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This is an archived USAID document retained on this web site as a matter of public record.

Remarks by Fredrick W. Schieck
Deputy Administrator
U.S. Agency for International Development

Remarks at the United Nations Standing Committee on Nutrition
31st Session
New York, NY
March 19, 2004

MULTISECTORAL APPROACHES TO HUNGER AND POVERTY:
MEETING THE CHALLENGE OF THE MILLENNIUM DECLARATION

INTRODUCTION

Let me welcome you to the United States and thank Catherine Bertini and the Standing Committee on Nutrition for this invitation to speak today.

I am pleased to have the opportunity to address you after the release of the 5th Report on the World Nutrition Situation and to discuss what we in the US Agency for International Development are doing to ensure that good nutrition is not only an outcome of the development process but a critical input as well.

Today I want to illustrate our commitment to the internationally agreed development goals, including those contained in the Millennium Declaration, by providing some specific examples of our work on new crop varieties, integrated community programs, and famine mitigation. We believe these are promising means for reducing poverty and hunger.

We are embracing new approaches to these nutrition goals. They are designed outside of single sector "stove pipes," that is to say, in integrated approaches that cross traditional sector boundaries. We are talking here about how to make agriculture both more productive and sustainable, for sure, but also how to fortify crops nutritionally. We also approach nutritional goals at different levels of society, by inducing behavioral change at community and family levels as well as national levels, in matters of economic policy and political governance.

The first example is an exciting approach which holds great promise in improving the quality of food in diet-poor populations. Through agricultural research and application of the latest developments in agricultural technology, we are transforming indigenous foods to meet specific dietary needs. The second example comes from the much misunderstood contribution of food aid to transformational development. Initiatives that USAID is sponsoring show how food aid can be programmed at the community level to change food consciousness and health behavior leading to better young child nutrition. Finally, I want to describe the new and more comprehensive approach we are taking to address the problem of famine. A good illustration are the measures USAID is taking in Ethiopia to end its chronic dependence on emergency food assistance and how to break the cycle of poverty and hunger it is caught up in.

As the Standing Committee on Nutrition knows well, hunger has many faces. The 5th Report tells us that undernutrition contributes to over half of all early childhood deaths. Even mild malnutrition can lead to tragic increases in mortality and morbidity.

Malnutrition also has less visible repercussions that don't appear in statistics. The 5th Report strongly reminds us that malnutrition diminishes individual lives and reduces their productivity. Adults do not reach their full potential because of inadequate nutrition as children. Nutritionists have also made us aware of a kind of "hidden hunger" which has devastating effects, particularly on the lives of women and children. I am speaking about widespread "micronutrient malnutrition" that affects billions of people in the developing world. Ironically, many of these people live and work on farms and in communities, where agriculture is the predominant way of life.

AGRICULTURE'S CONTRIBUTION TO NUTRITIOUS DIETS

Over the past twenty years or so, the development community has neglected agriculture at our peril. We have rested on the accomplishments of the "Green Revolution" and have failed to build upon it. Agriculture offers crucial opportunities for improving the basic nutrition of the smallhold farmers in the developing world, while enhancing their means of livelihood. It brings benefits that are short and long term in terms of improving both health and economic well-being.

USAID has been at the forefront of efforts to promote agricultural productivity on a sustainable basis while enhancing the nutritional component of agricultural produce in ways that provide real, measurable improvements in health. Through the Consultative Group for International Agricultural Research [CGIAR] and Harvest Plus Challenge Program, we are promoting cutting-edge research that draws upon the latest developments in genetic and nutritional sciences. We are looking for breakthroughs that can be readily adapted and sustained, and which promise immediate and substantial benefits.

USAID has been one of the pioneers in biofortification. In collaboration with The International Food Policy Research Institute [IFPRI] and the Danish International Development Agency [DANIDA], we have begun to address the problem of micronutrient deficiency, what I previously referred to as a "hidden hunger." We are looking at what agricultural science can do to improve the content of key micronutrients: iron, vitamin A, zinc and others. The 5th Report says that 140 million preschoolers suffer from vitamin A deficiency. This will bring immediate health benefits to the families of some of the planets poorest and most marginalized peoples. Indigenous crops can be the vehicle if micronutrients can be introduced in cost effective ways without affecting local tastes and traditional farming practices.

The Bill and Melinda Gates Foundation recently pledged $25 million to back the use of science and plant breeding in developing highly nutritious staple foods. We will be an important partner in this new alliance. We are joining other donors and will provide $3 million a year in support of biofortification efforts.

This partnership is important for several reasons. It is illustrative of a new paradigm in foreign aid. If we are to effectively meet the development challenges of the new century, we must pool our resources and work in coordinated ways with the whole range of aid agencies and resources - international, national, non-governmental, and private.

Plant breeding has yielded fortified foods that are already making a difference. In southern Africa, the common variety of "sweet potato" was a starchy one, lacking the nutritional value of the orange-fleshed, high-Beta carotene varieties. USAID sponsored research in South Africa showed that when children are fed these orange-flesh sweet potatoes, their serum vitamin A levels rise substantially. The research also found that children in South Africa, Mozambique, and Tanzania love the new variety of sweet potatoes - a "sweeter" sweet potato than the traditional starchy one.

The Consultative Group for International Agricultural Research [CGIAR] has worked with an array of national and NGO partners to get the word out that orange sweet potatoes are good for you. The International Institute for Tropical Agriculture [IITA] - the Consultative Group for International Agricultural Research's tropical Africa center in Mozambique - has delivered these new, improved varieties to hundreds of thousands of families. Schools and stores are participating in a social marketing nutrition education program that is transforming agriculture.

We can draw a number of lessons from this. It shows how food based approaches can be critically important to improving nutrition. It also demonstrates how even relatively low-budget interventions can have high-impact results when innovatively conceived. It also shows how thinking is evolving. We are coming to understand that if agriculture is to enhance nutrition, nutrition must also lead the way in transforming agriculture.

The sweet potato success story is rather straightforward. There are other examples as well of how biotechnology can be utilized in the search for new ways of improving the nutritional content of foods which can save lives. USAID is working with partners in developing countries in both the public and private sectors toward this end. I can mention several examples.

In India, Michigan State University and the Tata Energy Research Institute are working with Monsanto to develop mustard oil with beta-carotene levels higher than that in red palm oil. Monsanto is donating the technology, originally developed in Canola research.

Mustard oil is the preferred oil in North India where micronutrient deficiency affects people at all economic levels, the poor most especially. Indian nutritional institutes see great potential for helping to alleviate vitamin A deficiency through such programs.

USAID is also working with partners in the public and private sector in the Philippines to develop Golden Rice. Researchers are making marked progress in enhancing the beta-carotene content of this rice. The International Rice Research Institute [IRRI], universities in Europe and the United States, and the Syngenta Corporation are collaborating on research to ensure that this product moves forward into nutritional and food safety testing as soon as possible.

In Bangladesh, USAID is supporting the introduction of improved methods for fish farming in rural villages where mineral deficiencies are prevalent. As a result, families are managing their ponds more effectively, greatly increasing the yield of marketable fish. The population of smaller fish has also increased. More are consumed at home and this has led to real improvements in the nutrition and well-being of families. Iron levels, especially among women and children, have improved.

It's important to note here that gender has an important role to play in bringing agriculture and nutrition goals together. Our work has shown that when women have a substantial involvement in an agricultural enterprise that provides good income, they make sure that children benefit. In the fish pond example I just cited, women typically manage the ponds. This places them in a position to ensure that increased food and income go to important household needs.

In East Africa, the International Livestock Research Institute has helped spread women-managed, smallholder dairy technology with astonishing results. In families that adopted improved technologies, not only did income rise, but the incidence of stunting and wasting in children fell sharply. The key here is combining productivity increases and the income they generate with a commitment to meeting the family's nutritional and health care needs. Increased income allows poor people to purchase more expensive fruits, vegetables, and livestock products, which helps to diversify diets and nutritional intake.

INTEGRATED COMMUNITY NUTRITION PROGRAMS

Researchers and practitioners have recognized for years that poverty is a key cause of hunger and malnutrition. They have also recognized that an exclusive focus on increasing incomes is not sufficient in and of itself to reduce the number of hungry and undernourished people, particularly in the short- to medium-term. In rural areas where most of the world's poverty and undernutrition are still concentrated, programs aimed at increasing agricultural incomes and crop varieties must be complemented with health, sanitation and nutritional education to achieve durable reductions in malnutrition.

It has also long been recognized that interventions need to get down to the community-level to be successful in improving health and nutrition, especially because changing behaviors is so central to achieving sustainable improvements in the wellbeing of the most vulnerable groups, particularly preschool children. And, because changing behaviors takes time, programs need reliable, multi-year funding to achieve results.

Our Title II program is the USG's largest component of assistance programs aimed at reducing food insecurity, hunger, and malnutrition at the community level. One third of the regular program, more than $380 million in 2003, is used to implement multi-year community-based development programs in 28 of the world's poorest countries.

The majority of the programs include maternal and child health and nutrition activities with a goal of reducing the underweight and stunting of children. Mother and child activities are integrated with activities aimed at increasing agricultural productivity, thereby creating linkages among health and nutrition and agriculture so that improvements in agricultural productivity and income may translate into better nutrition in households.

A USAID-funded CARE program in Mozambique, for example, links training in home-enrichment of complementary foods with a crop diversification activity. As a result, 87 percent of women in the program are now using crops such as groundnuts, sesame and sunflower to enrich their young children's food, up from 11 percent at the beginning of the program.

Over the past 6-8 years, these mother and child health and nutrition programs have evolved from predominantly facility-based food distribution programs to integrated community-based development programs with long-term health and sustainability objectives. The programs have had proven successes in reducing undernutrition among young children in the target population.

The mother and child health and nutrition programs build upon the latest research and promote interventions of proven worth in reducing maternal and child death, as well as combating disease and undernutrition. This includes promotion of exclusive breastfeeding, instruction on appropriate complementary feeding, care and support for the HIV/AIDS infected, and the prevention and treatment of preventable childhood diseases.

It raises consciousness as to the importance of micronutrient consumption and advises on easily adapted improvements in ante-natal care.

The programs predominantly target children under the age of two and their mothers because we know that children under that age are at the greatest risk of becoming undernourished and also receive the greatest benefit from preventative interventions.

A recent analysis of these programs has shown that, on average, they reduced the prevalence of stunting by 2.4 percentage points per year and underweight by 1.9 percentage points per year to the benefit of 6.6 million children. These children will be more educable and productive, less vulnerable to acute malnutrition in disasters and to chronic disease later in life.

Our challenge is to build on the experience of these programs and to bring them to scale so that more families and communities can benefit. While these results are promising, to achieve the goal of halving undernutrition by 2015 will require a concerted effort by the international community in many sectors to achieve measurable and sustainable results.

NEW THINKING ON FAMINE PREVENTION

We should not for a moment forget that the most prominent development failures and highest levels of under-nutrition are to be found in the most fragile, disaster prone countries. I hardly need to remind you that much of the work and resources of the world community is focused on disaster situations that threaten whole countries with famine.

Much of the credit belongs to agencies and individuals right here in this room for taking on the responsibility to feed people and save lives in often insecure and intractable situations.

Two years ago the Standing Committee on Nutrition symposium addressed nutrition in complex emergences. While one might think we can now move on to nutrition in development contexts, I am reminded that underdevelopment and emergencies are intimately interrelated. Poverty, low agricultural productivity, and frequent disasters create a mutually reinforcing cycle of failed development and rising risk of famine.

Nowhere have the dimensions and dynamics of famine been more clearly demonstrated than in Ethiopia. In 2003, the international community provided $1.7 billion in relief resources. The U.S. alone provided over $530 million in food and non-food assistance. Our combined efforts enabled Ethiopia to pull back from the brink of famine, but not without unacceptably high levels of excess child malnutrition and mortality.

I support the Tufts University Famine Center analysis of the situation in Ethiopia. Famine and famine response there fell into an all too familiar pattern. The world community has treated recurring famines in Ethiopia as discrete episodes to be addressed largely by external food assistance. Non-food responses and development processes, such as agricultural production, livelihood erosion, and chronic nutrition deficits were largely unaddressed.

The necessity for multisectoral approaches to food insecurity and famine, perhaps first articulated by Amartya Sen, is a lesson that development practitioners are beginning to implement. We see that the most serious food and nutrition emergencies arise at the end of a chain of failed development processes across sectors, with basic causes grounded in economic injustice and poor governance. Drought and climatic change may push a country into famine. But we must not mistake the immediate cause of famine for more fundamental ones.

It had become clear to the Government of Ethiopia and to the international donor community that business as usual was no longer possible if the cycle of famine was to be broken in that country. A little over a year ago, USAID commissioned a team to work on a Famine Prevention Framework. At the same time, the USAID Mission in Ethiopia worked with a new National Security Coalition, which assembled key ministries of the Government of Ethiopia, civil society groups, and the international donor community, to rethink food security and food assistance for Ethiopia.

Working in conjunction with the Coalition, USAID is now implementing a new multisectoral strategy for drastically reducing famine vulnerability, hunger and poverty in Ethiopia over the next five years. The central tenant of the new approach is precisely that economic, social, and governance strategies must be designed to build resilience at the national, local, and household levels to inevitable future shocks. The goal is to break the cycle of destructive famines by bringing comprehensive changes to Ethiopia necessary for reducing her vulnerability to hunger and poverty.

Its features include:

• A coordinated effort by the international community to assist the Government of Ethiopia to implement the comprehensive economic and governmental reforms requisite to exit the cycle of famine and enter onto the path of development.
• Stimulating small holder agricultural commercialization through policy and institutional changes to increase growth rates by 6 percent by 2006. This includes economic reform and the establishment of a financial infrastructure that can stimulate trade and outlets for its farm production;
• Implementation of a new productive safety net for five million chronically vulnerable people, designed to protect the Ethiopians assets and enhance their human resources in way that will lead to more viable livelihoods;
• As part of the safety net, USAID is designing innovative developmental-relief project models using US Title II resources that will combine emergency and non-emergency resources to increase long-term resilience to future droughts or economic shocks.
• Coordinating health, nutrition, agriculture, and HIV/AID programs to mitigate the devastation that disease is bring to Ethiopian society.
• If these measures are successful, the number of food insecure people could be halved in 10 years, per capita incomes could grow by 50%, and the projected rise of malnutrition - one-third over the next 15 years - could be halted and reversed.

CONCLUSIONS

The hope for making hunger and poverty a thing of the past challenges us to work together. Together, we can develop new and nutritious crops that will address the persistent and debilitating micro-nutrient deficiencies still sapping the potential of billions. In countries, such as Ethiopia we can reduce famine vulnerability with coalitions of government ministries, donors and civil society finding new and creative synergies. In USAID Title II programs we demonstrated what nutritionists have known for decades -and what is a key conclusion of the 5th Report, that integration of sectors in the community, health, agriculture, education, are key to nutritional improvement. Only by integrating our know-how and resources can our challenges be met.

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