[House Hearing, 114 Congress]
[From the U.S. Government Publishing Office]
LEVERAGING U.S. FUNDS: THE STUNNING GLOBAL
IMPACT OF NUTRITION AND SUPPLEMENTS
DURING THE FIRST 1,000 DAYS
=======================================================================
BRIEFING AND HEARING
BEFORE THE
SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH,
GLOBAL HUMAN RIGHTS, AND
INTERNATIONAL ORGANIZATIONS
OF THE
COMMITTEE ON FOREIGN AFFAIRS
HOUSE OF REPRESENTATIVES
ONE HUNDRED FOURTEENTH CONGRESS
SECOND SESSION
__________
JUNE 9, 2016
__________
Serial No. 114-212
__________
Printed for the use of the Committee on Foreign Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.foreignaffairs.house.gov/
or
http://www.gpo.gov/fdsys/
___________
U.S. GOVERNMENT PUBLISHING OFFICE
20-382PDF WASHINGTON : 2016
________________________________________________________________________________________
For sale by the Superintendent of Documents, U.S. Government Publishing Office,
http://bookstore.gpo.gov. For more information, contact the GPO Customer Contact Center,
U.S. Government Publishing Office. Phone 202-512-1800, or 866-512-1800 (toll-free).
E-mail, [email protected].
COMMITTEE ON FOREIGN AFFAIRS
EDWARD R. ROYCE, California, Chairman
CHRISTOPHER H. SMITH, New Jersey ELIOT L. ENGEL, New York
ILEANA ROS-LEHTINEN, Florida BRAD SHERMAN, California
DANA ROHRABACHER, California GREGORY W. MEEKS, New York
STEVE CHABOT, Ohio ALBIO SIRES, New Jersey
JOE WILSON, South Carolina GERALD E. CONNOLLY, Virginia
MICHAEL T. McCAUL, Texas THEODORE E. DEUTCH, Florida
TED POE, Texas BRIAN HIGGINS, New York
MATT SALMON, Arizona KAREN BASS, California
DARRELL E. ISSA, California WILLIAM KEATING, Massachusetts
TOM MARINO, Pennsylvania DAVID CICILLINE, Rhode Island
JEFF DUNCAN, South Carolina ALAN GRAYSON, Florida
MO BROOKS, Alabama AMI BERA, California
PAUL COOK, California ALAN S. LOWENTHAL, California
RANDY K. WEBER SR., Texas GRACE MENG, New York
SCOTT PERRY, Pennsylvania LOIS FRANKEL, Florida
RON DeSANTIS, Florida TULSI GABBARD, Hawaii
MARK MEADOWS, North Carolina JOAQUIN CASTRO, Texas
TED S. YOHO, Florida ROBIN L. KELLY, Illinois
CURT CLAWSON, Florida BRENDAN F. BOYLE, Pennsylvania
SCOTT DesJARLAIS, Tennessee
REID J. RIBBLE, Wisconsin
DAVID A. TROTT, Michigan
LEE M. ZELDIN, New York
DANIEL DONOVAN, New York
Amy Porter, Chief of Staff Thomas Sheehy, Staff Director
Jason Steinbaum, Democratic Staff Director
------
Subcommittee on Africa, Global Health, Global Human Rights, and
International Organizations
CHRISTOPHER H. SMITH, New Jersey, Chairman
MARK MEADOWS, North Carolina KAREN BASS, California
CURT CLAWSON, Florida DAVID CICILLINE, Rhode Island
SCOTT DesJARLAIS, Tennessee AMI BERA, California
DANIEL DONOVAN, New York
C O N T E N T S
----------
Page
BRIEFER
Mr. Ajay Markanday, Director, Liaison Office for North America,
Food and Agriculture Organization of the United Nations........ 4
WITNESS
Beth Dunford, Ph.D., Assistant to the Administrator, Bureau for
Food Security, U.S. Agency for International Development....... 17
LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE RECORD
Mr. Ajay Markanday: Prepared statement........................... 8
Beth Dunford, Ph.D.: Prepared statement.......................... 20
APPENDIX
Hearing notice................................................... 38
Hearing minutes.................................................. 39
LEVERAGING U.S. FUNDS: THE STUNNING
GLOBAL IMPACT OF NUTRITION AND
SUPPLEMENTS DURING THE FIRST
1,000 DAYS
----------
THURSDAY, JUNE 9, 2016
House of Representatives,
Subcommittee on Africa, Global Health,
Global Human Rights, and International Organizations,
Committee on Foreign Affairs,
Washington, DC.
The subcommittee met, pursuant to notice, at 2 o'clock
p.m., in room 2255 Rayburn House Office Building, Hon.
Christopher H. Smith (chairman of the subcommittee) presiding.
Mr. Smith. The hearing will come to order and good
afternoon to everybody.
We are here today to examine the global impact of nutrition
and supplements during the first 1,000 days of life, a period
from conception to roughly age two, and how we can leverage
U.S. taxpayer funds to achieve maximum results.
As you know, this subcommittee has played a key role in
advocating for an enhanced focus on food security. For the past
two Congresses, I have been working on authorizing legislation
for our flagship nutrition and food security program, Feed the
Future, and worked very closely with Dr. Shah before he left
USAID, on crafting that legislation.
I authored the Global Food Security Act of 2015, H.R. 1567,
which passed the House in April, as did its predecessor bill in
the last Congress, thanks in large part to the leadership of
Majority Leader Kevin McCarthy, who has a very personal and key
interest in ensuring that this legislation becomes law.
Today's program also follows upon a hearing we did in the
latter part of 2015 called Food Security and Nutrition Programs
in Africa, which highlighted the role implementer play on the
ground as well as a hearing we held last Congress that we
called ``The First One Thousand Days: Development Aid Programs
to Bolster Health and Nutrition.''
For this afternoon's program, we will step back and take a
look at the role played not only by the U.S. Government, which
has been pivotal, but also the United Nations.
Thus, we will be hearing from USAID's Assistant to the
Administrator Dr. Beth Dunford, who will relay to us remarkable
results that USAID-led Feed the Future initiative has achieved
in reducing stunting by emphasizing those first 1,000 days and
the implication of those results for developing nations that
are seeking to grow not only their human capital but also their
economies.
We will also be briefed first by Ajay Markanday of the
Innovations Food and Agricultural Organization. Part of our
ability to leverage U.S. funds depends on our partners who play
key roles in enhancing food security throughout the globe and
none is more important in this regard than the FAO.
I want to highlight that in his statement there is an
underscored in a key point of this hearing the rationale for
supporting proper nutrition is not simply a moral imperative
but it is also economic.
It has been long established that malnutrition undermines
economic growth and perpetuates poverty. Indeed, there is
perhaps no wiser investment that we could make not only in an
individual person but also in the economies of the developing
world than to concentrate on ensuring that sufficient nutrition
and health assistance is given during those first 1,000 days of
life.
Children who do not receive adequate nutrition in utero are
more likely to experience lifelong cognitive and physical
deficiencies, due in particular to stunting. UNICEF estimates
that one in four children worldwide are stunted due to a lack
of adequate nutrition.
The African Union Commission's Cost of Hunger in Africa
study estimated that the economic costs associated with child
under nutrition are substantial, from 2 percent to 16 percent
of the gross national product in several African nations.
For instance, this cost was estimated at $4.7 billion in
Ethiopia in 2000 alone, which is equivalent to 16 percent of
Ethiopia's GNP.
Conversely, by helping women throughout pregnancy receive
adequate nutrition and supplemental micro nutrients such as
iodine, Vitamin A, and folic acid, and ensuring that they are
well nourished by nursing, children and mothers thrive.
To give one example, studies indicate that if we provide
women of childbearing years with the recommended dose of folic
acid during the 3 months prior to pregnancy and during the
first month of pregnancy, the risk of autism spectrum disorder,
or ASD, is reduced by a whopping 40 percent.
We do look forward to hearing some of the results that
USAID has been able to accomplish with regard to reducing
stunting, again, attributable to the Feed the Future program.
It is also my hope that as we look now to the next
administration that we will be able to enshrine food security
and nutrition as a firmly planted cornerstone of U.S. policy.
Consider how President Bush beginning in 2002 had the
initial foresight to elevate the import role of food security
in U.S. foreign policy, especially in Africa, via the
Initiative to End Hunger in Africa, or the IEHA, which was
funded through development assistance and implemented through
USAID.
At the same time, the Millennium Challenge Corporation
began making substantial investments in agriculture-led
economic growth programs, particularly in Africa.
This is a policy course that President Obama has continued
and built upon with the Feed the Future initiative instituted
at the G8 meeting in Italy in 2009 when the countries of the
world came together to ensure that we cultivate resiliency in
food insecure countries so they can withstand the next food
crisis such as what we saw in 2007 to 2008, a crisis that Dr.
Beth Dunford was on the front lines in battling.
It is my hope and the committee's hope that the next
administration, whomever the President may be, will build upon
this and continue that focus, for by addressing nutrition
during the first 1,000 days of life we can help ensure that the
next 25,000 days, or whatever the number our Creator has
allotted for that individual, are filled with good health.
I would like to now yield to my good friend and colleague,
Ranking Member Bass, for an opening statement.
Ms. Bass. Thank you, Mr. Chair.
I also want to thank Mr. Markanday and Dr. Dunford for
appearing before the subcommittee this afternoon, and I look
forward to hearing their perspective and testimony on what is
one of the most important issues facing the developing and
developed world.
As I have said in the past, the U.S. has long been a leader
in the realm of food aid internationally and over the years has
contributed consistently and innovatively regarding the global
challenge.
President Obama established the Bureau of Food Security in
2010 and by doing so demonstrated the high priority that we
place on addressing the issue of global food insecurity.
This key decision by the Obama administration has led to
greater coordination amongst government agencies and leveraged
strategically government efforts to combat global hunger and
food insecurity by not only working with recipient governments
but also with international organizations and other donors.
Feed the Future stands out in this effort to combat some of
the most challenging examples of food insecurity worldwide.
I believe one of the reasons that the U.S. has led so
effectively in this arena is the focus that the government
places on strong partnerships with recipient countries.
Also, the Feed the Future program has worked with not only
host governments, but also the private sector and, critically,
local civil society, I believe, this inclusive approach is the
key to the initiative's effective implementation.
Addressing food security challenges effectively also means
addressing the challenges facing newborns in countries plagued
with food insecurity.
In this regard, I look forward to hearing the testimony of
Dr. Dunford regarding progress and ongoing challenges regarding
stunting. Of particular interest to me are identifying what
approaches work successfully and whether success in one region
of Africa, for example, can be duplicated in another region.
Also, I would like to know what role capacity training has
played in these efforts. I would also welcome statistical
information regarding successes and challenges faced by
countries in both Africa and Asia and how our country in
concert with the host countries, the international community,
and donors can help address such challenges.
Thank you.
Mr. Smith. Thank you very much, Ms. Bass.
I would like to now point out that pursuant to committee
rules we will suspend the hearing and convene an official
briefing in its stead to receive a statement from Dr. Ajay
Markanday of the Food and Agricultural Organization.
He is the director of its liaison office for North America
and is an expert in sustainable agricultural development with
over 35 years of experience in over 20 countries, having served
in a number of international development agencies. He is
uniquely positioned and has a keen understanding of the
importance of leveraging international organizations to further
global development goals and initiatives.
He has earned many accolades and commodations for his
efforts in promoting global food and nutrition security and
most recently received and was recognized by the Prime Minister
of Cambodia for his work on the country's agricultural and food
security program.
Mr. Markanday, the floor is yours.
STATEMENT OF MR. AJAY MARKANDAY, DIRECTOR, LIAISON OFFICE FOR
NORTH AMERICA, FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED
NATIONS
Mr. Markanday. On behalf of Dr. Graziano da Silva, the
Director-General of the United Nations Food and Agricultural
Organization, I would like to thank Chairman Royce, Chairman
Smith, and Ranking Members Bass and Engel for the opportunity
and honor to brief you this afternoon on the work the FAO is
undertaking to support the efforts of the United States in the
fight against global hunger and malnutrition.
I would also like to acknowledge USAID, an extremely valued
partner of FAO and, especially, Dr. Beth Dunford and the Feed
the Future team who are staunch advocates for the principles of
Chairman Smith's Global Food Security Act.
Chairman Smith's contribution, passion, and unyielding
drive in advancing the health and nutrition needs of children
worldwide is at the core of what brings us here today.
From the beginning, FAO has been inspired and supported by
generous contributions from the people of the United States.
The United States and FAO have a historic relationship and the
U.S. was instrumental in its creation and leadership.
In 1943, President Franklin Roosevelt convened 40 countries
in Hot Springs, Virginia to charter an international
organization dedicated to global food nutrition and
agriculture.
So, Mr. Chairman and honorable members of the subcommittee,
FAO owes a tremendous debt of gratitude to your country's
vision for a world free from hunger.
To this day, America's vision remains at the heart of FAO's
charter. Chairman Smith's Global Food Security Act and its
significant bipartisan sponsorship further demonstrates U.S.
leadership where no child is left malnourished.
I hope that the U.S. further leverages the longstanding
relationship and partnership with FAO in advancing the act's
worthy principles.
As background and to further underscore the significant
relationship between the U.S. and FAO, it is important to note
that the U.S. is not only FAO's founding member country but
also our largest resource partner.
The United States contributes the lion's share of the FAO
budget and is second only to the European Commission in
voluntary contributions.
In addition to significant financial contributions through
USAID, USDA, and other U.S. agencies, FAO receives valuable in-
kind contributions from the U.S. through scientific and
technical expertise.
U.S. expertise had been instrumental in shaping key FAO
policies and programs at the global and country levels. Major
areas of cooperation include food and nutrition security,
emergency assistance and resilience, food safety, and
sustainable agricultural production and natural resource
management. There is ample scope for expanding and deepening
our collaboration in nutrition.
And now I will turn to the concerted efforts of FAO in the
area of global nutrition in the first 1,000 days.
Ending hunger, food insecurity, and malnutrition is our
director general's highest priority. In 2014, FAO co-hosted the
second international conference in nutrition where 170
countries made the noble commitment of reducing all forms of
malnutrition under the Rome Declaration.
Following the Declaration, I am pleased that the United
Nations General Assembly has unanimously endorsed the Decade of
Action for Nutrition earlier this year.
Supporting proper nutrition is not simply a moral
imperative but, it makes economic sense. Malnutrition
undermines economic growth and perpetuates poverty with
productivity losses to the individual estimated at greater than
10 percent of lifetime earnings.
To the economy, losses are high and in Africa and Asia are
estimated at over 11 percent per annum of GDP. Yet, targeted
investments in promoting nutrition, providing micro nutrients,
and supporting community-based programs targeted at children
rank among the highest of all investments.
Improving nutrition in the first 1,000 days must be backed
by sustainable private-public partnerships. In this regard, FAO
values the role of the private sector and recognizes its
essential contribution to ensure nutritional quality and food
safety, investment to infrastructure and storage, and
improvements in supply chains.
The private sector is our key ally under our private sector
strategy. The first 1,000 days in a child's life are critical.
Malnutrition leads to infection and stunted growth, resulting
in poor physical and cognitive development, as Chairman Smith
has just pointed out.
However, malnutrition during this period can effectively be
addressed through targeted investments, proper proteins and
vitamins, and especially through diversified diets.
FAO's unique comparative advantage and strength amongst
development partners includes the ability to convene
governments and other actors, the sharing of information and
best practices, the development of effective policy dialogue,
the development and dissemination of norm standards and
guidelines, and the delivery of technical assistance at the
primary school as well as the university levels.
The key elements of FAO's comprehensive strategy on
nutrition include increased knowledge in scientific exchange,
diversified food systems, the importance of food intake and
food safety, and creating an enabling environment by main
streaming those policies into national agricultural and
investment plans.
FAO has partnered with USAID in many spheres, especially
under FANTA to monitor programs, progress in outcomes and has
developed indicators.
Additional collaborative efforts with USAID and Feed the
Future include field-based trials in countries like Bangladesh
and Cambodia, where I served, and Zambia.
A good example is Bangladesh, where FAO leveraged financing
from USAID to leverage other financing from the European Union.
These activities are now being scaled up as part of the
USAID--FAO Meeting the Under Nutrition Challenge program with
main-streaming this program into national food policy and
country investment plans.
FAO also works closely with USAID in support of the African
Union's new partnership for African development in building
capacities of the 50 member states of the African Development
Bank to main-stream nutrition and agriculture investment plans
through the CAADP Nutrition Capacity Development Initiative.
Mr. Chairman and honorable members, in conclusion, FAO is
an international organization and is at the service of its
members. We are both an instrument of the collective policies
and the goals of our member governments.
As I have noted, the United States is a leading member and
partner of FAO. Our history is longstanding and your
contribution is unmatched. The U.S. should expect results from
FAO to be a collaborative instrument in furthering the goals of
the Global Food Security Act.
We have 197 member countries and organizations, and offices
and programs in 130 countries. Therefore, FAO can be
strategically leveraged by the United States as a partner to
collaborate directly with our members who achieve far-reaching
positive goals, results, and progress.
For example, the last world food summit hosted by the FAO
brought together 5,000 delegates from 180 countries including
60 heads of state. During this summit, $20 billion was pledged
to end world hunger.
FAO has the political neutrality and mandate to globally
raise levels of nutrition and standards of living and FAO can
be instrumental in articulating and fostering your global
health, nutrition goals, and initiatives.
Chairman Smith, Ranking Member Bass and members of the
subcommittee, recognizing that your oversight extends to
international organizations, I leave you with one final thought
for your consideration and for this I am removing my FAO cap
and doffing my international civil servant cap.
In addition to the FAO, I have worked with and within many
international organizations globally. I cannot think of a
single one that, like FAO, which the United States does not
contribute to and invest in generously.
In fact, the United States of America usually invests to
the vast majority of other countries. These international
organizations to which the U.S. belongs and invests can and
should be effective and responsive instruments in promoting
sound global policy be it for health, nutrition, trade,
economics, or wherever your priorities exist.
For many countries that have limited national resources,
they effectively use international organizations as vehicles to
leverage their policy agenda and goals.
I submit for your consideration that the U.S. can be even
more effective in your strategic engagement with these
organizations and enrich new investments substantially.
Demand return on your investments. And on that note, I will
now replace my FAO cap and pledge to this subcommittee and the
entire U.S. Government and citizens that as the director of FAO
for North America you have my highest assurances that I will
strive every day to deliver results and return on your
investment on behalf of FAO.
Once again, Chairman Smith and members of the subcommittee,
I thank you for the honor and privilege of briefing you today.
[The prepared statement of Mr. Markanday follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
----------
Mr. Smith. Mr. Markanday, thank you for your excellent
statement, even more so your extraordinary leadership. And
without objection, your full statement will be made a part of
the record.
I just want to say, I know that the rules preclude us
asking a number of questions. But I would want to thank you for
underscoring the importance of the Decade of Action on
Nutrition, and it does coincide, I believe, in a very good way,
a synergistic way with the post-2015 Sustainable Development
Goals so that--but it is a matter of prioritization with the
SDGs.
There is so much in the SDG mandate that nutrition could
easily get lost. So having that decade of action, having your
leadership, of course, having Dr. Dunford's leadership and the
leadership of the U.S. Feed the Future initiative hopefully
will keep this front and center because this is a winnable
initiative.
And every time we win we collectively--the international
community, women, children, and families' lives are enhanced.
It can't be said enough, and Dr. Dunford says in her statement
that in 2011, 45 percent of child deaths, 3.1 million children,
were attributable to undernutrition.
That is, in a way, a scandal that we haven't even done more
to eviscerate that causation of death, which we could do, I
believe. Thanks also for recognizing the generosity of the
American public. We often get criticized that on a per capita
basis we don't provide enough. Very often not on the ledger or
airlift, what our military does, working side by side with
USAID and NGOs.
I myself and certainly Piero, we have been to the typhoon
that took place in the Philippines and the military was there
working side by side and if they were not there many more lives
would have been lost.
And there was the USS Abraham Lincoln and a few years
before that when the tsunami hit Banda Aceh and other areas
they were there saving lives and none of that ever gets
calculated in terms of costs.
So I do believe the American people are very generous, as
are other countries, and we do, as you pointed out, we need to
demand accountability. We do do oversight. We need to do more
of it and I thank you for ensuring that your money that you are
allotted from multiple sources is well spent on behalf of
people.
I would like to yield to my friend. Thank you. Do you have
any other comments you would like to make? Because your
statement was excellent.
Mr. Markanday. Thank you very much, Chairman Smith, and I
am so happy that you have underscored a lot of the things that
I did include into my briefing in terms of the Decade of Action
on Nutrition and how we should leverage more out of our
international organizations. I think that is terribly important
for results.
I think the only point that I would like to make that the
FAO was, as I said, under U.S. leadership established in 1945.
The world has changed, and we, as an organization, recognize
that we have to be fit for purpose for the future and the
challenges that are coming.
So I think with your leadership we are looking to being
that type of an organization.
Mr. Smith. Thank you. And Mr. Markanday, also--and you'll
never have this problem but compassion fatigue is a problem we
have to be careful about.
I will never forget after the first drought--man-made
drought by Mengistu in Ethiopia everybody was on board. We are
the world. When it hit the second time it was like been there,
done that, got the T-shirt. People were not interested. It was
horrible because people were dying.
So, again, you're part of the leadership that ensures that
these individuals are never forgotten. The emphasis on not just
saving lives, but enhancing your ability to get a better
education and to go on to raising more dollars by way of their
capabilities for their families, it's a win-win-win all over
the place. So thank you again for your leadership.
Thank you. We would like to now resume our congressional
hearing and again thank Mr. Markanday for his appearance here
today and his insights.
We would like to welcome to the witness table Dr. Beth
Dunford, who is the Assistant to the Administrator in USAID's
Bureau for Food Security as well as Deputy Coordinator for
Development for Feed the Future, the U.S. Government's global
hunger and food security initiative.
In this dual role, Dr. Dunford coordinates implementation
of Feed the Future across the U.S. Government, a whole of
government approach, oversees its execution, reports on
results, and leads engagement with the external community to
ensure that food security remains high on the development
agenda.
Dr. Dunford also oversees USAID's technical and regional
expertise focused on improving food security to sustainable
reduce hunger, poverty, and undernutrition.
A career Foreign Service Officer, she most recently served
as Director of USAID's Mission in Nepal and has also served in
Ethiopia, Afghanistan, and a number of roles in Washington.
Please proceed as you would like.
STATEMENT OF BETH DUNFORD, PH.D., ASSISTANT TO THE
ADMINISTRATOR, BUREAU FOR FOOD SECURITY, U.S. AGENCY FOR
INTERNATIONAL DEVELOPMENT
Ms. Dunford. Thank you. Good afternoon, Chairman Smith,
Ranking Member Bass, members of the subcommittee. Thank you for
inviting me to speak today and thanks to all of you for your
continued support and leadership on nutrition and food
security.
I also want to thank Mr. Markanday for that presentation.
We are grateful for the FAO's close collaboration with Feed the
Future and it is wonderful to hear Mr. Markanday reaffirm just
how seriously the FAO takes nutrition.
In particular, I would like to express my gratitude to you,
Chairman Smith, for introducing the Global Food Security Act,
which shows the U.S. Government's strong bipartisan commitment
to reducing global hunger, poverty, and malnutrition.
The Global Food Security Act has passed both the House and
the Senate and we are looking forward to working with the
subcommittee members and Congress to pass it into law.
And as Feed the Future's Deputy Coordinator for
Development, I am honored to be able to talk to you today about
the important role the U.S. Government is playing in the fight
against global hunger, poverty, and malnutrition, particularly
during the critical 1,000-day window between pregnancy and a
child's second birthday when good nutrition matters the most.
Nutrition bridges many areas. It affects human health,
development, economic growth, agriculture, education and
resilience, and because of this Feed the Future has taken a
comprehensive approach to undernutrition.
And this approach has contributed to substantial progress
on food security and nutrition globally. Farm productivity is
on the rise among much of the global south. Poverty rates and
hunger have fallen dramatically in many of the countries where
we work.
Growth rates in agriculture are among the highest in recent
history, and preliminary data demonstrate that we are on track
to see poverty and stunting reduced by an average of 20 percent
across the areas where Feed the Future works by 2017.
Just one example of this is Cambodia, where from 2010 to
2015 the prevalence of stunting fell by 23.3 percent across the
areas where Feed the Future focuses its efforts.
And while we have seen impressive gains over the past 5
years, particularly on stunting and nutrition, there is still
much more to be done.
We know that 795 million people are still undernourished
globally, and that is 795 million too many.
Undernutrition, particularly early in life, impairs
cognitive, socio-emotional, and also motor development. It
leads to lower levels of educational attainment, productivity
and lifetime earnings, and ultimately it slows economic growth.
For example, we know that by reducing stunting by just 20
percent can lead to an 11 percent increase in incomes. We also
know that relatively simple interventions such as increased
consumption of vitamin-rich orange-fleshed sweet potatoes can
have a transformative impact on people's lives, especially
children's.
Our interventions in nutrition are a smart investment in
building human capital and shared prosperity. Every dollar
spent on improved nutrition yields up to $18 in returns.
But to accelerate progress on poverty and hunger, and to
ensure robust inclusive economic growth for years to come, we
must do more to end malnutrition.
Significant reductions in stunting take time. But given the
solid collective results over the past decade, and the global
community's commitment to solving these issues, I am optimistic
that we can work together across sectors, across disciplines,
and we will see the elimination of malnutrition.
And while it's clear that Feed the Future can and has done
a lot, we know that we will never be able to eradicate global
hunger, poverty, and undernutrition on our own.
To succeed, we have to have additional partners committed
to transforming agro-food systems so we can deliver benefits
like good nutrition for years to come.
But impact like this does take funding, and to pay for it
all we must develop a new international framework for financing
agriculture, food security, and nutrition, one that goes beyond
donor assistance to better leverage resources from all sectors.
So going forward, Feed the Future will intensify our
partnerships--and we have been intensifying our partnerships--
with: developing country governments to expand ownership and
create environments that allow our investments to take root,
multiply, and thrive; the private sector to bring market
access, cutting-edge business practices, and innovative
insights to the development table; and financial institutions
to spur greater investment in small and medium enterprises and
small-holder farms, ensuring inclusive sustainable economic
growth on a macro level.
And civil society is also important. They help to amplify
our message, increase transparency, and make sure that
vulnerable groups are protected and our investments reach our
targeted population.
By bringing partners together, to focus efforts on
agriculture and nutrition, Feed the Future and the U.S.
Government have achieved a great deal. Our approach is working
and we can and will leverage it to do much more.
And that is why Feed the Future will continue to forge new
partnerships and strategically steward our resources to
multiply our impact and build a more food- and nutrition-secure
future.
One of the most important partners we have in this is the
United States Congress, and I want to thank you again for your
leadership on this issue.
I am grateful for the opportunity to speak with you today
and I welcome any questions, comments, and suggestions you
might have.
[The prepared statement of Ms. Dunford follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
----------
Mr. Smith. Thank you very much for your excellent
testimony. Without objection, your full, very extensive
commentary will be made a part of the record.
And just a few opening questions and I yield and to my good
friend, Mr. Clawson, and then maybe have some follow-up
questions at the end.
You have pointed to some excellent results in Cambodia,
Honduras, Bangladesh, for example. I know when we spoke
privately you talked about what was going on in Nepal.
Ms. Dunford. Right.
Mr. Smith. Which you might want to elaborate even further
on, particularly that way of--I know it's not a food security
issue but that great birthing technique that you were meaning
to elaborate on when we last met, particularly with regards to
the umbilical cord, which saves lives.
But Nigeria is one of the worst of the worst when it comes
to the loss of childs' lives both neonates--newborns and unborn
children--and I am wondering if the new government has been
responsive to initiatives.
Of course, they are challenged with Boko Haram. We all know
that. I know that children in the three northern states
particularly are probably even more malaffected than anyone
else. But if you could speak to some of the other African
nations but particularly Nigeria.
Ms. Dunford. Great. So I wanted to highlight, as you
mentioned, chlorohexidine which is an important intervention
where it was based on years of research that USAID funded in
Nepal and in partnership with a local private sector company
that we also help to support.
The government really took on this initiative. It's a gel
that you put on the umbilical cord after birth to keep the
umbilical cord sanitary to prevent against tetanus.
And as we know, as child mortality rates are decreasing,
neonatal mortality rates are often the most difficult to really
start seeing great movement on. And this really can reduce the
infant mortality rate by 23 percent just by use of this one
gel. It costs pennies to distribute and in Nepal we are working
to have it disseminated across the country.
A network of 48,000 community health volunteers have taken
up this effort under government leadership and are working to
get it out to the farthest reaches of way up in the mountains,
way out into the plains.
It is very easy to apply. It is something that these
community health volunteers, when they work with pregnant women
to inform them of best practices going forward to have a
healthy pregnancy, it's something they can give to the women.
There is one person who is always present at a delivery,
and it's the mother. So the mother carries the packet around
with her and it's just one application that anyone can do. So
that is a very, very important intervention, and I do know the
Government of Nigeria has gone to Nepal to receive training and
to better understand how chlorohexidine works and how they
might integrate it into the health system.
How far it has actually gone I am not sure. But it is one
of several governments that have learned from Nepal in this
effort.
And we are looking at working with the African Union, which
has shown tremendous leadership on the issue of food security
and nutrition and we are really working to highlight what we
are calling champions of change, to work with partner country
governments that are demonstrating the type of leadership by
putting their own funds into agriculture and food security, by
putting in place the right policies that can really allow space
for private sector investment to further fuel the agricultural
transformation and to fuel investments in nutrition. And by
elevating those leaders that are doing a good job, they are
really incentivizing others to follow suit and we are hopeful
that Nigeria will go along that path as well.
Mr. Smith. You mentioned the importance of faith-based
organization and private sector. Are you finding a lot of buy-
in from the faith-based community when it comes to these
initiatives? Are they included in a robust way by the
governments? I know our own seeks and reaches out. But are the
other governments doing it as well, particularly in the 19
countries where we are--we're involved.
And secondly, if I could just ask you with regards to the
post-2015 SDGs and, of course, the Decade of Action on
Nutrition. I am always concerned when there are so many
aspirational goals, targets, indicators and the three-pronged
approach with the post-2015 that there is so much people then
don't prioritize and do as much as they could, particularly on
such a life-changing, life-enhancing initiative like Feed the
Future.
To ensure that we don't get lost in other good things but
they get crowded out by trying to do it all. Your thoughts on
how we can keep this prioritized going forward between now and
2025 with the decade and also 2030 with the post-2015.
Ms. Dunford. Thank you. Thank you, Chairman, for those
important questions.
I wanted to touch, first, upon faith-based organizations,
which are incredibly important to Feed the Future and its
implementation.
As we work with civil society, faith-based organizations
are a critical part of that throughout all of the 19 focus
countries where we work on many, many different levels.
Just to provide one example, in Zambia, Catholic Relief
Services is out there working specifically to deliver nutrition
messages to first 1,000 day mothers and also to first 1,000 day
mothers in their communities, helping them to understand what
types of nutrition they need to ensure that they take advantage
of this really critical window and also making sure they have
access to those nutritious foods as well.
I wanted to talk also about the SDGs, and I think you're
right. The SDGs are--it is a very important global moment where
world leaders came together to agree on how important
development is and codify that.
As we know, SDG 2 is most focused on hunger. We think it's
a really important way to elevate the work that we all think is
so important.
There are a lot of competing priorities out there. I like
to say that hunger and food security weaves itself through all
of the SDGs and is central to everything that we can and will
do.
I think in order to help us raise the profile of this
effort are the results that we are starting to see come in.
With the right types of investment we can see change and I
think that is as motivating a factor as anything to keep this
at the top of the policy agenda.
Mr. Smith. Thank you.
Ms. Bass.
Ms. Bass. Thank you very much for your presentation.
You know, in many ways we are talking about a difficult
subject but in many ways you are filled with a lot of good news
too in terms of practices that are really making a difference.
And I wanted you to expand on that. So a few things in
terms of Feed the Future, I have traveled to a couple of
countries and have seen Feed the Future in action, specifically
though as it relates to farming.
In your written testimony, you have a couple of examples
that I wanted you to elaborate on. One was Chicken Choice in
Kenya. And so I wanted to know if you could give a couple of
examples of a Feed the Futures best practices that weren't very
specifically agricultural.
Ms. Dunford. Thank you, Ranking Member Bass, for that
question and also for your support of the Global Security Act.
Chicken Choice is one of my favorite examples which I think
is why it made it into the testimony. It's really a nice
example of someone who worked in a chicken factory who saw that
chicken parts were being sort of discarded and these poor women
who had no other choice, no other avenues, were coming to dig
through the trash to find these parts in order to have
something to feed their children that was nutritious. And so he
started a product made from these by-products and started
expanding to different locations throughout Kenya. He ended up
with nine locations but had difficulty reliably transporting
this very nutritious but low-cost product to these nine
locations. We helped him buy a refrigerated truck, as simple as
that. Given that transport can be dicey, this really helped him
expand his business and get this low-cost nutritious food out
to many more people.
So I am glad you like that example. That's the type of
ingenuity and innovation that we need to see from the private
sector that we are trying to support.
Other examples, just to put out there, I was just in Rwanda
last month and I went with a group of women to their field of
beans, and they have been growing iron-fortified beans.
This bean has doubled the amount yielded by a traditional
bean. It cooks in half the time, which is very significant for
people who are time-bound and needing to get fuel to cook all
their food with, and has a very important source of iron.
And so I think these seeds we are starting to disseminate
throughout Rwanda will be very much game changing when one of
these staple foods becomes something that is iron-fortified
from the very beginning.
So there are a couple of examples. I am happy to provide
more as well.
Ms. Bass. Great, and I appreciate that.
I wanted to know some other input around Africa. You talked
about how the African Union was really taking a leadership role
and maybe you could be specific about what you mean.
And then in that regard, also I wanted to know if you feel
that there are examples of roles being played by the African
regional economic communities regarding a more regional
approach, especially with some of the smaller countries.
Ms. Dunford. Yes. So the Malabo Commitments that came out
of the 2014 African Union summit are very, very good if you
read them and I think the African Union is looking to see how
can we use CAADP to fuel the implementation or the attainment
of these goals, which include things like reducing stunting and
poverty, and tripling trade and the rest.
And they're launching this campaign called Seize the
Moment, talking of champions of change--like I said, really
elevating country leaders who are doing the right thing on
agriculture and malnutrition. And so we're looking forward to
seeing how that campaign goes on to really elevate this issue,
as Chairman Smith said.
On the regional issue, I think the regional economic
communities play a very, very important role. I'll take the
example of Senegal and then I've also got an example of Togo I
can give.
ECOWAS, the regional economic body in west Africa, passed
standard certifications of seed, but these were not adopted by
Senegal for many, many years.
So what you found were that private sector actors involved
in seed production and multiplication were not able to operate
freely in Senegal, and that the government was left with an
inadequate system--really, trying to get seeds out to farmers
and didn't have access to the latest seeds.
So the Government of Senegal, as part of its New Alliance
commitments, in 2013 passed a law that put Senegal in line with
these regulations that had been passed and encouraged by the
regional economic community, and therefore, allowed for private
sector engagement in the seed sector.
We helped to amplify this effort once the policy was right
to get private sector actors out there producing and
multiplying seeds that were able to reach many, many more
farmers.
As a result, NERICA rice now is readily available on the
market. It's a rice that's drought resistant, drought tolerant,
and also increases yield by up to 3 times.
And so as part of our interventions working with private
sector and this important policy change, now 180,000 farmers
have access to this new technology that's really game changing.
Also, the regional economic community put in place some
regulations on how many border check points you could have--a
maximum of 30 border check points--which is critically
important.
And we supported some businessmen in Togo who really went
to the ministers and said, wait a minute, you aren't abiding by
this regional economic rule and had an advocacy campaign to get
people out to see all of the check points. And upon
understanding what it took to get food from the north of Togo
down to southern Togo--which was taking up to 4 days, they were
aghast and put in place these changes and now it only takes 1
day to go from the north.
Ms. Bass. Wow. That's great. That's wonderful, because a
problem throughout the continent----
Ms. Dunford. Absolutely.
Ms. Bass [continuing]. Is how to support intra-African
trade.
So one question that always comes up in my district
whenever I talk about Feed the Future, and I brag about Feed
the Future all the time, but I'm always questioned as to
whether or not GMOs are a real big factor.
Like when you were describing the beans and then also the
rice, and so I wanted to know if you could comment on that.
Ms. Dunford. So I think that genetically-engineered
technology is one of many, many tools that we use along with
conventional breeding, along with other techniques, to help
farmers increase their productivity, that have to do with
things like drip irrigation and the rest.
We definitely follow countries' own laws, regulations, and
wishes around genetically modified crops.
Ms. Bass. Thank you. Thank you very much, Mr. Chair.
Mr. Clawson. Thank you for coming. Thank you for your
important work.
Ms. Dunford. Thank you.
Mr. Clawson. My firsthand experience tells me that for
subsistence farmers to make meaningful progress, A, they have
to have diversification, which you have spoken to, and B, they
have to have credit.
And we have been talking about microcredit since I was in
college and I have got a lot of gray hair right now. And so I
hear and read and see with my own eyes lots of really good
programs, small programs in Southeast Asia, Africa, or
wherever.
But given the level of corruption for a lot or most of
these governments, depending on how charitable we want to be, I
don't know of any examples of countries that are struggling
with hunger that also have widespread microcredit available for
a market of struggling subsistence farmers. And without that,
all of this is just anecdotal talk to me. I'm glad you're doing
what you're doing.
But if there's no microcredit in Africa or Southeast Asia
at a broad level because there is so much corruption and there
is not a developed private market for it, we are just blowing
in the wind as far as I can tell.
Am I wrong about what I'm saying or--I'd like you to tell
me I'm wrong and there is a country that is struggling to make
the jump and that has a large noncorrupt microcredit market for
people that need it. Does that exist in the world?
Ms. Dunford. So Mr. Clawson, thank you so much for your
question and also before I go on I also want to thank you for
your support of the Global Food Security Act.
I think you hit on one of the key issues. As I said, all of
this takes money, and money at different levels, to invest in
public sector infrastructure and research but really to invest
so that the small and medium enterprises can really move the
agricultural system to have the kind of outcomes that we're
looking for. So I think you are right. Credit is one of the
critical components to enable us to reach our goals.
I just wanted to provide another example from Senegal,
where one of the problems with getting agricultural credit out
there is that often you need a little bit bigger loans. The
payback time needs to be a little longer sometimes because you
have to wait for crop cycles and, frankly, it's a very risky
investment for commercial lenders and so how do we get money
out to these people?
And I think that there have been some very creative ways
over the years. One thing that we found in Senegal was to
really look at how can we work with banks to have more creative
means of collateral.
One thing that we did with working with farmers in Senegal
is that we basically took out iPads and found one or two people
in the communities who actually were computer literate who
could start recording production data from all of these farmers
and after they built out a couple years of production data to
be able to take that information to banks to say look, here's a
record, it is not so risky to lend money to this farmer so he
can purchase the inputs he needs to have a good harvest because
here's his production record and that will give some guarantee.
We also found in Uganda, where five youth who met at a Feed
the Future innovation conference came together and started a
mobile app company that provides information to farmers on best
practices, but what it also does is these agents are then able
to go out to farmers, collect information and create a credit
profile for these farmers, who are often illiterate, to take to
banks to get them to be able to loan money to farmers.
So I think finding creative ways to get these funds out to
farmers is critical.
Mr. Clawson. And what country actually has a functioning
microcredit market for these kind of folks? Does that exist?
I love what you're telling me. But does that exist?
Ms. Dunford. So I think you're right, there's----
Mr. Clawson. I'm not saying that it doesn't exist. I'm
asking you. You know, is there anywhere in Southeast Asia or
Africa of a developing country that has a microcredit market
that actually gives poor people an opportunity to expand their
crops, without paying 20 percent a month?
Ms. Dunford. I think that if you saw a system that worked
very, very well you would see great reductions in poverty and
hunger.
In the countries where we work, there are instances of
credit being available but we have not yet succeeded in making
this something that's universal across the country.
So I think you've hit on one of the key obstacles that
we're tackling, moving forward.
Mr. Smith. In your testimony, Dr. Dunford, you talk about
the 11 different Federal agencies for the whole of government
initiative. Of course, that language is reflected in our bill--
both the Senate and the House bill.
And the list includes, of course, the Office of the United
States Trade Representative and I am wondering--you know, there
are--there are agencies that are all in and doing more--just
because of what their past has been, especially your
leadership, how helpful has that Office of the United States
Trade Representative been?
I've been in arguments with them over TPP and other issues.
I think you have, too. But it seems to me that this is a golden
opportunity. Just like the World Bank has done such
extraordinary humanitarian work in a number of areas and most
people, when they think of the World Bank, don't automatically
think of that.
So if you could maybe----
Ms. Dunford. Thank you very much for this question. I think
that working with USTR, they have been an incredibly important
partner for us. Really expanding trade is one of the most
important things--trade, not aid, is really going to lead to
the future that we seek of a food-secure world.
And so we've been partnering with USTR to build a capacity
for Africans to increase their trade. We've also been working
in other areas as well. So I think they are an incredibly
important partner, mostly in the capacity building of key trade
systems, and will continue to be moving forward.
Mr. Smith. Can I ask you how well-coordinated is the effort
to ensure that folic acid is included? As I think I know and I
might have commented this to you when we met, I wrote three
laws on combating autism including the Combating Autism Act.
The Autism CARES Act just became law, and the most recent
compilation of NIH research suggests three studies that say
the--children on the spectrum can be reduced by 39 percent with
400 micrograms of folic acid per day as long as it's 3 months
before actual conception and no later than 1 or 2 months after
conception.
After that, it's helpful but not determinative and it also
reduces spina bifida and other neurological problems.
I'm wondering how well can you coordinate that to ensure
that that's part of the package. In the year 2007, I was with
my staff director for this subcommittee, in Lagos and I gave a
speech on human trafficking.
And a man came up and said well, what are you doing about
autism in Nigeria. I said, nothing. We had dinner that night
and it was a learning experience for me to find out how much
unmet need there is in Nigeria and the rest of Africa.
The WHO has said there are tens of millions of autistic
children in Africa, largely underreported and not getting
anything like early intervention. But folic acid could be not a
panacea but part of the solution and I'm wondering how well
that's integrated.
Ms. Dunford. So I think our efforts are really focusing on
helping people to grow and access the right types of food in
order to have a balanced diet that would include all of the
types of micronutrients that you're talking about, including
folic acid.
And I know our colleagues in the Bureau for Global Health
work also in micronutrients and I will check with them and get
back to you in a written answer on how we include folic acid
specifically.
Mr. Smith. That would be great, if you would.
[The information referred to follows:]
Written Response Received from Beth Dunford, Ph.D., to Question Asked
During the Hearing by the Honorable Christopher H. Smith
Folic acid deficiency is one of several micronutrient deficiencies
that USAID nutrition programs address. Global Health programs support
folic acid supplementation as part of maternal health interventions,
plus any multi-micronutrient supplementation provided to children. Feed
the Future works jointly with Global Health on improving food
fortification capacity in East and West Africa, plus other countries,
such as Afghanistan, where folic acid may be included as a fortificant.
Folic acid may be supported as a fortificant, along with iron, vitamin
A or iodine, depending on the food vehicle fortified and the specific
country needs that address their population's nutritional deficiencies.
Mr. Smith. And for the record, how much are we spending on
Feed the Future in fiscal year 2016?
Ms. Dunford. $895 million.
Mr. Smith. Okay. Are there any other questions?
Unfortunately, we are being called over for a vote.
Ms. Dunford. Yes, of course. Of course.
Mr. Smith. And I apologize for that.
Ms. Dunford. That's okay.
Mr. Smith. We are planning a meeting and I would hope you
and Mr. Markanday, if you would consider this as well--we are
going to invite the Ambassadors from Africa and other
countries, particularly developing countries, to a forum on
Feed the Future.
We are hoping that Roger Thurow--we have asked him already
and he seemed very interested to come and speak about the all-
important first 1,000 days.
But, of course, what follows is important as well.
Ms. Dunford. Right.
Mr. Smith. But it would be a great opportunity for all of
us to encourage the Ambassadors to be in contact with the home
front and home office and health minister to say okay, we've
all signed up, scaling up, but what are we really doing--are we
really making this a priority?
Because the intentions are great in many capitals but
competing challenges sometimes crowd out this highly
efficacious effort to help women and children.
So if you would at least consider being part of that panel
it would be very, very helpful.
Ms. Dunford. Absolutely. I would be honored.
Mr. Smith. As soon as we get a date we will get to you. We
are trying to find out when the African Ambassadors especially
would be most available. But we're also--we want the other
Ambassadors to be there as well.
I was actually in Guatemala the day they signed up with us
to work on the first 1,000 days, and I met with the Speaker
that day and was--you know, he was all in and very excited
about what it would do for stunting in Guatemala.
So is there anything else you would like to add? And I have
more questions but we are almost out of time because of the
vote.
Ms. Dunford. Well, I just want to thank you so much. It's
been an honor to be able to testify before you and your
committee today. I really appreciate your interest and support
in this effort.
I wanted to just give one more example of really talking
about the importance of women in Feed the Future and the
groundbreaking work of the Women's Empowerment in Agriculture
Index that has really helped us to--for the first time--measure
women's empowerment and understand where and why empowerment
goes up and down.
This is an area where Bangladesh, when we did the first
round of WEAI Surveys scored the lowest of all our focus
countries on this index. And it led our mission and also the
country of Bangladesh to take this seriously and say, ``What
can we do to increase women's empowerment?'' The WEAI found
that public speaking was one of the key issues and Bangladesh
really worked to ensure that women had opportunities to be
trainers in agricultural extension and also looked at how they
had problems with control over their production and really
understanding that actually fishing was one of the biggest
smallholder activities and the big nets being used were so big
that men had to actually harvest the fish, which led women to
be dependent on men to harvest the fish for their own
consumption and also for sale.
And so we've worked to develop a smaller net that more
women can use so they can then control the efforts of their
production.
So you've seen a big improvement of women's empowerment in
Bangladesh and just showing how measurement combined with
government leadership and our efforts can quickly move the dial
on an issue that has been so pervasive for decades.
Mr. Smith. My colleague, Mr. Clawson, raised some, I think,
interesting points about microcredit lending. I have actually
authored two laws on microcredit lending and the biggest
takeaway I had about all of that was how well women were able
to take modest amounts of money and almost like the loaves and
fishes multiply the effect.
Fed not only their families but hired people, paid back the
loan so that the revolving funds were back into the kitty to
help other people.
But I'm wondering, maybe as a question, do you find that
there is a good interface between Feed the Future initiatives,
private sector, NGOs, FAO, of course, and yourselves and the
micro lending initiatives as well?
Ms. Dunford. Absolutely. That is one of things we are
really trying to do. I think Mr. Clawson hit on a key issue
that is a hard nut to crack and we are really working toward
getting there.
So yes, that is well coordinated. If I could say one more
point, I started out my career in international development at
USAID as a young officer in Ethiopia back in 2002, 2003 where
there was a famine--14 million people on the verge of
starvation. It was my first experience with anything like
this--very, very formative.
That year, I was working on providing food assistance to
those people. The USAID Mission in Ethiopia that year spent $5
million on agricultural development and nutrition, the type of
work we are talking about today, and spent $500 million on
handing out food to people.
And while that's a very, very important effort, I just
really applaud your support for us to actually reverse that, to
spend more money actually on building the long-term capacity
that's going to help people pull themselves out of poverty and
pull themselves out of hunger.
I really appreciate your efforts.
Mr. Smith. Okay. But again, we appreciate your efforts
because you guys are walking point and doing a tremendous job.
Thank you for your personal leadership, expertise, and
determination.
The hearing is adjourned.
[Whereupon, at 3:04 p.m., the committee was adjourned.]
A P P E N D I X
----------
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
[all]