Testimony of Dr. Beth Dunford before the House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations

Thursday, June 9, 2016


Chairman Smith, Ranking Member Bass, and Members of the Subcommittee, thank you for the opportunity to appear before you today.

Before I begin, I want to thank both of you as well as the members of this Subcommittee for your continued support and leadership on nutrition and food security.  In particular, I want to thank you, Mr. Chairman, for sponsoring the Global Food Security Act, which demonstrates the U.S. Government’s commitment to reducing global poverty and hunger through increased food security and improved nutrition.  The Global Food Security Act will solidify our standing as a global leader on these issues and send an important signal to rally others to this work.  The passage of the Global Food Security Act in the House of Representatives would not have been possible without your strong support and the leadership of this Committee, including Chairman Ed Royce and Ranking Member Eliot Engel. We look forward to working with you and colleagues in the House and Senate to get this important legislation to the President’s desk.

I am pleased and honored to address the important role that the U.S. Government is playing to help reduce global hunger, poverty and malnutrition through the President’s Feed the Future initiative, including during the critical 1,000 day window between pregnancy and a child’s second birthday.  

The Food and Agriculture Organization of the United Nations estimates that 795 million people are undernourished globally, 98 percent of whom live in developing countries. While this number has fallen by 167 million over the last decade, it is still 795 million people too many.  Compounding this problem, research indicates that by the year 2050 the world's population is projected to increase by over 30 percent to nearly ten billion, which, combined with changing diets, will require up to a 60 percent increase in food production.

During the Bush Administration, the United States allocated resources for a near- and longer-term response to the 2007-2008 food price crisis that focused on boosting agricultural productivity, strengthening supply chains, and promoting sound market-based principles for agriculture sector development and regional trade.  This approach was consistent with ongoing efforts by African leaders to invest in and revitalize agriculture as a proven means to reduce poverty.  Early success provided near-term gains in agricultural productivity in West Africa and increased food availability.

In 2009, following record high food prices and a dramatic increase in the number of poor and hungry in the world, the Obama Administration built upon the Bush Administration’s efforts to address this problem.  The President pledged to provide at least $3.5 billion over three years to attack the root causes of global hunger and poverty, implemented through Feed the Future.  This commitment rallied the global community behind these efforts and led to additional donor pledges of more than $18.5 billion.  

Feed the Future has brought together the knowledge and expertise of 11 different federal agencies for a whole-of-government initiative.  The initiative is led by the U.S. Agency for International Development, the lead U.S. agency that works to end extreme poverty and enable resilient, democratic societies to realize their potential, and draws on the wider diplomacy, agriculture, trade, investment, science, development, and policy resources and expertise of the U.S. Departments of Agriculture, Commerce, State and Treasury; the Millennium Challenge Corporation; the United States African Development Foundation; the Peace Corps; the Overseas Private Investment Corporation; the Office of the United States Trade Representative; and the U.S. Geological Survey.  

Feed the Future has positioned the United States as a global leader in the political, economic and moral fight against hunger and poverty.  With a focus on smallholder farmers, particularly women, Feed the Future supports countries to develop their agriculture sectors as a catalyst for broad-based economic growth and trade, to raise incomes and help reduce hunger.  It represents the first time that nutrition and agriculture became closely tied together in development efforts.  Productivity gains by farmers make food more available and affordable for low-income consumers, drive demand, and generate local employment, further helping the poor.  Feed the Future also seeks to address the root causes of recurrent food crises and to help vulnerable populations become more resilient when crises occur.  Feed the Future is also based on the principle that to succeed we need to work hand-in-hand with host governments, civil society, the private sector, and the international community

Feed the Future’s Progress on Nutrition

Because of Feed the Future’s efforts and those of our many partners, we have seen significant progress.  Farm productivity has risen, poverty and hunger have fallen dramatically in many countries where we work, and growth rates in agriculture are among the highest in recent history.  Preliminary data indicate we are on track to meet the target of helping to reduce poverty and stunting by an average of 20 percent across targeted areas in Feed the Future focus countries by 2017.

On nutrition, the world has seen a drop in stunting from 39.6 percent to 23.8 percent as a result of better nutrition since 1990, although many countries are lagging far behind, including countries  where Feed the Future is working.  Since the initiative began, the average annual rate of reduction in stunting for all children doubled across the Feed the Future focus countries for which we have data.  Preliminary data from recent surveys also show encouraging reductions in stunting for children in the targeted areas in many focus countries where Feed the Future collaborates with host governments and other development partners to improve nutrition.  From 2011 to 2014, stunting in Bangladesh dropped by 14.4 percent in the two districts that make up most of Feed the Future’s Zone of Influence, accelerating the annual rate of reduction to 5.1% from only 0.6% annually over the previous four years.  In neighboring Cambodia, the prevalence of stunting significantly decreased by 23.3 percent between 2010 and 2015 across the Zone of Influence where Feed the Future concentrates its programs, an increase in the annual rate of reduction to 6.4% compared to 4.7% over the previous five years.  Between 2012 and 2014, Feed the Future-supported beneficiaries in Honduras saw their incomes rise by an average of 55 percent. This and other interventions helped contribute to a 56 percent reduction in the prevalence of underweight among children under two directly benefiting from the Feed the Future activities. 

While we have seen impressive progress over the last five years, particularly on stunting and nutrition, there is still much to be done.  According to the latest data, approximately 159 million children under the age of five, still suffer from chronic malnutrition.  In 2011, undernutrition contributed to over 3.1 million child deaths—45 percent of child deaths worldwide.  It also reduces the economic growth potential of low- and middle-income countries by up to eight percent. The World Food Program estimates that child mortality associated with undernutrition has reduced national workforces by one percent to 13.7 percent globally, and roughly one half of the world’s working age population suffered from stunting as children.

Efforts to address early childhood malnutrition are essential to breaking the cycle of poverty and facilitating development.  Malnutrition contributes significantly to maternal and child mortality, decreases resistance to infectious diseases and prolongs episodes of illness, impedes growth and cognitive development, threatens resilience, and negatively impacts countries’ human capital and economic growth.  The damage caused by undernutrition may be irreversible, especially during the critical 1,000 day window of opportunity between a woman’s pregnancy and the child’s second birthday.  Undernutrition impairs cognitive, socio-emotional, and motor development, which leads to lower levels of educational attainment, reduced productivity later in life, lower lifetime earnings, and slowed economic growth of nations.  In the face of this, we know that relatively simple interventions to increase dietary diversity such as the increased consumption of fruits, vegetables, such as orange-fleshed sweet potatoes, a bio-fortified food, can have a transformative impact on people’s lives.  Orange-fleshed sweet potatoes contribute to decreasing vitamin A deficiencies and thus night blindness in young children.

Recent studies show that investments in nutrition build human capital and boost shared prosperity. Early nutrition programs can increase school completion by one year, plus raise adult wages by five percent to 50 percent later in life.  Children who escape stunting are 33 percent more likely to escape poverty as adults.  Reductions in stunting can increase GDP in the world’s least developed regions by four percent to 11 percent.  According to recent estimates, every dollar spent on improved nutrition yields up to $18 dollars in return.

To make progress on poverty and hunger, and to ensure robust, inclusive economic growth, we must do more to end malnutrition globally.  The U.S. Government has long been a leader in the effort to reduce undernutrition around the world.  In 2014, USAID launched our Multi-sectoral Nutrition Strategy, and on June 14 of this year, the U.S. Government will release its Global Nutrition Coordination plan, outlining high-impact nutrition actions that will help achieve this goal.  The U.S. Government Global Nutrition Coordination Plan is designed to harness the power of the many diverse investments across the U.S. Government through better communications, collaboration, and linking research to program implementation.  By embracing cross-U.S. Government partnerships and coordination, we leverage our advantages so that U.S. resources have a greater impact on nutrition worldwide.

As we meet today, we can for the first time perceive the end of hunger and undernutrition.  While significant reductions in stunting take time, given the solid results achieved over the last ten years, I am optimistic that we will see the elimination of global malnutrition.  The adoption of the Sustainable Development Goals and commitments from governments, donors, and the private sector toward meeting them has added to already substantial momentum.  The world has committed to eliminating extreme poverty and the hunger that accompanies it, while ensuring everyone on Earth has the opportunity to have an adequate diet necessary to health and well-being.  Setting down that marker is a monumental step forward, and Feed the Future is committed to leading the way, hand-in-hand with our many partners, to ensure we take all necessary steps to achieve our goal.

A Framework for Sustainable Financing for Agriculture, Food Security and Nutrition

Given the complexity of the problems we face, it is clear that Feed the Future can do a lot, the U.S. Government can do a lot, and our partner donors can do a lot, but we will never be able to eliminate hunger, poverty, and undernutrition on our own.  To succeed, we have to have partners, including the private sector, committed to this work, and we must develop a new framework and innovative mechanisms to finance agriculture, food security, and nutrition.

To be clear, donor financing is as important as ever.  When used strategically it can catalyze new investment from the private sector or accelerate the impact of investment by the governments of countries where we work.  Donor financing allows us to work with U.S. universities and international partners to develop and introduce new technologies and innovations that can have a major impact.  And donor financing allows us to ensure that interventions reach women and other marginalized, vulnerable groups who might otherwise be overlooked.  Funding for Feed the Future is critical to these efforts.  But our efforts have to strategically complement and foster private sector and national investments to create an environment that sustainably contributes to eliminating extreme hunger and undernutrition.

Going forward, Feed the Future will intensify our partnerships with governments to expand country leadership; the private sector to catalyze sustainable investment in the global food system; financial institutions to accelerate growth among small and medium enterprises and smallholder farmers; and civil society to ensure that growth is inclusive and transparent.

The Critical Role of Country Leadership

Leadership and support of national governments are among the most important factors to successful and sustainable progress in a particular country.  Going forward, we must build on our work with governments to help them create the enabling environments that allow our investments to take root and thrive.  By enacting policy changes, improving infrastructure, and supporting research, which is a public good, governments can build the space and opportunity for civil society and the private sector to flourish.  We will continue to encourage governments to build the infrastructure necessary for agricultural systems to grow and to forge partnerships with the private sector to create a viable and sustainable local economy.  Governments set the tone for their country's development and have the ability to make issues such as nutrition a national priority.

For example, in Nepal, where I served as the USAID Mission Director, the Nepalese Government committed $193.4 million to nutrition efforts over five years.  They made clear that increasing investments in nutrition was a national priority and that improving the nutritional status of children and women was necessary for future economic growth and development.

On September 17, 2012, the Government of Nepal, donors, members of the private sector, and civil society signed a major policy declaration committing to the acceleration of improvements in maternal and child nutrition and rallying partners behind the Government’s Multi-sectoral Nutrition Plan.  

Feed the Future was there to support and build on their efforts.  USAID’s five-year, $57 million nutrition project complemented their work by providing key health and nutrition information to “1,000-day households.”  Through local radio programming, community interactions, and household visits, families learned about nutrition, safe childbirth, childcare, hand washing, how to build latrines and safely dispose of solid waste, planting household gardens, and breeding chickens as a source of protein.

Under the Nutrition Plan, Feed the Future supported the training of more than 48,000 current government health and agricultural extension workers.  Our complementary nutrition project trained these workers on nutrition, water, sanitation and hygiene, child health, and homestead food production.  With these skills, the workers continue to serve their communities in 41 districts, further ensuring that these nutrition activities continue long after Feed the Future’s project ends.

This partnership has paid off.  In 2015, when a 7.8 magnitude earthquake hit Nepal, devastating communities across the country, we expected that a high number of children under five in the earthquake-affected districts would need to be treated for severe acute malnutrition (SAM). Given the high, historical prevalence of wasting in Nepal and the rates of SAM following other disasters, we were not hopeful.  At the time, the Mission’s nutrition group estimated that we would find about one percent of children suffering from SAM.  In the five earthquake-affected districts where USAID has a presence, we anticipated 836 SAM cases.  We began screening efforts and, when all was said and done, we only identified 244 children affected by SAM (or 0.3 percent).  These low levels of SAM were probably largely due to the Nepalese Government's leadership on nutrition, and Feed the Future is encouraged by this example of country ownership.  It is something that we hope to see replicated in other countries. 

The Importance of Private Sector Partnerships

A sustainable global food system requires a vibrant private sector, which brings market access, cutting-edge business practices, and innovative insights to the development table.  Inclusive economic growth is the most sustainable way to accelerate development and eradicate extreme poverty.  The evidence shows that public-private partnerships advance the impact of sustainable development and foster private sector-led growth in emerging markets.  They are fundamental to reducing poverty, fighting hunger, and improving nutrition across the globe. For our nutrition efforts to succeed over the long haul, we have to work hand-in-hand with the business community.

I would like to highlight one example of how we are partnering to catalyze access to a more diverse diet.  Protein is an important part of a healthy diet.  Access to affordable meat is one way to provide women and children with B12, which is only available in animal source foods and is necessary for healthy nerve development, red blood cell production, and iron absorption.  When Eric Muraguri, a Kenyan entrepreneur, noticed women and children collecting chicken byproducts outside the poultry processing plant where he worked, he saw an opportunity.  Eric quit his job and launched Chicken Choice, a company that prepares safe and affordable chicken products for those most vulnerable to malnutrition.  Today he has nine shops across Kenya, but early in the growth of his business Eric ran into a problem.  Because of unreliable refrigeration while transporting products from the processing plant to his outlets, Chicken Choice struggled to keep up with demand.  Feed the Future’s work on cold chain storage was able to help Eric purchase a refrigerated truck, which allowed Chicken Choice to keep up with the growing demand.

By working with private sector partners like Eric, through a relatively small investment, Feed the Future is able to create sustainable and scalable pathways to access nutritious foods at an affordable cost.

Expanding Access to Financing

Without access to financing, however, it is difficult for businesses like Eric’s to grow.  To ensure inclusive, sustainable economic growth on a macro level, which will lead to better nutrition outcomes for all, we need to create new tools to give rural small and medium enterprises and smallholder-farmers access to credit.  We are investing in scaling up mobile technologies and easy access to real-time market information, and developing new tools that demonstrate the creditworthiness of rural agribusinesses.  For example, low-tech solutions such as developing farm profiles using data to predict future yields give banks confidence in farmers’ ability to repay their loans, which lowers the level of risk associated with granting loans to agribusinesses.

In East Africa, Feed the Future works with Partners in Food Solutions, a consortium comprised of General Mills, Cargill, Hershey’s, Royal DSM, and Bühler, to introduce new technologies and knowledge to local food processors with the aim of expanding the availability of affordable and nutritious processed foods.  Since its inception in 2012, this project has supported dozens of food processors in five countries and has also conducted market surveys on food fortification, identifying opportunities and challenges of implementation of food fortification.

But without access to financing, these processors would struggle to grow their businesses and implement what they have learned.  Feed the Future also supports Root Capital, a nonprofit social investment fund, to make loans to small and growing agricultural businesses that are improving food security and nutrition throughout Africa.  Our support is allowing Root Capital to disburse more than $50 million in loans over five years.  Small agribusiness such as these food processors are the recipients of these loans, allowing people across East Africa increased access to affordable and nutritious foods.

Partnering with Civil Society

As important as engaging governments and the private sector is, we also have to continue partnering with community and faith-based organizations, farmer cooperatives and associations, and women's groups to amplify our message about the importance of good nutrition, ensure transparency, and make certain that vulnerable groups are protected and our investments get to those we target.  Civil society provides important checks and balances and lends on-the-ground credibility to our programs and partners.  We cannot succeed without their support.  Feed the Future is partnering with civil society and community leaders to spread our message about the importance of good nutrition and hygiene practices and share promising interventions.  By tailoring messages to the local context and gaining buy-in from community leaders, Feed the Future aims to sustainably advance the health status of women and children.

The Path Ahead

Feed the Future and the U.S. Government have achieved a great deal, and we can do much more, but we cannot do it alone.  We need partner country governments, the private sector, research institutions, and civil society to succeed.  We need partners throughout the world committed for the long haul, committed to seeing this through.  That is why Feed the Future will continue to forge new partnerships and strategically steward our resources to multiply our impact.

One of our most important partners in this work is the United States Congress, and I would like to thank you again for your leadership on this issue.  Feed the Future looks forward to continuing our work together to end child and maternal malnutrition, building a safer and more prosperous future for all.

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