Declaration of Conflict of Interest Allan Davison, Sarah Luthe Kyuragi, Smita Pakhale, Kris Roberts declare that in the past 3 years: I have received manufacturer funding from the following companies*: None I have done consulting work for the following companies*: I have done speaking engagements for the following companies*: I or my family hold individual shares in the following*: *pharmaceutical or medical/dental equipment

Global shifts: What’s their impact on the roadmap to make hunger history? Sarah Luthe Kyuragi (MD) National Center for Global Health & Medicine, Tokyo, Japan     Allan Davison (PhD) Simon Fraser University Vancouver, Canada Team effort – names on slide. We’ll focus on 2 nutrition related MDGs *MDG1 decrease extreme poverty & hunger by 50%, and *MDG4 decrease infant mortality by 66% Sarah will deal with big picture Allan will deal with Kris Roberts (MSc student) Simon Fraser University Vancouver, Canada Smita Pakhale (MD) Ottawa, Hospital Research Inst & University of Ottawa Canada

3A World income $1000s / person 3B Trickle down? 3A World income $1000s / person 3 UNICEF 2011 “Beyond the bottom billion” 1 Quintile Poverty trap < $1.25 / day < $2 / day Top 1% $3000 / day Top 1% $3000 / day Inflation adjusted PPP This first slide is the most important. It shows the contrast between rich an poor, and one of the main reasons why trickle down doesn’t work – the poverty trap First, the world is getting spectacularly richer. The nation at the top changes, but the trend never changes. With so much wealth, why still 600 million poor? World GDP/cap = Cuba’s (Cuba has U5MR 1/10 of world (58) and slightly better than U5MR than US or Canada) The graph on the right shows the POVERTY trap: people don’t have enough for daily needs, They are trapped there, because there’s nothing left over to invest in their future. Staying alive is their goal. Those in the bottom 1% will almost all die unless helped from the outside. The next slide shows they are getting helped. A great deal! Money seems to magnetically attracted to those who have lots, sticks to the top 1% and almost nothing reaches $1.25 /day PPP (purchasing power and inflation adjusted) Bar width = income / day Bottom 1% won’t live to 5 y

% of people below $1.25 PPP / d Global stunting Slide 4 % of people below $1.25 PPP / d MDG1 indicator [Hunger] 7 6 5 4 3 2 1 Number of stunted (billions) Headlines were made when the World Bank announced that Poverty MDG was met in 2011. Since confirmed independently several times. (% < $1.25 is changing about 1% pa). % stunted is decreasing 3x slower. Only some are getting what’s needed. Not everyone is getting average, some more, some less Main factor is that most nations are getting richer, in 35 years 3.5 billion more were fed 22% saved from stunting were in Poverty trap & they were HELPED! 3.5 billion more were adequately fed, but because of population growth, it’s not enough for MDGs to be met Except for poverty growth, MDG for stunting would have been met. Look at the bar on the right. There are now more fed people on the ladder of development. As they rise, they have more to give to development and fewer people need help. So, having looked at some effects of economic changes. Lets turn to demographics, and immediately we’ll see an enormous change that will have a big effect on nutrition and MDGs Bars show absolute numbers UNICEF & WHO www.who.int/entity/nutgrowthdb/jme_unicef_who_wb.pdf

Global under-5 mortality rate Deaths per 1000 live births Predicted

Three of four in MICs Where do the poor live? India 30% China 35% 30% 20% 10% 0% India Three of four in MICs China The story is easy to tell. There has been a tremendous concentration of poverty in the Middle Income Countries. Most poor people live in just two countries. That have rapidly growing economies. [Conversely, in the USA, the life expectancy of people without high school education is shrinking]. I’d like to talk about how this convergence has been happening, also divergence This means that middle income countries are now on the ladder of development, but not all allow the poor to share, while the lowest income countries have not been included in the benefits Philippines Nigeria Indonesia Pakistan from Canbur & Sumner Slide 6 http://www.voxeu.org/article/poor-countries-or-poor-people-new-geography-global-poverty

Compare: Nigeria vs Bangladesh http://tinyurl.com/globgap Nigeria Now a “MIC” Bangladesh a “LIC” Bangladesh resource poor I’ll show you Bangladesh & Nigeria, as two 2 similar countries. & introduce you to the resource curse! Which wd you prefer to live in, not a big spread of incomes, higher average income. Nigeria has enormous resources and Bangladesh almost none. BUT Oil had just been discovered. the export of oil has expanded to be almost 90% of Nigeria’s GDP. So shouldn’t that have benefited the people? All African many Arab know this curse. Every corrupt multinational corporation to bribe anyone who’d allow them to export more oil, no tax less than it’s worth. So what you see here is that Nigeria lost ability to improve hunger. More oil, the worse for the poor. You will get some surprizes if you compare Japan and the USA; also Indonesia & Brazil Nigeria resource rich Slide 7

Something is changing for better but … Resources don’t benefit country if wealth flows out  GDP / cap doesn’t mean food for all Indices of poverty, hunger all decreasing Increasingly, govmts are uplifting all 1 There are 2 main conclusions from the evidence presented There is steady progress on global MDGs for poverty which will has been met, and for hunger and the U5MR which will be met a few years after deadline. But one needs to drills down to specific communities, there are vast inequities Disaggregation of data on the basis of wealth distribution can invalidate conclusions drawn on the basis of GDP / capita There’s a huge number of special interests trying to control the whole world so it works for their benefit. There’s a huge number of people trying to just get what it takes to keep alive. I think the future will be determined by a growing number of people, sick at the flow of wealth from the rich to the poor Angry at the dead children who pay for the greed of the rich passionate for food as a human right, innovating to make a more equal world. Today, I’m glad to be among you 2050 will be a very different world

More information, free PowerPoint slides Thank you! Contact: adavison@sfu.ca [please disturb] sarah.luthe@gmail.com More information, free PowerPoint slides www.sfu.ca/global-nutrition

“Stable poor countries are increasing GNI /capita” Brookings Poorer 100% rIcher $500pa /cap $5000pa Fragile Nigeria “Stable poor countries are increasing GNI /capita” Bangladesh India China Stable 2000 → 2005 Animation

Take home message Trends predict: hunger will be history mid-century This doesn’t help 15000 children born today who will not reach their 5th birthday. Long term optimism & short term impatience are appropriate Thank you for your attention. The End Slide 11