IFPRI Report

Disease and Food Security: Two New Perspectives

Perhaps the most serious health problem facing the world is the AIDS pandemic, now devastating many developing countries. In several Sub-Saharan African countries it is now the leading cause of death among people between the ages of 15 and 39 years, and it is the second leading cause of child mortality in that region. AIDS is also spreading rapidly through Asia, and it is there that most new cases may well occur in the next decade.

How will the AIDS pandemic affect the development and food security prospects of these countries? In "The Potential Impact of AIDS on Population and Economic Growth Rates," Discussion Paper 15, Lynn R. Brown describes the current status of HIV/AIDS infection, particularly in Sub-Saharan Africa, and reviews existing models that predict the effect of the disease on population growth, economic growth, and food security.

It is difficult to forecast the effect of AIDS on future population growth, because of uncertainty about how long it takes from infection with HIV to development of AIDS and about what AIDS will do to fertility rates. In the worst-affected countries of Sub-Saharan Africa, AIDS may reduce population growth rates somewhat in the next couple of decades, but it is unlikely to curb population size or growth rates globally.

Would any decrease in population growth help contribute to greater food security and well-being in developing countries? Only, writes Brown, if the decline in population growth is large enough to bring it below economic growth rates. To date, AIDS has appeared to hit more educated populations in Sub-Saharan Africa during their most productive years. This trend could have devastating results for economic growth in developing countries.

The prospects for food security, especially in Sub-Saharan Africa, are grim. While AIDS may do little to reduce population growth, and thus demand for food, it is likely to have a severe effect on productivity, thus reducing incomes in developing countries. Smaller incomes will hamper access to food. In addition, the costs of AIDS--in terms of both health care and forgone production--threaten to stretch government budgets to the limit, crowding out investment in agricultural research, non-AIDS-related health care, education, and sanitation.

To improve the prospects for food security and economic growth in developing countries, it is imperative to arrest the AIDS pandemic in Sub-Saharan Africa and prevent fledgling epidemics in South and East Asia from becoming pandemics. This work will require the efforts of not just health organizations, but the entire development community.

Another health problem affecting millions worldwide is diarrhea among preschool children. Nutritionists have known for some time that links between food consumption, diarrhea, and malnutrition are strong, and this knowledge is now making its way into the economics literature. Managing Interactions between Household Food Security and Preschooler Health, Discussion Paper 16, by Lawrence Haddad, Saroj Bhattarai, Maarten Immink, and Shubh Kumar, uses data from Ethiopia, the Philippines, and Pakistan to assess the significance of the complex interaction of illness and lack of food for malnutrition rates among preschool children, as measured by the children's growth. When diarrhea is prevalent, the effects of food shortages on child malnutrition are worse, and when food is scarce, the effects of diarrhea on child malnutrition are worse.

Researchers and policymakers often overlook these synergies between the various contributors to nutrition. Households, however, cannot afford to adopt a single-minded focus on food or health. Policies and programs to improve children's nutrition status should thus work to exploit these synergies and to identify the main constraints to exploiting them. Besides aiming to increase incomes or food consumption, they must concern themselves with access to health care, clean water, sanitation, and other factors that contribute to good health.