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Feeding Latin America's children.

More than US $1.6 billion is spent annually on 104 programs in 19 Latin American and Caribbean countries to subsidize or provide food for people supposedly at risk of malnutrition. This amount constitutes only 0.2% of these countries gross national product. If there is no double-counting, these programs reach more than 80 million people, or 21% of the population, at a cost of $20/beneficiary or $4 per capita. Yet some 10 million children are malnourished, which suggests that the expenditures are poorly directed or ineffective. There is little hard evidence that these programs are preventing much malnutrition; even curative results are seldom measured. THe effort is too small in some countries with great needs, while other countries have nearly eliminated malnutrition. 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 education necessary to attack all 3 root causes of malnutrition: poverty, disease, 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.