Sumo Nayak feeds children at a Nutrition and Health Day meeting in Irikpal in Chhattisgarh state, India. Courtesy of Ami Vitale/CARE

Hunger takes different forms, but they all can cause death and undue suffering, mostly in developing countries. More than 850 million people go hungry even though the world produces enough food to feed everyone. Food aid helps in emergencies, but long-term, sustainable solutions are needed to move toward achieving the international goal of halving the number of hungry people.

CARE is a leading humanitarian organization fighting global poverty. Bob Bell is director of CARE's Food Resources Coordination Team, David Kauck is a senior program technical adviser, Marianne Leach is director of CARE's Government Relations Team, and Priya Sampath is a senior policy analyst.

The U.N. Food and Agriculture Organization (FAO) estimates that more than 850 million people worldwide suffer from hunger today, 820 million of them in developing countries.

In the 1980s, CNN brought us images of millions of starving children and adults in Ethiopia, showing the Western world what hunger looks like in developing countries. Aid and assistance poured into the country. Since then, however, we have become somewhat inured to the phenomenon as every year brings the now all-too-familiar pictures of famines, floods, and other disasters or of abject poverty.

That there are nearly a billion hungry people in the world today despite the gains made in agricultural productivity seems unimaginable. Recognizing the enormity of the issue, the World Food Summit in 1996 set a goal to reduce by half the number of hungry people in the world by 2015, later reaffirmed in the first Millennium Development Goal. But half way to 2015, it is becoming clear that this goal will not be met -- the estimated number of undernourished people has risen from 798 million in 2000 to about 852 million today.

What Is Hunger?

Hunger is a phenomenon related to food insecurity. Food security is a condition that "exists when all people, at all times, have access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life," according to a 1996 World Food Summit statement. Hunger results when households and individuals are food insecure for a period of time.

Hunger affects the normal functioning and development of the human body and contributes to the global disease burden by drastically reducing the body's ability to resist infection. In extreme cases, death results from starvation brought about by prolonged hunger or by succumbing to infectious disease. Hunger weakens people physically. As persistent, chronic hunger limits the body's ability to use energy for activities, the undernourished have difficulty performing at school, finding work, and being productive. Employers and teachers may see hungry people as slow or lazy, when in fact they suffer from lethargy, the body's response to prolonged calorie and nutrient deprivation.

Hunger thus traps individuals and households in a vicious cycle of ill health and diminished capacity for learning and work, causing and contributing to widespread poverty and death. These damaging effects extend to communities and economies.

Widespread hunger undermines the development potential of nations. Improved nutrition affects economic growth directly through improved labor productivity. An FAO study of developing countries over 30 years found that if countries with high rates of undernourishment had increased food intake to an adequate level, their economic output, or gross domestic product (GDP), would have risen by 45 percent. Losses in labor productivity due to hunger can cause reductions of 6 to 10 percent in per capita GDP, according to a U.N. task force on hunger.

Why Does Hunger Still Persist?

Hunger is a complex issue, and addressing it appropriately needs to be informed by an understanding of why it exists in the first place, free of commonly held misperceptions and myths.

Myth #1: People go hungry because not enough food is produced -- it's about supply.

Fact: To date, global food supply has kept pace with world population, defying Malthusian doomsday scenarios of population growth outstripping food supplies. At the same time, however, many regions of the world are unable to continuously satisfy the food needs of their residents through local production alone. Seasonal shortages and periodic crop failures are quite common and are not necessarily a cause for alarm.

When there is a bad harvest in a region that has extensive, properly functioning markets, commodities from stocks or food-surplus regions normally flow into the market in response to rising prices, thus alleviating local food deficits. It is only when markets are poorly developed or fail to function properly that persistent problems of food availability are likely to occur.

Over the past 150 years, famines due to persistent food shortages have ceased to be a common occurrence in many parts of the world. In large part, this is because of improvements in transportation infrastructure, the expansion of markets, and steady growth of domestic and international trade.

Nonetheless, there are still times and places where food availability can be a serious problem. There are parts of the world -- including several large, isolated regions deep in the interior of the African continent -- where the impediments to trade are still so great that rising prices fail to trigger adequate inflows of commodities when they are needed. In these places, the risk that crop failures will trigger famine can be substantial. Very frequently, hunger occurs in places where there is even a food surplus but where certain socioeconomic groups nonetheless face extreme hardship. The term "food access" refers to the ability of individual households to acquire sufficient food to meet their basic needs.

Households acquire food through some combination of production, purchase, or noncommercial social transfers (from family, friends, or some form of welfare). Poor households face hunger when their food production, savings, income, and entitlements are insufficient to meet their food needs. Circumstances that are likely to contribute to deepening problems of food access include:

• Loss of productive assets
• Falling wages
• Changes in commodity prices that erode the purchasing power of the poor.

Analyses of "food access" focus attention on the productive capacity and purchasing power of poor households. They also shine a light on the relationship between changing patterns of income inequality and the distribution of hunger. Another critical aspect of hunger is "utilization," how food itself is biologically used. Does the food provide sufficient energy and other essential nutrients? Is there potable water available, and are there adequate sanitary conditions to prevent diseases and enable the body to absorb the energy and nutrients contained in food? Finally, what are the knowledge, attitudes, and practices of people consuming the food? Certain family members lack the ability to command an adequate share of household resources due to gender, age, or other culturally determined factors, with resulting increased hunger.

Finally, "vulnerability" plays a role. Vulnerability is the likelihood that a household's food security will be compromised by a major catastrophe or by the cumulative effects of a series of small shocks to a person's or household's livelihoods. The level of vulnerability depends on the likelihood of these events and the ability of households to cope with it -- their resilience to withstand and adapt.

Households need the capacity to cope with and recover from disasters to stay food secure.

Myth #2: Hungry people need food -- so food aid is the answer.

Fact: Food aid is not the universal or long-term solution.

For more than 50 years, the American people have generously responded to the needs of hungry people around the world primarily through a program called Public Law 480 -- Food for Peace. This program provides food aid as the principal source of assistance for responding to both urgent food crises and chronic hunger. This assistance has indisputably saved millions of lives in its current form.

However, the increasing numbers of undernourished tell us that world hunger cannot be solved in a sustainable way by the provision of food assistance alone.

CARE has long been associated with food distribution programs and is justifiably proud of assisting poor, vulnerable, and crisis-affected people worldwide through food aid programming. But current policies and programs have shortcomings.

First, in most years, 70 to 75 percent of U.S. food aid is used to address transitory hunger resulting from emergencies and humanitarian crises. While emergency food aid is vital in times of crisis, it neither addresses the root causes of chronic hunger nor reduces the likelihood of future emergencies.

Second, addressing chronic hunger, as opposed to emergencies, needs sustained, long-term assistance, which is hard to provide under current programs and policies.

Current programs have multiple policy goals and short time frames, which often prevent the use of some of the most appropriate, cost-effective approaches and often do not reach the neediest. For example, agricultural programs targeted toward increasing productivity and rural incomes do not often reach the most vulnerable households, which tend to be smallholders or day laborers. Further, most interventions are fragmented and undertaken in isolation by several different agencies, each having separate funding streams, time frames, and reporting requirements. Such fragmentation diffuses the overall effectiveness of these programs.

Emerging Challenges, Outlook

Notwithstanding the adequate global availability of food supplies, there are emerging challenges to their continued adequacy.

Experts say that the Green Revolution's reliance on technological and chemical inputs has resulted in increased soil erosion and polluted groundwater and surface water, and has caused serious public health and environmental problems, putting the revolution's sustainability in doubt.

In addition, several developing countries are already experiencing the effects of climate change -- changes in weather patterns, reduced rainfall, modified river flows, and increased desertification have all been projected to dramatically affect food production.

At the same time, rising demand for food crops for biofuels is also projected to threaten world food security by driving up cereal crops prices and eroding the purchasing power of poor households.

If predictions about climate change and increased use of crops for biofuels are realized, there will likely be dramatic increases in the incidence of chronic hunger.

A Better Way

CARE believes that it is time to recast the usual approaches to hunger to fully and meaningfully address chronic hunger.

Reducing chronic hunger will require programs to target very poor, vulnerable people and to provide support before emergencies arise. Programs must use approaches that address not only the basic needs of hungry people, but also focus on the underlying social, economic, environmental, and political causes of hunger.

Attacking the causes of hunger requires a massive, sustained effort that is beyond the capacity of one country and one donor to provide. Donor agencies must coordinate and support national governments to put in place and adequately resource national policies, strategies, and plans, rather than pursuing stand-alone projects.

Much of the current emphasis of U.S. government programs needs to change. Multiyear, integrated strategies and adequate multiyear resource commitments not subject to annual appropriations limitations must be put in place. Addressing the complexities of hunger requires assured, long-term commitments of resources.

Most importantly, practitioners need flexibility in programming to choose the most appropriate, cost-effective approach to any given food security situation. This means having freedom to address the underlying causes of hunger. To address these causes, programs will be required to invest in education, health, livelihood support, and asset protection. It also means that programs, where appropriate and based on sound analyses, use resources such as imported food aid, locally or regionally procured food, and/or cash transfer options (vouchers, food stamps, and cash for work) as part of a broader response.

These elements need to be integrated as part of a plan to reduce, progressively and steadily, the number of people living in crisis or at great risk and to increase the numbers accessing, securely and sustainably, their food and nutrition requirements. Only then can we begin the slow, long march toward eradicating hunger and its causes to ensure that no child goes to bed hungry.

The opinions expressed in this article do not necessarily reflect the views or policies of the U.S. government.