Escolar Documentos
Profissional Documentos
Cultura Documentos
Health
Revision Notes
Paper 2
Syllabus
Health is defined by The World Health Organisation as ‘a state of complete physical, mental and social well-being’.
Food miles: A measure of the distance that food travels from its source to the consumer. This can be given either in units of
actual distance or of energy consumed during transport.
HALE: Health-adjusted life expectancy, based on life expectancy at birth but including an adjustment for time spent in poor
health (due to disease and/or injury). It is the equivalent number of years in full health that a newborn can expect to live, based
on current rates of ill health and mortality.
Transnational corporation (TNC): A firm that owns or controls productive operations in more than one country through foreign
direct investment.
Life expectancy - The average number of years a person born today would be expected to live given constant mortality
conditions.
Infant Mortality Rate - The number of infant deaths – deaths of children below 1 year old – per 1000 live births per year
Calorie Intake - The amount of energy intake from food per person per day. Measured in kilocalories per person per day
Access to safe drinking water - Where the source of water is 1km from its place of use and can reliably provide 20 liters of
water per member of the household. The water must meet the World Health Organization or national standards for drinking
water quality.
Access to health services - Access to health refers to the number of healthcare facilities per 10 000 people or healthcare
expenditure per capita.
Malnutrition - A state of poor nutrition. This usually results from a deficiency of proteins, energy or minerals. May lead to
one of a range of diseases depending on the particular nature of the malnutrition.
Temporary hunger - Hunger is both a state where there is a desire for food and an absence of food. This is a short term
need for food, triggered by physiological responses caused by food deprivation.
Chronic hunger - A state where the desire for food becomes extreme, due to prolonged food deprivation, to the point
where normal bodily functions begin to be affected.
Famine - Famine is determined by the United Nations, and is a ‘legal’ definition. In this respect it is similar to the definition
of a pandemic: certain numerical conditions need to be met. The recent famine in Somalia in 2011 was the first ‘real’ famine for
some time. We will look in more detail at this event later in the unit. Famine is defined technically as: “a situation where acute
malnutrition rates among children exceed 30%, more than 2 people per 10 000 die per day, and people are not able to access
food and other basic necessities...”
Endemic: A disease that occurs frequently in a specific geographic location or within a species.
E.g. how HIV/AIDS is endemic in Sub-Saharan Africa, avian flu is largely endemic to birds and certain strains (e.g. H5N1)
are endemic to humans
Superbug: A strain of bacteria that has become resistant to normally used antibiotics
E.g. Methicilin resistant Staph aureus (MRSA) and extensively drug resistant tuberculosis (XDR TB), which is resistant to
drugs such as isoniazid
Re-emergent: a disease that had previously decreased in incidence due to being controlled or eliminated, which has
recently increased in incidence
E.g. Lyme disease (Endemic to Northern Hemisphere, transmitted by deer ticks, re-emerged in Italy, 2008), West Nile
Virus (Endemic to Uganda and East Africa, transmitted by mosquitoes, re-emerged in NYC in 1999 and became global)
Variations in
health
Variations in health – reflected by life expectancy (LE) – since 1950
Describe the In 1948, the income and LE disparity between countries was wider than ever
variations in health as o Asian and African countries were still poor and had low LEs (below 45)
reflected by changes However! Japan was catching up with the wealthier nations after WW2
in life expectancy at o Europe in top right corner of the graph w/ N Amer (LEs around 70-80)
national and global After 1950
scales since 1950. o Asian colonies gained independence and their national incomes and LEs began to
Explain the improve.
patterns and trends in However! South Asian countries are further behind
terms of differences o European and N Amer countries still remain healthy and wealthy
in income and LE increased towards the 80s
lifestyle. Middle Eastern and N. African countries had higher incomes and higher LEs due to the
revenue earned from oil exports.
o Sub Saharan countries are still poor and sick
1970s
o Asian and S. American countries (e.g. Mexico, Malaysia, South Korea) became
emerging economies and caught up with the developed N. American and European
countries.
1980s till 21st Century
o Emerging economies in Asia and S. Amer continue to see improvements in income
and LE.
o Some African countries (e.g. Ghana) see improvements in income and LE.
o However, African countries such as the Congo and South Africa/Botswana do not
see large improvements due to civil war (Congo) and HIV/AIDS (S. Africa)
Without HIV/AIDS, it is estimated that S. Africa would have an LE of 69
instead of the current 41 years
Currently in the 21st Century
o Estimated that ALL countries now have LEs above 40
However, not all countries have income per persons above $3000
o Middle income countries or emerging economies (EEs) are able to compete with
high income countries in terms of LE and income due to the 2007-8 financial crisis.
European and N. American countries experience lower incomes
Low income countries in Africa hit hard
EEs predicted to see improvements in economic growth and development
of healthcare.
o Huge income differences between developed countries and developing countries
e.g. comparing Luxemburg and the Congo
o Inequalities within countries
E.g. Shanghai, China has the equivalent LE and income of Italy
However! Rural areas in Guizhou, China have the same LE and income of
Ghana
Wealth
Affects whether people are able to afford high quality healthcare treatment.
o Low wealth = inability to access high quality healthcare treatment
E.g. only have access to general use drugs, no specialized drugs
o High wealth = access to more advanced forms of treatment
E.g. radiotherapy and chemotherapy treatments for serious diseases e.g.
cancer.
Affects diet – quantity and quality of nutrition obtained
Affects location & access to healthcare
OVERALL: Wealth is a factor that affects health in a multitude of ways.
Education
Affects how educated members of population are about diseases
o Poor education on diseases: inability to identify diseases by symptoms or how to
treat them.
Often in LEDCs because low access to education from high rural popns or
low incomes.
Education regarding hygine practices
LE definition: the average number of years that a newborn can be expected to live
Sweden
If conditions remain at 2007 level
1 dies in adulthood, 4 die at old age
In LE, one must consider the infant mortality as well, as it will affect patterns in the LE.
LE is low when infant & child mortality rates are high – higher probability of dying at an
earlier age
LE is an average, although most ppl in Burundi live past the age of 50, some may die at infancy or
during childhood years.
Conclusion
Infant mortality rate is a more sensitive, possibly accurate indicator of health as it deals
with post-natal care, which is a very delicate area due to the number of factors affecting an
infant’s health.
Although there may be inaccuracies, infant mortality serves as an effective comparison of
health standards.
Health Adjusted Life Expectancy (HALE) - HALE is calculated using Sullvian’s method, which
measures the real health of a population when adjusted for mortality levels and is independent of
the age structure. Specifically, Sullivan’s method measures the number of years an individual of a
particular age is expected to live in a healthy state.
Pros
Unlike life expectancy, HALE measures both the quantity and quality of health as it takes
the average number of years lost to disability or poor health into account.
Shows the influence of chronic diseases or degenerative diseases, e.g. arthritis or
Alzheimer’s Disease, on a country’s health.
Demonstrates how health can be affected by both external factors from the environment
and internal or endogenetic factors – that relate to genetic diseases.
Calculation of HALE also produces additional statistical data of DALYs – disability adjusted
life years – which measure the number of years of productive life lost to disability.
Cons
Data gathered for HALE may be more unreliable. This is because data needs to be gathered
via health surveys or reported data from hospitals. Survey data may be harder to obtain –
especially in LEDCs due to the time and monetary cost.
Serves as an average indicator of years expected to live in full health, there would still be
regional or ethnic variations in HALE within a country.
Difficult to measure morbidity – which relates to the frequencies of diseases – because it
relies again on reported data.
Conclusion
Compared to life expectancy, HALE serves as a far more specific indicator of health by
measuring quantity and quality of health.
However, because the HALE uses more specific data, there is a higher chance that this data
is inaccurate. This may be especially true in developing countries where it may be harder to
conduct household surveys due to lack of government funding.
Calorie Intake
Pros
Used to measure the degree of undernourishment in a country – the state of people having
not enough food to eat.
By using the current recommended calorie intake of 2000kcal/day for women and
2500kcal/day for men, one is able to identify countries that have higher degrees of
undernourishment.
Shows the access to food or food supply in different countries and allows for international
comparison between countries
Cons
Proxy data – does not measure health itself, but measures a factor that affects health.
Does not measure malnourishment – whether individuals have nutrient deficiencies or
nutrient imbalances, which could have serious impacts on health.
Following from previous point, one does not know the source of the calories consumed,
and they may come from foods that are high in fat.
When comparing calorie intake across countries, the caloric requirements in each country
will differ due to factors such as age structure or weather.
E.g. Calorie intake in colder countries – e.g. Canada – will be higher because of the colder
climate. In Asian countries caloric intake tends to be lower due to smaller stature and
physique of people.
Within countries there would be variations in terms of ethnicity, gender, occupation and
other factors. E.g. a Tour De France cyclist will require up to 10,000kcal/day during a race,
would be significantly higher than average calorie intake of the rest of the population.
Conclusion
Calorie intake may not serve as the most effective measure of health, however it does
provide a suitable indicator for the degree of undernourishment across countries.
Although similar to other indicators of health in the sense that it may hide regional or
ethnic patterns in the data for one country, calorie indicator also hides variations
depending on the type of occupation or profession, e.g. whether individuals are
professional atheletes.
Major limitation would be that it does not show what kind of food the calories are obtained
from, hides whether the population has nutrient deficiencies or imbalances.
Access to safe drinking water
Pros
Access to safe drinking water has direct links to sanitation and is a key factor affecting
health.
Indicates the quality of sanitation and sewage systems in a country – which both link to
health.
Low access to safe drinking water would mean a higher incidence of water borne diseases
e.g. schistosomiasis (bilharza) and cholera.
Cons
Proxy data – does not measure health but instead measures a factor affecting it
Data may contain inaccuracies – difficult to measure the distance away from a water source
for each community, especially in a rural area of an LEDC. Data collected in LEDCs would be
less reliable due to low government funding combined with high time and monetary cost.
The drinking water quality standards used by certain countries may be more strict or lower
than the WHO drinking water standards, causing difficulty in comparing access to safe
drinking water.
Distance of 1km away from the water doesn’t measure how easy it is to travel that for that
1km, it could be mountainous or flat for example.
Conclusion
Access to safe drinking water provides proxy data with a stronger link to a country’s health,
as water is seen as vital for human life (e.g. one can only survive 3 days without water).
In addition, because unsafe drinking water can carry such a variety of potentially dangerous
microbes and diseases, access to safe drinking water is seen as a more sensitive and specific
source of proxy data linked to health.
However, one must bear in mind that access to safe drinking water is proxy data and only
serves as a factor affecting health.
In the 1960s China introduced widespread primary health care. Thousands of paramedics, called
barefoot doctors, where trained in the use of basic medicine and sent to work in rural areas to care
for farmers and their families. Similar systems have since been established in many countries,
including Iran, Sudan and Sri Lanka. Many LEDCS have realised that it is impossible, and
inappropriate, to copy overseas health care systems without questioning basic assumptions and
financial demands. It i s usually better to develop a system of healthcare which is affordable and
suited to the specific needs of the country concerned.
Reflecting (or perhaps contributing to) the differences in the quality of health care standards around
the world is the distribution of health care. There are vast differences between the ratio of doctors
to the people of the nations of the world. The countries with most people per doctor are Ethiopia
(60,000 people per doctor) and Burkina Faso (57,200) whilst in Russia it is 180 and Italy 230.
In most countries one of the greatest differences occurs between urban and rural areas.
Your case study for this should be based on your notes on HIV/ AIDs (see later section). Prevention
of HIV/AIDs involves stopping people getting HIV in the first place. This has occurred through:
Screening of people for HIV
Giving medication and education to HIV+ pregnant mothers to stop them passing it onto
their unborn babies.
Promotion of abstinence
Education about contraceptives that prevent HIV (e.g. condoms)
Distribution of free or subsidised contraceptives
Publicity campaigns
In Uganda developed a national HIV/AIDS policy in 1992. A variety of approaches to AIDS education
have been employed, ranging from the promotion of condom use to 'abstinence only' programmes.
To further Uganda's efforts in establishing a comprehensive HIV/AIDS program, in 2000 the MOH
implemented birth practices and safe infant feeding counseling. According to the WHO, around
41,000 women received Preventing Mother To child Transmission (PMTCT) services in 2001. Uganda
was the first country to open a Voluntary Counselling and Testing (VCT) clinic in Africa called AIDS
Information Centre and pioneered the concept of voluntary HIV testing centers in Sub-Saharan
Africa.
The Ugandan government has promoted this as a success story in the fight against HIV and AIDS,
arguing it has been the most effective national response to the pandemic in sub-Saharan Africa.
Though equally there has in recent years been growing criticism that these claims are exaggerated,
and that the HIV infection rate in Uganda is on the rise, perhaps linked to over-emphasis on
abstinence at the expense of condom use.
An overarching policy known as "ABC", which consisted of abstinence, monogamy and condoms,
was set up with the aim of helping to curb the spread of AIDS in Uganda, where HIV infections
reached epidemic proportions in the 1980s. The prevalence of HIV began to decline in the late 1980s
and continued throughout the 1990s. In fact, between 1991 and 2007, HIV prevalence rates declined
dramatically from about 15% in 1991 to about 6% in 2007.
Shortly after he came into office in 1986, President Museveni of Uganda spearheaded a mass
education campaign promoting a three-pronged AIDS prevention message: abstinence from sexual
activity until marriage; monogamy within marriage; and condoms as a last resort. The message
became commonly known as ABC: Abstinence, be faithful, use a condom if A and B fail. This message
also addressed the high rates of concurrency in Uganda, which refers to the widespread cultural
practice of maintaining two or more sexual partners at a time. Mass media campaigns also targeting
this practice including the "Zero-Grazing" and "Love Carefully" public health messages in the 1990s
The government used a multi-sector approach to spread its AIDS prevention message: it developed
strong relationships with government, community and religious leaders who worked with the
grassroots to teach ABC. Schools incorporated the ABC message into curricula, while faith-based
communities trained leaders and community workers in ABC. The government also launched an
aggressive media campaign using print, billboards, radio, and television to promote abstinence,
monogamy and condom use.
Some reports suggest that the decline in AIDS prevalence in Uganda was due to monogamy and
abstinence, rather than condom use. A 2004 Science study also concluded that abstinence among
young people and monogamy, rather than condom use, contributed to the decline of AIDS in
Uganda.
However, some studies have suggested that a large part of the decline in prevalence of HIV-AIDS is
due to the premature death of those who have contracted it. This led to the popular play on the ABC
campaign, 'A-B-C-D', with the D standing for Death. Because only prevalence is measured, incidence
can actually increase while prevalence decreases if those who contract HIV are not treated for the
disease, thereby dying younger. Later studies have seriously questioned the veracity of Uganda's
miraculous HIV-AIDS claims
In the 1990s there had been limited access to treatment in the form of anti-retrovirals for those who
are HIV positive. Through the combined effort of US PEPFAR, the Government of Uganda and
international agencies (Clinton HIV/AIDS Initiative, the Global Fund, UNITAID) this has improved. The
country's HIV-AIDS campaign focuses solely on prevention rather than cure, and that prevention is of
questionable success.
Criticism
The scope of Uganda's success has come under scrutiny from new research. Research published
in The Lancet medical journal in 2002 questions the dramatic decline reported. It is claimed statistics
have been distorted through the inaccurate extrapolation of data from small urban clinics to the
entire population, nearly 90% of whom live in rural areas.
Alternatively, the Roman Catholic organization Human Life International says that "condoms are
adding to the problem, not solving it" and that "The government of Uganda believes its people have
the human capacity to change their risky behaviors."
It is feared that HIV prevalence in Uganda may be rising again; at best it has reached a plateau
where the number of new HIV infections matches the number of AIDS-related deaths. There are
many theories as to why this may be happening, including the government’s shift from abstinence-
based prevention programmes, and a general complacency or 'AIDs fatigue'. It has been suggested
that antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable,
manageable disease; this may have reduced the fear surrounding HIV, and in turn have led to an
increase in risky behaviour.
Global availability
of food
Identify
global
patterns of
calorie intake
as one
measure of
food
availability.
This shows the global distribution of calorific intake by nation. This is shown as kcal which represents
1000 ‘small calories’. If you look at any food wrapper you will see the energy value of the food
shown in these 2 forms.
According to the National Health Service of the United Kingdom the average man should consume
around 2500 kcal per day to maintain his weight, and the average woman should consume around
2000 kcal. These figures are guidelines, and would need to be adapted according to the age, and
physical activity of the person, but they give a sense for what would be a reasonable consumption of
food. Of course the distribution of access to calories is not equal, and even within countries that
would be considered to be economically developed not everyone is always well fed. How does this
variation in calories impact on people?
Distinguish Malnutrition - A state of poor nutrition. This usually results from a deficiency of proteins, energy or
between minerals. May lead to one of a range of diseases depending on the particular nature of the
malnutrition, malnutrition.
temporary
Temporary hunger - Hunger is both a state where there is a desire for food and an absence of food.
hunger,
This is a short term need for food, triggered by physiological responses caused by food deprivation.
chronic
hunger and Chronic hunger - A state where the desire for food becomes extreme, due to prolonged food
famine. deprivation, to the point where normal bodily functions begin to be affected.
Famine - Famine is determined by the United Nations, and is a ‘legal’ definition. In this respect it is
similar to the definition of a pandemic: certain numerical conditions need to be met. The recent
famine in Somalia in 2011 was the first ‘real’ famine for some time. We will look in more detail at
this event later in the unit. Famine is defined technically as: “a situation where acute malnutrition
rates among children exceed 30%, more than 2 people per 10 000 die per day, and people are not
able to access food and other basic necessities...”
Hunger map
Measures # of people that are undernourished in order to measure hunger
Over 35% of population undernourished – high prevalence of hunger
Areas with high prevalence of hunger
Sub Saharan Africa
Areas in South Asia and towards Ctrl Asia
Usually applies to landlocked countries
No water resources for fishing
No trade
More arid
Discuss the Unless your parents have put a padlock on the fridge, you are likely to be fairly secure. For millions
concept of of people in the world, however, feeding themselves and their family is far less certain. Concern over
food security. where the next meal might be coming from creates a physiological stress on the body. Over time,
uneven access to food impacts on the health of individuals, particularly young children, for whom
this can have life-long impacts.
You may have had to wait longer than you wanted for a particular meal, but globally, millions of
people are uncertain of the source of their next meal, and have to travel for many miles to increase
their food security. This is a major driving force in global migration, as well as leading to land use
change and pressure on resources such as water.
Food security “exists when all people, at all times have access to sufficient, safe and nutritious food
to meet their dietary needs and food preferences for an active and healthy life..."
Map showing food security around the world. Food security will be discussed further in the next
sections
Fair trade: ensures that farmers are treated equitably and receive a fair price for their
produce, minimizing the need for middlemen and allowing farmers to supply directly to
overseas economies.
Incentive to increase yield and productivity.
The Green Revolution is the name given to the approach that was developed by Norman
Borlaug and others to increase the productivity of agricultural land in key countries of the
world by educating farmers and introducing new technologies. Genetic engineering was
used to produce higher yielding varieties of crops. This also needed mechanisation,
pesticides, herbicides, chemical fertilisers and irrigation water.
Through the 1960 and 1970ss a range of techniques were introduced, some of which were
based on techniques that had been used successfully in Mexico. These techniques
increased productivity so much that Mexico became a net exporter of cereals.
One of the major aspects of the Green Revolution was the use of technology.
Another success was achieved in Punjab state in India, where wheat and rice production
doubled (using the IR8 Mexican rice which had a shorter stalk and a larger head and yielded
twice as much rice. It could also be cropped twice a year rather than the one crop that they
were used to achieving). The Punjab became known as the ‘bread basket’ of India. India is
fed using an area of land seven times smaller than the land needed to ‘feed’ a similar
population in Africa.
These hybrid seeds produced plants with shorter stalks. Instead of putting the energy into
growing taller, energy went into the grain. These HYVs (high yielding varieties) of staple
crops were produced by genetic engineering. In some cases, several harvests were possible,
rather than just one.
Things that didn't work so well
Inputs into the farm system were increased. These include the things that are needed for the farm
to operate successfully.
Artificial fertilisers were needed to ensure high yields. Whereas the traditional methods used
animal manure and didn’t need any additional inputs, the HYVs needed artificial support, as they
were sometimes more prone to pests and disease due to the genetic manipulation that went into
their production.
Costs were higher as there were fees for these artificial additions to the farm system. Farmers in
these areas found it difficult to access loans and additional funding, and didn’t want to get into
debt. Richer farmers ended up getting richer but the poorer farmers who could not afford the new
technology were often forced off their land (or made to pay higher rents) and ended up worse off.
Some crops also needed improved irrigation, which was required for maximum yields. In areas of
water scarcity this was not always easy to guarantee. Salinisation occurred in some areas because
of inefficient irrigation. There was also increased eutrophication and increased amounts of cancer
which is believed to be because of the increased amounts of pesticides in the water.
Traditionally, farming has a simple system of inputs, processes and outputs. Although different farms will
generally have variations on a theme, this pattern is reproduced on each farm. There are usually limiting
factors such as climate, soil, topography etc. plus the historical use of that particular piece of land. Many
farmers are driven by the necessity to feed the family, or make a profit to please shareholders.
There have been many changes to agriculture over the years. Agriculture also requires investment of vari
kinds. Many countries have prioritised other areas over agriculture, and only a small percentage of foreig
tends to be spent on agricultural projects
Commercial: crops are grown and the produce is sold for the purpose of selling to other markets
Subsistence: produce from crops grown is largely consumed by the farmer and his or her family. Crops ar
grown in order to sustain ones household’s own food consumption. More farmers turning to commercial
farming: selling their produce instead of using it to feed themselves and storing the surplus
Commercial farmers receive several advantages
Affected more by political and economic influences.
o E.g. government policies or grants, falling costs in farm equipment or transport to markets
o Commercial farms benefit more from such policies or improvements.
Farmers have increased incomes
Knock on effect to the entire economy: increases a country’s GDP
Farmers have higher disposable income to purchase more consumer goods, necessities and gain acc
to svcs e.g. healthcare and education.
Increase in demand stimulates rural non-farm economy (i.e. industries & businesses in rural areas th
are not related to agriculture). Multiplier effect = increased standard of living in rural areas
o OVERALL: Improved standard of living
o
Commercial farmers can overcome constraints of biophysical environment.
o Mainly due to the fact that commercial farmers have more money and access to more adva
farming technologies/equipment.
o E.g. commercial farmers can afford more fertilizers and better irrigation systems, compared
subsistence farmers. Results in plants receiving nutrients and water despite poor conditions
o In more developed areas, commercial farmers can have greater control of biophysical
environment w/ controlled greenhouses.
Increasing specialization
Increased income due to commercial farming = farmers can buy their own food from other markets. Do n
need to grow own food.
Thus, farmers can specialize into growing one type of crop.
Specialization into a cash crop = more money earned.
Imagine a hundred small fields owned by separate farmers. They are responsible for their own cultivation
harvesting. They all need machinery. They all need to find a market and negotiate a price for their crops.
There is likely to be additional effort expended, and because of their small size they will have less bargain
power. Now imagine the same area of land combined into one huge field.
Agribusiness is the name given to the aggregation of farmland under the control of a single business. The
are often owned in turn by large trans-national corporations. Companies such as Nestle also control food
production in large areas, as do companies that produce tea and coffee.
Economies of scale are usually mentioned as a key benefit of this approach to agriculture. Costs are reduc
when scale is increased. One associated issue here is that of monoculture. Generally, businesses will focu
growing one crop, having secured a favourable position. Large fields are generally planted with one crop.
means that after harvesting the soil over a large area is bare and disturbed, and may be prone to soil eros
Large areas of a single crop may also be more prone to disease and therefore require extra spraying of
pesticides. Large companies may also negotiate favourable prices, and the terms under which they opera
within a region. How big can these fields be ?
The image on the next page shows that some fields have crops which are ‘stressed’ through lack of
water. These fields could then be targeted for irrigation, thereby saving water, and ensuring that
yields didn’t suffer.
The images could be obtained from commercial satellites, or from flyovers by drone planes
equipped with camera able to capture images at certain wavelengths. There is also the use of GIS
(geographical information systems) to accurately map farms. Not only does this enable more
accurate claims for subsidies, but also maps the area that is used for conservation, and can result
in better calculations of orders of seeds and chemicals. With nitrogen based fertilisers costing
hundreds of pounds per tonne it is important that they are not wasted.
Accurate weather forecasts can avoid waste where rainfall or high winds might reduce the impact
of freshly applied chemicals.
Link to increased productivity: access & development of more efficient farming equipment
improves efficiency of farming and ensures higher yield per plot of land.
Farmers can perform tasks more easily and quickly
Linked to increased productivity and increased commercialization. People can afford to purchase
more inputs to help increase production
From 1980 to 2002, amount of land used to grow crops increased on a global scale of 33.5%
Largest increase in amount of cultivated land was in Asia, with an increase of 73.3%
Africa had a more modest increase in the amount of cultivated land, at 30.3%
Other regions had even smaller increase in the amount of cultivated land.
o Europe: 16.7% increase
o Latin America: 13.7% increase
o North America: 11.8% increase
Large increase in food prdctn in Asia can be explained by the rapidly growing populations in
emerging economies, namely China and India, as they entered the 21st century.
Both China and India have high populations, meaning these countries must have higher food
production as well.
N. America and Europe had lower increases in amt of cultivated land because of:
o Shift towards tertiary and quaternary sectors due to higher wages and less
physical labour
o Ability to import cheaper food from developing countries
o OVERALL: Decreasing importance of agriculture
An obvious way to increase food production would seem to be to put new land under the
plough. There are several issues with doing this for a number of locations. Because agriculture
has been taking place for centuries it is not surprising perhaps that the ‘best’ land has already
been identified, and many other areas are urbanised and cannot be used.
Similarly large areas have been taken out of production as a result of land ‘improvement’ or
reclamation such as grazing marshes in some coastal areas. Changing land use is often a
secondary impact of major engineering schemes which reduce the potential flood risk of an area.
In Japan there is very little available flat land due to the nature of the terrain. This puts added
pressure on the few available areas of flat land. This means that farmers have to be very precise,
and have developed a range of machinery which is on a smaller scale than most commercial
farms in the developed world. Land reclamation has also taken place, although this is usually so
expensive that the land it creates is used for residential use, or for developments such as Kansai
airport near Osaka.
On a much smaller scale, communities have looked to make use of available plot of land to grow
food. One small-scale initiative is ‘Incredible Edible Todmorden’. Todmorden is a small town in
West Yorkshire, England. The local community have identified small areas of land in and around
the town, and secured permission for them to planted up with food crops. Bollywood Veggies in
Singapore is another example here.
Examine the One issue which may lead to food issues is the land that is required to feed a single person,
environmental depending on their diet and lifestyle. Changing diets and lifestyles are one consequence of the
, greater economic prosperity that some countries have been enjoying for the first time. Changes
towards including more meat and dairy mean that the land is not used as efficiently.
demographic,
political,
Putting food on the table has always been a struggle for people in many of the world’s countries.
social and Sometimes parents go without food, so that their children have enough. In some locations, young
economic children miss out on education to find employment in the informal sector to enable food to be
factors that purchased. As food prices continue to rise globally, more people than ever go to bed hungry, and
have caused even in the more ‘developed’ nations of the world, a higher proportion than ever are struggling to
areas of food feed their family appropriately.
deficiency and
food There are a number of factors that have been suggested for the inequalities in food supply which
insecurity. have meant a greater number of families are relying on food banks.
There are two important terms to bear in mind here: food availability deficit (FAD) and food
entitlement deficit (FED)
Food availability deficit suggests that food shortages were caused by local difficulties in supply,
perhaps the result of drought or floods (two extremes of water availability).
Amartya Sen applied economics to the problem of food supply, and suggested that there were
actually famines in areas where food production had been increasing. The problem was with the
political and economic framework in the area. Rising costs of food relative to average incomes, Sen
said, were a major factor in the availability of food. It is this situation that, remarkably, is facing
many families in what are recognised as being ‘developed nations’. A lack of wages/income means
the term food entitlement deficit (FED) has been introduced as well.
Definition of food insecurity: no access to safe, sufficient and nutritious food in order to live
an active, healthy lifestyle and to meet dietary needs
Areas of food insecurity: Sub Saharan Africa, central Asia and southern Asia
o Statistics
Factors that contribute to food insecurity: social, political, economic, environmental,
demographic
Social
Providing education to females, reducing gender inequalities in terms of inheritance laws for land
and access to credit
Political
Economic
Environmental
Droughts
Changes in rainfall regularities
Floods
Soil degradation
Pest outbreak
Use of appropriate farming techniques to overcome biophysical environment
Salinization/Saltwater intrusion
Climate change:
Desertification in Australia
Increases in global temperature affect
More extreme natural disasters – loss of more produce and crops
Demographic
Increasing global population: 9 billion by 2050
Places great strain on food production - Some may go hungry
Increasing urbanization
Essay Plan
Discuss the statement: “Poverty is the main cause of food insecurity” [10 marks]
Introduction
Define food insecurity – the state of people being unable to access a sufficient, safe supply
of nutritious food to meet food preferences and dietary needs at all times.
o 870 million people in the world do not have enough food according to UN World
Food Program
98% of world’s hungry population lives in the developing world.
o Asia & Pacific region holds approx. 570 million hungry people.
Poverty is often seen as the leading cause of food insecurity because of the lower GDP per
capita in these regions and the large amount of people living below the poverty line of
$1.25 PPP
However there are several other factors that contribute towards food insecurity, such as
internal conflict/civil war, poor environmental conditions or natural disaster.
I will be discussing the importance of each of these factors with reference to examples
Poverty statistics:
GDP per capita: USD $660, second poorest country in the Caribbean
54% of all Haitians live on below US$1 per day
Malnutrition statistics:
World Food Program reports that the food supply in Haiti only covers 55% of the population
24% of children under 5 suffer from chronic malnutrition
Hunger responsible for almost 60% of all deaths of those under 18
Conflict as main cause of food insecurity: Demographic Republic of the Congo (DRC), Africa
DRC: Located in central-southern region of Africa, north east of Angola and south west of Sudan
Food insecurity
United Nations Food & Agriculture Organization estimates 30% of DRC is food insecure
Over 4 million people facing severe food and livelihood crisis
6 out of 11 of DRC’s provinces have acute malnutrition rates above 10%
Conflict
Ravaged by conflict in the past: First and Second Congo Wars
Conflict erupted in Kivu region in eastern DRC recently in 2012
Natural disasters
Madagascar is a very natural disaster prone region, in the past 35 years it has experienced
46 natural disasters, including floods, drought and cyclones
Avg of 3 to 4 cyclones per year
Recently affected by Cyclone Haruna: for every 25 ha of crops an estimated 10 ha were
destroyed by the subsequent flooding
35% of households are affected by chronic food insecurity
Conclusion
In conclusion, it can be identified that there are 3 main causes for food insecurity: poverty,
conflict and natural disasters.
Most major factor contributing: poverty. Thus I agree with the statement in the question.
o Most of example countries are highly impoverished
However, unable to determine which is the main cause in situations e.g. Haiti, which is both
impoverished and experienced a natural disaster.
Important to determine the main cause in order to provide appropriate aid.
o However it is often a mix of different causes, may hinder provision of aid.
Case study
Most aid agencies including the UN use the five-stage Integrated Phase Classification system of food
emergencies.
Phase 4, a 'Humanitarian Emergency', is when up to two people per 10,000 are dying each day,
when acute malnutrition rates are between 15 per cent and 30 per cent, almost all livestock have
been lost and there is less than 7.5 litres of water available each day per person.
Phase 5, 'Famine/Humanitarian Catastrophe', means more than two people per 10,000 die each day,
acute malnutrition rates are above 30 per cent, all livestock is dead, and there is less than 2,100 kcal
of food and 4 litres of water available per person per day.
Other factors in a famine include large-scale and concentrated movement of people from their
homes looking for help, and widespread armed conflict.
Economic: rising food prices due to poor harvests and rising fuel prices. In Ethiopia, maize prices
have tripled in some areas. Prevents locals from affording food.
Loss or destruction of farmers’ assets results in lower incomes, e.g. loss of cattle due to conflicts
between ethnic groups in Kenya. Unable to purchase enough food for family.
Demographic: high levels of population growth in these developing countries
Large population live in rural areas of these countries, limiting their access to food.
Environmental causes:
Irregular rainfall patterns: normally there are 2 seasons of rainfall, one during Mar to May and the
other from September to December. Rainfall failed in the fall from September to December. El Nino
causes spring rains to be very heavy, exceeding 800mm, and caused damage to crop harvetsts.
Soil degradation from poor, inefficient farming techniques used, e.g. slash n burn, land in Somalia is
experiencing a decline in quality
Deforestation:loss of 19% of tree cover between 1990 and 2010. This causes increase in the amount
of land exposed to directly sunlight to increase, increasing the ariditu. 60% of the HOA considered
food insecure.
Global climate change: rise in temperatures in Kenya and Ethiopia are 1 and 1.3 degrees Celsius
respectively. Increases the aridity of the area and causes rainfall patterns to change.
Conclusion:
Conclude that human factors are more responsible.
Lack of access to food appears to be the main problem
Government efficiency to solve food insecurity. Amartya Sen, a Nobel Prize winner, observed that
famines do not occur in functioning democracies
However one must not deny that environmental factors are a cause as well, it affects the availability
of food.
In order to combat famine, a mix of techniques must be used to combat it.
Production and Food is produced in numerous locations around the world. It is not always available to everyone
markets who lives in that area, and this results in inequalities and, potentially, conflict.
Examine the impacts Some of the food that is produced is not intended for the domestic market. These cash crops are
intended to be exported, which provides foreign exchange for the government, and guarantees jobs
at a variety of scales
are maintained as long as the relationship with the overseas market is maintained, and the price is
of trade barriers, guaranteed. This is not certain.
agricultural subsidies,
bilateral and At times of increasing global pressure on food production and markets, countries are concerned to
multilateral ensure food security, while keeping an eye on the price of this security. Transnational Corporations,
agreements, and mindful of their markets are involved at this point in negotiations to ensure that they are part of any
transnational future equation. When many countries are no-longer self-sufficient in food, these huge companies
corporations (TNCs) play an important role in our daily experience of food, and spend billions on marketing to ensure
on the production and that they remain an important presence in our lives. Every day, food is moved in huge quantities
around the world. Who produces it, where is it sold, and how does it get to us?
availability of food
There are numerous strict EU standards for imported food products, including hygiene and health
standards as well as regulations for size, form and colour of a certain product. While the regulations
are supposed to protect European consumers, they can have devastating impacts on small farmers
in export countries. These standards have prompted many stories in some newspapers who are
concerned at the apparent silliness of some of the standards, which have been relaxed in recent
years after concerns over food waste that they were partly to blame for.
These regulations may have serious consequences for some producers elsewhere. In Morocco for
instance, a report suggested that in one year’s crop, around 40% of the tomatoes that had been
cultivated to be exported to Europe failed to meet the European standards. Instead of being shipped
abroad, the tomatoes were sold cheaply on Moroccan markets. Small local farmers have a hard time
competing with the cheap produce and struggle to survive. Such a practice is sometimes called ‘food
dumping’ and can be an unintended consequence of food aid.
Trade Barriers
Trade barriers are often put in place around specific countries or areas. These barriers are not necessarily
‘physical’ barriers, although they may be in some circumstances due to the nature of the relationship
with surrounding countries. Some physical barriers would include the restrictions facing some contested
areas of the Middle East, or enclaves within countries.
Trade barriers include tariffs (additional charges), subsidies (support from government for domestic
industries restricting other countries from trading freely) and quotas (limits on what can be imported or
exported).
One problem that faces farmers wanting to import their products into the EU is the restrictions, some of
which we explored during the starter activity. They have to meet certain standards, some of which are
not based on the taste or quality of the food, but its physical dimensions. There have also been examples
of products having to undergo inspections which delay its arrival on the market, which may mean it is not
competitive in price.
Sometimes barriers are put up for political reasons, at other times they may be to protect consumers.
Russian food import standards were raised after the country became a favoured ‘dumping ground’ for
meat and fish products produced by EU countries that had failed to meet EU standards for sale within
the EU. Agriculture is an industry that has often required financial support, particularly given the
globalised nature of the world, and the material flows of food around the world.
In the European Union, there has been a history of additional investment. In many parts of the world,
agriculture is not a profitable activity due to the low prices that farmers are paid for their produce.
Farmers have to look a year or two ahead and predict what the likely market conditions will be when
deciding how to farm their land. They are also dependent on the vagaries of the weather.
Some parts of the British Isles, for example receive additional support and payments. Hill Sheep farmers
get additional payments due to the harsh nature of the land which they farm, which restricts the density
of animals, and therefore the profit they can gain from farming the land. Their work maintains a
landscape which is of high amenity value. Other payments are related to the environment, so that
farmers may be paid for planting hedges, draining land or repairing stone walls.
Bilateral Agreements
A bilateral agreement is one made between two different ‘parties’, which could be countries, which
benefits both.
Some of these agreements relate to former colonies of European countries, which developed a
relationship involving the production of foods, some of which might have a particular cultural
significance. Recent bilateral negotiations took place between the EU and India.
India is one of the world’s largest potential markets for EU products, and there were discussions over
furthering links between the two areas.
Can also occur when a consumer such as a large supermarket makes a decision e.g. the Co-op decided to
only sell Fairtrade bananas which meant those countries which had more producers signed up to the
scheme benefited.
Multilateral Agreements
A multilateral agreement is one that involves many countries. Agriculture can also be protected by the
tariffs that are introduced when countries group together to form a Trading Bloc.
Countries merge together for various reasons. This is usually for the benefit
of the participating countries. The EU is obviously one example of a trading
bloc, but there are many others.
There have also been multilateral agreements which have been agreed
between these organisations and other NGOs (Non-governmental
organisations).
These include the Lome and Cotonou Conventions which date back over 30
years and were intended to support producers in the less developed parts of
the world. These included agreements on the import of tropical produce
such as bananas, which clearly cannot be grown in the EU.
Many of the world’s biggest companies have become that way by offering a basic necessity which we
cannot stop buying.
TNCs are driven by profits rather than the desire to provide us with the best possible food. Decisions are
not made on the grounds of existing arrangements, and firms are not necessarily sympathetic to changes
in local conditions.
McDonalds have a strategy which focuses on a one-brand image, but some of these other food
companies own lots of brands, and their involvement is less obvious. This can mean that their overall
operations are not always subjected to the same public focus.
Large companies have increased their involvement in more aspects of the production chain.
This has increased their profits. Felicity Lawrence in her book Not On the Label: What Really Goes into
the Food on Your Plate says: “Fifty years ago, 50-60p of every pound spent on food and drink in the UK
went to the farmers, now it is just 9p in every pound.”
“Africa needs more money, but if it's not linked to ending European agricultural subsidies, it's
blatant hypocrisy. The way to build lasting economic growth, healthcare and education is for
Europe to end the CAP. Stopping trade-distorting subsidies will allow African products to be
exported and stop European goods being sold more cheaply in Africa.” – Lord Digby Jones (2005)
The Common Agricultural Policy (CAP) introduced in the 1960’s was a system devised to offer financial
support for farmers in the European Union countries. It introduced a minimum price for part of what
farmers produced the aim being to increase productivity so that food security was increased and the EU
became more self sufficient, and less reliant on food imports. The knock on effect of this was for the
farmers to earn a decent living whilst being able to offer the customer a guaranteed supply at a
moderate price. In order to offer stability to the internal market, the EU guaranteed to ‘buy’ produce at a
predetermined price and impose charges on cheaper imports. Farmers started to produce more food
than before, and by the early 1980’s subsidised goods had become so overproduced they couldn’t sell
them all. The EU was unable to sell this surplus as it would impact on markets, which led to the storing of
food in warehouses. The phrase ‘wine lakes’ and ‘butter mountains’ raised this issue in the public
consciousness.
In 2007, information was revealed in the House of Commons that large amounts of products were still
being over-produced.
At the time the EU was apparently storing 12,187,741 tonnes of cereals, and there were 1,112,651
tonnes of sugar - enough for 445 billion cups of tea; 117,831 tonnes of butter and milk, which would
spread 78.5 billion sandwiches and fill 252 million pint bottles; and enough rice - 61,589 tonnes of it - for
615 million curries.
The policy has undergone reform several terms, partly as a result of concern over the cost of
implementing the policy compared with other aspects of EU membership. 2010 Budget for CAP: 44
billion Euros (around 30% of EU budget) – costs Britain around £10 billion a year.
How much does each EU taxpayer contribute to the CAP per year?
80 Euros per year
Why has the CAP been reformed a number of times?
Disagreements between member countries on the distribution of subsidies per country
May have been reformed recently due to environmental damage from use of pesticides and fertilizer
International disagreements on the food surpluses created by the CAP: may result in lowering of
agricultural subsidies
Changing global food prices means EU will have to change the minimum buying price
The Cairns Group formed by countries e.g. Argentina, Brazil and the Phillippines in 1986 is critical of the
CAP.
Addressing Introduction
imbalances Globally, there are 870 million people who do not have enough food to eat
One of the causes would be food shortages, where the food supply in an area doesn’t meet
Evaluate the the population’s nutritional and energy needs.
relative Food shortages caused by factors e.g. internal conflict, poverty or global climate change.
importance of
food aid, free What is food aid?
trade and fair
trade in All food-supported interventions aimed at improving the food security of people living in poverty in
alleviating the short- and long-term, whether funded via international, national, public, or private resources.
food
shortages. If food aid constitutes less than 2 percent of global agriculture trade, 78 percent of which goes
directly to emergency situations, why is so much attention being paid to it?
Unjust international trade regulations and practices prevent the advancement of developing
countries. Developed countries have refused to liberalize their agricultural sectors due to domestic
pressure. This is a decision taken at the expense of the developing world where agricultural
production is often more efficient than in wealthy nations. The European Union argues that food aid
creates a production and price advantage, and thus a hidden subsidy, for (largely) American farmers.
Therefore, farmers in developing countries are placed at a disadvantage. There is also a perception
that food aid may distort markets in developing countries, thus undermining the potential for long-
term development.
Advantages
Provision of food aid can be useful in alleviating emergency food shortages. E.g. in 2011, Britain
aimed to provide food aid for 1.3 million people in 3 mths to relieve food shortage caused by
drought in Ethiopia.
In-kind commodity food aid is the free provision of food aid to a country, which ensures that it will
benefit lower income households. E.g. Action Against Hunger launched program in Haiti,
where food aid was provided to children through canteens, with each canteen serving 400
children and increasing avg meals from 1 to 2.34 per child.
Food aid can alleviate future food shortages, e.g. in the Democratic Republic of the Congo,
agricultural production was increased as food aid was distributed along with seeds.
Disadvantages
Providing food aid to markets in LDCs depresses food prices and can cause food production to
decrease. E.g. Malawi, 2002 to 2003, where 1 million metric tonnes food aid caused maize
prices to fall from $250 to $100 per tonne and $15 mil in losses due to lower agricultural
production.
Rising fuel costs and rising food prices reduce the amount of food aid able to be provided to the
targeted country, reducing its effectiveness.
Food aid often suffers delays in reaching the targeted countries, e.g. it can take up to 4-5 months for
food aid to reach the intended country. The quantity and type of food provided may be
insufficient.
The structural impediments to food security include: inadequate or nonexistent national food
security policies; lack of international action to address environmental degradation; unfair trade
rules; unpayable debts; and insufficient investment and development aid. These conditions force
developing nations into chronic food insecurity. Until these unjust policies are corrected, food aid
will be required. The central issue under discussion in multilateral negotiations is that of agricultural
subsidies and agreement on flexibilities for countries to promote food security in their communities.
Shouldn’t all food aid be locally purchased, therefore stimulating the local economy and pointing
the country toward long-term food security?
The nominal amounts of food aid procured locally would create negligible long-term benefit for an
economy. Only sustained production and inclusion in emerging regional/global markets will lift a
country out of poverty and into food security. The potential for negative market impact is similar for
in-kind and local purchase food aid. Commodity prices will be affected both through in-kind
distribution and cash purchase. Therefore, a detailed market analysis is required to accompany any
injection of “aid” into a country’s economy. This analysis has been required for all U.S. food aid
programs over the last 20 years. Secondly, the risk of corruption or mismanagement carried with all
aid provision is significantly increased with regard to direct cash compared to food commodities.
Using earmarked cash to buy food from rural, smallholder farmers is not as efficient in practice as it
is in theory. There is a significant chance that the cash will be appropriated for alternative uses or
never arrive at the targeted populations. It is easier to misuse $1,000 than it is to misuse 1,000
metric tons of food.
Yes. Purchasing food locally can have significant negative impact on local markets. Recent examples
in Niger and Uganda have demonstrated that purchasing quantities of food has in fact driven up the
price of local food, and made it impossible for many who did not receive aid to buy it themselves. In-
kind food aid must be made available to mitigate such market impacts.
Give an example of how in-kind food aid was a critical success factor in saving people’s lives.
--East/Northern Africa, 2000 – present (Sudan)
--Asia, 2000 – present (Mongolia, Cambodia)
--Caribbean, 1990s – present (Haiti, Dominican Republic)
The context of these situations required in-kind food aid as the short-term solution to meeting
people’s needs on account of several factors. Cash to purchase locally posed an equally, if not a
more, cumbersome process than cash for food. The situation in these populations had deteriorated
to such a grave extent that food aid resources intended for other ports were re-directed and sent to
these destinations. The C-SAFE consortium was an excellent example of a dedicated pipeline of food
for a consortium of NGOs across four countries (Zambia, Zimbabwe, Malawi, and Lesotho) over
multiple years.
FREE Trade
The act of opening up economies is known as "free trade" or "trade liberalisation." It usually benefits
the larger, wealthier countries whose big companies are looking to expand and sell their goods
abroad. In the one sector where developing countries have the most to gain - agricultural goods -
wealthier countries maintain the highest level of "protection" of their own markets.
Globalisation has made the world a much smaller place. Global trade refers to the act of buying and
selling goods and services between countries. Today these goods and services can travel further and
faster so that - for instance - products from all over the world can be found at your corner shop. This
can be anything from fruits and vegetables, to cars, banking services, clothing, and bottled water.
The scale and pace of this kind of trade has only increased over time, and has become a very
powerful tool. International trade is considered a prime driver of how well a country develops, and
affects very much how well the economies of different countries are doing.
The act of opening up economies is known as "free trade" or "trade liberalisation." Trade
liberalisation means opening up markets by bringing down trade barriers such as tariffs. Doing this
allows goods and services from everywhere to compete with domestic products and services.
But in practice the set-up of global trade rules and the way these are administered by the World
Trade Organisation, works best for those countries who are already rich, and increases the gap
between them and poorer countries who are already struggling to compete.
Part of the problem is that trade is not always equal. It is not just a tool - it can also be a weapon.
When countries put restrictions, such as tariffs, on goods from other countries, imported goods
become more expensive and less competitive than goods from their own country.
Another thing that can be done is subsidising domestic businesses. This means that governments
give money or other forms of support to local or domestic businesses, to make sure that they are
cheaper over imported products and services. This can allow unsuccessful and inefficient businesses
to do well, since they receive all kinds of government support. And while these businesses continue
to grow, smaller or local producers, especially in many poorer countries - those that need support
the most - are being destroyed.
Any measure like this is called "protectionist," since it has the effect of closing off a country's
markets to goods from other countries. Many wealthy countries in Europe, as well as the US and
Japan use these tactics to support their own domestic economies, making it impossible for smaller,
or less developed countries to gain a foothold in the global marketplace.
As they go about protecting and closing off their own markets, many of these very same countries
are creating double standards, by forcing other countries to open up their markets.
Advantages
Removal of agricultural subsidies given to MDC farmers, e.g. US corn subsidies of $5bn USD per year,
improves competitiveness of LDC food products. Revenue can be used to reinvest in increasing
agricultural output.
Removal of trade barriers allows certain countries to export more food, and countries facing food
shortages to import this food. E.g. with rice, if voluntary export restrictions were removed the
percentage traded would increase greatly from the current level of 5-7%
Free trade allows farmers to earn increased revenues from exports, which can be used to afford
food in the short and long term. E.g. in Africa, if its share of global trade increased by 1%, it would
generate $70bn revenue.
Disadvantages
Only larger farmers may benefit from trade liberalization, as they can compete with farmers in MDCs
Limited access to markets in countries e.g. the Democratic Republic of the Congo with the recent
conflict in the Kivu region in 2012, results in households being unable to access the food
needed.
Countries may begin to produce cash crops for sale instead of food crops, which would not be
effective in increasing the supply of food.
Fair Trade
Advantages
FairTrade farmers are given a guaranteed price for their produce, regardless of market prices.
Therefore d guaranteeing them income during periods where food prices are low. This would in
turn allow them to purchase more food.
Consumers also pay a social premium on the FairTrade products, which is reinvested in rural farming
communities. Improvements can be made to alleviate future food shortages. E.g. In Mali, West
Africa, FairTrade cotton farmers used profit to construct grain warehouses in their villages.
Farmers operate in co-operatives, e.g. Kuapa Kokoo in Ghana, West Africa, covers 65,000 farmers in
1600 villages. Co-operatives can negotiate for higher prices, increasing farmers’ revenues and
allowing for more reinvestment in the community.
Disdavantages
FairTrade is ineffective at alleviating emergency food shortages because it does not focus on short
term food provision.
FairTrade does not focus on reducing costs of production received by farmers. Short term increase in
the prices of inputs can affect farmers’ food production.
Co-operatives may not be run efficiently by farmers alone, as they may not possess the education or
skills. Results in villages not receiving significant benefits
Conclusion
In conclusion, it is complex to evaluate the importance of each measure on the whole.
Food aid proves to be the most versatile, as it can alleviate short term shortages and
improve long term food insecurity.
Fair Trade is a relatively new movement that can prove effective in guaranteeing farmers
higher revenues and improved protection against food insecurity.
Free trade may not be beneficial to very poor countries because of farmers’ lower access to
capital and inputs.
Food shortages difficult to combat because they have so many causes and they vary
enormously
Case Study
Solutions
Key to stimulating purchase of coffee beans from LDCs: increased advertising in coffee
conventions
o Increasing consumer awareness of the impact of low food prices on coffee
Fair Trade: Social premium from fair trade Ethiopian coffee results in farmers receiving
increased profit.
o In agricultural communities, profit can be invested into improving the healthcare,
education and infrastructure in these communities.
Increase free trade: If Africa’s share of WT increased by 1%, $70 bn revenue generated. x5
the amount they receive in aid
Interesting facts
Coffee is world’s 2nd most actively traded commodity
2 billion cups of coffee drank per day on a global scale
Since 1990 retail coffee sales increased from $30 bn to $80bn
4 multinationals dominate coffee market:
o Kraft
o Proctor and Gamble
o Sara Lee
o Nestle
Sustainable Sustainability is a relatively straightforward concept to define but it is harder to achieve. Think of it
agriculture as a 3 legged stool. The stool needs all 3 legs to remain standing.
Farmers can be seen as stewards of the land. The decisions they make can cause damage to the
topsoil or water balance and need to be taken carefully. This can be compromised when there is a
perceived need to produce as much food as possible as quickly as possible in response to food
insecurity or rapidly rising food prices.
Sustainable farming involves the production of food in such a way as to maintain the capacity for
growing food from the same land in the future. The sustainable yield is the amount of food (Yield)
that can be taken from the land without reducing the ability of the land to produce the same
amount of goods in the future, without any additional inputs. If the production of palm oil, for
example, reduces the nutrient availability in the soil or moisture in the soil it is not sustainable.
There are several key ideas which will be found on most farms which are attempting to work
sustainably. Generally, these farms try to copy natural processes, which often means that they are
organic, or are more likely to be organic. Areas that are commonly focused on include:
This might
involve animal manure, or ploughing the brash or waste
from harvest back into the soil. There may also be some
land which has to be left for a period of time to allow the
soil moisture to be replenished. In some marginal land,
even turning over the soil would lose the available
moisture so careful management and cropping techniques
need to be used.
Using chemicals
would not be seen as sustainable practice.
Free range
grazing encourages this nutrient cycling to take place
naturally
This is of increasing importance to consumers. Sales of food that has various animal
welfare related badging have increased. Local sourcing, organic and free-range foods are
popular, although there is often a price premium. With the increasing economic
uncertainty across Europe, will there be a reduction in demand for food produced in this
way, and more pressure to return to less sustainable practices ?
Some farmers also see the benefit of engaging with project such as Fairtrade and
Rainforest Alliance certifications.
Organic farming
In the rich world, the damaging environmental effects of intensive commercial farming
have led to the promotion of more sustainable farming. These include:
Examine the concept Food miles are: A measure of the distance that food travels from its source to the consumer. This
of food miles as an can be given either in units of actual distance, or of energy consumed during transport. Food miles
indicator of have been steadily increasing over time. The concept of food miles serves as a useful reminder of
the need to control the amount of energy used to move food from one place to another. Food
environmental
distribution accounts for 40% of road freight. However the concept is simplistic and difficult to apply
impact. in a practical sense. For example, distance travelled is not necessarily determinant of the amount of
energy used to move food from one location to another, e.g. air travel v sea travel. Recent research
suggests that many parts of the world, eating locally grown food may lead to an increase rather than
a decrease in energy use and the carbon footprint. This is because certain areas are better suited
physically for producing particular foods than others, and this eating locally produced food may
increase energy use (e.g. in the UK tomatoes grown locally may need artificial heating, and large
amounts whereas tomatoes grown in Spain do not require this (therefore the imported Spanish
tomatoes end up being may energy efficient even when the transport is taken into consideration.
Different food are more energy efficient that others, e.g. producing rice is far more energy efficient
than producing all forms of meat. Farm animals account for 20% of greenhouse gas emissions.
Food miles fails to take into account the various other factors in the production of the food and the
energy required to get it to your plate, e.g. amount of fertiliser used, packaging, processing, storage.
Oxfam have suggested that a better way of calculating this is by using a Lifecycle Analysis where all
factors in the production of the food are taken into consideration (and the energy used).
Externalities are also not taken into account with food miles, e.g. has the food been farmed on
deforested land or are chemicals used in the growing damaging the local area and people.
Also, if consumers buy more locally produced food then it may have a damaging effect on some
LEDC countries who rely on selling food for income. An estimated 1 to 1.5 million livelihoods in sub-
Saharan Africa depend directly and indirectly on UK-based supply chains. Oxfam believe that people
should think more about the term Fair Miles which looks more at the overall amount of energy
needed to get the food to the plate and the impact that it might have on other parts of the world.
The spread of Diseases don’t stay put. They tend to move and spread. This is how they perpetuate themselves: by
disease replication.
Explain how This section of the unit explores the way that diseases move. Diseases are more mobile than
previously, because we are more mobile than before as a species, and we carry diseases with us. The
the
network of communications by road, rail and air means that potential carriers of diseases (people
geographic who are still capable of infecting others with a particular disease) can travel across the globe in a
concepts of matter of hours. Less than two hundred years ago, diseases travelled slowly and it was possible to
diffusion by quarantine an area more easily.
relocation and
by expansion Whereas early plagues were carried by rats and their fleas squatting in the holds of sailing ships,
apply to the modern plagues are more likely to be brought in by a business traveller who’s just been on a mini-
spread of break.
diseases.
Examine the
application of
the concept of
barriers in
attempts to
limit the
spread of
diseases.
Describe the
factors that Diffusion
Methods
have enabled
reduction in Diseases are spread by contact between people, and the crowded and unsanitary
incidence of a conditions in many parts of the world encourage diseases to spread further.
disease.
It must also be remembered that the 1918 influenza pandemic (sometimes referred to as
Spanish Flu) killed an estimated 40 million people worldwide within just a few months,
with some estimates of casualties closer to 90 million. To put this into some sort of
context, the total number of battlefield fatalities in World War One in the previous four
years was around nine million, plus around six million deaths amongst civilians.
There are various methods by which diseases spread, and these contribute to the
overall risk factors for different populations.
There is a reducing effect with distance from the original outbreak, and also a time
delay. Diseases tend to spread like a ‘wave’ from the central point.
Factors that slow down the spread of disease include physical barriers (these might
include mountains, water barriers such as seas or oceans, forests and difficult terrain)
plus political boundaries. Travel restrictions and screening of travellers can form part of
these more ‘human’ barriers. Public health advice can also help in some cases.
Disease will also change from an original infusion into a population, through inflection
and saturation, before it declines and leaves a population.
There are 4 main methods of diffusion:
EXPANSION - the disease has a source and diffuses outwards into new areas from
this original point
RELOCATION - the spreading disease moves into new areas, leaving behind its source
(often the result of global travel by an infected person)
CONTAGIOUS - the spread of an infectious disease through direct contact with the
affected individuals
HIERARCHICAL - the spread of a disease from place to place in an orderly way e.g.
from cities, to neighbouring villages, or vice versa
There are some cases of malaria in the UK every year for example, and most
of those are close to airports. Mosquitoes survive in the plane just long
enough to bite someone when they leave. Climate change may allow them
to survive longer of course.
1) What is the difference between relocation diffusion and expansion
diffusion?
Diffusion by expansion refers to the process where a disease originates and
develops in a source area and spreads from this area, where the
prevalence and incidence of this disease is highest in the original source
area. An example of diffusion by expansion would be the spread of
cholera from its source in a dirty or contaminated well to other
neighbouring settlements. Expansion diffusion usually occurs in areas
where populations are in fixed settlements and have sedentary living
patterns.
Relocation diffusion differs from expansion diffusion in that the disease
evacuates the source area when carriers of the disease migrate
elsewhere. An example of a disease that spreads via relocation diffusion
would be the human immunodeficiency virus (HIV), where if the carriers
of the virus change location, the virus travels with them and HIV is no
longer present in the source area.
Provision of medication:
Treatments and antibiotics provided for diseases such as TB, e.g. with drugs
such as isoniazid (INH) or rifampin (RIF). By curing the disease in carriers,
prevents further spread of disease and lowers incidence.
Success: 85% of all TB cases successfully treated in 2010.
Vaccination:
Regarded as one of the most effective methods of completely eradicating a
disease, as it allows more individuals to become immunized and thus
have their immune systems combat the disease, preventing further
transmission.
Has been successful for diseases e.g. smallpox, which is the first globally
eradicated disease. From having a mortality of 30% after WW2, it was
totally eradicated in 1980. Also shown successful in developed countries,
e.g. measles in the USA. Measles cases fell from approx. 89,000 in 1941
to only 44 in 2002.
Effective screening
Allows carriers to be identified, isolated and treated, preventing any further
spread of disease among people that unknowingly carry the disease.
Use of screening or testing in the treatment of HIV/AIDS, where there are a
total of 119 countries that carry out HIV testing and councilling, with 95
million 15-49 year olds who received HIV testing and counseling in 2010
Public health campaigns have been used for various diseases over the years. The
early AIDS campaigns have been criticised for being unduly negative in their imagery.
There have been a range of recent scares over possible pandemics. Every now and
then, a story emerges of someone who has died from avian flu.
A pandemic is a disease which has spread to affect a very large area, either several
continents or possibly most of the globe. Its name comes from the Greek meaning
“all the people” which gives you an indication of who is affected.
In recent years, there have been hysterical headlines warning of mass deaths from
various diseases. One of the more recent ones was a disease called SARS (severe
acute respiratory syndrome)
Area of origin:
Foshan City, Guangdong province, South China
Originated as a spread of a new strain of highly contagious pneumonia in November
2002
A physician treating pneumonia patients near Foshan City contracted the virus
himself and travelled to Hong Kong, spreading the virus.
How it spread overseas
Disease officially spread outside of China after a Chinese-American businessman in
the same hotel as the infected physician contracted SARS and travelled to Hanoi,
Vietnam.
Measures to prevent or reduce spread of SARS
Contact tracing: identifying infected individuals
Reducing the time between the onset of symptoms and the isolation of patients
Health screenings at airports: consists of a series of questions and temperature check
Travelers advised to consult doctors and identify whether they have histories of
pneumonia or fever. These individuals would be advised against travel
Community containment measures (non-hospital measures) and quarantine of
infected persons
How it spread to Singapore
Officially spread to Singapore via 3 guests who travelled from Hong Kong.
1 of the guests, Esther Mok, spread the SARS virus to 22 other individuals in the Tan
Tock Seng Hospital and started the SARS epidemic
SARS spread especially quickly among healthcare workers and taxi drivers due to
their job nature having them be in close contact with potentially infected customers.
206 cases reported in 2003, with 8 imported cases
Measures against SARS in Singapore
Postponement of travel to highly SARS afflicted areas: namely HK, Guangdong and
even to Toronto
Designation of Tan Tock Seng Hospital as a designated SARS hospital, where no
further admissions and public visits were allowed
Designated ambulances used to transport SARS patients to TTSH
No-visit rule extended to all public hospitals
Military personel used to aid contact tracing and to enforce quarantine
Closure of schools for a short period: 2 to 3 weeks
Screening of visitors at airports and seaports
Singapore used a wide-net health screening where even mild symptoms related to
SARS – e.g. mild fever, chest radiograph anomalies – were treated as symptoms of
SARS, and patients were appropriately quarantined
Quarantine of all SARS infected individuals for at least 10 days, with the possibility of
electronic tagging in order to prevent people from breaking quarantine.
Fines used in order to enforce quarantine, in addition CISCO and military personnel
used to monitor quarantine areas
Handling and disposal of all bodies due to SARS within 24 hours
Intensive education and provision of protective personal equipment, e.g. face masks
(N95), gloves, hospital gowns, eyewear
Healthcare workers had temperature checks thrice a day
Examine the geographic factors responsible for the incidence and spread of HIV/AIDS. [10m]
Introduction
- HIV/AIDS is one of the world’s most significant health problems that is easily spread through
unprotected sex, breast milk, blood, and from mother to child. More than 34 million people
currently live with the disease, and 7000 are diagnosed each day.
- South Africa has one of the highest prevalence of HIV/AIDS, with 4.2 million people infected and
250,000 deaths each year. Southern Africa has the highest prevalence within Africa, in areas such
as Swaziland, Botswana, Lesotho, South Africa. In comparison, Northern Africa has low prevalence
of HIV/AIDS.
Political factors
- Mbeki government is unconvinced that HIV causes AIDS
- Ignorance about HIV/AIDS
Demographic
- Only 5% of children receive treatment
- 10% of women receive treatment
- 10% of orphans receive government support
- Affects economically active age group, increasing dependency ratio
Cultural
- Belief that contraception affects men’s masculinity
- Religion does not allow use of contraceptives
- Sex with virgins can cure HIV, leading to rape
- Virginity test in Kwazulunatal
- Polygamy and mistresses increases spread
- South Africa vs Northern Africa - difference in religion could account for difference in HIV
prominence
Environmental
- Distance to travel limits access
- Limits education on HIV/AIDS
- Lack of infrastructure
Economic
- Higher levels of trade increases HIV prevalence
- Impacts working population therefore impacting economy
- Patents hinder production of low cost alternatives
Conclusion
In conclusion, political, demographic, cultural, environmental and economic factors all contribute to
the spread of HIV/AIDS, but it is mainly misguided cultural beliefs that should be corrected in order
to reduce and possibly reverse the spread of the disease.
Malaria
Catchy opening lines
3 billion people are at risk from malaria
There were approximately 860,000 deaths from malaria in 2008, 89% of which occurred in Africa
Every 30 seconds a child dies from malaria
About 3.3 billion people - half of the world's population - are at risk of malaria.
Every year, this leads to about 250 million malaria cases and nearly one million deaths. People living
in the poorest countries are the most vulnerable.
Malaria is especially a serious problem in Africa, where one in every five (20%) childhood deaths is
due to the effects of the disease.
An African child has on average between 1.6 and 5.4 episodes of malaria fever each year.
Malaria has been estimated to cost Africa more than U.S. $12 billion every year in lost economic
productivity, and can cost households as much as 32 percent of their entire monthly income.
Insecticide-treated bed nets could prevent as many as 1 million deaths from all causes of malaria for
children under 5.
If universal malaria prevention could be maintained until 2015, an estimated 2.95 million African
children’s lives could be saved.
Malaria Management
Mosquitoes are more active at night
Being inside a building does not guarantee protection
Anti-malarial drugs
Drugs are expensive and there are millions of people who would need to be taking them, which
could mean that they lose some of their natural resistance that they have. Drug companies make
millions of dollars from drugs, which are not necessarily supplied at the cheapest price. Many aid
agencies and organisations such as the Bill and Melinda Gates Foundation distribute drugs in places
where malaria is having a major impact.
How realistic is it to distribute drugs to all people living in countries where malaria is endemic? Do
drugs lose their effectiveness is used on a large scale and over a longer period of time.
This strategy involves reducing the areas of stagnant water where the mosquito might breed. Open
water should be covered, redundant irrigation channels should be filled in and open drains avoided.
Fish can also be stocked into ponds to eat the larvae. This has the added benefit of providing a food
supply. One issue is that many of the ponds where the mosquitoes breed are not permanent, but
are caused by seasonal rains, or intermittent flooding. When there is flooding on a massive scale,
stagnant water can sit around for months, and there is no chance of removing it. This strategy is
aimed at disrupting the life cycle of the mosquito and has been tried in Somalia, and is known as
“larval control”. The use of insecticides is expensive, and can contaminate groundwater. Insects also
build up a resistance to the insecticides over time.
Number of doses of artemisinin based combinations produced worldwide: from 0.5 million in 2001
to 160 million in 2009
20 years ago 1 in 5 deaths in Kenya were caused by malaria. Mid to late 90’s malaria became
recognised as an issue of international importance. 28 million Kenyans live in areas that puts them at
risk of malaria. Ministry of Public Health and Sanitation has led the malaria eradiction event working
with other partners such as UNICEF and the World Health Organisation. Since 2003 $6 million has
been spend on ITNs and 21 million nets have been distributed. Pregnant women and children, who
are most at risk, have nets provided for free.
Community outreach programmes have also been started up to go into the most rural settings and
help provide education and nets. Support is also given in fitting the net successfully in their house.
The other focus area has been providing free drugs for people with malaria. As it is free treatnment
is occurring straight away, rather than only when the child gets very sick. ACT drugs are provided
free for all people confirmed with malaria. Hospital admissions have dropped by half. People are
now able to work more effectively as they are not getting malaria as much as before.
More money is needed to eradicate malaria from Kenya. There are still some rural areas where
further education, ITNs and drugs are needed to further reduce malaria.