Drastic Jumps in Food Prices Threaten the World's Most Vulnerable With Disease and Starvation

by Beryl Lieff Benderly

The life of Fanta Lingani, a housewife in Ouagadougou, the capital of the African nation of Burkina Faso, was recently chronicled in the Washington Post. Fanta used to cook meat, vegetables, and rice in the three meals she and a co-wife prepared for their family each day.ⁱ  But today, the household of 25, which includes Fanta’s husband, her two co-wives, and nearly two dozen children and grandchildren, must get by on a single meal of corn meal mush.  In addition to drastically altering their daily diet, the household has cut other expenditures and Fanta and a co-wife have taken twice-weekly part-time jobs sweeping city streets.

Food prices have doubled since last year in Burkina Faso, one of the world’s poorest countries, and the changes that families have had to make are desperate though largely futile attempts to stretch their income to cover their nutritional needs. 

Consumers in many countries have been jolted by sharp hikes in prices of daily necessities, especially food and petroleum products. For the prosperous, adjusting may mean nothing more than choosing less expensive cuts of meat and fewer luxury items—annoyances, perhaps, but certainly no threat to their ability to get sufficient nourishment.  But for the 800 million people who were chronically hungry even before the price rise, circumstances are now dire.ⁱⁱ

In Haiti, another of the world’s poorest nations, food goes unsold while more than half the population is undernourished and unable to afford the prices sellers must charge to cover their costs. Unless conditions in the country improve, observers warn, widespread starvation is possible.ⁱⁱⁱ  In many other countries as well, millions are cutting their spending on such pressing needs as health care and education in order to buy food, and are forced to eat less at each meal, eat fewer meals, eat poorer quality and less nutritious foods, or even not eat at all. 
 
Complex Insecurity
  
 Food security, once an obscure technical concept, is suddenly a hot issue for the media and political figures. At the G8 meeting in Toyako, Japan, in July 2008, for example, the assembled leaders declared themselves “deeply concerned that the steep rise in global food prices coupled with availability problems in a number of developing countries is threatening global food security.”^iv 

According to the Food and Agriculture Organization (FAO), food security exists “when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”^v  As this definition suggests, the issues causing the current price crisis and threatening food security for millions are, in the words of the G8 leaders, “multifaceted and structural,” involving the international economic system, world commodity prices, national governmental policies, and the internal politics of numerous countries. 

Nominal international prices of major food commodities—prices not adjusted for changes in the value of currency—stand at “their highest levels in nearly 50 years” and real prices—adjusted for currency value changes—are “the highest in nearly 30 years,” according to a report from the FAO’s High-Level Conference on World Food Security held in June 2008.^vi  Food prices shot up 24 percent overall in 2007, according to the FAO world index. World vegetable oil, dairy and rice prices rose 87 percent, 58 percent and 46 percent, respectively. “Prices are likely to remain high in the next few years and…affect most developing country markets,” the report predicts.

Numerous interlocking factors have contributed to crisis, experts agree. On the supply side, “a critical trigger” has been a drop in cereal production by leading exporting countries that began in 2005, coupled with a decline in the level of stockpiled grain that began in the 1990s, according to the conference report.^vii  On the demand side, a major new use for certain food crops, biofuel for vehicles, is now competing with household consumers for such basic commodities as maize (corn), sugar, oilseeds, and palm oil. Policies spurred by concerns about climate change and dependence on foreign oil, such as those by the United States that have mandated ethanol content in gasoline and provided subsidies for its production, have encouraged significant diversions of food commodities.

More than 30 percent of 2008 U.S. maize production, which amounts to about 12 percent of the worldwide crop, for example, is destined for fuel tanks rather than cooking pots.^viii  The newly high price of maize is persuading farmers to grow it rather than less lucrative food crops that they formerly grew, such as wheat and soybeans. In addition, the sharply higher petroleum prices that helped make biofuel production economically viable simultaneously boosted costs of raising food and transporting it to market. Furthermore, policies that some producing nations adopted in response to the crisis, especially export restrictions to protect their own domestic supplies and price levels, have amplified these effects. Shifts in currency values and international exchange rates have also contributed.

A ‘Silent Tsunami’

The crisis, “a silent tsunami, is not a natural catastrophe, but is man-made,” according to Robert B. Zoellick, president of the World Bank Group.^ix  “The nexus between high energy and food prices is unlikely to be broken, and will be exacerbated by global climate change…This is a 21st century food-for-oil crisis.” In response, the G8 leaders declared themselves “determined to take all possible measures in a coordinated manner, and since January 2008 have committed, for short, medium and long-term purposes, over US$10 billion to support food aid, nutrition interventions, social protection activities and measures to increase agricultural output in affected countries.  In the short-term, we are addressing urgent needs of the most vulnerable people.” They also urged a variety of longer-term steps such as “reversing the overall decline of aid and investment in the agricultural sector.”^x  These would have varying influences on food supply, observers note. In addition, the G8 leaders have “tasked a G8 Experts Group to monitor the implementation of our commitments” and “will review the progress on this issue at our next Summit.” Numerous rich countries have also pledged additional funds.

The rise in prices, the G8 leaders warned, “could push millions more back into poverty” and prevents attainment of the United Nations’ Millennium Development Goal 1 (“eradicate extreme poverty and hunger”), Target C to “reduce by half the proportion of people who suffer from hunger.”^xi  Nor have market forces and national policies distributed the effects evenly within affected nations. In both the developed and the developing worlds, some people, such as farmers growing sought-after crops, have benefited. The adverse effects have generally fallen most harshly on buyers with limited budgets who must purchase food in the open market, particularly city and town dwellers and landless rural residents.  

“It is not surprising that this is provoking social unrest across the developing world,” notes the High-Level Conference. Food riots have toppled Haiti’s government and demonstrations have broken out in five dozen nations, including Egypt, Bangladesh, Mexico, El Salvador, Senegal, Cameroon, and Cote d’Ivoire.

In the long run, economists expect that “high prices will stimulate a supply side response to increase production and, where existing transport and market infrastructure allow, to supply the market. This may represent an important opportunity for promoting agricultural and rural development in many low-income countries.”^xii  

Hitting Home
 
“Maternal and child undernutrition remain pervasive and damaging conditions in low-income and middle-income countries,” according to a study by Robert E. Black of the Johns Hopkins Bloomberg School of Public Health and co-authors.^xiii  It is “the underlying cause of 3.5 million deaths, 35% of the disease burden in children younger than 5 years and 11% of total global disability-adjusted life years - DALYs. [The DALY is a metric of illness or health used in comparisons of the burden of disease and the cost-effectiveness of interventions; see box]. The number of global deaths and DALYs in children less than 5 years old attributed to [the effects of undernutrition] constitutes the largest percentage of any risk factor in this age group.”  

The relationship between undernutrition and infectious disease, for example, constitutes a “baleful synergy,” according to Disease Control Priorities in Developing Countries, 2^nd Edition, one of three publications of the Disease Control Priorities Project (DCPP). “Undernutrition reduces immunological capacity to defend against diseases, and diseases deplete and deprive the body of essential nutrients.”^xiv 

Children’s nutrition affects far more than childhood health and mortality, however. “Undernutrition and infectious diseases further exacerbate poverty through lost wages, increased health care costs and—most insidiously—impaired intellectual development that can significantly reduce earning potential.”^xv  Recent research shows long-term consequences stretching well into adulthood. One study tracked Guatemalan children who received supplemental feeding between 1969 and 1977. Three decades later, the data show, men who received the supplements before their third birthdays earned wages between 33 percent and 47 percent higher and incomes 14 percent to 28 percent larger than men who had not.^xvi  Men and women who had received the supplements scored 17 percent higher on reading comprehension.^xvii 

What’s more, although the results of undernutrition in childhood “are very obvious (high mortality, losses in cognitive development)…obviously nutritional deficiencies are also important in the other 88 percent of the developing world’s population,” write Sue Horton and co-authors in the 2008 Challenge Paper on hunger and malnutrition of the Copenhagen Consensus Group.^xviii  One particularly crucial group are women of childbearing age, partially because young children’s health and development “depends critically on nutrition of their mothers during pregnancy and lactation,”^xix  but also because women’s own ability to survive repeated and often closely spaced pregnancies also depends on the diet they receive at that time and earlier in their lives. Iron-deficiency anemia, for example, is a major contributor to maternal death. Small stature due to poor nutrition is a major cause of obstructed labor, which can damage or kill both mothers and babies. For people of all ages and both genders, furthermore, inadequate nutrition has been implicated in a wide range of other diseases and conditions.

Micronutrients, Macro Results

Whether people suffer from undernutrition depends on the quantity and quality of the food they eat, and whether it provides a sufficient supply of calories and protein and specific nutrients vital to health but needed in relatively small quantities. These micronutrients provide a promising opportunity for effective nutritional interventions, especially as rising prices force people to shift to cheaper and less nourishing foods. “Recent intervention studies show that real and significant benefits can be achieved if diets are improved,” according to the Copenhagen Consensus Group.^xx  

Low-priced micronutrient supplementation, especially with the “big three” of vitamin A, iron, and zinc, is extremely cost-effective. Adding iodized salt to diets also pays big health dividends. The trend toward people eating cheaper and less nutritious foods greatly magnifies the importance and potential impact of supplementation. Adding vitamin A cuts death rates by 32 percent in children under 3 at a cost of $100 to $500 per life saved, 20 cents per person annually, or $3 to $16 per DALY averted. Supplementary iron can raise cognitive development in children and also prevent anemia in pregnant women (life-threatening to mother and child), at a cost of only $66 to $115 per DALY averted. Zinc has been shown to be effective in treating diarrhea, a major killer of children in developing countries, and also appears to reduce other mortality and morbidity rates and foster growth at a cost of about 5 cents per day, or $73 per DALY and $2,100 per death averted.^xxi  

 
Persistent Hunger Crisis

Clearly, the benefits of improving nutrition and food security for millions of underfed children and adults are enormous. But equally clear is the challenge of doing so in the many developing countries whose people

Calculating DALYs A year lived in complete health counts as 1.0 DALY. A year following death, on the other hand, is worth 0.0 DALYs. A year spent in less than full health counts as some portion of a DALY, the exact amount determined by the severity of the incapacity or disability that affected individuals typically suffer, a judgment based on a consensus expert estimate. The total DALY loss to an individual from an episode of disease or injury depends on the length of time the condition generally lasts, ranging from a stretch of acute illness lasting only days or weeks to a lifetime of disability. The value of a year of life does not depend on a person’s age when death or disability occurs, but because the future is generally considered to be worth less than the present, and given the unreliability of predicting people’s future survival, years of life remaining from the time of the occurrence are discounted at the rate of 3 percent per year. The total DALY loss from a particular illness or injury in a population, also called the burden of disease, is the average individual loss multiplied by the incidence of the disease or injury—the number of people newly affected by it in that year. The cost-effectiveness of an intervention to prevent, treat, or palliate a condition is calculated at the individual level and depends on how much of the health loss the intervention can prevent or remove. The DALY values of burden from various diseases, and of the cost-effectiveness of interventions, come from calculations based on worldwide research and summarized in DCPP.

experienced insufficient nourishment even before being hit hard by a global situation far beyond their or their nations’ control. Supplementation is effective in improving the quality of diets only when people eat adequate amounts of food. It offers no solution to the current crisis facing those who simply cannot get sufficient calories and protein.

For international organizations and wealthy nations seeking ways to lessen the suffering, the complex and interconnected factors behind the current world food crisis add a new and difficult set of challenges. As yet, it is unclear whether those who can help will muster the determination, commitment, resources, logistics, and strategies to provide even basic nutrition on a sustained basis to many of the world’s countless hungry people, let alone to counteract the forces driving prices upward.

As long as severe food insecurity is an inescapable fact of life for increasing numbers in many countries, the health and survival of more than a billion individuals unable to afford the food they need will remain at risk.

Beryl Lieff Benderly is a prize-winning Washington journalist and author specializing in health, behavior, and science policy. Her articles appear in major magazines and on the Internet, and she is a regular contributor to the Science magazine website. Her eight books include In Her Own Right: The IOM Guide to Women’s Health Issues.
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ⁱ Sullivan, K. “Africa’s Last and Least.” Washington Post. July 20, 2008.

ⁱⁱ High-Level Conference on World Food Security: The Challenges of Climate Change and Bioenergy. Soaring Food Prices: Facts, Perspectives, Impacts and Actions Required. Rome. June 3-5, 2008.

ⁱⁱⁱ Carroll, R. “Haiti: Mud Cakes Become Staple Diet as Cost of Food Soars Beyond a Family’s Reach.” The Guardian. July 29, 2008.

^iv G8 Leaders Statement on Food Security, July 8, 2008.

^v FAO. 2002. The State of Food Insecurity in the World 2001.

^vi High-Level Conference on World Food Security.

^vii Ibid. 

^viii Ibid.

^ix Zoellick, R.B. “A 10-Point Plan for the Food Crisis.” Financial Times. May 29, 2008.

^x United Nations Development Programme.

^xi Ibid.

^xii High-Level Conference on World Food Security.

^xiii Black, R.E., L.H. Allen, Z.A. Bhutta, L.E. Caulfield, M. de Onis, M. Ezzati, C. Mathers, and J. Rivera. Maternal and Child Undernutrition: Global and Regional Exposures and Health Consequences. The Lancet. 2008; 371: 243-60.

^xiv “Stunting, Wasting, and Micronutrient Deficiency Disorders.” 2006. In Disease Control Priorities in Developing Countries, 2nd ed., ed. D.T. Jamison, A.R. Measham, J.B. Breman et al. New York: Oxford University Press.

^xv Ibid.

^xvi Hoddinott, J., J.A. Maluccio, J.R. Behrman, F. Rafael, and R. Martorell. “Effect of a Nutrition Intervention During Early Childhood on Economic Productivity in Guatemalan Adults. The Lancet. 2008; 371: 411-16.

^xvii Maluccio, J.A., J. Hoddinott, J. Behrman, R. Martorell, A.R. Quisumbing, and A.D. Stein. “The Impact of Nutrition During Early Childhood on Education Among Guatemalan Adults. PIER Working Paper. 2006; no. 06-026.

^xviii Horton, S., H. Alderman, and J.A. Rivera. 2008. Copenhagen Consensus Challenge Paper: Hunger and Malnutrition.

^xix Ibid.

^xx Ibid.

^xxi Ibid.