This report presents the latest statistics on global undernourishment and concludes that structural problems of underinvestment have impeded progress toward the World Food Summit goal and the first Millennium Development Goal hunger reduction target. This disappointing state of affairs has been exacerbated by first the food crisis and now the global economic crisis that, together, have increased the number of undernourished people in the world to more that one billion for the first time since 1970. This crisis is different from those developing countries have experienced in the past, because it is affecting the entire world simultaneously and because developing countries today are more integrated into the global economy than in the past. In the context of the enormous financial pressures faced by governments, the twin-track approach remains an effective way to address growing levels of hunger in the world. Investments in the agriculture sector, especially for public goods, will be critical if hunger is to be eradicated.
Poverty and health
Ending poverty is almost certainly doomed to fail if it is driven solely by the imperative of boosting economic growth through investment, trade, new technology or foreign aid, according to this book. Fighting poverty is about fighting deprivation, exclusion, insecurity and powerlessness. People living in poverty lack material resources but that more than that, they lack control over their own lives. To tackle global poverty, we need to focus on the human rights abuses that drive poverty and keep people poor. Giving people a say in their own future, and demanding that they be treated with dignity and respect for their rights is the way to make progress. Through personal reflection and case studies, Khan shows why poverty is first and foremost not a problem of economics but of human rights. As the numbers of people living in poverty swell to upwards of two billion, she argues that poverty is the world's worst human rights crisis. Slums are growing at an alarming rate condemning a billion people to live in dismal conditions. More than half a million women are dying every year due to complications related to pregnancy and childbirth, and 99% of these are in the developing world because of discrimination and denial of essential health care.
This report lays out a seven-point plan that includes a treatment package to reduce childhood diarrhoea deaths and a prevention strategy to ensure long-term results: fluid replacement to prevent dehydration; zinc treatment; rotavirus and measles vaccinations; promotion of early and exclusive breastfeeding and vitamin A supplementation; promotion of hand washing with soap; improved water supply quantity and quality, including treatment and safe storage of household water; and community-wide sanitation promotion. Dr Margaret Chan, Director-General of the World Health Organization, said: ‘We know where children are dying of diarrhoea. We know what must be done to prevent those deaths. We must work with governments and partners to put this seven-point plan into action.’ Yet, despite the known benefits of improving water supply and sanitation, some 88% of diarrhoeal diseases worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. As of 2006, an estimated 2.5 billion people were not using improved sanitation facilities, and nearly one in every four people in developing countries was practicing open defecation.
Five years ago, pregnant women in the village of Sauri, in western Kenya's Nyanza Province, had access to just one rundown and poorly staffed sub-district hospital. Few chose to use it, instead giving birth at home, risking complications during delivery and, for those living with HIV, passing it on to their child. Sauri is now part of the Millennium Villages Project, which, since December 2004, has established maternity wards in nine health facilities across Yala division. The village project, part of the United Nations (UN) Millennium Project, aims to lift communities out of extreme poverty through community-led initiatives to improve health, agriculture, education, gender equality and environmental sustainability. ‘With the improvement of these health facilities through the provision of free maternal services, 64% of expectant women in Sauri now come to deliver in health centres,’ said Patrick Mutuo, science coordinator and team leader of the Sauri cluster. ‘Right now those mothers still delivering at home are doing so not because of cost or distance. It could be due to cultural beliefs or other reasons. We have also initiated door-to-door voluntary testing and counselling services and health education,’ he added.
Treating household water with low-cost, widely available commercial bleach is recommended by some organisations to improve water quality and reduce disease in developing countries. This study analysed the chlorine concentration of 32 bleaches from twelve developing countries. The average error between advertised and measured concentration was 35% (range = -45%–100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing.
The drought that has ravaged parts of northeastern Kenya, killing a large number of livestock, has affected the availability of milk, in turn undermining child nutrition, say officials. Most of the rural population in the areas where Save the Children is working is heavily dependent on relief food and many children are eating only one meal a day, of corn porridge. ‘This poor diet means they are missing out on vital nutrients, which can mean they grow up stunted and their brains and bodies can suffer permanent damage,’ the organisation said. Since July, the number of severely malnourished children seeking treatment at its northeastern emergency feeding centres has increased by 25%. ‘The government and donors need to be aware of the changing climate now and in future, and shape their policies accordingly,’ Philippa Crosland-Taylor, head of Oxfam in Kenya, said in August. ‘Emergency aid is urgently needed now, but in the long term we need to rethink policies to focus on mitigating the risks of droughts before they occur, rather than rushing in food aid when it is too late.’
Context matters with regard to foreign aid. The implications are only slowly coming to the fore: external funders are realising that they will not find a magic wand or global prescription or best practice by which they can unleash the change that will reduce poverty on a significant and sustainable scale. Context – the institutional, social, political, cultural and economic fabric of society – matters, and its significance is much greater than that of aid from external partners. So, the problem for funders in dealing with context seems to be first and foremost dealing with their own context that forces them to try to do more than they objectively can. The challenge is to find ways to change the political and systemic factors that constrain the capacity and willingness of funders to act with modesty, realism and humility. This requires an environment in which their stakeholders are genuinely happy to be small contributors to processes that mainly depend on everything but funders and aid.
This paper estimates the economic impact of HIV and AIDS on the KwaZulu-Natal province and the rest of South Africa. It extended previous studies by employing: an integrated analytical framework that combined firm surveys of workers' HIV prevalence by sector and occupation; a demographic model that produced both population and workforce projections; and a regionalised economy-wide model linked to a survey-based micro-simulation module. Results indicate that HIV and AIDS greatly reduces annual economic growth, mainly by lowering the long-run rate of technical change. However, impacts on income poverty are small, and inequality is reduced by HIV and AIDS because high unemployment among low-income households minimises the economic costs of increased mortality. By contrast, slower economic growth hurts higher income households despite lower HIV prevalence. The increase in economic growth that results from addressing HIV and AIDS is sufficient to offset the population pressure placed on income poverty. Moreover, incentives to mitigate HIV and AIDS lie not only with poorer infected households, but also with uninfected higher income households. The findings confirm the need for policies to curb the economic costs of the pandemic.
Violence and injuries are the second leading cause of death and lost disability-adjusted life years in South Africa. With a focus on homicide, and violence against women and children, this paper reviews the magnitude, contexts of occurrence, and patterns of violence, and refer to traffic-related and other unintentional injuries. The social dynamics that support violence are widespread poverty, unemployment, and income inequality; patriarchal notions of masculinity that valourise toughness, risk-taking and defence of honour; exposure to abuse in childhood and weak parenting; access to firearms; widespread alcohol misuse; and weaknesses in the mechanisms of law enforcement. So far, there has been a conspicuous absence of government stewardship and leadership. Successful prevention of violence and injury is contingent on identification by the government of violence as a strategic priority and development of an intersectoral plan based on empirically driven programmes and policies.
This collection of articles includes an article on food security in Kenya. Since 2006, the rains in Kenya’s Central Highlands have become less reliable. The March and April rains regularly arrive late, and the season is much shorter. In 2008, there were only four days of rain. The seasonal rivers that provide water for irrigation, livestock and domestic uses have mostly dried up, leading to water and food shortages. These burgeoning problems are pointing in one direction – poverty, malnutrition and health problems for the nation’s poor. Declining production, and the limited access and affordability of imported food, mean food security has declined, with many impacts. The government should store grain during bumper harvests to provide food in poor seasons; processing this surplus can also add value and avoid wastage.