Author: Steve Hansch

Hungry in a Prosperous Nation, America

July 28, 2026   By Nadira Kabir      The United States is one of the wealthiest nations in history, a global agricultural powerhouse that produces enough food to feed millions beyond its borders. Yet beneath this abundance lies a growing contradiction: more middle‑class Americans are struggling to afford groceries.

These are not households facing chronic poverty.  They are teachers, nurses, military families, first responders, nonprofit staff, government workers, and small business owners, people who work full time, often own homes, and once felt economically secure. Increasingly, their paychecks no longer stretch far enough.

Prosperity Does Not Equal Security

Traditional indicators paint a picture of economic strength: low unemployment, steady consumer spending, and continued growth. But national statistics rarely capture what families experience around the kitchen table.

According to the U.S. Department of Agriculture, 13.7% of American households, or nearly 48 million people, experienced food insecurity in 2024, the highest rate in almost a decade.  Nearly one in five households with children struggled to afford enough food for an active, healthy life.  51 million U.S. households are ALICE,  Asset Limited, Income Constrained, Employed (United Way, 2024).

Food banks now report more first‑time visitors from suburban neighborhoods, including people arriving directly from work in uniforms or business attire. Some who once donated to food drives now rely on them.

The Cost of Being Middle Class Has Changed

For much of the twentieth century, a middle‑income salary could support a family, cover housing, allow modest savings, and reliably put food on the table. That equation has unraveled.   Housing costs have increased. Childcare rivals college tuition. Healthcare premiums continue to rise. Transportation, insurance, utilities, and property taxes consume larger shares of household budgets.  Grocery prices rose 25% between 2020 and 2024 (BLS CPI).

Food becomes the only flexible expense.  Families stretch groceries by buying fewer fresh fruits and vegetables, reducing meat purchases, choosing generic brands, shrinking portions, or skipping meals, often parents first, so children can eat normally. These sacrifices rarely appear in GDP reports, yet they increasingly define middle‑class life. 

When Groceries Become Debt

A recent Urban Institute analysis found that many Americans are not just paying more for groceries, they are borrowing to buy them. Working‑age adults increasingly rely on credit cards, emergency savings, or short‑term financing to cover food costs.  Credit card balances reached a record $1.37 trillion in 2024, with food purchases among the fastest‑growing categories (Federal Reserve).  This trend mirrors other reporting from World Hunger Education Service, which highlights rising financial strain among working families, including farm workers, the very people who harvest the nation’s food.   Hunger Rising in America, offers a deeper look at how economic pressures are reshaping who struggles to afford food: https://www.worldhunger.org/hunger_rising_in_america/ and https://www.worldhunger.org/america-farm-workers-face-food-insecurity/

A growing number of households fall into the “missing middle”: earning too much to qualify for assistance but too little to absorb rising costs. SNAP remains one of the most effective tools for reducing food insecurity, yet many working families sit just above eligibility thresholds.  This benefits cliff, where a small increase in income results in losing assistance even though financial strain remains, is one of the most pressing challenges in U.S. anti‑hunger policy.  Food insecurity is highest in the South and Southwest, with rates exceeding 15% in states such as Louisiana, Mississippi, and Texas (Feeding America).

What Middle-Class Hunger Looks Like Today

Hunger is not defined by homelessness. Today, it may be:

  • A suburban family whose mortgage doubled.
  • A teacher working a second job.
  • A nurse juggling childcare costs.
  • A military family navigating another relocation.
  • A retiree watching food prices outpace Social Security.

These households work full time, pay taxes, and appear financially stable — which makes their struggles easy to overlook. A family of four becomes ineligible for SNAP at roughly $40,000–$42,000 annual income, even though average living costs exceed $60,000 in most states.

Hunger Is About More Than Food

Food insecurity affects far more than grocery budgets.  Children facing food insecurity are at higher risk of developmental delays, behavioral challenges, and lower academic performance. Adults experience higher rates of stress, anxiety, depression, diabetes, and hypertension.  Poor nutrition also increases healthcare costs, reduces workplace productivity, and strains social service systems.

Rethinking Hunger in a Prosperous Nation

Anti‑hunger efforts have long focused on households below the federal poverty line. But today’s food insecurity demands a broader lens.   Strengthening food security entails improving economic security: affordable childcare, reduced healthcare costs, wage growth, and modernized nutrition assistance programs that reflect real household budgets.

A Global Lens on a Domestic Crisis

International development practitioners have long recognized that hunger is rarely caused by a lack of food.  It stems from inadequate access — shaped by poverty, conflict, or economic shocks.  The same principle applies in the United States.  Grocery shelves are full.  Agricultural production is strong.  The challenge is affordability.

Toward a More Honest Measure of Prosperity

A prosperous nation is not defined solely by the size of its economy or the abundance of its harvests. It is defined by whether working families can meet basic needs with dignity.  Recognizing the changing face of hunger is the first step. The next is ensuring public policy reflects the realities families face today.   See: The Politics of Hunger, which examines how policy decisions shape who receives support and who is left behind:

Further Reading

A Promising Model to Predict Rates of U.S. Food Insecurity

May Data Shows Food Insecurity Rising in America

Foreclosures of American Farms Increase

  1. U.S. Department of Agriculture. Household Food Security in the United States, 2024.
  2. Urban Institute. Many Families Rely on Credit and Savings to Afford Groceries (2026).
  3. Feeding America. Map the Meal Gap.
  4. Federal Reserve Bank of New York. Food Insecurity and Consumer Pessimism (2026).
  5. Bureau of Labor Statistics. Consumer Price Index.
  6. Brookings Institution. Research on Affordability and Middle-Income Households.

Update about Hunger & War in Iran

July 26, 2026   By Stephen Sellers        What began as a single day of strikes on February 28, 2026 has become one of the longest and costliest U.S. military engagements in decades, and the humanitarian toll on Iran’s youngest children has deepened rather than resolved. Nearly five months on, the threat to child nutrition described in our initial briefing has moved from a fear we anticipated to documented reality, compounded by a currency collapse, a leadership crisis, and a war whose ceasefire has repeatedly failed to hold.

Hunger Notes reported large-scale population displacements in February.  Most of 3.2 million Iranians who were displaced have returned home.  A residual caseload of displaced remains from destroyed housing: 149,528 civilian units damaged (according to the Iranian Red Crescent, in June); ~400,000 people had homes directly affected. Only ~9,000 were still in tracked shelters in June.

Iran’s safety net appears to be effective at reaching vulnerable children, and preventing rates of wasting from increasing.  The Iranian Welfare Ministry food-basket program, Phase 34 (17–18 July 2026), which provides the most recent concrete figure, identifies 180,826 malnourished children aged 5–59 months who are enrolled for subsidized food baskets (152,788 in “very needy” households + 28,038 “moderate need”).

Malnutrition is worsening in the provinces Hunger Notes flagged as most vulnerable

Sistan-Baluchestan, which was named in our February briefing as an already-strained border province, remains the hardest hit by hunger.  Up to one-third of children under five in the province now face severe malnutrition. Many families subsist on little more than bread and tea, and the loss of free school meal programs has left some students too depleted to concentrate in class or attend at all. Nationally, child stunting continues to concentrate in Sistan-Baluchestan, Kerman, and Hormozgan, alongside a parallel crisis of; roughly 30% of pregnant women are failing to gain sufficient weight during pregnancy.

The war has not ended — it has cycled through ceasefires that collapsed

After more than five weeks of fighting, the United States and Iran agreed on April 7–8 to a ceasefire that also encompassed Israel.  U.S. President Trump extended it indefinitely on April 21, but both sides violated it almost immediately. A June memorandum of understanding sought to reopen the Strait of Hormuz and formally end the war within 60 days. Instead, fighting resumed in July after Iran struck three commercial vessels that had bypassed its pre-approved shipping route. By mid-July, the U.S. President had declared the ceasefire over following a new round of strikes after Tehran targeted vessels in the strait, and as of July 18 there was no sign the renewed fighting would end soon; a week of intensified strikes had left the ceasefire in tatters. Adding to the instability, Iran’s Supreme Leader Ali Khamenei was killed and buried after marathon funeral ceremonies. His son and successor, Mojtaba, has not appeared publicly since taking over leadership.

Overall food production is up this year, or near average according to the U.N. Food and Agriculture Organization.  The Government is purchasing large amounts of wheat, but remains constrained in being able to pay farmers.  Iran has imported 22 Metric Tons of food, with Russia as the main source.

Iran’s food supply (production plus imports) has recovered  over the six months, while household food security has deteriorated sharply due to inflation and the collapsing value of the Iranian currency, the rial.

A collapsing currency has turned food into a luxury for many

The economic backdrop against which malnutrition is now unfolding is far worse than in February. Iran’s currency, the rial, approached 1.95 million to the dollar on July 20  down in value by roughly a third since January,with the IMF projecting nearly 69% average inflation and a contracting economy for 2026, leaving the official minimum wage worth only about $87 a month. Iran has not published GDP data since 2024, and a nationwide internet blackout has made even the country’s own statistics hard to verify from outside.

Food prices have increased 140% year-on-year, with flour up 170% and rice up 220%.  One dollar bought roughly 1,350,500 rials on January 1; by July 20 it bought nearly 1.9 million.  This means a  household purchasing-power collapse layered directly on top of the wartime disruption to food imports described in our original briefing.

The blockade of the Strait of Hormuz is squeezing food and fertilizer supply chains region-wide

More than 90% of Iran’s annual trade passes through the Strait of Hormuz. The strait’s effective closure, combined with a subsequent U.S. blockade, has cut off up to 70% of Iran’s export revenue. The damage is not confined to Iran. Since the end of February, roughly 3.9 million tons of fertilizer exports, about 30% of the Gulf states’ annual fertilizer trade, have been suspended, and shortage risk keeps rising the longer the strait stays closed. The war continues to choke deliveries of fuel, fertilizer, medicine, and aid shipments transiting the Middle East, forcing the World Food Program and Save the Children to reroute aid around restricted waterways, adding weeks of delay and millions of dollars in cost.

The war’s humanitarian shockwaves have reached far beyond Iran’s borders

Perhaps the starkest change since February is how far the malnutrition impact has traveled. This past March, Hunger Notes projected that increases in fertilizer prices would result in reduced food production worldwide, and resulting hunger.

Save the Children, the nonprofit, projects that every $5 rise in oil prices tied to the conflict wipes out a month’s worth of life-saving humanitarian aid for nearly 40,000 children. . In Nigeria, children who had recovered from malnutrition are relapsing: hospital records in Sokoto show nearly 40 children previously treated since February back under treatment, with many more undocumented, as families lose income to war-driven fuel price increases. Hunger Notes,  UNICEF, Reuters, and the Financial Times have warned that a continued war will likely  push up to 23.4 million additional children worldwide into monetary poverty by year’s end.

What has changed, and what hasn’t

The core vulnerabilities identified in February include Iran’s large under-five population, pre-existing pockets of wasting and stunting concentrated in Sistan-Baluchestan and other border provinces, a food supply chain dependent on imports now vulnerable to blockade, and a government historically wary of Western humanitarian NGOs — have all held true and intensified. What has changed is the scale and duration: a war many observers once expected to last days or weeks instead approaches its fifth month with no durable ceasefire, a currency in freefall, a change in the country’s top leadership, and malnutrition effects now documented as far away as Nigeria and Somalia. Without a lasting cessation of hostilities and a functioning channel for food and medical imports, the compounding crisis facing Iran’s youngest children, and the children of countries dependent on the same shipping lanes and aid budgets, shows no sign of leveling off.

Humanitarian aid to Iran is relatively small.  Domestic organizations, such as the Iranian Red Crescent Society, provide most aid.  In April 2026, the ICRC delivered more than 170 tons of relief supplies, followed by another 18-ton shipment in June, UNICEF continues to provide child health, nutrition, vaccines and hygiene.

Further Reading:

FAO’s Global Information and Early Warning System

World Food Programme

 

 

U.S. Food Aid (Part 9): Critiques of Recent Development Food Aid (RFSAs)

July 24, 2026     Since 2019, U.S. Food for Peace spent between $1.8 and $2 billion in development programs called RFSAs, for Resilience Food Security Activities.  RFSAs were more than simple food distribution; they combined food or cash transfers with nutrition educaiton, water supply, hygiene, agriculture, savings groups, market links, mentoring, disaster risk reduction, local governance, gender, and behavior change. The complex designs of these programs made them hard to evaluate, to ascertain whether they reduced hunger or malnutrition.  Most of the measurements from these programs were not about nutrition or hunger, but were about NGO activities or skills training, water committees, microfinance organizations or planning.

Making sense of what RFSAs actually accomplished is clouded by all the complex things NGOs sought to do.  In their own reporting aid agencies are more prone to showcase their field activities over their outcomes or impacts.  For instance, much of what has been written in recent years about the Food for Peace RFSAs is about their design, their theory of change, how many people reached, but not as much about what they accomplished.

The numerous US-funded RFSAs showed many promising near-term outputs, but in the end, showed minimal long-term change in nutrition.  In other words, a repeated lesson from RFSAs was that short-term improvements do not prove durable resilience.  Food aid and complementary activities may improve consumption and nutrition while the project is operating, but lasting impact requires stronger local systems, markets, income streams, water access, and shock-responsive safety nets.

 One RFSA evaluation expert had these reflections about RFSAs:

>   “The  kitchen sink approach (many sectors, scattered activities) to a problem (malnutrition) is difficult to implement and merits more prioritization;”

>   “The USAiD strategy of sequencing and layering makes sense conceptually but it may be hard to implement.  It is hard to assess or evaluate, and should not be an after thought;”

>   “Revisiting the project’s theory of change each year represents a big burden on everyone involved;”

>   “Separating the leaning function from the monitoring and evaluation function, i.e. giving roles to different institutions, is unnecessary and reflects too much micro management.  Meanwhile,tThere were too many monitoring and measuring activities;”

>   “The subsidies given out as supplemental income to buy food will not work if amounts are too low or if other non-food needs are so great that funds are diverted by families to other ends than food.”

>    “Project management offices were too far from the areas of implementation.”

Across the evaluation literature, only a minority of RFSAs produced strong causal evidence that malnutrition rates changed because of the RFSA.  One of the larger programs, in Ethiopia, was evaluated by IFPRI:  despite high baseline stunting and wasting, there was no measurable average impact on child anthropometric status from the Ethiopian SPIR program package.  Meanwhile, in Asia, the multi-year SHOUHARDO RFSA in Bangladesh had a rigorous pre-post evaluation that documented improvements in per capita food expenditures (increasing from $2.03 to 22.22) but found no attributable differences in child malnutrition.

Many of the RFSAs provided cash and food to families and then measured whether the families had more wealth (more cash).  In other words, people given money had more money, at least during the project period, and they said they consumed more food.  But 18 months later, while  families said they were better off,  nutrition gains were not sustained.

Several of the RFSAs never published final project reports or impact results. The most sobering evidence comes from Malawi’s WALA long-term evaluation, where positive endline trends in nutrition and food-aid need were not clearly sustained several years later under climate and pest shocks.   Other evaluations included as Niger’s Hamzari/Girma/Wadata, Zimbabwe’s Amalima/Nuyok/Apolou, Madagascar’s Fararano/Maharo/Fiovana, and Malawi’s UBALE/Njira. These could not isolate RFSA effects from broader trends, shocks, or selection.

Other evaluation lessons of RFSAs include:

The graduation model of sequencing each household’s intervention and mentoring appears to have improved livelihoods and food security.  But the sequencing/layering method did not work in other countries.

Nuggets of success can be identified.  For example, mothers’ “Care Groups” is a model of improving nutrition that is  scalable, and cost-effective. Lead mothers (volunteers) reach 10–15 neighboring households with timed, sequenced messages. Evidence from multiple contexts shows strong improvements in young child feeding practices, hygiene, and service utilization.  Greater success was consistently associated with interpersonal nutrition counseling and home visits, population- and community-based Social and Behavior Change Communication (SBCC) strategies, and targeting children under two or three years (the critical window).

Programs providing preventive supplementary feeding achieved twice the rate of stunting reduction, an average annual decline of 1.69 percentage points, compared to recuperative-only or no-ration programs.  (Less successful programs often relied on stand-alone Positive Deviance/Hearth (PD/H) approaches focused narrowly on recuperation rather than prevention, or failed to integrate services.)

The RFSA model was most effective when it gave poor households a real consumption floor through food, cash, or vouchers and it layered a credible economic pathway: assets, savings, coaching, agricultural or livestock support, market access.

Photo credit:  from CARE’s SHOUHARDO III Plus Program page at https://www.facebook.com/groups/2195296804116047/

U.S. Food Aid (Part 8): Nawiri in Arid Lands of Kenya

July 24, 2026    This is the eighth Hunger Notes article about Food for Peace programs to help inform the public and USDA about lessons learned during past decades about the design and evolution of US food aid, intended to inform USDA which has an outstanding request for information.

Nawiri was the most recent Food for Peace program for Kenya, with about $200 million to different NGOs, led by two groups, Catholic Relief Services and Mercy Corps, covering drought-prone arid lands with mixed pastoral and agricultural economies.  The CRS consortium included Caritas, Tufts University, IBTCI, Concern, Village Enterprise and Kenyatta University and worked in Isiola and Marsabit counties, while Mercy Corps worked in Samburu and Turkana counties, with Research Triangle Institute, AVSI, Viamo, Caritas and the African Population and Health Research Center.  Together these teams  reached some 550,000 people.

Program metrics showed that Nawiri achieved substantial positive impacts but the benefits were often uneven, context-dependent, and constrained by severe environmental shocks.   The implementing agencies found that acute (wasting) malnutrition varies significantly between neighboring wards, across different seasons, and over time, meaning that generalized regional approaches are often ineffective.  Also, screening methods like mid-upper arm circumference (MUAC) and weight-for-height z-scores (WHZ) behave differently across seasons, sex, and age groups.  Relying solely on MUAC can delay the identification of malnourished children; employing both metrics is necessary to accurately capture different characteristics and stages of malnutrition.  Not surprisingly, they found that dry climate correlated with worse malnutrition.

NGO evidence generally showed that where their interventions were concentrated, malnutrition measurably fell.   During the period of study, wasting malnutrition declined by over 20% in target areas, though it increased 40% in Turkana. Furthermore, longitudinal studies noted that stunting (long-term malnutrition) increased significantly over time for the sample as a whole, particularly in Laisamis.

Increased systematic screening and referral of malnourished children to health posts were an important reason for those declines seen in wasting.  In the  Turkana, Nawiri equipped 210 community health volunteers in 4 communities with dosage carts, pneumonia beads, and malaria test kits.  Concern piloted an integrated health intervention that added malaria, pneumonia and diarrhea case management with existing integrated-management of acute malnutrition.

Some 57 water systems were rehabilitated, important in a dry lands, and Nawiri fostered 35 local “Water Use Associations” for ongoing improvements for tanks, pipes and water points.  Crops were expanded with irrigation: sorghum, maize, watermelon, green grams, fodder. A 7 km canal was desilted.

“The primary pathway between water insecurity and malnutrition in the arid lands of Kenya is women’s time burden collecting water to meet the minimum drinking and hygiene needs of the household. Water collection is performed exclusively by women and girls and remains one of the pervasively gender inequitable elements of pastoral life. Nawiri aims to address the role of water system functionality through borehole rehabilitation.”

The project found that traditional pastoralist strategic mobility and social institutions (like sharing milk, food, and childcare) are the frontline of disaster response and foundational to community resilience.  Nawiri helped establish retail shops (dukas) in remote areas to stock better varieties of nutritious foods, bringing vibrant markets to communities that previously had to travel up to 7 kilometers for basic goods.  Nawiri promoted livestock health and livestock disease surveillance.

Applying the graduation model, some 500 households in 14 villages graduated with Village Enterprise assistance.  In The Isiolo pilot (600 households) launched 204 businesses and 20 savings groups; Food Consumption Score rose from 51.3% to 83.8% in 3.5 months and children (6–23 mo) meeting minimum acceptable diet rose from 6.38% to 31.65%.

The Double-Edged Sword of Diversification: While livelihood diversification provides alternative income, it can act as a maladaptive coping mechanism if it forces women into labor-intensive, low-return activities,. The program observed that as women spent more time on business activities, time spent on childcare decreased, which in some zones led to reduced breastfeeding and higher acute malnutrition.  While the drought pushed communities to diversify away from livestock, weak local economies meant many new businesses sold the same basic goods (like sugar and flour), fast-tracking local market saturation

Under CRS, 207 teenagers graduated the “Nawiri na Ujuzi” course (tailoring, masonry, plumbing, electrical, mechanics, driving), which was jointly funded by Nawiri and the County Government of Isiolo.  CRS Deputy COP Margaret Kahiga notes all beneficiaries come from households with under-five children facing malnutrition.  In a separate area, a randomized controlled tiral conducted with the Rural Entrepreneur Access Project (REAP) in Samburu revealed a limitation to these economic benefits:  if market saturation crossed a certain tipping point (over 60% enrollment in a specific locality), the income impact for individual businesses could reduce over time as businesses competed against one another

Resilience was highly dependent on informal safety nets, asset ownership, and access to savings.   The program emphasized layered, sequenced interventions (e.g., combining water with agriculture, nutrition education, and markets) and local ownership, leading to better resilience against shocks like drought. The partner county governments agreed to sustaining gains post-closeout, including asset handovers and policy integration. The NGOs also observed a chronic deficiency in prioritizing and budgeting of government resources for nutrition, and political leaders frequently lack awareness of the importance of multisectoral nutrition approaches.

Much of Nawiri intentionally focused on formative research and theory-of-change-analysis during the first two years.  The  Feinstein International Center at Tufts University managed a longitudinal study (bimonthly surveys) in four sentinel sites.  Tufts found that few individual/household variables predict malnutrition, whereas basic structural drivers (pastoralism under pressure, climate variability, weakening customary institutions) dominate.  Mercy Corps’ review of longitudinal data found that wasting malnutrition had persistently been above 15% for three decades, without improvement.

Notably, DOGE terminated the CRS program, despite positive progress and investments, because DOGE’s simplistic word search through the fun. ding agreement found politically-offensive words, like “gender”, and “climate.”  Because Nawiri was terminated early, a full, independent endline evaluation of final impact may be incomplete.

–  Contributed by WHES board member, Steven Hansch

 

 

U.S. Food Aid (Part 7): Lessons of Exit & Sustainability

July 21, 2026   This is the seventh part of a Hunger Notes series that review of lessons of U.S. food aid.

The ultimate goal of aid agencies’ food aid projects is to solve hunger problems in a lasting way.  Rarely, however, are aid agencies able to come back and see what improvements persisted after the project was over.

Unique and powerful research conducted by Beatrice Lorge Rogers and Jennifer Coates of Tufts University’s School of Nutrition (commissioned by the USG Food for Peace program) looked in-depth at what happens after food assistance projects ended. Their key conclusion was that project success at the moment of exit does not reliably predict long term sustainability.  (see:  synthesis report.)

The study found that many interventions that looked strong around the end of implementation weakened or collapsed once external aid resources and incentives disappeared.  As a result, the researchers argued that sustainability must be designed from the beginning of a project, not added late in the final year. They emphasized that sustained outcomes require three jointly necessary factors. These are:  1) a continuing source of resources, 2) technical and managerial capacity, and 3) motivation that does not depend on project inputs. A fourth factor, linkages to institutions, is often essential for phase over. The study stated that “endline achievement is not evidence of durability” and that “hope is not a strategy.”  In a series of reports produced by Tufts University, they demonstrated that sustainability is a trajectory that unfolds over years, not a status measured at a single point in time.

The research followed twelve NGO projects funded by the US Food for Peace program in four countries: Bolivia, Honduras, India, and Kenya. These projects had been deemed to have been generally successful at the time of their completion, and had documented sustainability plans.  Included in the study were ADRA, CARE, Save the Children, World Vision, Food for the Hungry, ACDI/VoCA, Counterpart International, and local sub-awardees.  The Tufts study used mixed methods and collected data at exit and again one to three years later. It examined whether services continued, whether practices were maintained, and whether outcomes persisted or changed. The findings challenged common assumptions in development programming.

One assumption they found NGOs too often make is that once people have been trained, they will continue the activity. But the study found that training alone was not enough. People also needed motivation, resources, linkages, and opportunities to refresh knowledge. Another assumption is that establishing contact between community actors and government services will create a durable relationship. The study found that linkages were sustainable only when responsibilities were explicit, the receiving institution valued the activity, and the institution had staff, authority, budget, and supplies.

The research also showed that abrupt exits often led to collapse, while gradual exits that allowed independent operation before departure were more promising.

Across countries, sustainability requires deliberate integration of resources, capacity, motivation, and linkages. These factors need to be built into program design from the start. The study found that the first three factors were jointly necessary. No project achieved lasting sustainability without all three functioning together. Resources refer to a continuing source of financial, material, or human capital. Capacity refers to technical and managerial skills. Motivation refers to incentives that do not rely on project inputs. Linkages refer to vertical connections to institutions that can provide supervision, supplies, or market access. The study found that projects often achieved high impact at exit because they were supplying resources and incentives; but, once those supports disappeared, outcomes could remain stable, improve, erode, or change in unexpected ways. The researchers warned that focusing exclusively on maximizing impact at exit, as is common, can undermine sustainability.

“Even evidence of continued impact at one point in time post-exit may not predict long-term sustainability.”

Case examples illustrate these findings.  In Bolivia, NGOs built piped water systems and established community water committees. Households paid monthly user fees. The systems were highly sustainable because they combined resources, capacity, and motivation. The user fees provided resources. The committees had strong managerial capacity. Households valued the benefit of piped water and were motivated to pay. In contrast, water quality testing and chlorination collapsed. NGOs had managed and paid for water testing until the final day. Committees had never practiced independent operation. Beneficiaries disliked the taste of chlorine and did not perceive the need for treatment. Motivation was absent.

“Impact and sustainability are distinct achievements, and an exclusive focus on impact at exit may jeopardize sustainability. For example, providing free resources up to the time of project exit may maximize project impact, but the withdrawal of those resources poses a bigger threat to sustainability than a gradual withdrawal with the development of substitute resources.”

In agriculture, NGOs relied on model farmers to teach improved techniques. They provided free inputs to incentivize the model farmers. When the free inputs ended, almost all model farmers stopped training others. In maternal and child health, NGOs provided free food rations to mothers as incentives to attend community growth monitoring sessions. When the free food stopped, mothers abandoned the sessions. Many volunteer community health workers lost motivation and felt their roles had diminished. Mothers shifted participation to government clinics where cash transfers and supplements were available.  See:  Bolivia synthesis.

In Honduras, abrupt withdrawal of free food rations caused a sharp decline in mothers’ participation in health monitoring. Community health workers became demotivated. Interventions that established fee for service models and gradual transitions were more sustainable. Community managed piped water systems achieved high sustainability because they secured resources through user fees, built capacity, and maintained motivation. Linking farmers directly to commercial buyers was effective. Farmers continued agricultural practices and incomes because the linkage provided market access and motivation. Phase over to government programs struggled due to national resource constraints and a political crisis. Government health systems lacked resources to supervise volunteer health workers. Without supervision and supplies, the workers’ functionality declined.

In India, the government context shaped sustainability. The Indian Supreme Court ruled that food is a basic human right, and the government banned import of genetically modified corn soy blends. Food for Peace projects devoted their final phases to transitioning food aid responsibilities to government programs. CARE transitioned the food supply chain to the Integrated Child Development Service.  Many Anganwadi Centers maintained uninterrupted food supply for preschool children after exit. Take home rations were less reliable. In Orissa, distribution dropped dramatically due to irregular deliveries. In some states, beneficiaries reported that the quality of government rations had degraded so much that some fed it to animals. Mothers continued attending health days only to receive the rations. Catholic Relief Services attempted to transition school feeding programs to the Mid Day Meals program. This largely failed because the government lacked motivation to provide free food to private religious and boarding schools.

“The study findings demonstrate that it is critical to verify the validity of a project’s underlying theory of change at the project design stage and to reassess its validity throughout project implementation.”

The most sobering lesson from India was that the projects failed to reduce child malnutrition. The assumption that combining food supplementation with health education would reduce undernutrition was not supported by evidence.   See:  Synthesis of India study.

In Kenya, gradual exit was effective. CARE’s Community Savings Mobilization project organized savings groups and provided training. CARE provided no external seed capital. All loan funds came from members’ savings. CARE graduated the groups to independent operation after one year. For the remainder of the project, CARE served only as an on call technical resource. Three years after exit, the groups were thriving and multiplying. They had high motivation and solid organizational capacity. In agriculture, CARE required basmati rice farmers to assume the cost of premium seeds before exit. This resulted in independent producer associations. In contrast, abrupt exits led to collapse. NGOs managed water quality testing until the final day. Committees had never practiced budgeting or hiring services. Beneficiaries disliked chlorine. The practice was abandoned. In maternal and child health, NGOs distributed free food rations as incentives. When the free food ended, participation collapsed. Volunteer health workers lost motivation. In livestock health, community-based animal health workers charged fees from the beginning. Livestock owners valued the benefit and paid. The fees provided resources and motivation. This intervention was highly sustainable.

Across all four countries, the study found that free handouts pose severe risks to sustainability when no alternative local source is established. Free food rations, free agricultural inputs, and free services created expectations that could not be maintained. When the free resources ended, participation and service delivery collapsed. The study found that fee for service models were more sustainable when culturally appropriate and introduced early.

Charging fees established expectations and built market viability. Attempting to impose fees at the end of a previously free project almost always failed. The study also found that linkages to institutions were often necessary but not always viable. Linkages succeeded when the partner had resources, motivation, and capacity. Linkages failed when the partner lacked budget, staff, or political will. The study stated that “government will take over is not a strategy unless the government unit has both commitment and operational capacity.”

The research also emphasized the importance of designing for context and resilience. Projects operate within environments shaped by political, economic, and environmental shocks. In Kenya, droughts devastated yields and livestock herds shortly after exit. Farmers continued applying improved techniques, but the shock wiped out yields. They lacked resources to purchase inputs for the next season. In Honduras, a constitutional crisis reduced government resources and undermined planned phase over of health services. Sustainability plans must account for predictable shocks. Projects should integrate crop insurance, promote diversified income streams, and establish drought resistant infrastructure.

RECOMMENDATIONS

  • •  Post-project sustainability needs to be designed from the start of the project. NGOs should consider embedding lasting resources, build capacity, align with intrinsic motivation, and secure viable linkages.
  • •  Donors should extend timelines when there is evidence of progress. True capacity building and phase over often require more than five years.
  • •  Donors should fund post project evaluations five to ten years after exit. Sustainability is a trajectory, not a one time status.
  • •  Projects should avoid free handouts unless a local source of resources will exist after exit. Fee for service models and business approaches are more sustainable when introduced early.
  • •  Projects should cultivate multiple layers of government ownership. Continuity should not depend on a single political stakeholder. Commitments should be incorporated into municipal plans, budgets, administrative decisions, departmental responsibilities, and civil service job descriptions.
  • •  Projects should ensure that linkages are viable. Responsibilities must be explicit. The receiving institution needs to value the activity and have staff, authority, budget, and supplies. Mechanisms for communication, supervision, and accountability must remain active.
  • •  Projects should plan gradual exits. Communities and local organizations need time to operate independently while the NGO is still present. Abrupt exits often lead to collapse.
  • •   Projects should design for resilience. They should anticipate shocks and build systems that can withstand them.

The studies’ headline conclusion is that achieving high impact at exit does not guarantee long term sustainability.  The researchers found that “even evidence of continued impact at one point in time post exit may not predict long term sustainability.” They argued that sustainability requires resources, capacity, motivation, and linkages. These factors must be deliberately integrated into program design. The study influenced USAID’s Food Assistance and Food Security Strategy. Development awards came to require explicit sustainability plans and exit strategies. The four factor vocabulary entered mainstream guidance. The research provided a blueprint for designing programs that outlive their funding cycles. It showed that lasting development success depends not on short term statistical triumphs but on long term resilience and independent operation.

These studies had a profound influence on USG planning.  FFP’s decade strategy (released October 2016) explicitly reframed the agency’s development goal around sustaining gains; it “broadens the previous goal of reducing food insecurity to one that envisions improving food security and sustaining it,” and commits FFP and partners to “strive for greater impact with greater efficiency and sustainability.” Tufts and its collaborators state the connection directly. In a Tufts Now feature (Jan 2017):  “Food for Peace has already incorporated many of the recommendations from the Tufts study in its guidance to aid organizations.” Implementing partners echoed this; ACDI/VOCA (2021) described FFP as having “incorporated many of the recommendations that arose from Tufts University research into its 2016–2025 strategy, now requiring detailed sustainability plans for all DFSAs.”

Refer to:

https://www.fantaproject.org/research/exit-strategies-ffp

https://www.fantaproject.org/sites/default/files/resources/India-Exit-Strategies-Report-Jan2017.pdf

The past FANTA project (formerly, USAID) also continues to provide summaries and links.

–  Contributed by WHES board member, Steven Hansch

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U.S. Food Aid (Part 6): A Timeline of U.S. Food Aid

July 20, 2026    This is the sixth posting in an effort to inform the public and USDA about Food For Peace lessons and directions.  Below is a timeline of selected milestones in the history of U.S. food aid sent overseas. World Hunger Education Service compiled this from a range of sources with inputs from various experts. It selects for different ways that the US has provided foods to other countries with a particular emphasis on Food for Peace, PL 480, Title II.

Notably, at the time of this publication the key food aid initiative is the same as the first, in 1812: aid to Venezuela in response to an earthquake. Contents in this table is meant to complement and not reiterate content published in other articles here at Hunger Notes.   Photo credit:  The John F. Kennedy Presidential Library and Museum, Boston.

Timeframe U.S. Food Aid Milestones
1812 USG sends food aid to Venezuela after earthquake. President James Madison and Congress appropriate $50,000 for wheat flour aid.
1847 Choctaw nation in Oklahoma raises famine relief funds for Ireland.
1914-1919 Commission for Relief in Belgium during WWI channels U.S. wheat that fed 10 million people in Belgium and Northern France, daily. Future president Herbert Hoover organizes first large scale food logistics to combat famine.
1918-22 American Relief Administration provides 700,000 MT of famine-relief food aid to Russia, Poland, Austria.
1930 U.S. Foreign Agricultural Service posts agricultural attachés around the world, starting in South Africa, Sydney, Belgrade.
1943 Catholic Relief Services (CRS) channels food aid in war-torn Europe. U.S. foods for Europe went through the United Nations Relief and Rehabilitation Administration (UNRRA) and the UN Food and Agricultural Organization.
1944 Dutch famine (Amsterdam, Rotterdam, The Hague) led to US Operation Chowhound of B-17 Airdrops of flour, meat, eggs. Later US military trucked in food as Operation Faust.
1945 WWII famine relief. George McGovern in the 741st Bomb Squadron flew surplus food aid to Trieste in northeastern Italy. George McGovern later becomes first director of the Office of Food for Peace, and Democratic nominee for President.
1945-47 CARE Packages as WWII relief, using surplus US Army “10-in-1” rations stockpiled for the canceled invasion of Japan. CARE leaders negotiated with the Army to acquire nearly 3 million pre-packaged rations. Post-WWII US aid also flowed through multilateral channels like UNRRA, the Marshall Plan/GARIOA. CARE and CRS bridged U.S. surpluses through private networks.
1948-49 USG and UK airlift 296,000 tons of food (and coal) to West Berlin. CARE delivered 230,000 packages to Berlin on its own planes.
1948-51 American Friends Service Committee, CARE, and USG provide aid to famine threatened parts of India during the Partition that created India & Pakistan. US passed India Emergency Food Aid Act providing 2 million MT of grain.
1950s India looms large as major concern for large food shortages & famine. US provided large scale grain shipments under Title I and II.
1950s US holds large domestic reserves, including surplus dairy products. FFP framed as a benefit to US farmers as safety valve for purchasing surplus production.
1954 FFP assistance to Korea includes large quantities of wheat flour shipped under Title I, a total of $1.6 billion through 1974. Later in 1987, Korea became a food donor.
1954 Western Wheat Associates (U.S. wheat growers) used food aid for market development, teaching bakers in Japan and India how to use wheat flour.
1954 PL 480 signed into law by President Eisenhower with primarily Title 1 government to government food going to governments.
1954-59 Food aid to Pakistan, Japan, Taiwan, Yugoslavia, Greece, Italy, Spain.
1955 CARE’s Board of Directors votes to not dissolve, but to refocus the organization’s aid from Europe to other continents, hence the name changes from Cooperative for American Remittances to Europe to “Cooperative for American Relief Everywhere.” This passed by a single vote. CARE implements Title I and II food aid in Haiti, Guatemala, Honduras, India and Dominican Republic.
1958 “Food and Fiber as a Force for Freedom” Senate report recommends food as a force for democracy and coins the phrase “food for peace”, written by Senator Hubert Humphrey, future nominee for US president.
1959 INCAP in Central America creates Incaparina weaning food to prevent malnutrition.
1961 President John F. Kennedy rebrands the initiative “Food for Peace” and consolidates U.S. overseas assistance under the U.S. Agency for International Development (USAID). Title III food aid created to incentivize agricultural modernization.
1961 WFP proposed by George McGovern, the first director of the U.S. Food for Peace program, as a three-year UN “experiment” to internationalize food aid.
1963 FFP fuels Operation Niños: Ag Secretary Orville Freeman claimed that U.S. food reached one in four Latin American children, that rural school-meal programs in Bolivia and Peru doubled school attendance. Food for Work also in S America.
1966 Egypt gets soft loans to purchase PL 480 food.
1966 Food aid in India peaked during the severe Indian famine of 1965–1966. During this time, the U.S. used food aid as a heavy diplomatic lever. CARE receives food aid for emergency food program in drought areas. President Johnson involved in every food aid decision related to India.
1966 The 1966 Food for Peace Act PL 89-808 reframes aid from surplus disposal to development conditionality and economic development. President Johnson transfers FFP direction from the White House to the State Department. Johnson emphasized agricultural reforms as a precondition for a country to receive food aid.
1966 Likuni Phala fortified weaning food is pioneered in Malawi.
1968 USAID offers Corn-Soy Milk (CSM) and Corn-Soy Blend (CSB) as fortified foods.
1968-69 U.S. C-97 Stratofreighters (Boeing) help deliver $50M of food aid to Biafra during war in Nigeria, via CRS, CARE, the ICRC and Joint Church Aid. First large scale deployment of new CSB. First live-televised famine; introduced kwashiorkor.
1972 World food crisis, Sahel famine.
1972-1974 Dan Shaughnessy directs Food for Peace and planning for the 1974 UN World Food Conference. Henry Kissinger plays central role in targeting countries for food aid.
1975 Integrated Child Development Services large child nutrition program in India. USG Corn Soya Milk and non-fat dried milk provided through South India Flour Mills for CARE’s “balahar” fortified food for school feeding, led by Tim Lavelle.
1976 World Hunger Education Service begins educating the public and USG about food aid issues and begins quarterly publication of the journal, Hunger Notes.
1977 Title III food aid revised to focus on barter for debt forgiveness and tying aid more explicitly to policy reforms and long-term development in recipient countries.
1979 Two key publications: Amartya Sen’s Poverty & Famines demonstrates that food insecurity is not only about food availability but also about access. Lincoln Chen demonstrates that risk of death increases non-linearly by degree of child wasting.
1979 U.S. donates polished (thiamine removed) white rice to anti-Khmer Rouge groups in Cambodia, resulting in epidemic beriberi (deficiency disease).
1980s Maternal Child Health (MCH) is main type of project supported by food aid, having grown during the 1970s. Food for Work also common for roads/infrastructure.
1983 Church World Service (CWS) stops taking USG FFP resources, following controversial episode of 60 Minutes on CBS about CWS programs in countries with communist governments. CWS goes overnight from being the largest food aid agency in the world to one of the smallest.
1984 Burma Border Consortium of NGOs formed, purchasing food locally for Burmese refugees in camps in Thailand, supported by the U.S. Department of State.
1985 Food for Progress Act explicitly references “Private Voluntary Organizations” or PVOs. Food for Progress authorized CCC financing for grants or credit sales to support agricultural development in developing countries and emerging democracies.
1985 6 million MT of food sent for African famine. Two supplemental appropriations made for Ethiopia famine. FFP manages $500M for Ethiopia alone, plus more for Sudan, and across 21 African countries.
1985 Farm Bill promotes PVO/NGO monetization, using Title II as an alternative revenue stream to direct-dollar grants. U.S. Dry Bean Council positioned pintos and black beans as shelf-stable, high-value food for NGOs to monetize. Initially monetization was to pay for internal transport, which was later funded by USAID in the 1990s.
1985 Ellen Levinson creates the Coalition for Food Aid of NGOs in Washington, DC to promote the roles of NGOs in food aid. Title II Enhancement Grant (later, Title II Strengthening Grant) for PVO headquarters capacity building.
1986 Famine Early Warning System Network (later named FEWS.NET), established on the advice of Tufts University’s President Jean Meyer. Credit also to John Field.
1989 Collapse of Soviet Union shifts emergency food aid gradually away from refugees fleeing regimes in host countries, instead to internally displaced persons.
1990 Food Aid Management funded by FFP with 5 original PVO members.
1990 Fred Cuny pioneers local purchase of food as a more appropriate response to food needs in Ethiopia.
1990s PVOs promote local village “grain reserves” with food aid for resilience.
1990-93 End of US food aid to Somalia leads to famine throughout 1992. President Bush directs US airlifts food via C-130s in late 1992. U.S. Food aid monetized to reduce retail prices across the country in 1993, but after famine has receded.
1990 “Partial monetization” turns into “100% monetization” for many NGOs.
1991 Famine Mitigation Project of experts convened by USAID to recommend best practices to prevention of famine. Including livestock, water, local food purchase.
1992 Food aid mobilization to former Soviet states where food insecurity tied to pensions lost from ruble devaluation. USG works through Red Cross movement. Operation Provide Hope channeled 25,000 MT to the Caucasus and Central Asian “Stans.” ADRA involved in Armenia and other states.
1992 Bosnia: Operation Provide Promise began July 2, 1992, becoming the longest-running humanitarian airlift in history. USG provided sorties into besieged Sarajevo, delivering food and other aid to civilians trapped by the Yugoslav war.
1992 Food Aid Management (FAM) publishes Generally Accepted Commodity Accountability Principles, GACAP, representing all NGOs working with US food aid.
1990s PVO/NGO “cooperating sponsors” include CRS, CARE, World Vision, Save the Children, ADRA, Land O Lakes, ACDI/VOCA, Food for the Hungry International, Project Concern, Africare, Technoserve, Partners for Development, World Relief, Mercy Corps, Lutheran World Relief, IOCC, UMCOR, and International Relief and Development. CARE is often lead food agency in refugee camps, while CRS is lead for IDPs.
1992-1994 FFP defines food security as: availability plus access plus bio-utilization.
1993-1996 FFP Director Robert Kramer rebalances food aid from entrenched USAID Mission projects to areas of greatest need (emergencies), and pushed WFP to recognize the greater priority in emergencies of food.
1993 FAM publishes NGO manual, Monetizing Food Aid, a Guide for PVOs.
1992 CRS’ Mike D’Adamo travels to Rome to strike a partnership with WFP, opening an era of WFP collaboration with NGOs.
1994 CARE and CRS account for roughly 72% of PVOs’ regular Title II programs.
1995 2 million refugees plus almost as many IDPs received some 240,000 MT of food in Rwanda and neighboring countries, following genocide and flight.
1995-97 North Korea’s famine received over 1.1 million metric tons.
1996 André Briend & Michel Lescanne create Plumpy’Nut, the first RUTF, at Nutriset.
1997 WFP strikes agreements partnering with NGOs for distribution activities.
1998 USG requires vegetable oil be fortified with vitamin A (and later, Vitamin D).
1997-2001 Asian financial crisis as currencies lost purchasing power. NGOs like IRD, and WFP used food aid as social protection safety nets.
1999 The majority of US food aid now channeled through WFP, not NGOs.
1999 USAID, FAM and the Canadian Govt convene food experts at a symposium at the American Red Cross to document feasibility of fortifying emergency food aid at the local level to mitigate micronutrient deficiency diseases widely seen among refugees.
2000 Global Food for Education Initiative $300 million, with CCC resources. Over next two decades, 5.5 billion meals for 31 million school children in 48 countries.
2000 Congress passes International Food Relief Partnership Act, amending Title II to authorized grants to US nonprofits to create shelf-stable food products for aid, such as Breedlove Foods in Texas.
2001 FFP Officer Tim Lavelle organizes long-term Bridge of Friendship pipeline from hub of Termez over the Amu Darya river from Uzbekistan to Afghanistan, facilitating hundreds of thousands of tons of famine-preventing food aid into Afghanistan.
2002 FFP nutritionist Tom Marchione promotes new formulations of CSB and nutrient-dense foods as part of commodity docket.
2002 CTC/CMAM modality for treating malnourished children with RUTF promoted.
2002 New McGovern-Dole Food for Education program passed in 2002 Farm Bill. This moves school feeding from Food for Peace to USDA.
2002 No more funding for Title III, a government-to-government program under PL 480 where the foreign government sold food for local currency proceeds.
2003 Large-scale U.S. emergency food aid rejected by five southern African famine-affected countries because US corn is genetically modified. Eventually the grain was milled in S. Africa before transporting to Zimbabwe, Malawi, Zambia, etc.
2000s Food aid targets HIV/AIDS response primarily in sub-Sahara Africa. USAID Administrator Natsios pushes for more flexibility for local purchase of food.
2003 Dr. Patricia Wolff from Washington University, St Louis, founds “Meds & Foods for Kids” in Haiti and produces Medika Mamba.
2003 FANTA and FFP develop criteria for prioritization of non-emergency countries.
2004 Jeanie Markunas retires from long career overseeing Food for Peace.
2004 C-SAFE consortium (World Vision, CARE, CRS) manages food aid across southern Africa, with the World Food Programme as a sub-grantee.
2004 Globally, World Vision now channels food aid mostly as a sub-awardee under WFP whereas a few years earlier it was primarily a prime.
2005–2011 RUTF increasingly mainstreamed among NGOs, UNICEF & USAID as part of a shift from blended-flour to lipid-based products for targeted feeding of malnourished.
2006 SMART survey manual released, about measuring acute malnutrition and mortality, with the intent to standardize reliable data across agencies. In 2008, the Global Nutrition Cluster designated Action Against Hunger (ACF) as the global convener of SMART, including ongoing infrastructure, guidance, consultations. FAM hosts a workshop about SMART for monitoring malnutrition.
2008 Farm Bill Sec. 3206 created the pilot USDA Local and Regional Food Aid Procurement Program. The rule established grants for field-based projects consisting of local or regional procurement.
2007 USAID & IFRC plan food aid reserves for future pandemics that contract markets.
2008 Prices for corn and oil increased 125% over a short period, increasing malnutrition worldwide. The USG provided additional $2.8 billion across all international food aid programs, delivering 2.3 million metric tons for 43 million people.
2009 Decades of US food aid to India ends. Meanwhile, India donates food to WFP.
2009 Land O’Lakes International Development nonprofit pilots local purchase of food baskets in Zambia for people with HIV.
2009 Food Aid Quality Review research starts at Tufts University School of Nutrition.
2010 Congress approves The Emergency Food Security Program (EFSP) to allow cash and voucher assistance, instead of only in-kind commodities, using International Disaster Assistance funds.
2010 MSF launches “starved for attention” campaign criticizing the US for donating CSB instead of only procuring RUTF.
2010s Ongoing scale up of RUF production by MANA and Edesia (U.S. NGOs).
2010-2011 Despite early warnings, over 200,000 Somalis die when US cuts off food aid because of Patriot Act. Food aid reinstated only after hunger season ended in 2011.
2010s “Sequencing, layering, and integration” promoted in FFP program designs.
2012 International Food Assistance Improvement Act of 2012 (H.R. 4141) sought to enhance nutritional quality and cost-effectiveness of food aid
2014 Farm Bill expanded Section 202(e) flexibility. USAID increase in authorized 202(e) funding to provide cash transfers, food vouchers, & local purchase modalities.
2014 Charles Hanrahan retires from the Congressional Research Service, after 29 years researching international food aid.
2015 Resilience Food Security Activities (RFSAs) formally introduced as new design of FFP development programs.
Mid 2010s Multi-year, development cooperative agreements, “MYAPs”, replaced by “DFAPs” as main form of FFP projects implemented by NGOs.
2017 Food to four well-publicized man-made famines: S Sudan, Somalia, Yemen & Nigeria.
2018 89% of FFP resources for emergencies. Development food aid % at all time low.
RFSAs emphasize new “graduation model”, along with theories-of-change, learning, and ‘pause and reflect.’
2019 USAID funds Nawiri resilience (RFSA) program in Kenya for northern, arid lands.
2020 Top recipient countries of US food aid from 2015 to 2020 were Yemen, Syria, South Sudan, Somalia, Ethiopia, DRC, Sudan, Afghanistan, Kenya, and Nigeria.
2022 Response to Ukraine war leads to full draining of the Bill Emerson Humanitarian Trust. USG also provides $388 million for shipping/freight, totaling $670 million.
2023 USG and WFP shut down food pipelines to Ethiopia. USAID Administrator on June 8 suspended food aid across Ethiopia because of widespread, coordinated theft of U.S. food by multiple actors (including to military units and markets). This stopped aid for ~20 million people amid drought and post-conflict needs.
2024 First RFSA program in Somalia.
2025 DOGE terminates many FFP (RFSA) and Food for Progress programs, while authority for FFP and FEWS shifted to State Department. A few RFSAs are re-started: Mercy Corps in Kenya, ADRA in DRC, Food for the Hungry in Ethiopia, and CRS in Haiti.
2025 December: FFP transitions again, to US Department of Agriculture which in February commits $452 million to WFP and bids new emergency programs for DRC, El Salvador, Ethiopia, Guatemala, Haiti, Kenya, & Rwanda.
2026 July: FFP announces $235 million to CRS for Ethiopia and Sudan.
2026 USG provides private and UN food aid in recovery from earthquake in Venezuela.

–  Contributed by WHES board members, edited by Steven Hansch

U.S. Food Aid (Part 5): Prepositioning Food Stores Overseas

July 19, 2026    This is the fifth article in a series about lessons about U.S. Food for Peace and food aid, recognizing the redesign of food aid by the US Department of Agriculture.   USDA which has requested inputs and advice for future FFP programming in their recent Request for Information, downloadable here.
…

Large emergency grain reserves, to have food aid ready for food crises were debated in the 1970s.  The USG, the World Bank, and others explored a large buffer stock of grains during years of abundance to release grain during dangerous global shortages.  The FAO and Food for Peace worked toward a distributed reserve.  The costs were, however, too large.  The Food Security Wheat Reserve Act of 1980 authorized a reserve of up to 4 million metric tons of wheat, solely for emergency humanitarian needs in developing countries, and this eventually became the Bill Emerson Humanitarian Trust.  In recent decades FFP concluded that it was more effective to have food aid pipelines — continuously moving food around the world – that permit food to be redirected for new crises.

However, because U.S. food aid often arrived too late to mitigate fast‑moving food crises, Congress encouraged Food for Peace (FFP) in 2000 to adopt prepositioning as a strategy to accelerate emergency response. A 2007 GAO review found that U.S. food aid was “generally too time-consuming to be sufficiently responsive in emergencies, requiring 4 to 6 months on average.”  

 What Prepositioning Is:  Prepositioning involves procuring and storing shelf‑stable foods, such as lentils, peas, vegetable oil, and other staples, in either U.S. warehouses or overseas sites near high‑need regions. Rather than waiting for a crisis before purchasing and shipping commodities, stocks are positioned in advance.   Prepositioning is also valuable when conditions evolve in complex emergencies and food access changes, and foods need to be offloaded to a prepositioned warehouse (keeping supplies on an ocean vessel is too expensive.).  FFP therefore seeks tactical flexibility that doesn’t rely on bulk ocean vessel carriers which cannot redirect routes.

The first overseas preposition pilot site was Dubai, with broader operational stockpiling beginning in 2005.  The Dubai hub was necessitated because food meant for Yemen had to be placed in storage while access in Yemen was unpredictably blocked due to war.  Questions arose about shelf life after foods were in storage for a period of time.

 Delivery Time Improvements:  The U.S. GAO estimates from FY 2007–2012 show that prepositioning reduced delivery times by one or more months, which can matter when responding to famines.  Timing is particularly relevant in regard to hurricanes, earthquakes and flooding, i.e. short-onset disasters.  But whereas short-onset disasters typically require a few hundred pallets of supplies, famine or larger emergencies often require thousands of tons.

Cost Implications:  Prepositioning adds significant costs due to warehouse storage, additional shipping legs, and sometimes higher commodity prices. Overseas prepositioning is far more expensive than domestic storage. A 2008 analysis found:

  •   __*   +$23/metric ton additional costs, for domestic prepositioning
  •   __*   +$164/metric ton additional costs for overseas prepositioning (about 7× higher) due to two or more ocean voyages

In FY 2012, USAID spent approximately $8 million on warehouses and $13 million on secondary ocean freight from overseas sites.

 Growth of Prepositioning:  Prepositioning expanded from ~3% of food aid (2005–2006) to 22–29% in some regions by the early 2010s.

 Operational Challenges and Losses

A 2013 Inspector General audit of the Djibouti warehouse found a 0.5% inventory reconciliation gap, far above the 0.02% contractual threshold;  Commodities were “infested by ants and tobacco beetles” that were not fumigated; USAID stopped tracking warehouse losses after 2011, despite recording $235,919 in losses in 2007

Poor warehouse management contributed to spoilage. For example:

  •  * In 2025, $2.9 million of Super Cereal Plus spoiled from insect infestation in Djibouti
  •  * In Dubai, $1.37 million of unused commodities incurred $919,000 in storage costs over two years—two‑thirds of their purchase value

Food for Peace Changes After 2014 GAO Recommendations

USAID improved data collection on shipment times, procurement costs, storage, and vessel tracking.  Additional refinements included:

  •  * Better inventory management and rotation
  •  * More site visits and stronger contracting
  •  * Adjusting domestic/overseas balances based on crisis patterns

Prepositioning sites expanded to include Dubai (UAE), Durban (South Africa), Mombasa (Kenya), Djibouti, Colombo (Sri Lanka), and the Canary Islands (Spain).

During the 2011 Horn of Africa famine, FFP deployed $124 million in prepositioned food:

  •   _*  Djibouti: 57%
  •   _*  Durban, South Africa: 25%
  •   _*  Houston: 10%
  •   _*  Mombasa, Kenya: 6%

A recent 2026 inspection report by the Office of the Inspector General found that during a visit in 2025, the storage of sorghum and vegetable oil in the Durban warehouse generally met the contract requirements and best practices, though with some deviations that may risk spoilage.

Prepositioning has been increasingly paired with strategic local procurement to improve responsiveness.  The USG has gained much experience with local purchase of foods in the last 15 years.  Regional purchase offers flexibility and can save on costs.

FAQR Findings and Recommendations

Tufts University’s Food Aid Quality Review (FAQR) identified prepositioning as essential for rapid emergency response. Key recommendations included:

  •    *   Revising procurement systems to allow 12–18‑month contracts with fixed volumes
  •    *   Supporting prepositioned stockpiles of Fortified Blended Foods (FBFs) and specialized nutritious products

Quality Assurance and Incident Management:  The FAQR found recurring quality problems at PREPO warehouses, including improper fumigation. However, incident reporting systems lacked sufficient detail to determine whether damage originated at the manufacturing plant, during shipping, or during storage. FAQR recommended updating Loss and Damage (L&D) reporting templates to better identify root causes and track where contamination or degradation occurred.

One finding:  Analysis of 2011–2016 data showed that overseas “transit” warehouses were the third‑largest destination for food aid products, primarily holding prepositioned stocks destined for Ethiopia and Sudan.

Tufts’ FAQR’s crafted a solution, their Commodity Supply Chain Optimization Model (see diagram below), which was created to help donors and NGOs evaluate prepositioning levels, routing, procurement, and transfer modalities to maximize cost‑effectiveness.

In more recent years, FFP has sought to minimize losses during ocean transport due to humidity, shock and high heat.  This has used advanced methods for small sensors in shipping containers and better tracking of ship routes, temperatures at sea, and queues at ports of disembarkation.
– Contributed by WHES Board member, Steven Hansch

U.S. Food Aid (Part 4): GACAP, Monetization, and Food Aid Management

July 18, 2026   This is the fourth in a series of articles about U.S. Food for Peace to inform the public and USDA about lessons of food aid.

For some time, U.S. NGOs or Private Voluntary Organizations (“PVOs”) came together to create a network for sharing lessons, learning, and principles about food aid.  This network was called Food Aid Management, or “FAM.”  It was originally created and led by Tom Zopf, who had been head of CARE’s food unit.

The most important product was the Generally Accepted Commodity Accountability Principles, or “GACAP,” as seen above left.  It emphasizes how each aid NGO commits to responsibly shepherding the public’s food donations.  As such, GACAP says, “Commodity management organizations engaged in commodity programs should develop and publish for their own use and that of the public and the donor organizations clear statements of the organization’s purpose and operating principles guiding the use of food aid.”

The GACAP name was intended to align with the GAAP standards for accounting (Generally Accepted Accounting Principles), set by FASB.

GACAP preceded the SPHERE project in setting forth NGO voluntary commitments toward accountability, and with greater detail:  “An essential aspect of the internal control system is the proper separation of the duties and responsibilities of employees. Organizational charts, statements of functional responsibilities, and policies and procedures manuals should reflect this separation. With respect to commodity accountability this means that the duties and responsibilities related to (1) the authorization to move and disburse commodities, add or delete distribution sites or change the quantities the sites should receive, (2) the physical control (custody) of commodities, and (3) the financial recordkeeping or the validation of commodity transactions should be assigned to separate personnel in, preferably, separate departments. For example, warehouse personnel with keys to and physical control over the warehouse should not be allowed to disburse commodities without the written approval of a separately authorized individual.”

Another FAM product of use by aid aggencies was a guide that collated many lessons from NGOs about their conduct of food aid monetization for both partial monetization and full monetization.  This manual “Monetizing Food Aid” can be downloaded here.  It was the result of several workshops and conferences and was the basis for various trainings.  At the time of the publication, monetization was growing fast among NGOs, and also with the Canadian Foodgrains Bank and World Food Programme.

It includes examples from NGOs like Save the Children, CARE, World Vision, Technoserve, Africare and Food for the Hungry.  FAM organized trainings about monetization best practices in Ghana, Ethiopia and Washington, DC.

This guide was used by both Food for Peace and Food for Progress, such as USDA’s $103 million food sales in the former Soviet states when it broke part.  In the Somalia famine, monetization was the main choice by USAID, CARE and WFP for addressing food access throughout the country, by working with merchants to increase supplies of foods in markets and lower the retail price.  The guide attempts to make auction and economic language easily understandable for NGO managers.  Among other things, the guide explains how commodity prices vary not only by country and season but across the countryside within a nation.

FAM was reincarnated later as the TOPS network among a few NGOs, which in turn morphed into the Food Security Network (FSN) at https://www.fsnnetwork.org/about which has a website today that offers other recent resources.

U.S. Food Aid (Part 3): Lessons from Tufts University’s “Food Aid Quality Review”,

July 17, 2026   This is the third in a series of briefs about U.S. Food Aid, recognizing the shift of programming to the U.S. Department of Agriculture.

Every year, for over a half century, the United States has shipped more than a million tons of food to hungry people in dozens of countries.  During this time the underlying products barely changed.  In 2009, USAID’s Office of Food for Peace (FFP) commissioned Tufts University’s School of Nutrition, in Medford (near Boston), Massachuseets to ask basic questions about how effective these foods are.   The resulting twelve-year “Food Aid Quality Review” (FAQR), was anchored by two principal investigators, Patrick Webb, and Beatrice Lorge Rogers, working with a team of Friedman School of nutrition faculty and students, and a stakeholder network spanning dozens of NGOs, implementing partners, and UN agencies across more than 40 countries.

Tufts University’s Friedman School of Nutrition Science and Policy’s FAQR, in partnership with USDA and the Department of Defense’s Natick food research laboratories, had three phases over twelve years:

Phase I (2009–2011): a diagnostic review of whether U.S. food aid products, programming, and institutional processes reflected current nutrition science.

Phase II (2011–2016): development and field-testing of reformulated products, including a large randomized prevention trial in Burkina Faso.

Phase III (2016–2021): a randomized treatment trial in Sierra Leone, supply-chain and packaging research, bioavailability science, and the institutionalization of the reforms across USAID and USDA.

The founding evidence base came from a survey of 64 responding USAID implementing-partner field offices across 40 countries, supplemented by expert panels and a formal public-comment period on the draft report.  This included extensive consultations with agencies, field trials (working with NGOs), facilitating product alignment among USAID, USDA, the World Food Programme, WHO and UNICEF, and interaction with the the congressionally established Food Aid Consultative Group (FACG), whose membership spans academicians, advocacy organizations, commodity groups, and NGOs.

The flagship Phase I report, “Delivering Improved Nutrition: Recommendations for Changes to U.S. Food Aid Products and Programs” (Webb, Rogers, Rosenberg et al., 2011), was built on a survey of 64 implementing-partner field offices across 40 countries (an 81% response rate), plus expert panels and public comment — the first systematic, evidence-based review of Title II food aid products in the program’s history. It organized its findings around three pillars: product quality, programming quality, and process quality , the idea that better food alone would not fix a broken system unless targeting, procurement, and delivery improved alongside it.

From there, Tufts led two of the largest field trials ever conducted on specialized nutritious foods:

      • Burkina Faso (2014–2017): a geographically randomized prevention trial with roughly 6,100 children aged 6–23 months, comparing four foods for their effect on stunting and wasting.
      • Sierra Leone “Four Foods” study (2017–2018): a cluster-randomized treatment trial with 2,683 children aged 6–59 months, testing recovery from moderate acute malnutrition, alongside sub-studies on body composition and gut health, and a novel 1.2 kg consumer package.

The headline finding surprised many in the field: the newer, more expensive, reformulated products did not outperform the upgraded standard corn-soy blend. In Burkina Faso, no food fully prevented growth decline, and a novel corn-soy-whey blend actually performed worse than standard CSB+ with oil. In Sierra Leone, recovery rates were statistically similar — around 62–65% — across all four products tested. In both trials, cost, not effectiveness, was what separated the products: CSB+ with oil was consistently the cheapest and therefore the most cost-effective option, at roughly $122 per child in Burkina Faso versus $140–$245 for the alternatives.

Tufts also stood up the REFINE database (Research Engagement on Food Interventions for Nutritional Effectiveness), an open-access knowledge-sharing platform built by Friedman School faculty, staff, and students together with a team from the World Food Programme.

KEY INSIGHTS and CONCLUSIONS

Regarding commodity quality, FAQR concluded that U.S. foods used in aid had “barely changed in decades” and were out of step with modern nutrition science, and (among other things) recommended adding a dairy-protein source (whey protein concentrate, WPC80) to fortified blended foods, upgrading micronutrient premixes, and adding lipid-based ready-to-use foods to the approved product list. USAID adopted uniform micronutrient specifications across 21 products, upgraded the micronutrient content of 8 products, developed 4 entirely new products, and set the first global minimum nutrient premix standard for ready-to-use foods.

  •  About programming quality, FAQR found that programs were commonly judged by tonnage shipped or numbers of people “fed,” not by nutrition outcomes achieved, and that a single “one-size-fits-all” ration could not meet the very different needs of infants, pregnant and lactating women, wasted children, and people on HIV treatment. It developed decision trees to match specific products to specific purposes and emphasized the first 1,000 days of a child’s life (conception to age two) as the priority window for specialized nutrition programming.

  •   When looking at process quality, FAQR found that the many hand-offs of food from procurement to delivery were poorly coordinated across agencies, and it recommended a standing interagency committee, stronger quality-assurance feedback loops, and later, in a 2021 review of 26 commodity incidents between 2018 and 2020, a formal Commodity Incident Management System with real-time, end-to-end traceability “from producer to consumer.”

FAQR‘s most durable legacy may be less about any single product than about how Food for Peace (today, USDA) should make decisions. Several implications carry directly into current and future food-aid policy:

  •   Cost-effectiveness, not unit cost, should drive product choice.  The central empirical finding,  that the cheapest option (CSB+ with oil) matched or beat costlier, more sophisticated products in both prevention and treatment trials, to treat moderate malnutrition is a standing rebuke to the assumption that newer and more expensive automatically means better.  USG programs should keep asking “cost per case of malnutrition averted,” not “dollars per ton shipped,” when choosing among products.   The FAQR’s Malawi Feasibility study (2013-14): tested increases in fortified vegetable oil (FVO) to Corn Soy Blend (CSB) from the usual ratio to 30g FVO:100g CSB, along with family education and repackaged 2-kg bags.  Finding: caregivers could achieve the ratio; intervention was more cost-effective than standard programming.

  •   Freight and procurement costs, not formulation, usually decide the winner. Because product price and international freight, not nutritional efficacy, drove most of the cost differences observed in the field trials, decisions about where to source, how to package, and how to ship deserve as much scrutiny as decisions about what goes in the bag.

  •   “Fit for purpose” should stay the organizing principle, not a slogan. No single food worked for every beneficiary group in FAQR’s trials. Continued investment in decision tools that match a specific product to a specific nutritional objective, context, and beneficiary,  rather than defaulting to one flagship commodity, is what the evidence actually supports.

  •   Interagency and international harmonization needs active maintenance, not a one-time fix. The alignment FAQR achieved among USAID, USDA, WFP, UNICEF, and WHO specifications reduced confusion for manufacturers and implementers, but harmonized standards drift apart again without a standing mechanism (like the FACG or an interagency committee) to keep revisiting them as new evidence and new products emerge.

  •   Supply-chain quality control deserves the same rigor as nutrition science. FAQR’s 2021 finding that losses are rare (under 1% of U.S.-sourced food) but that the health risk from what does slip through is high,  combined with weak, uncoordinated incident tracking, points to unfinished business: a real-time, end-to-end traceability system was recommended but not fully built out before the project closed in 2021.

  •   Evidence infrastructure needs a permanent home. REFINE was built specifically because, before FAQR, a lack of evidence on which foods to use and how to deliver them was a genuine gap, not a rhetorical one. Sustaining REFINE, or something like it, as a living, continuously updated evidence base, rather than letting it lapse once grant funding ends,  is the clearest way to keep future USG food-aid decisions grounded in current science rather than institutional habit.

Other Recommendations:

•   Increase the processed food portfolio in the food aid basket.

•   Adopt “feed-the-colon” strategy to promote gut health.
•  Improve the stability of vitamin C.

•    Use water as a vehicle for fortification of water-soluble vitamins.

•  Formulate foods to accommodate the elevated micronutrient needs of beneficiaries with infections.

The main FAQR finding that upended conventional wisdom was not that U.S. food aid needed fancier, costlier products; it was that a smarter, evidence-driven version of what USAID already had,  better targeted, better formulated, and more honestly costed, outperformed the alternatives. That is the standard FAQR leaves behind for whatever comes next in U.S. government food assistance.

The USG largely accepted and adopted FAQR’s recommendations. USAID adopted uniform micronutrient specifications across 21 products, upgraded the micronutrient content of 8 products, and developed 4 new products. They also formally added lipid-based products, such as Ready-to-Use Supplementary Foods (RUSF), to their approved list of commodities. USAID adopted the recommendation to add an animal-source protein, specifically whey protein concentrate (WPC80), to fortified blended foods (FBFs) like Corn Soy Blend (CSB) to improve protein quality and bioavailability. This led to the creation of upgraded products like CSB+ and Corn Soy Whey Blend.

….

SELECTED PUBLICATIONS

Michael Joseph et al. , 2019, Enhancing the Nutrient Bioavailability of Food Aid Products,  explores current processed foods for malnourished children and recommends adding defatted toasted wheat germ (DWG) or synthetic amino acids (following ideal protein concepts) as cost-effective soy alternatives to boost protein efficiency; diastatic malt (0.25% barley) to enzymatically thin porridges, raise solids/energy density, degrade phytates, and improve mineral/protein digestibility; omega-3-rich oils (e.g., canola) with antioxidants; and prebiotic oligosaccharides (scGOS/lcFOS blends) plus yeast cell-wall components for gut health and mycotoxin binding.  Further, processing upgrades such as extrusion, compaction of FBFs for better shelf life/transport, and optimized milling/dehulling further enhance matrix performance, noting that changes can improve cost-effectiveness and health outcomes (e.g., recovery from wasting).

Griswold, Langlois, Manary, Rogers et al.  2020, Comparative Cost-Effectiveness of Four Supplementary Foods in Treating Moderate Acute Malnutrition in Children 6-59 Months in Sierra Leone  found no significant differences in recovery rates from moderate acute malnutrition  among the four supplementary foods tested: CSB+ with oil, CSWB with oil, SC+A, and RUSF, observing unadjusted graduation rates of 62–65% and no observable differences after covariate adjustment in its sample of 2,653 children.  Cost per recovered child ranged from $90–$94 across arms from the program perspective, with no discernable differences in cost-effectiveness.  Caregivers’ opportunity costs were lowest for RUSF but did not alter the overall conclusion of similar cost-effectiveness.  The study observed that intrahousehold sharing occurred at similar rates (~25%) across all foods and was unassociated with recovery, as was adherence to recommended recipes.  Direct observation confirmed that actual consumption of the supplement by the target child was positively associated with recovery; sustained recovery at four weeks post-discharge was lower for RUSF (73%) than CSB+ (81%), and presence of environmental enteric dysfunction (EED) reduced recovery rates independently of food type, with no food-specific differences in body composition changes.

Ilana Cliffer et al, 2019 Comparative Cost-Effectiveness of 4 Supplementary Foods in Preventing Stunting and Wasting in Children 6-24 Months.  In Burkina Faso, FAQR conducted a 3-year, clustered, four-pronged trial with random assignment to determine the effectiveness and cost-effectiveness of four different supplementary foods for the prevention of stunting and wasting in children aged 6 to 23 months. This trial enrolled 6,112 children, with roughly 1,500 per study arm, making it one of the largest randomized controlled trials of supplementary foods. The trial compared Corn Soy Blend plus (CSB+), CSWB, LNS, and a super cereal product, following children monthly during the supplementation period and measuring growth, morbidity, and dietary intake outcomes.  The authors found that children receiving CSWB performed worse over time but because it was shared with other household members more frequently and was consumed by the intended child less often.  RUSF was the most expensive, largely because of its higher commodity and packaging costs. Flour products required more caregiver time for preparation and feeding, so adding the value of caregiver time substantially increased their total societal cost.  Nevertheless, CSB+ with oil was the most cost-effective option. It was the least expensive and was at least as effective as SC+ and RUSF, and more effective than CSWB.

Griswold, Schmall, Webb, Rogers et al.  2021  Additional Analysis of Two Field Studies Comparing Four Supplementary Foods for Treatment or Prevention of Malnutrition, FAQR.  The authors discerned that Mid Upper Arm Circumference (MUAC) and Weight for Height (WHZ) measures of malnutrition differ more than previously thought in identifying children.  The disagreement between the measures is both by gender and age.  The report strengthens the case for dual‑criterion admission (MUAC + WHZ).  Authors also found that children whose malnutrition became worse, even after program enrollment, could be identified within the first few weeks, and should be flagged.  Programs can introduce early intensified support for children showing stagnation in the first month.  Predictors of such decline included fever, diarrhea, vomiting, or cough, even if they had no illness at enrollment.  From the data in Burkina Faso, the authors identified that children with the worst stunting had consistently slower growth velocities from early infancy onward, not sudden drops, meaning that support should be continuous.  Surprisingly, the authors found that at the family level, dietary diversity, water treatment, latrine use, ration sharing, and caregiver engagement did not predict whether a child improved from wasting malnutrition sustainably.

FACET.  FAQR the Food Assistance Cost-Effectiveness Tool (FACET) for Supporting Specialized Nutritious Foods (SNF) Programming Decisions, a novel interactive decision-support instrument designed to help funders and implementing partners integrate cost-effectiveness analysis into nutrition program design.  FACET was designed as a computer-based interactive tool that guides users through three categories of input parameters: program specifics (such as target population, duration, and coverage rate), cost
components (including procurement, transport, storage, distribution, monitoring, and overhead costs), and nutrition impact measures (such as changes in anthropometric outcomes, micronutrient status, or
dietary adequacy). The tool generates a range of cost-efficiency indicators, including cost per beneficiary per day, cost per kilocalorie delivered, and cost per unit of specific micronutrient delivered, as well as more complex cost-effectiveness ratios that link program expenditures to measurable
nutritional outcomes. FACET was published in the journal Current Developments in Nutrition in 2020 and has been made freely available to the international nutrition community through the FACET4SNF
website.

Lauren Thompson,  AudreyKarabayinga,; Beatrice Rogers, Patrick Webb, . 2021. The Potential Value-Added to USAID of Open Access Data on Food Assistance for Nutrition. Report to USAID. Boston, MA: Tufts University finds that supposedly open-access datasets in food assistance for nutrition research are either inaccessible, lack necessary documentation, or are too heterogeneous to be useful for pooled secondary analyses. Consequently, the FAQR recommends that funding organizations implement tougher data-sharing guidance and infrastructure, such as requiring comprehensive data management plans and the curation of complete datasets with accompanying documentation, to make open data truly meaningful and reusable.

see also:  https://evidencesummit2.wordpress.com/resources/

–  Contributed by WHES board member, Steven Hansch

 

U.S. Food Aid (Part 2): FAFSA – “Food Aid & Food Security Assessments”

July 13, 2026   This is the second of a series of Hunger Notes articles about the re-design of the U.S. Food for Peace (FFP) program,that is now in process at the U.S. Department of Agriculture, which just released a request for informational inputs this past week.

In past decades, USAID commissioned two expert teams to review experience with development food-aid programming: the first in 2002–2003 and the second in 2012–2013.   The first, the 2002 “Food Aid and Food Security Assessment“ (FAFSA 1) found that success in health, nutrition, and agricultural components was largely driven by U.S. Government (USG) complementary inputs, such as technical assistance (TA) and training, both of which were primarily financed through the monetization (sale) of food aid. FAFSA 2 reinforced this, emphasizing that distributing food alone is of reduced value for improving food security and should be combined with non-food resources to build durable livelihoods and community resilience.  Although styled as an ‘assessment,’ the 2002 report functioned primarily as a broad program review.  It addressed the wide variety of competing mandates being pursued, including support for microenterprise, education, HIV/AIDS and emergencies, all while achieving sustainability.

During the two decade period, 1993 – 2013, the US shipped an estimated 17 million metric tons of food, worth $4.5 billion (not adjusted for inflation) for development programs (not including the larger volume for emergencies)..

Both studies found that FFP exit strategies were weak and that project outcomes were often not sustained.  Both studies reported broad improvements in child nutritional outcomes across the countries reviewed though this was based on a mixed set of project evaluations that did not include randomized controlled trials (i.e., with control groups).   Measures of child (under five years of age) nutritional status focused on stunting (which is a long-term outcome) and weight-for-age, not weight-for-height (wasting) that is more critical for health.

FAFSA-1:  Implementing agencies “should continue to use growth monitoring and promotion as key strategies to improve the nutritional status of children under 3 years old and improve referral and follow-up of malnourished children. [They] should establish clear protocols for identification and referral of malnourished children to health facilities.”

  • ◊ Agricultural programs ought to be market-driven, not just production-driven. While early programs often focused merely on increasing staple crop yields, FAFSA-2 found that the most successful agricultural programs adopted a “Pull Plus Push Model.” This approach links farmers to promising, higher-value markets (the “pull”) while simultaneously providing them with  new technologies, TA, and training needed to compete in those markets (the “push”).  Furthermore, FAFSA-2 emphasizes that programs should target farmers who are “vulnerable and viable.” For food-insecure populations who lack sufficient land or assets to farm their way out of poverty realistically, programs should focus instead on creating off-farm jobs and non-agricultural income generation.

  • ◊  Maternal and Child Health and Nutrition (MCHN) should focus on prevention during the first 2 1/2 years of life.  A major finding in FAFSA-2 was that preventive supplementary feeding, targeting all pregnant/lactating women and children under two years of age, is significantly more effective at reducing stunting than recuperative feeding, which only treats older children who are already malnourished. Additionally, evidence suggests that providing food to individual people is more effective and cost-efficient than providing larger rations to whole families.

◊  Food-for-Work (FFW) should be focused on the creation of public goods such as roads and canals.  The authors viewed FFW as having poor sustainability.
…
◊  Income generation should be combined with behavioral change such as caretaker behavior for diets and improved hygiene.  Increasing a household’s income does not always  improve family diets or reduce child undernutrition.
…
◊ Program evaluations should be more independent, standardized, and professionalized.  FAFSA-1 noted the need to reduce variability in how performance indicators were defined and measured and recommended shifting the burden of complex evaluations away from those NGOs implementing programs.
Both study teams, composed of different individuals, were led by agricultural economists, so it was not unusual that both studies focused on gains in crop yields and supply chains.
…

Differences

Co-authored by Roberta van Haeften, Mary Ann Anderson, Herbert Caudill and Eamonn Kilmartin, the FAFSA-2 (2013) report goes further than the first report by:

  • » Quantifying impacts (e.g., stunting reductions, income improvements).  FAFSA-2 calculated that U.S. food aid led to reductions in underweight children by 0.63%/year. Asia/LAC outperformed Africa (1.53% vs. 0.98% annual stunting reduction).
  • »  Emphasizing water, sanitation and hygiene interventions:

“Ninety-four percent of the Title II programs with WASH interventions created and trained Village Water Committees. This very important step greatly improved the likelihood of successful operation and maintenance once the Title II programs ended.”

  • »  Introducing new frameworks (e.g., risk/vulnerability, Food Security Country Frameworks).
  • »  Aligning with broader U.S. initiatives (Feed the Future,  Global Health).
  • »  Documenting external critiques (e.g., monetization, urbanization).

Where the first report dwelled more on qualitative data, the second report tried to include a meta-analysis of nutritional impacts, standardized indicators (MAHFP, HDDS), and quantitative trends (e.g., stunting reductions).

The second (FAFSA-2) report reviewed total of 101 programs (projects) across 28 countries. These were distributed geographically with 64 programs in Africa, 23 in Latin America and the Caribbean (LAC), and 14 in Asia.  FAFSA-2: observed that the majority (57%) of food aid beneficiaries were women (2009), with a slightly higher female participation in health and nutrition programs (59%)

FAFSA-2 addressed supplementary feeding for families with AIDS and TB patients.  And it took a broader view of USAID programming, looking at alignment with non-FFP funding areas by Feed the Future (FTF) and Global Health Initiative (GHI), that had not yet been launched in 2002 when FAFS-1 was commissioned.  FAFSA-2’s review included some~80% of resources going to agriculture (49%) and household nutrition (35%).  A declining 8% went to food-for-education, which has been phased over USDA.

Using the conceptual model shown below, the FAFSA-2 report concluded that FFP programs were generally successful at increasing household access to food, with 92% of the reporting programs seeing improvements in the number of months of adequate household food provisioning. Furthermore, 79% of reporting programs saw improvements in household dietary diversity, and 80% exceeded their targets for increasing household income.  The FAFSA-2 report highlights that by identifying and applying the specific technical models, approaches, and practices that contributed to these positive food security impacts, and by learning from the strategies that did not work well, there is a tremendous opportunity to improve overall program performance in the future.