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The Geography of Food and Health Revision Notes Paper 2

The Geography of Food and Health

Revision Notes Paper 2

Syllabus

 

Health is defined by The World Health Organisation as ‘a state of complete physical, mental and social well-being’.

Food miles: A measure of the distance that food travels from its source to the consumer. This can be given either in units of actual distance or of energy consumed during transport.

HALE: Health-adjusted life expectancy, based on life expectancy at birth but including an adjustment for time spent in poor health (due to disease and/or injury). It is the equivalent number of years in full health that a newborn can expect to live, based on current rates of ill health and mortality.

Transnational corporation (TNC): A firm that owns or controls productive operations in more than one country through foreign direct investment.

Life expectancy - The average number of years a person born today would be expected to live given constant mortality conditions.

Infant Mortality Rate - The number of infant deaths deaths of children below 1 year old per 1000 live births per year

Calorie Intake - The amount of energy intake from food per person per day. Measured in kilocalories per person per day

Access to safe drinking water - Where the source of water is 1km from its place of use and can reliably provide 20 liters of water per member of the household. The water must meet the World Health Organization or national standards for drinking water quality.

Access to health services - Access to health refers to the number of healthcare facilities per 10 000 people or healthcare expenditure per capita.

Malnutrition - A state of poor nutrition. This usually results from a deficiency of proteins, energy or minerals. May lead to one of a range of diseases depending on the particular nature of the malnutrition.

Temporary hunger - Hunger is both a state where there is a desire for food and an absence of food. This is a short term need for food, triggered by physiological responses caused by food deprivation.

Chronic hunger - A state where the desire for food becomes extreme, due to prolonged food deprivation, to the point where normal bodily functions begin to be affected.

Famine - Famine is determined by the United Nations, and is a ‘legal’ definition. In this respect it is similar to the definition

of a pandemic: certain numerical conditions need to be met. The recent famine in Somalia in 2011 was the first ‘real’ famine for some time. We will look in more detail at this event later in the unit. Famine is defined technically as: “a situation where acute malnutrition rates among children exceed 30%, more than 2 people per 10 000 die per day, and people are not able to access

food and other basic necessities

...

Prevalence: The number of cases of a disease per 10,000 of the population Incidence: The risk of developing a disease or condition, measured by the number of new cases confirmed annually Infectious: the quality of a disease being caused by an infectious agent which is directly or indirectly transmitted from a source of infection living or non-living to a susceptible host. Non-communicable: the quality used to describe a disease that cannot be transmitted from an infected host. Degenerative: a quality of a disease where the structure and function of the infected tissue worsens over time.

E.g. osteoporosis, Alzheimer’s Disease, Huntington’s Disease

Viral: A disease that is caused by the presence of a virus

E.g. HIV (Human Immodeficiency Virus), H1N1

Parasitic: A disease caused by the presence or because of reaction to a parasite

E.g. Schistosomiasis (Bilharzia snail), Malaria (mosquitoes), Dracunculiasis (Guinea worm)

Endemic: A disease that occurs frequently in a specific geographic location or within a species. E.g. how HIV/AIDS is endemic in Sub-Saharan Africa, avian flu is largely endemic to birds and certain strains (e.g. H5N1)

are endemic to humans

Bacterial: A disease caused by the presence of bacteria

E.g. Cholera, E. coli, Staphylococcus

 

Superbug: A strain of bacteria that has become resistant to normally used antibiotics E.g. Methicilin resistant Staph aureus (MRSA) and extensively drug resistant tuberculosis (XDR TB), which is resistant to

drugs such as isoniazid

Re-emergent: a disease that had previously decreased in incidence due to being controlled or eliminated, which has recently increased in incidence E.g. Lyme disease (Endemic to Northern Hemisphere, transmitted by deer ticks, re-emerged in Italy, 2008), West Nile

Virus (Endemic to Uganda and East Africa, transmitted by mosquitoes, re-emerged in NYC in 1999 and became global)

Variations in health

 

Variations in health reflected by life expectancy (LE) since 1950

Describe the

In 1948, the income and LE disparity between countries was wider than ever

o

variations in health as

Asian and African countries were still poor and had low LEs (below 45)

reflected by changes

 
  • However! Japan was catching up with the wealthier nations after WW2

in life expectancy at

o

Europe in top right corner of the graph w/ N Amer (LEs around 70-80)

national and global

After 1950

scales since 1950.

o

Asian colonies gained independence and their national incomes and LEs began to

Explain the

improve.

patterns and trends in

  • However! South Asian countries are further behind

terms of differences

o

European and N Amer countries still remain healthy and wealthy

in income and

  • LE increased towards the 80s

lifestyle.

Middle Eastern and N. African countries had higher incomes and higher LEs due to the revenue earned from oil exports.

o

Sub Saharan countries are still poor and sick

1970s

o

Asian and S. American countries (e.g. Mexico, Malaysia, South Korea) became emerging economies and caught up with the developed N. American and European countries.

1980s till 21 st Century

o

o

Emerging economies in Asia and S. Amer continue to see improvements in income

and LE. Some African countries (e.g. Ghana) see improvements in income and LE.

o

However, African countries such as the Congo and South Africa/Botswana do not

see large improvements due to civil war (Congo) and HIV/AIDS (S. Africa)

  • Without HIV/AIDS, it is estimated that S. Africa would have an LE of 69

instead of the current 41 years

Currently in the 21 st Century

o

Estimated that ALL countries now have LEs above 40

  • However, not all countries have income per persons above $3000

o

Middle income countries or emerging economies (EEs) are able to compete with high income countries in terms of LE and income due to the 2007-8 financial crisis.

  • European and N. American countries experience lower incomes

 
  • Low income countries in Africa hit hard

o

  • EEs predicted to see improvements in economic growth and development of healthcare. Huge income differences between developed countries and developing countries

  • e.g. comparing Luxemburg and the Congo

o

Inequalities within countries

  • E.g. Shanghai, China has the equivalent LE and income of Italy

  • However! Rural areas in Guizhou, China have the same LE and income of

Ghana

Patterns & trends in health with respect to income & lifestyle

Wealth

Affects whether people are able to afford high quality healthcare treatment. Low wealth = inability to access high quality healthcare treatment

o

  • E.g. only have access to general use drugs, no specialized drugs

o

High wealth = access to more advanced forms of treatment

  • E.g. radiotherapy and chemotherapy treatments for serious diseases e.g. cancer. Affects diet quantity and quality of nutrition obtained

Affects location & access to healthcare

OVERALL: Wealth is a factor that affects health in a multitude of ways.

Rural or urban location Rural areas: harder to access healthcare facilities

o

o

  • Affects whether ppl in rural areas can afford the time and money to seek

Low frequency of clinics and hospitals

Opportunity cost of travelling to seek treatment would be time used to earn

income and provide food via agriculture

healthcare

o

Fewer doctors in rural areas because population does not meet the threshold population for a clinic or healthcare center (not enough people to support a clinic)

  • Longer waiting lists for doctors

o

Quality of healthcare facilities and doctors

  • Availability of preventative measures such as vaccinations

Urban areas: relatively easier access to healthcare Higher population density = more clinics and facilities located there

o

o

Many types of transport infrastructure

  • Easy access

Quality of sanitation and sewage systems Availability and quality of sanitation facilities e.g. toilets.

o

o

Affects how sanitary the environment is

Spread of diseases

Poor quality toilets long-drop or open defecation are often found in poorer, rurall areas that lack amenities.

o

These areas also often have open sewage systems

Conversely, richer areas tend to have better sanitation infrastructure namely toilets and sewage systems.

 

Most urban areas have closed-sewage systems and flushable toilets Availability of sinks/clean, running water

o

Provision of clean water and food Whether the water comes from a clean, purified source. Water from ground wells found in poorer, arid countries (sub-Saharan) are

o

causing bacteria or parasites

from an open source that allows it to be easily contaminated and to breed disease-

Major events affecting LE 1810: Most countries were in bottom left corner of the graph sick and poor

o

o

LE below 40 in all countries

Income less than $3000

o

UK and the Netherlands were better off, but not by much LE fluctuated due to famines and disease

o Industrial revolution at end of 19 th century o Europe and N. America first began to grow richer due to industrialization (development of new technologies) Health in Europe an N. America then began to improve

o

o

  • Movement away from the sick and poor area, makes them richer and healthier Asian colonies and Sub-Saharan African countries remained sick and poor

  • LE still remained below 40 towards the end of the 19 th century

Spanish Flu and WW1 in early 20 th century caused massive drops in life expectancy

In 1948, the income and LE disparity between countries was wider than ever

o

Asian and African countries were still poor and had low LEs (below 45)

  • However! Japan was catching up with the wealthier nations after WW2

o

Europe in top right corner of the graph w/ N Amer (Les around 70-80)

After 1950

o

Asian colonies gained independence and their national incomes and LEs began to

improve.

  • However! South Asian countries are further behind

o

European and N Amer countries still remain healthy and wealthy

  • LE increased towards the 80s

Middle Eastern and N. African countries had higher incomes and higher Les due to the revenue earned from oil exports.

o

Sub Saharan countries are still poor and sick

1970s

o

Asian and S. American countries (e.g. Mexico, Malaysia, South Korea) became emerging economies and caught up with the developed N. American and European countries.

1980s till 21 st Century

o

o

o

  • Without HIV/AIDS, it is estimated that S. Africa would have an LE of 69

Emerging economies in Asia and S. Amer continue to see improvements in income

and LE. Some African countries (e.g. Ghana) see improvements in income and LE.

However, African countries such as the Congo and South Africa/Botswana do not

see large improvements due to civil war (Congo) and HIV/AIDS (S. Africa)

instead of the current 41 years

Currently in the 21 st Century

 

o

Estimated that ALL countries now have LEs above 40

  • However, not all countries have income per persons above $3000

o

Middle income countries or emerging economies (EEs) are able to compete with

high income countries in terms of LE and income due to the 2007-8 financial crisis.

  • European and N. American countries experience lower incomes

  • Low income countries in Africa hit hard

o

  • EEs predicted to see improvements in economic growth and development of healthcare. Huge income differences between developed countries and developing countries

  • e.g. comparing Luxemburg and the Congo

o

Inequalities within countries

  • E.g. Shanghai, China has the equivalent LE and income of Italy

  • However! Rural areas in Guizhou, China have the same LE and income of

Ghana

Factors affecting health (based on LE)

Wealth

Affects whether people are able to afford high quality healthcare treatment.

o

Low wealth = inability to access high quality healthcare treatment

o

  • E.g. only have access to general use drugs, no specialized drugs High wealth = access to more advanced forms of treatment

  • E.g. radiotherapy and chemotherapy treatments for serious diseases e.g. cancer. Affects diet quantity and quality of nutrition obtained

Affects location & access to healthcare

OVERALL: Wealth is a factor that affects health in a multitude of ways.

Rural or urban location Rural areas: harder to access healthcare facilities

o

o

Low frequency of clinics and hospitals

Opportunity cost of travelling to seek treatment would be time used to earn

income and provide food via agriculture

  • Affects whether ppl in rural areas can afford the time and money to seek

o

healthcare Fewer doctors in rural areas because population does not meet the threshold

population for a clinic or healthcare center (not enough people to support a clinic)

  • Longer waiting lists for doctors

o

Quality of healthcare facilities and doctors

  • Availability of preventative measures such as vaccinations

Urban areas: relatively easier access to healthcare Higher population density = more clinics and facilities located there

o

o

Many types of transport infrastructure

  • Easy access

Quality of sanitation and sewage systems Availability and quality of sanitation facilities e.g. toilets.

o

o

Affects how sanitary the environment is

Spread of diseases

 

Poor quality toilets long-drop or open defecation are often found in poorer, rurall areas that lack amenities.

o

These areas also often have open sewage systems

Conversely, richer areas tend to have better sanitation infrastructure namely toilets and sewage systems.

Most urban areas have closed-sewage systems and flushable toilets Availability of sinks/clean, running water

o

Provision of clean water and food Whether the water comes from a clean, purified source. Water from ground wells found in poorer, arid countries (sub-Saharan) are from an open source that allows it to be easily contaminated and to breed disease-

o

o

causing bacteria or parasities In more developed countries esp. urban areas water has been purified at treatment plants.

  • Sufficient water infrastructure

Quantity & quality of food consumed Quantity: amount of food (measurable by kilocals/day)

o

o

Quality: whether food is clean and provides sufficient nutrients. Developing vs developed countries: MEDCs generally hv greater qty of food per

person than LEDCs.

  • Due to higher incomes and availability of food that is imported

o

Quality of food tends to be better in MEDCs due to ppl’s ability to vary their diet

and have food from all food groups.

Education Affects how educated members of population are about diseases Poor education on diseases: inability to identify diseases by symptoms or how to

o

treat them.

  • Often in LEDCs because low access to education from high rural popns or low incomes.

Education regarding hygine practices

Quality of working conditions Affects the amount of risk at work would affect LE LEDCs where work tends to be in the pri. & sec. sectors involves manual labour risk of injury involved

o

  • Low standard of living = poorer working conditions

  • Working conditions may be poorer due to government lacking funds and time to regulate these.

o

MEDCs: occupations in the tertiary & quaternary sectors don’t involve heavy labour –

less risks & hazards at occupations.

  • Good working conditions due to high standard of living

  • Government or external bodies to regulate working conditions.

Infant care and maternal care Affects infant mortality, child mortality & mortality rate in general (for mothers): thus affecting LE, the avg. # of years a person is expected to live from their date of birth

E.g in Sierra Leone: 1 in 8 women die in childbirth contributes to higher mortality rate Developing countries vs developed countries

o

   

o

Developing: lack of access to high quality medicines and medical facilities = higher IMR, CMR & maternal deaths.

 
  • Poorer quality post natal care

 

o

  • Shortage of doctors & nurses reliance on midwives or family births (more unsanitary) Developed: higher quality medical treatment and facilities = better quality post natal care

Life expectancy (LE)

 

LE definition: the average number of years that a newborn can be expected to live

Comparing 2 countries: Burundi, Central America (50) & Sweden (81) Burundi

 

If conditions remain at 2007 conditions

2 out of 5 people can live past the avg life expectancy of 50

Sweden

 
 

If conditions remain at 2007 level

1 dies in adulthood, 4 die at old age

In LE, one must consider the infant mortality as well, as it will affect patterns in the LE. LE is low when infant & child mortality rates are high higher probability of dying at an

 

earlier age

 

LE is an average, although most ppl in Burundi live past the age of 50, some may die at infancy or during childhood years.

Measuring health

Life Expectancy

 

Evaluate life

Pros

expectancy, infant

 

Considers various factors in measuring life expectancy e.g. gender, history of related diseases, alcohol consumption and hours of sleep received.

mortality rate (IMR)

Serves as a measure of the overall health of a country’s population

and child mortality, HALE (health-

Average life expectancies can be compared across different countries in order to compare the level of health.

adjusted life

Encompasses all three aspects of health: physical, social and mental well-being

expectancy), calorie

Cons

intake, access to safe

 

May be difficult to collect data in developing countries due to low government funding and

water and access to health services as

larger amount of local run clinics that are not accounted for. As life expectancy is an average figure for a country, within the country there may be large

indicators of health.

regional or ethnic variations. In some cases, countries may measure life expectancy differently, making it difficult to

compare the health of different countries. For example some countries measure life expectancy from birth, while others may measure life expectancy from another age.

Life expectancy does not measure the quality of life in terms of how many years of one’s

life is spent in poor health.

Conclusion

 
 

Life expectancy serves as a good measure of the general health of a country.

Provided that the measure of life expectancy is standardized across countries, can serve as a method to compare health.

   

However, this only examines the ‘quantity’ aspect of health in terms of how long people live

Infant Mortality rate Pros

 

Considered a more accurate measure of a country’s health because the first year of infancy

 

is a sensitive, vulnerable period of time where the infant requires sensitive care. Shows the

 

quality of a country’s healthcare system. Infant mortality rate can reflect the quality of a country’s sanitation, household income,

nutrition and other factors Infant mortality rate also links towards the life expectancy of a country.

E.g. a high infant mortality rate usually correlates with a lower life expectancy due to higher chances of dying before age of 1.

Data for infant mortality can be acquired mostly from hospital records, making data collection relatively easy

Cons

 

Factors such as emigration or conflict can cause inaccuracies in the infant mortality rate

data. Some families might not register children or gave birth to children via unofficial means e.g.

Conclusion

midwives.

 

Infant mortality rate is a more sensitive, possibly accurate indicator of health as it deals with post-natal care, which is a very delicate area due to the number of factors affecting an

infant’s health. Although there may be inaccuracies, infant mortality serves as an effective comparison of health standards. Health Adjusted Life Expectancy (HALE) - HALE is calculated using Sullvian’s method, which

measures the real health of a population when adjusted for mortality levels and is independent of the age structure. Specifically, Sullivan’s method measures the number of years an individual of a particular age is expected to live in a healthy state.

Pros

 

Unlike life expectancy, HALE measures both the quantity and quality of health as it takes

the average number of years lost to disability or poor health into account. Shows the influence of chronic diseases or degenerative diseases, e.g. arthritis or

Alzheimer’s Disease, on a country’s health. Demonstrates how health can be affected by both external factors from the environment

and internal or endogenetic factors that relate to genetic diseases. Calculation of HALE also produces additional statistical data of DALYs disability adjusted

Cons

life years which measure the number of years of productive life lost to disability.

 

Data gathered for HALE may be more unreliable. This is because data needs to be gathered

via health surveys or reported data from hospitals. Survey data may be harder to obtain especially in LEDCs due to the time and monetary cost. Serves as an average indicator of years expected to live in full health, there would still be regional or ethnic variations in HALE within a country.

 

Difficult to measure morbidity which relates to the frequencies of diseases because it relies again on reported data.

Conclusion

Compared to life expectancy, HALE serves as a far more specific indicator of health by

measuring quantity and quality of health. However, because the HALE uses more specific data, there is a higher chance that this data

is inaccurate. This may be especially true in developing countries where it may be harder to conduct household surveys due to lack of government funding.

Calorie Intake

Pros

Used to measure the degree of undernourishment in a country the state of people having

not enough food to eat. By using the current recommended calorie intake of 2000kcal/day for women and

2500kcal/day for men, one is able to identify countries that have higher degrees of undernourishment. Shows the access to food or food supply in different countries and allows for international

Cons

comparison between countries

Proxy data does not measure health itself, but measures a factor that affects health.

Does not measure malnourishment whether individuals have nutrient deficiencies or

nutrient imbalances, which could have serious impacts on health. Following from previous point, one does not know the source of the calories consumed,

and they may come from foods that are high in fat. When comparing calorie intake across countries, the caloric requirements in each country

will differ due to factors such as age structure or weather. E.g. Calorie intake in colder countries e.g. Canada will be higher because of the colder climate. In Asian countries caloric intake tends to be lower due to smaller stature and physique of people.

Within countries there would be variations in terms of ethnicity, gender, occupation and other factors. E.g. a Tour De France cyclist will require up to 10,000kcal/day during a race, would be significantly higher than average calorie intake of the rest of the population.

Conclusion

Calorie intake may not serve as the most effective measure of health, however it does

provide a suitable indicator for the degree of undernourishment across countries. Although similar to other indicators of health in the sense that it may hide regional or ethnic patterns in the data for one country, calorie indicator also hides variations depending on the type of occupation or profession, e.g. whether individuals are professional atheletes.

Major limitation would be that it does not show what kind of food the calories are obtained from, hides whether the population has nutrient deficiencies or imbalances.

Access to safe drinking water Pros

Access to safe drinking water has direct links to sanitation and is a key factor affecting

health. Indicates the quality of sanitation and sewage systems in a country which both link to health.

 

Low access to safe drinking water would mean a higher incidence of water borne diseases e.g. schistosomiasis (bilharza) and cholera.

Cons

Proxy data does not measure health but instead measures a factor affecting it

Data may contain inaccuracies difficult to measure the distance away from a water source for each community, especially in a rural area of an LEDC. Data collected in LEDCs would be less reliable due to low government funding combined with high time and monetary cost.

The drinking water quality standards used by certain countries may be more strict or lower than the WHO drinking water standards, causing difficulty in comparing access to safe drinking water.

Distance of 1km away from the water doesn’t measure how easy it is to travel that for that

1km, it could be mountainous or flat for example.

Conclusion

Access to safe drinking water provides proxy data with a stronger link to a country’s health,

as water is seen as vital for human life (e.g. one can only survive 3 days without water). In addition, because unsafe drinking water can carry such a variety of potentially dangerous microbes and diseases, access to safe drinking water is seen as a more sensitive and specific source of proxy data linked to health.

However, one must bear in mind that access to safe drinking water is proxy data and only serves as a factor affecting health.

Access to Health Services Pros

Access to healthcare facilities is a factor that has direct effects on the health of a

population. Shows whether individuals in a country are able to seek effective treatment for diseases or preventative care. Hospital beds & physicians per 10 0000 people show the level of strain placed on

healthcare services. A standard measure of 23 doctors/nurses/midwives per 10000 people is used as the minimum number of healthcare workers per 10 000 to ensure a coverage rate that maintains adequate healthcare. This can be used to compare various countries.

Healthcare expenditure shows the level of investment and development in healthcare systems affecting the overall health of a country.

Cons

Proxy data does not actually measure health, rather it measures a factor affecting it.

In LEDCs the figures may not be as accurate due to unlicensed healthcare workers or

unofficial healthcare centers. Number of physicians per 10000 does not indicate the quality of the healthcare services

offered. Within a country there would be large variations in the number of healthcare workers per 10000 based on location. I.e. rural areas would have fewer physicians per 10000 than in an urban area.

The age structure of a country’s population could affect the health expenditure per capita.

Conclusion

Access to healthcare facilities is proxy data linking to the health of a country. Provides a direct link to whether members of the population have the access to preventative treatments or medicines to treat disease.

 

However, in the case of physicians per 10000 population the most common method of measuring access to healthcare facilities it does not measure the quality of the services provided by the physicians

Prevention relative to treatment

Most nations of the world emphasise curative health care facilities. In other words, governments spend money on hospital and medical facilities which are designed to cure illnesses rather than

beyond the resources of many of the world’s countries if curative healthcare is to be adequate.

Discuss the geographic factors

prevent them. Curative health care needs large numbers of hospitals, doctors, medicines and facilities. The results can be impressive where enough resources are allocated, with heart transplants, surgery and other techniques saving lives. However, the sums of money involved are

that determine the relative emphasis placed by policy- makers, in one country or region, on prevention as opposed to treatment of disease

Primary Health Care is different to health care in that it combines prevention with cure. Many nations of the world are coming to realise that to it is better to prevent diseases where possible than to wait for people to get sick. Keeping people well enables them to work productively, feel better and not be a drain on government spending by being in hospital. Screening for diabetes, doing pap smears to detect cervical cancer in women, using TB detecting tests and mass inoculations for diseases such as polio and Hepatitis B are cheap and could save millions of lives in LEDCs. It is estimated providing all the primary health care needed in the world would cost an extra $50 billion per year for the next 20 years. This sounds like a lot of money, but it is only a small percentage of what is spent on cigarettes or arms and the military.

In the 1960s China introduced widespread primary health care. Thousands of paramedics, called barefoot doctors, where trained in the use of basic medicine and sent to work in rural areas to care for farmers and their families. Similar systems have since been established in many countries, including Iran, Sudan and Sri Lanka. Many LEDCS have realised that it is impossible, and inappropriate, to copy overseas health care systems without questioning basic assumptions and financial demands. It i s usually better to develop a system of healthcare which is affordable and suited to the specific needs of the country concerned.

Reflecting (or perhaps contributing to) the differences in the quality of health care standards around the world is the distribution of health care. There are vast differences between the ratio of doctors to the people of the nations of the world. The countries with most people per doctor are Ethiopia (60,000 people per doctor) and Burkina Faso (57,200) whilst in Russia it is 180 and Italy 230.

In most countries one of the greatest differences occurs between urban and rural areas.

Your case study for this should be based on your notes on HIV/ AIDs (see later section). Prevention of HIV/AIDs involves stopping people getting HIV in the first place. This has occurred through:

Screening of people for HIV

Giving medication and education to HIV+ pregnant mothers to stop them passing it onto

their unborn babies. Promotion of abstinence

Education about contraceptives that prevent HIV (e.g. condoms)

Distribution of free or subsidised contraceptives

Publicity campaigns

Prevention of HIV in Uganda ABC Campaign (Abstinence, Be Faithful, Condoms)

The very high rate of HIV infection experienced in Uganda during the '80s and early '90s created an urgent need for people to know their HIV status.

In Uganda developed a national HIV/AIDS policy in 1992. A variety of approaches to AIDS education have been employed, ranging from the promotion of condom use to 'abstinence only' programmes.

To further Uganda's efforts in establishing a comprehensive HIV/AIDS program, in 2000 the MOH implemented birth practices and safe infant feeding counseling. According to the WHO, around 41,000 women received Preventing Mother To child Transmission (PMTCT) services in 2001. Uganda

 

was the first country to open a Voluntary Counselling and Testing (VCT) clinic in Africa called AIDS Information Centre and pioneered the concept of voluntary HIV testing centers in Sub-Saharan Africa.

The Ugandan government has promoted this as a success story in the fight against HIV and AIDS, arguing it has been the most effective national response to the pandemic in sub-Saharan Africa. Though equally there has in recent years been growing criticism that these claims are exaggerated, and that the HIV infection rate in Uganda is on the rise, perhaps linked to over-emphasis on abstinence at the expense of condom use.

An overarching policy known as "ABC", which consisted of abstinence, monogamy and condoms, was set up with the aim of helping to curb the spread of AIDS in Uganda, where HIV infections reached epidemic proportions in the 1980s. The prevalence of HIV began to decline in the late 1980s and continued throughout the 1990s. In fact, between 1991 and 2007, HIV prevalence rates declined dramatically from about 15% in 1991 to about 6% in 2007.

Shortly after he came into office in 1986, President Museveni of Uganda spearheaded a mass education campaign promoting a three-pronged AIDS prevention message: abstinence from sexual activity until marriage; monogamy within marriage; and condoms as a last resort. The message became commonly known as ABC: Abstinence, be faithful, use a condom if A and B fail. This message also addressed the high rates of concurrency in Uganda, which refers to the widespread cultural practice of maintaining two or more sexual partners at a time. Mass media campaigns also targeting this practice including the "Zero-Grazing" and "Love Carefully" public health messages in the 1990s

The government used a multi-sector approach to spread its AIDS prevention message: it developed strong relationships with government, community and religious leaders who worked with the grassroots to teach ABC. Schools incorporated the ABC message into curricula, while faith-based communities trained leaders and community workers in ABC. The government also launched an aggressive media campaign using print, billboards, radio, and television to promote abstinence, monogamy and condom use.

Some reports suggest that the decline in AIDS prevalence in Uganda was due to monogamy and abstinence, rather than condom use. A 2004 Science study also concluded that abstinence among young people and monogamy, rather than condom use, contributed to the decline of AIDS in Uganda.

However, some studies have suggested that a large part of the decline in prevalence of HIV-AIDS is due to the premature death of those who have contracted it. This led to the popular play on the ABC campaign, 'A-B-C-D', with the D standing for Death. Because only prevalence is measured, incidence can actually increase while prevalence decreases if those who contract HIV are not treated for the disease, thereby dying younger. Later studies have seriously questioned the veracity of Uganda's miraculous HIV-AIDS claims

In the 1990s there had been limited access to treatment in the form of anti-retrovirals for those who are HIV positive. Through the combined effort of US PEPFAR, the Government of Uganda and international agencies (Clinton HIV/AIDS Initiative, the Global Fund, UNITAID) this has improved. The country's HIV-AIDS campaign focuses solely on prevention rather than cure, and that prevention is of questionable success.

Criticism

The scope of Uganda's success has come under scrutiny from new research. Research published in The Lancet medical journal in 2002 questions the dramatic decline reported. It is claimed statistics

 

have been distorted through the inaccurate extrapolation of data from small urban clinics to the entire population, nearly 90% of whom live in rural areas.

Alternatively, the Roman Catholic organization Human Life International says that "condoms are adding to the problem, not solving it" and that "The government of Uganda believes its people have the human capacity to change their risky behaviors."

It is feared that HIV prevalence in Uganda may be rising again; at best it has reached a plateau where the number of new HIV infections matches the number of AIDS-related deaths . There are many theories as to why this may be happening, including the government’s shift from abstinence- based prevention programmes, and a general complacency or 'AIDs fatigue'. It has been suggested that antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable, manageable disease; this may have reduced the fear surrounding HIV, and in turn have led to an increase in risky behaviour.

Global availability of food

This shows the global distribution of calorific intake by nation. This is shown as kcal which

This shows the global distribution of calorific intake by nation. This is shown as kcal which represents

Identify

global

patterns of

calorie intake

as one

measure of

food

availability.

 

1000 ‘small calories’. If you look at any food wrapper you will see the energy value of the food

shown in these 2 forms.

According to the National Health Service of the United Kingdom the average man should consume around 2500 kcal per day to maintain his weight, and the average woman should consume around 2000 kcal. These figures are guidelines, and would need to be adapted according to the age, and physical activity of the person, but they give a sense for what would be a reasonable consumption of food. Of course the distribution of access to calories is not equal, and even within countries that would be considered to be economically developed not everyone is always well fed. How does this variation in calories impact on people?

Global distribution of calorie intake America: 3770kcal per day, highest calorie intake of all countries. Countries w/ high calorie intake concentrated around N. America and areas in Europe. Specific countries include USA, Canada, Greece and Romania Countries w/ lowest calorie intake concentrated in Sub Saharan Africa, Southern Asia. South Amer. has high disparity in calorie intake: with most having above 2000kcal. Except for Bolivia

 

Dem. Republic of the Congo: 1590kcal, has the lowest calorie intake of all countries. DRC has 12 th largest population of countries, possibility that there are ppl that consume far below the avg calorie intake. State of health in specific countries DRC high prevalence of underweight, undernourished people. USA high calorie intake above recommended average. Seems to suggest better quality of health, however people might be overweight or overeating.

Dem. Republic of the Congo: 1590kcal, has the lowest calorie intake of all countries. DRC has

Distinguish

Malnutrition - A state of poor nutrition. This usually results from a deficiency of proteins, energy or

between

minerals. May lead to one of a range of diseases depending on the particular nature of the

malnutrition,

malnutrition.

temporary

hunger,

Temporary hunger - Hunger is both a state where there is a desire for food and an absence of food.

chronic

This is a short term need for food, triggered by physiological responses caused by food deprivation.

hunger and

famine.

 

Chronic hunger - A state where the desire for food becomes extreme, due to prolonged food deprivation, to the point where normal bodily functions begin to be affected.

Famine - Famine is determined by the United Nations, and is a ‘legal’ definition. In this respect it is similar to the definition of a pandemic: certain numerical conditions need to be met. The recent

famine in Somalia in 2011 was the first ‘real’ famine for some time. We will look in more detail at

this event later in the unit. Famine is defined technically as: “a situation where acute malnutrition rates among children exceed 30%, more than 2 people per 10 000 die per day, and people are not

able to access food and other basic necessities

...

Hunger map Measures # of people that are undernourished in order to measure hunger Over 35% of population undernourished high prevalence of hunger Areas with high prevalence of hunger

Sub Saharan Africa

Areas in South Asia and towards Ctrl Asia

Usually applies to landlocked countries

No water resources for fishing

No trade

More arid

   

Discuss the

Unless your parents have put a padlock on the fridge, you are likely to be fairly secure. For millions

You may have had to wait longer than you wanted for a particular meal, but globally, millions of

concept of

of people in the world, however, feeding themselves and their family is far less certain. Concern over

food security.

where the next meal might be coming from creates a physiological stress on the body. Over time,

 

uneven access to food impacts on the health of individuals, particularly young children, for whom this can have life-long impacts.

people are uncertain of the source of their next meal, and have to travel for many miles to increase their food security. This is a major driving force in global migration, as well as leading to land use change and pressure on resources such as water.

Food security “exists when all people, at all times have access to sufficient, safe and nutritious food

to meet their dietary needs and food preferences for an active and healthy life

...

"

Map showing food security around the world. Food security will be discussed further in the next sections

 Discuss the Unless your parents have put a padlock on the fridge, you are likely

Areas of food

Increased productivity

sufficiency and deficiency

Land use per capita has shown decreasing trend 0.44 ha per capita in 1964

5 reasons why productivity increased

 
 

Explain how

0.25 ha per capita in 1984

changes in

0.21 ha per capita in 2001

agricultural

OVERALL: Trend shows increased amount of yield per plot of cultivated land =

systems, scientific and technological

increased productivity

innovations, the expansion of the area

I.

Adoption of high yielding varieties of crops (HYVs)

under agriculture and the

Definition: crop varieties that are genetically engineered to have higher yields, increased resistance to diseases and pests as well as shorter growing cycles. HYVs of rice and wheat have shorter, thicker stems that allow each plant to hold a

growth of agribusiness

heavier head of grain. Increased resistance to disease and pests = less crops lost and more grain/produce is

have increased the

harvested Shorter growing cycles = crops can be harvested twice or thrice each year, increasing

availability of food in some

yield per year India quadrupled food production between 1955 and 2005 mainly due to HYVs

areas, starting with the

 
  • 2. Improved irrigation systems

Green Revolution

Allows more cultivated land to have adequate supply of water to support a larger amount of healthier crops, resulting in more yield.

and continuing

Between 1980 and 2000, % of world’s irrigated cropland incrased from 15.7% to 19.7%

since.

Largest increase: Asia (from 31.3% to 37.9%) Specific e.gs

o

Bangladesh: 17% to 33%

o

Nepal: 22% to 35%

  • 3. Increased use chemical fertilizers and pesticides

Fertilizers supply crops with vital nutrients nitrogen, phosphorous and potassium

Global increase in fertilizer use:

that ensures healthy growth of crops and thus increased yield. Pesticides ensure pests do not attack crops and ensure that more is able to be

harvested.

1964: 29kg of fertilizer/ha of cropland

1981: 87kg of fertilizer/ ha of cropland

2003: 101kg of fertilizer/ha of cropland

 
  • 4. Increased improvements and access to mechanical farming technology

Use of more efficient farming machines results in greater productivity per plot of land, less labour required

o

HWVR! Results in unemployment of farmers that are made redundant by machinery

Global increase in use of tractors and harvesters 1980 to 2002: increase in number of tractors by 16.6%

 

Increase in nmbr of harvesters by 11.5%

Specific e.gs 903% increase in S. Korea from 1980 to 2002

o

o

353% increase in Indonesia from 1980 to 2002

Changing nature of agricultural workforce

Decrease in total number of workers involved in agriculture, esp. noticeable in

developed economies (low proprtn employed in agriculture) and emerging economies (falling proprtn employed in agriculture). Despite this, increased improvements to mechanical technology mean fewer workers are required

 

Farm amalgamations: a large neighboring farm/corporation buys surrounding plots of land to increase farm size and fully utilize farming machinery (e.g. combine harvesters).

 

5.

Increasing importance of free trade and Fair Trade

Free trade: lowering/elimination of most trade barriers between countries Resulted in lower prices of imported food and increased ease to purchase.

Farmers increase yields due to increased size of market

Fair trade: ensures that farmers are treated equitably and receive a fair price for their produce, minimizing the need for middlemen and allowing farmers to supply directly to overseas economies.

Incentive to increase yield and productivity.

The Green Revolution

 

The Green Revolution is the name given to the approach that was developed by Norman Borlaug and others to increase the productivity of agricultural land in key countries of the world by educating farmers and introducing new technologies. Genetic engineering was used to produce higher yielding varieties of crops. This also needed mechanisation, pesticides, herbicides, chemical fertilisers and irrigation water.

Through the 1960 and 1970ss a range of techniques were introduced, some of which were based on techniques that had been used successfully in Mexico. These techniques increased productivity so much that Mexico became a net exporter of cereals.

One of the major aspects of the Green Revolution was the use of technology.

Another success was achieved in Punjab state in India, where wheat and rice production doubled (using the IR8 Mexican rice which had a shorter stalk and a larger head and yielded twice as much rice. It could also be cropped twice a year rather than the one crop that they were used to achieving). The Punjab became known as the ‘bread basket’ of India. India is fed using an area of land seven times smaller than the land needed to ‘feed’ a similar

population in Africa.

 

Things that worked

Using hybrid grain seeds (mainly rice, wheat and corn).

These hybrid seeds produced plants with shorter stalks. Instead of putting the energy into growing taller, energy went into the grain. These HYVs (high yielding varieties) of staple crops were produced by genetic engineering. In some cases, several harvests were possible, rather than just one.

 
Things that didn't work so well Inputs into the farm system were increased. These include the

Things that didn't work so well

Inputs into the farm system were increased. These include the things that are needed for the farm to operate successfully.

Artificial fertilisers were needed to ensure high yields. Whereas the traditional methods used

animal manure and didn’t need any additional inputs, the HYVs needed artificial support, as they

were sometimes more prone to pests and disease due to the genetic manipulation that went into their production.

Costs were higher as there were fees for these artificial additions to the farm system. Farmers in

these areas found it difficult to access loans and additional funding, and didn’t want to get into

debt. Richer farmers ended up getting richer but the poorer farmers who could not afford the new technology were often forced off their land (or made to pay higher rents) and ended up worse off.

Some crops also needed improved irrigation, which was required for maximum yields. In areas of water scarcity this was not always easy to guarantee. Salinisation occurred in some areas because of inefficient irrigation. There was also increased eutrophication and increased amounts of cancer which is believed to be because of the increased amounts of pesticides in the water.

Changes in agricultural systems

Traditionally, farming has a simple system of inputs, processes and outputs. Although different farms will generally have variations on a theme, this pattern is reproduced on each farm. There are usually limiting factors such as climate, soil, topography etc. plus the historical use of that particular piece of land. Many farmers are driven by the necessity to feed the family, or make a profit to please shareholders.

There have been many changes to agriculture over the years. Agriculture also requires investment of var kinds. Many countries have prioritised other areas over agriculture, and only a small percentage of foreig tends to be spent on agricultural projects

Commercial: crops are grown and the produce is sold for the purpose of selling to other markets Subsistence: produce from crops grown is largely consumed by the farmer and his or her family. Crops ar grown in order to sustain ones household’s own food consumption. More farmers turning to commercial farming: selling their produce instead of using it to feed themselves and storing the surplus

 

Commercial farmers receive several advantages Affected more by political and economic influences. E.g. government policies or grants, falling costs in farm equipment or transport to markets

o

 

o

Commercial farms benefit more from such policies or improvements. Farmers have increased incomes

Knock on effect to the entire economy: increases a country’s GDP

Farmers have higher disposable income to purchase more consumer goods, necessities and gain acc to svcs e.g. healthcare and education.

Increase in demand stimulates rural non-farm economy (i.e. industries & businesses in rural areas th are not related to agriculture). Multiplier effect = increased standard of living in rural areas

o

OVERALL: Improved standard of living

o

Commercial farmers can overcome constraints of biophysical environment. Mainly due to the fact that commercial farmers have more money and access to more adva

o

o

farming technologies/equipment. E.g. commercial farmers can afford more fertilizers and better irrigation systems, compared

o

Increasing specialization

Do n

subsistence farmers. Results in plants receiving nutrients and water despite poor conditions In more developed areas, commercial farmers can have greater control of biophysical

environment w/ controlled greenhouses.

Increased income due to commercial farming = farmers can buy their own food from other markets. need to grow own food.

Thus, farmers can specialize into growing one type of crop.

 

Specialization into a cash crop = more money earned.

Increased spatial integration Increased integration between farmers and the markets they sell to

Improved transportation infrastructure to nearby market towns

o

Increase efficiency in selling produce

Increased development of ancillary financing services: ensure that farmers can effectively utilize the money they earn

o

E.g. development of banks, insurance providers, marketing firms

Increased rural electrification and communication infrastructure Results in more farmers having access to televisions, telephones, computers and the Internet

Allows for increased spread of globalization and allows farmers access to world information

Link to increased commercialization: access to such global information gives farmers opportunities t learn about new, efficient farming techniques and innovate agricultural techniques.

Aids in the diffusion (spread) of an idea and the impact it has.

 

Increased farm sizes Due to rise in mass production technologies, farm sizes must be larger to ensure their optimal usage

Land plots used are rectangular, increase efficiency of farming machinery

Larger area of cultivated land = more profit made

E.g. commune system from 1950s to 1980s After the rise of CCP, land was confiscated from landlords and redistributed to peasants. Land was la

bought by government and amalgamated into large communes.

 

Abandoned in 1980 in favour of responsibility system: farmers give fixed amount of produce to govt. do as they please w/ remainder

 

The Growth of Agribusiness

Imagine a hundred small fields owned by separate farmers. They are responsible for their own cultivatio harvesting. They all need machinery. They all need to find a market and negotiate a price for their crops. There is likely to be additional effort expended, and because of their small size they will have less bargain power. Now imagine the same area of land combined into one huge field.

Agribusiness is the name given to the aggregation of farmland under the control of a single business. The

are often owned in turn by large trans-national corporations. Companies such as Nestle also control production in large areas, as do companies that produce tea and coffee.

food

Economies of scale are usually mentioned as a key benefit of this approach to agriculture. Costs are redu

when scale is increased. One associated issue here is that of monoculture. Generally, businesses will

focu

growing one crop, having secured a favourable position. Large fields are generally planted with one crop

means that after harvesting the soil over a large area is bare and disturbed, and may be prone to soil ero

Large areas of a single crop may also be more prone to disease and therefore require extra spraying

of

pesticides. Large companies may also negotiate favourable prices, and the terms under which they opera within a region. How big can these fields be ?

Scientific and Technological Innovations

The image on the next page shows that some fields have crops which are ‘stressed’ through lack of water. These fields could then be targeted for irrigation, thereby saving water, and ensuring that

 

yields didn’t suffer.

The images could be obtained from commercial satellites, or from flyovers by drone planes equipped with camera able to capture images at certain wavelengths. There is also the use of GIS (geographical information systems) to accurately map farms. Not only does this enable more accurate claims for subsidies, but also maps the area that is used for conservation, and can result in better calculations of orders of seeds and chemicals. With nitrogen based fertilisers costing hundreds of pounds per tonne it is important that they are not wasted.

Accurate weather forecasts can avoid waste where rainfall or high winds might reduce the impact of freshly applied chemicals.

Link to increased productivity: access & development of more efficient farming equipment improves efficiency of farming and ensures higher yield per plot of land.

Farmers can perform tasks more easily and quickly

E.g. walking tractor developed in China First introduced from Russia in form of handheld plow

Was developed into a walking tractor, substituted people manually transporting farm eqpmt and produce. Saves individuals time and effort that can be invested in other areas.

Also serves as form of transport in rural areas

E.g. Japan: rice farming technology Carries out more menial tasks e.g. ploughing, planting, harvesting and winnowing Allows Japanese farmers to seek other part time jobs to earn additional income

o

 

Allows for optimization of rice growing: machines plant 5 rows of rice crops at 1 time, with the distance from each seedling optimized at 20cm.

However this means there is need for standardized conditions, can increase time lags in farming. Increases efficiency in rice paddys

o

Increased purchased inputs More purchases of machinery, fertilizers and pesticides Also more purchases made to repair machinery

o

Linked to increased productivity and increased commercialization. People can afford to purchase more inputs to help increase production

Increased control of biophysical environment Availability of fertilizers, pesticides and irrigation systems can overcome poor soil nutrition, pests, lack of water.

Use of controlled greenhouses in developed regions

E.g. China’s scheme to eradicate birds

Done in 1954 to prevent speard of encephalitis, a disease fatal to rice & wheat crops

People asked to go in rotating shifts to stand outside and create loud noise to scare away

birds, preventing them from landing. Caused birds to die from heart failure mid-flight. Was effective: in 3 days there were almost no

birds in Beijing HOWVR! Disrupted natural ecological balance - caused

Change in social strucutres

 

Increased organization among farmers, follows China’s commune system

Commercialization has caused traditional culture to erode.

Loss of importance of growing crops to households, seen as a means to income rather than a

tradition or a way to sustain ones living. Loss of religious festivals related to agricultural growing cycles.

Increased control over physical environment = less respect for physical environment

Expansion of the area under agriculture

From 1980 to 2002, amount of land used to grow crops increased on a global scale of 33.5%

Largest increase in amount of cultivated land was in Asia, with an increase of 73.3%

Africa had a more modest increase in the amount of cultivated land, at 30.3%

Other regions had even smaller increase in the amount of cultivated land.

 

o

Europe: 16.7% increase

o

Latin America: 13.7% increase

o

North America: 11.8% increase

Large increase in food prdctn in Asia can be explained by the rapidly growing populations in emerging economies, namely China and India, as they entered the 21st century.

Both China and India have high populations, meaning these countries must have higher food production as well.

N. America and Europe had lower increases in amt of cultivated land because of:

 

o

Shift towards tertiary and quaternary sectors due to higher wages and less physical labour

 

o

Ability to import cheaper food from developing countries

o

OVERALL: Decreasing importance of agriculture

An obvious way to increase food production would seem to be to put new land under the plough. There are several issues with doing this for a number of locations. Because agriculture has been taking place for centuries it is not surprising perhaps that the ‘best’ land has already been identified, and many other areas are urbanised and cannot be used.

Similarly large areas have been taken out of production as a result of land ‘improvement’ or

reclamation such as grazing marshes in some coastal areas. Changing land use is often a secondary impact of major engineering schemes which reduce the potential flood risk of an area.

In Japan there is very little available flat land due to the nature of the terrain. This puts added pressure on the few available areas of flat land. This means that farmers have to be very precise, and have developed a range of machinery which is on a smaller scale than most commercial farms in the developed world. Land reclamation has also taken place, although this is usually so expensive that the land it creates is used for residential use, or for developments such as Kansai airport near Osaka.

On a much smaller scale, communities have looked to make use of available plot of land to grow food. One small-scale initiative is ‘Incredible Edible Todmorden’. Todmorden is a small town in West Yorkshire, England. The local community have identified small areas of land in and around the town, and secured permission for them to planted up with food crops. Bollywood Veggies in Singapore is another example here.

Examine the environmental ,

One issue which may lead to food issues is the land that is required to feed a single person, depending on their diet and lifestyle. Changing diets and lifestyles are one consequence of the greater economic prosperity that some countries have been enjoying for the first time. Changes towards including more meat and dairy mean that the land is not used as efficiently.

demographic, political,

Putting food on the table has always been a struggle for people in many of the world’s countries.

social and

Sometimes parents go without food, so that their children have enough. In some locations, young

economic factors that

children miss out on education to find employment in the informal sector to enable food to be purchased. As food prices continue to rise globally, more people than ever go to bed hungry, and

have caused

even in the more ‘developed’ nations of the world, a higher proportion than ever are struggling to

areas of food deficiency and

feed their family appropriately.

food insecurity.

There are a number of factors that have been suggested for the inequalities in food supply which have meant a greater number of families are relying on food banks.

 

There are two important terms to bear in mind here: food availability deficit (FAD) and food entitlement deficit (FED)

Food availability deficit suggests that food shortages were caused by local difficulties in supply, perhaps the result of drought or floods (two extremes of water availability).

Amartya Sen applied economics to the problem of food supply, and suggested that there were actually famines in areas where food production had been increasing. The problem was with the political and economic framework in the area. Rising costs of food relative to average incomes, Sen

said, were a major factor in the availability of food. It is this situation that, remarkably, is facing

many families in what are recognised as being ‘developed nations’. A lack of wages/income means the term food entitlement deficit (FED) has been introduced as well.

 

Definition of food insecurity: no access to safe, sufficient and nutritious food in order to live

o

an active, healthy lifestyle and to meet dietary needs Areas of food insecurity: Sub Saharan Africa, central Asia and southern Asia

Statistics

Factors that contribute to food insecurity: social, political, economic, environmental,

Social

demographic

Food wastage: retailers and consumers dispose of perfectly edible food 1/3 of global food production for human consumption is wasted per year: 1 billion tonnes of food High waste in developed regions of N. Amer and Europe: 100kg per consumer. Compared to only 6- 11kg in Asia and sub-Saharan Africa Often is due to fresh food being thrown away because it does not appear fresh, when it is actually still edible 1 for 1 promotions Food could be sent to developing countries Investment in women for food security in poorer areas. In poorer areas, men often emigrate to urban areas to seek employment. Women left behind in rural areas. If women were given access to same access to resources as men:

Agricultural yields from women increase from 20% to 30% National food production: 2% to 4.5% Malnourished reduced by 12%

Providing education to females, reducing gender inequalities in terms of inheritance laws for land and access to credit

Political

High standards of imported food (bad) Trade barriers (bad) Tariffs on imported food from developing countries affect the amount of food bought Agricultural subsidies e.g. Common Agricultural Policy in the EU EU government guaranteed local farmers that they would buy a fixed amount of their product:

caused large food surplus. Food surplus sold cheaply in developing economies Although provides cheap food in these developing countries Forcing farmers to grow cash crops instead of their own food

Economic

Rising global food prices Farmers cannot afford food

Affects farmer’s revenues from food exports

Caused by increased demand in countries e.g. China Higher transportation costs due to rising oil & fuel prices Biofuels decreases supply of produce exported as food Increased demand for food increases scarcity Increased demand for food Global economic recession

 

Lower incomes: affects economic access to food

Environmental

 

Droughts Changes in rainfall regularities Floods Soil degradation Pest outbreak Use of appropriate farming techniques to overcome biophysical environment Salinization/Saltwater intrusion Climate change:

Desertification in Australia Increases in global temperature affect More extreme natural disasters loss of more produce and crops

Demographic Increasing global population: 9 billion by 2050 Places great strain on food production - Some may go hungry Increasing urbanization

Essay Plan

Discuss the statement: “Poverty is the main cause of food insecurity” [10 marks] Introduction Define food insecurity the state of people being unable to access a sufficient, safe supply of nutritious food to meet food preferences and dietary needs at all times.

 

o

870 million people in the world do not have enough food according to UN World Food Program

98% of world’s hungry population lives in the developing world.

 

o

Asia & Pacific region holds approx. 570 million hungry people.

Poverty is often seen as the leading cause of food insecurity because of the lower GDP per capita in these regions and the large amount of people living below the poverty line of $1.25 PPP

However there are several other factors that contribute towards food insecurity, such as internal conflict/civil war, poor environmental conditions or natural disaster.

I will be discussing the importance of each of these factors with reference to examples

Poverty is the main cause of food insecurity: Haiti, the Caribbean

Haiti: Located directly east of the Dominican Republic and south east of Cuba

Population: 10.12 million

Poverty statistics:

 

GDP per capita: USD $660, second poorest country in the Caribbean

54% of all Haitians live on below US$1 per day

Malnutrition statistics:

 

World Food Program reports that the food supply in Haiti only covers 55% of the population

24% of children under 5 suffer from chronic malnutrition

Hunger responsible for almost 60% of all deaths of those under 18

Why is Haiti poor?

 
 

Main reason: most of Haiti’s population impoverished due to great political mismanagement under two of its presidents, Francois and Jean-Claude Duvalier.

Link between poverty and food insecurity Low income = many households are unable to afford food

Conflict as main cause of food insecurity: Demographic Republic of the Congo (DRC), Africa

Low levels of education = households that use subsistence farming do not have knowledge

on how to fully utilize land Lack of access to inputs such as land, credit or tools and machinery = subsistence farmers

find it difficult to grow food Inputs may be available in certain areas, but cannot be afforded or accessed due to poor infrastructure

DRC: Located in central-southern region of Africa, north east of Angola and south west of Sudan

Food insecurity United Nations Food & Agriculture Organization estimates 30% of DRC is food insecure

Over 4 million people facing severe food and livelihood crisis

6 out of 11 of DRC’s provinces have acute malnutrition rates above 10%

Conflict

Ravaged by conflict in the past: First and Second Congo Wars

Conflict erupted in Kivu region in eastern DRC recently in 2012

Link between conflict and food insecurity:

Displacement of people affects access to constant, reliable sources of food.

o

1.7 million people displaced in 2011

o

2.4 million in mid-2012

Conflict has disrupted harvesting patterns of farmers

People afraid to visit markets due to possibility of attack prevents people from accessing

food Destruction of crop storage facilities prevents possibility of storing food

Poor transport infrastructure limits access to markets and other sources of food.

Natural disaster as main cause of food insecurity: Madagascar, Africa

Madagascar: Located off the eastern coast Africa, east of Mozambique

Population: 21 million

Natural disasters Madagascar is a very natural disaster prone region, in the past 35 years it has experienced

46 natural disasters, including floods, drought and cyclones Avg of 3 to 4 cyclones per year

Recently affected by Cyclone Haruna: for every 25 ha of crops an estimated 10 ha were

destroyed by the subsequent flooding 35% of households are affected by chronic food insecurity

Link between natural disaster and food insecurity Possibly due to the effects of climate change, such as the rising sea level causing flooding

o

Contributes towards direct destruction of crops currently being cultivated

o

Loss of stored produce surpluses

Obstruction or destruction of infrastructure prevents access to food

Locust swarms also constantly plague Madagascar. Estimated that locust swarms will affect 2/3rds of the country by September 2013 if unchecked

   

o

Causes destruction of crops and decreases the amount of yield available.

Conclusion

In conclusion, it can be identified that there are 3 main causes for food insecurity: poverty,

conflict and natural disasters.

Most major factor contributing: poverty. Thus I agree with the statement in the question.

o

Most of example countries are highly impoverished

However, unable to determine which is the main cause in situations e.g. Haiti, which is both

impoverished and experienced a natural disaster. Important to determine the main cause in order to provide appropriate aid.

o

However it is often a mix of different causes, may hinder provision of aid.

Case study

What is the difference between a 'food emergency' and a 'famine'?

What is the difference between a 'food emergency' and a 'famine'?

Examine the variety of causes responsible for a recent famine

Most aid agencies including the UN use the five-stage Integrated Phase Classification system of food emergencies.

Phase 4, a 'Humanitarian Emergency', is when up to two people per 10,000 are dying each day, when acute malnutrition rates are between 15 per cent and 30 per cent, almost all livestock have been lost and there is less than 7.5 litres of water available each day per person.

Phase 5, 'Famine/Humanitarian Catastrophe', means more than two people per 10,000 die each day, acute malnutrition rates are above 30 per cent, all livestock is dead, and there is less than 2,100 kcal of food and 4 litres of water available per person per day.

Other factors in a famine include large-scale and concentrated movement of people from their homes looking for help, and widespread armed conflict.

 

To what extent were human factors responsible for a recent famine?

Introduction

 

Famine is not simply a wide outbreak of hunger, it is classified as a nation or region wide disaster and can even result in affected countries declaring states of emergency. Definition of famine:

20% of the popn receive less than 2100 kcal per day

Malnutrition prevalence among children exceeds 30%

2 deaths per 10,000 people occur each day

Debate of whether famines are human caused or natural caused.

E.g. some may argue that widespread poverty leads to famine, whereas others claim it would be caused by lack of rainfall or a large natural disaster. I will be using the case study of the 2011 Horn of Africa (HOA) famine to explore the extent which human factors were responsible for a famine.

Body

HOA: Located in Northeastern Africa where the continent juts into the Arabian Sea

Comprised of countries e.g. Eritrea, Ethiopia, Somalia and Kenya

Covers 2 million km 2 With 40% of the region’s population living in food shortage prone areas, the 2011 famine has further

exacerbated the food insecurity in the region. Human causes: broken into political, social, economic and demographic factors Political: Governments e.g. Ethiopia’s have begun leasing farmland to overseas investors in China, India and Saudi Arabia. Deprives locals of arable land to grow crops. Internal conflict in countries, e.g. Somalia and the Al-Shabab militant group. They may cause direct destruction of food stores and also force almsgiving on farmers, taking some of their harvest or livestock. Also prevents access to food aid, 2.8 million of the 3.7 million that need food can’t be accessed. Social: displacement of households due to conflict 1.4 million internally displaced people in Somalia These displaced individuals are forced to migrate to urban areas or refugee camps, do not have access to food during journey.

Economic: rising food prices due to poor harvests and rising fuel prices. In Ethiopia, maize prices have tripled in some areas. Prevents locals from affording food.

Loss or destruction of farmers’ assets results in lower incomes, e.g. loss of cattle due to conflicts between ethnic groups in Kenya. Unable to purchase enough food for family. Demographic: high levels of population growth in these developing countries Large population live in rural areas of these countries, limiting their access to food.

 

Environmental causes:

Irregular rainfall patterns: normally there are 2 seasons of rainfall, one during Mar to May and the other from September to December. Rainfall failed in the fall from September to December. El Nino

causes spring rains to be very heavy, exceeding 800mm, and caused damage to crop harvetsts. Soil degradation from poor, inefficient farming techniques used, e.g. slash n burn, land in Somalia is experiencing a decline in quality Deforestation:loss of 19% of tree cover between 1990 and 2010. This causes increase in the amount of land exposed to directly sunlight to increase, increasing the ariditu. 60% of the HOA considered

food insecure. Global climate change: rise in temperatures in Kenya and Ethiopia are 1 and 1.3 degrees Celsius respectively. Increases the aridity of the area and causes rainfall patterns to change.

 

Conclusion:

Conclude that human factors are more responsible. Lack of access to food appears to be the main problem Government efficiency to solve food insecurity. Amartya Sen, a Nobel Prize winner, observed that famines do not occur in functioning democracies However one must not deny that environmental factors are a cause as well, it affects the availability of food. In order to combat famine, a mix of techniques must be used to combat it.

   

Production and

Food is produced in numerous locations around the world. It is not always available to everyone

markets

who lives in that area, and this results in inequalities and, potentially, conflict.

Examine the impacts at a variety of scales of trade barriers,

on the production and

Some of the food that is produced is not intended for the domestic market. These cash crops are intended to be exported, which provides foreign exchange for the government, and guarantees jobs are maintained as long as the relationship with the overseas market is maintained, and the price is guaranteed. This is not certain.

agricultural subsidies, bilateral and multilateral agreements, and transnational corporations (TNCs)

availability of food

At times of increasing global pressure on food production and markets, countries are concerned to ensure food security, while keeping an eye on the price of this security. Transnational Corporations, mindful of their markets are involved at this point in negotiations to ensure that they are part of any future equation. When many countries are no-longer self-sufficient in food, these huge companies play an important role in our daily experience of food, and spend billions on marketing to ensure that they remain an important presence in our lives. Every day, food is moved in huge quantities around the world. Who produces it, where is it sold, and how does it get to us?

There are numerous strict EU standards for imported food products, including hygiene and health standards as well as regulations for size, form and colour of a certain product. While the regulations are supposed to protect European consumers, they can have devastating impacts on small farmers in export countries. These standards have prompted many stories in some newspapers who are concerned at the apparent silliness of some of the standards, which have been relaxed in recent years after concerns over food waste that they were partly to blame for.

These regulations may have serious consequences for some producers elsewhere. In Morocco for

instance, a report suggested that in one year’s crop, around 40% of the tomatoes that had been

cultivated to be exported to Europe failed to meet the European standards. Instead of being shipped abroad, the tomatoes were sold cheaply on Moroccan markets. Small local farmers have a hard time

competing with the cheap produce and struggle to survive. Such a practice is sometimes called ‘food dumping’ and can be an unintended consequence of food aid.

Trade Barriers

‘physical’ barriers, although they may be in some circumstances due to the nature of the relationship

Trade barriers include tariffs (additional charges), subsidies (support from government for domestic industries restricting other countries from trading freely) and quotas (limits on what can be imported exported).

One problem that faces farmers wanting to import their products into the EU is the restrictions, some

of products having to undergo inspections which delay its arrival on the market, which may mean it is competitive in price.

Sometimes barriers are put up for political reasons, at other times they may be to protect consumers.

Russian food import standards were raised after the country became a favoured ‘dumping ground’ for

meat and fish products produced by EU countries that had failed to meet EU standards for sale within

Trade barriers are often put in place around specific countries or areas. These barriers are not necessarily

with surrounding countries. Some physical barriers would include the restrictions facing some contested areas of the Middle East, or enclaves within countries.

or

of

which we explored during the starter activity. They have to meet certain standards, some of which are not based on the taste or quality of the food, but its physical dimensions. There have also been examples

not

 

the EU. Agriculture is an industry that has often required financial support, particularly given the globalised nature of the world, and the material flows of food around the world.

In the European Union, there has been a history of additional investment. In many parts of the world, agriculture is not a profitable activity due to the low prices that farmers are paid for their produce. Farmers have to look a year or two ahead and predict what the likely market conditions will be when deciding how to farm their land. They are also dependent on the vagaries of the weather.

Bilateral Agreements

A bilateral agreement is one made between two different ‘parties’, which could be countries, which

benefits both.

Some of these agreements relate to former colonies of European countries, which developed a relationship involving the production of foods, some of which might have a particular cultural significance. Recent bilateral negotiations took place between the EU and India.

India is one of the world’s largest potential markets for EU products, and there were discussions over furthering links between the two areas.

Multilateral Agreements

A multilateral agreement is one that involves many countries. Agriculture can also be protected by the tariffs that are introduced when countries group together to form a Trading Bloc.

Countries merge together for various reasons. This is usually for the benefit of the participating countries. The EU is obviously one example of a trading bloc, but there are many others.

There have also been multilateral agreements which have been agreed between these organisations and other NGOs (Non-governmental organisations).

These include the Lome and Cotonou Conventions which date back over 30 years and were intended to support producers in the less developed parts of the world. These included agreements on the import of tropical produce such as bananas, which clearly cannot be grown in the EU.

These agreements are particularly important when a country is dependent on a single crop or product for a large proportion of its total exports. There are also problems when production is greater than consumption: for

Some parts of the British Isles, for example receive additional support and payments. Hill Sheep farmers get additional payments due to the harsh nature of the land which they farm, which restricts the density of animals, and therefore the profit they can gain from farming the land. Their work maintains a landscape which is of high amenity value. Other payments are related to the environment, so that farmers may be paid for planting hedges, draining land or repairing stone walls.

Can also occur when a consumer such as a large supermarket makes a decision e.g. the Co-op decided to only sell Fairtrade bananas which meant those countries which had more producers signed up to the scheme benefited.

   

example more coffee is grown each year than is drunk, despite the rapid growth of coffee chains such as Starbucks and Costa.

 

Another organisation involved here is the World Trade Organisation (WTO) this has been in existence since 1995 when it replaced GATT (General Agreement on Tariffs and Trade.

TNCs: Transnational Corporations

Many of the world’s biggest companies have become that way by offering a basic necessity which we

 

cannot stop buying.

TNCs are driven by profits rather than the desire to provide us with the best possible food. Decisions are not made on the grounds of existing arrangements, and firms are not necessarily sympathetic to changes in local conditions.

McDonalds have a strategy which focuses on a one-brand image, but some of these other food companies own lots of brands, and their involvement is less obvious. This can mean that their overall operations are not always subjected to the same public focus.

Large companies have increased their involvement in more aspects of the production chain.

This has increased their profits. Felicity Lawrence in her book Not On the Label: What Really Goes into the Food on Your Plate says: “Fifty years ago, 50-60p of every pound spent on food and drink in the UK went to the farmers, now it is just 9p in every pound.”

 

Food Inc. Notes

Way we eat has changed recently in the past 50 years. Food now produced in factories and

Although chickens grow more quickly in terms of muscle (meaning more meat), their bones and

assembly lines Modern America: 47000 products

Information not revealed to public, fear that it will discourage them from eating products.

Industrial food system began with the development of the fast food restaurant

Began with the development of the drive-thru in America, 1930s

Fast food restaurant: brought assembly line techniques to kitchens, workers and staff specialize

into spec. McDonalds is one of the largest purchasers of beef, potatoes Top 4 beef packagers control 80% of the market for beef

In modern times, it takes 48 days to rear a chicken from birth to maturity, compared to 70 days

in the 1850s. Chickens are larger at maturity as well. Mechanization of chicken farms: chickens now highly regulated in size and amount of meat

Allows for increased production from a fixed plot of land

Chickens up to 300,000 are contained within chicken farms. Chickens are kept in the dark,

not exposed to sunlight. Highly contaminated surroundings: dust and faeces

internal organs cannot keep up with their growth, causing brittle bones. Chicken feed contains antibiotics: however bacteria and micro-organisms build up increased

resistance to the antibiotics. Farmers controlled by corporations by debt, most farmers borrow $500000 and earn $18000

per year. This is because of high start-up cost of setting up farms, corporations give farmers loans. Farmers progressed from growing 20 to 200 bushels of corn per year.

30% of USA is used to plant corn. Corn produced in surplus

Most products contain corn products: due to versatility of corn to be processed into various

substances Corn also used as feed for livestock for animals due to low cost of corn

 

Corn diet is not cow’s natural diet: has caused development of E-coli in the cow’s stomach.

 

Cows are standing in their own manure = hides become caked in manure.

Thus in slaughterhouses, manure is able to escape into processed meat. Causes transmission

of

E-coli Runoff from meat processing plants results in contamination of other agricultural products.

200 pounds of meat per person in America

FDA conducted 50000 food inspections in 1960, number fell to 9100 in 2002

Microbiological tests for salmonella, e-coli and other diseases conducted by the FDA. Allowed

FDA the power to close meat production plants producing large amounts of contaminated meat. Kevin’s Law: FDA able to shut own meat processing plants

Ammonia and ammonia hydroxide used to treat E-coli from meat instead of returning animals

e.g. cows to their natural diet of grass. Processed food products e.g. hamburgers, fast food are cheaper than fresh fruits and

vegetables. Due to the subsidized given to the ingredients of such processed food products, namely corn. Reflects dominant corn agriculture After 2000, 1 in 3 American will contract early onset diabetes.

Use of corn feed for cows: contributes towards more CO2 emissions. Need to harvest, collect,

transport and process corn, results in more emissions of CO2. Compared to grass feeding, involves fewer stpeps in the process. Most workers belong to low income minority groups from more impoverished areas in America

Workers have lost most of their privileges, union rights and have much lower wages. This is due

to meat processing industries growing larger in size. Food is highly subsidized in order to create low food prices. Due to high costs in collection,

transportation and processing Organic food industry has high annual growth of 20% per year.

Large MNCs in food processing industry are trying to gain foothold in organic food industry via

acquisition. Organic farmers willing to partner with large MNCs because of money from the

sale/compensation. Allows them to invest more in physical or natural capital that can be used to improve their yield/product. Monsanto: one of the largest food processing company

Developed Roundup: allowed plants to be more resistant to pesticides.

Seed saving was tranditional practice used to ensure future crops have ideal traits. Now seed

saving is made almost illegal practice by farmers under Monsanto. Ensures that Monsanto has the ideal seeds. Seed traders have been forced to close due to emergence of Monsanto.

Common Agricultural Policy (CAP)

“Africa needs more money, but if it's not linked to ending European agricultural subsidies, it's blatant hypocrisy. The way to build lasting economic growth, healthcare and education is for Europe to end the CAP. Stopping trade-distorting subsidies will allow African products to be exported and stop European goods being sold more cheaply in Africa.” – Lord Digby Jones (2005)

The Common Agricultural Policy (CAP) introduced in the 1960’s was a system devised to offer financial support for farmers in the European Union countries. It introduced a minimum price for part of what farmers produced the aim being to increase productivity so that food security was increased and the EU

became more self sufficient, and less reliant on food imports. The knock on effect of this was for the farmers to earn a decent living whilst being able to offer the customer a guaranteed supply at a moderate price. In order to offer stability to the internal market, the EU guaranteed to ‘buy’ produce at a predetermined price and impose charges on cheaper imports. Farmers started to produce more food

than before, and by the early 1980’s subsidised goods had become so overproduced they couldn’t sell

them all. The EU was unable to sell this surplus as it would impact on markets, which led to the storing of

 

food in warehouses. The phrase ‘wine lakes’ and ‘butter mountains’ raised this issue in the public

consciousness.

In 2007, information was revealed in the House of Commons that large amounts of products were still being over-produced.

At the time the EU was apparently storing 12,187,741 tonnes of cereals, and there were 1,112,651 tonnes of sugar - enough for 445 billion cups of tea; 117,831 tonnes of butter and milk, which would spread 78.5 billion sandwiches and fill 252 million pint bottles; and enough rice - 61,589 tonnes of it - 615 million curries.

The policy has undergone reform several terms, partly as a result of concern over the cost of implementing the policy compared with other aspects of EU membership. 2010 Budget for CAP: 44 billion Euros (around 30% of EU budget) costs Britain around £10 billion a year.

When was the CAP introduced:

1960, after WW2

Original objectives of the CAP:

Improving agricultural production yields Ensuring a fair living standard for farmers Provide stability in agricultural markets Ensuring food is available at reasonable prices

How much land area is affected by the CAP?

Two thirds of the EU’s land area

How much does each EU taxpayer contribute to the CAP per year? 80 Euros per year Why has the CAP been reformed a number of times?

Disagreements between member countries on the distribution of subsidies per country May have been reformed recently due to environmental damage from use of pesticides and fertilizer International disagreements on the food surpluses created by the CAP: may result in lowering of agricultural subsidies Changing global food prices means EU will have to change the minimum buying price

Purpose of June 2003 reform

Subsidies are not granted based on food production, instead they are based on the amount of area farmed. Subsidies granted on cross compliance: farmers must met environmental & welfare standards Diversion of funds away from agricultural subsidies to rural development projects

Difficulty to agree on reforms:

EU members with larger, efficient farms e.g. Britain, Sweden, the Netherlands do not require such large grants and are in favour of reducing subsidies However EU members with smaller, less efficient farms, namely France, are unwilling to accept reductions in subsidies and are not in favour of making subsidies less accessible. This is possibly due to worry of smaller farmers suffering or due to greed

Why are LEDCs critical of the CAP

for

The Common External Tariff on food products and the overly-rigorous food standard tests deny farmers in LEDCs access to the EU food market. This is because the tariff causes the imported food to be relatively expensive compared to local produce and that farmers may not meet all food standards, leaving produce that is not accepted by the EU

 

E.g. of a group of countries that are critical of the CAP

Addressing

 

Introduction

imbalances

Globally, there are 870 million people who do not have enough food to eat

Evaluate the

One of the causes would be food shortages, where the food supply in an area doesn’t meet the population’s nutritional and energy needs.

relative

Food shortages caused by factors e.g. internal conflict, poverty or global climate change.

importance of food aid, free

What is food aid?

trade and fair trade in alleviating

All food-supported interventions aimed at improving the food security of people living in poverty in the short- and long-term, whether funded via international, national, public, or private resources.

food shortages.

If food aid constitutes less than 2 percent of global agriculture trade, 78 percent of which goes directly to emergency situations, why is so much attention being paid to it?

 

Unjust international trade regulations and practices prevent the advancement of developing countries. Developed countries have refused to liberalize their agricultural sectors due to domestic pressure. This is a decision taken at the expense of the developing world where agricultural production is often more efficient than in wealthy nations. The European Union argues that food aid creates a production and price advantage, and thus a hidden subsidy, for (largely) American farmers. Therefore, farmers in developing countries are placed at a disadvantage. There is also a perception that food aid may distort markets in developing countries, thus undermining the potential for long- term development.

 

Advantages

Provision of food aid can be useful in alleviating emergency food shortages. E.g. in 2011, Britain aimed to provide food aid for 1.3 million people in 3 mths to relieve food shortage caused by drought in Ethiopia. In-kind commodity food aid is the free provision of food aid to a country, which ensures that it will benefit lower income households. E.g. Action Against Hunger launched program in Haiti, where food aid was provided to children through canteens, with each canteen serving 400 children and increasing avg meals from 1 to 2.34 per child.

Food aid can alleviate future food shortages, e.g. in the Democratic Republic of the Congo, agricultural production was increased as food aid was distributed along with seeds.

 

Disadvantages

Providing food aid to markets in LDCs depresses food prices and can cause food production to decrease. E.g. Malawi, 2002 to 2003, where 1 million metric tonnes food aid caused maize

Agricultural surpluses bought by the EU government are dumped on LEDCs at below-market-prices, often using the provision of food aid as an excuse. Dumping hurts the competitiveness of farmers in LEDCs because they are unable to sell their produce at lower prices than the dumped food, and thus they have reduced revenues.

The Cairns Group formed by countries e.g. Argentina, Brazil and the Phillippines in 1986 is critical of the CAP.

 

prices to fall from $250 to $100 per tonne and $15 mil in losses due to lower agricultural production.

Rising fuel costs and rising food prices reduce the amount of food aid able to be provided to the targeted country, reducing its effectiveness. Food aid often suffers delays in reaching the targeted countries, e.g. it can take up to 4-5 months for food aid to reach the intended country. The quantity and type of food provided may be insufficient.

What are the structural impediments to food security?

The structural impediments to food security include: inadequate or nonexistent national food security policies; lack of international action to address environmental degradation; unfair trade rules; unpayable debts; and insufficient investment and development aid. These conditions force developing nations into chronic food insecurity. Until these unjust policies are corrected, food aid will be required. The central issue under discussion in multilateral negotiations is that of agricultural subsidies and agreement on flexibilities for countries to promote food security in their communities.

Shouldn’t all food aid be locally purchased, therefore stimulating the local economy and pointing

the country toward long-term food security?

The nominal amounts of food aid procured locally would create negligible long-term benefit for an economy. Only sustained production and inclusion in emerging regional/global markets will lift a country out of poverty and into food security. The potential for negative market impact is similar for in-kind and local purchase food aid. Commodity prices will be affected both through in-kind distribution and cash purchase. Therefore, a detailed market analysis is required to accompany any injection of “aid” into a country’s economy. This analysis has been required for all U.S. food aid programs over the last 20 years. Secondly, the risk of corruption or mismanagement carried with all aid provision is significantly increased with regard to direct cash compared to food commodities. Using earmarked cash to buy food from rural, smallholder farmers is not as efficient in practice as it is in theory. There is a significant chance that the cash will be appropriated for alternative uses or never arrive at the targeted populations. It is easier to misuse $1,000 than it is to misuse 1,000 metric tons of food.

Can local cash purchase negatively affect developing country markets?

Yes. Purchasing food locally can have significant negative impact on local markets. Recent examples in Niger and Uganda have demonstrated that purchasing quantities of food has in fact driven up the price of local food, and made it impossible for many who did not receive aid to buy it themselves. In- kind food aid must be made available to mitigate such market impacts.

Give an example of how in-kind food aid was a critical success factor in saving people’s lives. --East/Northern Africa, 2000 present (Sudan) --Asia, 2000 present (Mongolia, Cambodia) --Caribbean, 1990s present (Haiti, Dominican Republic)

The context of these situations required in-kind food aid as the short-term solution to meeting

people’s needs on account of several factors. Cash to purchase locally posed an equally, if not a

more, cumbersome process than cash for food. The situation in these populations had deteriorated to such a grave extent that food aid resources intended for other ports were re-directed and sent to these destinations. The C-SAFE consortium was an excellent example of a dedicated pipeline of food

 

for a consortium of NGOs across four countries (Zambia, Zimbabwe, Malawi, and Lesotho) over multiple years.

FREE Trade

What is free trade?

The act of opening up economies is known as "free trade" or "trade liberalisation." It usually benefits the larger, wealthier countries whose big companies are looking to expand and sell their goods abroad. In the one sector where developing countries have the most to gain - agricultural goods - wealthier countries maintain the highest level of "protection" of their own markets.

Globalisation has made the world a much smaller place. Global trade refers to the act of buying and selling goods and services between countries. Today these goods and services can travel further and faster so that - for instance - products from all over the world can be found at your corner shop. This can be anything from fruits and vegetables, to cars, banking services, clothing, and bottled water.

The scale and pace of this kind of trade has only increased over time, and has become a very powerful tool. International trade is considered a prime driver of how well a country develops, and affects very much how well the economies of different countries are doing.

Free Trade - who is paying the price

The act of opening up economies is known as "free trade" or "trade liberalisation." Trade liberalisation means opening up markets by bringing down trade barriers such as tariffs. Doing this allows goods and services from everywhere to compete with domestic products and services.

But in practice the set-up of global trade rules and the way these are administered by the World Trade Organisation, works best for those countries who are already rich, and increases the gap between them and poorer countries who are already struggling to compete.

When trade is a weapon - tariffs and subsidies

Part of the problem is that trade is not always equal. It is not just a tool - it can also be a weapon. When countries put restrictions, such as tariffs, on goods from other countries, imported goods become more expensive and less competitive than goods from their own country.

Another thing that can be done is subsidising domestic businesses. This means that governments give money or other forms of support to local or domestic businesses, to make sure that they are cheaper over imported products and services. This can allow unsuccessful and inefficient businesses to do well, since they receive all kinds of government support. And while these businesses continue to grow, smaller or local producers, especially in many poorer countries - those that need support the most - are being destroyed.

Any measure like this is called "protectionist," since it has the effect of closing off a country's markets to goods from other countries. Many wealthy countries in Europe, as well as the US and Japan use these tactics to support their own domestic economies, making it impossible for smaller, or less developed countries to gain a foothold in the global marketplace.

As they go about protecting and closing off their own markets, many of these very same countries are creating double standards, by forcing other countries to open up their markets.

Advantages

 

Removal of agricultural subsidies given to MDC farmers, e.g. US corn subsidies of $5bn USD per year, improves competitiveness of LDC food products. Revenue can be used to reinvest in increasing agricultural output. Removal of trade barriers allows certain countries to export more food, and countries facing food shortages to import this food. E.g. with rice, if voluntary export restrictions were removed the percentage traded would increase greatly from the current level of 5-7%

Free trade allows farmers to earn increased revenues from exports, which can be used to afford food in the short and long term. E.g. in Africa, if its share of global trade increased by 1%, it would generate $70bn revenue.

 

Disadvantages

Only larger farmers may benefit from trade liberalization, as they can compete with farmers in MDCs Limited access to markets in countries e.g. the Democratic Republic of the Congo with the recent conflict in the Kivu region in 2012, results in households being unable to access the food needed.

Countries may begin to produce cash crops for sale instead of food crops, which would not be effective in increasing the supply of food.

Fair Trade

Definition - A not-for-profit organization that focuses on benefiting farming communities in less developed countries by guaranteeing farmers a price for their products and ensuring more profit is returned to the farmer

 

Advantages

FairTrade farmers are given a guaranteed price for their produce, regardless of market prices. Therefore d guaranteeing them income during periods where food prices are low. This would in turn allow them to purchase more food. Consumers also pay a social premium on the FairTrade products, which is reinvested in rural farming communities. Improvements can be made to alleviate future food shortages. E.g. In Mali, West Africa, FairTrade cotton farmers used profit to construct grain warehouses in their villages. Farmers operate in co-operatives, e.g. Kuapa Kokoo in Ghana, West Africa, covers 65,000 farmers in 1600 villages. Co-operatives can negotiate for higher prices, increasing farmers’ revenues and allowing for more reinvestment in the community.

 

Disdavantages

FairTrade is ineffective at alleviating emergency food shortages because it does not focus on short term food provision.

FairTrade does not focus on reducing costs of production received by farmers. Short term increase in

 

the prices of inputs can affect farmers’ food production.

Co-operatives may not be run efficiently by farmers alone, as they may not possess the education or skills. Results in villages not receiving significant benefits

 

Conclusion

In conclusion, it is complex to evaluate the importance of each measure on the whole.

Food aid proves to be the most versatile, as it can alleviate short term shortages and improve long term food insecurity.

 

Fair Trade is a relatively new movement that can prove effective in guaranteeing farmers

Case Study

higher revenues and improved protection against food insecurity. Free trade may not be beneficial to very poor countries because of farmers’ lower access to

capital and inputs. Food shortages difficult to combat because they have so many causes and they vary

enormously

Geography of Food and Health: Black Gold Intro to Ethiopia

Ethiopia was the country where coffee was first discovered

World’s largest coffee producer

o

15 million Ethiopians depend on coffee farming for their livelihoods

o

67% of export rev

Main problem: low coffee prices

International Coffee Agreement used to regulate coffee prices until collapse in 1989

Coffee prices at a 30 year low, due to countries encouraging more farmers to grow coffee, increasing the supply of coffee and lowering the price.

o

Falling prices of coffee has affected coffee industry: due to low prices people

become unwilling to work, resulting in unemployment.

  • Many farmers are discouraged from working due to the unreasonably low price of coffee Comparing prices of coffee in Ethiopia to Western World: 1 birr ($1.2) per kg in Ethiopia, 25 birr per kg ($2.90) in Western World

International price determined in London and NY: e.g. NY Coffee Contract Futures market in NY allows for coffee that has not been grown to be bought at

o

o

future prices: guarantees certainty of coffee prices If price in NY falls by 5 cents, price in Ethiopia falls by 5 cents

HOWEVER! Farmers in Ethiopia have lack of up to date price information on coffee price Selling price must be higher than buying price for farmers to profit, most often not

o

the case

Middlemen and the coffee supply chain

Government coffee auctions e.g. in Addis Abba, Ethopia, are where coffee suppliers and

middlemen meet to agree on prices e.g. Volcafe (middleman) buys for Starbucks and Nestle

o

o

Sidama region in Southern Ethiopia: region responsible for growing coffee for Starbucks

Middlemen inspect quality of coffee beans and agree on a price Chain of selling coffee also involves coffee exporters, roasters, retailers

o

o

  • Coffee export processing workers mostly female earn 4 birr and 50 cents per day from working 8 hours, translates to less than 50 cents per day. Middlemen often buy coffee at lower prices than farmers would want and may

take some of the farmer’s profits

Coffee co-ops and unions

Since middlemen in the process of selling coffee take cuts of the profit, many cooperative

and coffee unions have developed to ensure farmers are paid more fairly.

 

o

o

o

E.g. Oromia Coffee Farmer Union represents 74,000 coffee producers

E.g. Kilseo Mokonisa Co-op buys coffee from 101 farmers in Southern Ethiopia

60% of coffee chain removed via working with cooperatives

Individual coffee exporters that work with coffee co-ops attempt to buy coffee at prices outside NY lvl.

Co-ops and coffee trade unions can help some Ethiopian coffee farmers break out of the poverty cycle they are trapped in.

o

Poverty cycle: coffee prices cause famers to fall into poverty, whole community falls into poverty, cannot construct more schools train teachers, poor education and continue to rely on coffee

Food insecurity and coffee farming

Farmers grow coffee instead of food crops because they want to profit, results in lower

food supply for local villages Children are most affected, most suffer from malnutrition and various types of vitamin or protein-energy deficiencies Therapeutic feeding centers in Sidama now admit adults in addition to young children, who

o

are the most vulnerable. Such feeding centers often have strict criteria for the children that are able to be admitted to avoid overcrowding. Only allows for severely malnourished children to

o

be admitted.

Chat and coffee Chat a narcotic plant is often grown instead of coffee by coffee farmrers in Ethiopia:

sells for higher price than coffee and is consumed in East Africa Chat addicts in East Africa provide a large market for the coffee farmers who grow

o

chat, provides then with a livelihood.

Solutions

Key to stimulating purchase of coffee beans from LDCs: increased advertising in coffee

conventions Increasing consumer awareness of the impact of low food prices on coffee

o

Fair Trade: Social premium from fair trade Ethiopian coffee results in farmers receiving increased profit.

o

In agricultural communities, profit can be invested into improving the healthcare, education and infrastructure in these communities.

Increase free trade: If Africa’s share of WT increased by 1%, $70 bn revenue generated. x5

the amount they receive in aid

Interesting facts Coffee is world’s 2 nd most actively traded commodity

2 billion cups of coffee drank per day on a global scale

Since 1990 retail coffee sales increased from $30 bn to $80bn

4 multinationals dominate coffee market:

o

o

o

o

Kraft

Proctor and Gamble

Sara Lee

Nestle

Sustainable

Sustainability is a relatively straightforward concept to define but it is harder to achieve. Think of it

agriculture

as a 3 legged stool. The stool needs all 3 legs to remain standing.

Examine the concept of sustainable agriculture in terms of energy efficiency ratios and sustainable yields

Examine the concept of sustainable agriculture in terms of energy efficiency ratios and sustainable yields

Is Sustainable farming possible?

Sustainability rests on the principle that we must meet the needs of the present without compromising the ability of future generations to meet their own needs. Therefore, stewardship of both natural and human resources is of prime importance. Stewardship of human resources includes consideration of social responsibilities such as working and living conditions of labourers, the needs of rural communities, and consumer health and safety both in the present and the future. Stewardship of land and natural resources involves maintaining or enhancing this vital resource base for the long term.

Energy efficiency ratios EER is a measure of the amount of energy input into a system compared with the output. Measured by energy outputs divided by energy inputs. An energy efficient system has an EER equal to or greater than 1. Energy can be direct (e.g. labour, machinery) or indirect (e.g. fertilisers, seeds, irrigation). Although outputs of some modern systems can be very high, this is usually because of high inputs resulting in a low energy efficiency ratio. Traditional techniques have a low output, but very low input resulting in a high EER.

Farmers can be seen as stewards of the land. The decisions they make can cause damage to the topsoil or water balance and need to be taken carefully. This can be compromised when there is a perceived need to produce as much food as possible as quickly as possible in response to food insecurity or rapidly rising food prices.

Sustainable farming involves the production of food in such a way as to maintain the capacity for growing food from the same land in the future. The sustainable yield is the amount of food (Yield) that can be taken from the land without reducing the ability of the land to produce the same amount of goods in the future, without any additional inputs. If the production of palm oil, for example, reduces the nutrient availability in the soil or moisture in the soil it is not sustainable.

There are several key ideas which will be found on most farms which are attempting to work sustainably. Generally, these farms try to copy natural processes, which often means that they are organic, or are more likely to be organic. Areas that are commonly focused on include:

Conservation and soil health

Nutrient recycling e.g. animal waste being used for fertilizer

Biodiversity this is helped through a minimal use of chemicals on the land

Animal welfare more care taken with animals, and different diets perhaps

Fair wages and treatment for workforce farm is part of the rural community

 

Instead of pushing for the maximum yield from the land, these farm look to produce the sustainable yield (the food that can be taken from the land without reducing the ability of the land to produce the same in future without external support).

Maintaining soil health

One of the simplest ways of maintaining soil health is to rotate the crops. This doesn’t mean turning your carrots by 90 degrees each night, it means growing alternative crops on land from year to year.

This also has the advantage of reducing the damage caused by pests which may stay in the soil from year to year. The secret to crop rotation is the use of leguminous plants, such as beans or pulses. These help replace nitrogenous compounds in the soil, and this is vital for plant health. Many artificial fertilizers are nitrogen or nitrate based.

The search for increasing profits can lead to some farmers taking less care with the soil, even though it can take thousands of years for a thin layer of topsoil to form. The American Dust Bowl of the 1930s chronicled in John Steinbeck’s The Grapes of Wrathwas the result of unsustainable farming practices.

Crop rotation was developed by Charles Townshend, who

estate in Norfolk. His use of turnips in his four field rotation

him gaining the nickname ‘Turnip Townshend’.

Nutrient cycling

This might involve animal manure, or ploughing the brash or waste from harvest back into the soil. There may also be some land which has to be left for a period of time to allow the soil moisture to be replenished. In some marginal land, even turning over the soil would lose the available moisture so careful management and cropping techniques need to be used.

Using chemicals would not be seen as sustainable practice.

Free range grazing encourages this nutrient cycling to take place naturally

This is of increasing importance to consumers. Sales of food that has various animal welfare related badging have increased. Local sourcing, organic and free-range foods are popular, although there is often a price premium. With the increasing economic uncertainty across Europe, will there be a reduction in demand for food produced in this way, and more pressure to return to less sustainable practices ?

 

Some farmers also see the benefit of engaging with project such as Fairtrade and Rainforest Alliance certifications.

 

Organic farming

In the rich world, the damaging environmental effects of intensive commercial farming have led to the promotion of more sustainable farming. These include:

Applying manure or compost rather than inorganic fertilisers

Using crop rotation to maintain soil nutrient status and allow recovery between

harvests Using biological controls rather than pesticides

Reducing transportation and energy used in manufacture

Allowing livestock to roam freely in open air.

Examine the concept of food miles as an indicator of environmental impact.

Food miles are: A measure of the distance that food travels from its source to the consumer. This can be given either in units of actual distance, or of energy consumed during transport. Food miles have been steadily increasing over time. The concept of food miles serves as a useful reminder of the need to control the amount of energy used to move food from one place to another. Food distribution accounts for 40% of road freight. However the concept is simplistic and difficult to apply in a practical sense. For example, distance travelled is not necessarily determinant of the amount of energy used to move food from one location to another, e.g. air travel v sea travel. Recent research suggests that many parts of the world, eating locally grown food may lead to an increase rather than a decrease in energy use and the carbon footprint. This is because certain areas are better suited physically for producing particular foods than others, and this eating locally produced food may increase energy use (e.g. in the UK tomatoes grown locally may need artificial heating, and large amounts whereas tomatoes grown in Spain do not require this (therefore the imported Spanish tomatoes end up being may energy efficient even when the transport is taken into consideration. Different food are more energy efficient that others, e.g. producing rice is far more energy efficient than producing all forms of meat. Farm animals account for 20% of greenhouse gas emissions.

Food miles fails to take into account the various other factors in the production of the food and the energy required to get it to your plate, e.g. amount of fertiliser used, packaging, processing, storage. Oxfam have suggested that a better way of calculating this is by using a Lifecycle Analysis where all factors in the production of the food are taken into consideration (and the energy used). Externalities are also not taken into account with food miles, e.g. has the food been farmed on deforested land or are chemicals used in the growing damaging the local area and people.

Also, if consumers buy more locally produced food then it may have a damaging effect on some LEDC countries who rely on selling food for income. An estimated 1 to 1.5 million livelihoods in sub- Saharan Africa depend directly and indirectly on UK-based supply chains. Oxfam believe that people should think more about the term Fair Miles which looks more at the overall amount of energy needed to get the food to the plate and the impact that it might have on other parts of the world.

The spread of

Diseases don’t stay put. They tend to move and spread. This is how they perpetuate themselves: by

disease

replication.

Explain how the geographic concepts of diffusion by

This section of the unit explores the way that diseases move. Diseases are more mobile than previously, because we are more mobile than before as a species, and we carry diseases with us. The network of communications by road, rail and air means that potential carriers of diseases (people who are still capable of infecting others with a particular disease) can travel across the globe in a matter of hours. Less than two hundred years ago, diseases travelled slowly and it was possible to quarantine an area more easily.

relocation and by expansion apply to the spread of

Whereas early plagues were carried by rats and their fleas squatting in the holds of sailing ships, modern plagues are more likely to be brought in by a business traveller who’s just been on a mini- break.

diseases. Examine the

application of the concept of barriers in attempts to limit the spread of diseases. Describe the

factors that

Diffusion

Methods

have enabled reduction in incidence of a

Diseases are spread by contact between people, and the crowded and unsanitary conditions in many parts of the world encourage diseases to spread further.

disease.

It must also be remembered that the 1918 influenza pandemic (sometimes referred to as Spanish Flu) killed an estimated 40 million people worldwide within just a few months, with some estimates of casualties closer to 90 million. To put this into some sort of context, the total number of battlefield fatalities in World War One in the previous four years was around nine million, plus around six million deaths amongst civilians.

 

Diffusion is the method by which diseases spread.

There are various methods by which diseases spread, and these contribute to the overall risk factors for different populations.

There is a reducing effect with distance from the original outbreak, and also a time

delay. Diseases tend to spread like a ‘wave’ from the central point.

Factors that slow down the spread of disease include physical barriers (these might include mountains, water barriers such as seas or oceans, forests and difficult terrain)

plus political boundaries. Travel restrictions and screening of travellers can form part of

these more ‘human’ barriers. Public health advice can also help in some cases.

Disease will also change from an original infusion into a population, through inflection and saturation, before it declines and leaves a population.

 

There are 4 main methods of diffusion:

EXPANSION - the disease has a source and diffuses outwards into new areas from this original point

RELOCATION - the spreading disease moves into new areas, leaving behind its source (often the result of global travel by an infected person)

CONTAGIOUS - the spread of an infectious disease through direct contact with the affected individuals

HIERARCHICAL - the spread of a disease from place to place in an orderly way e.g. from cities, to neighbouring villages, or vice versa

There may also be NETWORK diffusion, which follows land-based transport networks e.g. road and rail.

There are some cases of malaria in the UK every year for example, and most of those are close to airports. Mosquitoes survive in the plane just long enough to bite someone when they leave. Climate change may allow them to survive longer of course.

1)

What is the difference between relocation diffusion and expansion diffusion?

Diffusion by expansion refers to the process where a disease originates and develops in a source area and spreads from this area, where the prevalence and incidence of this disease is highest in the original source area. An example of diffusion by expansion would be the spread of cholera from its source in a dirty or contaminated well to other neighbouring settlements. Expansion diffusion usually occurs in areas where populations are in fixed settlements and have sedentary living patterns. Relocation diffusion differs from expansion diffusion in that the disease evacuates the source area when carriers of the disease migrate elsewhere. An example of a disease that spreads via relocation diffusion would be the human immunodeficiency virus (HIV), where if the carriers of the virus change location, the virus travels with them and HIV is no longer present in the source area.

2)

What is the difference between the contagious diffusion and hierarchical diffusion (which are both subcategories of expansion diffusion)?

In contagious diffusion, the disease spreads from its source area in all directions, where individuals are affected by the disease by coming into contact with other carriers of the disease. An example of a disease that spreads by contagious diffusion would be tuberculosis, where the source area could be from a farm with contaminated milk and the disease is spread through airborne means. On the other hand, hierarchical diffusion occurs where there are channels of diffusion where the people or groups in these channels have high incidence and prevalence of the disease (more susceptible). An example of this would be how sexually transmitted diseases such as chlamydia or gonorrhea are more likely to be spread among sex workers or the more sexually active, promiscuous population.

 

3)

What is time-distance decay?

Time-distance decay would be a natural barrier against the diffusion of disease. The concept of time-distance decay states that the further the

distance and the longer the time period of the disease’s diffusion, the

lower the incidence and prevalence of the disease. This is caused by the

relationship between the distance travelled by the disease and the time taken for diffusion. As the disease travels further, its time of diffusion increases. In this time span, there is an increased likelihood that individuals develop natural immunity or that artificial barriers can be put in place to prevent the disease. Therefore, the prevalence and incidence of the disease decreases.

4)

Give examples of effective barriers to diffusion of diseases

Elimination of the vector:

Using indoor residual spraying (IRS) to combat malaria by reducing mosquito

populations. Often termed ‘fogging’, where pesticides, e.g. DDT, are

sprayed in large areas. Effectiveness was shown in the Malaria Extermination Program launched by the WHO from 1955 to 1969, where the population at-risk of contracting malaria was reduced by 700 million, with malaria eradicated in regions e.g. Europe, the former USSR countries and in certain Asian & Caribbean countries.

Provision of medication:

Treatments and antibiotics provided for diseases such as TB, e.g. with drugs such as isoniazid (INH) or rifampin (RIF). By curing the disease in carriers, prevents further spread of disease and lowers incidence. Success: 85% of all TB cases successfully treated in 2010.

Vaccination:

Regarded as one of the most effective methods of completely eradicating a disease, as it allows more individuals to become immunized and thus have their immune systems combat the disease, preventing further transmission. Has been successful for diseases e.g. smallpox, which is the first globally eradicated disease. From having a mortality of 30% after WW2, it was totally eradicated in 1980. Also shown successful in developed countries, e.g. measles in the USA. Measles cases fell from approx. 89,000 in 1941 to only 44 in 2002.

Effective screening Allows carriers to be identified, isolated and treated, preventing any further spread of disease among people that unknowingly carry the disease. Use of screening or testing in the treatment of HIV/AIDS, where there are a total of 119 countries that carry out HIV testing and councilling, with 95 million 15-49 year olds who received HIV testing and counseling in 2010

Public Health Campaigns

Public health campaigns have been used for various diseases over the years. The early AIDS campaigns have been criticised for being unduly negative in their imagery.

There have been a range of recent scares over possible pandemics. Every now and then, a story emerges of someone who has died from avian flu.

 

A pandemic is a disease which has spread to affect a very large area, either several continents or possibly most of the globe. Its name comes from the Greek meaning

“all the people” which gives you an indication of who is affected.

In recent years, there have been hysterical headlines warning of mass deaths from various diseases. One of the more recent ones was a disease called SARS (severe acute respiratory syndrome)

Case study: SARS in Singapore Definition Severe acute respiratory syndrome (SARS) is a severe form of respiratory infection caused by a coronavirus, which is a common form of virus responsible for upper- respiratory infections Symptoms:

Fever

Headache

Body aches

Dry coughs

Pneumonia

Area of origin:

Foshan City, Guangdong province, South China

Originated as a spread of a new strain of highly contagious pneumonia in November

2002

A physician treating pneumonia patients near Foshan City contracted the virus himself and travelled to Hong Kong, spreading the virus.

How it spread overseas

Disease officially spread outside of China after a Chinese-American businessman in the same hotel as the infected physician contracted SARS and travelled to Hanoi, Vietnam.

Measures to prevent or reduce spread of SARS

Contact tracing: identifying infected individuals Reducing the time between the onset of symptoms and the isolation of patients

Health screenings at airports: consists of a series of questions and temperature check Travelers advised to consult doctors and identify whether they have histories of pneumonia or fever. These individuals would be advised against travel Community containment measures (non-hospital measures) and quarantine of infected persons

How it spread to Singapore

Officially spread to Singapore via 3 guests who travelled from Hong Kong. 1 of the guests, Esther Mok, spread the SARS virus to 22 other individuals in the Tan Tock Seng Hospital and started the SARS epidemic

SARS spread especially quickly among healthcare workers and taxi drivers due to their job nature having them be in close contact with potentially infected customers. 206 cases reported in 2003, with 8 imported cases

Measures against SARS in Singapore

Postponement of travel to highly SARS afflicted areas: namely HK, Guangdong and even to Toronto Designation of Tan Tock Seng Hospital as a designated SARS hospital, where no further admissions and public visits were allowed Designated ambulances used to transport SARS patients to TTSH No-visit rule extended to all public hospitals Military personel used to aid contact tracing and to enforce quarantine Closure of schools for a short period: 2 to 3 weeks

 

Screening of visitors at airports and seaports Singapore used a wide-net health screening where even mild symptoms related to SARS e.g. mild fever, chest radiograph anomalies were treated as symptoms of SARS, and patients were appropriately quarantined Quarantine of all SARS infected individuals for at least 10 days, with the possibility of electronic tagging in order to prevent people from breaking quarantine. Fines used in order to enforce quarantine, in addition CISCO and military personnel used to monitor quarantine areas Handling and disposal of all bodies due to SARS within 24 hours Intensive education and provision of protective personal equipment, e.g. face masks (N95), gloves, hospital gowns, eyewear Healthcare workers had temperature checks thrice a day

Geographic factors and impacts HIV + Malaria

What is HIV / AIDS?

HIV is human immunodeficiency virus. It is a disease which reduces the ability of the body to fight off

Examine the

other diseases. It reduces the efficiency of the body’s immune system.

geographic factors responsible for the incidence and spread of two diseases.

Two-thirds of all people infected with HIV / AIDS live in Sub-Saharan Africa: over a million adults a year die from the disease, despite improvements in treatments including antiretroviral drugs (ART). Access to these drugs is not equal, and millions of people who would benefit from these treatments don’t receive them. One in four schoolchildren in South Africa lives with the impact of HIV / AIDS.

Evaluate the geographic impact of these two diseases at the local, national and international

Former president of S. Africa President Mbeki denied the link between HIV and AIDS, limiting the dispersion of ARVs 400,000 people unnecessarily died on president Mbeki’s rule New president, president Zuma, accepts the link between HIV and AIDS, allowing progress to be made. Controversy Zuma caught sleeping around Video 2

scales. Evaluate the management strategies that have been applied in any one country or region for one of these diseases.

Less than 65 million ppl had been affected in 2005. 25 million ppl in Africa diagnosed as being HIV positive 7000 HIV infection per day LE in Sub Saharan Africa has fallen from mid 60s to mid 40s In worst affected countries, e.g. Mozambique, Leosotho, LE is below 40 Affordable treatment ARVs and prevention are available. Lack of access to ARVS 20% of HIV infected individuals that desperately need ARVs cannot receive the ARVs LE increases between 6 & 24 years on treatment from ARVs. Gives HIV/AIDS affected children the opportunity to learn Lack of infrastructure, education & health workers slow the distribution of ARVs around Africa 5% of HIV affected children receive treatment 10% of HIV/AIDS afflicted women receive they need 10% of the orphaned population from HIV/AIDS receives government support HIV/AIDS has the most number of drugs that are able to treat it, largest number of preventative measures. Video 3 Lack of access to reproductive health supplies in Sub Saharan Africa Many have unplanned pregnancies and have no choice regarding the matter Cannot access contraceptives E.g. condoms, inter-uterine devices (IUD) Lack of access would be the large amount of paperwork involved in ordering contraceptives

 

Can be improved through improved communication with pharma. companies and electronic filing or pricing systems Ineffective treatment for HIV/AIDS Preventative measure: family planning Transport is a major factor affecting access to preventative measures & ARVs Solution: local family planning clinics used to provide population with family planning methods. 215 million women want to avoid pregnancies, cannot access contraceptives 53 million unplanned pregnancies

Video 4 TED talk: HIV/AIDS in Sub-Saharan Africa Uganda is the only African country with successful treatment of the AIDS epidemic US President pledged $15 billion in 5 years to combat HIV/AIDS 50% to 6% prevalence from 1990s to 2005 ABC program used in Uganda abstain, be faithful, contraceptive Can’t develop effective policy without understanding the AIDS epidemic.

Uninfected male in Botswana doubles their chance of dying when getting a new partner

View health as an investment if you do not have a long life, disincentive to invest in one’s health. Low LE in most areas of Africa, means that people have disincentive to invest in their own health and change the # of sexual partners they have as HIV prevalence increases. This is because they feel that they will die quickly, see this as an excuse to have much more sex.

US president’s $15 billion program may not be effective due to the lack of incentive to change sexual

behaviour. Inconsistent HIV prevalence data in Africa below 2003 because of improper testing. AIDS kills people in their prime AIDS. Comparing death rates from HIV/AIDS between Egypt and Botswana (more AIDS). Death rate of people in 25-30 is much higher for Botswana Areas in Africa with more transport infrastructure have higher HIV/AIDS prevalence, due to more people transitioning through the area and spreading HIV/AIDS Truck drivers & migrants have the highest HIV infection rates Link between economic activity and HIV/AIDS prevalence X2 export activity, x4 HIV/AIDS prevalence LINK TO UGANDA: in 1990s, coffee prices fell, which led to the fall in # of new HIV infections. Link between the two, decline in HIV infection would have declined by 25% without education program. 4.1 million HIV positive women in S. Africa give birth per year 250 million deaths from HIV per year

Video 5 link between HIV/AIDS and marriage 1/3 of new HIV infections in Uganda are amongst married couples in 2005 Zambia and Rwanda, more than ½ of new infections are among married couples (2004) Danger of having multiple sexual partners spread of HIV/AIDS amongst sexual partners Many patriarchal societies in Africa, e.g. Kenya men run the household Cultural belief that if women control family planning, challenges the masculinity of the men in the relationship As such most women remain subservient Between married couples in Kenya, majority do not use a condom. Viewed as a symbol of mistrust (?) Often, women are not concerned with the promiscuity of men unless they continue to support them and their children. Polygamy is still thriving in Kenya 43% of married women in Kenya report domestic abuse 2006, Kenya passed Sexual Violence Act to reduce the prevalence of sexual violence. Promiscuity and sexual violence is a cultural issue Men do not like being blamed for causing the spread of HIV/AIDS through promiscuity, stops preventive measures from being put in place. Effective treatment cannot be achieved without internalizing the issue of HIV/AIDS in Africa

 

Affect of political factors on spread of HIV/AIDS

Political factors

President Mbeki doubts link between HIV/AIDS Due to his ignorance or possibly political corruption Offered ineffective treatment for HIV/AIDS garlic and sweet potato Possibly due to Mbeki having fear of admitting his mistake, ignorance Worry about the loss of control from S. Africa due to influx of foreign aid to reduce HIV/AIDS Political alliance with other richer countries e.g. Uganda & the USA. Allows Uganda to receive ARVs and financial aid Catholicism in Africa prevents Africa from receiving contraceptives However, new pope, Pope Francis, allows for the use of contraceptives for the prevention of

HIV/AIDS. Muslim countries in Africa are more open to the use of contraceptives

Demographic factors

Economically active population has highest rates of HIV infections

Affects the dependency ratio in the economy HIV afflicted become unable to work after awhile HIV orphans many children HIV/AIDS kills parents Social issue children may not receive adequate healthcare/education. Increase in crime rates amongst children as they try to make a living 10% of women receive treatment 10% of orphans receive government support 5% of children receive the treatment they require Large proportion of newly infected in S. Africa from babies born w/ HIV

Cultural factors

Men in S. Africa afraid to have their masculinity challenged POSITIVE Virginity test for young females discourages sexual promiscuity Lack of education/cultural beliefs result in people being ignorant of treatments E.g. belief that eating garlic & sweet potatoes cures HIV/AIDS, sex with a virgin will cure AIDS, having a shower cures HIV/AIDS. Male-female relationships in Africa have men wielding power over family matters

Polygamy still would be active in rural areas in S. Africa Comparing religions between S. Africa and Northern Africa Southern Africa

Environmental factors

Lack of access to healthcare facilities in rural areas

Limits access to contraceptives (prevention) or ARVs (treatment) Women unable to check their HIV/AIDS status Lack of transportation infrastructure

In rural populations, there is a disincentive to go to school due to the distance and the main industry being agriculture. Children do not become educated on preventative measures against HIV etc

Economic factors

HIV/AIDS is a largely poverty related disease Lack of healthcare and educational facilities Inability of large proportion of population to afford preventative measures e.g. contraceptives. Higher promiscuity due to poverty possibly linked to higher rates of prostitution Impact: renders people unable to work, HIV affects larger proportion of economically active

population. Loss of economically active individuals due to poor health or death: slowdown in economic growth. Knock-on impact: children that become orphaned do not receive education = low

investment in children’s future, they end up w/ low paying employment in the future

However, there is a counterargument that there is higher HIV/AIDS prevalence in areas with higher levels of trade & transportation. E.g. migrants and truck drivers have highest rates of HIV infection

When coffee prices in Uganda fell, rates of HIV infection fell

 

Video #7 Hans Rosling & HIV Gapminder graph Money per person on x axis % of HIV infected adults on y axis Size of bubbles = population infected with HIV First heavily infected Asian country Thailand Uganda & Mozambique were first Asian countries to have 1% of all adults in the world are HIV infected 30 to 40 million countries Problem with graph: In richer countries e.g. Botswana, Africa, govt. can afford to treat HIV/AIDS affected individuals with ARVs, thus % of population with HIV/AIDS remains constant Emphasis placed on prevention of HIV treatment

Argue: HIV is considered a ‘disease of poverty’, there is a rough negative correlation between HIV

infected adults and income. HOWEVER, it is not very clear, e.g. richer countries such as S. Africa have

high HIV infection rates Africa is a large continent large variation in the countries with HIV infection Southern Africa has 50% of all HIV infected adults 4% of the world population

Examine the geographic factors responsible for the incidence and spread of HIV/AIDS. [10m]

Introduction

  • - HIV/AIDS is one of the world’s most significant health problems that is easily spread through

unprotected sex, breast milk, blood, and from mother to child. More than 34 million people currently live with the disease, and 7000 are diagnosed each day.

  • - South Africa has one of the highest prevalence of HIV/AIDS, with 4.2 million people infected and 250,000 deaths each year. Southern Africa has the highest prevalence within Africa, in areas such as Swaziland, Botswana, Lesotho, South Africa. In comparison, Northern Africa has low prevalence of HIV/AIDS.

Political factors

  • - Mbeki government is unconvinced that HIV causes AIDS

  • - Ignorance about HIV/AIDS

Demographic

  • - Only 5% of children receive treatment

  • - 10% of women receive treatment

  • - 10% of orphans receive government support

  • - Affects economically active age group, increasing dependency ratio

Cultural

  • - Belief that contraception affects men’s masculinity

  • - Religion does not allow use of contraceptives

  • - Sex with virgins can cure HIV, leading to rape

  • - Virginity test in Kwazulunatal