FEEDING LATIN AMERICA'S

More than US $1.6 billion is spent annually on 104 programs in nineteen Latin American and Caribbean countries to subsidize or provide food for people sup-posedly at risk of malnutrition. This amount constitutes only 0.2 percent of these countries ' gross national product. If there is no double-counting, these programs reach more than 80 million people, or 21 percent of the population, at a cost of $20 per beneficiary or $4 per capita. Yet some 10 million children are malnour-ished, which suggests that the expenditures are poorly directed or ineffective. There is little hard evidence that these programs are preventing much malnutri-tion; even curative results are seldom measured. The effort is too small in some countries with great needs, while other countries have nearly eliminated malnu-trition. Where coverage is high, programs—although generally targeted and with sensible criteria—do not always reach the neediest. They may also fail to provide enough food or to combine food with the health care and nutritional ed-ucation necessary to attack all three root causes of malnutrition: poverty, dis-ease, and ignorance. The evidence, limited mostly to program inputs rather than results, suggests that greater progress against undernourishment is possible even with current spending levels. I t is a commonplace that malnutrition is unacceptably widespread in LatinAmerica and the Caribbean, particularly among preschool-age children(United Nations 1989); that economic growth alone would be very slow to eliminate it; that other means are available to reduce malnutrition more rapidly and surely; that among these means are targeted programs providing some combination of food, nutrient supplements, health care, and education t