Monitoring Policy Making at the United Nations |
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Public Action to Remedy Hunger
By Amartya Sen
Hunger Project
August 2, 1990I feel very deeply honoured by the invitation to give this lecture[1] and also extremely privileged to have the opportunity of presenting some ideas on the role of public action in eradicating hunger in the modern world. I shall argue that systematic public action can eradicate the terrible and resilient problems of starvation and hunger in the world in which we live. But I shall also argue that for this to be secured on a lasting basis it is important to integrate the protective role of the government with the efficient functioning of other economic and social institutions - varying from trade and commerce to the news media and political parties. It is also important to see public action in a broad perspective - involving active parts played by the public itself, going well beyond state planning and governmental actions.
Based on recent economic analyses as well as the comparative reading of actual empirical experiences, it is, I believe, possible to identify the measures that can bring about the elimination of famines and hunger. What is crucial at this time is to make public action match that technical understanding. This lecture is concerned both with the underlying economic analysis and with the political and social procedures that can make that matching exercise more likely and secure. In trying to answer these questions, I shall draw on my earlier work on this subject,[2] and particularly on the joint work with Dr. Jean Drèze, for the World Institute for Development Economics Research.[3]
Famines and endemic deprivation
The problem of hunger can be broadly divided into two types, viz., (1) famines, and (2) endemic deprivation. Famines are transient but violent events - they come and go, decimating the population and causing extreme misery and widespread death. In contrast, endemic deprivation is a more persistent phenomenon, forcing people to live regularly and ceaselessly in a state of undernourishment, disease and weakness. While endemic deprivation is less fierce as a calamity, it is also more resilient and affects more people. If famines kill millions through starvation and epidemic diseases, endemic deprivation can afflict hundreds of millions through debilitation and illness, increasing mortality rates and shortening people's lives. It is possible to have endemic deprivation without famines, and vice versa. For example, India has been successful in preventing famines - there has been no substantial famine in India since independence in 1947. The last such famine was three years before independence, the Bengal famine of 1943, in which about 3 million people died. Since then there have been many occurrences of substantial crop failures, often covering large regions, and sometimes sharp declines in national food availability, but the threatening famines have been stopped by public action before they could become major killers. While this has happened throughout the post-independence period, there is evidence of increased efficiency in averting famine conditions. For example, the threatening famines in Maharashtra in 1973, in West Bengal in 1979, in Gujarat in 1987 have all been prevented much more speedily - with relatively little adverse impact on mortality rates - than happened in the earlier case of near-famine in 1967 in Bihar.
But this effectiveness and increased efficiency in preventing famines have not insulated India from chronic undernourishment and endemic deprivation. Indeed, a substantial portion - perhaps as much as a quarter - of the rural population suffers from persistent undernourishment and chronic ailments. In contrast, China has dealt much better with endemic deprivation, and has radically enhanced normal life expectancy, and the lessons of its experience must also be studied. But China has also experienced a gigantic famine during 1958-61 (one of the largest in recorded history) in which, it is now estimated, between 23 to 30 million people died.[4] The contrast is striking,[5] and one aspect of it is illustrated in Chart 1, which presents the time series of life expectancy at birth in China and India from the early fifties to the early eighties. The chart shows much faster expansion of life expectancy in China, until the late seventies, than in India, but it also shows a sharp increase in mortality and a severe drop in the expectation of life during the Chinese famines of 1958-61.
Some countries do, of course, regularly experience both the problems of periodic famines and persistent undernourishment. For example, many of the sub-Saharan economies in Africa, such as the Sahel countries, Ethiopia, Somalia, Sudan, and others have had recurrent famines in recent years, in addition to experiencing endemic hunger and widespread distress. There are many cases of unremitting deprivation punctuated by intermittent famines. Famines and chronic undernourishment have different - though related - causal backgrounds, and the strategic issues that arise in dealing with the respective problems can be quite different. We have to discuss the part that public action can play in eliminating both famines and endemic deprivation. They have to be treated as distinct - though interconnected - problems. Pessimism versus remedial action
One of the problems that makes the task of the prevention of famines and hunger particularly difficult is the general sense of pessimism and defeatism that characterizes so much of the discussion on poverty and hunger in the modern world. While pictures of misery and starvation arouse sympathy and pity across the world, it is often taken for granted that nothing much can be done to remedy these desperate situations, at least in the short run. There is, in fact, little factual basis for such pessimism and no grounds at all for assuming the immutability of hunger and deprivation. Yet those unreasoned feelings dominate a good deal of public reaction to misery in the world today. In fact, pessimism is not new in this field, and has had a major role over the centuries in dampening hearts and in forestalling preventive public action.
"Does not this weather frighten you?" wrote James Mill, the utilitarian philosopher, to David Ricardo, the pioneering economist, in the troubled English summer of 1816. "There must now be of necessity a very deficient crop, and very high prices - and these with an unexampled scarcity of work will produce a degree of misery, the thought of which makes the flesh creep on one's bones - one third of the people must die - it would be a blessing to take them into the streets and high ways, and cut their throats as we do with the pigs." David Ricardo did not dissent from James Mill's paralysing gloom, and in a later letter assured him that he was "sorry to see a disposition to inflame the minds of the lower orders by persuading them that legislation can afford them any relief."[6] The unquestioning fatalism that characterizes this exchange between two of the leading minds of nineteenth century Britain remains distressingly common even today. And yet famines are nearly always avoidable, even after gigantic natural disasters. Sensible public action, including appropriate legislation, can systematically eradicate large-scale starvation altogether. The inflamed minds of "the lower orders" had got the picture more nearly right than two of the foremost intellectuals of Britain.
Public action, the economy and the society
To understand how all this might work, it is necessary to see public action and legislation in rather broad perspective. First, public action includes not only what is done for the public by the state, but also what is done by the public for itself. It includes, for example, what people can do by demanding remedial action and through making governments accountable. The relevant legislation includes not only the protection of certain basic provisions of public support and social security, but also - at a deeper level - the guaranteeing of democratic rights of free elections, uncensored news reporting and unfettered public criticism. Even though these political features may, on a superficial view, look rather remote from the elementary economic problem of hunger and starvation, they are, in fact, closely connected. They promote the political incentive for governments to be responsive, caring and prompt.
Second, while public action includes actions of the state, it is important to see such actions in conjunction with other social institutions and practices. State action, as I shall presently discuss, can be particularly crucial in regenerating lost incomes of potential famine victims and in providing health care and social services to the relatively deprived. But these actions must not be seen as excluding the efficient functioning of markets, commerce and incentives. The heroic view of the state as a "lone ranger" cleaning up the wild west is as unreal as it is pernicious in trivializing and ignoring the positive functions of other social and economic institutions. The mistake of absent public action must not be replaced by the opposite mistake of complete concentration on state activities ignoring - or stifling - trade, commerce, scientific research, the news media, political parties, and other instruments of economic, social and political actions.
Endemic undernourishment, health and education
I first take up the more widespread but less acute problem of endemic undernourishment, and will address the problem of famines later on in this lecture. Persistent undernutrition is partly a matter of insufficient food intake, but the problem cannot be dissociated from that of deprivation of health care and basic education. For example, undernutrition is often generated by parasitic disease. Also, epidemics can lead to widespread undernourishment. Being insufficiently nourished is both a cause and an effect of ill-health, and the deprivation of food cannot be studied independently of the insufficiency of health care.
Furthermore, the actual use of medical facilities depends not only on what is provided, but also on the public's informed concern with health needs and available opportunities. The basic level of education of the public can play an important part in the utilization of communal health care and of general medical facilities, and female education in particular is especially important in this.[7] For example, if we contrast the life expectancy at birth in different states in India, we find that the state of Kerala despite being no richer - indeed rather poorer - than the Indian average has a remarkably longer life expectancy than the Indian average of 56 to 58 years. The latest estimates suggest a life expectancy in Kerala around 70 years - not far from European figures. There is much evidence that this is closely connected with the high level of literacy - especially female literacy - in Kerala. The massive educational expansion in what is now Kerala began as early as 1817 with a powerful call for mass literacy by Rani Gouri Parvathi Bai, the ruling female monarch of what was then the "native state" of Travancore.[8] That policy of education and public health has been pursued fairly consistently ever since, and has been further consolidated in recent decades by state governments keen on public services in education and health. There is also plenty of other evidence connecting education, especially female education, with good use of health care. Widespread education also leads to better understanding of the need for public health care, and stronger popular demand for it, with more vigilance in that pursuit. In this field, as in many others, what one gets is not independent of what one seeks and demands.
Markets and participatory growth
The different deprivations - of food, health care, education - tend typically to go together. Given the current euphoria with the achievements of the market mechanism, the point has often been made that there is no surer way of getting to economic prosperity and of eliminating poverty and deprivation than unleashing the market forces. Is that view correct? The achievements of the market have indeed been significant, not only in enhancing the gross national product, but also in providing the basis for raising the quality of life. For example, if we look at the top-10 performers in reducing infant and child mortality (the so-called "under-5 mortality") among all the developing countries during 1960 to 1985, we find in our list such examples of successful capitalism as South Korea, Hong Kong, and Singapore, and also Kuwait and United Arab Emirates.[9] It is, however, important to note that these countries have not only had high growth of real incomes - to a great extent through the market mechanism (though supplemented by state planning in some cases, most notably South Korea) - but they have also ploughed back a lot of the fruits of that growth in the public distribution of education and health care.
There is a striking contrast between these experiences and those of, say, Brazil or Oman, with comparably high economic expansion but much less use of public intervention - and correspondingly lower achievements in mortality reduction and in other fields. Furthermore, the high level of basic education in Hong Kong, Singapore, South Korea, etc., has led to widespread participation in the process of growth, with rewarding employment spreading the fruits of growth across the nation. What we may call the policy of "unaimed opulence", illustrated by the experiences of countries such as Brazil, contrasts sharply with the use of "participatory growth" in countries such as South Korea, with employment-oriented expansion and with broad public support of education, epidemiological planning and general health care.[10] The success of the market does not preclude the need for fruitful and efficient public action.
Public provisioning and mortality reduction
Another issue concerns the identity of the remaining five countries in the list of the top ten in reducing infant and child mortality. They are all much poorer countries which have nevertheless achieved tremendous lowering of under-5 mortality (reductions of 70 to 80 per cent during 1960-85), and have reached very low absolute mortality rates, mainly through public programmes of medical care, epidemiological control and elementary education. The list includes socialist economies such as China and Cuba. Others in the list are Costa Rica, Chile and Jamaica, and all of them have used, for significant parts of the period, much public intervention in securing health care, medical facilities and basic education across the population.[11]
Chart 2 presents the comparative picture of five selected countries in terms of average opulence (measured by gross national product per head), on the one hand, and life expectancy at birth, on the other. While Brazil, South Africa and Oman have many times the income per head of China or Sri Lanka, those poorer countries, making good use of public delivery of health and education, have remarkably higher achievements in life expectancy and mortality reduction than what is observed in the countries that have pursued "unaimed opulence".[12]
In China the general reduction of mortality rates took place much before the economic reforms of 1979. Indeed, since then progress in public health care and mortality reduction seems to have somewhat halted despite high economic growth. Chinese official statistics record a considerable rise in mortality rates after the economic reforms of 1979, and this happens at the same time as the decline of communal medical insurance previously provided by production brigades and a substantial reduction of village-level medical workers (and barefoot doctors). There is certainly a spurious element in this mortality increase (connected particularly with changing age composition and better data coverage), but even after taking note of that, there is evidence of some set back in mortality reduction taking place along with a deterioration of communal health care, precisely when the growth of GNP speeded up.[13] A massive increase in Chinese life expectancy (despite the temporary decline during the famines of 1958-61) took place before the speeding up of economic expansion with the reforms of 1979, and that increase has slowed down (even if not reversed) precisely with the acceleration of economic growth ushered in by the reforms. While communal agriculture did little for agricultural output itself, it had the effect of providing a good deal of support for public health both in terms of social insurance and communal care. That situation has changed with privatization, which has been enormously beneficial for agricultural output, but not quite for communal health services. While growth of real incomes can, obviously, be very useful for eliminating deprivation, public action and communal facilities are also of crucial importance.
It is some times forgotten that the reduction in mortality rates and the increase in life expectancy in the Western countries themselves also took place with much public action and state planning. For example, if we look at the increase in English life expectancy in different decades in this century, we find moderate increases in each decade of one to four years, except for two decades, viz, 1911-21 and 1940-51, when life expectancy increased by nearly seven years (Chart 3). Those decades of the world wars saw radical expansion of public action and planning, including public employment, food rationing and health care, and even the National Health Service was born in the decade of the forties, just after the war.[14] Similar connections between public action and expansion of life expectancy can be shown from the history other rich countries, including Japan.[15]
Can poor countries afford health services and education?
The method of combining high economic growth with expansion of public support has obvious advantages and much to recommend it. The question must, however, also be raised as to whether a poor country should have to wait for many decades before it has enough resources generated by economic growth to undertake ambitious public programmes of health care and education. It is not illegitimate to wonder whether a poor country can "afford" to spend so much on health and education.
In answering this question we must not only note the empirical reality that many poor countries (such as Sri Lanka, China, Costa Rica, the Indian state of Kerala, and others) have done precisely that with much success, but also understand the general fact that the cost of delivering public health care and basic educational facilities is enormously cheaper in a poor country than in a rich one. This is because both health and education are labour-intensive activities and this fact makes them much cheaper in poorer countries because of lower wages.[16] Thus, even though a poor country is tremendously constrained in expending money on health and education because of general poverty, the money needed to pay for these services is also significantly less when a country is still quite poor. The fact of the relative cheapness of labour-intensive services (including health care and education) to some extent counteracts the constraint of poverty.[17] When the proper economic calculations are made, taking note of relative costs, there is less reason for pessimism here - even for quite poor countries than is frequently supposed. We must resist the tendency to rely on plain cynicism based on over-theoretical reasoning, masquerading as cunning practical wisdom.
Famines as entitlement failures
I turn now to the more extreme problem of famines. As was noted earlier, this is a rather different matter from endemic deprivation. Indeed, as was discussed earlier, a country like China can be enormously successful in subduing persistent deprivation and yet experience one of the largest famines in recorded history. What causes a famine? The temptation to see it as invariably associated with a large and sudden drop in food production and availability is strong, but huge famines have occurred without such a drop - both in Asia and in Africa.[18] Sometimes famines have coincided with years of peak food availability, as in the Bangladesh famine of 1974. Chart 4 presents the time series of food availability per head in Bangladesh between 1971 and 1976, with the famine year (1974) being characterized by a peak rather than a trough.
Even when a famine is, in fact, associated with a decline in food production (as it clearly was in the case of the Chinese famine of 1958-61 or in the Irish famines in the 1840s [19]), we still have to go beyond the output statistics to explain why it is that some parts of the population get wiped out, while the rest do just fine. To be sure, there are alleged accounts of famines in which nearly every one in a country had to go hungry, but most of these accounts do not bear much scrutiny. For example, the authoritative Encyclopaedia Britannica, in its vintage eleventh edition, does indeed refer to the Indian famine of 1344-5 as one in which even "the Moghul emperor was unable to obtain the necessaries for his household". But that story runs into many problems. An elementary issue relates to the fact that the Moghul empire in India was not established until 1526. More importantly, the Tughlak emperor in power in 1344-5 not only had no great difficulty in securing necessaries for his household, but also had enough means to organize one of the more illustrious programmes of famine relief in history. The anecdotes of unified starvation do not tally with the reality of divided fortunes.
Since food and other commodities are not distributed freely, people's consumption depends on their "entitlements", that is, on the bundles of goods over which they can establish ownership through production and trade, using their own means. Some people own the food they themselves grow, while others buy them in the market on the basis of incomes earned through employment, trade or business. Famines are initiated by severe loss of entitlements of one or more occupation groups, depriving them of the opportunity to command and consume food.
Famines survive by divide and rule. For example, a group of peasants may suffer entitlement losses when food output in their territory declines, perhaps due to a local drought, even when there is no general dearth of food in the country. The victims would not have the means to buy food from elsewhere, since they wouldn't have anything much to sell to earn an income, given their own production loss. Others with more secure earnings in other occupations or in other locations may be able to get by well enough by purchasing food from elsewhere. Something very like this happened in the Wollo famine in Ethiopia in 1973, with impoverished residents of the province of Wollo unable to buy food, despite the fact that food prices in Dessie (the capital of Wollo) were no higher than in Addis Ababa and Asmera. Indeed, there is evidence of some food moving out of Wollo to the more prosperous regions of Ethiopia where people had more income to buy food.
Or, to take a different type of case, food prices may shoot up because of the increased purchasing power of some occupation groups, and as a result others who have to buy food may be ruined because the real purchasing power of their money incomes may have shrunk sharply. Such a famine may occur without any decline in food output, resulting as it does from a rise in competing demand rather than a fall in total supply. This is what started off the famine in Bengal in 1943, with urban dwellers gaining from the "war boom" - the Japanese army was round the corner and the British and Indian defence expenditures were heavy in urban Bengal, including Calcutta. Once the rice prices started moving up sharply, public panic as well as manipulative speculation played its part in pushing the prices sky high, beyond the reach of a substantial part of the population of rural Bengal.[20] The Devil, then, took the hindmost.
Or, to take yet another type of case, some workers may find their "occupation's gone" as the economy changes and the types and locations of gainful activities shift. This has happened, for example, in sub-Saharan Africa, with changing environmental and climatic conditions. Erstwhile productive workers may then be without work or earnings, and in the absence of social security systems, there wouldn't be anything else to fall back on. In some other cases, the loss of gainful employment can be a temporary phenomenon, with powerful effects in initiating a famine. For example, in the Bangladesh famine of 1974, to which I referred earlier, the first signs of distress were found among the landless rural labourers, after the summer floods, which disrupted the employment of labour for transplanting rice. These labourers, who lead a hand to mouth existence, were forced to starve as a result of the loss of wage employment, and this phenomenon occurred much before the crop that was adversely affected were to be harvested.[21]
Income creation and public intervention
Since famines are associated with the loss of entitlements of one or more occupation groups in particular regions, the resulting starvation can be prevented by systematically recreating a minimum level of incomes and entitlements for those who are hit by economic changes. The numbers involved, while often absolutely large, are usually small fractions of the total population, and the minimum levels of purchasing power needed to ward off starvation can be quite small. Thus, the costs of such public action for famine prevention are typically rather modest even for poor countries, provided they make systematic and efficient arrangements in good time.
Just to get an idea of the magnitudes involved, if potential famine victims constitute, say, 10 per cent of the total population of the country (they usually affect a much smaller proportion than that), their share of total income in normal circumstances would typically not exceed, say, about 3 per cent of the GNP. Their normal share of food consumption may also, typically, not be greater than 4 or 5 per cent of the national food consumption. Thus the resources needed to recreate their entire income, or to resupply their entire normal food consumption, starting from zero, do not have to be very large provided the preventive measures are efficiently organized. In fact, of course, famine victims typically have some resources left (so that their entitlements do not have to be recreated from zero), and the net resource requirement can be, thus, even smaller.
Also, a good deal of the mortality associated with famines results from diseases unleashed by debilitation, breakdown of sanitary arrangements, population movements and infectious spread of diseases endemic in the region.[22] These too can be sharply reduced through sensible public action involving epidemic control and communal health arrangements. In this field too, the returns to small amounts of well-planned public expenditure can be very large indeed.
Food production, diversification and economic growth
Needless to say, in organizing famine prevention measures, it helps to have a more opulent and growing economy. Economic expansion typically reduces the need for entitlement protection, and also enhances the resources available for providing that protection. This is a lesson of obvious importance for sub-Saharan Africa where the lack of over-all economic growth has been a major underlying source of deprivation. The proneness to famines is much greater when the population is generally impoverished and when public funds are hard to secure. Attention has to be paid to problems of appropriate incentives to generate the growth of outputs and incomes - including inter alia the expansion of food output. This calls for devising sensible price incentives, but also for measures to encourage and enhance technical change, skill formation and productivity - both in agriculture and in other fields.[23]
While growth of food output is important, the main issue concerns overall economic growth, since food is purchasable in the world market provided the country has the resources to buy it. It is often pointed out - rightly - that food output per head has been falling in sub-Saharan Africa. This is indeed so and is obviously a matter of concern, and has implications for many aspects of public policy - varying from agricultural research to population control. But it is also important to note that the same fact of falling food output per head also applies to many countries in other regions of the world as well.[24] These countries did not experience famines both (1) because they achieved relatively high growth rates in other areas of production, and also (2) because the dependence on food output as a source of income is much less in these countries than in the typical sub-Saharan African economy.
The tendency to think of growing more food as the only way of solving a food problem is strong and tempting, and often it does have some rationale. But the picture is more complex than that, related to alternative economic opportunities and the possibilities of international trade. As far as lack of growth is concerned, the major feature of the problems of sub-Saharan Africa is not the particular lack of growth of food output as such, but the general lack of economic growth altogether (of which the problem of food output is only one part). The need for a more diversified production structure is very strong in sub-Saharan Africa, given the climatic uncertainties, on the one hand, and the existence of other fields of productive activity, on the other. The often-advocated strategy of concentrating exclusively on the expansion of agriculture - and specifically food crops - is like putting all the eggs in the same basket, and the perils of such a policy can be great.
It is, of course, unlikely that the dependence of sub-Saharan Africa on food production as a source of income can be dramatically reduced in the short run. But some diversification can be attempted straightaway, and even the reduction of over-dependence on a few crops can enhance security of incomes. In the long run, for sub-Saharan Africa to join in the economic expansion that has taken place in much of the rest of the world, sources of income and growth outside food production and even outside agriculture would have to be more vigorously sought and used.
Social security, environment and peace
However, no matter how successful Africa is in enhancing economic growth, the need for public action in protecting entitlements will undoubtedly remain important in the foreseeable future, if only because there are variations over time and between regions - often related to uncertain climatic conditions and also to social disorders (sometimes ending in military actions). I should also mention that the need for corrective public action can be substantially reduced in the long run both by better environmental planning and also by the cultivation of peace. The climatic uncertainties in sub-Saharan Africa are not unrelated to environmental neglect, and the time has certainly come to reverse that negligence. Environmental changes take time, but coordinated public efforts in this field can make a difference in the long run.
The urgency of peace in Africa is hard to overstate. Many of the recent famines in sub-Saharan countries have been directly connected with military conflicts (for example, in Ethiopia, Sudan, Somalia, Uganda, Chad, Nigeria and Mozambique). Wars not only lead to massacres and associated horrors, they also destroy crops and other economic resources, undermine traditional patterns of livelihood, discourage economic investment and capital formation, and also disrupt the normal operations of trade and commerce. They also help consolidate the grip of the military on civil life and tend to disrupt civil liberties, including the freedom of the press, which - as I shall presently discuss - is an important safeguard against famines and other man-made catastrophes. The "peace dividend" in Africa can stretch well beyond the saving of financial and economic resources on which the discussion in the West has tended to concentrate.
Public employment for famine prevention
Generating minimum incomes for entitlement protection can be done in different ways. Public employment with cash wages can be an effective method. Offering public employment to potential famine victims can recreate lost purchasing power and prevent starvation. In many cases, this is best done through paying cash wages to the people thus employed. This might, at first, appear to be an odd way of preventing famines, since the idea of famine relief is so firmly linked with the vision of food distribution and relief camps. But this is an obvious line to pursue if famines are seen as being caused by entitlement failures of some sections of the population.[25] Also, the strategy of preventing a famine through timely regeneration of incomes has to be distinguished from the tactics of relieving an unprevented famine through whatever emergency means may be still available to provide support for starving victims.
There are two different issues related to the strategy of using regenerating incomes through cash wages being paid in public employment: (1) Why employment, rather than relief in the form of hand outs? (2) Why cash payments rather than direct distribution of food (either as relief-camp feeding, or as food wages)? To take up the question of employment first, the rationale of this procedure can be understood only in the context of the hard problem of selection involved in giving away something for nothing. The possibility of abuse can be particularly serious in a country where most people are generally rather poor - even though not as poor as the famine victims. The unconditional provision of employment at a basic wage can serve as a screening device to select the really needy who are willing to take up employment opportunities. This reduces the possibility of corruption and abuse.
Further, providing protection through employment is less disruptive of the victims' economic, social and family life, compared with herding them together in make-shift feeding camps. It is easier to combine family living with working for a wage in a public employment project than what is permitted by the standard relief camps. There is also more scope for continuing to look after one's farm or other economic assets and continuing productive operations. It is also less humiliating for the dispossessed.
Cash wages, public action and private trade
The second issue concerns the question of using cash wages. One advantage is that this method can be used with speed. Unlike direct distribution of food, a system of cash wages does not require moving food through governmental organization before relief can be given. It permits the newly created demand of potential famine victims to be met by normal channels of trade and transport. The system can be supplemented by building up a sizeable stock of food grains in the public distribution system, to reduce the danger of manipulative inflation through the collusion of private traders.
A mixed system of this kind is typically much easier to organize than direct public distribution of food, and it cuts out a lot of bureaucracy. Cash payment for work combines public action and market functioning. The incomes are created by public employment, but the demand for food generated by the newly-created incomes are met by the normal channels of trade and transport. Of course, special provisions have to be made in particular cases in which those channels are effectively underdeveloped, or fragile, or disrupted, especially as a consequence of war. But in general, the alternative experience of moving food through bureaucratic methods (often involving ad hoc trading and transporting arrangements, with harassed civil servants wrestling with hastily requisitioned lorries) has not been an encouraging one, especially in sub-Saharan Africa. The public sector is often as bad in meeting market demand as the private sector is in generating relief incomes, and pragmatism has something to offer against prejudice in either direction.
Economic reasoning and practical experiences
Understanding the causation of famines in terms of entitlement failures points directly to the possibility of making effective use of public employment and of cash wages. But the case for this strategy is not only based on economic theory, but also on practical experience in different parts of the world. Comparative studies of different methods of famine prevention used in India and in different countries in sub-Saharan Africa confirm the great practical advantages of this mixed technique, combining state action with private trade and marketing.
In India this method has been used intermittently for a long time, and it has in recent years become the principal procedure for famine prevention. Famines have been averted in post-independence India by having systematic public arrangements for regenerating incomes when a large section of the population lose their normal incomes as a result of a drought or a flood or other economic changes. Some times the availability of food in India has been much lower than that in the Sahel countries and others experiencing famines, and nevertheless famines have been prevented from developing because of the timely strategy of public employment with extensive use of cash wages. Chart 5 presents the time series of food availability in the Sahel countries, in India and in the state of Maharashtra threatened with famine by severe droughts over 1972-74.[26] It is easy to see how much lower the Maharashtrian availability figures are (even after taking note of food imports into that state from the rest of India) compared with that in the Sahel, and yet Maharashtra avoided having a famine precisely when the Sahel countries experienced the well-known famines of the early seventies. The system of "employment guarantee" in Maharashtra had a major role in this achievement.[27]
To illustrate how the process of income regeneration works, it is useful to look at Chart 6. The cash wage payments to the destitutes seeking employment did not prevent a decline of food consumption of the hard-hit groups (viz, the farm labourers, the small cultivators and other poor people), but it stopped the decline from being disastrously large. But what is particularly important to note in Chart 6 is that as a result of protecting the purchasing power of the hard-hit groups through wage payments, they did not lose their competitive power entirely, and the decline was shared by other - more prosperous or less affected - groups as well. Indeed, every occupation group represented in Chart 6, including industrial workers and large farmers, had reduced food consumption in the drought period, and thus the fall of total food consumption was shared by the different occupation groups, rather than being borne exclusively by the people destituted by the drought. Much of the task of famine prevention lies in stopping the Devil from taking the hindmost, by giving a helping hand to the hindmost to keep up better with the others.
There have also been several cases of successful prevention of famines in sub-Saharan Africa, making use, among other methods, of public employment, some times with cash wages. Since failures in famine prevention in sub-Saharan Africa are often much discussed in the international press, it is particularly important to note this fact. Some countries (such as Botswana, Zimbabwe, Cape Verde and others) have experienced climatic disasters of severe magnitude with dramatic declines in food output and availability, and have often been able, nevertheless, to prevent the occurrence of famines altogether. As a matter of fact, these countries (such as Botswana, Zimbabwe and Cape Verde) often had much larger crop failures than did most other countries in Africa, many of which actually did experience famines (because of inadequate or inappropriate public efforts in famine prevention).[28]
Political incentives, news media and democracy
While there is no great practical difficulty in organizing effective measures for famine prevention, provided the problems are correctly diagnosed and addressed, one reason why this does not occur adequately - or at all - in many parts of the world is that the penalty of the famines are borne only by the suffering public and not by the ruling government. If the government were to be accountable to the public, through elections, free news reporting and uncensored public criticism, then the government too would have good reasons - to avoid condemnation and ultimately rejection - to do its best to eradicate famines. It is not, in fact, surprising that in the terrible history of famines in the world, there is hardly any case in which a famine has occurred in a country that is independent and democratic with an uncensored press. This absence of famines applies not only to the rich economies, but also to poor but relatively democratic countries, such as post-independence India, or Botswana, or Zimbabwe.
It is also significant that famines continued to occur in India right up to independence (the last one was in 1943 in Bengal four years before independence in 1947), whereas there has been no major famine at all since then. This has been helped by the expansion of food production since independence, but a crucial difference has been made also by the changed political circumstances. With a democratic political system, a relatively free news media and active opposition parties eager to pounce on the government whenever there are news reports of any starvation (or fears expressed of food shortages), the governments at the centre and at the state have been under severe pressure to take quick and effective action whenever famines have threatened. Since famines are easy to prevent once there is a real effort to stop them, prevention has been possible in the lines I have already discussed.
An uncensored and active news media can have a very important part to play in alerting the government as well as the public about impending threats of famines, by reporting early cases of starvation which often serve as tell-tale indicators of things to come, unless prevented by decisive public action. The diversity, which I discussed earlier in this lecture, of causes of famines indicates that the current passion for formal "early warning systems" cannot be realized by focussing on some simple indicator of an on-coming famine. Famines can be caused by quite different factors and processes and there is no alternative to fairly detailed economic analysis.[29] No less importantly, there is an inescapable need to be on the look out for straws in the wind. An active and vigorous newspaper system by drawing attention to such straws (for example, early starvation in some remote areas) can often do more to prevent famines than admirably cunning early warning systems set up by whiz kids.
But in addition to this informational role, the news media can play a vital "adversarial" function - in putting the government under constant pressure to be responsive and sympathetic to the plight of the common people.[30] So long as famines are relatively costless for the government, with no threat to its survival or credibility, effective actions to prevent famines do not have the urgency to make them inescapable imperatives for the government. The persistence of severe famines in many of the sub-Saharan African countries - both with "left-wing" and "right-wing" governments - relates closely to the lack of democratic political systems and practice.
The issue relates also to the Chinese famines of 1958-61 in which, as was mentioned earlier, possibly up to 30 million people died. The Chinese government, despite being politically very committed to eliminating hunger in general, did not substantially revise its disastrous policies associated with the failed "great leap forward", during the three famine years. The lack of a free system of news distribution misled the government itself, fed by its own propaganda and by rosy reports of local party officials competing for credit in Beijing. Indeed, there is evidence that just as the famine was moving towards its peak, the Chinese authorities mistakenly believed that they had 100 million more metric tons of grain than they actually did.[31]
No less importantly, the lack of a free news media and the absence of opposition parties entailed that the government was not subjected to adversarial critique for its disastrous failure to save its population from starvation and famine. During that terrible calamity the government faced no pressure from newspapers, which were controlled, or from opposition parties, which were absent. Perhaps the most important reform that can contribute to the elimination of famines, in Africa as well as in Asia, is the enhancement of democratic practice, unfettered newspapers and - more generally - adversarial politics.
Ending hunger through integrated public action
To conclude, there is nothing inevitable about famines. Famines are typically precipitated by the loss of entitlements of one or more occupation groups, and the process can be halted by generating replacement incomes for the potential victims. To do this efficiently, the protective role of the government has to be integrated with the functioning of other economic and social institutions, including the normal channels of trade and commerce. As was discussed earlier in this lecture, there is nothing inescapable about endemic undernourishment either. Persistent deprivation can also be eradicated through positive public action without stifling other social institutions. While the public action needed for eliminating famines involve somewhat different problems from those of endemic undernourishment and deprivation, both programmes require clear-headed diagnostics of the causation of the respective problems and determined efforts to counteract those causes. I have tried to discuss briefly - I fear much too briefly - the nature of the respective challenges, and have tried to outline possible lines of solution, drawing both on economic and political reasoning and on the reading of actual empirical experiences of different countries.
The eradication of famines and the elimination of endemic deprivation can both profit from active and efficient planning, with state action seen in conjunction with the normal functioning of the economy and the society. Public efforts have to be integrated with the role of other social institutions. The market mechanism cannot be supplanted by state action, but nor can it be taken to be adequate on its own to deal with the resilient problems of persistent undernutrition and recurring famines.
Public action and the public
While incentives are central to ending hunger, some of the key relationships involve political - rather than economic - incentives, operating on the government. Democracy and an uncensored press can spread the penalty of famines from the destitute to those in authority. There is no surer way of making the government responsive to the suffering of famine victims. However, while democracy is a major step in the right direction, a democratic form of government is not in itself a sufficient guarantee for adequate public activism against hunger. For example, in India the issue of famines has been thoroughly politicized, helping to eliminate the phenomenon, but the quiet continuation of endemic undernourishment and deprivation has not yet become correspondingly prominent in the news media and in adversarial politics. The same can be said about gender bias and the greater relative deprivation of women. The political incentives to deal with these major failures would enormously increase if these issues were to be brought into political and journalistic focus, making greater use of the democratic framework.
As was argued earlier on in this lecture, public action has to be seen as actions by the public and not just as state actions for the public. To eliminate the problem of hunger, the political framework of democracy and uncensored press can make a substantial contribution, but it also calls for activism of the public. Ultimately, the effectiveness of public action depends not only on legislation, but also on the force and vigour of democratic practice. There is need for moving ahead in different fronts simultaneously to eradicate hunger in the modern world. The public is not only the beneficiary of that eradication, but in an important sense, it also has to be its primary instrument. The first step is to see the public as the active agent rather than merely as the long-suffering patient.
Notes
1. Text of the Arturo Tanco Memorial Lecture given in London on 2nd August 1990, arranged by The Hunger Project and CAB International, in association with The Commonwealth Trust and The Royal Institute of International Affairs. The lecture draws on my joint book with Jean Drèze (a study for the World Institute for Development Economics Research), Hunger and Public Action (Oxford: Clarendon Press, 1989), and on the material presented in the 1987 Lionel Robbins Memorial Lectures at the London School of Economics and the 1989 Annual Lectures at the Bangladesh Institute of Development Studies. I am most grateful to Jean Drèze, Siddiq Osmani, Emma Rothschild and Rehman Sobhan for helpful comments and suggestions.
2. Including Amartya Sen, Poverty and Famines (Oxford: Clarendon Press, 1981), and Hunger and Entitlements (Helsinki: World Institute for Development Economics Research, 1987).
3. Our joint book, Hunger and Public Action, is being followed by three other volumes of jointly edited papers, shortly to be published under the general title, The Political Economy of Hunger (Oxford: Clarendon Press). These publications are part of the series of "WIDER Studies in Development Economics".
4. See B. Ashton, K. Hill, A. Piazza, and R. Zeitz, "Famine in China, 1958-61," Population and Development Review, 10 (1984). See also X. Peng, "Demographic Consequences of the Great Leap Forward in China's Provinces," Population and Development Review, 13 (1987).
5. I have discussed the political and economic roots of this contrast in my "How Is India Doing?", New York Review of Books, Christmas Number 1982, and "Development: Which Way Now?" Economic Journal, vol.93 (1983), reprinted in Resources, Values and Development (Oxford: Blackwell, and Cambridge, MA.: Harvard University Press, 1984).
6. See P. Sraffa, ed., The Works and Correspondence of David Ricardo (Cambridge: Cambridge University Press, 1971).
7. See Drèze and Sen, Hunger and Public Action, and the literature cited there.
8. See Drèze and Sen, Hunger and Public Action, pp. 221-5.
9. See Drèze and Sen, Hunger and Public Action, Table 10.3.
10. See Drèze and Sen, Hunger and Public Action, Chapter 10, and the literature cited there.
11. These experiences are discussed in Drèze and Sen, Hunger and Public Action, Chapters 10-12.
12. See Drèze and Sen, Hunger and Public Action, Chapters 10-12, and the literature cited there. On the Chinese experience, see particularly Carl Riskin, China's Political Economy (Oxford: Clarendon Press, 1987), and his "Feeding China: The Experience since 1949," in Drèze and Sen, The Political Economy of Hunger. It should be mentioned that Sri Lanka did not figure among the top ten in the comparison of reduction of under-five mortality in the period 1960 to 1985, reported earlier, because the expansion of public delivery of education, health care and free food took place in Sri Lanka in an earlier period. Free food distribution and massive expansion of public health facilities were both initiated in Sri Lanka in the 194Os, and the death rate in Sri Lanka fell from 2O.6 per thousand to 8.6 per thousand between 194O and 1960. See Drèze and Sen, Hunger and Public Action, section 12.2.
13. See Judith Banister, China's Changing Population (Stanford: Stanford University Press, 1987); Athar Hussain and Nicholas Stern, "On the Recent Increase in Death Rates in China," mimeographed, London School of Economics, 1988; R. Baumgartner, "China: Long-Term Issues in Options for the Health Sector," mimeographed, The World Bank, 1989; and also Drèze and Sen, Hunger and Public Action, Chapter 11, and the literature cited there.
14. On these issues, see Drèze and Sen, Hunger and Public Action, Chapter 10, and the literature cited there, particularly R.J.Hammond, History of the Second World War: Food (London: HMSO, 1951), and J.M. Winter, The Great War and the British People (London: Macmillan, 1986).
15. See Jean Drèze and Amartya Sen, "Public Action for Social Security," in S.E. Ahmed, et.al., eds., Social Security in Developing Countries (Oxford: Clarendon Press, forthcoming).
16. See Drèze and Sen, Hunger and Public Action, Chapters 10-3.
17. Further, health care and education are what economists call "public good" - different persons' consumptions are partly complementary and not entirely competitive with each other (see Paul Samuelson, "The Pure Theory of Public Expenditure," Review of Economics and Statistics, 35, 1954; on related matters see also Kenneth Arrow, "Uncertainty and the Welfare Economics of Health Care," American Economic Review, 53, 1960). As a result an efficient public policy can often get away with a rather economic budget even when providing the same services through private schooling and private health care can be much more expensive.
18. On this see my Poverty and Famines, Chapters 6-10.
19. The fact that Ireland was exporting food to England during the famines is some times cited as evidence that food output had not declined in Ireland. But that is an erroneous conclusion, both because we have direct evidence of a decline in Irish food output (associated with the potato epidemics), and because the movement of food is determined by relative prices, and not just by the size of food output in the exporting country. Indeed, "food counter-movement" is a common phenomenon in a "slump famine" in which there is a general economic decline, which can make demand for food go down even more than the reduction of supply (on this and on related matters, see my Poverty and Famines). In the Chinese famines too, a much larger proportion of the reduced food output of rural China was being taken out into the urban areas as a result of official policy (on this see C. Riskin, "Feeding China: The Experience since 1949", in Drèze and Sen, The Political Economy of Hunger).
20. There were also other factors behind the differential mortality in the Bengal famine of 1943, including the governmental decision to shelter the urban population in Calcutta through food rationing, price control and fair-price shops, leaving the rural poor thoroughly unprotected. On these and other aspects of the Bengal famine, see my Poverty and Famines, Chapter 6.
21. On this see M. Alamgir, Famine in South Asia (Cambridge, MA: Oelgeschlager, 1980), and my Poverty and Famines, Chapter 9. For a major economic study of the Bangladesh famine (and much else), see also Martin Ravallion, Markets and Famines (Oxford: Clarendon Press, 1987). Ravallion also shows how the rice market exaggerated the extent of the future decline of food supply in Bangladesh, making the anticipatory price rise a good deal steeper than it need have been.
22. On this see Alex de Waal, Famines That Kill (Oxford: Clarendon Press, 1989). See also my Poverty and Famines, Appendix D, on the pattern of famine mortality in the Bengal famine of 1943.
23. There is a large literature on this, which is discussed and critically assessed in Drèze and Sen, Hunger and Public Action, Chapter 9. See also C.K. Eicher, Transforming African Agriculture (San Francisco: The Hunger Project, 1986); M.S. Swaminathan, Sustainable Nutritional Security for Africa (San Francisco: The Hunger Project, 1986); M. Glantz, ed., Drought and Hunger in Africa (Cambridge: Cambridge University Press, 1987); J. Mellor, C. Delgado and C. Blackie, eds., Accelerating Food Production in Sub-Saharan Africa (Baltimore: Johns Hopkins Press, 1987). See also the papers of Judith Heyer, Francis Idachaba, Jean-Philippe Platteau, Peter Svedberg and Sam Wangwe in Drèze and Sen, eds., The Political Economy of Hunger.
24. See Drèze and Sen, Hunger and Public Action, Table 2.4, page 33.
25. On this see my "Food, Economics and Entitlements," Lloyds Bank Review, 160 (1986), reprinted in Drèze and Sen, The Political Economy of Hunger, in which see also the major empirical studies of famine prevention in India and Africa by Jean Drèze. Also, see Drèze and Sen, Hunger and Public Action, Chapter 8.
26. These estimates and the comparative analysis are the results of research undertaken by Jean Drèze; see his "Famine Prevention in India," in Drèze and Sen, The Political Economy of Hunger. See also Drèze and Sen, Hunger and Public Action, Chapter 8.
27. On this see Jean Drèze, "Famine Prevention in India," in Dreze and Sen, The Political Economy of Hunger; and Drèze and Sen, Hunger and Public Action, Chapter 8.
28. See Drèze and Sen, Hunger and Public Action, Chapters 5-8. See also the papers by Drèze on famine prevention in Africa and India in Drèze and Sen, The Political Economy of Hunger, critically evaluating the African and Indian experiences.
29. For an illuminating economic analysis of the problem of "early warning" of famines, see the paper by Meghnad Desai in Drèze and Sen, The Political Economy of Hunger.
30. On this see my "Development: Which Way Now?" Economic Journal, vol. 93 (December 1983), and Resources, Values and Development (Oxford: Blackwell, and Cambridge, MA: Harvard University Press, 1984), and also Drèze and Sen, Hunger and Public Action, Chapter 13. See also N. Ram's paper in Drèze and Sen, The Political Economy of Hunger, and Article 19, Starving in Silence: A Report on Famine and Censorship (London: Article 19 International Centre on Censorship, 1990), with contributions by Frances D'Souza, Alex de Waal, and an anonymous Chinese scholar.
31. See T.P. Bernstein, "Stalinism, Famine, and Chinese Peasants," Theory and Society, 13 (1984), p. 13. See also Riskin, China's Political Economy (1987).
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