The book was co-edited by The American University of Rome’s Visiting Professor Dr. Harold Alderman, a Senior Research Fellow at the International Food Policy Research Institute (IFPRI) in Washington, DC. It covers six case studies from countries around the world, including the USA’s largest program, SNAP -- or Supplemental Nutrition Food Program -- which is on potentially on the Trump chopping block.

In January, Dr. Alderman gave a course on nutrition policies and programs to AUR students in the graduate Food Studies program. Students also attended his lecture about the book at the United Nations Food and Agriculture Organization (FAO) based in Rome. The course was hosted by Food Studies Program Director Maria Grazia Quieti, a former senior policy officer at FAO.

“It was really interesting to learn about his research and the success of cash transfers,” said student Kelly Powers.

Students in the Master’s in Food Studies program pose on the speakers’ podium with Program Director, Maria Grazia Quieti (second row, middle) and to her right, Militezegga Abduk Mustafa, a nutrition policy consultant at FAO.

What seems to drive improvements in food assistance programs is not so much the transfer modality, explained Alderman, but factors like political leadership at key junctures, credible evidence, a judicious use of technology, appropriate delivery processes, and ways to hold providers accountable. (See links below for a free downloadable PDF version of the book and videos of the lecture)

A summary of key points from an AUR interview with Dr. Alderman and his FAO lecture is provided below.

Lessons from the Panda’s thumb
In his talk, entitled “Cash it out? Why food-based programs exist, and how to improve them,” Alderman sets out the common themes found in the world’s oldest and largest food-based programs.

One is that food-based programs are here to stay, despite the trend in past decades towards direct cash transfers and overwhelming evidence that cash systems are more cost-effective and efficient.

The title of the book, in fact, refers to the 1.5 billion people in the world that receive food subsidies, the majority as food, not cash. (The cover of the book is a photo of the first printing of US food stamps, in 1939. Food stamps were the predecessor of SNAP which allows people to buy food with a debit card.)

“Reforms of these programs are often two steps towards cash and one step back,” said Alderman. “Food and cash often co-exist. The evolution can be quite complex with countries going back and forth between the systems over the years.”

One reason for that is that programs are jury-rigged. To illustrate this, he used a metaphor from Stephen J. Gould’s book, “The Panda’s Thumb: More Reflections in Natural History.” Pandas don’t really have thumbs, explained Alderman, but Mother Nature has given them a spur, or bone, which extends from their paw. It’s not perfect, or jointed, or flexible like a thumb, but it does the job of stripping bamboo, which is the panda’s livelihood. “The same holds true for many programs,” argues Alderman. “They are jury-rigged sometimes. They are not what you would design if you were starting from scratch, but often they are still quite effective in their objectives.”

SNAP is a good example of a jury-rigged system. It started with food distribution programs to reduce agricultural surpluses and then evolved into food stamps in the Great Depression. In the 1960s, it became a permanent, federally-funded benefit to combat hunger across America. By 2004, technology arrived to replace stamps with debit cards, cutting costs and streamlining bureaucracy. But essentially, it has remained a food-based program and not a straight cash transfer (the debit card is only good for food). Today, it reaches 45.8 million Americans and is part of a wider—mostly in-kind—safety net, including school meals and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Almost 80 years after its birth, it is considered one of the most effective social assistance programs in the world. But it’s not perfect and still faces challenges like all the rest.

Why this book matters now: The multi-purpose need for food programs
This publication examines the barriers and challenges to food programs in the USA as well as: Mexico (PAL - Programa de Apoyo Alimentario); Egypt (Ration Cards and Baladi bread subsidies); India (TPDS – Targeted Public Food Distribution System); Indonesia (Rastra); and Sri Lanka (Samurdhi food stamps). It offers the latest empirical data on poverty alleviation programs and the trade-offs of delivering food through in-kind, cash or a mix of programs.

Written by a worldwide team of 19 food policy experts, it is also one of the first major cross-country reviews of social protection since the 1980s. Co-editing the project with Alderman were his longtime colleagues, Ugo Gentilini and Ruslan Yemtsov, both economists in the Social Protection and Jobs Global Practice of the World Bank.

One of their goals for the book was to counter the “lack of institutional memory” of how these programs developed and more importantly, why they have changed through the years. “That’s the origin of this book,” said Alderman. “There is a gap. I’m not a historian or political scientist but this is an attempt to remind people that we don’t sit around and design projects from scratch. And that conditions the direction and where we can go with programs.” The policy choices available at any given time are not just about optimal strategies, he said, but rather, in part, the legacy of previous policies.

Food-based programs were designed to meet a mix of government objectives, firstly economic and then, social protection. Today, for example, food programs support farmers via procurement (agriculture); manage price fluctuations with strategic storage (risk management); and provide income support to low-income consumers (social assistance). The multi-purpose nature of food-oriented programs makes “cashing them out” more difficult because they impact so many parts of the economy. Instead, the role of cash is more streamlined; it largely revolves around one goal -- poverty alleviation – with the aim of “graduating” participants off the list. Programs like SNAP, however, expand and decrease depending on the economy, meaning the number of participants changes monthly as people cycle on and off for brief periods of time.

Democracy & Crises: Friend or Foe?
Most of the book’s flagship programs were introduced or significantly reformed during war-times or after severe economic shocks. History shows that a crisis can reboot a program that is lagging due to inertia or rent-seekers – people with a vested interest in keeping the status quo. For example, The North American Free Trade Agreement (NAFTA) caused a foreign exchange crisis and changes in producer prices which caused riots in Mexico. This brought about much-needed reforms in their food policy. Democracy, on the other hand, can play a role in advancing or hindering progress, said Alderman. For example, after a major electoral sweep, both Sri Lanka and Jamaica changed to food stamps.

However, democracy also creates clientelism where votes are exchanged for food privileges. In India, for instance, where the right to food is in the constitution, the food program is the largest in the world, serving 800 million people. This makes it a highly political issue, where promises of new cash transfers or subsidies have become a routine part of electoral campaigns to win votes.

Still room for improvements in nutrition
Sadly, while many of these programs live up to their economic goals, they fall short in their potential to provide the right nutrition for a healthy diet. “If you use food, how much does it help nutrition? Turns out that both cash transfers, conditional and unconditional, they change food purchases -- we know that -- they don’t have the impact on nutrition we hoped they’d have,” said Alderman, whose current research focuses on links between nutrition and early childhood development and how nutrition and social protection programs contribute to long term economic growth.

Getting the right nutrition means making healthy choices and that requires education and hygiene. “A few more dollars in my pocket, I can’t change the sanitation system,” said Alderman. “A few more dollars doesn’t change my knowledge of what child care practices are best.” That’s because food aid really needs to be linked to behavior change communication, water and sanitation programs. Mexico and Sri Lanka have food supplements targeted to the needs of young children or pregnant women – that mix probably works better than cash alone, he said. But many in-kind transfers are not fortified with micro-nutrients. “I don’t understand why they don’t do that,” he added.

That is something which AUR’s Food Studies graduates will have to consider as they design the programs of the future. In the meantime, Alderman’s book is required reading. And, based on reviews, it should be a “must-read” for policy makers, advisors, and those working on the UN Sustainability Goal #2 to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture for all by 2030. That includes, obviously, the United States Government.

Watch the book launch with Dr. Harold Alderman and comments by food policy experts at the International Food Policy Research Institute

Downloadable PDF of the book, published by The World Bank