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Food and hunger in Sub-Saharan Africa
NORMAN MYERS and JENNIFER KENT∗ Upper Meadow, Old Road, Headington, Oxford OX3 8SZ, UK
Summary. Sub-Saharan Africa is by far and away the most disadvantaged of the world’s three main developing regions. Worse, its situation has mostly been deteriorating for much of the past several decades. Its agriculture is severely under-productive, and per capita food supplies have been steadily dwindling. Its environments and natural-resource base, characterised by water deﬁcits, soil erosion, fuelwood shortages, rudimentary agro-practices, and grossly inadequate infrastructure, are generally unfavourable for sustainable agriculture. The population has expanded until it far exceeds carrying capacity, yet its growth rate is the highest in the world. The region also suffers from more disease than any other region. There is widespread and deepening poverty. As a result of these and other problems, and despite major food imports, two-thirds of the people are malnourished, one-quarter of whom endure outright hunger, even semi-starvation. Both these proportions appear set to keep on increasing both relatively and absolutely. Were these problems to persist with their decades-long trends, there could eventually arrive a stage when much larger numbers of people would succumb to terminal malnutrition, precipitating a human tragedy of unprecedented proportions. Fortunately, success stories demonstrate that solutions are available, on the part of both governments concerned and international agencies. Because of ignorance, or rather ‘ignoreance’ of the potential mortality disaster ahead, however, not nearly enough has been done to address the challenge with the energy and urgency to match its scale. Keywords: Sub-Saharan Africa, poverty, famine, diseases, population growth
Introduction In April 2000, another famine crisis arose in Ethiopia, placing eight million people at risk of starvation (Food and Agriculture Organization, 2000a). This was all the more remarkable in that Ethiopia had been viewed as a semi-success story in the mid-1990s with markedly increased grain harvests. Also, in early 2000 neighboring Sudan featured six million enfamished people, and Somalia three million, while drought in Kenya left nearly three million people facing severe food shortages. This has demonstrated that hunger remains a frequent phenomenon in Sub-Saharan Africa.
∗ For a 46,000-word report on which this article is based, see Myers and Kent (2000). The article reﬂects a research project funded by the Winslow Foundation in Washington, DC, USA.
It is pertinent to review the situation in this article, and to ask whether there is a prospect of improvement—or whether a more likely outlook is that the region could eventually face a starvation disaster with mortality on an unprecedented scale. This is not to discount the famines and increased mortality of the mid-1970s, the mid-1980s and parts of the 1990s in areas such as the Sahel, the Horn of Africa, Rwanda, Burundi, Angola and Mozambique. Fortunately these crises were fairly short lived, even though they cost the lives of millions of people. By 2025 the region may not be able to produce food for more than 40 percent of its people (United Nations University, Institute for Natural Resources in Africa, 1999). To cite the World Food Summit in 1996, “Sub-Saharan Africa’s precarious food security could lead to a genuine human tragedy.”
Myers and Kent — 250 million people have no access to health services. — The death rate from several diseases is proportionately higher than in any other region; the region suffers 90 percent of all malaria deaths worldwide. — The region features 67 percent of all HIVinfected people worldwide, and 83 percent of AIDS deaths have occurred here. — At least 400 million people are malnourished, over 100 million of whom endure outright hunger if not semi-starvation. — The region suffers the highest mortality among under-ﬁve children. — It features proportionately more civil strife, military violence and wars than any other region. For details of trends in population growth, food supplies, malnutrition, and economic factors in the region, see Tables 1–3. This is not to overlook an improvement in some countries during the last few years. Overall, however, there is much evidence that the long-term trends will continue. This is all the more likely insofar as many African governments and international agencies have not been doing enough to reverse these long-term trends. While no starvation episodes of several million have yet overtaken the region (the largest to date was one million in Ethiopia during 1984/85), the implicit response on the part of bodies responsible, viz., governments and international agencies, is that the situation is somehow tolerable. They may protest that this is quite the opposite of what they intend. But if they did not view the situation with a modicum of ‘ignore-ance,’ they would surely have done more to rectify it. It is not unrealistic to suppose that the region could soon start to experience many more hunger crises, each on a larger scale and overtaking more countries than before. Suppose too that each crisis costs the lives of not just one million people but conceivably several millions—and not just once in two decades but several times a decade, a human debacle of altogether unprecedented proportions is likely to arrive. There is much scope for debate about the prospect of a starvation disaster ahead. Remarkably, not a single government or agency has explicitly addressed the issue head on, even though the
Background Sub-Saharan Africa lags behind the two other developing regions in terms of virtually every criterion, whether socio-economic, environmental or political. Worse, its situation promises to deteriorate further unless exceptional efforts are made to reverse its adverse trends. For sure, its plight has not yet resulted in any marked or persistent increase in the documented numbers of people dying from hunger. But there has been a steady and even a strong trend in several key factors that contribute to hunger crises: declining food production per person; declining food imports in relation to needs; high growth rates for populations, that in many, if not most countries, have already surpassed carrying capacity; increasing malnutrition and diseases; declining stocks of cropland, water and fuelwood per person; increasing soil erosion among other forms of land degradation, including desertiﬁcation; increasing environmental rundown of several other sorts; spread of absolute poverty; declining aid, trade, and investment; and continuing political instability and civil strife. To illustrate these points: — The region’s per capita food supplies are lower than for any other region including Southern Asia. A decades-long decline in supplies seems set to continue. — The region’s aggregate economy, excepting industrialised South Africa, is less than Belgium’s with its 10 million people. It enjoys around 1 percent of global trade. — 400 million people have incomes of less than $1 per day, and their numbers are growing faster than the population as a whole. Unemployment runs at over 50 percent. — Population growth is still as high as 2.5 percent per year, and the average family size is 5.8 children. — The region receives less and more erratic rainfall than either of the other two main developing regions. — 200 million people live in water-short countries. — More than 150 million adults are illiterate and 40 million children are not in primary school. — 40 million women have an unmet need for family planning.
years 24 29 22 55 24 33 32 24 29 32 32 27 24 — 27 Total fertility rate/ family size 1960 2000 6.4 3.9 5.9 6.8 2.5 1.7 6.2 5.9 — 2.2 6. ∗∗∗ A minor fall in calorie supply translates into a much larger percentage of the population being malnourished.4 2.5 to 3. % na 8 11 15 20 28 32 39 40 41 55 51 63 33∗∗∗ Country South Africa Nigeria Ghana Ivory Coast Sudan Uganda Cameroon Madagascar Tanzania Kenya D.R.7 7.0 to 4. this goes some way to substantiate this paper’s estimate that 62%.0 6. .6 — 6.7 4. 2000.5 Population doubling time.5 to 2.0 to 4. Table 2.3 7.0 to 2.2 1. this falls to below 2000. 2 = food production growth less than population growth.2 2.0 na Food production in relation to population growth∗ na 2 1 1 1 2 2 2 2 1 2 2 1 na Ofﬁcial estimates of population malnourished 1995–1997.0 to 0.1 2.0 Below −1 0 2.0 6. Sub-Saharan Africa: population.8 43 Country Nigeria Ethiopia D. United Nations Population Division.0 3. millions 2000 2025 2050 (projected) 117 64 52 43 35 30 30 23 20 19 16 15 15 479 646 205 115 105 35 60 34 46 48 27 21 23 25 29 773 1053 304 188 182 33 88 39 59 84 32 23 31 35 47 1145 1556 Natural increase.9 6.0 — 5.6 6. 2000.9 4.Food and hunger in Sub-Saharan Africa Table 1.0 Over 5.0 Over 5.6 4. ∗∗ When Nigeria is excluded from regional supply estimates. Food supplies.9 2. UNICEF.3 2.8 8. 1999.5 5. are malnourished.R.0 −1 0 to −0 5 2.5 6. Together with analysis of the skewing factor of Nigeria.6 2. 400 million people.9 6. Congo South Africa Tanzania Kenya Sudan Uganda Ghana Mozambique Ivory Coast Cameroon Madagascar Total of above Total for region Married women using modern contraceptives.2 2.5 0.0 6. 1999a–c.8 6.2 2. Note: These 13 countries account for three quarters of the region’s population.2 2. Congo Ethiopia Mozambique Total for region Source: Food and Agriculture Organization.2 5. (the category 2 countries comprise 364 million people). Population.0 Over 5. % 7 3 3 55 16 32 7 8 13 5 7 7 10 — 13 Sources: Haub and Cornelius. Per-capita daily calorie supply (1995/97) 2990 2750 2620 2570 2380 2170 2140 2020 2000 1980 1820 1820 1780 2185∗∗ Annual rate of change of food output (1994–1998) na 1.0 3. Notes: ∗ I = production growth greater than population growth. annual % 2.6 6.6 5.5 to 2.5 6. viz.9 2.
food output per head is generally expected to drop by about 0. and many more people will become malnourished to some degree. 1996 and 1999a. 1999.a. % (1998) capita (and per capita) 2880 300 700 300 610 290 390 210 320 100 110 260 210 480 06 11 57 15 67 50 46 32 58 −0 8 40 48 11 3 22 −1 2 −1 7 36 −0 9 38 27 19 06 29 −3 2 07 16 92 −0 4 Population below poverty line (ppp $1 per day).0 percent annual decline since 1970. So per capita food production in most of the region has declined by an annual average of at least 1. for another decade. Food and Agriculture Organization. Excluding the region’s economic leader. World Bank 1998. Many experts (e. Worse. % 24 31 18 50 Na N/a N/a 16 N/a 46 N/a N/a N/a 48 External debt. which. generally 3. has generally been no better than 2. As a result. World Bank 1996b and 1999a–c. On top of all this there are several environmental constraints. Note: These 13 countries account for three quarters of the region’s population and GNP.0 percent (Food and Agriculture Organization. until at least the year 2010. $billion. the remaining 12 countries account for two thirds of population and three-ﬁfths of GNP. many people will become more malnourished than ever. probably less. Sector-by-sector review Food and agriculture During the past 30 years the region’s population growth rate.R. Fortunately some countries in recent years have enjoyed an increase in per capita food production. they will become increasingly prone to hunger-related diseases. US Department of Agriculture. and possibly by a similar amount during the following decade. To close the nutrition gap by 2010 would require an annual growth rate in food production of 3. and % of GNP (1997) 25 2 28 5 15 6 65 93 16 3 59 72 37 10 1 12 3 41 60 219 19 72 141 49 93 182 57 77 31 131 215 85 135 70 Foreign aid.a. has remained ahead of the growth rate for food production. US Department of Agriculture. Rukuni. Economies of the 13 largest countries. as is more probable. 1999. Because of unpromising baseline conditions generally and particularly with respect to harsh climate in much of the region (Falkenmark. risk of such a disaster is surely greater than zero. 1998.44 Myers and Kent Table 3.5 percent p.5 percent p.4 percent (US Department of Agriculture. 1999).g. 1996). $ per capita 1990 1997 3 59 51 39 36 38 48 42 21 24 35 76 43 12 2 31 16 36 7 28 31 41 11 4 59 58 33 Country Income distribution. South Africa. 1999) (Tables 1 and 2). GNP growth rate $billion $ per 1997–1998. 1994.a. it is widely supposed . United Nations Development Programme.0 percent or more. 1999) agree that food production is unlikely to grow annually at better than 2.0 percent (United Nations Development Programme. Pinstrup-Andersen and Cohen. Whether this is the start of a long-term advance or a temporary spike in the trend is subject to much uncertainty. bottom 60% top 20% 17 6 27 3 33 8 28 9 36 4 32 9 32 7 32 5 64 8 49 3 44 1 50 2 41 7 45 5 46 1 47 7 South Africa 119 0 Nigeria 36 4 Ivory Coast 10 1 Kenya 97 Cameroon 87 Sudan 82 Ghana 72 Tanzania 67 Uganda 67 Ethiopia 61 D. while population growth remains at around 2. While this is only half of the 1. those experiencing severe hunger already could become threatened with outright starvation—or.. signiﬁcantly so.3 percent p. 1999b. the prospect deserves to be considered in appropriate detail. Hulme. In light of the potential human tragedy it would entail. GNP. 1999b. 1999. 1999). Congo 53 Madagascar 38 Mozambique 36 Total for region 304 Sources: United Nations Development Programme. GNP. 1999a. Nigeria and South Africa apart (see below).
Gardner. produces 30 percent of its grain—a distinctly skewing factor for the region-wide average of food supplies. Iran. Indeed the region will need to import 30 million t of grain by 2020..5 percent and Asia’s 0. US Department of Agriculture. Myers and Kent. An alternative way to assess the future outlook is to consider that twenty countries with total projected populations of almost 430 million are expected to experience up to 25 percent shortfalls in food supplies by 2008. 1999. the region’s growth rate is expected to be still around 1. Pimentel et al. 1998). and those who will be semi-starving.Food and hunger in Sub-Saharan Africa (e. 1996). There are sizeable differences between what derives from the crop ﬁeld and what reaches the meal table. 1997. Ehrlich and Ehrlich. Brown et al. Other food-short countries will ﬁnd it increasingly difﬁcult to compete in global markets given the large and fast-growing demands on the part of North Africa. Population It is signiﬁcantly due to its unequalled population growth that the region has difﬁculty in feeding itself. 1999).g. India.. But this is strictly a demographic projection. These countries include Nigeria which. due to wastage along the way. If this prospect were aggravated by the climatic vicissitudes of global warming (Glantz. 1998) that adverse weather conditions could quickly trigger further onsets of broadscale famine. In 2050 the region will account for almost half of the annual global increase. Brown et al. Moreover because of unequal distribution of food in these four countries—where the richest one ﬁfth will enjoy more than the rest—they will still feature large numbers of inadequately fed people (US Department of Agriculture. 1998.4 percent (United Nations Population Division. and takes no account of the region’s capacity to support such . by contrast with Latin America’s 0. the population could readily top two billion (United Nations Population Division.a. but vulnerable to summary starvation (Myers and Kent. World Bank. 1994.5 percent p. 1999b. and especially China (Rosegrant. 1999) regard the present population as too high for the region’s physiobiotic carrying capacity and its governments’ planning capacities. This contrasted with Latin America’s growth rate of 1. by contrast with only one ﬁfth in 2000. food supply is more than food consumption. 1994..1 percent p. a 141 percent increase over today (Haub and Cornelius. Nigeria imported 17 percent of the region’s cereals in 1998. Probably facing still more severe food deﬁcits will be another eight countries with total projected populations of 67 million. 1997. In many instances we should not consider resource shortages. Delgado et al.. Many observers (Sai... 1999a). Food and Agriculture Organization. Mexico. 1997. Poleman. 1995. 1994. Downing. Roughly one ﬁfth of food grown is wasted (Biswas. As far ahead as the year 2050. Pinstrup-Andersen et al. 1999).a. 1994. and 1556 million by 2050. The region’s population in mid-2000 was growing by 2. Cleaver and Schreiber. Islam 1996. By the time the region reaches zero population growth at some stage in the 22nd century. Marsili. 2000) (Table 1). The mid-2000 population of 646 million is projected to reach 1053 million by 2025. 2000). The conclusion must be that the majority of Africans are signiﬁcantly malnourished—probably twice as many as the ofﬁcial and minimalist estimates of 210 million (Alexandratos 1995. Food aid provided worldwide in 1998 was only 8 million t. Food imports are a long way from closing the gap.. 1999). Moreover. 1996. 1997 and Watson et al. World Food Programme 1999a). 1994. Food and Agriculture Organization.8 percent and developing Asia’s 1. 1995. Fortunately there is a better outlook for four countries with a projected total of 200 million people. A further conclusion is that large numbers of Africans are malnourished to an extent that leaves them not only chronically hungry. but population longages. with 18 percent of the region’s population. in order to meet minimal needs of a 45 population that will have increased by 54 percent. 1999). let alone to counter existing levels of malnutrition (Harris. 1995. of which less than 3 million t went to Sub-Saharan Africa (Food and Agriculture Organization.5 percent. 1999). double the average for the late 1990s. which are expected to have adequate food overall by 2008. a 63 percent increase. which is expected to widen still further. there could be marked impact on the large numbers of both those people who will be malnourished.
especially those of the Francophone countries. Not all these children were wanted or planned—not by a long way. but only 13 percent of couples use modern contraception methods (Haub and Cornelius. and a population growth rate of 3. As many as 29 percent of married women do not want any more children or want to defer their next pregnancy. Congo. 1996. 2000). with some countries achieving a fertility decline of 17–18 percent. United Nations Development Programme. the need would be all the greater. Namibia and Swaziland. Fortunately more than 30 countries now have active family planning programmes. leaving the region’s numbers to keep on expanding apace (United Nations Population Division. pneumonia. 1997. 1994. World Bank. However. Haub and Cornelius. an average family size of 7. 1999a). 1999). 1999). 1999). Note the latent power of “demographic momentum”. 1995. the demographic consequences would be marked.2 percent per year (doubling time. 1998. tuberculosis. United Nations Population Division. These governments include that of D. 1999). 1996. Added to this is the fact that several governments of the region. In 1975 it was as high as 6. Because of the youthful population proﬁle—as many as 44 percent of the present population are under the age of 15 (Latin America 33 percent. 2000). Haub and Cornelius. Alan Guttmacher Institute. Diseases The region is the most diseased of all three main developing regions. life expectancy at birth is seven years less than it would have been without AIDS (Lutz et al. Countries that could soon experience zero population growth include Zambia. even though the country has 52 million people already. 1999). Even if African women were to average two children from today. falling only to 6.g. 2000). in Kenya from 68 to 40 years (12 percent). Zimbabwe. life expectancy is expected to plunge. 1999.R. the region’s population would still grow for best part of two generations and almost double (cf.5 in 1984 and 5. South Africa’s population is expected to decline from 43 million today to 35 million in 2025 (Haub and Cornelius. just 22 years) (Haub and Cornelius.. where the . Asia 32 percent)—there are huge numbers of potential parents for the future. Assuming a moderate spread of AIDS beyond the countries deeply affected already. but they lack the family planning facilities to put their wish into practice. (If unmarried women were included. AIDS will slow population growth only marginally in the long term. or an average of 30 percent of the distance to replacement fertility (Westoff and Ochoa. 1999. in Kenya the rate is 47 percent among married teenage women and 74 percent among unmarried teenage women (United Nations Population Fund. What of the population impact of AIDS in a region where one person in 30 is infected with HIV? The most immediate consequence is for life expectancy. 1997.0 percent at the height of the pandemic. Rosen and Conly.) The 29 percent rate is the highest among all developing regions. have no population policies at all. Fortunately there is much scope to reduce population growth by tackling the key factor of unmet need for family planning. United Nations Population Division. Botswana. Cleaver and Schreiber. an unprecedented increase. e. 1996). In the 29 hardest-hit countries. 1999. the region would be well on the way to producing enough to feed itself (Kendall and Pimentel. This is specially important in that the number of children per reproductive woman has declined very slowly. with its premium on urgent and incisive action. the region’s population growth rate is expected to fall to perhaps 2. Were the unmet needs to be met. It should reﬂect deteriorating conditions such as spreading poverty. Rukuni. Ten governments view their population situation as ‘satisfactory’. Jain. in Zambia from 66 to 33 years (HIV rate 19 percent). 2000. US National Research Council. In large-population countries with high adult HIV rates. and in South Africa from 60 to 40 (13 percent) (Caldwell and Caldwell. If the growth rate of population could be halved and the growth rate of food production could be doubled by 2020.2 children (no decline since 1980). United Nations Population Division. hunger and disease.8 in 2000 (United Nations Population Division. 1999). 2000). malaria.7. in Zimbabwe from 70 to 40 years (26 percent). Infectious diseases such as measles.46 Myers and Kent average is around 16 percent (Bongaarts and Bruce. 1994.
a. it costs less than 33 US cents per dose when supplied in bulk (World Health Organization. 1996a). 1996a).. diarrhoea and especially malnutrition. so a vicious circle ensues which is hard to break down. Other sources of disease include intestinal parasites from contaminated food. 1999). rather they succumb to diseases that are strongly facilitated by malnutrition. 1996. 1999). and women are more heavily hit than in any other region (World Health Organization.Food and hunger in Sub-Saharan Africa diarrhoea and AIDS cause more than 70 percent of ill health. and national . Although the therapy generally needs to be applied several times a year to counter recurrent bouts.5 million). with nearly 70 percent of all HIV cases among 10 percent of the world’s population. and there is a strong linkage to malnutrition through potentiating impacts in both directions (Murray and Lopez. 1999). The people most affected by HIV/AIDS tend to be those in their most productive and energetic years. An African child runs a 1000-fold greater chance of dying from measles than a developed-country child. 1995). and by 2015 they are expected to have totalled well over 20 million. water and soil. 1999). World Health Organization. Over one million children in Sub-Saharan Africa 47 die from diarrhoea each year (Murray and Lopez. have reached 2 million (worldwide 2. United Nations Development Programme. Another major scourge in Sub-Saharan Africa is measles. Hookworms can remove up to 30 ccs. 1998. 1998. During the period 1970–90 several countries recorded an increase in malaria incidence ranging from four-fold to over 150-fold. Zimbabwe and Botswana. 1993). as many as one quarter of adults are affected. In some areas. engineers. an increase which is continuing (World Health Organization. 23 million are in the region (United Nations Population Division. Zambia. All diseases together levy such a nutritional toll that 5–20 percent of food intake is needed to offset maladies (Pimentel and Pimentel. 1998. plus loss of nutrients through diarrhoea and dysentery (Shetty and Shetty. Moreover. notably government planners.a. so diseases leave malnourished people all the more vulnerable to the rigours of semi-starvation. of blood from a host in a single day. diarrhoea and especially malnutrition (World Health Organization. 1996). They result in reduced intake of nutrients. plus infections from mothers to unborn children (Mann and Tarantola. 1996. AIDS. yet at least every second child remains unimmunized against the disease (World Health Organization. 1999). and the most readily treatable disease. To emphasize a key point: people rarely die directly from hunger. is diarrhoea. AIDS sufferers may lose as much as ten years of productive life. due to complications from pneumonia. 1999). 1999). Today’s total could well double before the pandemic ﬁnally abates. Most of such deaths could be prevented with oral rehydration therapy. Malawi. a technical name for a salt-and-sugar mixture that replaces nutrients lost through the disease. Malaria kills almost one million people each year (90 percent of all malaria deaths worldwide). yet malnutrition makes people much more susceptible to disease. and regionwide it claims more than twice as many children’s lives as do malaria or measles. Just as malnutrition greatly predisposes people to diseases. and teachers—hence those who most drive national economies. The biggest scourge. agronomists. This surely ranks as the ‘forgotten’ malady. UNICEF. HIV is spreading more rapidly than ever in the region. almost nothing is spent on its basic epidemiology and on vaccine research. World Health Organization. 1999. with four million new infections annually. the two processes do not generally work in additive fashion: they are likely to be multiplicative. 1996. Of 34 million HIVinfected people worldwide. is already killing two million people p. In the worst-hit countries. leaving the person susceptible to other diseases (Hotez and Pritchard. being those with above-average education and skills. World Health Organization. The region is the epicenter of the global HIV/AIDS pandemic. and accounts for one in ﬁve of all childhood deaths in the region. The most widespread and injurious. whether directly or in combination with other forms of ill health such as respiratory infections. AIDS deaths p. Already the disease is the leading cause of mortality among adults aged 15–39 in Uganda. The virus may ultimately cause more child deaths than any other single microbe. Pimentel et al. Worst of all. Daily and Ehrlich. Although hookworm undermines the health of millions of people throughout Sub-Saharan Africa.
(As it is. Scherr and Yadav. coastal erosion $150 million. The region has 10 percent of surface water supplies worldwide. for a total of $5. because of its poverty. and fully half of the spare land that could be used to produce food features poor soils or is covered with forests with their many beneﬁts economies could be reduced by 10–15 percent in a single decade. As a result. resulting in more frequent and severe droughts (Watson et al.. fuelwood deﬁcits and shrinking per capita croplands. it features climatic conditions that are. weather/climate. It is possible for a country to keep on pushing up its food output year by year over the short term. safe water and sanitation. 1993. 1996. Falkenmark et al. Other problems include soil erosion. Only 20 percent of the region’s rainfall feeds into streams.. deforestation $750 million. by contrast with Asia’s 38 percent and South America’s 45 percent (Oldeman et al. Being the driest of the three developing regions. 1996. Bongaarts. so they have to reduce investments in primary health care. Pingali and Rajaram. yields could decline at least twice as much by the year 2020 (Lal.4 percent of GDP. with all that implies for government investments in agriculture. (Fig. In Zimbabwe. There are also wider costs from environmental depletion: in Nigeria. There are several other forms of land degradation. with all forms together affecting 65 percent of the region’s agricultural lands..48 Myers and Kent losses $10 million. 1997). notably desertiﬁcation. with all the indirect consequences this would have for morbidity and mortality. 1998). for instance. with food losses averaging 10. Many countries could ﬁnd themselves declining into even worse poverty and far more severe food deﬁcits than today. 1996. 1999a) (cf. The situation is often made worse by poor land management and rudimentary agriculture. ﬁshery declines $50 million. live in watershort countries. the campaign to stem malnutrition. child mortality could more than quadruple as early as 2010 (Brown. and one third live in droughtaffected grainlands (Chievba. the region’s health expenditures amount to only around 1. Water shortages are likely be accentuated by climate change. health and other sectors that reﬂect food and nutrition (Forsythe. Pinstrup-Andersen and Pandya-Lorch. the nation’s economy. 1995. infrastructure and education. 1999). 1999). compared with 37 percent globally. In 1995 droughts in several sectors of the region caused food production to drop to two-thirds of the 1994 level (Rosegrant. 1998). gulley erosion $100 million. 2). There are widespread shortages of water for agriculture and other purposes (Fig. 1996). etc. almost one-third of the total population. which in turn reﬂect the region’s poverty. water contamination $1 billion. Postel. 1). $36 billion). by comparison with South America’s 26 percent and Asia’s 36 percent (Postel. Gardner.. 1998). but with costs to the environmental resource base (soils. Half of all the farmers experience unusually low and variable rainfall. 1995). In addition. with rainfall becoming more sparse and erratic.a. 1996). Moreover.5 million t p.a. 1996). Environments and natural resources The region has some of the most adverse environments anywhere. 1999. If accelerating erosion continues unabated. and wildlife . Child mortality is one of the main factors spurring high fertility. governments are shifting medical funds to combat AIDS. soil degradation in 1992 was worth $3 billion p. Virtually all good lands have already been mobilized.1 billion (World Bank. it is anticipated there will be major reductions in food production in several parts of the region. Yet no other region is less able than Sub-Saharan Africa. distinctly unfavourable to agriculture.) that eventually levy a toll on the potential for future output (Daily et al. to adapt to the impacts of climate change.. 1997. for the most part. and by 2010 over twice as many people will likely face severe water constraints on food production—a total that by 2025 could climb to 700 million (Gardner-Outlaw and Engelman. rivers and underground aquifers.) All this militates against the biggest battle. water hyacinth blockages $50 million. Bojo. so family planning campaigns could well be set back by several decades (Caldwell and Caldwell. the pandemic will mean a reversal in many countries of hard-won trends in infant and child mortality. agriculture. Already more than 200 million people. water. 1990. 1996). 1998. World Health Organization. In the early 1990s soil erosion region-wide caused crop yields to decline by 2–40 percent.
more than two-thirds of the region’s populace. a typical African farmer today needs at least 0. . In any case. today the gap is expected to have widened to 36 out of 64 million.14 ha in 2025 (Engelman and LeRoy. Forest cover is shrinking almost everywhere. In 1990 fuelwood supplies in Ethiopia were enough to support only 37 million people. 1995).R.68 ha. 1994). A lengthy list of other countries reveal similar and growing gaps (Pearce et al. fuelwood provides most of the energy needs of the region.a. 1999). 1995). Congo.07 ha is enough in principle for just one individual to survive off a largely vegetarian diet. 1995. (Alexandratos.34 ha. 3). and is projected to decline drastically by 2025. As many as 400 million people in 1993. without using modern intensive agronomic inputs and with no signiﬁcant environmental constraints such as water shortages. The latter ﬁgure is no more than the equivalent of ﬁve tennis courts. Brown et al. sometimes at rates as high as 2 percent p. An expanse of 0.Food and hunger in Sub-Saharan Africa 49 Figure 1. the amount in 1960 was 0. even allowing for a moderate expansion of croplands. Wollo region of Ethiopia (Photo Courtesy: Mark Edwards/Still Pictures). 1998. the country with the largest population. Moreover many of these lands lack enough water for sustainable agriculture (Ingram and Frisvold. much land with agricultural potential is unevenly distributed: two-ﬁfths of it are in D. and it is projected to be only 0. while the population totalled 51 million. Topsoil being removed in a dust storm. in 1990 it had contracted to 0. Even with near-perfect planning. Bokena Valley. with equable climate and with average-fertility soils. In Nigeria.. 1996). Together with its derivative charcoal.. 1999). Due to population growth. World Resources Institute. Nigeria and Sudan alone (United Nations Environment Programme.1 ha to feed one individual (Engleman and LeRoy. There are major fuelwood deﬁcits in at least 20 countries (Fig. the per capita expanse has been shrinking markedly in most countries. found it was often as difﬁcult to heat the supper bowl as to ﬁll it (Cleaver and Schreiber. 1994).
semicooked food is not so nutritious and it contains more pathogens. Digging a well in Burkina Faso. when global warming starts to bite? Economics and poverty The region is the most impoverished of the developing world. with two-thirds of the 50 poorest countries in the world (World Bank. inadequate as they are for overall nutritional needs. even though the threat has been temporarily held at bay by increasing amounts of fertiliser? What if cropland per person has been shrinking due to population growth until the amount becomes too small for even subsistence purposes (given meagre agro-technologies and rural support services)? What if soil erosion and per capita cropland shrinkage occur at the same time and place. Africa has a widespread water shortage. above all. whereas the developing world’s average is $1260. too. 1999a). If South Africa’s GNP of $119 billion is discounted. its people have mostly been growing poorer for much of the past several decades. the regional GNP declines to . take no account of environmental degradation. Its aggregate economies total around $300 billion. This had a vital linkage to malnutrition. in a manner that causes each to reinforce the other in synergistic fashion? What if. by contrast with Belgium’s $259 billion for 10 million people. the situation is compounded yet again by water shortages and fuelwood deﬁcits? What. West Africa involves a further man at the bottom of the well (Photo Courtesy: Mark Edwards/Still Pictures). Today’s per capita GNP is around $500. What if soil erosion over the past several decades has reduced the future potential of farmlands.50 Myers and Kent Figure 2. Projections for food production in Sub-Saharan Africa. and by contrast with the other two developing regions. Worse.
with per capita GNP growth of around 2. This means that many people. During the two decades 1975–95. There are major fuelwood deﬁcits throughout much of Africa (Photo Courtesy: Mark Edwards/Still Pictures). hardly greater than that of London (Table 3). 1997. These women in Kalsaka village. 1995. it is 24 percent) (African Development Bank. governments too.8 percent of the world’s private direct investment and around 1 percent of global trade.a. Globalization is overlooking Sub-Saharan Africa. Almost two-thirds of the population. with all three shares declining (World Bank. 1999a). 1999c). followed by a partial recovery in 1995–98 (often due to better rains supporting agriculture). The impoverished total has more than doubled since 1987 (Pinstrup-Andersen. 400 million people. $185 billion. 1999b. 1998. live in absolute poverty with incomes of $1 or less per day (the share of population rises in nine countries to over 60 percent. 1998). United Nations Development Programme. walk for an hour to an area where they can ﬁnd fuelwood. The regional economy has slipped to less than 1 percent of the global economy. 1999a. even in the richest country. or more in several countries. During the more recent period 1991–97 it declined by an annual average of only 0. South Africa.0 percent p. The region’s aggregate economy is less than the assets of the world’s 15 richest individuals (United Nations Development Programme.0 percent p. it is a problem of poverty as well. Malnourishment is not just a problem of food shortages. The region’s 20 smallest economies are together worth less than General Motors’ annual sales of $164 billion. 1999). it accounts for only 0. (World Bank. United Nations Development Programme. though with dips in still more . the region’s per capita GNP fell by 20 percent or an average of 1.a. the region is getting left further behind.2 percent. 1998. Worst of all. Burkina Faso. World Bank. 1999).Food and hunger in Sub-Saharan Africa 51 Figure 3. South Africa with $119 billion. Speth. cannot afford to buy food. Another way to put perspective on these ﬁgures is to note that the world’s seven largest corporations have annual sales larger than the GNP of the region’s leading economy.
1999. 1997. 1999). One analysis (United Nations Development Programme. 1997. down from $40 in 1990). 1997). World Bank. 1999) asserts that even if GNP growth were to continue at the best recent rate of around 4. There is mixed economic support from outside the region.0 percent p. The new regimes. Cleaver.a. or less than $50 for the decade (Paarlberg.. 1999a). 1999).. accompanied by an agricultural growth rate of 4–5 percent p. tend to maintain themselves by more force. GNP growth would have to average 6–7 percent p. World Bank. having gained power by force. Nigeria’s labour force is projected to triple and Ethiopia’s quadruple (International Labour Organization. Sub-Saharan Africa has featured in more violent conﬂicts and outright wars than any other region. 1999).. though not by more than 1. 1996. the one in Ethiopia 1974–92. notably the sheer lack of economic development (World Bank. see also Ndulu et al.52 Myers and Kent there has been some marginal relief during 1999. 1999a. A second analysis calculates that in order to achieve an ‘acceptable’ annual reduction in the numbers of poorest people. There are various prognoses of what needs to be done to tackle poverty. jobs will need to be created at a rate of 3. World Bank. countries (World Bank. 1996. while hunger is often used as a weapon. The Angola war lasted 1975–94. Furthermore. During the decade 1998–2007 per capita GNP may well continue to grow.4 percent p. Yet during the next 20 years there will be 16 million people entering the labour force annually (India with 37 percent more people will add only 10 million p. World Bank. The situation is worst in rural areas with 71 percent of the population. United Nations Development Programme. and in Liberia 1985– 93. In 1996 the region featured 12 out of 34 conﬂicts worldwide. 1999. In recent years there has been an increasingly important role for private direct investment. These two prognoses are heavily optimistic given the record of the past two decades. 1999b)..a.. Civil disorders and military activities The food and nutrition prospect in Sub-Saharan Africa is undermined by the many civil disorders and military activities that afﬂict the region. Devarajan et al. Poverty is a more important cause of hunger than civil strife. and it is primarily for purposes of domestic oppression that political leaders engage in extravagant spending on arms and other military activities. there have been more than 70 violent overthrows of governments. Speth. 1997. If the unemployment rate is to be reduced below 10 percent by 2020. followed by further fall-offs in several other countries during the ﬁrst part of 1999. Foreign aid in 1997 totalled $16 billion (worth $26 per capita. In Somalia hostilities have been running for 10 years. More than offsetting foreign aid is the debt burden. 1998. 1998. Messer et al. but the region’s share amounts to only $5 billion out of $400 billion for all developing countries (Messer et al. 1996. the future is less promising than it might be thanks to the present jobs famine. Conversely— and a hopeful portent for the future—more than half of the 19 peace agreements achieved around the world during 1989–96 were in the region (Tilford. During the next 50 years. The reverse also applied: food shortages and hunger were often among the root causes of violent conﬂicts.. In fact greater violence is directed by governments at their own people than at neighbouring countries. 1999b). 1999b). 1998. (which would not only help to relieve poverty but to reduce malnutrition) (Cleaver. Renner. though . down from 11 percent in 1990 (Dollar.a. In addition.a. during 1980–1997 it increased eight times. World Bank. War leads to acute (temporary) rather than chronic food shortages and this factor tends to divert attention from underlying problems. in Mozambique 1981–92.a. and in Sudan for 15 years. It amounted to 5 percent of the region’s collective GNP. exacerbated by the emergent phenomenon of jobless development. Some of these conﬂicts had been underway for a long time. 1999a). equivalent to an increase of 380 million new jobs by 2020. 1998. PinstrupAndersen and Cohen. violent conﬂicts led to reduced food production and increased malnutrition. During the period 1970–90. Several such conﬂicts were implicated in the famines of the 1980s and 1990s (Marchione.0 percent. these being strategically important people insofar as they are food-producing farmers (Donovan. 1999). the region would still need at least a decade merely to recover to its 1980 level.).
4 billion (2. Ethiopia two to three times as much. 1995. the government has been spending $78 million on the civil war in D. 1996. R.60 spent every day on each refugee ﬂeeing from Kosovo (Oxfam. The proportions have generally been much greater than for the other two developing regions. and Mozambique’s $10 and $80 (United Nations Development Programme.3 percent (Colletta et al. 1998).. let alone on growing food. Oxfam. where 26 percent of the adult population is HIV-positive. spent $78 million to support its favoured side in D. Congo. 1993. before declining in 1994 to $3. the government was spending $1 million per day on its war with Eritrea.2 (United Nations Development Programme. military expenditures have surpassed those for education and health combined (Colletta et al.. 1999).1 billion (3. more than twice as much.Food and hunger in Sub-Saharan Africa Military expenditures have long been rising. 1999). Some 12 countries experiencing extensive and prolonged conﬂict during 1970–1993 produced a mean of 15 percent less food per capita in war years than in peace time. 1996. During the ﬁrst half of 2000. the region spent in 1984 a total of $4. 1999). 1999). extra money available for socio-economic growth generally would relieve poverty and offer more people the funds to purchase food. the Zimbabwe government. This ‘hidden hunger’ is the root cause of much if not most ill health and excessive mortality. by contrast with $1. and by being more educated people could do a more productive job with farming and other agricultural activities such as marketing and distribution. 1996).. Pinstrup-Andersen and Cohen. Messer et al.7 percent to 3. United Nations 53 High Commissioner for Refugees. and in 1992 to a peak of $6. Messer and Uvin. 1999). 1998. Renner. etc. from 1980 onwards peace would have added between 2. while spending only $1 million on the prevention of AIDS. the region featured 8 million of the world’s 25 million refugees who had crossed international borders. 1996. (In Zimbabwe. plus 18 million ‘internally displaced persons’ or 60 percent of the global total (Minear and Weiss. the proportion of the region’s collective GNP devoted to military activities rose from 0. albeit falling off somewhat in recent years..) Were basic health and education to be assured. By contrast.R. In constant 1994 dollars.11 on each of these refugees and displacees.5 percent). Military turmoil has undermined anti-malaria programmes in many countries.) would go far to combat the many diseases that afﬂict the region. Somalia has been spending ﬁve times as much.9 percent.8 percent to the region’s annual per capita food production. Most significant of all. people would be less susceptible to diseases with their potentiating impacts on malnutrition. vaccines. Perhaps most important of all. Gallick. In 1991 Ethiopia spent $15 per person on military activities when its per capita GNP was a mere $120. it cannot be spent on clinics and schools. It has destroyed rural infrastructure wholesale. Pinstrup-Andersen and Cohen. During the period 1960–92. Sudan’s ﬁgures were $23 and $400. 1996. Equally important. The close relationship between conﬂict and food production has been prominent in many parts of the region throughout the past three decades. Sivard. At the time of the early 2000 famine in Ethiopia. When one dollar is spent on soldiers and tanks. It has grossly disrupted agricultural activities. 1998. In the whole of 1999 outside donors spent only $0. much more could be accomplished with more money spent directly on food production (Marchione. During the 1990s war has reduced growth rates of per capita food production by between 3. which is unable to feed more than half its citizens properly.3 percent of GNP). 1996. Certain countries have spent way above the average. a relatively peaceful country.9 and 5.9 and in Ethiopia 4. whether in ﬁelds or markets.8 billion (3. 1995. Money could be better spent on helping people to live rather than to kill each other. The ratio of soldiers to teachers in Somalia is 5.5 and 5. it has forced millions of people to abandon their farmlands. mounting in 1987 to $4.1 billion (3. Malnutrition and hunger Sub-Saharan Africa suffers proportionately more malnutrition than any other region.9 percent). Messer et al. Congo’s civil war. In many countries.2 percent) (Ul Haq. There are other forms of the humanitarian toll. 1998). It also . Relatively small expenditures on preventative medicine (research. In 1994. and even Tanzania.
Jolly. 1999. 1998. It is not enough to sustain even low levels of activity: it is close to starvation. 1999a. If it falls to 1500 per day. The region’s malnutrition has steadily worsened. 1992. 1997. If Nigeria is excluded from the regional calculation. see Sharma et al. experience some degree of malnutrition. postulating 361 million malnourished in 1998 and 516 million in 2008. They declined by 1985 to 2050 calories and by 1991 to 2040 calories. Nor does consumption always equate with nutrition. Their situation leaves them vulnerable to pandemic diseases as well as summary starvation (Myers and Kent. That this is a reasonable estimate is conﬁrmed by a detailed recent calculation by the US Department of Agriculture (1999). Worse than ‘standard’ malnutrition is undernutrition. James and Schoﬁeld. 2000). Moreover the poorest one-ﬁfth. in order to be conservative. 1997). to 2220 calories (Food and Agriculture Organization 1999b. Because of unequal distribution of food within Nigeria. and by 1994/96 210 million or 39 percent (Food and Agriculture Organization. 1995). To be conservative again. These people are viewed here as so severely malnourished that they are chronically hungry. Bender and Smith. for similar. it still features many malnourished people. due mainly to disproportionate consumption by the top 20 percent of people with their larger incomes. 1999). US Department of Agriculture. some 517 million people. 1999b. sufferers start . whereupon it disables and it can kill. Poleman. Only the one-ﬁfth of the population enjoying the highest income. malnutrition sets in...54 Myers and Kent to ‘consume their bodies’ as their system eats up their muscles: it is outright starvation. diarrhoea can overtake children as often as every month and thus undercut the nutritional value of food consumed. Another key factor is that per capita food supplies are substantially higher than actual consumption for the majority of people. which through intrapolation implies 392 million in 2000. 1999c.. Conversely a woman with her smaller body size needs fewer calories than a man—though a pregnant woman needs an additional 300 calories a day. Bender and Smith. 1999). Rukuni. 1997. it is possible to discount most of them. estimates. Especially hard hit by malnutrition are women and children. the per capita calorie supply falls from 2220 to below 2000 (Food and Agriculture Organization. 1989. 1999. 2000). 1993. 1997. comprising 130 million people. Per capita food supplies region-wide amounted in 1965 to 2100 calories per day. Alberts. a nutrition level that is expected to decline by 2008 to 70 percent (US Department of Agriculture. (South Africa enjoys a per capita calorie supply of almost 3000 per day. with almost two out of ﬁve children underfed. or 1700 calories. 1999. The average household now consumes 20 percent less food than 25 years ago. before rising by 1998. 2000b). But people do not often die of outright starvation. de Haen et al. Malnutrition contributes to at least reduces worker productivity and cognitive capacity (Dasgupta. Myers and Kent. and her lactation will require an extra 500 calories a day. the minimum for basic nutrition. and suppose that the people who are signiﬁcantly malnourished total 400 million. The cause of death in a malnourished person is usually an infectious disease. This means that food intake is less than 80 percent of recommended calories per day. But these are cautious and minimalist estimates. 1996. thanks largely to (temporarily?) better rainfall. has been receiving only 74 percent of nutritional needs. or outright hunger. But note the skewing factor of Nigeria which enjoys a per capita supply of 2750 calories per day. 1996b. Much depends too on a person’s activity. receives the basic nutritional requirement of 2100 calories per day. by 1990/92 196 million or 40 percent. 1999b. their total today is put at 100 million. A child may get by with 1000 calories (World Health Organization. totalling 130 million people today. A subsistence farmer with heavy labour may need 3500 calories per day (US National Research Council. To cite but one problem. The other four-ﬁfths. Because the second quintile are only just below the cut-off level of 2100 calories per day. Dreze et al. A minimum daily intake of 2100 calories should provide sufﬁcient food energy for reasonable physical activity (Food and Agriculture Organization. well above the regional average (Food and Agriculture Organization. 1990). but it is not included in the Food and Agriculture Organization’s regional estimates). but divergent. 1999b). Below that level. During 1979/81 it ofﬁcially affected 130 million people or 35 percent of the total population. World Health Organization. United Nations Development Programme. 1996b).
1999). often with compounded impact. generating their own supersynergized effects—there can emerge what is technically known as a discontinuity. however. 1995). US Agency for International Development. Consider too the many interactions in the diseases sector. to cite but the best known cases. “The malnutrition straw does not have to be heavy to break the pre-school child’s back” (Haddad. violent conﬂicts. its agriculture suffers. chronic malnutrition. War leads to acute (temporary) rather than chronic food shortages. whereas poverty persists when the war ends. When a country is short of croplands. etc. Thus even a marginal amount of malnutrition can lead to mortality. Hansch. This does not mean. Intersectoral linkages The above points up the particular importance of intersectoral linkages. let alone quantitatively. notably those between croplands. its agriculture suffers again— though not in additive fashion. Overall assessment These seven reviews show that the region is subject to a host of problems. The biggest threat is not only that the region’s problems will become more numerous and more potent.5 million children die from malnutrition and related diseases each year. the most obvious discontinuity arises when people no longer keep on growing hungrier but they start to die. 1998. as illustrated notably by the mass starvation deaths during the Ethiopia famine of 1984–85. Ethiopia. Angola and Mozambique (Hansch. World Health Organization. violent conﬂict resulted in mortality rates from malnutrition and disease more than 20 times greater than usual (Webb and von Braun. Somalia. Moreover. and if that same country is short of water too. hence its rather less technical and more comprehensible name of non-linearity. In the Horn of Africa during the early 1990s. rather through multiplicative effects. 1997. Similarly important are linkages among resource supplies. Now for the most important point of all. There have been many such instances of mass mortality in the Sahel. several countries were afﬂicted by both drought and civil war: Chad. 1996. Such synergized interactions are likely to become an ever-more frequent phenomenon in Sub-Saharan Africa. largely because the ﬁrst is three times more prevalent than the ﬁrst (Jolly. During the 1982–84 famines. Sudan. The interacting mixture cannot be untangled and evaluated even qualitatively. A still more signiﬁcant cause of hunger and eventual starvation can lie with poverty. In practice it is not possible to separate out the various contributions of food shortages. The foreseeable future could well feature increasing numbers of discontinuities in the form of greater starvation crises and mass mortality. This much is obvious. 1997. Sudan. The failure to implement disease-prevention measures is viewed . 1995). 1994. There is scant empirical evidence of the ‘pressure point’ stage when coping measures are exhausted. rather than severe. 1999). This is sudden and pronounced departure from a trend. absolute poverty. All in all. that the prospect of more discontinuities should be ignored simply because the analytic complexities cannot be resolved. 1999). or over 4000 per day (equivalent to a jumbojet-ful every second hour (Murray and Lopez. UNICEF. the great majority of these childhood deaths is associated with mild to moderate. malnutrition. The same applies only more so with regard to soil erosion and fuelwood deﬁcits when they impose their compounding impacts on cropland and water shortages. at least 1. Angola and Mozambique. but that they will often reinforce each other’s effects. US Agency for International Development. 1998. In Sub-Saharan Africa. 1995).Food and hunger in Sub-Saharan Africa half and perhaps two-thirds of all mortality among under-ﬁve children (World Health Organization. each of which reduces food consumption and fosters malnutrition. pandemic diseases. Put one problem together 55 with another problem and the outcome may not be a double problem but a super problem. all being resources that are coming into increasingly short supply and that are inclined to interact. Somalia. Less obvious though more important is the way in which these problems interact. People can be malnourished even in a country with plenty of food. forests and water stocks. When problems interact together to generate a compounded impact—or when several compounded impacts arise at once. UNICEF.
and hence total 130 million by 2010. most of these deaths derived from the general economic breakdown hanging over from the mid-1990s civil wars. and only 3. and 200 deaths every day related to severe malnutrition.8 percent of the country’s population. Note in particular the many ‘linked linkages’ or multi-pronged linkages. There are many other instances of such subsectoral factors that further multiply and strengthen the linkages listed. education and many other basic needs. it can often be the case that several driver sectors are operating at once.5 percent of the people in question (Oxfam. 3.0 percent of the population (a decidedly minimalist estimate) are thought to have died from hunger and starvation together with starvation-related diseases (though economic breakdown itself would have been a prime source of food shortages). 1999c). comprising 2. and lack of vaccines (World Health Organization.R. Whereas each of the ten ‘driver’ sectors in Table 4 affects several other sectors. This means that the people in question are unduly impoverished. Bearing in mind the potent phenomenon of synergized linkages. 1999). 1997). a 30 percent increase). diarrhoea and nine other major diseases. (This 5 percent estimate. that total being 1. 1999). poor or non-existent health services. such people could readily be pushed across a threshold into terminal starvation or die from malnutrition-related diseases. recall that only people in the top income quintile receive more than the adequate food intake of 2100 food calories per day. The bottom 60 percent of the region’s people enjoy only around 30 percent of national incomes (World Bank. malnutrition. 2. this meant that each month saw the demise of over 6000 or 1. Some limited insight can be gained by looking at four speciﬁc instances cited earlier. lack of clean water and sanitation.56 Myers and Kent eight persons or 12 percent of the local population. Thirdly. during the Ethiopia famine of 1984–85 well over 1 million people died of starvation. and little able to purchase food or agro-inputs. On top of the intersectoral linkages are subsectoral factors. in late 1998 several areas of Burundi. Malnutrition is implicated in ﬁve diseases (World Health Organization. Compare these empirical data with a theoretical and more expansive calculation. Potential mass mortality ahead? How many of the 100 million people who are now on the verge of starvation will ﬁnd themselves with even less to eat—or simply too little to eat? Equally to the point. which in turn will often be a good deal less than actual consumption and nutrition.4 to 3.0 percent in the four instances cited above.5 percent of local populations. while malaria is considered a ‘highly signiﬁcant’ consequence of several other factors.4. The deaths in these four examples thus amounted to 1. 130 million people. how many of the other 300 million malnourished people are likely to experience still worse malnutrition until they join the 100 million? This is the most fundamental and difﬁcult question of all. Secondly. During the coming decade there will probably be a projected decline in per capita food production. at least 100000 people died of hunger or related diseases. or to pay for health. Rwanda and eastern D. while the bottom quintile. Suppose too that by 2010 some 5 percent of these 130 million ﬁnd themselves deprived of only a small part of their food intake due to the projected decline in food consumption. Still more to the point. 1999). If this latter intake falls still further. This serves to conﬁrm the earlier calculation that over 100 million people are so severely malnourished that they are on the verge of starvation (clearly a cautious and conservative estimate).) as a ‘highly signiﬁcant’ factor with respect to malaria. at least 100 million of them severely malnourished.8. The 1973 drought in the Sahel left 7 million people acutely dependent on food handouts.e.4 percent of the food-short people.0 and 1. i. receive less than 75 percent of the 2100 minimum. while higher than the 1. A notable one is the skewedness of income. Congo suffered a mortality rate of almost one in . A fourth example concerns Angola with over 400000 people hungry in mid-1999. Suppose that the 100 million people increase in proportion to the projected rise in the numbers of malnourished people (from 400 million to 516 million. 1550 calories (US Department of Agriculture. The crucial point is that 400 million people are malnourished today. consider some interactions among the various sectors reviewed earlier Table 4.g. is realistic as witness the paragraph below on mortality among under-ﬁve children. e.
5 million of the 130 million could die in 2010. Recall the single biggest mass mortality to date. via reduced worker productivity Malnutrition impacts on: — farm production via physical incapacity — disease via potentiating effects — poverty via reduced productivity — economic development via retardation of children’s physical and mental capacities Poverty impacts on: — malnutrition via shortage of means to purchase food — disease via lack of health care — food production via shortages of agro-inputs and knowhow of modern farming — forests via over-exploitation of fuelwood stocks Violent conﬂict impacts on: — farmland degradation via military activities — food production via abandoned farmlands — malnutrition via disruption of food supplies — disease via run-down of health services — economic development generally and poverty in particular via funds diverted from development Economic development impacts on: — all of the above—just as all of the above impact on economic development These 5 percent will rank as people so malnourished that they experience outright hunger and ﬁnally starve. Some 44 million under-ﬁve children.4 million. The 5 percent proportion will mean that 6. hence these deaths total between 2.2 million deaths per year. hence on disease and malnutrition — women’s education.4 million. and if two-thirds. so 17 percent more than the 108 million children in 1999). are so malnourished that they are unusually susceptible to starvation and hunger-related diseases. Note that the 3 million ﬁgure represents 5 percent of the 60 million children at risk. If there are 126 million under-ﬁves by 2010 (increasing by a projected average of 1. and if the malnourished proportion remains at 41 percent. hence on malnutrition and disease — forests through clearing of forestlands for agriculture Forest shortages impact on: — fuelwood supplies. to malnutrition. placing an additional 8 million at risk and raising the total of malnourished under-ﬁves from 52 million to 60 million.9 million of the 4. 41 percent of 108 million such children in the region today. or 4. the one million people who died in the 1984–85 famine in the single country of Ethiopia. then 3. this will result in 5. viz. If half of them die from malnutrition. If the mortality rate for the under-ﬁves remains at 4. Between half and two-thirds of all child deaths can be attributed.1 percent. In turn this means that malnutrition deaths among children would total between 3 million and 4 million in 2010. But child malnutrition is expected to increase by 15 percent by 2010. Intersectoral linkages.4 million per year. Some 4.7 percent per year. through time spent on seeking fuelwood from distant stocks — agriculture through the food-growing opportunity costs of women seeking fuelwood from distant stocks — watershed functions via upland erosion Water shortages impact on: — cropland productivity via lack of soil moisture — diseases via lack of safe water and sanitation — women’s education. It thus rein- .1 percent. whether directly or indirectly. this means an additional 8 million malnourished children. of under-ﬁves die from all causes each year.6 million deaths.Food and hunger in Sub-Saharan Africa Table 4. Food shortages impact on: — malnutrition and hunger — land degradation via unsustainable farming practices — water deﬁcits via unsustainable demand in dry areas — diseases via potentiating effects of malnutrition Cropland shortages impact on: — food production. making a total of 52 million. hence fertility too. via time spent on seeking water from distant sources — agriculture through the food-growing opportunity costs of women seeking water from distant sources Population impacts on: — cropland supplies via sheer pressure of growing numbers — land degradation via demands beyond carrying capacity — food consumption via demand to feed growing human numbers — malnutrition via insufﬁcient food for growing numbers — poverty via unsustainable economic demands from over-rapid growth in human numbers — fuelwood shortages via excessive consumption — water shortages via excessive demand 57 — other resource shortages via population ‘longages’ — disease via infections in over-crowded communities — violent conﬂicts via shortages of land and other resources Disease impacts on: — population via incentives for large families to compensate for child mortality — malnutrition via potentiating effects — economic development in general and agriculture in particular.2 million and 2. this will amount to 2. hence fertility too. Consider the prospect from still another standpoint.
A long-standing process abruptly changes course (a discontinuity). 2000). The calculations thus far reﬂect a simple extrapolation of recent trends. unusually serious but usually disregarded until some threshold effect precipitates a long a-building debacle? It is not possible to hazard an estimate of how many people could ultimately be overtaken by the crisis-to-catastrophe processes. this article has presupposed there will not be sufﬁcient response until too late to avert a catastrophe of some degree. Whether rightly or wrongly. a catastrophe that does not build up ﬁnal momentum until a later date would allow more manoeuvring time to reduce the ultimate scale of the catastrophe. notwithstanding its limitations. Yet the steady build-up to the sudden switch can be exceedingly difﬁcult to perceive ahead of time. Add in long-term soil erosion. the latter. steadily undermining cropland fertility. But leaders both within the region and the wider world have watched forces the earlier estimate earlier that 5 percent of the 130 million people (children of all ages and adults alike) receiving less than 1500 calories per day could well die in 2010. it implies that it is probably an underestimate to postulate that 6. While the former. More often. that of perception. together with trade terms at near historic lows. which constitute an exceptional crisis already. regular droughts. and thus engage in anticipatory measures of scope and scale to match the problems. and (b) it is warranted. with extensive while less than conclusive evidence in support. It becomes clear that all manner of increasing problems could make a difﬁcult situation eventually tip over the edge from crisis into catastrophe. Add in declining food imports in relation to needs. the sudden emergency. The authors believe that (a) it is realistic. see Myers and Kent. and equally plainly according to this article. Plainly a catastrophe is unlikely to arrive next year. Now consider some circumstances that could transform the ‘trend crisis’ into an unprecedented catastrophe. however. Add in declining aid and rising debt. famine and starvation are generally acknowledged as such only when a dramatic change occurs from one stage to another. Add in more violent conﬂicts that degrade croplands and disrupt food transportation. they are not a discrete event but stem from a continuous process that has been quietly building up until it erupts into catastrophe. etc. it will surely ensue at some stage within the foreseeable future—unless the region and the outside world determine to tackle the source problems in far more timely and energetic fashion than to date. there would be clear beneﬁt in as much lead time as possible—in which case.5 million total of people dying as early as 2010 could well prove to be an under-estimate. marketing networks. Add in several other adverse factors documented above. even exploratory. the ‘creeping’ crisis. This may sound unduly pessimistic. arises intermittently in Sub-Saharan Africa. is far more frequent.58 Myers and Kent combination of pervasive poverty. This evaluation is preliminary and approximate. Collectively these problems ﬁnally reach a critical mass and cross over a ‘break point’. What covert trends of this sort are underway today. Even more important. The deepest uncertainty lies with the question of when a starvation catastrophe might start to overtake the region. Whether the ﬁrst onset of major mortality occurs by the year 2010 or is deferred until a later stage is not so important as the question of what should be done to pre-empt the prospect. notably the potentially profound disruptions of global warming (for extended detail. Were ameliorative or even preventive measures to be implemented. resulting from a . One likely factor is the combination of declining per capita food supplies and the regional population increase of 16 million people per year. All this hinges on a decided switch in response from governments and development agencies both within the region and outside. land degradation. in order to gain a grasp of what is an entirely possible prospect for the region. even a severe under-estimate. all of which accentuate the spread of absolute poverty.5 million people (children and adults alike) will die from malnutrition in 2010. disease pandemics. failing agriculture. By 2020 the situation could have deteriorated to an extent that precipitates an even larger disaster. with all the humanitarian implications at stake. viz. outbreaks of violence. etc. viz. Sufﬁce it say that the 6. There is still another pivotal perspective. as it switches from a malnutrition level that is somehow tolerable in normal times but becomes intolerable under new circumstances. anti-malaria projects. fertiliser supplies. Like the concept of an epidemic.
and they have not done nearly enough to achieve a turn-around. 1999).7 percent.0 children per reproductive woman in 1960 to 4. 1999). Region-wide the number of cases has decreased by more than 95 percent since the eradication campaign started in 1986. 1998. The Carter Center in Atlanta. Botswana and South Africa have undertaken structural adjustments and related reforms sufﬁcient to place them on a ﬁrm track toward sustainable economic advancement. In the diseases ﬁeld.5 million people. World Bank. and it has cut its population growth rate from over 4 percent in 1980 to to 2. 1997. by contrast with the regional average of 5. US Department of Agriculture. which during 1990–98 achieved an average annual growth of over 11 percent (Richardson. Nigeria 1. while Uganda has cut the rate of new HIV infections (United Nations Development Programme. South Africa’s modern contraceptive prevalence rate is 55 percent and Zimbabwe’s 50 percent—ﬁgures that compare well with some of the more advanced developing countries such as Indonesia with 55 percent. generally taken to be roughly 10 percent (by contrast with the 33 percent ofﬁcially estimated for the region by the Food and Agriculture Organization and the 62 percent postulated in this article). though at least half its people are still malnourished. surely an unacceptable total. a campaign against guinea worm shows what can be done.0 and South Africa’s 2. Policy responses: the scope for action There is much evidence that the region knows how to get things right. there will ultimately be a human tragedy of altogether unprecedented scale in Sub-Saharan Africa. Nigeria has greatly increased its maize harvest and expanded the average yield of cassava threefold (US Department of Agriculture. notably Angola. Ethiopia and Uganda. followed in early 2000 by food aid needed for eight million people (Food and Agriculture Organization. 1997). 1998). countries as disparate as Ivory Coast. Senegal has expanded its distribution rate for condoms from 800000 in 1987 to over 7 million in 1997. The front runner has been Botswana. and how quickly it manifests itself in its full scope. and the country is still susceptible to natural disasters such as the ﬂoods of early 2000. and it was hoped that the disease may be all but eliminated by late 2000 provided that the campaign is not hampered by war and other civil upheavals (World Health Organization. 4). During the half decade 1994–98. a large share of them being in Sub-Saharan Africa. 1999). in conjunction with United Nations agencies.6 percent. 1999). Others. Kenya has slashed its fertility rate from 8. Recall nonetheless that the World Food Summit in 1996 proposed that a major breakthrough would be to cut malnutrition worldwide by half to ‘only’ 400 million people by 2015. Kenya increased its average annual food output by 3. Ethiopia 2. managed per capita GDP growth of more than 2 percent during 1995–97. Uganda has doubled or even tripled its production of several major staples. 2000a). Nigeria. and has done it on various occasions. all countries in the region have a long way to go before they reduce malnutrition to what is viewed by governments and international agencies as an ‘acceptable’ level.9. A level of 10 percent would still leave 65 million people malnourished. today only onetenth (Poleman. 1998.5 and 2. Twenty years ago two-thirds of Ghanaians were malnourished. Despite these success stories.0 percent (Cleaver. In the population ﬁeld. though in 1998 there was a falloff and it needed food aid for six million people due to inadequate rainfall and renewed war. and South Africa and Tanzania between 1. 1996.. Altogether ten ‘strong performers’ achieved average annual growth in per capita GDP of 7 percent during 1995–97. in Nigeria the total has declined from 653000 in 1989 to 18000 in 1995. Ethiopia has doubled its production of certain staple grains since 1990 (Fig. Ghana.Food and hunger in Sub-Saharan Africa the region’s people become poorer and hungrier for most of three decades. In the economics ﬁeld.1 percent today.7 children today. Messer et al. . To repeat: it is uncertain for present purposes when the catastrophe ﬁnally arrives. With respect to HIV/AIDS as well as family planning.0 percent or more.8. But what is not uncertain is that if decades-long trends persist. 59 and ahead of Pakistan and Bolivia with 48 percent. Namibia. Mozambique has stepped up its agricultural output by half now that its long civil war is at an end. Zimbabwe’s fertility rate is 4. has helped to eliminate the disease from 3.
Each additional $1 of income from agriculture adds almost $2 to the overall economy (Pardey et al. they have favoured commercial farmers who grow cash crops for export rather than subsistence farmers who grow food for local consumption. especially labour-intensive goods and services. Particularly adverse policies have included artiﬁcially low prices for agricultural outputs. For future purposes. 1996. Gardner. and overvalued exchange rates (Paarlberg. Various authors give details of how agriculture . export quotas for farm products. have been macroeconomic policies that have long contributed to the stagnation or even the decline of agriculture. 1995).60 Myers and Kent Figure 4. 1997). Rudimentary agriculture on sloping terrain fosters soil erosion (Photo Courtesy: Mark Edwards/Still Pictures). 1997. Governments have been inclined to favour industry over agriculture. even though agriculture often contributes 30 percent or more to GDP (Abdulai and Delgado. Abdulai and Delgado. though indirectly so. Specially signiﬁcant are the consumption linkages that arise when increases in agricultural income lead to increases in household consumer demand for non-agricultural goods. moreover. Poleman. Donovan. Nonetheless the success stories offer hope. Agriculture promotes economic growth through its many forward and backward linkages to nonagriculture sectors. governments’ ﬁnancial support for agriculture has amounted to only about 10 percent of budgetary spending. 1995. 1995).. Pinstrup-Andersen et al. via high inﬂation. Within agriculture. Worst of all. and other restrictive practices that have resulted in a ‘plundering of agriculture’ (Shiff and Valdes. subsidies for food imports. 1995. what speciﬁcally should the region’s governments and citizens undertake? Food and agriculture The many measures that reduce incentives for farmers to produce more food should be reversed. 1999. Tweeten and McClellan. negative interest rates. 1996).. Just as harmful. budget deﬁcits of 10–20 percent of GDP. 1995. and cities over countrysides.
As long as parents see many of their children dying. whereas expenditures for research on diseases such as AIDS. extension services. 1997. Hazell. fostering women’s participation in rural activities. World Bank. The technologies are all available at little cost. they will feel inclined to have as many children as they can in order to mobilise a kind of insurance. more focus on land tenure and agrarian reform.. with limited success (Wirth and Cattani. or an average of 30 percent of the distance to replacement fertility. Similar progress has been achieved in Kenya through the long-term support of President Daniel arap Moi. 2. Much too could be achieved through measures to encourage family planning motivation among those parents who still want large numbers of children. on antimalaria drugs.1 percent of research spending. 1995. More widespread use of these vaccines could prevent 1. whooping cough. 1999).) To be speciﬁc. There is huge scope to reduce child mortality. The country’s modern contraception prevalence rate has risen from 61 17 percent at independence to today’s 50 percent. yet it attracts only 0. Its exceptional record has beneﬁted strongly from the promotional activities of just a few politicians. Teklu. Measles immunisation costs only $0. marketing networks. 1995). as epitomised by Zimbabwe. This stems in part from the persistently high mortality rate for children due to the great killer diseases such as malaria and diarrhoea.6 million child deaths a year worldwide. yet barely half of the region’s . Population The huge unmet need for family planning must be tackled—and within a context of improved health and education for females and with enhanced social status for women generally. There are vaccines against measles. 1993). Jayne et al. NGOs and the private sector in policy. 1994. 1996. 1999). better environmental management... Alexandratos. the demographic consequences could be marked. there is need to increase farmers’ productivity so as to achieve a sustained 4. with some countries achieving a fertility decline of 18 percent. 1995. This could be accomplished through greater policy attention to scientiﬁc research.1 percent).0 percent rate of food production. Meantime a single bout of the disease for an adult costs an average of 10 working days. World Health Organization. 1996. Were these needs to be met. de Haen et al. mosquito coils and insect repellents each year. twice as much as today. Sharma et al. and upgraded rural infrastructure. As it is. tuberculosis and yellow fever. 1999. Diseases Malaria could be reduced through modest outlays of research funding. notably marketing roads (Elz. or an average of one-ﬁfth of their cash incomes. there is need for a host of further supplementary measures. Gardner.a. 1996. In Sub-Saharan Africa malaria accounts for almost 10 percent of the disease burden overall (worldwide. through for example the health and education of females. and credit systems (especially for women farmers) (Pinstrup-Andersen. 1987. incentives for smallholders. expanded credit facilities through cooperative-owned banks which mobilize individuals’ savings. 1997). one in four child deaths could be prevented through insecticide-treated bed nets (World Health Organization. many African families spend up to $65. Abdulai and Delgado. These include: greater participation by farmers. up from $790 million in 1987 (World Health Organization.Food and hunger in Sub-Saharan Africa contributes to economic growth generally. A 10-percent increase in female literacy reduces child mortality by 20 percent (Meier. and thus warrants much greater support from governments (Abdulai and Hazell. 1996. Staatz et al. Worldwide spending on a malaria vaccine in 1997 was $60 million per year. tetanus.25 for a single vaccine dose. down from $84 million in 1983. stronger links between agroresearch and farmers. In addition. Many investments will generate further dividends. Today’s outlay is equal to under $60 per malaria death. 1996. 1995. polio. 1995. Johnson. and the economic burden of malaria now costs the region $2 billion per year. cancer and asthma are 100–100000 times higher. programming and project planning. Many of the region’s diseases are both preventable and treatable at low cost. 1999b). For just $11 per child p. diptheria. agronomic inputs such as fertilizer.. Note the scope for political leadership..
1999b). This could slash diarrhoea mortality by 65 percent (World Health Organization. Meinzen-Dick and Rosegrant. Hardly anybody died of hunger. or more than 30 times the amount spent annually by international donors for AIDS programmes in all developing countries combined. and to support regional crisis management (Atwood. foreign aid to support anti-AIDS campaigns in SubSaharan Africa amounted in 1997 to no more than $150 million. though distribution would push up the cost somewhat (World Health Organization. 1999). 1999). The ﬁrst is inevitable. Were the United States to pay its arrears to the United Nations.62 Myers and Kent funds (Piuf. In Botswana. 1997. the hardest hit countries will lose 10–15 percent of GDP to AIDS deaths in a single decade (Forsythe. together with development agencies. and induced unprecedented imports of 10 million t of grain to relieve starvation among 80 million people. World Food Programme. is through improved water supply and sanitation. a semi-desert country. 1996). to pre-position food stocks. 1992). 1996).4 percent of GDP. On that same day an equal number of children.5 times less (Bellamy. A disease that cannot be countered through immunisation is diarrhoea. are working to establish early warning systems for tens of millions of at-risk people. Fortunately it can be readily resisted through a simple therapy known as oral rehydration with small sachets of salts. 1995. Environments and natural resources Governments and citizens should recognize that drought need not mean famine. Only 60 percent of Africans enjoy access to basic health services. Fortunately famine was averted through an early warning system. measles and malaria. the country avoided famine despite four droughts in ﬁve years. the second is not—as witness the Greater Horn of Africa Initiative. most of them in Sub-Saharan Africa. Thamae. the government built an anti-famine capacity with a permanent safety net for the poorest people. and it could be accomplished at triﬂing cost—triﬂing. 1999). The region has 10 times as many new AIDS cases each year as the United States but a budget 5. United Nations Development Programme. however. for outside donors but still viewed as too expensive for most of the region’s governments.. The prime way to reduce diarrhoea. 1995. Not so readily tackled is HIV/AIDS. 1999). Esrey. except by much more widespread use of condoms. Many doctors have to moonlight to supplement salaries of a mere $3 per day. Although the therapy generally needs to be applied several times a year to counter recurrent bouts. The purpose is to identify food crisis areas. it costs less than 33 cents per dose when supplied in bulk (World Health Organization. All this has been in marked contrast to what might well have happened if the droughts had occurred in the Sahel where there are few anticipatory measures (Smith et al. whereby ten governments. caused more than a 50 percent drop in food harvests. In 1991/92 the worst drought in several decades devastated the subregion’s agriculture. Some 16000 people worldwide contract the HIV virus each day. together with regional co-ordination and international support. A similar success story is at work in Southern Africa. equivalent to the annual budget of a small hospital in Europe. 1998. To manufacture all these vaccines together costs less than $1 each. Yet a World Conference on Diarrhoea would not receive a fraction of the attention as the regular AIDS conferences. Government spending on health often averages just 1. To supply an individual with one year’s condoms costs just $14 (World Health Organization. The World Bank (1999a) estimates that treatment of all AIDS cases in Sub-Saharan Africa would cost $10 billion a year for drugs alone. 1999). 1995. 1997). As it is. pneumonia. that is. that would go some way to helping the World Health Organization to expand its immunisation efforts. compared with Southern Asia’s 78 percent (UNICEF. The region’s governments contributed $15 million from their meagre . The region has virtually no access to the new generation of protease inhibitors that have radically cut the AIDS death toll in the United States and Europe. die from traditional illnesses such as diarrhoea. children are immunised by their ﬁrst birthday. By contrast. less than $10 per person per year. The disease burden could be reduced by 30 percent through the investment of an additional 1 percent of GDP (World Bank. 1999).
Veit et al. What has actually been accomplished? Answer: quite a lot. realistic trade and pricing policies. the distribution of growth is critical in determining which groups beneﬁt from more jobs and other income-earning opportunities. falling foreign aid. albeit with some reform in some countries (Fischer et al.. The main sources of poverty are easy to list: jobs famine. This implies that a policy attack should be directed at factors of basic human well-being: clean water and sanitation. mounting external debt. especially agriculture. 1995. or indirectly through improved social services. International Monetary Fund. declines in commodity prices. Veit. Such activities have exacted the inevitable penalties: reduced private incentives.). and food of sufﬁcient quantity and quality. Prominent among these are: huge ﬁscal deﬁcits. pragmatism and entrepreneurial energy—all of which have translated into sluggish economic growth. together with a parallel reordering of priorities by donor agencies.. So much for what needs to be done. health.and mega-problems. an erosion of productivity. notably those in remote rural areas and urban slums (World Bank. in 63 order to encourage production and exports. All these essentials can be provided through a rigorous rejigging of government budgets. 1995. inefﬁcient parastatal institutions. 1999). 1998). poor access to markets. increasing protectionism. environmental degradation with reduced productivity of natural resources. and reform of public enterprises and marketing boards (International Monetary Fund. These have been more numerous and deleterious than in any other developing region. Regrettably they have generally not worked out. in itself. there is need for several prime policy responses: control of government expenditures. and worst of all. 1998.Food and hunger in Sub-Saharan Africa In terms of environmental safeguards overall. and meagre private investment. especially in agriculture. terms-of-trade shocks. These constraints were cited by McNamara (1991). reduce poverty. Domestic price controls have been liberalised if not abolished in several countries. Exchange rates have been freed and uniﬁed in many countries. Most governments have eliminated direct controls on bank credit and have established market-determined interest rates. and many persist today. Economics and poverty Governments should recognise how far their policies have undermined the region’s economies. Many state enterprises have been privatised. the effort would become far less difﬁcult. some 30-plus countries of the region have developed policies and programmes for better management of their environments and natural resources. 1999a). 1995. housing. primary school education. Binns. and lack of participation by the poor in development programmes. low levels of human capital (education. 1999. steep shifts in international interest rates. . Entire economic sectors have fallen under the control of political élites with their corrupt practices. Structural reforms have been implemented in many countries. cutting ﬁscal deﬁcits. Corrective measures should concentrate on the over-riding problem of poverty. Non-tariff barriers have been eliminated in most countries. To correct these meta. poor pricing and trade policies. and import duties reduced in several. Inefﬁcient public monopolies have been dismantled. In addition. etc. Note that greater GNP growth will not. Such measures are being attempted in certain countries (Cleaver and Schreiber. 1999a). Were the outside world to play its full part. 1995. leading to a plethora of bureaucratic controls. dictated prices. 1994. World Bank. Burman. In turn. minimal access by the poor to even small-scale credit. soaring fuel prices. inadequate land and capital. and over-valued exchange rates that discriminate against agricultural exports. whether directly through increased employment and incomes. Hence there is need to target certain pivotal growth sectors. It is the pattern of growth that must beneﬁt the poor. health. Controls over government spending have been tightened markedly. due to lack of community management based on local self-help initiatives. meagre rural development in the most deprived areas. the region has endured problems that stem from beyond its borders: persistent upsets in the global economy. also exchange rates. jobs. and certain communities. Most important of all have been the many government interventions in economies. proliferant administrative controls. limits on monetary expansion.
though several countries. This can best be done through addressing their source causes. The UN Secretary General Koﬁ Annan (himself an African) has urged the region’s governments to cap their military spending at 1. The best way to consolidate democracy is by strengthening NGOs. Scrimshaw. In many countries. 38 countries held open legislative elections (regrettably several countries are taking a step back with military take-overs and political repression). Famine can occur even when there is plenty of food in the country. In response. At the political level. Specially helpful would be a political commitment to establish food and nutrition security as a basic human right. freeing up the media. and the prerogatives of ofﬁce. moreover. much policy leverage would be available through a national food and nutrition policy in order to boost sectors such as agriculture. Famines have never occurred in democratic countries. Democratisation is also the best way to overcome corruption. with enhanced partnerships between governments. 1997). notably those that facilitate food . and reduce poverty (World Bank. often generating a synergised success. governments should foster transparency Finally note the strong linkages between poverty and famines. To cite Nobel Prize winning economist Amartya Sen (1999). Malnutrition Overcoming the ‘hidden hunger’ requires a spectrum of policies. These policies work best when hand in hand with each other. One has to shift attention from famine as a food crisis. there are some general opportunities. this means that famines can be prevented by creating public projects to provide income for potential famine victims. if income collapses because of unemployment or a fall in real value of wages. as well as by slashing military expenditures. narrowly deﬁned. to participate in politics at all levels (women constitute fewer than one third of administrators and managers. however. public health and education. even very poor ones. In turn. Jolly. It is partly due to pervasive corruption that only 64 percent of the World Bank’s energy projects during 1978–96 performed ‘satisfactorily’. notably Mozambique. NGOs and donor agencies. Governments should bolster the process of democratisation that is underway in many parts of the region. in contrast to elaborate feeding programs. in colonial regimes and in oneparty states. patronage. compared with a developing-world average of 79 percent (Covarrubias. This needs to be addressed through strategies to raise nutritional questions higher on political agendas. and providing more opportunity for people. increase social equity (especially distribution of food). that have regular elections and a free media. “It is important to realize that people starve when they do not have the means to buy food. resources. broadly deﬁned. many governments remain inclined to resolve their problems by military force. and to commit themselves to zero growth in defence budgets within ten years. which has long been endemic throughout the region. and occupy only 12 percent of parliamentary seats and 7 percent of cabinet positions (United Nations Development Programme. except for example measures to tackle iodine deﬁciency and other micro-nutrient shortfalls. 1994. The process combines market mechanisms with government assistance. not just ﬁnancial wrong-doing but political chicanery of many sorts. Nigeria and Liberia. By contract. Election victories tend to assume a winner-takes-all reaction with respect to wealth. As it is. famines are associated with the absence of democracy. During 1990–1994. There is a ‘culture of corruption’. Many famines have occurred without any decline in food output.5 percent of GDP forthwith. On top of these seven sets of options for policy responses at sectoral level. they have occurred in military dictatorships. to famine as an economic crisis. appear to have left behind their long-standing proclivity for ever-more war. 1999)). 1993. improve health facilities. especially women. which disrupt economic and social activity. the private sector. 1999).64 Myers and Kent production.” Civil disorders and military activities There is the obvious imperative to curb such disruptions. There are few ‘magic bullet’ options for policy initiatives to counter malnutrition.
P. Both Ghana and Botswana. 212–13. I. Chichester. paralleled by similar efforts on the part of the world at large. M. (1995) The causes of Unmet need for contraception and the social content of services. 1999. USA: World Bank. 101–19. though only just time. The process should be helped by the communications and computer revolutions that are greatly expanding the reach of global knowledge. USA: IFPRI/International Food Policy Research Institute. 1972–1992. (1994) Agriculture and Environment: A Review. W. (1996) The Potential Impact of AIDS on Population and Economic Growth Rates. (1995) Expanding NGO Participation in African Environmental Policy Reform. Washington. DC. and Caldwell. Bojo. agriculture and the environment: 15–19. USA: IFPRI/International Food Policy Research Institute. Finally. IFPRI/ International Washington DC. Develop. Sci. and Bruce. (ed. and Caldwell. Washington DC. 192–97. USA: World Bank. K. Could this offer scope for a new form of globalisation? References African Development Bank. Bongaarts. Agriculture and Environment Nexus in SubSaharan Africa. (1998) The African Development Report 1998. USA: World Bank.M. M. and Develop.) (1995) World Agriculture Towards 2010: An FAO Study. 7. Rev. medicines and other supplies at next to no notice. and Smith. They should establish a rapid relief task force. all governments should set up early warning systems to alert them to crises while they are still building up. and people can join political parties of their choice. Kostner. Abidjan. P. Washington. and Halweil. UK: John Wiley and Sons. compared with the developed world’s average of less than 70 percent (World Bank. DC. J. J. J. (1996) Drought. and Wiederhofer. New York. Norton.. Chichester. Strong political and legal institutions reduce the risks for foreign entrepreneurs. J. R. Cleaver. Pop. USA: Food Policy Research Institute. W. SubSaharan Africa can still squeeze through the bottlenecks ahead. J. 57–75.) (1995) Reestablishing Agriculture as a Priority for Development Policy in Sub-Saharan Africa. (1999) Beyond Malthus: 19 Dimensions of the Population Challenge. M. Pop. DC. (1996) Global trends in AIDS mortality. These revolutions can allow the region to leapfrog out-dated technologies that still hold sway in many industrialized countries. J. T. 16. famine and environmental degradation in Africa. (ed. Most countries now enjoy freedom of the press.A. All this places a premium on political leadership—a resource that is often scarce due to lack of civic traditions at national level. food and nutrition. human capital. B. to tribalism and other forms of sectarianism. 14. Binns.C. (1994) Reversing the Spiral: The Population. (1995) Keynote Address. Studies in Family Planning 26. 817– 48. Sustain. Biswas. Atwood. Colletta. Gardner. 19. 62–68. 25–27. Bender. (1996) The Transition from Water Peace in Sub-Saharan Africa. . DC. Caldwell.. G. Abdulai. in A 2020 vision for food. C. 22. Ecol. R. Abdulai. UK: Wiley. N. 21–45. Technol.C. Bongaarts. and with particular respect to starvation crises. Am. Sussex. Brown.B. Issues in Sci. Rev. J. Caldwell. Chiebva. Ivory Coast: African Development Bank.M. (1996) The African AIDS epidemic. Brown. (1999) Statement at Lusaka AIDS Conference. respect for human rights. This will require unprecedented efforts by the region’s countries. USA: W. Washington. Cleaver. USA: Alan Guttmacher Institute.J. and Hazell. A. and Schreiber. have 100 percent digital telephone networks.) (1995) People and Environment in Africa. C. Fortunately there is an emergent set of new political leaders. preferably under the United Nations. to avert a human tragedy of unprecedented scale. L. Centrally important is to build up the most valuable resource of all. DC. for example. G. and to a tendency toward authoritarianism. A. and Delgado. 1999c). E. Prominent among them is President Museveni of Uganda. Ambio/May 3. There is still time..L. Washington. ready to ship grain. USA: World Resources Institute. Pop. Washington. These numerous openings for policy and action mean that all the region’s profound problems can be converted into profound opportunities. B. (1993) The nature and limits of the sub-Saharan African AIDS epidemic: Evidence from geographic and other patterns. (1995) The role of agriculture in sustainable economic development in Africa. Ambio 25. S. Burman. In turn this can promote scope for a vital lubricant of the region’s economies: foreign investment and business. 161–73.Food and hunger in Sub-Saharan Africa and openness in all their activities. 65 Alberts. and democratic processes generally. Econ. (eds.. who argues for the rule of law. K. (1998) Toward a global science. L. New York. Alexandratos. P. J. Agri. (1997) Population. 51. Alan Guttmacher Institute (1997) Issues in Brief: Risks and Realities of Early Childbearing Worldwide. (1996) The costs of land degradation in sub-Saharan Africa. N. (1997) Rural Development Strategies for Poverty Reduction and Environmental Protection in Sub-Saharan Africa. Bull. Bellamy.
Epdemiol. and LeRoy. K.). continued pain. Washington. USA: Island Press. 17. S. World Bank. Washington.R. (ed. Environ. (1995) Hookworm infection. Sen. Washington DC. Cambridge. DC. J.fao. 608–23. Econ. A. and Pritchard. M.: IFPRI/International Food Policy Research Institute. DC. Rome. C. R. (1997) Agriculture and food security: Looking forward-continued gain. 2000. Esrey. (1999c) Food Supply Situation and Crop Prospects in Sub-Saharan Africa. M. World Bank. P. Econ. 1. Downing.. Washington. R. (1996) Shrinking Fields: Cropland Loss in a World of Eight Billion. Oxford. (1996) Climate Change and Southern Africa. USA: Worldwatch Institute. Hopkins.M. M. Food and Agriculture Organization. UK: Clarendon Press. (1996) Managing Natural Resources to Feed Africa.C. Rome.H. AFTES Working Paper 18. G. (1995) How Many People Die of Starvation in Humanitarian Emergencies? Washington. (2000a) Africa Food Emergencies. and Cornelius. In F. 103–15.C. Rajkumar. D. Uppsala. UK: Cambridge University Press. (1996) Impacts of development and global change on the epediomological environment. (1998) Food production. 143. (ed. Washington.) Malthus and Mendel: Population. (1999) Water: A Reﬂection of Land Use. Oxford. (1998) Agricultural Growth Linkages in Sub-Saharan Africa.R. Washington. H. USA: World Bank. Gallick. DC.). In M. (1999) World Employment Report 1998–99. A. (1998) Assessing Aid: What Works. USA: Population Action International. Italy.). Dreze. Elz. Andersson. and Frisvold. Covarrubias. USA: World Bank. population growth. (1995) The Betrayal of Science and Reason: How Anti-Environmental Rhetoric Threatens our Future.S. DC. and Engelman. J. Consumption and Wood Resources. V. Daily. K. and the environment. DC. Falkenmark.B. and Hussain. DC. P. USA: Development Research Group. USA: Refugee Policy Group. (1999) Relative impacts of human-induced climate change and natural climate variability. Food and Agriculture Organization. (1997) Sustaining Water. P. G. USA: Arms Control and Disarmament Agency. Washington. DC. Fischer. Washington. Science and Sustainable Food Security. (1994) Drought Follows the Plough. (1993) An Inquiry into Well-Being and Destitution. Hotez. (1999b) State of Food and Agriculture 1998.. (1996) World agricultural futures: Regional sustainability and ecological limits. DC. R.. Food and Agriculture Organization. Ingram. Engelman. T. DC. Donovan. (1996) AIDS in Kenya: Socioeconomic Impact and Policy Implications. Ehrlich. USA: Population Reference Bureau. USA: International Monetary Fund. 1996. M. UK: The Royal Society. and 15 others. (2000b) Food Balance Sheets. D. Delgado. India: Madras Editorial Services. Rome. Haub. N. S. Switzerland: International Labour Organization. Harris. de Haen. Gardner-Outlaw. Rome. (1998) Factﬁle: Number of Hungry People Rising. (1995) The Political Economy of Hunger. (1987) Agricultural Marketing Strategy and Pricing Policy. What Doesn’t. (1999) What Does Aid to Africa Finance? Washington. and Swaroop. New York. 1998. (1999a) Food Balance Sheets 1997. G. L. Sci. G. P. Rome.. Geneva. and Kelly. T. A. Forsythe.org/wfs/fs/e/agricult/AgLoo-e/htm . 311–46. T. Hansch. Castensson. http://www.. Italy: Food and Agriculture Organization.. Italy: Food and Agriculture Organization. Washington. (1996) Water... D. Swaminathan. Dasgupta. USA: IFPRI/International Food Policy Research Institute. and Khan. University of East Anglia. Sweden: Swedish Science Press. (eds. (1999) Lending for Electric Power in SubSaharan Africa. Washington. R. Devarajan.. Italy: Food and Agriculture Organization. Gardner-Outlaw. USA. Food and Agriculture Organization.S. and Geneva.A. C. USA: IFPRI/International Food Policy Research Institute. Rome. DC. Switzerland: Food and Agriculture Organization and World Health Organization. A. International Labour Organization. Italy: Food and Agriculture Organization. (1996) Agriculture and economic reform in subSaharan Africa. (1995) Conserving Land: Population and Sustainable Food Production. L. Food and Agriculture Organization. J. Rome. (1996) World Military Expenditures and Arms Transfers. (ed. Hulme. Italy: Food and Agriculture Organization. Develop. and Ehrlich. J. A. Hernandez-Cata. Gardner. Italy: Food and Agriculture Organization. E. Washington.A. M. Rome.L. Food Emergencies. (ed. USA: Population Action International.. Falkenmark.66 Myers and Kent Food and Agriculture Organization.F. Hazell.R. Science 281. S.. (2000) World Population Data Sheet. Daily. Rome. 68–75.). DC. J. Dollar. Alexandratos. Ecol. and Bruinsma. (1994) Productivity in African agriculture: Sources of Growth and Stagnation. Population: The Complex Reality: pp. Glantz. Food and Agriculture Organization. (1999) Forest Futures: Population. P. Norwich. London. DC.D. and Ehrlich. 1291–92. G. (1994) Landscape as life support provider: Water-related limitations. USA. and Why. USA: Population Action International. Italy: Food and Agriculture Organization. Am. Washington. Italy: Food and Agriculture Organization. (ed. Department of Agriculture. V. (1992) Nutrition and Development: A Global Assessment. 272. DC. J.H. (1998) Africa: Is This the Turning Point? Washington. (1999) Prospects for the world food situation on the threshold to the 21st century. USA: U. P.S. and Sundblad. (1995) The March of Malnutrition to 2020: Where are the Solutions? Washington. Am. Nature 397.. UK: Climatic Research Unit. UK: Clarendon Press. 95–115. waste and well-being: A multicountry study. and Engelman. (1996) Crucial Role of Irrigation Development in Increasing Food Production in SubSaharan Africa. DC. C. Graham-Smith. DC.T. D. Washington.J. DC. Easing Scarcity: A Second Update. Chennail Madras. D.). Food and Agriculture Organization. 688–91. USA: Oxford University Press. Food and Agriculture Organization. Haddad.
USA: IFPRI/International Food Policy Research Institute. 198–205. Haddad. 62–63. McNamara. Report to the Winslow Foundation.W.. Environ. M.C. Hakkeling. P. P.L. Pandya-Lorch. and Rosegrant. P. Jain. 345–58. Pinstrup-Andersen. J.S. (1997) Doubling of world population unlikely. Wageningen. (1998) Food security and sustainable use of natural resources: a 20:20 Vision. Johnson. Pop. Nature 387.J. W. Sanderson.J. M. Econ. Kendall. USA: Colorado University Press. 1–10. 67 Ndulu. Family Planning Perspectives 25. Netherlands: International Soil Reference and Information Centre. USA: US General Accounting Ofﬁce. Washington. H. S. S.D. 817–26.A. Paarlberg. G. and Babu. 85–101. USA: IFPRI/International Food Policy Research Institute. Pinstrup-Andersen.G. Pardey. Futures 28. M. Colorado. (1998) HIV 1998: The global picture. Agriculture. Our Planet 8. Ecol. (1995) Investments in African Agricultural Research. (1998) Food from Peace: Breaking the Links between Conﬂict and Hunger. and d’Costa. DC. R. (1990) Human Energy Requirements. P. K. DC. Oldeman. Environ.J. and Atkinson. Boulder.L. X.L..) (1996) The Hunger Report. Italy: Food and Agriculture Organization. and the Environment in Southern Africa. Pinstrup-Andersen.L.T. (1996) A hopeful path for development in Africa. USA: IFPRI/International Food Policy Research Institute. Washington. Weiss. (1997) Impact of population growth on food supplies and environment. Myers. Rome. P. and Kent. Pinstrup-Andersen. Islam. Food Policy 12. DC. Oxfam UK. 1. 39–43. E. 83–102. B. (1994) Constraints on the expansion of the global food supply.. R. USA and International Service for National Agricultural Research. USA: International Monetary Fund. (1993) Humanitarian Action in Times of War.W. Jolly. In L. D. Paarlberg. (1998) Technological Opportunities for Sustaining Wheat Productivity Growth Toward 2020. D. New York. Pingali. See also The World Food Situation: Recent Developments. 19. (1996) Agenda for Africa’s Economic Renewal. Lal.G. USA: IFPRI/International Food Policy Research Institute. (1995) Environmental Exodus: An Emergent Crisis in the Global Arena.) (1996) The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases. P.P. Cohen. Cambridge.. 59. Washington. Washington. 7–9. Cordova. Netherlands: Gordon and Breach. (1996) Food Security in Africa. and Kent. (1999) External Impact Assessment of IFPRI’s 2020 Vision for Food. J. USA: IFPRI/International Food Policy Research Institute. USA: Lynne Reinner Publications. and T. Wellesley. (1997) Third Report on the World Nutrition Situation. P. Amsterdam. 49.T. and Uvin.L. Murray. Washington. S. Washington. July. Emerging Issues and Long-Term Prospects. BioScience 48. W. (1998) Ecology of increasing disease: population growth and environmental degradation. Oxford.. USA: Overseas Development Council. D.S. (suppl. (1995) Foreign Assistance to Agriculture: A Win-Win Proposition. and Pimentel. Soil Sci. Achieving Food Security in Southern Africa: 203–24. Netherlands: IFPRI/International Food Policy Research Institute. and Beintema. Washington. Wellesley College.). DC. J. (1999) Sub-Saharan Africa: Economic Policy and Outlook for Growth. Am. DC. DC.. Pandya-Lorch... DC. and Pandya-Lorch. Massachusetts. DC. Washington. (1996) Measuring sustainable development: progress on indicators. R. W. R. USA: IFPRI/International Food Policy Research Institute. East Lansing. Massachusetts. P. M. R. Soc. USA.M..M. Colorado. ed. J. (1997) Managing water supply and demand in southern Africa. USA: Michigan State University. M. C. (1999) Should eliminating unmet need for contraception continue to be a program priority? Int. DC. Ambio 23. USA: Climate Institute. Meier. Washington. A. A. Pimentel.M. (1991) A Global Population Policy to Advance Human Development in the 21st Century. R. (1995) The Challenge for a 2020 Vision: Extent of Today’s Human Suffering and the View Toward 2020. N. DC. and Cohen. . Energy and Society. E. 9–14. and Sombroek. Jayne. W. Meinzen-Dick. DC.J. and Garrett. T. H. and Scherbov. Develop. (1999) World Food Prospects: Critical Issues for the Early 21st Century.J. Lutz. Washington. DC. R. and Rajaram. et al. and the Environment Initiative. Pimentel. Messer. N.S. 803–04. and Tarantola. Department of Agricultural Economics.. Econ. (1996) The right to food in the post-cold war era. Washington. Roseboom. United Nations Development Programme. (1994) Market-Oriented Strategies to Improve Household Access to Food: Experience from Sub-Saharan Africa. J. Messer. Pinstrup-Andersen. and Pimentel. Myers. USA: IFPRI/International Food Policy Research Institute. (eds. R. Mann. M. New York. Injuries. J. (2000) Food and hunger in sub-Saharan Africa. 26. USA: IFPRI/International Food Policy Research Institute. R. J. R. Washington. and Pimentel. Marsili. Washington. L. 1995. (1995) Erosion-crop productivity relationships for soils of Africa. USA: Harvard University Press. James. (1999) Africa’s Forgotten Crises: People in Peril. (1990) World Map of the Status of Human-Induced Soil Degradation. UK: Oxford University Press. Agriculture. DC. USA: IFPRI/International Food Policy Research Institute. Sci. (1996) Securely sustainable. (1994) Food Supply and Crops in Sub-Saharan Africa. L. P. (eds. DC. T.R.Food and hunger in Sub-Saharan Africa International Monetary Fund. et al. Pinstrup-Andersen. The Hague. R. and Risk Factors in 1990 and Projected to 2020. Boulder. D. and Schoﬁeld. D. (1997) Politics and Food Insecurity in Africa. N. Michigan. Washington. Oxford. UK: Oxfam. (1996) Food. D. Pearce. Marchione. Hamilton. USA: Department of Economics. and Lopez. Am. DC. A. (1997) A 2020 Vision for Food. and Rosegrant. Washington. Pimentel. N. R. M. E. Minear. (1999) An Overview of the Future Global Food Situation. Huang. Lundberg.W.. USA: Sub-Committee on Nutrition. et al. USA: United Nations. 661–67.
Carlisle. Washington.W. Mascarenhas. (eds. DC. New York. New York. UNICEF. US Army War College. US National Research Council.). London.. W.org/news/1999. (1997) Land Degradation in the Developing World: Issues and Policy Options for 2020. New York. USA: IFPRI/International Food Policy Research Institute. USA: World Resources Institute. USA: Oxford University Press. DC. Finance and Development (March). London. J. M. USA: Michigan State University. Department of Agricultural Economics. New York. USA: US Department of Agriculture. E. USA: United Nations Childrens Fund (UNICEF). S. Tilford. New York. DC. (eds. Renner.B. F.S. East Lansing. (1993) Parasitic infection and chronic energy deﬁciency in adults. USA: National Academy Press. US Department of Agriculture. L. V. (1995) Who Will go Hungry? Scenarios for Future Global and Regional Food Supply and Demand. Published as Staff Paper.B. Cambridge. Piuf. 340–57. New York. USA: Strategic Studies Institute. (1998) Human Development Report 1998. R. DC. Fred Sai Speaks Out.htm UNICEF. (1995) Refugees at a Glance: Information Brief. Iowa. Norton. United Nations Population Fund. Cambridge. Washington. Washington. (2000) The State of the World’s Children 2000. (Jr. and Conly.68 Myers and Kent Thamae. Tokyo. and Valdes. USA: World Resources Institute. UK: Earthscan.). United Nations Population Division. 3–24. (1998) Africa’s Valuable Assets: A Reader in Natural Resources. Poleman. L. USA: United Nations. Qureshi. Ul Haq. USA: IFPRI/International Food Policy Research Institute.). United Nations University. (ed. Pennsylvania. US National Research Council. O. Michigan. USA: Population Action International. V. DC. Scrimshaw. United Nations High Commissioner for Refugees. In L. DC. (1999) Global Environment Outlook 2000. (1997) Recent trends in food availability and nutritional wellbeing. et al. and Brown. USA: Worldwatch Institute. A. Staatz. Postel. USA: W.991006-e. Tweeten. (1993) Restructuring food systems to support a transformation of agriculture in sub-Saharan Africa: Experience and Issues.) (1997) Promoting Third World Development and Food Security. J. Johnson. (eds. (1995) Lessons from the Group Up: African Development that Works. (1994) Dr. in Stanley R. Ames... UK: Cambridge University Press. DC.G. Institute for Natural Resources in Africa. J. (1998) Africa’s Population Challenge: Accelerating Progress in Reproductive Health. UK: Cambridge University Press.J. M. Japan: United Nations University. 1999. Rosen. UK: International Planned Parenthood Federation. Norton. US Agency for International Development. (1999) www. Rosegrant. et al. (1999) Human Development Report 1999. (1996) Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioural Sciences. Washington. 93– 96. Washington. and Ampadu-Agyei. Westport. USA: IFPRI/International Food Policy Research Institute. Food Nutr.S. T. (1996) Food Prices and Food Security: Where are we Headed? Washington. New York. UNAIDS. Shetty. USA: National Academy Press. P. (1995) Executive Summary. (1998) The State of the World’s Children 1998. W. M. R. United Nations Development Programme. (1999) Food crisis: need for an African solution to an African problem. USA: Iowa State University Press. DC. A.R. Washington. USA: United Nations Childrens Fund (UNICEF). United Nations Development Programme. (1999) State of World Population.G. In L. Rosegrant. Haddad (ed. N. and Shetty. Speth. pp. (1995) Whatever happened to the peace dividend? Our Planet 7. Washington. M. Africa Can Feed Just 40% of its Population in 2025. (1995) The plundering of agriculture in developing countries. Washington. 8–10.fao. USA: W. Bull. USA: Oxford University Press. Sen. (1999) The plight of the poor: The United States must increase development aid. New York. (1997) Institutional arrangements for the effective development of southern Africa’s water resources. J. DC. and Yadaf. S159–67. N. T. (1999) At the 11th UN AIDS Conference in Zimbabwe. Veit. DC. (1999) Pillar of Sand: Can the Irrigation Miracle Last? New York. In K. USA: IFPRI/International Food Policy Research Institute.). USA: World Priorities. UK: Overseas Development Institute. United Nations Environment Programme. 145–65. (1996) Overcoming Malnutrition: Is there an Ecoregional Dimension? Washington. (1999) Food Security Assessment: Why Countries are at Risk. (1994) The consequences of hidden hunger for individuals and societies. Foreign Affairs 78. Garcia. Washington. pp. Sharma. Brown et al. DC. USA: United Nations Population Fund. USA: IFPRI/International Food Policy Research Institute. J. USA: United Nations Population Division. (1996) World Military and Social Expenditures 1996.) (1998) World View: The 1998 Strategic Assessment. DC. USA: IFPRI/International Food Policy Research Institute. Strzepak and Smith. (1995) Employment Programs for Food Security in Sub-Saharan Africa. Scherr.T. S. (1999) Wars increase once again. A. M. Richardson. S. M. S. and McClellan. Shiff. (1989) Recommended Dietary Allowances.G. L. (1999) (website). 226–34. (1996) Structural Adjustment and Environmental Linkages: A Case Study of Kenya. Sivard. J. USA: Praeger Press. pp. Sai. Washington. As Climate Changes: International Impacts and Implications. D. Parasitology 107. (1999) World Population Prospects: The 1998 Revision.M. . 19. Food Security: New Solutions for the 21st Century. United Nations Development Programme. 13–17. A. DC. (1999) Development as Freedom. Achieving Food Security in Southern Africa. Veit. pp. London. Connecticut. pp.. 15.G. See also Ending Violent Conﬂict. Washington. Vital Signs 1999. Washington.. Pop.E. New York. M. M. Teklu. 112–13. DC. Smith.M. Environ. Rukuni. (2000) Human Development Report 2000. 1–18. USA: Oxford University Press.
and Nairobi. (1999c) World Development Indicators. (1999) World Health Organization report on Infectious Diseases: Removing Obstacles to Healthy Development. C. Geneva. Washington. Kenya: United Nations Environmental Programme. Washington. 16–20. D. (1997) Winning the war against malaria.C. Washington. (1993) World Development Report 1993. DC.H. . Cattani. DC. USA: World Bank. USA: Oxford University Press. (1998) The Worldwide Magnitude of Protein-Energy Malnutrition: An Overview from the WHO Global Database on Child Growth.) (1998) Regional Impacts of Climate Change: An Assessment of Vulnerability. 1998. F. (1999b) Global Economic Prospects and the Developing Countries 1998/99. (1998) World Development Report 1998. M. World Health Organization. 100. Rev. World Bank. Switzerland: World Health Organization. P. Geneva. New York. and J. R. J. USA: World Bank. USA: World Bank. DC. (1996) The potential demographic signiﬁcance of unmet need. (1999a) World Development Report 1999–2000. (1995) The Current Global Situation of the HIV/AIDS Pandemic. and von Braun. (1996b) Micronutrient Malnutrition—Half of the World’s Population Affected. World Bank. Switzerland: Intergovernmental Panel on Climate Change. USA: Oxford University Press. World Bank. (1996b) Poverty Reduction and the World Bank: Progress and Challenges in the 1990s. Int. (1997) Global Economic Prospects and the Developing Countries. Washington. DC. World Bank. USA: World Bank. World Resources Institute. USA: Oxford University Press. Geneva. Chichester. 52–61. World Bank.T. Switzerland: World Health Organization. DC. (1996a) Toward Environmentally Sustainable Development in Sub-Saharan Africa. 1999. Geneva. Westoff. Switzerland: World Health Organization. 1994– 1998. New York. USA: Oxford University Press. Perspectives. DC. 22. Switzerland: World Health Organization. Geneva. Rome. USA: World Bank. Switzerland: World Health Organization. (1997) Taking Action to Reduce Poverty in SubSaharan Africa. World Food Programme. DC. Switzerland: World Food Programme. Family Plan. World Health Organization. Geneva. New York. (1997) Health and Environment in Sustainable Development. New York. R. USA: Oxford University Press. and I. Geneva. and Moss. Zinyouwera. Washington. New York. New York. World Meteorological Organization. Washington..Food and hunger in Sub-Saharan Africa Watson. See also. see also Child malnutrition: fact sheet no. (1999a) World Food Programme Statistics. Technol. (1992) World Development Report 1992. (1994) World Development Report 1994. 41–44. USA: Oxford University Press. Ochoa. World Health Organization. USA: World Bank. Webb. UK: John Wiley. 69 World Bank.H. Wirth. (1995) African Development Indicators 1994–95. USA: World Bank. World Bank. (eds. Weekly epediomological record of the World Health Organization 71. World Health Report. 119. World Bank.F. World Bank. World Health Organization. (1996a) World malaria situation in 1993. Italy: World Food Programme. World Health Organization. (1998) World Resources Report 1998–1999. Washington. World Bank. (1994) Famine and Food Security in Ethiopia: Lessons for Africa. World Health Organization. World Bank. (1999b) World Food Programme and Global Food Aid Shipments by Country and Region. World Food Programme. World Bank.
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