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Food and Nutrition Security and

the Important Role of


Agricultural Development
Matin Qaim
Keynote at the KfW Development Finance Forum
9-10 July 2015, Frankfurt

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and Rural Development

Overview
Part I: The Problem
1. The Triple Burden of Malnutrition
2. Can We Stop Worrying About the Quantity of Food Production?

Part II: Possible Solutions


3. Direct Nutrition Interventions
4. Promoting Pro-Poor Growth
5. Agriculture-Nutrition Linkages

Department of Agricultural Economics


and Rural Development

PAS Study Week 2009

Worldwide around 795 million people are


chronically undernourished
Africa
29%

Rich countries
2%
Latin America
4%

Asia
65%

Source: FAO (2015).

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Recent trends
Progress has been made:
o Number of undernourished down from 1 billion in 1990
o Proportion decreased from 23% to 13%
However, progress is too slow and geographically uneven
In Sub-Sahara Africa, 23% of the population remain
undernourished
Globally, 161 million children under age 5 are stunted
(25%); 51 million are wasted (8%)
Even in economically fast-growing countries like India,
childhood undernutrition remains high

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and Rural Development

PAS Study Week 2009

Micronutrient malnutrition is even more


widespread (hidden hunger)
Sufficient

Deficient

Billion people

6
5
4
3
2
1
0
Calories

Iron

Zinc

Iodine

Vitamin A

Sources: WHO (2015), FAO (2015), IFPRI (2014).

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and Rural Development

PAS Study Week 2009

Africa

Asia

America

Europe

Prevalence of overweight and obesity


Germany
England
France
Greece
Poland
Brazil
Canada
Mexico
USA
Venezuela
China
India
Indonesia
Iran
Thailand
Egypt
Ethiopia
Kenya
Liberia
South Africa

Overweight
Obese

10

Source: IASO (2013).

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20

30
40
50
Percent of adult population

60

70

80

Health consequences of undernutrition


Infectious diseases, child mortality, impaired physical and
mental development, lost work productivity and quality of live
Causes of child mortality
Proportion due to undernutrition

Total

Other infectious
diseases
Pneumonia
Diarrhea
Neonatal disorders
0

10

15

20

25

30

35

% of child deaths
Source: Black et al. (2013).

Department of Agricultural Economics


and Rural Development

PAS Study Week 2009

Top-20 risk factors for global health burden


High blood pressure
Tobacco smoking
Alcohol use
Air pollution (in-house)
Diet low in fruits
High body mass index
High plasma glucose
Childhood underweight
Air pollution (outdoor)
Low physical activity
Diet high in sodium
Diet low in nuts and seeds
Iron deficiency
Suboptimal breastfeeding
High cholesterol
Diet low in whole grains
Diet low in vegetables
Diet low in omega-3
Drug use
Occupational injuries

0%

In many developing
countries, childhood
underweight and
micronutrient
deficiencies are still
among the top-5 risk
factors

Source: Lim et al. (2012).

1%

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2%

3%

4%

5%

PAS Study Week 2009

6%

7%

8%
8

2. Can We Stop Worrying About the


Quantity of Food Production?
The world currently has enough food, so that nobody would
have to go hungry.
With more equal access, every person could have a diet
with >2500 kcal per day.
This leads many to conclude that hunger and undernutrition
today are only distribution problems.
The recognition that malnutrition is not primarily about
calories but more about dietary quality contributes to the
notion that production increases are not required anymore.
However, a focus on dietary quality cannot replace
continued productivity growth. Both are required.
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PAS Study Week 2009

Developments over time


350
Source: FAO (2014).

300

Index

Food production
250
200

Population
150

Arable land
100
1961

1968

1975

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1982

1989

1996

2003

2010
10

Development of grain prices (1960-2000)


450
400
Maize

350

Wheat

US$/t

300
250
200
150
100
50
0
1960

1965

1970

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1975

1980

1985

1990

1995

2000
11

Price developments (2000-2015)


450
400
350

Maize
Wheat

300

200
150
100
50
Source: EU Commission (2015).

Jan-00
Jul
Jan-01
Jul
Jan-02
Jul
Jan-03
Jul
Jan-04
Jul
Jan-05
Jul
Jan-06
Jul
Jan-07
Jul
Jan-08
Jul
Jan-09
Jul
Jan-10
Jul
Jan-11
Jul
Jan-12
Jul
Jan-13
Jul
Jan-14
Jul
Jan-15

US$/t

250

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12

Challenges until 2050


Climate change

Global cereal yield (t/ha)

Demand
projection

Resource
scarcity

6
5
4
3

Investment in
agricultural R&D

Investment in
rural
infrastructure

1
0
1960 1970 1980 1990 2000 2010 2020 2030 2040 2050
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Part II: Possible Solutions


3. Direct Nutrition Interventions
4. Promoting Pro-Poor Growth
5. Agriculture-Nutrition Linkages

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3. Direct Nutrition Interventions


Direct nutrition interventions are often
required to break the vicious circle
Women/ children particular target groups
Common interventions include:
o
o
o
o

Micronutrient supplementation
Complementary feeding
Breastfeeding programs
Nutrition and health education

Long-term social payoff can be substantial


Scaling up investments by $10 billion per
year could reduce child mortality by 15%
and stunting by 20% (Bhutta et al. 2013)
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DRC
Burundi
Liberia
Niger
Malawi
Togo
Mozambique
Mali
Ethiopia
Burkina Faso
Nepal
Rwanda
Yemen
Uganda
Chad
Benin
Ghana
Zambia
Bangladesh
Kenya
Senegal
Cameroon
Sudan
Nigeria
Pakistan
India
Vietnam
Philippines
Indonesia
South Africa
Sri Lanka

Benefit-cost ratios of nutrition interventions

60

20
Sources: Hoddinott et al. (2013),
IFPRI (2014).

50

40

30

Median B/C ratio: 16

10

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4. Promoting Pro-Poor Growth


Proportion of people undernourished

60

Relationship between mean income and


undernutrition

50
40
30
20

Source: Data from FAO (2015) and World Bank (2015).

10
0
0

5.000

10.000

15.000

GNI per capita (US$)


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Investments in rural infrastructure


promote pro-poor growth
Irrigation

Example from China

Electricity

Source: Fan et al. (2004).

Telephone
Road infrastructure
Agricultural research and technology
Education
-10

-8
-6
-4
-2
Reduction in number of poor per 1000$ investment

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5. Agriculture-Nutrition Linkages
The focus on a few major cereal crops during the green
revolution has helped to keep staple foods affordable for
consumers and to lift many farm families out of poverty
However, this focus has also narrowed down dietary
diversity, causing other types of nutrition problems (and loss
of biodiversity)
Nutrition-sensitive agricultural systems:
o Broadened focus in agricultural R&D
o Reduce policy disincentives for more diverse production (e.g.,
prices, subsidies, marketing policies)
o Promote markets for neglected crop/animal products

More diverse food systems can help reduce triple burden of


malnutrition (incl. obesity)
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Production diversity and dietary diversity


Dietary diversity is a good indicator for food security and
micronutrient status
Many of the undernourished are smallholder farmers
Common assumption: promoting production diversity on
smallholder farms improves household nutrition
Little empirical evidence to support this assumption
Smallholders are not pure subsistence producers; market
transactions make relationship more complex
o Production diversity may be associated with foregone
income benefits from specialization
o Role of off-farm income
o Who controls different types of incomes (gender)?
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Factors influencing dietary diversity in


smallholder households
Regression results (% interpretation)
Pooled
(n=8230)

Indonesia
(n=674)

Kenya
(n=397)

Ethiopia
(n=2045)

Malawi
(n=5114)

Production diversity

0.9***

5.4***

0.3

0.2

1.5***

PD squared

-0.01*

-0.7***

0.01

0.01

-0.03**

Market access

4.5***

--

--

4.2*

4.7***

Off-farm income

3.9***

-0.9

5.9**

7.3**

8.3***

PD X Market access

-0.5***

--

--

-0.4**

-0.6***

The dependent variable is the household dietary diversity score, including 12 food groups. Production diversity is a
count of all crop/livestock species produced. Not all variables shown for brevity. *** p<0.01; ** p<0.05; * p<0.1

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Lessons learned
1. Production diversity helps to improve dietary quality in some
situations, but not in all (adjust common assumption)
2. Improving market access often seems to be more important
for smallholder nutrition (infrastructure, institutions)
Research challenges
There are no one-size-fits all solutions for making
agriculture more nutrition-sensitive
More research to better understand agriculture-nutrition
linkages in particular situations (new methods)

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Role of agricultural technology


Technology can improve nutrition in smallholder households
through food production and income pathways
Even non-food cash crops can improve dietary quality
Effect of new seed technology
for cotton in India
(panel of 530 smallholder households)

Per capita
consumption

Calories

Iron

Zinc

Vitamin A

+5.1%

+4.6%

+4.5%

+9.6%

Source: Qaim and Kouser (2013).

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Biofortification
Many interesting R&D projects
underway in various staple foods
One of the first biofortified crops
adopted so far is orange-fleshed
sweetpotato (OFSP)
Recent study of 1300 children in Mozambique showed that
OFSP program reduced diarrhea prevalence by 11.4%
(Jones and De Brauw 2015)
Ex ante studies for biofortified rice, wheat, cassava, and
other crops show that these technologies can help reduce
the health burden of micronutrient malnutrition in a costeffective way (Qaim et al. 2007; Meenakshi et al. 2010)
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Role of improved market access


Effect of sustainability certification for coffee in Uganda
(study with 420 smallholder households)

Per capita
consumption

Calories

Iron

Zinc

Vitamin A

+19%

+35%

+48%

+37%

Source: Chiputwa and Qaim (2015).

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Gendered control of production and revenue


Sustainability certification includes components to strengthen
womens roles (awareness, training, payment modalities)

Share of households

100%
80%
60%

Joint
Female
Male

40%
20%
0%
Certified

Non-certified

Coffee production

Certified

Non-certified

Coffee revenue

Source: Chiputwa and Qaim (2015).

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Nutrition effects of improved market access


(conceptual pathways)
Market access

Household
income

Farm
specialization

Gender roles
within
household

Economic
access to food

Availability of
homeproduced foods

Food sales and


purchase
decisions

Household nutrition

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Vegetable farmers in Kenya


Contracts with supermarkets
(study with 400 smallholder households)

Supermarket contracts: income


Calories

Iron

vegetables
Zinc

male control
Vitamin A

Income
Specialization on
vegetables
Male control of
revenue
Source: Chege, Andersson, Qaim (2015).

Combined contract effect on nutrition is positive, but it could be


even more positive with a more gender-sensitive approach
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Conclusion
Undernutrition remains a problem with substantial human
and economic costs
Problem much broader than calories, but food quantity
challenge must still be kept in mind
Investments in agriculture and beyond
Nutrition-sensitive agriculture and food systems:
o
o
o
o
o

Focus on small farm sector


Adjust simplistic assumptions
Improving market access (infrastructure, institutions)
Research to better understand agriculture-nutrition linkages
Cooperation across communities, not only in research, but also
in program design (e.g., use agricultural extension service to
deliver nutrition/health education)

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