Roadmap to the future (PowerPoint) by fjzhangxiaoquan


									          Global Nutrition Part 2
                           The ugly

              The good

The bad

                 Roadmap to a world
                   without hunger
             Roadmap to a
             world without
   Who to ask what’s happening?
    Where are we now, really ?
What works & what doesn’t?
  Evidence-based analysis & solutions
Questions that need qualifying
The 50% (actually 49.2%) is children that will
  require food-aid at some time during childhood
• Pct % of people hungry is declining dramatically
Who’s lying? Be deeply suspicious of
•Those with a strong self interest ...   follow the
•Those with history of lying or cheating   money
•Those who speak from dogmatic idealism
Keep an open mind: free enterprise, free trade,
             GM seeds, globalization? ...
                    Yunus - yes if it helps the poor
          When experts disagree ...
• ... don’t expect to agree with anyone?
• Do we believe in globalization?
                                             Look for
• Do we believe in free enterprise?          common
• Do we believe in free trade?
 Be deeply suspicious of ...
                                           Follow the
•Those with a strong self interest
•Those with history of bribery, lying, or cheating
•Beware of those with small ears, ideologues, those who
allow no voice for the dispossessed
        What kinds of aid don’t work
Teams of publish or perish “anthropologists”

   “Another needs assessment? …         Look around. Ask people”

“We have noticed that Americans have very tiny ears” ...

                            ... & very large mouths. But we would
                               prefer it to be the other way around

Aid that designed to benefit the donor, not the recipient
Advocates for the poor rate the World Bank, IMF, & WTO fail!
                                                       Vandana Shiva

Not billions given to buy loyalty of corrupt leaders
        Who tilts the playing field ...
           We do: Our tax dollars, the leaders we elect
                                Harper? Ignatieff? Layton?
Development begins at independence

Discovery of natural resources  impoverishment!

Donor countries insist that recipient open their markets

... farmer’s lobby in rich countries get barriers
Food must be bought from US farmers, processed in US
  mills, shipped in US ships
                              WTO? World bank?
                               Read: Confessions of an economic hit-man
          The poorest of the poor
Have resources worth less than $1 per day
                                           Jeffrey Sachs video

 •a significant fraction will be unable to stay alive
 •they live mostly in isolated rural areas
 • most are subsistence farmers
 •what they eat this month is what they can take
  out of the ground from last month's planting
 •who to call in an emergency? ...
             If you give a cell phone, battery will run down!
                                                            Page 7
          Don’t give them money …
                                Money? Useless

• Unless one has seen remote villages, it’s hard to imagine a
  community without commerce
• No shops to spend money in, no one to employ anyone, no
  one to sell things to
• Hungry & stunted children are all too visible. Those who
  didn’t survive are in tiny unmarked graves
• Hospital, dispensary, emergency services > 1 day walk
Their needs are much more immediate than money.
 We don’t need studies to learn what they need - read on!
                                                        Page 8
   What’s more important than $?
•Short term – need to survive
 emergency rations, safe water, first aid, antibiotics,
      public health – vaccinations, drugs, &c
 In conflict zones, shelter, safety to live, plant, harvest
•Medium term - need is to become self-sufficient :
 good seeds, fertilizer, usable water, sanitation, low
 technology agricultural info & resources, drip-
 irrigation, mosquito nets,

                                                       Page 9
           Long term village needs

tools for sustainable development
health services, Dispensary pharmaceuticals,
 emergency nurse within 7 miles
Hospital within 50 miles
Transport system
bicycle ambulance
Every village has a cell phone, a motor-cycle
Every truck-driver has a cell phone
Kids need perinatal & long term nutritional support
     Pitfalls problems & roadblocks
•   Financial melt-down Diverts development & aid $
                             Increases the price of foods
•   National scale land purchases
•   Food  fuel ...
                             Also  displaced persons &
•   War on terror ...        Destroys the local economy
•   Nations in bondage to IMF debt
•   Unfair trade practices
                         Vandana Shiva on    Vandana Shiva on
•   Climate change         globalization        Food Laws
•   Globalization of food economics
•   Clean water & air have become commodities
             Routes to famine
Being landlocked – no one to trade with ...      Lesotho

                                              South Africa
Discovering resources ...

Being on a trade or pipeline route ...          Afghanistan

Bad governance ...                              Zimbabwe

Armed conflict …                                Everywhere

Uncertain rainfall & drought ...              Sahel, Palestine

Out of a tiny acorn the mighty oak doth grow ...
             Yunus:        ... or a tiny bonsai tree
Let’s try to avoid blaming the victim, the people
A vicious cycle: economics, hunger, health

Poverty  diminished access                     Physical & cognitive
   to agricultural & food                           impairment,
 resources  malnutrition                    susceptibility to disease,
                                             early death  inability to
                        nutrition                 earn an income

                          inability to provide
                           for self or family

                                                               Page 13
      Initiatives making a difference
The Millennium Development Goals

Grameen Family of social enterprises
The Millennium Village project

The Kings of Philanthropy

Influential voices for change
Scientists & students who are making a difference
            If you believe 1 person can’t make a difference,
You! ...         you’ve never been in a tent with a mosquito
           $7 can deliver an insecticide treated mosquito net
                                              MGH students
    Innovations that make a difference
Barefoot agiculturists   Soil conservation, don’t burn
                          contour farming, irrigation,
Pump installation         crop rotation

Burkina Faso planting-pits & stone furrows  land
 food for 500,000
Tilapia in Phillipines for 30,000,000
Hybrid rice in China – enough for 60,000,000
Market liberalization in Bangladesh  rice yield 3x
                                Millions fed

Zero-tillage wheat-seeder drill - $100?

                              Doubled yield  govt

                              Farmer buys & rents
                               to pay off

                              2 factories 100 in
                               Haryana & Punjab

 Labour goes further. Earlier planting  yield 
                                           Innovations that make a difference
              Appropriate technology
Watering can irrigation           $25 pump irrigates ½
                                  acre  $100/y net

    sub-surface drip irrigation
                                                   rainwater collection pits
  The Millennium Development Goals
World’s nations committed to meet 8 goals by 2015
• The development challenges were identified
• Specific actions & targets (the MDGs)
• A pledge to provide the means was made by
  189 nations & signed by 147 heads of state
The MDGs break down into: 21 quantifiable targets
• with 60 time-lined indicators.
Some of the richest now say they will not meet their
  commitments ... but those who keep faith &Arab
  states, Cuba, China &? will turn the tide     Page 19
   Nutrition & Millennium Development Goals
                                                          Primary goal is to
                                                          eradicate extreme
                                                          poverty & hunger
 Gender equity
                     Achieve universal                                  see next 2
  Empower   ♀        primary education                                    slides

                     1                   HIV, malaria,
                                         other diseases
 Child mortality
                                                      Environmental
                                                                 Global partnership
                                                                  for development

                    Nutrition – direct prerequisite to goals
     maternal
      health           1, 3, 4, 5 & 6; indirectly to 7 & 8                 Page 20
Centrality of nutrition to MDGs 1, 2, & 3

1. Eradicate extreme poverty & hunger. Poverty is the main
   determinant of hunger. Malnutrition irreversibly
   compromises physical & cognitive development &
   transmits poverty & hunger to future generations.
2. Achieve universal primary education. Malnutrition
   diminishes the chance that a child will go to school, stay
   in school, or perform well in school
3. Promote gender equality, empower women. Women’s
   malnutrition impairs the whole family’s health & nutrition

                                                        Page 21
 Centrality of nutrition to MDGs 4, 5, & 6
4. Reduce child mortality. Delivery of a live healthy
  child is dependent, above all, on a well nourished
  mother. Protein & folic acid are critical here
5. Improve maternal health. Malnutrition accentuates
  all major risk factors for maternal mortality. NB protein,
  iron, iodine, vitamin A & calcium
6. Combat serious infectious diseases. Malnutrition
  aggravates infections, immune competence,
  transmission & mortality in HIV, malaria, tuberculosis
                            Adapted from Gillespie and Haddad (2003)
                                     Page 22
   Solutions to global hunger are
      within our reach - IFPRI
• "Successes in agricultural development need
  to be recognised ... so that others can learn
  lessons from them“
• "The need to invest in agriculture is more
  important and urgent than ever before."
Progress toward elimination of poverty
                           Millennium Development Goals Report
                                     Panel of experts July 2009
Many factors complicate
                                  % of people below $1.25 per day
BRIC countries (Brazil,     42
Russia, India, China)
break the curve

Sub-Sahara Africa has not
done as well

Experts agree that the
situation has worsened
since 2008 – food prices     0
    remedy is urgent               1990      1995       2005
          Slow progress toward the MDGs
       Goal                Sub-targets likely to be        At risk urgent action needed
1. Eradicate          reduce poverty by ½              Eradicate hunger: ½ those in sub-
extreme poverty &     developing countries’ export     Saharan Africa may still live on <
hunger                earnings devoted to servicing    $1/d; ¼ of all children are
                      external debt fell by ~50%       underweight. Fairer trade unlikely
2 Universal           Primary school enrolment of      Promising progress
primary education     at least 90%
3 Promote gender      The gender parity index in       Of 113 countries 18 may achieve
equality, empower     primary education > 95%          parity in 2o ed; Parity in employment
women                                                  & politics seems unlikely
4 Reduce child        Measles deaths is declining      Child mortality has dropped by ½
mortality             89% of children receiving        but still too high
5  maternal health                                    Some progress, 500,000 pregnant
                                                       women still die of complications
6 infectious          AIDS declining deaths & new Some 2.5 billion people, almost half
disease & safe        infections, malaria prevention the developing world’s population,
water                 tripled, tuberculosis to decline live without improved sanitation
                      1.6b people have gained
                      access to safe drinking water
7 Global              Unprecedented verbal             In reality, aid expenditures declined
partnership for       agreement & generous             for 2 years. Few meet 0.7% of GNP
development           promises
At half-way, most MDGs are partly met.
                                               Only goal #2 is fully within reach!     Page 25
           Who gives 0.7% of GNP?
           Myths, truth, & omissions
In absolute terms the USA gives more than anyone else

$57.5: given by the EU’s 20 most developed countries
$22.74: given by USA with about the same population
     US aid goes mostly to nations it can use
Kuwait gives 8.2% of GNO, Saudi Arabia 4% in 2002
Cuba may give the highest % of GNP. China & India??
Social enterprizes – Grameen family
  Grameen family of Social Businesses
1 Grameen Community Development Bank for the poor (p)
2 Grameen Trust (np) 37 countries
3 Grameen Fund (np) Risk capital for small-med business
4 Grameen Telecom (np)  poor to profit from a cell phone
5 Grameen Phone (p) 50% of all telephones in Bangladesh
6 Grameen Solutions (p) fast-growing software company
7 Grameen Communicns (np) soft & hardware networking
8 Grameen Fish & Livestock (np) village aquaculture & dairy
9 Grameen Shakti (np) renewable energy in remote regions
10 Grameen Shikkha (np) educational loans literacy & tech
11 Grameen Byabosa Bikash (np) supp services for microcr.
12 Grameen Danone Foods (p&np) nutritious food near cost
13 Grameen America (p) alleviate poverty in working poor
Microfinancing successes
        Drip irrigation allows
         winter cukes @ 3x
        price. 1A farm profit
         $100  $550 / yr

         Donkey carts for
          $200 repay in
            2.5 mos

                                  4 Factories for
                                  treadle pumps.
                                 Now there are 75
   Business Week
           Grameen Impact

Grameen village phone
10M subscribers
300k cell-phone ladies



         9.4 million poor have been helped
         1,000,000 microloans have been generated
Farm production                               Nutritional services

                        Village                     Environment


Gender equity       Energy &                      Prevent malaria
                  environment   Health services        & TB
             The GOBI prescription:
             doesn’t have to be big $
Growth monitoring                Oral rehydration
                 Child health –
               low-cost solutions

  Breast-feeding                    Immunization

$14 can save a child’s life   (2 mosquito nets@$7)
Eliminate hunger & malnutrition in the village
increase production of nutritious foods
improve nutritional status of pregnant & nursing mothers & infants < 2
                                        micronutrient supplementation
Provide equipment for a safe supply of drinking water

Train local community health workers for home-based care

Renovate or construct a local clinic & dispensary

Equip kitchens with improved stoves outfitted with a chimney
          Access to clean water & sanitation
Explore and cost options technologies (e.g. boreholes, dug wells) for increasing water supply at
the household level at each village
                                                                               Rainfall pits
                                                          Drip irrigation
 Install and train community in rainwater harvesting and collection from rooftops and storage
 tanks in schools, medical facilities and other appropriate buildings in the area

Provide material and training to filter and/or disinfect all collected water depending on the raw
water quality

Promote the creation of ventilation improved pit latrines
  Improve livelihoods & increase incomes for
             agricultural workers
Provide technical expertise and required inputs to diversify parts of farmland to higher
value products after food security is achieved focus on improving nutritional status of
pregnant women, nursing mothers and infants under two
Provide equipment for water harvesting
techniques for small-scale irrigation

Provide training to develop new village
businesses (e.g. agro-based processing, small
livestock cooperatives, small-scale artisans)

Assist farmers and entrepreneurs to partner
with larger food processors, supermarkets and
export-oriented distributors
                                               Provide all-weather vehicle access road and
Develop organized systems for selling products village vehicle
to more distant markets and purchasing farm
         The Kings of Philanthropy                                   CBC Ideas 2009
Bill Gates $28b +
Warren Buffet $37b ($10b to B&M Gates)
George Soros $6b
Gave $1b to start world's largest social entrepreneurship foundation
Omidyar ebay owner $10b
a conversation with the world to discuss the direction of their philanthropy
Ashoka Bill Drayton CEO, Lecturer at Harvard & Stanford "In US people
are very down on foreign aid, because its just not working!
University in a box
Rider Sahel
Jeffrey Skoll $1b ebay ceo
President Obama proposed $50-million for the Serve America Act
Jim Brockerman Benetec Silicon valley deliberately non-profit
 Ben Kingsley balancing the planet
Ted Turner $1b to UN programs
EU gov money will follow
Rockefeller Philanthropy advisors President Melissa Berman has guided $1b in private
resources for public benefit
 The person giving the $ away has a hard time getting honest criticism
There's a need in philanthropy to set very high goals Need for a critique
  Resources for a world without hunger
Clinton Global Initiative

Bill & Melinda Gates Foundation
Grameen Family of Social Businesses
Millennium Village Project (WHO, UN, Jeffrey Sachs)
Official Development Aid
                                 Sweden, Luxenbourg, Norway, Netherlands, Denmark
The Cuba, China model for bootstrap development
                                        spreading in Africa, Latin America, Middle East
University Global Health initiatives
     Spreading in Latin America, Africa, USA, Australia, Canada, Switzerland – through
                                          student power, and top administration, not ...
What can we do?
      Take home message
• Catastrophic inequities in distribution of foods
                   A billion overweight - a billion hungry
             not just across nations – increasingly within
• Kinds of nutritional status & health impact
                  water, protein, iron, vitamin A, iodine
• Through the life cycle, the hardest hit are
                      childbearing women and children
• We’ve faced difficult questions re inequities
                 “Not by accident?”; “Who’s responsible?”
As we face the future we are ...
                       Optimistic             Impatient
  America is well covered in text,
Canada gets a nod - world is ignored!
Roadmap to the next 2 lectures
1. Where are we, the world, now?
2. How did we get here?
3. Where are we going?
4. What is working and isn’t
Compare your mindset with evidence-dataset
             Indignation at inequities & the causes
      Realistic optimism re a world without hunger

        Impatience at slow progress & cost in lives
                          Next lecture
Nutritional concerns in Canada and in LMICs
           Do we need to know?

We live in an interconnected world
We ignore our compassionate impulses at our peril
          Nutrition in relation to global health

• For all nations, rich & poor, among the immediately
  modifiable factors that affect individual & public health
  … nutrition is of prime importance
• nutrition determines physical health & development through
   the life-cycle, including:
    – Success in childbearing, cognitive function, socio-economic
      independence, education, disease resistance & employability
    – Health & economic development are contingent on provision
      of adequate food, nutritional resources & support
at every stage of life lays a foundation for the ensuing stage

                                                         Page 45
           Nutrition in Global Health
                   Causes, mechanisms, solutions

1. Why nutrition is crucial to global health & MDGs
2. Overview of nutrition across humankind
3.   Human nutrition fundamentals in global context
4.   Top five world nutrition problems, & their solutions
5.   Nutrition across the life cycle & in rich and poor nations
6.   Cause & effect: Determinants in population nutrition
7.   Roadmap to a world without hunger: Nutrition Part II

                                                                  Page 48
                 Worldwide distribution of malnutrition
   Over 20 million children suffer from acute malnutrition WHO

Scientific American, Sept 2007

                                                            Page 49
Worldwide, nutritional inequities follow poverty
         (as do health inequities & life expectancy)

• Globally, there is plenty of food for everyone but …those
  who have more than they need don’t want to share
• The result – in the time we spend on this module over 1000
  children will have died of hunger
• Each day 1500 children go forever blind from lack vitamin A
• The poorest are 50-200x more likely to die in pregnancy
• About 2 billion people (56% of pregnant women) have iron
  deficiency. Their babies have low birth-weight, &  mortality

                                                        Page 50
  The goal is to see everyone self-sufficient,

• The MDG agreement & promises of 0.7% of
  rich country GDP for aid could, in a few years,
  eliminate extreme poverty & hunger
• But there are some nations whose promises
  mean little. Long before 2008, US & Canada
  “changed their minds”
• Thanks to those nations that keep their
  promises, extreme poverty will be largely
  eliminated, but in 50 (not 15) years

                                                 Note g
                                                 Page 51
      Some communities may need long-term help
• Even among the richest, there are some individuals so
  marginalized that there seems little hope for them
  The larger culture, if it is compassionate, takes long-term
  responsibility for ensuring them the necessities of life
• Globally there are communities that have been denied
  the resources to ever become wealthy. Often from
  geography, climate, invasion, or appropriation of their
  natural resources
Regardless, a world community of compassion provides the
  necessities of life, & offers new life to refugees the
  dispossessed, even North America once opened its doors
                                                      Note h
                                                        Page 52
Roadmap to a world without hunger-
    what works & what doesn’t
Canadian nutrition in global context
Nutrition Canada Report 1974
The good
We are privileged c.f. the rest of the world
No difference among income groups!
The bad
>10% of population are at risk for (& signif clinically)
   folic a 60%, thiamine, vit C, iron, fibre, fluoride, Ca
The ugly
•obesity is widespread 9/10 provinces - diabetes
•alcoholics, teenage girls, first nations, vegetarians
•big differences among income groups (new data)!!

•Compassion for the needy, but no political action
                                 at home or abroad
            Reasons for the decline
On the Canadian scene
We exercise too little
2 out of 3 don’t consume recommended food groups
Healthy foods are priced out of the reach of many ...
       fish, fruit, some vegetables, nuts
  ... mass produced junk is cheap & promoted
Social concerns no longer  political action
No update of 25 year-old data

On the global scale
We are no longer good global corporate citizens
        The N American diet lacks:
Ca, iron, folate:     present in available foods
Iodine, vitamin D:      in fortified foods
Fluoride, fibre:        supplement indicated
vitamin E, Mg, Zn: no symptoms despite
                          intakes below the RNI
Most of all we lack evidence-based info
    misinformation is commercially driven
Even more true globally
    misinformation is political & ideological
           Nutrition in Global Health
                  Causes, mechanisms, solutions

1. Why nutrition is crucial to global health & MDGs
2.   Overview of nutrition across humankind
3.   Human nutrition fundamentals in global context
4.   Top five world nutrition problems, & their solutions
5.   Nutrition across the life cycle & in rich and poor nations
6.   Cause & effect: Determinants in population nutrition
7.   Roadmap to a world without hunger: Nutrition Part II

                                                                  Page 57
Determinants of population nutrition

                                       Any broken
                                       link can 

                                       Think about
                                       how …

                                         Page 58
The mechanisms of hunger – many paths

                        Notice how one path can feed-back
                                 to affect others

                             As diagrammed by WHO


                           “Repositioning Nutrition as Central to
                            Development: A Strategy for Large-
                                       Scale Action”
                                                    Page 59
            Sub-determinants of nutritional sufficiency

Each factor has its own contingencies. Here are a few:

Economic development depends on agricultural sustainability
• irrigation & soil maintenance (crop rotation, contour plowing)
• seeds, fertilizers, appropriate insecticides

Agricultural productivity depends on good harvests
• climatic – drought and floods
• drought- and frost-resistant crops
• hybrid seeds and related biotechnology
• market for any excess crop, non-exploitative pricing

                                                               Page 60
             Sub-determinants of nutritional sufficiency

Each factor has its own contingencies. Here are a few more:
Stability includes freedom from disruptive forces
• war (revolts, invasion, political upheaval, social disruption)
• exploitation from outside
• corruption externally – from rich countries or multinational
  corporations who offer bribes
• corruption internally –where some developed nations set a
  poor example e.g. non-transparent procurement policies

                                                                   Page 61
        Poverty - greatest cause of malnutrition
    (hunger, blindness, disease, birth defects, maternal/neonatal death)

 The causes of poverty are disputed – no one wants to be part of
 the cause. What we know is….

• Poverty doesn't just happen, it is caused by economic, political,
  social & geographical circumstances & and decisions

• Usually these decisions are made outside the groups of people
  most affected by it!

                                                                       Page 62
          Poverty - greatest cause of malnutrition
      (hunger, blindness, disease, birth defects, maternal/neonatal death)

• Old people, women and under-supported children are most likely
  to be impacted by poverty

• Uneven distribution: 2/3 of undernourished people live in Asia

• Hunger is growing fastest in Ethiopia, Sudan, Rwanda, Burundi,
  Congo, Sierra Leone, Zimbabwe, Somalia, Kenya and Tanzania.

                                                                             Page 63
           Nutrition in Global Health
            Core concepts: Global nutritional issues:
                  causes, mechanisms, solutions
1.    Why nutrition is crucial to global health & MDGs
2.    Overview of nutrition across humankind
3.    Human nutrition fundamentals in global context
4.    Top five world nutrition problems, & their solutions
5.    Nutrition across the life cycle & in rich and poor nations
6.    Cause & effect: Determinants in population nutrition
7.    Roadmap to a world without hunger (Millions more are
     being fed but without urgent action, millions more will still
     starve. Introduction to Part II Nutrition module)

                                                                 Page 64
   Where are we? Considerable hope for the future, with
         great distress & urgency in the present

• Globally, more are now adequately fed than ever before.

• Many populations are growing ... and yet the percentage being
  fed continues to increase

• The MDGs will mostly be mostly met ... but not on schedule,
  while extreme hunger decreases worldwide

                                                            Page 65
       Where are we? Great hope for the future, with
         great distress & urgency in the present

Does that mean we are doing enough? Absolutely not!
• Sadly, improvements in nutrition are not equally spread: in
  Africa more are hungry

• Most of us born today will live to see hunger shrink to temporary
  pockets, efficiently managed by food aid

• Meanwhile, each year of delayed progress millions of lives are
  needlessly lost

                                                                Page 66
 What has changed? At last it’s clear
Disparities are now so great that there is now complete
agreement that the plight of the poorest must be addressed

The cost of conferring great benefits is a fleabite to the rich. $20
from an individual can save a child’s life and 0.7% of GDP from the
richest nations could, in two decades, wipe out the deadliest
  What has changed? At last it’s clear
   What’s needed was defined in 2001. Amazingly 22
    nations signed on to fund 7 MDGs with 60 indicators
    of success, and to provide the funds!

    1st aim: eradicate extreme poverty & hunger

We’ve seen what worked & what didn’t. The MDG
 projections were accurate, but ...

                                                          Page 68
                While some well-intended nations ...

... honoured their commitments in full, or at a higher level (here we
       honour Northern EU & Kuwait)
... most provided approximately half the aid that they undertook –
       (here we include many nations of west-central EU & Saudi Arabia)
... a very few provided a fourth or less of what they contracted – (here
       we must list the nations of N. America)

          the consequences are unsurprising….

                                                                 Page 69
    The consequences are unsurprising

• Thanks to nations & individuals who put worthwhile goals ahead
  of personal greed, we see a better nourished world emerging
• The majority of nations are now solidly on the development
• Millions will die unnecessarily in Sahel & sub-Saharan Africa, and
  the major cause rests with a few nations

                                                                Page 70
            Roadmap toward a world without hunger
We’ve concluded Part I of the nutrition modules with a preliminary
assessment of prospects for “eradicating extreme poverty & hunger.” In
Part II we ask “what works and what doesn’t?” We will…

1. … discuss the confounders & wild cards & elaborate on the
        range of possible future scenarios
2. … contend that many controversies fail to realize that many
       “competing” approaches are, in fact, complementary
3. ... categorize competing viewpoints as evidence- or ideology-
         based & subject them to the test of science
4. … survey current strategies, assessing their strengths,
       weaknesses, & applicability to real life problems

                                                                Page 71
Review your pre-quiz to confirm that you have advanced your
knowledge. As we move now to the future, here is part of the
          pre-quiz for the Part II Nutrition module
• Does globalization promote nutritional health? For whom?
• Is free enterprise good for everyone? If not, for whom?
• Are most African leaders dictators?
• Does most Africa aid end up in Swiss bank accounts?
• Does food aid do more harm than good?

Academics & politicians argue about these questions and what
should be done. Does that mean that we don’t know what to do?
We will show in Part II that the answer is:
                                                   Absolutely not!
                                                             Page 72
         Summary: What you’ve learned (& applications)

• Nutritional health is not equitably distributed worldwide
• Correcting nutritional inequities is crucial to a viable future
• We've reviewed nutritional principles in global context
• Nutritional health, public health, & economics are inseparable
• Worst nutritional risks: water, protein, iron, vitamin A, &
• Putting this information to work in context helps us know
  what to look for, what to ask for, and what to do
         Summary: What you’ve learned & its applications

• Across the life cycle, kids & mothers are at greatest risk. So we
  know priorities & best practices for risk mitigation
• We have seen setbacks, slow progress toward the MDGs
• We have substantial agreement about what needs to be done
• We see powerful signs of hope: fortunes given away, crazy
  ideas, lending money to the poorest & getting it back, & fresh
  voices with new workable strategies for a better future
• We join those working for a better world with renewed clarity
  & energy
I can single out only a few of many whose insights, persistence, &
courage evaporated the dread & pessimism with which I began this task.
In rough chronological order:
Jeffrey Sachs, Yunus Muhammad, Raj Patel, Kumi Naidoo, Paul Collier,
Howard Zinn, and Frances Moore Lappé
I learned from them, and others of a generous spirit, that:
(1) clear thinking & scientific evidence trump ideology
(2) generosity & compassion can flourish amid greed
(3) a combination of indignation, optimism and impatience
   Useful links for additional information
Note ff: Tool kit for finding information
 An amazing collation of resources is available The New Zealand Digital Library Project is maintained by Lethbridge University in Canada,
and is machine searchable at Each of the following selection of topics has many dozens of useful
(evidence-based) modules on topics relevant to the tool kit of an "agent of change"
Agricultural Information Modules
Medical and Health Library
Virtual Disaster Library
FAO on the Internet (1998)
FAO document repository
Collection on Critical Global Issues
Food and Nutrition Library 2.2
WHO Health Library for Disasters
Indigenous Peoples
Poverty Alleviation
Greenstone wiki collection

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Books, publications, and talks from any of the writers mentioned in the
Acknowledgements section are a reliable source of information
regarding what works and what doesn’t in relation to aid.
Germs, guns & steel
Confessions of an economic hitman
Sources of government information

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