On Resilience: Hunger, Food and Disease Outbreaks

by Steve Hansch

March 15, 2020

The current coronavirus (COVID-19) global outbreak – pandemic – may very well have implications for hunger and food security. This would be particularly so in poorer, developing countries where large urban populations may depend on fragile supply chains for food.

We know that shocks – including wars – can impair movement of basic life-sustaining foodstuffs, as in Yemen today. We also know that food is an intrinsic part of how we currently address some diseases. Many humanitarian agencies have published at length about the value of ensuring food and nutrition for African families affected by HIV/AIDS.

Food aid has been important for helping families or breadwinners to self-quarantine after being identified as having been in contact with a carrier of a disease in other instances. For example, in West Africa in 2014/2015, and in Central Africa today, nonprofits and the World Food Programme have been providing food or food-purchasing vouchers to families under watch for suspected new cases of Ebola.

Food aid also helps promote compliance for health care. Often food aid is helpful to ensure prenatal screenings in programs in refugee camps for pregnant and lactating women. As another example, in many countries today, low-income persons with Tuberculosis (TB) find it hard to take the complex regimen of drugs necessary each morning without food also provided, so aid agencies provide food assistance alongside the medical assistance to ensure compliance.

Hunger may also appear as a secondary crisis following the shocks of a larger pandemic. Often in pandemics, ports shut down, trade freezes up, and food does not transport as it had. Any time a city or region is quarantined, it automatically poses constraints to food trade.

Indeed, the food aspects of a pandemic could prove to be the most controversial, posing major policy dilemmas with highly variable outcomes. Many experts believe that the most variable or preventable forms of death due to a pandemic are not from the immediate medical impact, but from the food and social effects. A global public goods perspective of a pandemic suggests that whereas health programs are a win-win for everyone, other goods, such as food, energy, or oil, are competed over and may become scarce.

As of today, the World Health Organization has defined the current COVID-19 spread as a pandemic. From the past, we understand that many pandemics tend to flow as waves. The 1918 flu influenza killed 100 million people, by some estimates, and circled world several times over the span of a year. Health science was so imperfect in that time, and World War I was such a distraction, that the existence of a pandemic killing people from India to Africa to Illinois was not immediately understood. In today’s world, the extent of an outbreak is more immediately tracked and mapped, with the consequence that travel and markets freeze up.

To understand the counter-intuitive ways that markets may respond to fears, consider the large number of people who died in India due to famine during World War II. In 1941-42, a severe famine killed up to two million people in the Bengal region of India. In studying this famine, Nobel Prize winning economist Amartya Sen recognized that it occurred despite a better-than-average local food harvest. Food was sequestered and kept out of retail networks due to an overall atmosphere of uncertainty and anxiety about future events, i.e. an invasion by the Japanese army (which never occurred). This led to a lack of food availability in markets for most of the consumers. The lesson is that events in one domain (war, disease) can lead to market disruptions that can worsen poverty and hunger, and in some pockets of the world, starvation.

The diagram below depicts one scenario of how a disease may pass through a country during a pandemic, similar to the 1918 case. The inner full lines depict the period when it is spreading person-to-person in a particular country – a few months – during a year. The broken line above it depicts the shock wave that is longer as markets tighten and access to food becomes limited. This diagram comes from a USG-funded interagency working group of UN agencies and NGOs in the 2000s, looking at scenarios of how a pandemic might unfold:

Diagram courtesy of Steve Hansch

 

That same study found that:

“The increase in food prices for some countries – those that are not food self-sufficient but depend on grain imports – will be sharper and higher than that seen in 1974 or in 2008, when food price increases made international headlines as a pervasive crisis.  The tightness in food markets in 1974 and 2008 provide some lessons about the dynamics of global food markets, though a pandemic’s effects on food trade could be far more lethal.   Just as occurred in 2008, food trade will become restricted and food will be rationed and hoarded, with the result that food prices will increase for most locations where populations aggregate (cities, towns), though food prices will decrease in rural agricultural areas.  Even if the virus spreads from foci to foci, along lines of airplane travel, or migration, the wave of food panic may be more diffuse and global.”

The study also cautioned that in many locations, as commercial food pipelines break down, stores that sell food (particularly in urban areas) will likely be in a hurry to disburse fresh (perishable) foods to friends and family before the markets shut down to avoid ransacking. If the store owners trust rumors that food transport will be interrupted and their inventories not replenished, they may see an incentive to protect the store itself by closing it down, boarding it up and posting “no more food” signs, rather than face break-ins, threats, or government requisition.

For these and other reinforcing dynamic reasons, food prices may inflate in urban areas many times above normal levels over the first few weeks of a pandemic. For poor families who are already spending their limited income largely on food, increased prices leads to reduced consumption. Most famines in modern history have shown that increased food prices lead to increased hunger and malnutrition-related death.

Experts recommend that key national-level goals are to reduce national panic and distress migration (for instance away from urban areas to rural areas). Therefore, food programs can support leaders by helping them to maintain credibility when communicating to the public that people need not panic about food shortages; therefore, governments need to have some credible back-up reserves of food with which to promise to provide targeted food for the malnourished. Many governments already dabble in maintaining emergency reserves of food. So, when an outbreak—such as COVID-19—begins to spread on the health side, governments can and should begin to quietly store and then allocate food resources to work with civil society agencies, such as the Red Cross, to quickly pre-purchase and move food storage to decentralized locations, to reach the most vulnerable people.

About the Author: Steve Hansch is a WHES Board Member with long-standing association with Hunger Notes.

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