year high.  Finally, high and volatile food and fuel prices make it more difficult for those in developing countries who spend 80 percent of their income on food to have stable access to the calories and nutrients required to live healthy, productive lives.  

At present, emergency programs are funded primarily through the International Disaster Assistance (IDA) account and Food for Peace.  Funding from the IDA account supports cash-based emergency food assistance for local and regional procurement of food in places where market conditions make this a faster and more cost effective option. Food for Peace emergency programs provide US commodities to meet emergency needs.  Given rising emergency needs, a total of $1.9 billion across all relevant accounts is recommended. This would allow the US to continue the historical tradition of providing resources to meet roughly 30 percent of emergency needs worldwide, leveraging the support of other donors to share the burden of effective international humanitarian response.

Emergency Programs
Account	Recommended funding
Food for Peace Emergency Programs	$  1.4 billion
International Development Assistance Emergency Food Security Program	$  500 million
Total	$  1.9 billion

 

Safety Net Programs and Systems:  There are an estimated 925 million people who suffer from chronic hunger and malnutrition.  Many of them live in countries that are in a state of protracted crisis: places where the cycle of conflict, natural disasters and grinding poverty has been continuous over decades.  According to World Bank statistics on progress towards achieving the Millennium Development Goals(MDG), there are more than 171 million people suffering from chronic hunger and malnutrition in the 22 countries that remain farthest from the MDG goal of halving hunger by 2015.  To reach these people with integrated programs providing safety net, nutrition and other support would cost approximately $8.7 billion annually.[52]

In this context, safety nets provide invaluable support to ensure that vulnerable people do not fall deeper into poverty each time a crisis, disaster or conflict occurs.  Safety nets help people to build resilience to shocks and to recover more quickly afterwards, as well as helping to avert more serious emergencies and crises.  For example, during the crisis in the Horn of Africa in 2011, those communities that were benefitting from effective safety net programs and systems were less likely to suffer the worst impacts of drought and were quicker to recover, limiting the need for more costly emergency response.  Safety net programs include food for work, cash for work and school feeding programs.  In countries where national governments have capacity, national safety net systems can also be piloted and developed, with host governments assuming control of the systems and providing financing for them.  

Safety net programs are currently funded through Food for Peace non-emergency programs, which also include some nutrition and agriculture programming targeting poor households and communities. Other safety net programs are funded through the Development Assistance account and through the McGovern-Dole International Food for Education and Child Nutrition program.  A total of $800 million across all relevant accounts is recommended given the impact that the development of safety nets has shown in effectively reducing chronic hunger.

Food for Peace non-emergency programs, funded in part by monetized Title II commodities, have proven highly effective at targeting chronically hungry people to promote development, improve child nutrition, and build resilience.  This type of programming warrants continued US support, but should be made more efficient by increasing flexibility and reducing reliance on monetization.  Over the past two years a small but growing amount of funding has been provided for these programs focused on the chronically hungry and poor through the Community Development Fund (CDF) within the Development Assistance Account.  If CDF funding increases further, it could provide a useful source of direct support for development programs that target the hungry poor and the most vulnerable, and could complement existing Title II resources while reducing losses from monetization cost recovery. An increased CDF could provide additional US support for programs that are designed to ensure that vulnerable populations are able to build household and community assets, suffer less serious impacts from economic and environmental shocks, and therefore build capacity to participate in rural economic growth.  These investments also serve to prevent hunger and malnutrition, lessening the need for emergency interventions over time.  To increase the effectiveness of the CDF and ensure programming is harmonized with existing Title II food aid programs, we recommend the CDF be managed by the Office of Food for Peace.

The US also provides support for safety net programs through the McGovern-Dole International Food for Education and Child Nutrition program.  School feeding programs increase school enrollment and ensure that children who attend receive at least one nutritious meal each day.  Through providing take-home rations for children under the age of five, school feeding programs can also improve early childhood nutrition, reduce the rate of underweight children and ensure that girls enroll in and attend school. School feeding programs are a vital tool for reaching the 66 million children who go to school hungry every day and for providing incentives for the additional 67 million children who are not enrolled in school to enroll and attend.  It costs just 25 cents a day to provide a child a nutritious meal at school, or about $3.2 billion a year to cover global need for those children already in school.  We recommend $300 million of US support, which would cover 10 percent of the global cost to reach hungry children who are enrolled through school feeding programs.  In addition, the US should promote increased sustainability of school feeding programs by supporting linkages with local agricultural producers who are well positioned to market their produce to participating schools so that children can have access to fresh, nutritious foods that are grown locally or regionally.  Development of effective linkages between schools and local producers will also provide vital market stimulus for increased farm production, thereby boosting local economies.  These linkages will also foster graduation of school feeding programs to national government management and financing.

Supporting development of national safety net systems that host governments can sustain is also a key element of reducing global hunger. For example, the national safety net system developed in Brazil costs the Brazilian government roughly 0.3 percent of GDP, yet over the six years between 2003 and 2009, this system helped lift 12.6 million people out of poverty and reduced the rate of underweight children by 50 percent.  While it is envisioned that these national safety net systems would be financed by host governments, the US can utilize the country-led planning process and other international diplomacy efforts to continue to promote development of safety net systems.  In countries that do not yet have the institutional capacity to develop national safety nets, the US can provide technical assistance and program support to incentivize safety net system development, working with host governments and where appropriate donors and multilateral institutions in order to assume control and financing for these systems over a several year period.

Safety Net Programs
Account	Recommended funding
Food for Peace Non-emergency Programs / CDF within DA*	$  500 million
McGovern-Dole International Food for Education and Child Nutrition**	$  300 million
Total	$  800 million

* In FY2013, the Administration's budget request indicates a $60 million request for the Community Development Fund that would provide direct program funding to the same types of programs financed through monetizing commodities provided through Food for Peace for non-emergency programs.  The total of $500 million indicates the total required for this program area, with the understanding that as the Community Development Fund develops and is more fully funded, a greater percentage of resources will be provided in direct program funding.

** The McGovern-Dole International Food for Education and Child Nutrition Program is authorized to also reach children younger than school-age, and should be funded and implemented to do so, particularly during the critical 1,000 day window from pregnancy to age two.

Nutrition Programs: Each year 3.5 million children die from malnutrition while another 170 million suffer serious, often irreversible, cognitive and physical damage from chronic malnutrition.  The World Bank has recommended urgent action to scale up the prevention of malnutrition and estimates that full scale-up to address malnutrition by promoting good nutrition practices and increasing vitamin and mineral intake, particularly for women and children in the 1,000 day window from pregnancy to age two, will cost $4.4 billion per year.  An investment of $450 million would allow the US to contribute roughly 10 percent of the total global cost for scaling up programs to promote good nutrition practices and increase vitamin and mineral intake in the countries with the highest burden of malnutrition, positively impacting as many as 356 million children under the age of five.

The US currently funds nutrition programs out of a variety of accounts, including Global Health, PEPFAR, Food for Peace, Development Assistance and others.  Because nutrition is a building block for all other programs, we recommend that nutrition be effectively integrated into all food security programs and funded directly from those program funds.  In addition, we recommend development of more consistent and transparent tracking of US investments in nutrition across accounts.  Given the importance and cost effectiveness of nutrition interventions, a total of $450 million annually is recommended specifically for nutrition programs to scale up critical interventions in the countries with the highest burden of malnutrition.

Nutrition Programs
Account	Recommended funding
Global Health	$  450 million**
Total	$  450 million

** The World Bank identifies nutrition as the world's most serious health problem and the biggest single contributor to child mortality.  We recommend additional funding to address nutrition within the global health account, recognizing that this will require an overall increase in the account to ensure sustained support for other valuable and complementary health programs.

Agricultural Development Programs:  To adequately address hunger, it is vital that the US continue to support agricultural development programs that ensure nutrition outcomes.  Investment in agriculture will serve to boost GDP and incomes in developing countries around the world as well as providing more food for local, regional and international consumption. Increasing production is a challenge of global proportions that the US must help to address.  To satisfy the demand that will be created as the population grows to a projected 9 billion people by 2050, food production must grow by 60 percent over 2005 – 2007 levels.  Meeting this challenge will require substantial international investment to improve the productivity of both commercial and small-scale farming, and to address the challenges in post-harvest storage and transportation.  Finally, in the face of increased weather events and price volatility, the effectiveness of agricultural development programs will increasingly depend upon investments in building resilience and increasing capacity to adapt to a changing climate.

However, increased food production is only part of the solution when it comes to reducing hunger.  For the past several decades the world has produced more than enough food to meet the caloric and nutritional needs of everyone on earth, yet almost a billion people have continued to suffer from hunger and malnutrition.  For agricultural development programs to contribute to reducing hunger, they must also address the specific needs of the vast majority of the world's chronically hungry people who are small-scale farmers that remain unable to provide sufficient access to nutritious food to guarantee food security for themselves and their families.  For example, it is estimated that if women had the same access to agricultural inputs as men, they could increase their production by 20 percent to  30 percent, reducing the number of chronically hungry people in the world by 100 million to  150 million.[53]  The capacities and needs of small-scale farmers must continue to inform all US agricultural development investments.

The US currently funds agricultural development through the Development Assistance account, the MCC, Food for Peace non-emergency programs, the Global Agriculture and Food Security Program and other accounts.  Given the importance of agricultural development for feeding a growing world population and reducing chronic and acute hunger, a total of $1.85 billion across all relevant accounts is recommended.

Agricultural Development Programs
Account	Recommended funding
Development Assistance – Feed the Future agricultural development/nutrition	$  1.3 billion
Development Assistance – Resilience programs*	$  200 million
Adaptation funding**	$  200 million
World Bank Global Agriculture and Food Security Program multilateral trust	$  150 million
Total	$  1.85 billion

*See recommendation 3 for a more complete description of resiliency programs.

** Adaptation funding includes allocations through the Development Assistance Account to USAID and State, the Economic Support Fund for the Least Developed Countries Fund and the Strategic Climate Fund and the Multilateral Account for the Pilot Program on Climate Resilience at the World Bank.

2.  Establish clear leadership roles to more effectively coordinate and integrate US global food security programs.  While there has been remarkable progress over the past three years in increasing the coordination of various US supported global food security programs, the overall US effort would benefit from further integration of programs with consistent leadership across all agencies.  All US efforts should be structured and supported by an overall strategic plan for increasing global food security that details the roles for all of the agencies involved. While USAID should continue to play the role of lead implementing agency for global food security efforts, the Interagency process should be led by the National Security Council (NSC), with the national security advisor designating a senior director to oversee the development and evaluation of US food security investments worldwide.  In the alternative, a Council on Global Food Security could be established with a global food security coordinator reporting to the president and the secretary of state.  The coordinator would be responsible for overseeing development and implementation of a government-wide strategy to address global hunger and malnutrition, with corresponding budget authority over all global food security programs.

The State Department should continue to play an essential role in pressing for increased contributions from other donor nations to build stronger international capacity to respond to emergencies and to enhance ongoing programs to ensure increased agricultural production and effective nutrition programs.  The US should maintain our current diplomatic leadership in promoting global food security.   As the US aims to promote country-led planning processes, the role of US ambassadors is essential in promoting global food security.  To this end, ambassadors should work with host country government officials to stress the importance of food security as a US policy priority and ensure that host country governments at the highest level develop coordinated, integrated programs to support policies and programs that alleviate hunger.

As a core component of ongoing coordination efforts, the US should continue to develop the Feed the Future results framework.  In future iterations of the framework, indicators should be developed to better measure and track the stability of food security and to better measure impacts of safety net and resilience programs.

3.  Support programs that build the resilience of people to resist shocks and to recover more quickly and fully, thereby reducing future emergency relief needs.  With the growth in the number of natural disasters — particularly floods and droughts — emergency needs continue to increase.  Rising and volatile food and fuel prices promise to make emergency response increasingly expensive.  In addition, a total of 1.5 billion people live in states that are mired in conflict, with fragile state structures. These countries are 40 percent to 60 percent behind other low income countries on achieving progress towards the Millennium Development Goals.  As of 2010, the United Nations Food and Agriculture Organization (FAO) identified 22 countries as being in a state of protracted crisis, defined as “those environments in which a significant proportion of the population is acutely vulnerable to death, disease and disruption of livelihoods over a prolonged period of time.”[54]  Given this situation, it is clear that if current trends continue, emergency needs will far outstrip available donor resources for effective response.  For this reason, increased investment must be made in mitigating the impacts of environmental and economic crises and breaking the cycle of protracted emergency situations. 

Unfortunately, there has traditionally been a gap between emergency funding — which generally lasts for three to six months after a crisis — and long-term development funding.  Most communities are not yet ready for long-term development programming only six months after a natural disaster or conflict, and they are often unable to access support to help them move on from the emergency stage and to fully recover.  While a range of programs have proven highly effective at reducing the need for repeated, costly emergency interventions, there is not, at present, a dedicated funding stream focused on supporting early and appropriate response and quick recovery activities intended to build resilience to natural and man-made shocks.

In addition, the majority of hungry people are women and children who are dependent on healthy ecosystems for their incomes and access to food. These same populations are often among the most vulnerable to the impacts of climate change.  Food production depends on a range of ecosystem services and processes, yet climate change threatens to negatively impact water availability, the spread of pests and diseases and crop yields. These impacts could leave as many as 25 million additional children undernourished by 2050[55], while decreased crop yields can also lower incomes or lead to higher prices for food.  To promote the health of ecosystems and protect the sustainability of natural processes and biodiversity, sustainable agricultural practices should be promoted and programs should include environmental assessments.  Vulnerability assessments that include consideration of social, political, economic and environmental considerations should be integrated to ensure that the needs of the most vulnerable are targeted.  Capacity building to enable communities to represent their needs in local and national planning processes, including the development of food security and development strategies, should be prioritized. Program planning should include climate projections to verify the long-term viability of agricultural development, and these projections and other climatic information should be available to farmers in a form they can access and understand.  These interventions will increase communities’ resilience and enhance their ability to respond proactively to increasing variability in their climatic conditions. 

Building resilience — reducing the impacts of natural disasters and food price shocks, enhancing local capacity for emergency response and promoting the sustainable development for poor and vulnerable households — has been proven to reduce the need for repeated, costly emergency interventions.  To ensure that US-supported programs are building resilience, food security program planning should integrate staff from both emergency and long-term development programs to jointly address emergency needs, promote recovery and build resilience to future shocks.  To promote integrated planning and programming, we recommend that funding is made available through the Development Assistance account that would be jointly programmed by US staff in countries at high risk of suffering crises — including relevant staff from USAID (Bureau of Food Security, Democracy, Conflict and Humanitarian Affairs, and other relevant Bureaus,) USDA (McGovern-Dole and Food for Progress) and other operational agencies — who would jointly set goals, develop programs and evaluate results.

4. Support effective safety net programs and build the capacity of host governments to develop and deploy their own national safety net systems. Research is demonstrating that targeted safety nets and disaster risk reduction programs can build and protect human capital and productive assets, strengthen community resilience, mitigate the impact of external shocks and contribute powerfully to longer-term growth and poverty alleviation. Many governments are developing national policies and frameworks to protect the most vulnerable people from shocks and aid them in recovery, with countries like Brazil demonstrating significant impacts from their investments.

The US should increase support for such initiatives and work with partners to build the capacity of governments to develop and manage strong safety net systems that connect, integrate and expand existing programs to meet food and nutrition security objectives.  One key way to do this would be to encourage inclusion of safety net programs and systems into country-led food security plans, developing timelines for programs to “graduate” to local and national government financing and management.  The US could also increase the sustainability of the McGovern-Dole school feeding program by expanding the use of local and regional procurement within this program so that governments can fully take over school feeding and continue to provide meals to school children without a need for external donor support.  In the last several decades more than 37 countries have assumed responsibility for school feeding programs and have continued to operate them without external donor resources.

5. Strengthen and institutionalize the focus on nutrition across all US programs.  This is a critical time to build on progress made to date on integrating nutrition into development and health programs, as well as to invest in significant reductions in child malnutrition.  Because nutrition is a vital component of all other types of food security as well as global health programs, coordination and integration is critical.  We recommend the establishment of a high-level focal point for global nutrition that has authority across relevant USG agencies, as each of the Scaling Up Nutrition partner countries are required to do.  A Global Food Security Coordinator or Council should also ensure that nutrition is a core component of the overall US food security strategy.  Further, an overarching, publicly available global nutrition strategy will be critical and should define interagency and inter-initiative roles, mechanisms for coordination, funding, nutrition impact targets and field guidance on nutrition, including monitoring and evaluation.  We applaud the inclusion of nutrition across some accounts in budget documents and urge further definition of a transparent nutrition budget across initiatives and accounts, including Feed the Future, Global Health Initiative, Food for Peace, PEPFAR, MCC and USDA.

USAID should continue to invest in development of field guidance to improve nutrition outcomes of programs, including guidance related to improving the nutritional quality of US food aid.  USAID should also invest in documenting and disseminating best practices for ensuring that agricultural interventions have a measurable impact on nutrition — especially during the 1,000 day window from pregnancy to age two, and during other critical stages of the life cycle — so that future funding can be directed to evidence-based approaches.  Further, USAID and USDA should continue to fully implement the recommendations in the 2010 Tufts Food Aid Quality Review as well as the recommendations in the May 2011 Government Accountability Office (GAO) report on improving the nutritional quality of food aid.

Finally, the US should allow for local fortification and bagging of commodities in the countries where they will be distributed, creating local industries and enhancing the nutritional content of the food while also reducing the costs of fortification.  This will also allow for increased fortification overall.

6. A shift to a country-led model of development will require the US to develop new capacities to encourage involvement of all stakeholders in planning and to utilize plans to promote effective donor coordination and increased transparency and accountability.  The country-led model requires active participation of both government and nongovernment stakeholders in charting a course for development.  While promising, this model will take time to fully develop because many countries are characterized by weak state capacity to meet basic needs, nascent civil societies operating in constrained political spaces, limited private sector participation and insufficient trust among government, private sector and civil society actors. Because the first round of country-led plans were developed rapidly and often with limited public participation, many of them focus almost exclusively on promoting agricultural development, with far less attention paid to the development of nutritional interventions or national safety net systems.  Important groups of stakeholders have been left out of many country planning processes. 

To address this problem and strengthen country-led plans, the US should strongly encourage the development and implementation of planning processes that involve all relevant stakeholders in identifying and addressing food security issues at all stages of the program cycle.  Given the role of women in agriculture in developing countries and their relative lack of access to productive resources, the USG should place a special emphasis on understanding and meeting the special needs of poor and marginalized women.  The US should continue to encourage the inclusion of gender, natural resource management and climate change considerations into country-led plans.  Several countries, including Ghana, are in different stages of developing national civil society coordination mechanisms to encourage the participation of stakeholders in the ongoing development of national food security plans.  The US should encourage and support these efforts.  Finally, a wealth of positive models for increasing food security in developing and middle income countries could be effectively shared through South-South exchange programs to strengthen country planning processes.

To ensure that country-led planning processes support the US policy goal of reducing hunger, the US should identify national laws, policies and conditions that have been shown to be the most conducive to advancing food security.  Country-led plans should be reviewed, with meaningful stakeholder participation, to determine if they adequately address the legal and institutional constraints that limit opportunities for smallholder food producers to lift themselves out of poverty.  Through development and diplomatic interventions, the US can press for progress in national laws, policies and conditions that create a pro-poor enabling environment. The country-led planning process provides a strong opportunity for encouraging more robust support for resilience programs, national safety net systems and Scaling Up Nutrition (SUN) implementation efforts.

Finally, the criteria for the selection of focus countries and zones of influence for US programs should be clear, transparent and focused on reaching the food insecure.  Food security programs should be implemented in areas where they can have the greatest impact on reducing hunger and malnutrition, especially in the 36 countries where 90 percent of stunted children live. 

 

Annex 1

Summary of the history of bipartisan support for US global leadership in addressing world hunger and malnutrition

The US government has been a global leader in responding to world hunger since 1812 when President James Madison sent emergency food aid to earthquake victims in Venezuela.  Bold and timely action by both Democratic and Republican Administrations — and bipartisan support from Congress — have since provided leadership for emergency food assistance and longer term development, agricultural and nutrition programs to alleviate acute and chronic hunger and malnutrition. 

US government relief and food assistance began in earnest during the early years of the 20^th century under the leadership of President Herbert Hoover.   Prior to becoming president, Hoover launched the Committee for Relief in Belgium in 1915, saving the lives of seven million Belgians and two million French citizens during World War I.  He then established the United States Food Administration and the American Relief Administration (ARA). These agencies provided humanitarian assistance to 23 war-torn European countries in the horrific aftermath of World War I.  This vital outreach included Russia, where a devastating famine broke out in 1921.  The ARA fed 10.5 million people daily in Russia and was comprised of a combination of funding provided by Congress and private donations from the American people. 

After World War II, President Harry Truman selected former President Hoover to recommend approaches to rebuild war-torn Europe.  The response included school meals programs and a range of other food assistance programs in 1947 and laid the foundation for the Marshall Plan that commenced in 1948-1949.  The Marshall Plan, named after Secretary of State George Marshall, also received bipartisan support from a Republican-led Congress, with Truman’s Democratic White House administering the plan.  The Marshall Plan’s large scale agricultural and industrial infrastructure investments provided a powerful goodwill dividend for the United States in the postwar era and ushered in a new era of American global leadership.  

In 1954, at the start of the Cold War, Republican President Dwight D. Eisenhower signed into law the Agricultural Trade Development Assistance Act (Public Law 480) to provide reliable food assistance and agricultural produce to the developing world.  Subsequently, Democratic President John F. Kennedy built upon Public Law 480, renaming it “Food for Peace” and placing it within the newly created US Agency for International Development (USAID).  At USAID, Food for Peace has provided food for billions of people over the past 57 years, assisting them during famine and providing longer term development assistance for food security by funding programs that address underlying causes of hunger. 

Support for food security, agriculture and nutrition programs have continued with subsequent US administrations.  The Bill Emerson Humanitarian Trust is a food reserve to allow the United States to respond to unanticipated food emergencies. The reserve was originally authorized by the Agricultural Trade Act of 1980 as the Food Security Wheat Reserve. Subsequent legislation in 1998 renamed the reserve as the Bill Emerson Humanitarian Trust.  Under the Clinton Administration, the USDA administered McGovern-Dole Global Food for Education and Nutrition Program garnered solid bipartisan support for programs to enable children to receive a meal at school, thereby improving both the nutrition and the education of tens of millions of children worldwide. More recently, the Bush Administration’s Millennium Challenge Corporation (MCC) has worked with developing country governments to agree on five-year compacts to implement agriculture, road and irrigation projects in support of market focused and sustainable food production that also supports basic food security objectives.  The MCC has also recently signed a compact with Indonesia that includes significant investments in nutrition programs.

 

Annex 2

Program integration: How emergency, safety net, nutrition and agricultural development programs work together to support global food security

Technical definitions of food security rely upon the measurement of indicators related to four interdependent factors.  To be food secure, a person needs adequate, safe and nutritious food to be available; they need the ability to access this food; they need the physical capacity to utilize this food; and the food production and distribution system must be stable enough to guarantee availability, access and utilization on an ongoing basis.  This diagram uses color coding to illustrate how all four types of programs suggested in the comprehensive approach to food security outlined in the Roadmap contribute to food security. (Emergency Response and Management, Safety Nets, Nutrition and Agricultural Development)

 

To be effective, integrated food security programs must be supported by an enabling environment that includes policies to address governance and rights, land tenure, women's rights and trade.

 

 

Annex 3.1

Productive Safety Net Program (PSNP)

Government of Ethiopia, with International NGOs, Ethiopia

 

IMPACT: More than seven million Ethiopians receive food and cash transfers and have been able to increase their food availability by up to one and a half months. They have also been able to increase their livestock assets from 0.4 to one additional animal.[56] By increasing food security and assets, the most poor and vulnerable people in Ethiopia have been able to improve their resilience, preparing them to better cope with adverse events, such as the food price crisis and drought. 

HOW THIS IMPACT WAS ACHIEVED: With support from the Food for Peace office of USAID (non-emergency), the PSNP is a government-led approach that is both long-term and far reaching. It has provided predictable food or cash to the most poor and vulnerable people in targeted woredas or communities since 2005. It also works alongside a Household Asset-building Program (HAP), which has been shown to have additive impacts on food security and asset creation by linking participants with technical advice, improved access to credit and working capital.

NGO programs which complement and work alongside PSNP activities also have shown to increase benefits to beneficiaries. For example, CARE’s Household Income Building and Rural Empowerment for Transformation Program — which aims to protect poor households while preventing asset depletion level through community self-help savings groups, market linkage nodes and marketing cooperatives and water and sanitation committees activities — has shown an increase of 1.67 months of food availability in beneficiary households. Catholic Relief Services similarly works alongside the PSNP in long-term efforts to improve nutrition outcomes of food insecure households and links them to markets through the provision of seeds and other agricultural inputs. The program is ongoing and results will be collected in 2013.

 

THE KEY LESSON:  A long-term approach, with government leadership and international support, is essential for social protection programming to build resilience in populations that have historically met adverse climate situations. Parallel programming by civil society that can focus on the distinct needs of the most poor and vulnerable people can have additive impacts on beneficiaries.

 

Annex 3.2

MERET: Land Regeneration in Ethiopia

World Food Programme (WFP) with the Government of Ethiopia

IMPACT:  WFP has supported the Ethiopian government to sustain the livelihoods of more than 1.5 million people by rehabilitating 2.5 million hectares of degraded land and restoring the ecosystem through Ethiopia’s land regeneration program called MERET (Managing Environmental Resources to Enable Transitions to More Sustainable Livelihoods). MERET has achieved increased food production and has mitigated harsh impacts of environmental shocks for previously food insecure communities

• Food shortage has declined by 50 percent in the localities embraced by the project where successful, integrated watershed management activities are undertaken.
• Eighty-five percent of the participating households in the project have managed to boost their capability to cope with drought.

HOW THIS IMPACT WAS ACHIEVED: Some 84 percent of the population lives in rural areas and is mainly engaged in rain-fed, subsistence agriculture. Thus, food insecurity in Ethiopia is linked mainly to the pattern of rainfall, land degradation, low levels of investment in rural areas and population density. However, by rehabilitating the production capacity of degraded lands, communities supported by MERET have greatly reduced soil erosion, improved the fertility of soil and increased the availability of water in order to become productive, resilient and self-sufficient.

Together with funding and implementing partners WFP, FAO, the UN Development Programme (UNDP), the German Society for International Cooperation (GIZ) and the World Bank, and in collaboration with the Ethiopian Ministry of Agriculture and Rural Development and local communities, WFP has integrated time-honored food for work activities with improved farming practices and better use of land and water resources to achieve higher agricultural productivity while conserving land and water. Key activities of the MERET program include soil and water conservation, community-based integrated watershed management, tree plantation and water harvesting activities.

THE KEY LESSONS:  Disaster Risk Reduction: At the UN Summit on Climate Change in Cancun in 2012, MERET was heralded as a model for climate change adaptation and mitigation that should be shared and replicated across the environmentally degraded areas of Africa. It is hoped that lessons from MERET can inform disaster risk reduction programming in contexts of recurrent weather-related hazards. To ensure that vulnerable households remain food secure despite climate variability, it is essential to build assets that contribute to resilience to shocks, improved food security and enhanced livelihoods.

Local Ownership: One reason for MERET’s success is that it is fully owned and implemented by the government of Ethiopia and communities, with support from WFP and international donors. WFP supports national efforts to improve food security by protecting livelihoods and building resilience to climate shocks through locally driven interventions, including income generation, asset creation, environmental conservation, land management, water harvesting and climate-proof infrastructure development. Communities are at the center of the decision making, using a participatory planning approach and local knowledge.

 

Annex 3.3

Local and Regional Procurement: Kyrgyzstan

Mercy Corps, Kyrgyzstan

IMPACT:   Mercy Corps’ Kyrgyzstan Emergency Food Assistance program demonstrated a rapid and cost effective impact on food security for IDPs, host families and other populations affected by the 2010 ethnic conflict in Kyrgyzstan. With funding from USAID / Food for Peace’s Emergency Food Security Program, cash grants were provided to these groups and reached beneficiaries 26 days after the signing of the agreement. Food purchased through the LRP program also demonstrated a 24 percent cost savings when compared to the same food basket through a Food for Peace commodity program, due to savings in commodity costs, shipping, inland rates and additional distribution expenditures such as warehousing. After the cash transfer, 87 percent of households reported having food stocks compared to 64 percent prior to the program and reported using the cash to purchase food such as flour, oil, meat, sugar, milk and eggs. Moreover, cash spent on energy costs for cooking also contributed significantly to food security of the target groups. Over the life of the program, market prices of staple food items did not increase disproportionately to the local baseline and world food prices.

HOW THIS IMPACT WAS ACHIEVED:   Because markets were operating 10 days after the onset of the ethnic conflict, sufficient goods were available locally and target groups were already accustomed to purchasing essential goods and services through market mechanisms. A pre-existing partnership with a local microfinance institution also allowed for safe delivery of the cash transfers.

THE KEY LESSON: Under the right conditions, cash distributions can be a rapid and efficient mechanism for improving food security. Cash transfers can get food to beneficiaries faster than commodity shipments, which typically take from four to six months to reach those in need. Savings in procurement, transfer and distribution costs result in comparative value for money.  Cash allows beneficiaries to self-select purchases allowing for variation in need and promoting empowerment and dignity, all while supporting local markets.

 

Annex 3.4

From Conflict to Coping: How Peacebuilding Programming Promoted Drought Resilience in Ethiopia

Mercy Corps, Ethiopia

IMPACT:  Mercy Corps’ Strengthening Institutions for Peace and Development (SIPED) program, funded by USAID, demonstrated linkages between peacebuilding impacts and drought resilience in Ethiopia.  The impact of conflict on community coping strategies has long been recognized as a factor in resilience, but the link between peacebuilding interventions and resilience has not been widely explored. During the 2011 drought, Mercy Corps conducted research comparing Ethiopian pastoralist and agro-pastoralist groups in SIPED program areas to similar communities outside the SIPED program. 

The research found that drought-affected communities where peacebuilding interventions had been successful were better able to cope with harsh conditions and resorted less frequently to destructive coping mechanisms such as productive asset stripping. The findings showed that the improvements to freedom of movement increased by 15 percent in target communities over the life of the program: the resulting access to water, pasture and other natural resources was a key contributing factor to household drought resilience.

The program demonstrated that the occurrence of conflict-related obstacles to livestock and access to pasture and water was decreased by half, primarily through the facilitation of negotiated agreements leading to improved co-management of resources. Moreover, groups with greater freedom of movement and access to natural resources proved to be less likely to rely on negative coping mechanisms in response to the extreme drought and were able to employ more adaptive capacities compared to groups without such access. For example, households that were unable to access pastures or water for their animals due to insecurity were nearly four times more likely to have resorted to killing their calves during the recent drought than households which did not experience such conflict-related barriers.

HOW THIS IMPACT WAS ACHIEVED:  The conflict management and mitigation programming addressed root causes of inter-communal conflict, which overlapped significantly with elements of drought resilience. The program focused on linkages between informal and formal governance and peace institutions, reconciliation processes leading to localized peace agreements and joint livelihoods projects to build cooperation and address violence. Improved security and social cohesion stemming from these interventions appears to have contributed to the increased freedom of movement and enabled better access to public resources that pastoralist groups depend on to cope with and adapt to severe drought, also facilitating market access. These improvements allowed target communities to exercise positive coping mechanisms and thereby preserve their productive asset base. 

THE KEY LESSON: Peacebuilding programming in areas that are vulnerable to food security shocks can create conditions that help mitigate the effects of such shocks and speed their recovery. Lessons drawn from peacebuilding programming in conflict affected pastoralist areas of the Horn of Africa should be considered and utilized in the design and implementation of other programs focused on strengthening resilience in similar contexts.

 

Annex 3.5

Country Leadership in Reducing Hunger: Brazil's Social Safety Net Program

Government of Brazil

IMPACT:  From 2003 to 2009, Bolsa Familia, one part of Brazil’s government program Fome Zero, helped lift 12.6 million people out of poverty and to reduce the rate of inequality from 22 percent to 7 percent. The program also greatly reduced the level of malnutrition throughout the country, reducing the prevalence of underweight children by half, and put the country on track to halve the rate of hunger before 2015. 

 

The program has shown positive impacts on employment, education and health: school attendance increased by 4.4 percent, participating pregnant women had 1.5 more prenatal visits with a healthcare professional than their non-participant counterparts and infants were more likely to receive their vaccinations on schedule. The program targeted women and mothers, influencing gender roles and empowering women.

 

Since the introduction of Bolsa Familia, many countries worldwide have followed suit to implement their own social safety net programs, including 16 other Latin American countries, Ethiopia, India and China. Because the greatest numbers of people suffering from hunger live in India and China, adaptation and replication of this model may prove to be one of the largest contributors to reducing global hunger.

 

HOW THIS IMPACT WAS ACHIEVED:  One-third of Brazil’s export earnings come from agriculture, yet in 2004, 72 million of its 185 million residents were affected by food insecurity. Recognizing that poverty and food insecurity could be addressed from multiple sides — improving agriculture and production for the poor on the one hand, but also increasing access to food and basic necessities through a social safety net — the government of Brazil implemented Bolsa Familia, a conditional cash transfer program. In exchange for regular transfers, Bolsa Familia requires poor households to fulfill certain human development requirements, such as child school attendance, vaccinations, nutritional monitoring, prenatal and post natal tests.

 

Recently the government also has incorporated the program into its anti-crisis package, which will help mitigate impact of crises on the most poor and vulnerable people, and will ensure that consumption levels of food are maintained.

 

The program success was largely due to the government of Brazil’s right to food policies and predictable funding to focus on the needs of poor people. The Bolsa Familia program costs around 0.3 percent of Brazil’s GDP, yet has seen great achievements. Civil society organizations also have been heavily involved in these efforts, ensuring that the legislature enacted appropriate policies and funding to implement the social safety net programs.

 

KEY LESSONS: 

 

A focus on Access to Food can generate high impact. Social safety net programs can successfully increase a household’s access to food through the provision of cash resources to the most poor and vulnerable people. Linking these programs to conditionalities can also create additive impacts on other areas including health, education and nutrition.

 

Strong leadership by country governments is essential to addressing food insecurity. The most successful safety net programs, as showcased by Bolsa Familia, require government commitment in order to be adequately funded and supported by national policies. National governments play a key role in promoting an integrated approach to food security and addressing poverty.

 

 

 

Annex 3.6

Sustainable School Feeding: Cape Verde Assumes Full Responsibility for National Program

Government of Cape Verde

 

IMPACT:  After 30 years since WFP began school feeding programs in Cape Verde, the government of Cape Verde completed a transition to full ownership of the program in 2010, to provide students with a daily school lunch.  The school lunch is not only a critical tool in the fight against hunger but also serves as an incentive for parents to send their children to school.  Today, 92 percent of Cape Verdean children attend school, and one of the common investments families make with their savings is in their children's higher and continuing education. Cape Verde is well on track to achieve most of its Millennium Development Goals (MDG) by 2015.

 

Since 1993, eight other African countries have made the transition to complete national ownership of their school meal programs.

 

HOW THIS IMPACT WAS ACHIEVED:  In 1979, WFP began its school feeding program in Cape Verde, fully funding and administering the program. In 2007, the government of Cape Verde began the process of taking over the funding and implementation of the program, fully completing the turnover in 2010.  WFP will continue to work with the government, lending program support focusing on cost effectiveness, achieving full coverage and the local procurement of food.

 

To achieve this result, the program understood the importance of government buy-in and partnership at the onset. It complemented the governments’ efforts to alleviate poverty through focusing on education. Throughout the process, the program focused on the capacity building of government employees, as well as stakeholder involvement, to ensure that they were well equipped when graduation was complete.

 

By providing a daily school meal, the program contributed to one-third of a child’s meals for the month. This was not only an investment in children’s nutrition and education, it also allowed poor and vulnerable families to use their family budgets on other essential needs, such as healthcare. 

 

KEY LESSONS: 

The process of social and economic change through supporting country ownership takes time, intense engagement and long-term investments, yet they are essential to true, sustainable development.

 

 

 

 

 

 

Annex 3.7

R4: Rural Resilience Initiative in Senegal

USAID, WFP, Oxfam America and Swiss Re, Senegal

IMPACT:  In September 2011, WFP and USAID joined with Oxfam America and Swiss Re to launch R4, a public-private partnership to help rural poor people to protect their crops and livelihoods from climate variability.  R4 will enable poor farmers in Senegal to strengthen their food and income security by managing risks through a four part approach — improving natural resource management (community risk reduction), accessing microcredit (“prudent” risk-taking), gaining insurance coverage (risk transfer) and increasing savings (risk reserves). R4 builds upon the highly successful growth of a multi-year pilot in Ethiopia known as the Horn of Africa Risk Transfer for Adaptation (HARITA) project. In its three of years of delivery, HARITA has scaled up from 200 enrolled households in one village in 2009 to more than 13,000 enrolled households in 43 villages in 2011.

HOW THIS IMPACT WAS ACHIEVED: The R4 initiative will develop mechanisms that extend the benefits of financial tools such as insurance and credit to the most vulnerable populations. In this way, R4 seeks to establish sustainable market-mediated risk management tools for the most vulnerable populations— – the kind of tools that will be needed to address the increased climate variability and risk projected under climate change.

KEY LESSON:  Disaster risk reduction for the most vulnerable populations is cost effective: Reducing and managing risk is key to effectively building resilience amongst the most vulnerable and food insecure communities. R4’s innovative risk management tools will enable beneficiary households to go from stabilizing income and access to food, to diversifying and building more resilient livelihoods that provide a pathway for these households to achieve food security despite increasing climate risk. 

National plans, especially social protection systems, deserve increased support: R4 focuses on mechanisms that can be integrated into national social protection systems, including productive safety nets, so that the results can be applied and replicated at a much larger scale by governments and international organizations if successful. 

 

 

 

 

Annex 3.8

Strengthening Household Ability to Respond to Development Opportunities (SHOUHARDO): Bangladesh

CARE,  Bangladesh                         

IMPACT:   The prevalence of stunting, a measure of chronic malnutrition, among children from six months to 24 months old in the SHOUHARDO project’s operational area declined from 56 percent to 40 percent over the life of the project (a 3.5 year period).  During this same period, stunting was stagnant in Bangladesh as a whole and even increased for some time due to a major food price crisis and adverse weather conditions.

This drop of 4.5 percentage points per year is far higher than that in Bangladesh country-wide for this age group, which was only 0.1 percentage points per year in the first decade of the new millennium. It is also higher than the experience of previous nutrition-oriented projects. The average USAID-funded Food for Peace food aid program is associated with a reduction in stunting prevalence among children under five years from baseline to final evaluation of 2.4 percentage points per year.[57]

HOW THIS IMPACT WAS ACHIEVED:   With funding from the Food for Peace office of USAID (non-emergency), CARE Bangladesh implemented a comprehensive approach which combines mother and child health and nutrition (provision of food rations to children from six months to two years and pregnant and lactating mothers), with interventions to counter:

1) Unsanitary living conditions (clean water and sanitation interventions);

2) Discrimination against women (women’s empowerment interventions through solidarity groups, early childhood care development for pre-schoolers and  participation of women in Parent Teacher Associations that encourage girls education for the most poor and marginalized);

3) Poverty (training and inputs to increase food production and incomes, savings group training, food and cash for work);

4) Discrimination against poor people (formation of village development committees to represent poor people in formal and traditional power structures); and

5) Recurrent natural disasters (supporting local institutional capacity to prepare for and respond to disasters, including developing public infrastructure).

THE KEY LESSON: Comprehensive, rights-based, livelihoods programming unlocks impact: Combining direct nutrition interventions — such as the 13 proposed by the World Bank and the Scaling Up Nutrition initiative — with programs that address structural causes of poverty has the potential to accelerate reductions in child malnutrition at a far greater rate than can be expected from direct nutrition interventions alone.

 

Annex 3.9

Food Security and Nutrition Program (PROSANO)

 

Save the Children USA and Mercy Corps, Guatemala

 

IMPACT:  In response to the drought of 2009 – 2012 in the eastern “Dry Corridor” of Guatemala, the PROSANO program was successful at averting acute malnourishment of 21,867 vulnerable families (131,256 total people) during a period of successive crop failures. This was accomplished via an integrated program of food assistance, health and nutrition interventions, women leader education and behavior change communication.

 

HOW THIS IMPACT WAS ACHIEVED: With funding from the Food for Peace office of USAID (non-emergency),  Save the Children Federation Inc. (SC) responded to a quickly evolving food insecurity emergency with a project called “Programa de Seguridad Alimentaria y Nutricional del Oriente” — PROSANO — (“Food Security and Nutrition Program in the Dry Corridor of Eastern Guatemala”). In year one, a sub-grant was awarded to Mercy Corps and three of the five departments (regions) of the “Dry Corridor” — Chiquimula, Zacapa and El Progreso.  These regions are in a mountainous area with depleted soils, increasing water scarcity and recurring agricultural pest disease issues.  In the first year, 161 communities at high risk of acute malnutrition were reached, and a total of 11,013 vulnerable families who had lost their entire subsistence corn and bean crops were served.  This clearly met the program objective of reducing the impact of the food security crisis in vulnerable households, while simultaneously mitigating and managing future shocks to health, nutrition, livelihoods and overall food security.

 

PROSANO focuses on three main outcomes: increasing household access to nutritious foods; improving nutritional status of children from vulnerable households; and improving the availability of nutritious foods.  The main beneficiaries have been small children and pregnant and breastfeeding women who were experiencing or were at risk of malnutrition. It delivered pre-packaged, monthly food rations of rice, corn soy blend, pinto beans and fortified oil.  PROSANO also conducted health assessments (weight and middle-upper arm circumference measurement) and provided nutrition education as part of the food aid distribution. 

 

In order to sustain program successes, more than 400 “Mother Leaders” and caregivers have been trained in health, nutrition and hygiene.  Some of these PROSANO participants have been certified by the Ministry of Health to expand their work outside the program, adding potential employment.  In addition, more than 500 “Agricultural Leaders” have been trained in crop and animal production, agro forestry and family gardens.  Rural family livelihoods have improved by introduction of certified seeds, low cost irrigation systems, worms for compost and grain storage silos.  Apiaries and laying hens now provide critical nutritional protein to check the advance of malnourishment in children.

 

Monitoring and evaluation systems using wireless cell phone and internet technology have been developed to track beneficiaries, provide food security alerts and track economic developments.

 

THE KEY LESSON: In this integrated, cross-sector assistance project, malnourished women and children were not only provided food aid, but also participated in health education and leadership training as a means to address and sustain household food security, nutrition and livelihoods.

 

Annex 3.10

YALLANDO KLEYA Child Survival Project (2004-2009)

Helen Keller International, Niger

IMPACT: The project used the Essential Nutrition Actions (ENA) framework to promote improved maternal, infant and young child nutrition practices in communities and to build skills for counseling on these practices among health workers and community-based volunteers in the Diffa region of Niger,  an isolated part of the country with extremely high levels of under-five mortality and child undernutrition, and very little government and NGO assistance. An end-line survey of knowledge and practices suggests significant improvements across several practices promoted by this well tested approach.

The initiation of breastfeeding within one hour of birth increased from 55 percent to 85 percent, while reports of substances other than breast milk given at birth fell from 90 percent to 51 percent. Major increases in exclusive breastfeeding during the critical first six months were also reported, and complementary feeding improved as the introduction of appropriate foods to children aged six months to nine months increased from 40 percent to  72 percent. The feeding of vitamin A-rich foods of both plant and animal sources increased markedly, with the proportion of children consuming adequate amounts increasing from 17 percent to 64 percent. Most impressively, the prevalence of anemia among pregnant women fell from 40 percent to 7 percent, and from 73 percent to 51 percent among children from six months to 23 months.

HOW THIS IMPACT WAS ACHIEVED: With funding from USAID’s Child Survival Health Grants Program, health workers were trained to provide essential nutrition services (for example, iron-folic acid and treatment for malaria and intestinal helminthes for pregnant women along with counseling on immediate and exclusive breastfeeding and demonstrations of how to enrich complementary foods at health centers) and community volunteers were taught to negotiate with mothers to test and adopt more healthful dietary practices during the 1000 day critical window from pregnancy to age two. Community radio broadcasts reinforced key messages about optimal nutrition practices.

THE KEY LESSON:  One-on-one interactions between the mothers and the trained health workers and community volunteers are essential to motivating and supporting long-term behavior change.

 

Annex 3.11

Developing New Nutritional Products with Private Sector Involvement

PepsiCo, Ethiopia

IMPACT: Improved seed and agronomic practices have demonstrated, on a pilot scale, a near doubling of yield and quality improvement in chickpea production in Ethiopia.  The long-term goal of Enterprise EthioPEA, which was launched at the Clinton Global Initiative in September 2011, is to improve chickpea production across Ethiopia and to produce nutritious products made from locally grown chickpeas for low income consumers. This inclusive business approach aims to engage local producers and manufacturers, contribute to economic development and create the opportunity to develop low-cost nutritious products for consumers.

HOW THIS IMPACT WAS ACHIEVED:  USAID provided advice and guidance on the pilot and is considering funding for expansion in 2012. 

 

• PepsiCo agronomists worked in partnership with Ethiopian partners: Omega farms (commercial vegetable farm with experienced management); Ethiopian Institute of Agriculture Research; and the Ethiopian Ministry of Agriculture. Through the able direction and management of local partners it was possible to test the hypothesis that productivity can be increased with new research (improved seed quality and varieties) and planting the crops in rows for better management.  The pilot has been executed on approximately five hectares of land in two main chickpea growing regions of Ethiopia.  A 1.5 -2 times increase in yield has been demonstrated.

 

• PepsiCo Foundation gave a grant of $3.5 million to WFP and a local commercial partner to optimize a chickpea-based, ready to use supplementary food (RUSF) and execute a pilot to prove product efficacy. The program is expected to drive innovative efforts aimed at breaking the cycle of hunger. The work will be executed in three phases: 1) Development and acceptability of a chickpea-based RUSF; 2) Distribution of chickpea RUSF to approximately 40,000 children in Ethiopia; and 3) Expansion of the WFP chickpea RUSF program.

 

THE KEY LESSON:  Diverse Partners are Driving Scale and Impact – USAID, the Ethiopian Ministry of Agriculture, WFP and PepsiCo are developing a Memorandum of Understanding for expanded collaboration in improving chickpea production in Ethiopia. This MOU will address specific initiatives for expansion and greater positive impact for farmers (extension services for sourcing areas; seed programs for improved chickpea varieties to meet identified market qualities; storage and infrastructure capital requirements).                                     

 

 

 

 

 

Annex 3.12

HarvestPlus Increases Nutritional Content of Foods

IMPACT: HarvestPlus leads a global effort to breed and disseminate micronutrient-rich staple food crops to reduce hidden hunger among malnourished populations through the process of biofortification. The biofortification focuses on three critical micronutrients that are recognized by the World Health Organization (WHO) as most limiting in diets: iron, zinc and vitamin A.

 

Since 2002, HarvestPlus has nearly completed two phases of its three phase program. The first phase of discovery, implemented from 2003 to 2008, included the identification of target populations and seed banks, identification of technical approaches and targets for breeding nutrient-rich seeds, research on the potential take-up by farmers and implementation of pilot programs. It also helped set up national biofortification programs in Brazil, China and India.

 

The second phase of development is ongoing, set to be complete in 2013. This phase includes developing and adapting nutrient-rich crops to perform well in target countries, testing and improving crops, developing strategies and implementing delivery of selected crops in target countries. The third and final phase of delivery through 2018, will evaluate the pilot projects and use those lessons to bring the program to scale in targeted program areas. It also will continue to monitor programs, while performing marketing exercises to reach target populations to the fullest extent.

 

HOW THIS IMPACT WAS/WILL BE ACHIEVED:  Funded through the Bill and Melinda Gates Foundation, and other generous donors, Harvest Plus was pioneered through the Consultative Group for International Agricultural Research (CGIAR), and co-convened by the International Center for Tropical Agriculture (CIAT) and the International Food Policy Research Institute (IFPRI) in 2002.  HarvestPlus works with more than 200 agricultural and nutrition scientists around the world. It is an interdisciplinary program that works with academic and research institutions, civil society organizations, governments and the private sector in more than 40 countries.

 

HarvestPlus takes three main approaches to ensuring that foods are well utilized by the target populations:

• Targeted: It makes staple foods that the poor already eat more nutritious and starts in and focuses on rural areas where about 75 percent of the poor people in developing countries live.
• Cost‐Effective: After one up-front investment in developing micronutrient-rich crops, recurrent costs of developing subsequent, high-nutrient varieties are relatively low. Nutrient-rich seeds can be planted year after year.
• Sustainable: Biofortification uses staple foods that poor people already eat regularly. Farmers can save most micronutrient-rich seeds, roots and cuttings and also share them. 

 

KEY LESSONS:

The biofortification of foods requires institutional investment, but has far reaching potential to reduce malnutrition. The initial development of the micronutritient-rich crops becomes cost effective and sustainable once populations adopt the new crop variety and can work to promote intake of essential vitamins and minerals.

 

 

Annex 3.13

ACORDAR: Alliance to Create Rural Development Opportunities through Agro-enterprise Relationships

Catholic Relief Services, Nicaragua

 

IMPACT:  Seven thousand farmers have shifted from supply-driven production of raw materials to agro-enterprise, producing and processing demand-driven agricultural goods with added value sold directly to more profitable and reliable markets. After four years of the five year project, farmers have increased their income by 44 percent, selling $39.8 million in agricultural products to WalMart, large agricultural exporters and major coffee and chocolate companies. Over the five year period, a total of $107.1 million in sales is expected. 

HOW THIS IMPACT WAS ACHIEVED:  With funding from the Food for Peace office of USAID (non-emergency),  ACORDAR worked with farmers to move out of low-profit local markets into formal high-profit supply chains by teaching technical skills to improve outputs, organizing farmers into cooperatives/enterprises to increase economies of scale, and ultimately to embrace an identity as a rural business person who maintains multiple off-farm relationships with financial service providers, buyers, local governments and added value certification bodies.  To achieve these results, ACORDAR helped farmers through: 

1) Enhancing market-based production through activities like repopulating plants, accessing new production technologies and installing greenhouses;

2) Improving water conservation and utilization through building water storage tanks and drip irrigation systems;

3) Adding value to production through post-harvest management techniques, such as washing, fermenting, selecting, drying and storing; 

4) Helping farmers access markets and both financial and non-financial services, providing significant opportunities for export and partnerships;  

5) Strengthening farmer enterprises by forming and working together in cooperatives to participate in economies of scale;

6) Engaging in value chain governance to establish and implement chain competitiveness plans; and

7) Creating an enabling environment for value chain development by working in alliance with 25 of the 50 municipal governments in northern Nicaragua to improve conditions for agricultural competitiveness through direct investments in productive infrastructure and training. 

 

THE KEY LESSON: Working along different areas of the value chain, and integrating a broad range of actors can move small-scale farmers into agro-enterprise, bringing profits and improved lives. ACORDAR works with international and local NGOs, municipal governments and the private sector to make the market work for small producers.

 

Annex 3.14

Purchase for Progress (P4P): Connecting Small-scale Farmers to Markets in 21 Countries

World Food Program

IMPACT:  With funding from Bill & Melinda Gates Foundation, the Howard G. Buffet Foundation, Canada, European Union, Saudi Arabia, US, France, Belgium, Ireland, Luxembourg and Netherlands, Purchase for Progress (P4P) promotes the development of agricultural markets so that by 2013 at least 500,000 low income small-scale farmers — most of whom are women — will produce food surpluses and sell them at a fair price to increase their incomes. P4P also reduces the cost of importing food from other countries and helps improve long-term food security by strengthening local agricultural systems.

More than 207,000 metric tons of food valued at $75.6 million has been contracted through P4P in 20 countries, either directly from farmers’ organizations and small and medium traders, or through innovative marketing platforms such as Commodity Exchanges and Warehouse Receipt Systems. Of this total, 61 percent has been delivered to WFP to use in its food assistance operations.  More than 116,000 farmers, warehouse operators and small and medium traders have received training from WFP and partners in improved agricultural production, post-harvest handling, quality assurance, group marketing, agricultural finance and contracting with WFP.

HOW THIS IMPACT WAS ACHIEVED:  Small-scale farmers face a number of significant barriers to accessing formal markets, as confirmed by a wealth of studies and evaluations of small-scale agriculture and value chains. By developing the capacity to sell to an institutional buyer such as WFP, small-scale farmers can acquire the knowledge, skills and confidence needed for engaging with formal markets. By raising farmers’ incomes, P4P seeks to turn WFP’s local food procurement into a vital tool toward long-term solutions to hunger and poverty.

KEY LESSONS:  Investing in small-scale farmers has great potential: Following decades of neglect, governments and development partners have recently begun to make substantial political and financial commitments to advance agriculture-led growth. A notable aspect of the global response has been to lend support to small-scale farmers in developing countries with a view to renewing investment in production, increasing productivity and promoting small-scale participation in domestic, regional and international markets.

Innovations in local procurement can extend impact of programs: Securing flexible, predictable and timely cash contributions to WFP’s regular program of work in the 21 pilot countries is central to P4P’s success. The value of cash donations, particularly when timely, is optimized when WFP is able to use its purchasing power to support the sustainable development of food and nutrition security systems.

 

Annex 3.15

Building the Capacity of Small-scale Farmers, Ghana

Development Action Association of Ghana, with Africa LEAD and Women Thrive Worldwide

IMPACT: An important element of food security programs is improved agricultural production, which can be achieved in part by professional training. Yet access to this important resource is often lacking in rural areas, particularly for women. In fact, a 2010 World Bank study found that in Ghana fewer than five percent of female headed households have access to agricultural extension services.[58]

The Development Action Association (DAA), a Ghanaian women farmers’ organization, has made significant contributions to reaching female small-scale farmers throughout the country. In 2011 alone, Executive Director Lydia Sasu and colleague Stella Effah have trained 161 rural farmers — more than 80 percent female — and they plan to reach many more. Their trainings have focused on educating farmers on existing agricultural programs and policies, strategic planning and identifying solutions to local challenges in agricultural production.

HOW THIS IMPACT WAS ACHIEVED: In February of 2011, Ms. Sasu attended a five-day leadership training course provided by Africa LEAD to deepen her understanding of CAADP. The course has since improved the effectiveness of DAA’s local training of small-scale women farmers, and it has cultivated host country capabilities. Since the training, Ms. Sasu has remained involved in the CAADP implementation process and meets regularly with the CAADP signatory in order to provide officials with updates and recommendations on behalf of women farmers. She has also used her skills in advocacy to encourage gender integration and analysis across all of CAADP’s thematic areas.

THE KEY LESSON: Engagement with civil society organizations is key for successful agricultural development programs.  Increased participation of a diverse cross section of stakeholders ensures that policies and programs are meeting the needs of the intended beneficiaries and contributes to greater flexibility and inclusivity.  When farmers are equipped with the right tools, they are better able to take advantage of programs and hold governments accountable for their commitments. Training programs that target women and small-scale farmers have the dual benefits of creating linkages between vulnerable populations and decision making bodies while also strengthening the entire community’s knowledge and dialogue.                    

 

Annex 4

Calculating the Chronic Hunger Need and Estimating a Cost to Address that Need

Indicators for MDG1.C  "Halve, between 1990 and 2015, the proportion of people who suffer from hunger."

1. Prevalence of underweight children under five years of age
2. Proportion of population below minimum level of dietary energy consumption (The World Bank uses the  term, undernourishment)

Countries with at Least 30 Percent  Prevalence in Either Indicator

Country*	Percent Underweight Children Under 5	Percent Undernourished	National Population (millions)	Population In Need** (millions)
Bangladesh	41.3	26	149	38.7
Burundi	35.2	62	8	5.0
Cameroon	—	33	20	6.6
CAR	—	44	4	1.7
Chad	—	39	11	4.3
Eritrea	—	65	5	3.3
Ethiopia	34.6	41	83	34.0
Haiti	—	57	10	5.7
Kenya	—	33	41	13.5
Laos	31.6	22	6	1.3
Liberia	20.4	32	4	1.3
Mozambique	—	38	23	8.8
Nepal	38.8	17	30	5.1
Niger	39.9	16	16	2.6
Rwanda	—	32	11	3.5
Sierra Leone	21.3	35	6	2.1
Tanzania	—	34	45	15.3
East Timor	45.3	31	1	0.3
Togo	21.0	30	6	1.8
Yemen	—	30	24	7.2
Zambia	—	44	13	5.7
Zimbabwe	—	30	13	3.9
			Total	171.7
			Cost per Person***	$51
			Total Cost	$8.7 Billion
			US Contribution (25 percent)	$2.2 Billion

(Source: World Bank)

— No data available

*Countries left off the list because of large oil or other revenues (Angola, Nigeria, India), for geopolitical reasons (North Korea, Somalia, Sudan), or for lack of information (DRC, Mauritania, South Sudan)

** Population in need is calculated using only the percent of undernourished people for each country.

***The cost per Food for Peace beneficiary was calculated based on funding and beneficiary numbers from 2008 – 2010’s International Food Assistance Reports issued by the US Government and USAID ($49.17, $52.86, $50.63)

 

Annex 5

Summary Chart of Funding Recommendations

               

Recommended Annual US Funding for International Food Security
Emergency Programs
Food for Peace Emergency Programs	$  1.4 billion
International Development Assistance Emergency Food Security Program	$  500 million
Total for Emergency Programs	$  1.9 billion
Safety Net Programs
Food for Peace Non-Emergency Programs / CDF within DA*	$  500 million
McGovern-Dole International Food for Education and Child Nutrition	$  300 million
Total for Safety Net Programs	$  800 million
Nutrition Programs
Global Health	$  450 million**
Total for Nutrition Programs	$  450 million
Agricultural Development Programs
Development Assistance – Feed the Future Agricultural Development / Nutrition	$  1.3 billion
Development Assistance – Resilience Programs	$  200 million
Adaptation funding***	$  200 million
World Bank Global Agriculture and Food Security Program multilateral trust	$  150 million
Total for Agricultural Development Programs	$ 1.85 billion
Total Recommended US investment in International Food Security Programs	$ 5 billion

NOTES:

* In FY2013, the Administration's budget request indicates a $60 million request for the Community Development Fund that would provide direct program funding to the same types of programs financed through monetizing commodities provided through Food for Peace for non-emergency programs.  The total of $500 million indicates the total required for this program area, with the understanding that as the community development fund develops and is more fully funded, a greater percentage of resources will be provided in direct program funding.

** The World Bank identifies nutrition as the world's most serious health problem and the biggest single contributor to child mortality.  Although we recommend additional funding to address nutrition within the global health account, we also recognize this will require an overall increase in the account to ensure sustained support for other valuable and complementary health programs.

*** Adaptation funding includes allocations through the Development Assistance Account to USAID and State, the Economic Support Fund for the Least Developed Countries Fund and the Strategic Climate Fund and the Multilateral Account for the Pilot Program on Climate Resilience at the World Bank.