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Multiple crises overwhelm emergency food relief agencies
World Report
Multiple crises overwhelm emergency food relief agencies Relief agencies are struggling to meet the demands of multiple pressing humanitarian emergencies worldwide, hampered in part by US politics over food aid. Sam Loewenberg reports. For The Lancet News podcast see http://www.thelancet.com/ lancet-news-audio/
Conflict, climate change, poverty, and underdevelopment have led to a confluence of crises this year that has overwhelmed relief agencies, who have been unable to reach many hundreds of thousands because of conflict and restricted access due to poor roads, heavy rains, and looting. Meanwhile, the USA, the world’s largest food donor, has been hampered by an antiquated, inefficient food delivery system that is now facing political challenges that could deny aid to millions more people. The world is currently facing its biggest refugee crisis since World War 2, with over 51·2 million forcibly displaced people by the end of 2013, according to the UN High Commission on Refugees (UNHCR). That is an increase of 6 million since the previous year, mainly the result of the war in Syria. Funding shortfalls mean that, as of June, a third of refugees in Africa had their rations cut, most by more than 50%.
Famine warnings
Nichole Sobecki/AFP/Getty Images
In May, the US-funded Famine Early Warning Systems Network warned that urgent action was needed in South Sudan to stave off famine in the coming months. An estimated 4 million people are facing
Malnourished children receive treatment at a hospital in South Sudan
482
emergency levels of food insecurity, and 900 000 of those are children younger than 5 years who will require treatment for moderate to severe malnutrition, according to the World Food Programme (WFP). Due to the continuing conflict, by July, the humanitarian community has been able to only help about 10% of the children needing assistance. Relief agencies say that they have received less than half of the US$1·8 billion needed for humanitarian operations.
“‘The number of crises around the world is far outpacing the level of funding for humanitarian operations...’” Meanwhile, in Somalia, aid agencies warned of a repeat of the famine of 2011, which took the lives of an estimated 260 000 people. “All the signs we saw before 2011’s severe famine are here—reduced humanitarian access, insecurity, increasing food prices, delayed rains, and rapidly worsening malnutrition among children”, said John Ging of the UN Office for the Coordination of Humanitarian Affairs in a statement last month. The current crisis affects 857 000 people, according to the UN, which said that its $933 million aid request is only 25% funded. “Today, 50 000 children are severely malnourished, including many at risk of death within weeks if they do not get the treatment they need”, said Ging. In the Central Africa Republic, which is riven with armed conflict, 1·6 million people are in “urgent need” of food aid, according to the WFP. “60% of households reported having exhausted their food stocks in December, 2013, and 90% said they consumed just one meal a day”, according to a WFP assessment.
Food ration cuts The effect is being felt on the ground, as major funding shortfalls hold up relief efforts. Earlier this month, the heads of the WFP and UNHCR announced cuts in food assistance for nearly 800 000 people in Africa due to funding shortfalls of $225 million. Already, rations have been reduced by 50–60% for nearly 450 000 refugees in the Central African Republic, Chad, and South Sudan. Hundreds of thousands of refugees in Liberia, Burkina Faso, Mozambique, Ghana, Mauritania, and Uganda have seen further food ration cuts. “The number of crises around the world is far outpacing the level of funding for humanitarian operations, and vulnerable refugees in critical operations are falling through the cracks”, said High Commissioner for Refugees António Guterres in a statement to donor country representatives in Geneva. Among the hardest hit are the 300 000 refugees from South Sudan and Central African Republic, now sheltering in Chad, who have had their daily ration of 2100 kilocalories reduced by 60% to just 850 kilocalories per day. Such steep cuts can have devastating consequences for already vulnerable refugees, particularly for small children, whose physical and mental development may be permanently affected. Vulnerability to disease is also substantially increased in undernourished children, who may be five times more likely to die from diarrhoea, according to the report jointly released by WFP and UNHCR. Conditions in the refugee camps were poor even before the current funding problems. The report cites nutritional surveys between 2011 and 2013 showing “critical levels” of acute malnutrition, stunting, and anaemia. www.thelancet.com Vol 384 August 9, 2014
More than 85% of the camps surveyed had stunting levels over 20%. Faced with the additional cuts in provisions, the agencies warn that refugees are engaging in “negative coping strategies”, such as dropping out of school to seek work, increased domestic violence, and “survival sex” by women and girls seeking to raise money for food.
Cold War era system In the face of the onslaught of catastrophes, the USA, by far the world’s largest food donor at about $2·3 billion annually, is being hamstrung by an antiquated food aid system that is widely agreed to be both costly and inefficient. Efforts to reform the Cold War era system— which requires that the bulk of food is purchased domestically and shipped on US flagged vessels—have been hampered by entrenched business interests and budget cuts. The US Agency for International Development’s (USAID) food aid programme “is under stress to be able to contribute to the levels that we would like to be able to contribute to allow our essential partners to do the life saving work that they need to do”, Matthew Nims, the deputy director of USAID’s Office of Food for Peace told The Lancet. The crises are expected to get worse in the coming months, he said. “We are nervous about this, this is a difficult time for us.” Things could get even tougher if a provision slipped into the Coast Guard and Maritime Transportation Act passed by the House goes through. It would raise the requirement that US food aid be shipped on US-flagged vessels from 50% up to 75%, reinstating what was essentially a Cold War subsidy to full strength. The current system raises shipping costs by 46%, according to a Cornell University study, and food can take 4–6 months to arrive. The measure to increase the domestic shipping requirement is being fought by the Obama Administration, which says that the cumulative effect of a www.thelancet.com Vol 384 August 9, 2014
potential increase, when coupled with new budget cuts eliminating support for the shipping costs, would mean a total loss of $150 million to food aid, which translates to an estimated 4 million fewer people receiving assistance. The shipping industry has mounted a lobbying campaign in favour of the higher requirement for US-flagged shipping, arguing that it helps both US national security and jobs. However, an analysis by the Defense Department contradicts the shipping industry’s claims, saying that lowering the shipping requirement would not affect military readiness or substantially affect jobs: “the reform proposal may affect 8–11 vessels—all non-militarily useful— and roughly 360 to 495 mariners.” Meanwhile, the food aid system has again missed a chance for reform, as the once-every 5 years Farm Bill that controls it has kept it unchanged.
“...the USA, by far the world’s largest food donor...is being hamstrung by an antiquated food aid system that is widely agreed to be both costly and inefficient.”
Future change A proposal for change in future years has come in the form of a bill introduced in the Senate in June that seeks to reform the current system, which hasn’t been substantially changed since it began in 1954. The bill would move food aid authority from the agriculture budget (the Farm Bill) to the foreign assistance budget, and end the requirements for monetisation (the sale of commodities overseas to fund development activities) and US-food purchase and shipping. The bill, sponsored by Bob Corker, the top Republican on the Foreign Affairs committee, and Democrat Chris Coons, the chairman of the Africa subcommmittee, would result in an additional 79 million people receiving food if enacted, claim supporters. But
Fred Dufour/AFP/Getty Images
World Report
US food aid arrives in the Central African Republic
they also acknowledge that it will be a challenge to get it enacted. “The legislation we proposed is setting a marker. The point of introducing the Food for Peace Reform Act was to have, for the first time, legislation introduced that would carry out full reforms instead of the piecemeal reforms that barely make it into law each year the Farm Bill and Agriculture Appropriations bills are passed”, said an aide to Senator Corker. The USA is not alone in playing politics with its humanitarian aid: the European Union’s (EU) aid programmes are also heavily influenced by domestic politics and strategic and historical interests, according to a recent internal EU analysis. A report commissioned by the evaluation section of the EU’s humanitarian aid arm found that “funding decisions were still ultimately determined by national strategic interests. At the end of the day donor staff are still part of government and are ultimately accountable to politicians. Political objectives will ultimately hold more sway than purely humanitarian objectives. For example, different criteria may apply to aid for recipient countries where there are strong historical ties with the donor.” The report adds: “Transparent resource allocations based solely on need is rarely achieved.”
Sam Loewenberg 483
Multiple crises overwhelm emergency food relief agencies Relief agencies are struggling to meet the demands of multiple pressing humanitarian emergencies worldwide, hampered in part by US politics over food aid. Sam Loewenberg reports. For The Lancet News podcast see http://www.thelancet.com/ lancet-news-audio/
Conflict, climate change, poverty, and underdevelopment have led to a confluence of crises this year that has overwhelmed relief agencies, who have been unable to reach many hundreds of thousands because of conflict and restricted access due to poor roads, heavy rains, and looting. Meanwhile, the USA, the world’s largest food donor, has been hampered by an antiquated, inefficient food delivery system that is now facing political challenges that could deny aid to millions more people. The world is currently facing its biggest refugee crisis since World War 2, with over 51·2 million forcibly displaced people by the end of 2013, according to the UN High Commission on Refugees (UNHCR). That is an increase of 6 million since the previous year, mainly the result of the war in Syria. Funding shortfalls mean that, as of June, a third of refugees in Africa had their rations cut, most by more than 50%.
Famine warnings
Nichole Sobecki/AFP/Getty Images
In May, the US-funded Famine Early Warning Systems Network warned that urgent action was needed in South Sudan to stave off famine in the coming months. An estimated 4 million people are facing
Malnourished children receive treatment at a hospital in South Sudan
482
emergency levels of food insecurity, and 900 000 of those are children younger than 5 years who will require treatment for moderate to severe malnutrition, according to the World Food Programme (WFP). Due to the continuing conflict, by July, the humanitarian community has been able to only help about 10% of the children needing assistance. Relief agencies say that they have received less than half of the US$1·8 billion needed for humanitarian operations.
“‘The number of crises around the world is far outpacing the level of funding for humanitarian operations...’” Meanwhile, in Somalia, aid agencies warned of a repeat of the famine of 2011, which took the lives of an estimated 260 000 people. “All the signs we saw before 2011’s severe famine are here—reduced humanitarian access, insecurity, increasing food prices, delayed rains, and rapidly worsening malnutrition among children”, said John Ging of the UN Office for the Coordination of Humanitarian Affairs in a statement last month. The current crisis affects 857 000 people, according to the UN, which said that its $933 million aid request is only 25% funded. “Today, 50 000 children are severely malnourished, including many at risk of death within weeks if they do not get the treatment they need”, said Ging. In the Central Africa Republic, which is riven with armed conflict, 1·6 million people are in “urgent need” of food aid, according to the WFP. “60% of households reported having exhausted their food stocks in December, 2013, and 90% said they consumed just one meal a day”, according to a WFP assessment.
Food ration cuts The effect is being felt on the ground, as major funding shortfalls hold up relief efforts. Earlier this month, the heads of the WFP and UNHCR announced cuts in food assistance for nearly 800 000 people in Africa due to funding shortfalls of $225 million. Already, rations have been reduced by 50–60% for nearly 450 000 refugees in the Central African Republic, Chad, and South Sudan. Hundreds of thousands of refugees in Liberia, Burkina Faso, Mozambique, Ghana, Mauritania, and Uganda have seen further food ration cuts. “The number of crises around the world is far outpacing the level of funding for humanitarian operations, and vulnerable refugees in critical operations are falling through the cracks”, said High Commissioner for Refugees António Guterres in a statement to donor country representatives in Geneva. Among the hardest hit are the 300 000 refugees from South Sudan and Central African Republic, now sheltering in Chad, who have had their daily ration of 2100 kilocalories reduced by 60% to just 850 kilocalories per day. Such steep cuts can have devastating consequences for already vulnerable refugees, particularly for small children, whose physical and mental development may be permanently affected. Vulnerability to disease is also substantially increased in undernourished children, who may be five times more likely to die from diarrhoea, according to the report jointly released by WFP and UNHCR. Conditions in the refugee camps were poor even before the current funding problems. The report cites nutritional surveys between 2011 and 2013 showing “critical levels” of acute malnutrition, stunting, and anaemia. www.thelancet.com Vol 384 August 9, 2014
More than 85% of the camps surveyed had stunting levels over 20%. Faced with the additional cuts in provisions, the agencies warn that refugees are engaging in “negative coping strategies”, such as dropping out of school to seek work, increased domestic violence, and “survival sex” by women and girls seeking to raise money for food.
Cold War era system In the face of the onslaught of catastrophes, the USA, by far the world’s largest food donor at about $2·3 billion annually, is being hamstrung by an antiquated food aid system that is widely agreed to be both costly and inefficient. Efforts to reform the Cold War era system— which requires that the bulk of food is purchased domestically and shipped on US flagged vessels—have been hampered by entrenched business interests and budget cuts. The US Agency for International Development’s (USAID) food aid programme “is under stress to be able to contribute to the levels that we would like to be able to contribute to allow our essential partners to do the life saving work that they need to do”, Matthew Nims, the deputy director of USAID’s Office of Food for Peace told The Lancet. The crises are expected to get worse in the coming months, he said. “We are nervous about this, this is a difficult time for us.” Things could get even tougher if a provision slipped into the Coast Guard and Maritime Transportation Act passed by the House goes through. It would raise the requirement that US food aid be shipped on US-flagged vessels from 50% up to 75%, reinstating what was essentially a Cold War subsidy to full strength. The current system raises shipping costs by 46%, according to a Cornell University study, and food can take 4–6 months to arrive. The measure to increase the domestic shipping requirement is being fought by the Obama Administration, which says that the cumulative effect of a www.thelancet.com Vol 384 August 9, 2014
potential increase, when coupled with new budget cuts eliminating support for the shipping costs, would mean a total loss of $150 million to food aid, which translates to an estimated 4 million fewer people receiving assistance. The shipping industry has mounted a lobbying campaign in favour of the higher requirement for US-flagged shipping, arguing that it helps both US national security and jobs. However, an analysis by the Defense Department contradicts the shipping industry’s claims, saying that lowering the shipping requirement would not affect military readiness or substantially affect jobs: “the reform proposal may affect 8–11 vessels—all non-militarily useful— and roughly 360 to 495 mariners.” Meanwhile, the food aid system has again missed a chance for reform, as the once-every 5 years Farm Bill that controls it has kept it unchanged.
“...the USA, by far the world’s largest food donor...is being hamstrung by an antiquated food aid system that is widely agreed to be both costly and inefficient.”
Future change A proposal for change in future years has come in the form of a bill introduced in the Senate in June that seeks to reform the current system, which hasn’t been substantially changed since it began in 1954. The bill would move food aid authority from the agriculture budget (the Farm Bill) to the foreign assistance budget, and end the requirements for monetisation (the sale of commodities overseas to fund development activities) and US-food purchase and shipping. The bill, sponsored by Bob Corker, the top Republican on the Foreign Affairs committee, and Democrat Chris Coons, the chairman of the Africa subcommmittee, would result in an additional 79 million people receiving food if enacted, claim supporters. But
Fred Dufour/AFP/Getty Images
World Report
US food aid arrives in the Central African Republic
they also acknowledge that it will be a challenge to get it enacted. “The legislation we proposed is setting a marker. The point of introducing the Food for Peace Reform Act was to have, for the first time, legislation introduced that would carry out full reforms instead of the piecemeal reforms that barely make it into law each year the Farm Bill and Agriculture Appropriations bills are passed”, said an aide to Senator Corker. The USA is not alone in playing politics with its humanitarian aid: the European Union’s (EU) aid programmes are also heavily influenced by domestic politics and strategic and historical interests, according to a recent internal EU analysis. A report commissioned by the evaluation section of the EU’s humanitarian aid arm found that “funding decisions were still ultimately determined by national strategic interests. At the end of the day donor staff are still part of government and are ultimately accountable to politicians. Political objectives will ultimately hold more sway than purely humanitarian objectives. For example, different criteria may apply to aid for recipient countries where there are strong historical ties with the donor.” The report adds: “Transparent resource allocations based solely on need is rarely achieved.”
Sam Loewenberg 483