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In: The population debate: dimensions and perspectives. Papers of the World Population Conference, Bucharest, 1974. Volume I. New York, New York, United Nations, 1975. 484-97. (Population Studies, No. 57; ST/ESA/SER.A/57)The issues dealing with the interrelationships between population growth, food supply, and agricultural development are summarized. Focus is directed to past trends in food supplies, food consumption and nutritional requirements, future demand, future food supplies, agricultural employment, and rural development policies. A table included in the annex gives population growth rates, food production rates, food demand rates of growth, dietary energy supply, and protein supply by country. Meeting the nutritional needs of population growth is possible. Supply and demand vary between countries; supplies are unevenly distributed. Increased production alone will not solve the problems of poverty. Food production must meet nutritional and employment needs. Food production declined slightly during the 1960s due in many cases to policy, but in developing countries it occurred in spite of policy. In 34 countries, food production failed to keep pace with population growth. Population growth accounts for 70% of the demand for food increases. Between 1952 and 1972, in 54 out of 85 developing countries food production increased less than demand. Balancing supply with demand was unaffected by the rate of population growth. 1965-66 brought bad weather and declines in production; 1967-70 is associated with the "green revolution" and increased production. In 1971-72, bad weather again prevailed and food production declined in absolute terms as well as in relation to population growth. Imported food has created dependency relationships. Nutrition is a measure of total availability of dietary energy; developing countries during the 1960s had a 3% deficit while developed countries were 20% above requirements. In 1970, 62 developing countries had overall dietary energy deficits. Insufficient food supply affects poorer families and particularly pregnant and lactating women and children. 10 million children under 5 years of age suffer from severe malnutrition, 80 million from moderate malnutrition, and 120 million from milder forms of malnutrition, or about 50% of all the children in the developing world. 14% of the population excluding Asian economies have insufficient food intake to meet energy needs. Reducing the rate of population growth is essential.
Assessment and implementation of health care priorities in developing countries: incompatible paradigms and competing social systems.
Social Science and Medicine. 1984; 19(4):373-84.This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practiced by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health which mass movements strive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the reassessment and implementation of health care priorities in developing countires with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between "stage theory" and modern consumption-production Malthusiansim. Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. In the context of underdevelopment, increased productivity is at the necessary cost of public health. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading "Basic Needs" orientation in the assessment and implementation of health care priorities derives. Marx said that "countries of developing capitalism suffer not only from its development but also from its underdevelopment." (author's modified)