1
Introduction

In 2007 and 2008, the world witnessed a dramatic increase in food prices. Between March 2007 and March 2008, price increases of 31 percent for corn, 74 percent for rice, 87 percent for soya, and 130 percent for wheat were documented (Hawtin, 2008). This increase in food prices posed a heavy burden on consumers in food-importing countries. The pressure of increasing food prices was a major factor in riots that erupted in many countries (Ngongi, 2008). High food prices not only caused civil unrest, but also exacerbated the humanitarian crisis of food insecurity; the tandem food price and economic crises struck amidst the massive, chronic problem of hunger and undernutrition in developing countries. Soaring food and fuel prices are a “perfect storm” for the most vulnerable billion—those living on $1 a day—who can’t afford to see their purchasing power further decrease (Sheeran, 2008).

The nutritional consequences of the food price increases could be considerable in poor urban populations, in rural areas that are net food purchasers, and in female-headed households. Malnutrition affects the survival, health, well-being, and developmental potential of vulnerable groups. Food shortages disproportionately impact women during pregnancy, leading to irreversible physical and cognitive damage to their unborn child. Both quality and quantity of the diet are important for successful birth outcomes (Global recession increases malnutrition for the most vulnerable people in developing countries, 2009).

National governments and international actors have taken a variety of steps to mitigate the effects of increased food prices on particular groups. While some of these actions have helped stabilize food prices, other actions may help certain groups at the expense of others, make food prices more volatile in the long run, and distort trade markets (von Braun, 2008).



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1 Introduction I n 2007 and 2008, the world witnessed a dramatic increase in food prices. Between March 2007 and March 2008, price increases of 31 percent for corn, 74 percent for rice, 87 percent for soya, and 130 percent for wheat were documented (Hawtin, 2008). This increase in food prices posed a heavy burden on consumers in food-importing countries. The pressure of increasing food prices was a major factor in riots that erupted in many countries (Ngongi, 2008). High food prices not only caused civil unrest, but also exacerbated the humanitarian crisis of food insecurity; the tandem food price and economic crises struck amidst the massive, chronic problem of hunger and undernutrition in developing coun- tries. Soaring food and fuel prices are a “perfect storm” for the most vulnerable billion—those living on $1 a day—who can’t afford to see their purchasing power further decrease (Sheeran, 2008). The nutritional consequences of the food price increases could be consider- able in poor urban populations, in rural areas that are net food purchasers, and in female-headed households. Malnutrition affects the survival, health, well-being, and developmental potential of vulnerable groups. Food shortages dispropor- tionately impact women during pregnancy, leading to irreversible physical and cognitive damage to their unborn child. Both quality and quantity of the diet are important for successful birth outcomes (Global recession increases malnutrition for the most ulnerable people in deeloping countries, 2009). National governments and international actors have taken a variety of steps to mitigate the effects of increased food prices on particular groups. While some of these actions have helped stabilize food prices, other actions may help certain groups at the expense of others, make food prices more volatile in the long run, and distort trade markets (von Braun, 2008). 

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 IMPACTS OF THE GLOBAL FOOD PRICE CRISIS Emphasizing the importance of child and maternal health and nutrition to international development, the Millennium Development Goals (MDGs) repre- sent a global commitment to poverty and hunger eradication.1 The first MDG is to eradicate extreme hunger and poverty; one of the 3 targets of MDG 1 is to halve, between 1990 and 2015, the proportion of people who suffer from hunger. MDGs 4 and 5 focus on reducing child mortality and improving maternal health, both inextricably linked to nutrition and food security. The recent abrupt increase in food prices, in tandem with the current global economic crisis, threatens progress made in these areas and could prove a serious barrier to achievement of these goals. WORKSHOP BACKGROUND The Institute of Medicine (IOM), with funding from the Bill & Melinda Gates Foundation and the PepsiCo Foundation, held a workshop titled Mitigating the Nutritional Impacts of the Global Food Price Crisis on July 14–16, 2009, in Washington, DC, at the Kaiser Family Foundation’s Barbara Jordan Conference Center. The workshop was a collaboration between the IOM Board on Global Health and the Food and Nutrition Board, in consultation with the Board on Agriculture and Natural Resources. Presenters were chosen by a planning com - mittee to describe the dynamic technological, agricultural, and economic issues contributing to the food price increases of 2007 and 2008, and their impacts on health and nutrition in resource-poor regions. The planning committee quickly realized that it was impossible to ignore the compounding effects of the current global economic downturn on nutrition. Subject matter experts were invited to the workshop and asked to discuss these tandem crises, their impacts on nutri - tion, and opportunities to mitigate their negative nutritional effects. The primary objectives of this workshop were to: • Set the stage for the deliberations by having an overview of the recent food price crisis and how it, in tandem with the current economic crisis, affects developing countries; • Understand the pathways from the food price and economic crises to nutritional impact, including a discussion of existing evidence and vulner- able populations; • Understand the range of country experiences with the food price and economic crises and their impact on food security and nutrition, as well as country-level responses to these crises; 1 The MDGs were adopted in 2000 by the member nations of the United Nations and the world’s major development institutions.

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 INTRODUCTION • Encourage a broad discussion of nutrition surveillance, including exist- ing nutrition surveillance systems, their capacity to monitor food price fluctuations, and the gaps and needs for improved surveillance; • Understand the landscape of the global nutrition field, those who work in it, and their respective roles and capacities to respond to the food price and economic crises; and • Discuss what the U.S. government can and should do to help avoid future food crises and to mitigate the negative nutritional effects of those that cannot be avoided. An IOM workshop illuminates scientific discussions to foster understand- ing among the public, academia, government, nongovernmental organizations, industry, and policy makers, but it does not make recommendations. A corner- stone of the approach is to air divergent views on sensitive and difficult issues in an atmosphere of respect and neutrality in order to encourage dialogue and strategic solutions. The goal of the summary report is to present relevant lessons from the workshop, to outline a range of pivotal issues and their respective challenges and opportunities, and to offer potential responses as discussed by the workshop participants. The remarks in the workshop summary are the views of the indi - vidual presenters, panelists, or attendees and do not reflect a consensus of those attending or the planning committee. The planning committee’s role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. The workshop summary is organized in chapters as a topic-by-topic descrip - tion of the presentations and discussions as they occurred at the July 2009 workshop. The workshop agenda, as well as speaker information and a list of reg- istrants, appears in the appendixes at the end of the workshop summary report. The reader should be aware that the material presented here expresses the views and opinions of the individuals participating in the workshop and not the deliberations and conclusions of a formally constituted IOM consensus study committee. These proceedings summarize only what participants stated in the workshop and are not intended to be an exhaustive exploration of the subject matter and should not be perceived as a consensus of the participants, nor the views of the planning committee, the IOM, or its sponsors. WELCOME FROM THE SPONSOR Ellen Piwoz, Sc.D., M.H.S., Senior Program Officer The Bill & Melinda Gates Foundation The timing of this meeting is absolutely critical. Never before has the international nutrition community had the breadth and depth of data that exists

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0 IMPACTS OF THE GLOBAL FOOD PRICE CRISIS today—showing the importance of nutrition to the lifelong health of children as well as that of their families, communities, and entire economies. Economic development and security require a healthy and fit population, and undernutrition undermines this process. In fact, it has been estimated that countries may lose 2–3 percent of their gross domestic product from deficiencies in such key nutrients as iron, iodine, and zinc (Vitamin and Mineral Deficiency: A Global Progress Report, 2004; Alderman, 2005). The increase in food prices has certainly brought this issue to the forefront, but it has also highlighted some of the challenges the international nutrition community is facing in a world where far too many people go to bed hungry and suffer from the consequences of malnutrition. It is hoped that this workshop can provide some tangible ways to respond, not only to the latest rise in food prices but also to ensure that nutrition is a component of every health and development strategy, in both donor and recipient countries alike, with the twin goals of improving nutrition while decreasing hunger and poverty. The Bill & Melinda Gates Foundation’s strategy for the nutrition program in global health is primarily focused on improving child nutrition from conception through 24 months; such improvements have a huge impact on the likelihood of a child’s survival, good health, and later learning and earning potential. Given the importance that good nutrition plays in lifelong health and productivity, address - ing nutrition early in life is one of the more cost-effective investments that can be made (Behrman et al., 2004; Global Crises, Global Solutions, 2004; Horton et al., 2008). The fact that this very workshop is an initiative of the IOM’s Board on Global Health, Food and Nutrition Board, and the Board on Agriculture and Natural Resources represents the complexity as well as the great opportunity facing the international nutrition community. No single agency or set of institu - tions has the sole mandate, or the resources, to coordinate a global response to the issue of undernutrition. But this cannot be an excuse for inaction. The recent announcement by the G8 to commit $20 billion toward food security is welcome and much needed. The international nutrition community must help to ensure that this strategy includes coordinated efforts to improve nutrition in addition to increasing food production. Although the problems to be discussed over the next 3 days are very real and tragic for millions and millions around the world, there must also be a sense of optimism. Existing evidence shows that progress is possible on a large scale even in the poorest of countries. Today, the tools, solutions, and knowledge to address hunger and undernutrition exist. With the combination of commitment, capacity, and resources, successes have been demonstrated. Over the past 5 years, the world has seen the introduction of new interventions—micronutrient powders and ready-to-use therapeutic foods— through the development of novel partnerships between researchers and the pri - vate and public sectors; these collaborations are beginning to have a broad impact. Countries from Asia to Africa to Latin America have been able to mount efforts

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 INTRODUCTION BOX 1-1 The Millennium Development Goals (MDGs) Goal 1: Eradicate extreme hunger and poverty. Goal 2: Achieve universal primary education. Goal 3: Promote gender equality and empower women. Goal 4: Reduce child mortality. Goal 5: Improve maternal health. Goal 6: Combat HIV/AIDS, malaria, and other diseases. Goal 7: Ensure environmental sustainability. Goal 8: Develop a global partnership for development. Three of the eight MDGs, adopted in 2000 by the member nations of the United Nations and the world’s major development institutions, are closely linked to mal- nutrition in young children and in women: MDG 1—Eradicate extreme poverty and hunger, MDG 4—Reduce child mortality, and MDG 5—Improve maternal health. With a key milestone of the MDGs fast approaching in 2015, the goal to decrease hunger by 50 percent is far off track. The current economic environment makes achieving the goals even more difficult. Momentum to reduce overall poverty in the developing world is slowing, and, in particular, higher food prices have reversed the nearly two-decade trend in reducing hunger. SOURCE: UN, 2008. to tackle such problems as vitamin A and iodine deficiencies. Many countries have been able to reduce the burden of underweight with a combination of direct nutritional interventions and other social and health investments. Child mortality rates are lower than ever before. Yet only 6 years remain to achieve the Millennium Development Goals, Goal 1 of which is to “Eradicate extreme hunger and poverty” (Box 1-1). The past decade’s progress is now threatened by the food and financial crises (UN, 2008). The international nutrition community must learn more about what is happening to people on the ground, which groups are being affected, and how these chal - lenges can be overcome. An African proverb states, “If you want to go fast, go alone. If you want to go far, go together.” This is the time to collectively mobilize knowledge, resources, and commitment to ensure that the most vulnerable popu - lations of the world are not further condemned to a lifetime of poor health and suffering because of undernutrition caused today.

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 IMPACTS OF THE GLOBAL FOOD PRICE CRISIS REFERENCES Alderman, H. 2005. Linkages between poverty reduction strategies and child nutrition: An Asian perspective. Economic and Political Weekly 40:4837-4842. Behrman, J. R., H. Aldermann, and J. Hoddinott. 2004. Hunger and malnutrition. Copenhagen Con- sensus: Challenges and Opportunities 58. Global Crises, Global Solutions. 2004. Edited by B. Lomborg. Cambridge: Cambridge University Press. Global Recession Increases Malnutrition for the Most Vulnerable People in Deeloping Countries. 2009. Rome: United Nations Standing Committee on Nutrition. Hawtin, G. 2008. CIAT’s Response to the World Food Situation. Cali, Columbia: CIAT. Horton, S., H. Alderman, and J. A. Rivera. 2008. Copenhagen consensus challenge paper: Hunger and malnutrition. Copenhagen Consensus Center. Ngongi, N. 2008. Policy Implications of High Food Prices for Africa. Washington, DC: International Food Policy Research Institute. Sheeran, J. 2008. High Global Food Prices: The Challenges and Opportunities. Washington, DC: International Food Policy Research Institute. UN. 2008. United Nations Millennium Deelopment Goals. http://www.un.org/millenniumgoals/ (accessed October 27, 2009). Vitamin and Mineral Deficiency: A Global Progress Report. 2004. Ottowa, Canada: The Micronutrient Initiative and The United Nations Children’s Fund. von Braun, J. 2008. Rising food prices: What should be done? EuroChoices 7(2):30-35.