1. Acutely missing the chronic crisis

2. Missing what? Under-lying, slow-changing, “chronic” food security, nutritional, environmental, or livelihood problems that remain permanently near or beyond emergency levels of prevalence or that may pass from critical into emergency levels with almost no evident tipping-point event.

3. The problem, illustrated: Niger Locust and drought issues had minor human impacts High prices were a major hit on food security and the household economy Richest farming areas were where severe acute malnutrition issues appeared to be worst Was there a nutritional “crisis”? Only if you agree there always is.

4. The problem, illustrated: Niger Chronically severe acute malnutrition levels are: present in all parts of the country and above critical levels, present every season, every year. They probably vary, yes, but apparently in a small range

5. The problem, illustrated: Niger Everywhere…All the time…Crisis levels… Peuch, IRAM, 2006

6. The problem, illustrated: Niger Mostly infants of 6-24 mos Rest of siblings and family members are “fine” Causality: malaria, poor water, infant feeding, poor mother’s education, poor health and sanitation facilities -- plus poor and insufficient diet/consumption Peuch, IRAM, 2006

7. High prices were hammering the household. Panic at the household, market, donor, Press, and international levels Motivated humanitarian actors made it an issue. Gathered infants. Why did the crisis become so prominent at this time? The problem, illustrated: Niger

8. Don’t forget that there are more severely malnourished children with 250 km of Maradi than anywhere else in the world

9. The view since then: Most agree this was mostly a nutritional problem, and secondarily a food problem, due to high prices Most agree this was not a food shortage-driven famine Most agree that non-food causality is (a/the) major factor Most agree we need to respond with more than food The problem, illustrated: Niger

10. Will it happen this year? Prices are higher than average, but stable Malnutrition rates haven’t apparently changed much It could, but probably won’t in Niger The problem, illustrated: Niger

11. Problems of EW/M&A approach FAv and FAc are generally seen as the most important causes of FI and a FS crisis. FUt conditions are most often seen as pre-disposing dimensions of FI, V or a FS crisis. Indicators of food utilization (FUt) are rarely regularly monitored or assessed. The context, or “baseline”, is assumed to be a stable, “normal” condition in which problems arise The causality of malnutrition is most often assumed to be a food-related (FAv and FAc) problem

12. Problems of EW/M&A approach A high prevalence of acute malnutrition is generally the most “impactful” indicator of a “FS” crisis. But, a permanently high prevalence of acute and severe acute malnutrition has not been considered a crisis in some areas. Monitoring and assessing prevalence levels of malnutrition has to be a primary objective for EW and FS M&A A need to monitor chronic conditions will require EW and FS M&A to adjust (its/their) approach

13. Need to adjust concepts? Early warning? “Food security”, and food insecurity vs humanitarian crisis Malnutrition ≠ starvation ≠ shortage of food ≠ famine The place of FUt and malnutrition in EW and FS M&A New EW and FS M&A tools and methods

14. Well? Do the same problems found in Niger exist elsewhere? What is the place of malnutrition in the food security concept (FAv, FAc, FUt, V)? What are the options for more effective early warning and food security monitoring and assessment? What is needed for more effective humanitarian response to malnutrition. Is it likely?