Malnutrition in emergencies: how can we do better and where do the responsibilities lie?

Over many years, the international relief system has been repeatedly criticised in terms of slowness of response, poor inter-agency co-ordination, and technical incompetence on a larger or smaller scale. Notwithstanding many initiatives to improve co-ordination and other aspects of international relief performance, relief failures, including epidemic malnutrition, continue to occur. The reasons for these failures are discussed from the perspective of the characteristics of the international system, and the way in which this would be expected to perform under different conditions. The chief limitations of the international system identified are: the lack of any focus for imposing co-ordination, other than governments of affected countries; the lack of any requirement for donor nations to ensure that adequate resources are supplied; and a tendency for the system to respond uncritically to the international media. A broad typology of international responses is proposed. It is suggested that relief failure can be recast in terms of the lack of any system which can ensure the correct allocation of food and other resources between emergencies, and ensure the systematic distribution of such resources as are supplied. It concludes that the scope for further improvement in the performance of the international relief system is now limited, but that the most promising area for investment would, where possible, support governments in affected countries to take greater control of the management of the international relief system.