First, do no harm

Many people will be hungry this Christmas. But despite what the official studies say, the globe is not going to hell in a handcart. Nicholas Eberstadt challenges the pessimists on both overpopulation and famine and argues that political and economic liberty are the best ways of combating malnutrition
January 20, 1997

In the century when the formula for attaining mass affluence was finally per-fected, more people have perished from famine than ever before in human history. Why? Why do we live in a world in which millions upon millions of children and adults suffer from the scourges of extreme hunger and malnutrition? These are profound and terrible questions. And there is scarcely a nobler quest in the world than the search for the right answers.

But in no other humanitarian venture do people so mistake good intentions for good policy. For some reason, it seems that contemplating the problems of starvation and famine can cause the vision of ordinarily brilliant intellectuals, learned academicians and clearheaded statesmen suddenly to blur. This peculiar phenomenon, moreover, is not confined to any particular country or group of countries. All around the world today, specia- lists and policymakers continue to entertain beliefs and accept premises about the world food situation that are demonstrably, sometimes glaringly, invalid.

To a strange and disturbing degree, modern international man is, quite literally, starved for ideas. Widely accepted misconceptions, stubborn id?es fixes and crude ideological notions about the nature of hunger and famine are impeding the quest to achieve food security for all. Guided-or misguided-by flawed assessments of the prevalence and causes of global hunger, we cannot hope to attain satisfactory results. At best, our well-meaning efforts will be ineffective; at worst, we risk making bad conditions worse, and injuring those we seek to help.

Modern myths about the world food problem are legion. There are three that seem to me particularly fashionable-and pernicious. The first concerns the current dimensions of the problem. The second might be described as the "Malthusian spectre." The third bears on the relationship between hunger and politics.

according to what is by now a large body of studies by reputable and authoritative organisations, the magnitude of global malnutrition is huge-so huge, in fact, as to be almost incomprehensible. According to some of these studies, moreover, the problem has, at least in some respects, been worsening over time.

For example, in 1950, Lord Boyd Orr, the first director general of the UN Food and Agriculture Organisation (FAO), warned that "a lifetime of malnutrition and actual hunger is the lot of at least two thirds of mankind." Thirty years later, a US presidential commission on world hunger concluded that "this world hunger problem is getting worse rather than better. There are more hungry people than ever before." In 1991, the world food council declared that "the number of chronically hungry people in the world continues to grow." And at the world food summit held in Rome in November 1996, a principal FAO document put the undernourished population of the world at well over 800m-indicating that one out of five people from developing countries was suffering from chronic undernutrition in the early 1990s.

That most recent FAO estimate seems to suggest both absolute and relative improvement in the world food situation over the period since Lord Boyd Orr issued his grim assessment. On the other hand, the FAO's 1963 third world food survey concluded that a fifth of the developing world was undernourished. By that reckoning, we would seem to have made no progress whatever against third world hunger over the intervening decades: given the growth of population in the less developed regions, the absolute number of hungry people in the world must have increased tremendously since.

These expert findings paint a disheartening picture. There is just one small thing wrong with it: astonishing as it may sound to the non-specialist, the methods underpinning every one of the main international studies over the past two generations that has attempted to quantify global hunger are flawed. Using the methods employed in any of these studies, it would be impossible, even under ideal circumstances, to derive an accurate impression of global hunger-and the conditions under which some of these studies were prepared were far from ideal. For citizens and policymakers committed to charting a course against world hunger, these studies offer a misleading map.

The flaws are sometimes technical, but they are never difficult to understand. In every instance, the expert calculations pivot upon questionable assumptions about individual nutritional needs in large populations, and upon equally questionable assumptions about the correspondence between national food supplies and individual food intake. Remember: malnutrition is a condition that affects individuals. Short of clinical or biomedical examination, there is really no reliable means for determining a person's health or nutritional status. Lacking such information, these studies draw necessarily crude inferences about individual wellbeing from highly aggregated economic and agricultural data. They cannot cope with such basic issues as whether individuals with lower caloric intake have lower than average caloric requirements; whether individual metabolic efficiency adjusts in response to changes in the nutritional supply; or whether individuals predicted by their models to be undernourished actually suffer from identifiable nutritional afflictions. To pose these questions is not to presuppose an answer to them; rather it is simply to discharge a basic duty of careful enquiry.

Sometimes the results of these hunger studies can be quickly dismissed. In 1980, for example, the World Bank published a paper purporting to show that three quarters of the population of the less developed regions suffered from "caloric deficits." This ominous conclusion, however, was reached by dubious suppositions, the most spectacular of which was that anyone receiving less than the average "recommended dietary allowance" was underfed. Logically, about half of any population will need less than the average allowance-that is the meaning of the word "average." Consequently, this model could only generate nonsense numbers. Its computations, for example, showed that nearly half the people in prosperous Hong Kong were getting too little food!

To their credit, the World Bank researchers on this project recognised that their work failed the "reality test," and went back to the drawing board. Unfortunately, others working on the problem have not always met the same standards of intellectual accountability. Lord Boyd Orr, for example, never explained the method underlying his now famous estimate of the prevalence of world hunger. After reviewing contemporary FAO data, one of the leading agricultural experts of the day, Merrill K Bennett, surmised that the estimate might have been an elementary computational mistake-a misreading of the figures in two particular columns of a table. The FAO, however, never replied to Bennett's inquiry and has never offered substantiating evidence for Lord Boyd Orr's original assertion.

Other FAO estimates about world hunger have remained similarly protected against outside inspection: most of the data and calculations in the first three world food surveys, for example, are still unavailable to the public. In more recent studies, where somewhat greater openness is on display, we can see that the FAO's definition of the caloric threshold level for undernutrition has been steadily climbing over time. But why? These upward revisions do not reflect any obvious changes in the scientific consensus concerning nutritional norms-but they do produce higher totals for any given estimate of the number of hungry people in the world.

If we could only for a moment extricate ourselves from this numerical house of mirrors, we would see that there are indeed meaningful data that bear upon the actual nutritional status of humanity-and they tell a rather different story.

Household spending patterns in less developed regions can reveal how the poor assess their own nutritional status. If a family treats food as a "superior good"-that is, if an increase in income raises the overall share of the household budget going to food-it suggests that its members have too little to eat. By this criterion, the incidence of serious hunger in the world would be far lower than the FAO currently suggests: for example, about two thirds lower in some years for India (a country which happens to have reasonably good household expenditure data).

Mortality rates, for their part, offer an unambiguous measure of the material condition of any population. Despite the limitations of demographic data, it is none the less clear that the third world has experienced a revolution in health conditions over the past generation. According to estimates and projections by the population division of the UN secretariat, life expectancy at birth in the less developed regions rose by an average of almost a decade and a half between the early 1950s and the early 1990s; over that same period, infant mortality in the less developed regions is estimated to have dropped by almost half. Can one imagine that such dramatic gains were entirely unaccompanied by nutritional progress?

The truth is that a precise and reliable method for estimating the incidence and severity of worldwide malnutrition has yet to be devised. We can be all too sure that scores of millions in our world suffer from heart-rending, life-impairing hunger. But exaggerating the size of the problem, and minimising the strides we have already made against it, will serve no worthy purpose. Hungry populations will not benefit. In an age of "compassion fatigue," these misrepresentations discourage action by depicting the problem as almost insurmountably large. To make matters worse, they may misdirect available humanitarian resources away from the places where they might have made the most difference. By obscuring true patterns of nutritional change, these misrepresentations obstruct our efforts to learn from experience. Denying the existence of progress against global hunger prevents us from studying, and applying elsewhere, the lessons of success.

let us turn now to the Malthusian spectre. The postwar variant of the idea first advanced by Thomas Malthus, the early 19th century economist, holds that the globe cannot support the enormous increase in human numbers that we are witnessing-and holds further that we will be faced by rising poverty, mass hunger and perhaps even worldwide catastrophe unless we check this uncontrolled demographic growth. Overpopulation, increasing scarcity of food and natural resources, and famine, Malthusians argue, are clear and present dangers-the existence of which prove that their model is correct.

In intellectual and political circles, the influence of Malthusian ideology ranges wide. For its proponents, Malthusianism has some of the trappings of a secular faith. Matters of faith, as we know, do not readily lend themselves to proof or disproof. If we try to treat the Malthusian spectre as an empirical rather than a theological proposition, though, we find little evidence that its advent is nigh.

Take the subject of "overpopulation." So much has been said about this subject over the years that you may be surprised to hear that there is no consistent definition of the term. None. How could we define it? In terms of population density? If so, Bermuda would be more overpopulated than Bangladesh. In terms of rates of increase? In that case, pre-revolutionary America would have been more overpopulated than contemporary Haiti. In terms of the "dependency ratio" of children and the elderly to working-age populations? That would mean Canada was more overpopulated in 1965 than India is today!

The images evoked by the term overpopulation-hungry children; squalid housing; early death-are all too real in the modern world. But these are properly described as problems of poverty. The risk of poverty, however, is obviously influenced by a panoply of non-demographic forces, not the least of these being the impact of a government's policies upon its citizens. The relationship between population growth and poverty is more complex than one is often led to suppose.

We know that rapid and sustained population growth does not preclude rapid and sustained economic and social advance. If it did, the huge rise in living standards we have already witnessed this century could not have occurred.

Since 1900, according to the best available estimates, the world's population has more than tripled. Nothing like this has ever taken place before-and although the tempo of global population growth appears to have peaked and to be declining, it is still proceeding with extraordinary speed by historical standards. This unprecedented demographic explosion, however, has not consigned humanity to penury and destitution. Just the opposite: it has been accompanied by a worldwide explosion of prosperity. According to the eminent economist, Angus Maddison, the world's per capita GDP quadrupled between the turn of the century and the early 1990s. In Latin America and the Caribbean, per capita GDP, by his estimates, has more than quadrupled this century; in Asia and the Pacific, it has more than quintupled; and even in troubled Africa it may have more than doubled. While such calculations cannot be exact, there should not be the slightest doubt about the consequence of the trends they represent.

Why has the most rapid period of population growth in the history of our species been the occasion for the most extraordinary economic expansion in human experience? Part of the answer may lie in the population explosion itself-or more precisely, in its causes. The modern population explosion was sparked not because people suddenly started breeding like rabbits, but rather because they finally stopped dying like flies. Fertility rates did not soar, but mortality rates plummeted. Since the start of the century, the average life expectancy at birth for a human being has probably doubled. Every corner of the earth has joined in this health revolution-and on the whole, incidentally, health progress in our century has been more dramatic in the less developed regions than the more affluent ones.

Improvements in health are conducive to improvements in productivity. It is not just that healthier populations are able to work harder: improvements in health and reductions in mortality enhance what economists call "human capital": education, training, skills, and the like.

What about fertility, which many experts consider to be excessive in one or another region of the world? Unlike better health and longer life, which are universally regarded as desirable, there is no universal view on optimal family size. The number of children that parents wish to have, like other big decisions in a person's life, is an inescapably subjective choice-while it may be shaped by economic, cultural or religious factors, in the final analysis it is a personal choice. Before we speak of excess fertility, we should ponder what this implies about other people's choices. Human beings are not heedless beasts. They do not procreate with utter disregard for their own wellbeing, much less the welfare of their children.

With the immense growth of human numbers, and of per capita output, the world's GDP has grown phenomenally in our century: Maddison's research suggests a 14-fold absolute rise. Despite this great surge in demand, however, the prices for foodstuffs and natural resources have not rocketed. In fact, the long term trend for primary commodity prices has been heading in exactly the opposite direction. Accord-ing to one careful World Bank study, inflation-adjusted prices for primary commodities-including energy products-have dropped by over a third between the turn of the century and the 1980s. The real price of primary commodities has fallen still further since then.

Other things being equal, scarce items are supposed to cost more; plentiful items, less. Yet by the very information that prices are intended to convey, it would appear that foodstuffs and natural resources have been growing less scarce despite mankind's steadily increasing demand for them. For convinced Malthusians, this seeming contradiction constitutes an unsolved mystery-and indeed an insoluble one, if they are to maintain faith in their doctrine.

And what of famine? Malthusians expect famines to strike what they call "overpopulated" regions, what we might call very poor regions. It is true that the margin for error for the very poor is perilously narrow. But it does not follow that the very poor are inexorably consigned to mass starvation-or that they are pushed there by their own fertility trends. If we examine the actual record, we will see that modern famines are a quintessentially political phenomenon. In the modern world, people do not starve en masse because famine is unavoidable. They starve because their own rulers are indifferent to their plight-or because the state under which they live has actively contrived to bring about their death.

Recall the most fearsome famines that have gripped nations in our century. Over 6m people perished in the Ukraine in 1933. That was Stalin's terror-famine provoked by a deliberately punitive collectivisation of agriculture. As many as 3m people died in Bengal, India in 1943. That was when the British Viceregency, with available stocks of grain at hand, refused to enact the empire's stipulated relief procedures, in case they compromised the war effort. Between 1959 and 1961, China lost as many as 30m people through Mao's collectivisation of the countryside. Perhaps 1m Biafrans perished from famine in the late 1960s during the Nigerian civil war, when food blockades were deliberately employed to starve the rebels into submission. In the late 1970s, perhaps 1m-maybe more-died from unnatural causes in Cambodia. That was the Khmer Rouge's barbaric programme of auto-genocide. In the 1980s and 1990s, famine has struck Ethiopia, Sudan, and Somalia. If these more recent tragedies differ in some details from earlier famines, the patterns are broadly the same.

Amartya Sen, the distinguished economist and philosopher, and the pre-eminent student of contemporary famine, has stated it starkly: "Famines are, in fact, extremely easy to prevent. It is amazing that they actually take place, because they require a severe indifference on the part of governments."

finally, let me turn to the relationship between hunger and political morality. At international gatherings, it is sometimes regarded as d?plac? to observe that one form of political or legal arrangement might be preferable to another. But how can we reflect upon the history of our century without being struck by the singular role certain political principles have played in abetting mankind's escape from hunger-and the dark role of other political philosophies in perpetuating the threat of hunger? This much is clear: economic liberty is the enemy of hunger, and political freedom the nemesis to famine.

There have been few instances of famine in countries where local newspapers were free to criticise their government, or where citizens enjoyed the right to participate in an opposition party. In open and accountable political systems where governments serve at the sufferance of the voter, there is huge pressure for policies that forestall famine. India has not suffered famine since its independence. Far from being a luxury that only the rich can afford, political freedom is a necessity for the very poor.

Just as political liberties place a systemic check on the threat of famine, so economic liberties can reduce the risk of severe malnutrition. This is so, quite simply, because the institutional framework for securing economic liberties happens also to be conducive to material advance. The rule of law; protection of individual rights, including property rights; enforceability of contracts; sound money; the sanction of mutually beneficial economic exchange-from the standpoint of protecting liberty, all these are virtues in their own right. But in so far as they decrease uncertainty, lower the costs of obtaining information and reduce what are called the "transaction costs" that confront individual economic agents, the underpinnings of economic liberty stimulate economic activity and enhance economic welfare.

In much of the world-including areas where basic political freedoms are secure-the workings of domestic and international markets are regarded with suspicion, even hostility, in many elite circles. Such circles speak gravely of the perils of "market failure," and claim these perils justify far-reaching interventions into economic life. Markets, like all human inventions, are imperfect. Some instances of modern market failure, have, indeed, been conspicuous. But before learning all the exceptions to the rules, it is best to get the rules themselves straight. For it is the opportunities that lie in market development and economic liberty that offer the greatest scope for improving the purchasing power of the world's poor, and thus for promoting nutritional security for vulnerable populations. What Deepak Lal, the development specialist, termed "the dirigiste dogma" is still deeply entrenched in many of the world's poorest, and hungriest, spots. This dogma commands faithful followers within the FAO and other multilateral institutions. Its adherents have an unsettling tendency to discover market failures where none in fact exist-and to misdiagnose the adverse consequences of their own preferred therapies as market failures that will only be remedied through further dirigiste treatments.

with the enormous increases in world population anticipated in the coming generations, we will need to arrange for an equally large expansion in agricultural production. A necessary condition for such increases is the establishment of effective, responsive and limited governance-a task barely begun in the world's hungriest regions. That will be the hard work. Fixing the misconceptions about hunger and population, discussed above, is the easy part. But you do not get to do the hard work unless you do the easy work first. One injunction above all should guide those-whether international officials or well meaning individuals-who seek to address the hunger problem. It is as old as the desire to do good itself: first, do no harm. First, do no harm.