Global Nutrition Part 2

Roadmap to a world without hunger

Where are we headed?

The ugly

What works?

It wasn’t an accidentHow did we get here?

Where are we now?

Can anything help?

Stuffed & starved

The badWhat doesn’t?

The good

Most of you will see

hunger in museums!

Who to ask what’s happening?Where are we now, really ?

What works & what doesn’t?

http://www.sfu.ca/global-nutrition

Roadmap to a world without

hunger

Questions that need qualifyingThe 50% (actually 49.2%) is children that will

require food-aid at some time during childhood• Pct % of people hungry is declining dramatically

Evidence-based analysis & solutions

Who’s lying? Be deeply suspicious of

Keep an open mind: free enterprise, free trade, GM seeds, globalization? ...

• Those who speak from dogmatic idealism

• Those with a strong self interest ...• Those with history of lying or cheating

Yunus - yes if it helps the poor

follow the money

When experts disagree ...

• Do we believe in free enterprise?

• ... don’t expect to agree with anyone?• Do we believe in globalization?

• Do we believe in free trade?

• Beware of those with small ears, ideologues, those who allow no voice for the dispossessed

• Those with a strong self interest

• Those with history of bribery, lying, or cheating

Look for common ground

Be deeply suspicious of ...Follow the

money

What kinds of aid don’t workTeams of publish or perish “anthropologists”

“Another needs assessment? …

“We have noticed that Americans have very tiny ears” ...

... & very large mouths. But we would prefer it to be the other way around

Aid that designed to benefit the donor, not the recipient

Not billions given to buy loyalty of corrupt leaders

Advocates for the poor rate the World Bank, IMF, & WTO fail!Vandana Shiva

Look around. Ask people”

Who tilts the playing field ...

Development begins at independence

Discovery of natural resources impoverishment!

Read: Confessions of an economic hit-man

Donor countries insist that recipient open their markets

... farmer’s lobby in rich countries get barriers

Food must be bought from US farmers, processed in US mills, shipped in US ships

We do: Our tax dollars, the leaders we elect

Harper? Ignatieff? Layton?

WTO? World bank?

•a significant fraction will be unable to stay alive•they live mostly in isolated rural areas• most are subsistence farmers•what they eat this month is what they can take out of the ground from last month's planting

•who to call in an emergency? ...

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The poorest of the poorHave resources worth less than $1 per day

If you give a cell phone, battery will run down!

Jeffrey Sachs video

Money? Useless

• Unless one has seen remote villages, it’s hard to imagine a community without commerce

• No shops to spend money in, no one to employ anyone, no one to sell things to

• Hungry & stunted children are all too visible. Those who didn’t survive are in tiny unmarked graves

• Hospital, dispensary, emergency services > 1 day walk Their needs are much more immediate than money.

We don’t need studies to learn what they need - read on!Page 8

Don’t give them money …

What’s more important than $?Everything

•Short term – need to survive emergency rations, safe water, first aid, antibiotics,

public health – vaccinations, drugs, &cIn conflict zones, shelter, safety to live, plant, harvest

•Medium term - need is to become self-sufficient :good seeds, fertilizer, usable water, sanitation, low technology agricultural info & resources, drip-irrigation, mosquito nets,

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Long term village needs

tools for sustainable development

health services, Dispensary pharmaceuticals, emergency nurse within 7 miles

Hospital within 50 miles

Transport system

bicycle ambulanceEvery village has a cell phone, a motor-cycle

Every truck-driver has a cell phoneKids need perinatal & long term nutritional support

Pitfalls problems & roadblocks• Financial melt-down• National scale land purchases• Food fuel ...• War on terror ...• Nations in bondage to IMF debt• Unfair trade practices• Climate change• Globalization of food economics• Clean water & air have become commodities

Vandana Shiva on globalization

Vandana Shiva on Food Laws

Diverts development & aid $ Increases the price of foods

Also displaced persons & Destroys the local economy

Routes to famine

Discovering resources ...

Armed conflict …Uncertain rainfall & drought ...

Being landlocked – no one to trade with ...

Bad governance ...

Afghanistan

Out of a tiny acorn the mighty oak doth grow ...

South Africa

Lesotho

Being on a trade or pipeline route ...Zimbabwe

Everywhere

Sahel, Palestine

... or a tiny bonsai treeLet’s try to avoid blaming the victim, the people

Yunus:

A vicious cycle: economics, hunger, health

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Economic marginalization

inability to provide for self or family

Poverty diminished access to agricultural & food resources

malnutrition

Physical & cognitive impairment, susceptibility to disease, early death

inability to earn an incomenutrition

Initiatives making a difference

Grameen Family of social enterprises

The Kings of Philanthropy

The Millennium Village project

Influential voices for change

Scientists & students who are making a difference

The Millennium Development Goals

You! ...

$7 can deliver an insecticide treated mosquito net

If you believe 1 person can’t make a difference, you’ve never been in a tent with a mosquito

MGH students

Innovations that make a differenceBarefoot agiculturists

Truck-drivers

Soil conservation, don’t burncontour farming, irrigation, crop rotationPump installation

Burkina Faso planting-pits & stone furrows land food for 500,000Tilapia in Phillipines for 30,000,000Hybrid rice in China – enough for 60,000,000Market liberalization in Bangladesh rice yield 3x

xx

Millions fed

Zero-tillage wheat-seeder drill - $100?

Labour goes further. Earlier planting yield

Doubled yield govt subsidy

Farmer buys & rents to pay off

2 factories 100 in Haryana & Punjab

Appropriate technologyInnovations that make a difference

$25 pump irrigates ½ acre $100/y net

Watering can irrigation

rainwater collection pitsvalve

sub-surface drip irrigation

The Millennium Development Goals

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World’s nations committed to meet 8 goals by 2015

• The development challenges were identified• Specific actions & targets (the MDGs)• A pledge to provide the means was made by

189 nations & signed by 147 heads of stateThe MDGs break down into: 21 quantifiable targets • with 60 time-lined indicators. Some of the richest now say they will not meet their

commitments ... but those who keep faith &Arab states, Cuba, China &? will turn the tide

Nutrition & Millennium Development Goals

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Primary goal is to eradicate extreme poverty & hunger

Nutrition – direct prerequisite to goals1, 3, 4, 5 & 6; indirectly to 7 & 8

see next 2 slides

1

maternalhealth

Child mortality

Gender equity Empower ♀ Achieve universal

primary education

HIV, malaria, other diseases

Environmentalsustainability

Global partnershipfor development

Centrality of nutrition to MDGs 1, 2, & 3

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1. Eradicate extreme poverty & hunger. Poverty is the main determinant of hunger. Malnutrition irreversibly compromises physical & cognitive development & transmits poverty & hunger to future generations.

2. Achieve universal primary education. Malnutrition diminishes the chance that a child will go to school, stay in school, or perform well in school

3. Promote gender equality, empower women. Women’s malnutrition impairs the whole family’s health & nutrition

Centrality of nutrition to MDGs 4, 5, & 6

4. Reduce child mortality. Delivery of a live healthy child is dependent, above all, on a well nourished mother. Protein & folic acid are critical here

5. Improve maternal health. Malnutrition accentuates all major risk factors for maternal mortality. NB protein, iron, iodine, vitamin A & calcium

6. Combat serious infectious diseases. Malnutrition aggravates infections, immune competence, transmission & mortality in HIV, malaria, tuberculosis

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Adapted from Gillespie and Haddad (2003)http://web.worldbank.org

Solutions to global hunger are within our reach -

IFPRI• "Successes in agricultural development need to be recognised ... so that others can learn lessons from them“

• "The need to invest in agriculture is more important and urgent than ever before."

Progress toward elimination of poverty

1990 1995 20050

21

42

% of people below $1.25 per day

Millennium Development Goals Report

Panel of experts July 2009 Many factors complicate interpretation

BRIC countries (Brazil, Russia, India, China) break the curve

Sub-Sahara Africa has not done as well

Experts agree that the situation has worsened since 2008 – food prices remedy is urgent

Slow progress toward the MDGs

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Goal Sub-targets likely to be achieved

At risk urgent action needed

1. Eradicate extreme poverty & hunger

reduce poverty by ½ developing countries’ export earnings devoted to servicing external debt fell by ~50%

Eradicate hunger: ½ those in sub-Saharan Africa may still live on < $1/d; ¼ of all children are underweight. Fairer trade unlikely

2 Universal primary education

Primary school enrolment of at least 90%

Promising progress

3 Promote gender equality, empower women

The gender parity index in primary education > 95%

Of 113 countries 18 may achieve parity in 2o ed; Parity in employment & politics seems unlikely

4 Reduce child mortality

Measles deaths is declining 89% of children receiving vaccination

Child mortality has dropped by ½ but still too high

5 maternal health Some progress, 500,000 pregnant women still die of complications

6 infectious disease & safe water

AIDS declining deaths & new infections, malaria prevention tripled, tuberculosis to decline 1.6b people have gained access to safe drinking water

Some 2.5 billion people, almost half the developing world’s population, live without improved sanitation

7 Global partnership for development

Unprecedented verbal agreement & generous promises

In reality, aid expenditures declined for 2 years. Few meet 0.7% of GNP

Only goal #2 is fully within reach!At half-way, most MDGs are partly met.

Who gives 0.7% of GNP? Myths, truth, & omissions

$57.5: given by the EU’s 20 most developed countries$22.74: given by USA with about the same population

US aid goes mostly to nations it can use

Kuwait gives 8.2% of GNO, Saudi Arabia 4% in 2002Cuba may give the highest % of GNP. China & India??

Myth:In absolute terms the USA gives more than anyone else

Truth:

Omissions:

Social enterprizes – Grameen family

Grameen family of Social Businesses1 Grameen Community Development Bank for the poor (p)2 Grameen Trust (np) 37 countries 3 Grameen Fund (np) Risk capital for small-med business4 Grameen Telecom (np) poor to profit from a cell phone5 Grameen Phone (p) 50% of all telephones in Bangladesh6 Grameen Solutions (p) fast-growing software company7 Grameen Communicns (np) soft & hardware networking8 Grameen Fish & Livestock (np) village aquaculture & dairy9 Grameen Shakti (np) renewable energy in remote regions10 Grameen Shikkha (np) educational loans literacy & tech11 Grameen Byabosa Bikash (np) supp services for microcr.12 Grameen Danone Foods (p&np) nutritious food near cost13 Grameen America (p) alleviate poverty in working poor

http://en.wikipedia.org/wiki/Grameen_family_of_organizations

http://www.grameenfoundation.org/

Microfinancing successes

Donkey carts for $200 repay in

2.5 mos

4 Factories for treadle pumps.

Now there are 75

Drip irrigation allows winter cukes @ 3x price. 1A farm profit

$100 $550 / yr

Business Week

Grameen Impacthttp://www.grameenfoundation.org/our-impact

9.4 million poor have been helped1,000,000 microloans have been generated

http://www.youtube.com/watch?v=kW-4gJmXy5M

http://www.youtube.com/watch?v=1UugpcDjjJU

Grameen village phone10M subscribers300k cell-phone ladies

Millennium Village Project

Farm production

Gender equity

Nutritional services

Energy & environment Health services

Water

Prevent malaria & TB

Environment

The GOBI prescription: doesn’t have to be big $

Growth monitoring Oral rehydrationtherapy

Immunization Breast-feeding

Child health – low-cost solutions

$14 can save a child’s life (2 mosquito nets@$7)

Eliminate hunger & malnutrition in the villageincrease production of nutritious foodsimprove nutritional status of pregnant & nursing mothers & infants < 2

Provide equipment for a safe supply of drinking water

Equip kitchens with improved stoves outfitted with a chimney

Renovate or construct a local clinic & dispensary

Train local community health workers for home-based care

micronutrient supplementation

Access to clean water & sanitationExplore and cost options technologies (e.g. boreholes, dug wells) for increasing water supply at the household level at each village

Install and train community in rainwater harvesting and collection from rooftops and storage tanks in schools, medical facilities and other appropriate buildings in the area

Provide material and training to filter and/or disinfect all collected water depending on the raw water quality

Promote the creation of ventilation improved pit latrines

Rainfall pitsDrip irrigation

Improve livelihoods & increase incomes for agricultural workers

Provide technical expertise and required inputs to diversify parts of farmland to higher value products after food security is achieved focus on improving nutritional status of pregnant women, nursing mothers and infants under two

Provide equipment for water harvesting techniques for small-scale irrigation

Develop organized systems for selling products to more distant markets and purchasing farm inputs

Provide training to develop new village businesses (e.g. agro-based processing, small livestock cooperatives, small-scale artisans)

Assist farmers and entrepreneurs to partner with larger food processors, supermarkets and export-oriented distributors

Provide all-weather vehicle access road and village vehicle

The Kings of PhilanthropyBill Gates $28b +Warren Buffet $37b ($10b to B&M Gates)George Soros $6bGave $1b to start world's largest social entrepreneurship foundation Omidyar ebay owner $10b http://www.omidyar.com/a conversation with the world to discuss the direction of their philanthropyAshoka http://www.ashoka.org/ Bill Drayton CEO, Lecturer at Harvard & Stanford "In US people are very down on foreign aid, because its just not working!University in a boxRider SahelJeffrey Skoll $1b ebay ceo http://www.businessweek.com/magazine/content/04_48/b3910407.htm President Obama proposed $50-million for the Serve America Act Jim Brockerman Benetec Silicon valley deliberately non-profit Ben Kingsley balancing the planet Ted Turner $1b to UN programsEU gov money will followRockefeller Philanthropy advisors President Melissa Berman has guided $1b in private resources for public benefit The person giving the $ away has a hard time getting honest criticism There's a need in philanthropy to set very high goals Need for a critique

CBC Ideas 2009

Resources for a world without hungerClinton Global Initiative

Bill & Melinda Gates Foundation

Grameen Family of Social Businesses

Millennium Village Project (WHO, UN, Jeffrey Sachs)

Official Development Aid

The Cuba, China model for bootstrap development

University Global Health initiatives

http://www.clintonglobalinitiative.org

http://www.gatesfoundation.org/Pages/home.aspx

http://en.wikipedia.org/wiki/Grameen_family_of_organizations

http://www.unmillenniumproject.org/

Sweden, Luxenbourg, Norway, Netherlands, Denmark

spreading in Africa, Latin America, Middle East

Spreading in Latin America, Africa, USA, Australia, Canada, Switzerland – through student power, and top administration, not ...

What can we do?

Take home message• Catastrophic inequities in distribution of foods

• Kinds of nutritional status & health impact

• Through the life cycle, the hardest hit are

• We’ve faced difficult questions re inequities

As we face the future we are ...

A billion overweight - a billion hungry

water, protein, iron, vitamin A, iodine

“Not by accident?”; “Who’s responsible?”

childbearing women and children

not just across nations – increasingly within

Impatient Optimistic

America is well covered in text, Canada gets a nod - world is ignored!

Roadmap to the next 2 lectures1. Where are we, the world, now?2. How did we get here? 3. Where are we going?4. What is working and isn’tCompare your mindset with evidence-dataset

Indignation at inequities & the causes

Realistic optimism re a world without hunger

Impatience at slow progress & cost in lives

Next lecture

Nutritional concerns in Canada and in LMICs

Do we need to know?

We ignore our compassionate impulses at our peril

We live in an interconnected world

Nutrition in relation to global health

• For all nations, rich & poor, among the immediately modifiable factors that affect individual & public health … nutrition is of prime importance

• nutrition determines physical health & development through the life-cycle, including:– Success in childbearing, cognitive function, socio-economic

independence, education, disease resistance & employability– Health & economic development are contingent on

provision of adequate food, nutritional resources & supportat every stage of life lays a foundation for the ensuing stage

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Nutrition in Global HealthCauses, mechanisms, solutions

1. Why nutrition is crucial to global health & MDGs2. Overview of nutrition across humankind3. Human nutrition fundamentals in global context4. Top five world nutrition problems, & their solutions5. Nutrition across the life cycle & in rich and poor nations6. Cause & effect: Determinants in population nutrition7. Roadmap to a world without hunger: Nutrition Part II

Worldwide distribution of malnutritionOver 20 million children suffer from acute malnutrition WHO

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Scientific American, Sept 2007

Worldwide, nutritional inequities follow poverty(as do health inequities & life expectancy)

• Globally, there is plenty of food for everyone but …those who have more than they need don’t want to share

• The result – in the time we spend on this module over 1000 children will have died of hunger

• Each day 1500 children go forever blind from lack vitamin A

• The poorest are 50-200x more likely to die in pregnancy

• About 2 billion people (56% of pregnant women) have iron deficiency. Their babies have low birth-weight, & mortality

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The goal is to see everyone self-sufficient,

• The MDG agreement & promises of 0.7% of rich country GDP for aid could, in a few years, eliminate extreme poverty & hunger

• But there are some nations whose promises mean little. Long before 2008, US & Canada “changed their minds”

• Thanks to those nations that keep their promises, extreme poverty will be largely eliminated, but in 50 (not 15) years

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Note g

Some communities may need long-term help

• Even among the richest, there are some individuals so marginalized that there seems little hope for them The larger culture, if it is compassionate, takes long-term responsibility for ensuring them the necessities of life

• Globally there are communities that have been denied the resources to ever become wealthy. Often from geography, climate, invasion, or appropriation of their natural resources

Regardless, a world community of compassion provides the necessities of life, & offers new life to refugees the dispossessed, even North America once opened its doors

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Note h

Roadmap to a world without hunger- what works & what doesn’t

Canadian nutrition in global contextNutrition Canada Report 1974 The goodWe are privileged c.f. the rest of the world No difference among income groups!The bad>10% of population are at risk for (& signif clinically)

folic a 60%, thiamine, vit C, iron, fibre, fluoride, CaThe ugly• obesity is widespread 9/10 provinces - diabetes• alcoholics, teenage girls, first nations,

vegetarians• big differences among income groups (new

data)!!

• Compassion for the needy, but no political actionat home or abroad

Reasons for the decline

On the Canadian sceneWe exercise too little2 out of 3 don’t consume recommended food groupsHealthy foods are priced out of the reach of many ...

fish, fruit, some vegetables, nuts ... mass produced junk is cheap & promotedSocial concerns no longer political actionNo update of 25 year-old data

On the global scaleWe are no longer good global corporate citizens

The N American diet lacks:Ca, iron, folate: present in available foods

Iodine, vitamin D: in fortified foods

Fluoride, fibre: supplement indicated

vitamin E, Mg, Zn: no symptoms despite intakes below the RNI

Most of all we lack evidence-based info misinformation is commercially drivenEven more true globally misinformation is political & ideological

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Nutrition in Global HealthCauses, mechanisms, solutions

1. Why nutrition is crucial to global health & MDGs2. Overview of nutrition across humankind3. Human nutrition fundamentals in global context4. Top five world nutrition problems, & their solutions5. Nutrition across the life cycle & in rich and poor nations6. Cause & effect: Determinants in population nutrition7. Roadmap to a world without hunger: Nutrition Part II

Determinants of population nutrition

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Any broken link can nutritional inequities.

Think about how …

The mechanisms of hunger – many paths

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“Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action

”

Notice how one path can feed-back to affect others

As diagrammed by WHO

in

Sub-determinants of nutritional sufficiency

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Each factor has its own contingencies. Here are a few:

Economic development depends on agricultural sustainability• irrigation & soil maintenance (crop rotation, contour plowing)• seeds, fertilizers, appropriate insecticides

Agricultural productivity depends on good harvests• climatic – drought and floods• drought- and frost-resistant crops• hybrid seeds and related biotechnology• market for any excess crop, non-exploitative pricing

Sub-determinants of nutritional sufficiency

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Each factor has its own contingencies. Here are a few more:

Stability includes freedom from disruptive forces• war (revolts, invasion, political upheaval, social disruption)

• exploitation from outside

• corruption externally – from rich countries or multinational corporations who offer bribes

• corruption internally –where some developed nations set a poor example e.g. non-transparent procurement policies

Poverty - greatest cause of malnutrition(hunger, blindness, disease, birth defects, maternal/neonatal death)

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The causes of poverty are disputed – no one wants to be part of the cause. What we know is….

• Poverty doesn't just happen, it is caused by economic, political, social & geographical circumstances & and decisions

• Usually these decisions are made outside the groups of people most affected by it!

Poverty - greatest cause of malnutrition(hunger, blindness, disease, birth defects, maternal/neonatal death)

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• Old people, women and under-supported children are most likely to be impacted by poverty

• Uneven distribution: 2/3 of undernourished people live in Asia

• Hunger is growing fastest in Ethiopia, Sudan, Rwanda, Burundi, Congo, Sierra Leone, Zimbabwe, Somalia, Kenya and Tanzania.

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Nutrition in Global HealthCore concepts: Global nutritional issues:

causes, mechanisms, solutions

1. Why nutrition is crucial to global health & MDGs2. Overview of nutrition across humankind3. Human nutrition fundamentals in global context4. Top five world nutrition problems, & their solutions5. Nutrition across the life cycle & in rich and poor nations6. Cause & effect: Determinants in population nutrition7. Roadmap to a world without hunger (Millions more are

being fed but without urgent action, millions more will still starve. Introduction to Part II Nutrition module)

Where are we? Considerable hope for the future, with great distress & urgency in the present

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• Globally, more are now adequately fed than ever before.

• Many populations are growing ... and yet the percentage being fed continues to increase

• The MDGs will mostly be mostly met ... but not on schedule, while extreme hunger decreases worldwide

Where are we? Great hope for the future, with great distress & urgency in the present

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Does that mean we are doing enough? Absolutely not! • Sadly, improvements in nutrition are not equally spread: in

Africa more are hungry

• Most of us born today will live to see hunger shrink to temporary pockets, efficiently managed by food aid

• Meanwhile, each year of delayed progress millions of lives are needlessly lost

What has changed? At last it’s clearDisparities are now so great that there is now complete agreement that the plight of the poorest must be addressed

The cost of conferring great benefits is a fleabite to the rich. $20 from an individual can save a child’s life and 0.7% of GDP from the richest nations could, in two decades, wipe out the deadliest disparities

What has changed? At last it’s clear

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What’s needed was defined in 2001. Amazingly 22 nations signed on to fund 7 MDGs with 60 indicators of success, and to provide the funds!

1st aim: eradicate extreme poverty & hunger

We’ve seen what worked & what didn’t. The MDG projections were accurate, but ...

While some well-intended nations ...

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... honoured their commitments in full, or at a higher level (here we honour Northern EU & Kuwait)

... most provided approximately half the aid that they undertook – (here we include many nations of west-central EU & Saudi Arabia)

... a very few provided a fourth or less of what they contracted – (here we must list the nations of N. America)

the consequences are unsurprising….

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The consequences are unsurprising

• Thanks to nations & individuals who put worthwhile goals ahead of personal greed, we see a better nourished world emerging

• The majority of nations are now solidly on the development ladder

• Millions will die unnecessarily in Sahel & sub-Saharan Africa, and the major cause rests with a few nations

Roadmap toward a world without hunger

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We’ve concluded Part I of the nutrition modules with a preliminary assessment of prospects for “eradicating extreme poverty & hunger.” In Part II we ask “what works and what doesn’t?” We will…

1. … discuss the confounders & wild cards & elaborate on the range of possible future scenarios

2. … contend that many controversies fail to realize that many “competing” approaches are, in fact, complementary

3. ... categorize competing viewpoints as evidence- or ideology- based & subject them to the test of science

4. … survey current strategies, assessing their strengths, weaknesses, & applicability to real life problems

Review your pre-quiz to confirm that you have advanced your knowledge. As we move now to the future, here is part of the

pre-quiz for the Part II Nutrition module

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• Does globalization promote nutritional health? For whom?• Is free enterprise good for everyone? If not, for whom?• Are most African leaders dictators?• Does most Africa aid end up in Swiss bank accounts?• Does food aid do more harm than good?

Academics & politicians argue about these questions and what should be done. Does that mean that we don’t know what to do? We will show in Part II that the answer is:

Absolutely not!

Summary: What you’ve learned (& applications)

• Nutritional health is not equitably distributed worldwide

• Correcting nutritional inequities is crucial to a viable future

• We've reviewed nutritional principles in global context

• Nutritional health, public health, & economics are inseparable

• Worst nutritional risks: water, protein, iron, vitamin A, & iodine.

• Putting this information to work in context helps us know what to look for, what to ask for, and what to do

Summary: What you’ve learned & its applications

• Across the life cycle, kids & mothers are at greatest risk. So we know priorities & best practices for risk mitigation

• We have seen setbacks, slow progress toward the MDGs

• We have substantial agreement about what needs to be done

• We see powerful signs of hope: fortunes given away, crazy ideas, lending money to the poorest & getting it back, & fresh voices with new workable strategies for a better future

• We join those working for a better world with renewed clarity & energy

AcknowledgementsI can single out only a few of many whose insights, persistence, & courage evaporated the dread & pessimism with which I began this task. In rough chronological order:Jeffrey Sachs, Yunus Muhammad, Raj Patel, Kumi Naidoo, Paul Collier, Howard Zinn, and Frances Moore Lappé

I learned from them, and others of a generous spirit, that:

(1) clear thinking & scientific evidence trump ideology(2) generosity & compassion can flourish amid greed(3) a combination of indignation, optimism and impatience

Useful links for additional information

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Note ff: Tool kit for finding information An amazing collation of resources is available The New Zealand Digital Library Project is maintained by Lethbridge University in Canada, and is machine searchable at http://nzdl.sadl.uleth.ca/cgi-bin/library. Each of the following selection of topics has many dozens of useful (evidence-based) modules on topics relevant to the tool kit of an "agent of change"Agricultural Information ModulesMedical and Health LibraryVirtual Disaster LibraryFAO on the Internet (1998)FAO document repositoryCollection on Critical Global IssuesFood and Nutrition Library 2.2WHO Health Library for DisastersIndigenous PeoplesPoverty AlleviationGreenstone wiki collection

Sources

Books, publications, and talks from any of the writers mentioned in the Acknowledgements section are a reliable source of information regarding what works and what doesn’t in relation to aid.Germs, guns & steelConfessions of an economic hitmanSalud!Sources of government information http://www.lib.berkeley.edu/doemoff/govinfo/intl/http://www.ifpri.org http://www.ifpri.org/2020chinaconference/wayforward.asp Supercourse http://www.pitt.edu/~super1/assist/keysearch.htm#n WHO Nutrition http://www.who.int/nutrition/en/ Nutrition databases http://www.who.int/nutrition/databases/en/ Nutrition & Global Health: Micheline Beaudry is professor of Community Nutrition and International Nutrition at Universite Laval in Quebec city, Canada (since 1989). From January 1995 to December 1996, she was on leave from the University and Chief of the Nutrition Section in UNICEF Headquarters (New York). Previous positions include professor at Universite de Moncton (1980-1989) and