Prevent Famine but Not Impoverishment or Malnutrition...

"The government is obliged to prevent famine, under the narrow definition of mass death due to epidemic failure of food consumption. It is not required or expected to prevent the wider process of impoverishment... Neither does the contract include the conquest of chronic malnutrition or other social ills... Famine is a legitimate, even obligatory, subject for political advocacy, but these are not." Famine Crimes, page 16.

The truth in this statement strikes me. I'm not quite sure why, as I have read about the famine contracts that exist and governments stepping in at the last possible moment to prevent complete and total famine. However, put in that framework, it definitely makes me think about prevention. Prevention not only costs less than treatment (or less a less articulate but accurate recon and clean-up) but it is a progressive step in promoting future public health work.

Prevention campaigns are often mentioned in respect to HIV campaigns, however not all have successful and measurable outcomes. Prevention campaigns worked extremely well in Cambodia and Thailand in the 90's with a "100% condom program." Sex workers were all encouraged to use and promote condoms, which drastically reduced the spread of HIV. One key factor in this was that governmental and non-governmental organizations fully supported this campaign, which emphasizes their focus on health care. Even though the epidemics in these two countries were very different, because people were dedicated to preventing future problems, awareness and education moved to the forefront.

Attention to nutrition, livelihoods (such as farming) and food security is very important in preventing a potential famine. It is definitely more efficient and cost effective. The problem, however, is that measurable outcomes are necessary for prevention programs to continue receiving funding, and that is often times difficult, especially for new prevention programs.

Cohen, J. (2003). Two Hard-Hit Countries Offer Rare Success Stories. Science, 301, 1658-1662.