For decades, the United States has been the world’s leading provider of food aid to vulnerable and malnourished people. Under the International Food Aid Convention, the country agreed to provide a minimum of 2.5 million metric tons of food per year.15 Over the years, the United States and other donor countries have delivered many millions of tons of food aid.
In theory, food aid is distributed according to the needs of a targeted population, but more often than not it is distributed according to what is available, which may not be appropriate nutritionally. Providing food aid is complex because it must respond to the complex, intertwined problems of famine, food insecurity, and malnutrition. Each year, tens of millions of people rely on food aid as their primary—sometimes their only—source of sustenance. This means that food aid donors must provide the right food—with the right nutrients.
No single food will meet the nutritional needs of all food aid recipients. In fact, studies show that a combination of different foods contributes more to overall nutrition than a combination of nutrients in a single food aid product.16 Similarly, no single approach to providing food aid will work in all circumstances. Food aid may be provided at community feeding centers, as in Gustavo’s case, or through home-based care programs or at health facilities.
Vulnerable groups, particularly severely malnourished children, need food aid that is specially designed to boost caloric intake and/or meet specific nutritional needs. This “targeted” food aid is usually intended for children younger than 5, women who are pregnant or lactating, or people living with HIV/AIDS or other chronic illnesses.
“Therapeutic feeding” is part of an emergency response to treat severely malnourished children; it includes foods high in fats, proteins, and vitamins and minerals (micronutrients). Milk-based therapeutic products, with formulas developed by UNICEF and the World Food Program, have been commonly used in therapeutic settings. Newer products have also become available that deliver precise, measurable quantities of nutrients to severely malnourished children.
Food aid for general distribution, provided to meet the needs of an entire population, is generally a dry commodity distributed in bulk. It can be fortified with micronutrients, either at the production plant or in the field, but usually whole grains (rice, corn, wheat, sorghum) are not fortified. Fifteen commodities account for the majority of food aid provided by the United States, although the list of approved products is much larger.17 U.S. food aid is made up mostly of cereal-based products. (See Figure 4.3) Corn Soy Blend (CSB) is made of cornmeal, soy flour, salt, and vegetable oil, fortified with micronutrients. Other formulations of CSB include powdered milk protein, which helps the body absorb nutrients. Some types of CSB include additional micronutrients, milk powder, de-hulled soybeans, vegetable oil, and/or sugar, giving them nutritional content similar to the newer lipid (fat)-based products. CSB is now sometimes available in the form of nutrition bars. The newest CSB products have not yet been tested with large numbers of at-risk people.
Clean water—whether from an improved water source, boiled, or treated—is a necessity anywhere cereal-based food aid is distributed, because these food products must be mixed with water. Food-borne and water-borne diseases, such as cholera and dysentery, are leading causes of illness and death in developing countries. The World Health Organization estimates that about 2.2 million people, most of them children, die from diarrhea each year. People who are malnourished or have weakened immune systems are more susceptible to contracting food-borne and water-borne diseases and more likely to die from them.
Food-borne and water-borne diseases, such as cholera and dysentery, are leading causes of illness and death in developing countries. Access to clean water is a necessity anywhere food aid is distributed.
The general distribution food aid commodities fall short of meeting the nutrition needs of pregnant and lactating women, small children, and people with compromised health. This is especially true in chronic food shortage emergencies, where food aid is the main source of nutrition for more than a year. More than half the food aid provided by the United States is for multi-year programs.
According to the U.S. Government Accountability Office (GAO), 21 of the 30 countries that received U.S. emergency food aid in fiscal year (FY) 2010 had been receiving it for four or more years.
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