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Where are we at mid-term for MDG 1?

Alvaro Matida, Executive Secretary

Brazilian Collective Health Association – Abrasco

Those who are hungry have hurry!¹

(Betinho 1935–1997)¹

In a recent survey, the legal office of the UN/Food and Agriculture Organization (FAO), reviewing 203 national constitutions worldwide, found out that only 22 of them made direct mention of the right to food for all the population. Even assuming that 114 national constitutions in this survey recognize the right to social security, only 23 out of the total, refer to the State's responsibility for food safety. Furthermore, just 13 make direct reference to the right to health, which could include the right to food.²

This evidence is even more controversial if we consider that by the last 10 December we celebrated the 60th anniversary of the Universal Declaration of the Human Rights (UDHR) and in this particular scenario, its 25th article reads

1. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care, and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control.
2. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.³

What is stated in the 25th article of the UDHR had been revisited and ratified worldwide by innumerous declarations and calls for action, including the resolution 2200A (XXI) of 16 December 1966 by the International Covenant on Economic, Social, and Cultural Rights – UN⁴; the Rio Declaration on Environment and Development (Rio de Janeiro, June 1992)⁵ and the adoption of the 21 Agenda (UN General Assembly, June 1997)⁶; the Rome Declaration on World Food Security (13 November 1996)⁷ and its further implementation plan and the FAO World Food Summit in November 1996,⁸ where the Heads of State and Government gathered in Rome, reaffirmed the right of everyone to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger.

By 18 September 2000, in New York, the UN General Assembly adopted the UN Millennium Declaration, committing their nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets – with a deadline of 2015 – that have become known as the Millennium Development Goals.⁹

Where are we?

Hunger is a geographically universal phenomenon, which has disastrous consequences no continent can escape from. Every land belonging to men has been, until today, a land of hunger. Scientific research carried out worldwide has acknowledged the fact that two thirds of the world's population suffer, either endemically or epidemically, from the crushing effects of hunger.
(Josué de Castro (1908–1973))

Since 2005, when final recommendations to the Secretary General of the UN – Investing in Development: A practical plan to achieve the MDG,¹⁰ was approved strategies have tried to involve governments and international organizations in partnerships. Inside and outside the UN, a monitoring and evaluation system has emerged, with reports about the eight goals coordinated and published by the Statistics Division of the UN Department of Economic and Social Affairs.

Even considering the existing criticism and controversies related to the theories, methodologies, and criteria to measure and following up hunger toward the globe, ... Still more deadly then severe and complete hunger is the phenomenon of chronic or partial hunger, because of its social and economical effects which silently undermine countless populations around the world.¹¹Josué de Castro (1908–1973)

Let us assume that the statistics that we have on hand are sufficiently robust to highlight the inequalities and inequities that we are facing today.

According to the MDG 2008 Report,¹² about one out of every four children in developing countries is considered to be underweight and at risk of having a future blighted by the long-term effects of undernourishment.

The last UN – FAO 2006 Report on 'the State of Food Insecurity in the World'¹³ estimates that 854 million people worldwide are undernourished; most of them – 820 million – live in developing countries. Assuming the estimated world population of 6.6 billion, this means that more than 12 individuals in each hundred suffer from chronic hunger and that 96 per cent of all these citizens live in the developing world, especially in Sub-Saharan Africa.

Using the 2008's adjusted parameters of the World Banks' Development Research Group and reviewing the poverty statistics,¹⁴ 1.4 billion people, or one quarter of the population of the developing world, is staying below the international poverty line of US$1.25 a day in 2005 prices. Twenty-five years earlier there were 1.9 billion poor, or one half of the population. Since then the poverty rate in East Asia fell from almost 80 per cent to under 20 per cent. It seems that the developing world as a whole is clearly still on track to attaining the first MDG of halving the 1990s 'extreme poverty' rate by 2015. However, it is also clear that China attained the MDG early in the millennium, almost 15 years ahead of the target date, whereas Sub-Saharan Africa stays at around 50 per cent of the target, though continuing so far with trends of progress since the mid 1990s. Chen and Ravallion¹⁴ in 2008 come to the conclusion ' ... that the developing world outside China will not attain the MDG without a higher rate of poverty reduction than we have seen over 1981–2005'. Moreover, the 2009 UN Executive Summary of the Global Report on Forced Labor – The Cost of Coercion – launched in May 2009,¹⁵ estimates that the total financial cost of coercion to the workers affected – excluding the victims of forced commercial sexual exploitation – is approximately $ 21 billion!

So what?

As a result of high food prices, the number of hungry people increased by about 50 million in 2007.
(FAO Director-General Jacques Diouf, Rome/Brussels, 3 July 2008)

The UN 2005 Report¹⁶ referring to the first MDG maintains that ' ... growing populations and poor agricultural productivity have been the main reasons for food shortages in these regions (Sub-Saharan Africa and Southern Asia). To stay short, this analysis is too partial, narrow, and simplistic, contradicting the values, and principles advocated by the UN institutions themselves and their partnerships. There is the real danger that the progress so far achieved comes to a halt or even may be reverted as is indicated by the statement of Jaques Diouf cited above.

Taking the recent past, especially the years 2008 and 2009, we must add that these new times have been marked by events of singular turbulence and unpredictable impact on global policies, particularly on those related to international public health. Recent and growing crises on fuel, food, and finance threaten the enormous efforts that we have been experiencing globally: from agricultural programs involving rural families to local and regional improvement of good governance; from local subsistence economic initiatives to sustainable development programs to reduce the impact of hunger, poverty, social exclusion, and injustice. Furthermore, the climate change and its repercussions have been deteriorating the living conditions of billions of people worldwide, especially again in developing countries. As stated by Margaret Chan, WHO Director General, in her keynote at the 12th World Congress on Public Health (Istanbul, May 2009)¹⁷ ... They (fuel, food and financial crises, and the climate changes) are not random events. Instead, they are the result of massive failures in the international systems that govern the way nations and their populations interact. In short: they are the result of bad policies.

Now, more than at any time, the commitments expressed by 189 world leaders when adopting, in 2000, the 8-goal action plan, must be strongly reiterated. Using the words addressed by Paulo Buss – president of the World Federation of Public Health Associations – at the opening ceremony of the 12th World Congress on Public Health, Istanbul, May 2009¹⁸ ... the global imbalances are morally unacceptable and politically unsustainable. I must note the unfairness of key global rules on trade and finance and their asymmetric effects on rich and poor countries, as well as the failure of current international policies to respond adequately to the challenges posed by globalization.

Hunger and poverty are both unacceptable and immoral! Our times bring together new and old challenges, opportunities, and commitments highlighted in the Istanbul Declaration on Health: the First Human Right.¹⁹ As citizens of this only-one-world, let us embrace Margaret Chan's encouragement¹⁷ ... let me say this to all my colleagues in public health. Stay steadfast. Steer steady through this turbulent sea of perils, old and new. After all, public health has always been on course.

References

1. De Souza Betinho,H. (1935–1997). To learn more about this Brazilian social scientist access, http://en.wikipedia.org/wiki/Herbert_de_Souza.
2. FAO – UN. (2006) The right to food guidelines information papers and case studies. Italy: FAO-Rome, http://www.fao.org/docs/eims/upload/214344/RtFG_Eng_draft_03.pdf, accessed 19 May 2009.
3. Universal Declaration of the Human Rights. (1948) Geneva, Switzerland, December, http://www.un.org/en/documents/udhr/, accessed 19 May 2009.
4. UN. (1966) Resolution 2200A (XXI), International covenant on economic, social and cultural rights, Geneva, Switzerland December, http://www.unhchr.ch/html/menu3/b/a_cescr.htm, accessed 19 May 2009.
5. UN. (1992) Rio Declaration on Environment and Development, Rio de Janeiro, Brazil, June, http://www.un.org/documents/ga/conf151/aconf15126-1annex1.htm, accessed 19 May 2009.
6. UN. (1977) Resolution adopting the 21 Agenda on Environment and Development, Geneva Switzerland, June, http://www.un.org/documents/ga/res/spec/aress19-2.htm, accessed 19 May 2009.
7. FAO – UN. (1996) Rome Declaration on World Food Security, Rome, Italy, 13 November, http://www.fao.org/docrep/003/w3613e/w3613e00.HTM, accessed 19 May 2009.
8. FAO – UN. (1996) World Food Summit, Rome, Italy, November, http://www.fao.org/DOCREP/W9990E/w9990e02.htm#TopOfPage, accessed 19 May 2009.
9. UN. (2000) Millennium Development Goals, New York, 18 September, http://www.un.org/millennium/summit.htm, accessed 19 May 2009.
10. UN. (2005) Investing in development: A practical plan to achieve the MDG, http://www.unmillenniumproject.org/reports/index.htm, accessed 19 May 2009.
11. Castro, J. (1946) Geography of hunger. New York, 1952 Editora O Cruzeiro, Rio de Janeiro, 1946. Última Edição – Gryphus, RJ, 1992. Prêmio José Veríssimo da Academia Brasileira de Letras.
12. United Nations. (2008) Millennium Development Goals 2008 Report, http://www.un.org/millenniumgoals/2008highlevel/pdf/newsroom/mdg%20reports/MDG_Report_2008_ENGLISH.pdf, accessed 19 May 2009.
13. Food and Agriculture Organization – FAO. (2006) Report on 'The state of food insecurity in the world', http://www.fao.org/docrep/009/a0750e/a0750e00.HTM, accessed 19 May 2009.
14. Chen, S. and Ravallion, M. (2008) The developing world is poorer than we thought, but no less successful in the fight against poverty, http://www-wds.worldbank.org/external/default/WDSContentServer/
    IW3P/IB/2008/08/26/000158349_20080826113239/Rendered/PDF/WPS4703.pdf, accessed 19 May 2009.
15. United Nation. (2009) Executive Summary of the Global Report on Forced Labor – The Cost of Coercion, http://www.ilo.org/global/About_the_ILO/Media_and_public_information/Press_releases/
    lang--en/docName--WCMS_106200/index.htm, accessed 19 May 2009.
16. United Nations. (2005) Millennium Development Goal 2005 Report, p. 8, http://www.un.org/summit2005/MDGBook.pdf, accessed 19 May 2009.
17. Chan, M. (2009) Keynote address at the 12th World Congress on Public Health, Istanbul, Turkey, 27 May, http://www.who.int/dg/speeches/2009/steadfast_midst_perils_20090428/en/, accessed 19 May 2009.
18. Buss, P. (2009) Keynote address at the 12th World Congress on Public Health, Istanbul, Turkey, 27 May.
19. World Federation of Public Health Associations – WFPHA. (2009) Istanbul declaration on Health: The First Human Right, Istanbul, Turkey, May, http://www.wfpha.org/2009_Turkey/Istanbul%20Declaration%20and%20annex%20(3).pdf, accessed 19 May 2009.