213. Memorandum From the President’s Special Assistant for Health Issues (Bourne) to Chip Carter, the President’s Assistant for National Security Affairs (Brzezinski), the President’s Assistant for Domestic Affairs and Policy (Eizenstat), and the President’s Science Adviser and Director of the White House Office of Science and Technology Policy (Press)1


  • World Hunger Initiative


The President’s interest in World Hunger is very timely and needed. Recent estimates indicate that 1.2 billion people are malnourished. Malnutrition is concentrated in the poor, infants and children, and among women (particularly nursing mothers). The largest number of chronically hungry people are found in India, Bangladesh, Pakistan, and Indonesia. The largest number of chronically food-deficient developing countries are found in Africa with the Sahel and Ethiopia of particular concern. Malnutrition, however, is endemic to almost all poor countries. In parts of South Asia, for example, malnutrition affects over 50 percent of the children. In Latin America, where nutrition is considerably better, malnutrition is a primary or contributing cause of almost 60 percent of the deaths of preschoolchildren. Nonetheless, experience in Sri Lanka, the State of Kerala in India, and China indicates that there is hope. Even very poor countries, if they strongly focus comprehensive social programs on the basic needs of the population, can alleviate or limit malnutrition significantly.

The food production and nutrition problem has several major international aspects. The world’s food production is now sufficient to meet the current needs, and promises to remain so in the immediate future. However, the demand for food in developing countries has been growing and continues to grow more rapidly than the supply of food distributed to those countries. Poor countries increasingly depend on food exports from the United States and a few other major agricultural exporters.

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Thus, world hunger is an explosive humanitarian and political problem, causing either directly or indirectly millions of deaths per year. In periods of widespread poor harvests and with no coordinated system of world food reserves to be drawn upon in times of need, catastrophic famines are occurring. Even worse, the distribution of available food is so poor that annually millions starve or are chronically malnourished. It is estimated that one million people died of hunger in India in 1972, and the situation that year was worse in Bangladesh.2 In this setting, the United States’ position as the world’s largest food exporter, as the largest donor in international food and agricultural assistance is highly visible and extremely vulnerable. Serious thought and strong leadership will be necessary to achieve humanitarian goals while at the same time avoiding foreign and domestic crises.

Human Rights Discussion:

We have stressed the need for cooperation and achievement of self-reliance in health care with developing nations. We should also, as an aspect of our overall human needs strategy, stress the need for achievement of self-reliance in food production and nutrition. We might consider the hunger issue as the touchstone of a major thrust in our foreign policy, and one in which we stress meeting human needs through increasing self-reliance in food production and nutrition, carefully integrated with health care and population policies. This thrust will complement our human rights policy, and establish a more firm foundation for it. The human right to food, similar to the right to health care, is fundamental. We cannot continue to focus on the deprivation of rights for thousands of political prisoners and relegate to back pages the unnecessary deaths of millions.

While our affirmations regarding world political rights may be occasionally elusive in terms of implementation, our specific actions in terms of social rights can be very tangible and concrete.3 We can establish broad but practical and measurable human needs goals, e.g., programs of food production and basic nutrition, development of low-cost health delivery systems, adequate maternal and child health programs, rural sanitary water supply development, humanitarian food trade policies, etc. Importantly, this must be done on a government-wide basis to ensure consistency and comprehensiveness. Implementation would then follow through the development of a comprehensive global plan, including goals for the basic human needs of life: adequate and quality food for everyone, basic health care, education, jobs.

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Therefore, I am suggesting that as part of a human rights (social justice) strategy, we should develop a human needs policy with hunger and health as the rallying points.

Problems Associated with a World Hunger Initiative:

“There is no single cause of the world food problem. Part of the explanation is to be found in the operation of many of the world’s international systems which deprive Third World countries of the opportunities to develop the resources required to meet their own food needs. Part can be found in the distribution of available food and, in particular, the emergence of meat eating in the industrialized countries as a consequence of affluence, a development which requires an enormous indirect consumption of grain to sustain it. It is also true that many Third World countries have themselves contributed to the world food problem. In some cases they have not given domestic food production the priority it deserves, choosing instead to invest their scarce resources in their cities or in ‘prestige’ projects. They have sometimes subordinated their food needs to those of the industrialized world, using some of their most productive areas for cultivating the cash crops required by the industrialized world rather than for producing their own food. In many cases they have also failed to free the small farmer from the poverty, ignorance, exploitation and discrimination which are traditionally his lot and thus prevented him from making the major contribution to development he is able to make. They have sometimes, as a matter of policy, kept prices of farm products very low with the net result that the small farmer overwhelmingly carries the burden of development. Many have been reluctant to initiate the land reforms required to expand food production and have failed to come to terms with post-harvest food losses which, in some countries, account for 50 percent of total grain production.”4

In this latter regard, the U.S. has strong but little-used leverage, e.g., favorable terms of trade and eligibility for food aid.

Given careful study and reflection, it is likely that U.S. policies, public and private, can be altered to encourage improved production and distribution at home and abroad.

While it is true that the U.S. is the world’s greatest exporter of agricultural products, we have powerful vested domestic interests which seek to maintain a consistent but complex set of domestic agricultural production policies, for there is a close relationship between world de[Page 673]mand for food and U.S. domestic food prices. Any pronounced change in prices will set in motion domestic forces, either from producers or consumers, which could give the President considerable political problems. On the other hand, the Administration has sought to develop policies which stress cooperation with developing nations, and we could do more (utilizing already substantial exhibited support at the grassroots level) to achieve humanitarian and political goals. The potential political liabilities can be avoided, but only by planning which avoids “quick fix” policy pronouncements, and by a strategy designed to gain broad-based consensus on a world food and nutrition policy among 26 Federal agencies and many private farm, labor, and other interest groups in the U.S.

Finally, we must recognize that the diet and health of our own citizens is strongly influenced by many of the same policies that affect the problem of world hunger: the food we grow, how we grow it. Our patterns of trade and aid determine in part what our own citizens pay for and find on their dinner plates. As responsible policy-makers, we must focus attention on how decisions in agriculture and foreign aid affect the health and well being of Americans.

Suggested Optional Approaches:

We should explore approaches that will accomplish these objectives:

—Place the President in a strong leadership position on world hunger.

—Develop public and governmental support for new initiatives, especially among business groups which have strong vested interest views on food policy and development assistance.

—Establish a framework for long-term follow up.

The following scenarios are suggested for consideration.

Scenario 1

Step 1: The President or a Cabinet member delivers a statement on world hunger before a world forum, such as the June 20th World Food Council meeting in Manila.5

Step 2: The President issues a statement appointing a Cabinet-level official, Presidential advisor, or distinguished American from the private sector to head up a public/private Council on World Food and Nutrition Policy. The Council would conduct regional hearings, beginning in Washington, and possibly extending overseas, to assess what could be done and recommend options for the President to consider. [Page 674] One or more members of the President’s family and other prominent figures might be involved.

Scenario 2

Step 1: The President announces a major reevaluation of food policy and agricultural development assistance, and calls for a Washington Conference on Food and Agricultural Assistance.

Step 2: Farm, business, labor, religious and public interests groups, foreign officials (especially representatives of international organizations) as well as Congressional and Executive Branch leaders are invited to a 3-day conference to testify before the President and Cabinet about their views. The President presides over one session each day, the co-chairman might be the Secretary of Agriculture, and Senate and House leadership. At the conclusion of the 3-day conference, the President could appoint a three to five-member Cabinet-level Executive Group (State, AID, Agriculture, Treasury, Commerce) to prepare a decision document based on the findings.

Step 3: The President’s decisions would be made public in the form of a Message to Congress.

Scenario 3

Step 1: The President requests each Cabinet Department with responsibilities related to food and nutrition to prepare a position paper on current policy and proposed initiatives. Papers would focus on domestic and foreign policy actions to improve the world food and nutrition situation within a basic human needs framework, with attention to domestic nutritional and economic concerns.

Step 2: A specially convened executive group, or one of the existing Executive Office agencies such as NSC, CEA, OMB, would integrate the position papers, and prepare a decision memorandum for the President.

Step 3: Legislative and administrative measures would be developed to implement the President’s decisions. A message to Congress and/or a world forum speech could publicize his decisions.

An integral government-wide policy with widespread support for a major world food program is required. It is not clear that Agriculture, Treasury, State, Commerce, Transportation, and AID are together on an approach to the problems previously identified, nor is there agreement in the private sector. Therefore, it is necessary to build support and to identify opportunities for consensus if the President is to be successful in this area. A cross-cutting mechanism of some kind which bridges domestic and international interests appears essential. People I have consulted in the private sector agree with this view.

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I believe something along the lines of one of the above approaches will enhance prospects for accomplishing meaningful results. In the past, efforts in this area have had mixed or poor results and public interest and action subsided because competing U.S. agency as well as private interests were not resolved.

These views are offered as a start toward the development of a joint memo to the President recommending a course of action. My assistant, Jerry Fill (ext. 6687), will serve as my representative on this issue during my vacation in England for the next 9 days.

  1. Source: Carter Library, Staff Office Files, Domestic Policy Staff, Eizenstat Files, Box 324, World Hunger [2]. No classification marking. A copy was sent to Onek. Another copy is in the Carter Library, White House Central Files, Box HE–6, Subject Files—Executive, 1/20/77–9/29/77.
  2. Documentation concerning the U.S. response to the 1972 South Asian food crisis is in Foreign Relations 1969–1976, volume E–7, Documents on South Asia, 1969–1972.
  3. Indeed, achievement of worldwide goals in food production will be more readily understood and felt by the average American. [Footnote in the original.]
  4. In: Reshaping the International Order. A Report to The Club of Rome. Jan Tinbergen, Coordinator. E.P. Dutton and Co., Inc., New York, N.Y., publisher. 1976, page 30. [Footnote in the original. The Club of Rome was established in 1968 as a think tank devoted to strategizing global issues.]
  5. See Document 221.