2005ACTION AGAINST HUNGER ANNUAL REPORT

F100TherapeuTic milk formula, developed and lefT unpaTenTed by acf’s scienTific commiTTee, has revoluTionized The TreaTmenT of severe acuTe malnuTriTion, slashing morTaliTy raTes and saving lives

800,000children were affecTed by The crises ThaT hiT mali and niger during 2005, suffering droughT, reduced access To food, and losses of animals and livelihoods. in mali alone, The malnuTriTion raTe reached fifTeen percenT; raTes of Ten percenT consTiTuTe an emergency. such cyclical crises will only reoccur wiThouT invesTmenTs in longer-Term measures

30 days is all iT Takes To save The life of a sTarving child. Through a rigorous seT of nuTriTional and medical proTocols, our pioneering work in The TreaTmenT of severe acuTe malnuTriTion can save people who are hours away from dying. our TherapeuTic feeding cenTers sTabilize a paTienT’s physical deTerioraTion, rehabiliTaTe meTabolic funcTions, and rebalance a paTienT’s physiology, preparing The way for recovery

6,000inTernaTional and naTional sTaff work for acf To ensure The success of our global programs

The earThquake in pakisTan claimed over sevenTy Thousand lives, injured more Than a hundred Thousand people, and caused The collapse of beTween sixTy and one hundred percenT of The buildings around The epicenTer. as The himalayan winTer approached, The u.n. esTimaTed ThaT The number of people lefT homeless was

2.5MILLION

million people benefiTed from acTion againsT hunger’s life-saving programs in 2005

4years of civil war have ravaged sudan, where Two million people have been killed, and four million have been displaced.

21

90cenTs of every donaTed dollar direcTly funds our programs

children were TreaTed for severe and moderaTe malnuTriTion aT acf’s TherapeuTic and supplemenTal feeding cenTers each monTh during 2005

680

2005ACTION AGAINST HUNGER ANNUAL REPORT

F100TherapeuTic milk formula, developed and lefT unpaTenTed by acf’s scienTific commiTTee, has revoluTionized The TreaTmenT of severe acuTe malnuTriTion, slashing morTaliTy raTes and saving lives

800,000children were affecTed by The crises ThaT hiT mali and niger during 2005, suffering droughT, reduced access To food, and losses of animals and livelihoods. in mali alone, The malnuTriTion raTe reached fifTeen percenT; raTes of Ten percenT consTiTuTe an emergency. such cyclical crises will only reoccur wiThouT invesTmenTs in longer-Term measures

30 days is all iT Takes To save The life of a sTarving child. Through a rigorous seT of nuTriTional and medical proTocols, our pioneering work in The TreaTmenT of severe acuTe malnuTriTion can save people who are hours away from dying. our TherapeuTic feeding cenTers sTabilize a paTienT’s physical deTerioraTion, rehabiliTaTe meTabolic funcTions, and rebalance a paTienT’s physiology, preparing The way for recovery

6,000inTernaTional and naTional sTaff work for acf To ensure The success of our global programs

The earThquake in pakisTan claimed over sevenTy Thousand lives, injured more Than a hundred Thousand people, and caused The collapse of beTween sixTy and one hundred percenT of The buildings around The epicenTer. as The himalayan winTer approached, The u.n. esTimaTed ThaT The number of people lefT homeless was

2.5MILLION

2.6

51,5503.9

1,200people in The democraTic republic of congo die every day, largely from disease and food shorTages linked To six years of war and The subsequenT collapse of The congo’s healTh sysTem and economy

counTries currenTly hosT acTion againsT hunger relief and developmenT programs

million people in The world suffer from malaria, which kills one million people each year, mosT of whom are children under The age of five. simple, cosT-effecTive soluTions, however, exisT for prevenTing The needless Toll ThaT malaria exacTs on poor communiTies

people were TreaTed in acf’s TherapeuTic and supplemenTal feeding cenTers in 2005, mosT of whom were on The brink of deaTh when They arrived. acf’s humaniTarian inTervenTions resTore life, digniTy, and self-sufficiency, uniquely bridging urgenT relief wiTh longer-Term developmenT

billion people lack basic saniTaTion Today—an asTounding forTy-Two percenT of The world’s populaTion. unsafe drinking waTer, inadequaTe saniTaTion, and poor hygiene lead To a hosT of infecTious diseases and chronic malnuTriTion ThaT ulTimaTely kill over Two million children a year

million congolese have died as a resulT of conflicT since 1998, mosTly from hunger and disease

acf head-quarTers make up our inTernaTional neTwork 396 1.1

BILLION

million people suffer from hunger around The world, in boTh iTs chronic and acuTe forms. hunger and malnuTriTion kill over five million children every year, induce Tremendous suffering, and cosT poor counTries billions of dollars in naTional income and losT producTiviTy

852million people benefiTed from acTion againsT hunger’s life-saving programs in 2005

4 43 5 26years of acf experTise in humaniTarian acTion

people lack access To safe waTer around The world, leaving Them vulnerable To daily indigniTies and frighTening raTes of deaTh and debiliTaTion

years of civil war have ravaged sudan, where Two million people have been killed, and four million have been displaced.

21

90cenTs of every donaTed dollar direcTly funds our programs

children were TreaTed for severe and moderaTe malnuTriTion aT acf’s TherapeuTic and supplemenTal feeding cenTers each monTh during 2005

680

CONTENTS

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10 14

16 17 20

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04

08 12

18

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action against hunger has pursued its vision of a world without hunger, saving the lives of malnourished children and families while seeking long-term, sustainable solutions to hunger. Recognized as a world leader in the fight against hunger and malnutrition, action against hunger specializes in responding to emergency situations of war, conflict, and natural disaster. Our innovative programs in nutrition, food security, water and sanitation, health care, and advocacy reach more than 4 million people in more than 40 countries, helping vulnerable populations regain their dignity, self-sufficiency, and independence. n

25yEARs

fOR mORE THAN

Letter from the Exeuctive Director

USA Headquarters Staff

Letter from the President

Board of Directors/Advisory Council

Our Programs

Highlights Emergency Response Nutrition Water and Sanitation in Haiti and Guatemala

Food Security: Farming In Bags

Health: We Advocate Breastfeeding

Advocacy: Working In Politically Charged Zimbabwe

Contributors

Financials

Where We Work

In-Kind Contributions

25

ACTION AGAINST HUNGER2005 ANNUAL REPORT �Photographs (from left): BlAzEj MIkUlA; RICHARd MOSS; BlAzEj MIlUkA; BlAzEj MIlUkA; jEAN lAPEGUE, AGENCE VU; jAMES POMERANTz Photographs (from left): ACF-SUdAN; BURGER/PHANIE; ClAUdINE dOURy, AGENCE VU; ACF-PAkISTAN; STEPHANIE BOUAzIz; ACF-PAkISTAN; BURGER/PHANIE

ACF International Network

ACF’s International Charter of Principles

ACTION AGAINST HUNGER2005 ANNUAL REPORT2

he year 2005 was a year of growth for Action Against Hunger in our efforts to eliminate hunger in the world. And the year put us to the test with a seemingly endless series of natural disasters.

We were on the frontlines racing to beat the arrival of winter following the major earthquake that struck Pakistan in October. We provided food, tents, and water to those rendered homeless by the magnitude 7.6 quake. We continued our efforts to rebuild in Sri Lanka and Indonesia after the December 2004 tsunami, moving to the rehabilitation phase in which we’re providing the tools necessary to restart fishing and farming activities. And we warned the world of impending droughts in Mali, Niger, and the Horn of Africa through our early warning systems that constantly monitor water, crop, and nutrition status.

These activities—demonstrating our improved emergency response capacity—were a result of the cooperative efforts of the ACF International Network, comprised of headquarters in New York, London, Paris, Madrid, and, as of August 2005, in Montreal. The five headquarters work together to maximize our efforts by pooling resources across borders. In Pakistan, for example, led by the New York headquarters, we were able to bring in staff variously overseen by our New York, Paris, London, and Montreal offices; monetary resources from New York, Paris, and Madrid; and supplies from Paris and New York. The result: We were on the ground delivering assistance within 48 hours of the earthquake.

During 2005, we also saw positive changes in the countries where we work that enabled us to grow. The Democratic Republic of the Congo prepared for elections scheduled for July 2006; the accompanying peace allowed us access to more areas of the country that were previously insecure and permitted us to shift the emphasis in some of our programs from lifesaving to life rebuilding. Similar changes are happening in southern Sudan with the signing of a peace accord in January 2006; refugees are returning to their homes, some of whom have not seen their native land in 10 to 20 years. Most will need our help to rebuild their lives.

By rebuilding lives we will truly beat hunger—attacking its causes through our programs in nutrition, water and sanitation, food security, basic health care, and advocacy. These provide the tools and training to save lives, to restart livelihoods, and to restore dignity to more than 4 million beneficiaries every year.

major event in 2005 for Action Against Hunger was the launching of programs in Pakistan in response to the 7.6-magnitude earthquake that struck in October. A primary reason that we were able to accomplish this so quickly and so

well is due to our experienced and motivated staff. Action Against Hunger transferred international staff to Pakistan from throughout its international network, especially those who had worked in previous disasters including the recent tsunami in Asia. In addition, we found a large pool of skilled Pakistanis ready and willing to join us. With our team in place, we were able to inaugurate programs quickly that provided food, shelter, and water to tens of thousands of earthquake victims and to continue providing that assistance throughout the harsh winter even while our staff lived in tents pitched in six feet of snow and two feet of mud.

Our staff comes in many shapes and forms: headquarters, international, national, and volunteer; administrative, technical, supervisory, finance, and general; fulltime and part-time. Our staff comes from all over the world: USA, France, Italy, Congo, Kenya, Cambodia, and more. Our staff includes water engineers, nurses, MBAs, agriculturalists, and logisticians. Our staff hones its skills in the field, sometimes rising through our ranks to become program directors or to work as part of our international staff. Our staff also includes volunteers who provide necessary pro bono work at our headquarters.

What ties them all together is their belief in the need to end hunger in the world, their dedication, and their professionalism. Put this together with our 26 years of experience fighting hunger in the field and you get well-run programs that are adapted to the specific needs of beneficiaries living in a variety of environments and under many different conditions. Everyone’s exemplary and frequently selfless performance explains how our modest resources assist more than 4 million beneficiaries every year.

LETTER fROm ThE ExEcUTivE diREcTOR LETTER fROm ThE PREsidENT

Cathy SkoulaExecutive Director

Burton K. HaimesPresident

Cathy Skoula Executive Director

Operations

David Blanc Program Director

Roger Persichino Desk Officer

Marie-Sophie Simon Nutrition Coordinator

Devrig Velly Food Security Coordinator

Jeanette Bailey Office Assistant/ Operations Assistant

Finance

Patrick Mouton Finance Director

Nelger Rios Accountant

Hamouta Yattara Field Comptroller

Human Resources

Philippe Rosen Human Resources Director

Kiera Downes-Vogel Human Resources Coordinator

Sarah Favorite Human Resources Administrator

Brendan Tronconi Office Manager/ Human Resources Assistant

Development and Communications

Randall Chamberlain Development and Communications Director

John Sauer Communications Manager

James Phelan Website and Database Manager

Erica Sackin Development and Communications Coordinator

BOARd Of diREcTORs

Burton K. Haimes, Chair Partner, Orrick, Herrington & Sutcliffe LLP

Raymond Debbane, Vice Chair President, The Invus Group, LLC

Joseph G. Audi, Treasurer President and CEO, InterAudi Bank

Alexis Azria Writer

Henri Barguirdjian President, Graff USA

Cristina Enriquez-Bocobo President, Enriquez-Bocobo Constructs

Yves-André Istel Senior Advisor, Rothschild, Inc.

Ketty Maisonrouge President, Ketty Maisonrouge & Company, Inc.

Daniel Py President, Medical-Instill Technologies

Patrick Siegler-Lathrop PSL Conseil

Cathy Skoula, Secretary (ex-oficio) Executive Director, Action Against Hunger USA

AdvisORy cOUNciL

Christian Blanckaert Président Directeur Général, Hermès

Harold A. Bornstein Vice President, Charles H. Greenthal & Co.

Olivier Cassegrain Managing Director, Longchamp

Sabine Cassel

Prof. Michael Golden Professor Emeritus, Aberdeen University

Iman Impala Inc.–Iman Cosmetics

Frank McCourt Author

Achim Moeller Achim Moeller Fine Art

Robert W. Rudzki President, KIBAN Corporation

Edward M. Sermier Vice President, CAO and Corporate Secretary, Carnegie Corporation of New York

Rick Smilow President, The Institute of Culinary Education (ICE)

Dr. Ronald Waldman Professor, School of Public Health, Columbia University

Jessica Weber President, Jessica Weber Design

Wendy C. Weiler Partner, Argosy Partners

Nina S. Zagat Co-Founder and Co-Chair, Zagat Survey

Tim Zagat Co-founder, Co-Chair & CEO, Zagat Survey

TA UsA hEAdqUARTERs sTAff

Action Against Hunger’s programs ensure effective assistance by targeting the most vulnerable and working directly with communities to develop strategies that restore dignity and self-sufficiency for the long term.

Photographs (from left): BlAzEj MIkUlA, BURGER/PHANIE, BURGER/PHANIE, ACF-FRANCE ACTION AGAINST HUNGER2005 ANNUAL REPORT 5ACTION AGAINST HUNGER

2005 ANNUAL REPORT�

Action Against Hunger’s programs reach more than 4 million people each year. Yet with an estimated 852 million people suffering from hunger and some 1.1 billion people lacking sufficient drinking water, much work remains to be done. Action Against Hunger’s innovative approach integrates nutrition, water and sanitation, food security, basic health care, and advocacy programs.

GuatemalaHondurasNicaragua

Bolivia

London HEAdqUARTERS

Paris HEAdqUARTERS

Madrid HEAdqUARTERS

WhERE WE WORK

ThE Acf iNTERNATiONAL NETWORKAction Against Hunger USA is part of the ACF International Network, named for the original member of the network, Action contre la Faim, or ACF, founded in 1979 in Paris. Today, the network consists of five independent organizations: Action Against Hunger USA (ACF-USA) in New York; Action contre La Faim (ACF-France) in Paris; Acción contra el Hambre (ACF-Spain) in Madrid; Action Against Hunger UK (ACF-UK) in London; and Action Contre la Faim/Action Against Hunger Canada (ACF-Canada) in Montréal. The network shares an overall vision of a world without hunger, and the five member organizations collaborate closely, sharing human resources, logistics, and technical capacity. Each country program is managed by one of the five member organizations.

NUTRiTiONOur Therapeutic Feeding Centers save the lives of severely malnourished children and adults who may be just hours away from death. Action Against Hunger developed, field tested, and pioneered the now widely used therapeutic milk formula F100, which has decreased the mortality rate of severely malnourished children under the age of 5 from as high as 25 percent to as low as 5 percent. We also operate Supplemental Feeding Centers, distributing nutritionally balanced food supplies to treat malnutrition before it becomes life-threatening.

WATER ANd sANiTATiONEvery year, 2.2 million people, most of them children, die from diseases associated with unsafe drinking water, inadequate sanitation, and poor hygiene. Action Against Hunger provides access to safe drinking water by tapping springs, drilling wells, and installing water systems. We also teach the importance of water and sanitation in preventing disease, and train local teams to maintain water and sanitation equipment.

fOOd sEcURiTyTreating malnutrition is only the beginning. Action Against Hunger combines emergency relief with programs that develop dependable sources of food and income. By providing seeds, tools, and training programs for income-generating activities such as farming, gardening, animal breeding, fishing, small-scale retailing, and food conservation, we work to help communities attain long-term self-sufficiency.

hEALThHunger and disease are inextricably linked. Action Against Hunger’s staff includes experts on the medical aspects of malnutrition, tailoring our treatment to ensure that malnourished children and their families receive not only the food they need to regain their health but also medical treatment for diseases associated with malnutrition. We also integrate health initiatives into all of our other programs, and are on the cutting edge of research on the links between HIV/AIDS and hunger.

AdvOcAcyAction Against Hunger continually analyzes the fundamental causes of hunger and publicizes our findings to government officials, international organizations, and the public. Our advocacy and public awareness efforts aim to effect institutional and cultural changes to help create a world without hunger.

OUR PROgRAms

Argentina

Colombia

Haiti

MontreaL HEAdqUARTERS

new York HEAdqUARTERS

Mali

Ivory Coast Liberia Sierra LeoneGuinea

NigerChad

North Sudan

South Sudan

DemocraticRepublic

of the Congo

Ethiopia Somalia

Kenya

UgandaBurundiMalawi

Zambia

Zimbabwe

Angola

Iran Afghanistan

Tajikistan

North Caucasus

Georgia

Armenia

Azerbaijan

Nepal

Sri Lanka

MyanmarLaosCambodia

Philippines

Mongolia

Indonesia

PalestinianTerritories

Pakistan

Our comprehensive, cost-effective approach to global hunger delivers a range of community-centered solutions to populations in crisis

4billion people lack sufficienT drinking waTer

million people benefiTed from acTion againsT hunger’s life-saving programs in 2005

852million people suffer from hunger

1.1Photograph: BURGER/PHANIE ACTION AGAINST HUNGER

2005 ANNUAL REPORT �ACTION AGAINST HUNGER2005 ANNUAL REPORT�

highLighTs: 2005REsPONdiNg TO dEvAsTATiON iN PAKisTAN

Action Against Hunger’s most daunting challenge during 2005 was the launching of programs in Pakistan at a time of extreme urgency. On October 8, a 7.6-magnitude earthquake killed an estimated 73,000 people and leveled villages across Afghanistan, India, and Pakistan, with Pakistan the most affected by far. The United Nations estimated that 4 million people were affected, whereas 2.5 million were left homeless in Pakistan. Their needs were vast, including blankets, drinking water, food, and winterized tents. Complicating the emergency was a Himalayan winter expected to arrive in full force at any moment.

Within a week we had established program headquarters in Islamabad and had flown 30 tons of food and water supplies to desperate beneficiaries. During the next few months we distributed shelter items (blankets, tents) and hygiene kits (soap, toothpaste) and established emergency water routes to more than 33,000 people in hard-hit and difficult-to-access areas surrounding Battagram and Bala Kot.

Meanwhile, temperatures in Pakistan hovered between -2 and 10 degrees Celsius, the ground alternated between frozen solidity and mud, snow fell heavily, and cases of pneumonia among the displaced tripled. Landslides blocked roads, so our team used helicopters to reach remote villages in Allai and Kahgan Valleys where we distributed 25 tons of food per day throughout the winter. Some refugees managed to reach camps at lower altitudes where we installed latrines and sanitation facilities. At year-end, our efforts continued.

WE PiONEER NEW TEchNOLOgy

In 2002, the U.S. Agency for International Assistance (USAID), in collaboration with other agencies in the U.S. and Canada, initiated the SMART Initiative. SMART is an acronym for Standardized Monitoring and Assessment of Relief and Transitions.

The idea behind SMART is to standardize measurements of humanitarian crises so that calls for aid will be seen as authoritative and so that donors can assess relative needs. In addition, as indicators of a crisis recede, the technology can signal that the emergency has passed. SMART software analyzes three measures of a troubled community: death rates, instances of malnutrition in children younger than five and levels of food security.

In 2005, the creators of SMART asked Action Against Hunger to field-test its new software, and we helped refine the initiative’s technology in Chad. In doing so, we also helped create the protocol for using SMART, and now the creators want us to teach that protocol to other aid organizations.

OUR PROgRAms REscUEd ThOUsANds fROm sTARvATiON

Our name informs the world that Action Against Hunger feeds beneficiaries—more than 4 million every year. But our most notable skill is giving life back to the dying victims of starvation through our internationally recognized protocols: our Therapeutic Feeding Centers (TFCs) provide an intensive month-long set of medical procedures and nutritional protocols designed for those desperately sick beneficiaries suffering from severe acute malnutrition; our Supplemental Feeding Centers (SFCs) are designed for the moderately malnourished and provide additional rations for those who need help but aren’t on the brink of death. In 2005, the TFCs and SFCs supervised by Action Against Hunger’s U.S. headquarters alone treated 51,550 patients. Some 84.2% of these beneficiaries were treated for moderate malnutrition. On average, we treated 680 children a month in our TFCs during 2005 and 11,000 in our SFCs. We operated 17 TFCs and 69 SFCs on average during the year in all seven countries where we work, and in March 2006 we opened several SFCs and baby-feeding tents in Pakistan.

In 2005, the beneficiaries of our feeding centers were distributed as follows: Chad, 1%; D.R. Congo East, 15%; D.R. Congo West, 10%; Kenya, 20%; South Sudan, 1%; Tajikistan, 22%; Uganda, 31%

OUR gALA hONOREd dEsmONd TUTU

On November 11, at our annual World Food Day Gala in New York City, producer/director Terry George (Hotel Rwanda) presented the Action Against Hunger Humanitarian Award to Archbishop Desmond Tutu. We honored the Nobel prize-winning archbishop for his efforts not only to achieve political equality but also to fulfill basic human needs such as adequate food, clean water, and healthcare.

In addition to hearing from Archbishop Tutu and Mr. George, 350 attendees were entertained by World Music diva Angélique Kidjo and heard deeply felt, first-hand testimony about our programs in Africa from Action Against Hunger’s National Staff Member of the Year, Aimé Lukelo, our Food Security Coordinator in Kinshasa, D.R. Congo.

The sold-out, glittering, formal evening raised more than $500,000 for our programs from ticket sales, an auction, and a wishing well that elicited specific donations for such essentials as drinking wells, medicines, and kits for farming and fishing activities.

ThE mEdiA fOcUs ON OUR gLOBAL EffORTs

In the summer of 2005, to avert a famine that the UN warned could affect a population of 2.5 million—including 800,000 children—Action Against Hunger distributed more than 4,000 tons of food in Mali and Niger. A prolonged drought had increased the vulnerability of pastoralists who wander in search of water and grazing land for their livestock. In addition, our international network set up Supplementary and Therapeutic Feeding Centers to treat severe infant malnutrition, and we constructed and rehabilitated water sources for people and animals.

One of our longstanding volunteers, media consultant and TV news reporter Kiran Khalid, advised Action Against Hunger on our media strategy during the crisis. Working with Action Against Hunger’s Communications staff, it was decided that the crisis in Mali and Niger deserved a segment on TV newscasts, so Kiran volunteered to travel there as a reporter, paying her own way. Our network of volunteers led us to cameraman Richard Rowely, who signed up to travel with Kiran, bringing his own editing equipment so that he and Kiran could assemble segments in the field.

As a result, for the first time we produced our own TV news spots. Ms. Khalid’s reports appeared on CNN International, and Reuters made them available to local TV stations around the world. After that, our intrepid news reporter and cameraman edited their footage into a short film, The Hunger Gap, which was honored by inclusion in the annual UN Film Festival in New York City in April 2006.

WE RALLiEd iN WAshiNgTON

On October 15, we held a public exhibition at Dupont Circle in Washington, D.C., in support of World Food Day, a UN designated day which brings attention to the issue of world hunger. Borrowing a tradition begun by our Paris office, volunteers set up 50 standing silhouettes in an open space. Then, beginning at noon and continuing until 3 p.m., every four seconds we sounded a gong, and a volunteer overturned one of the silhouettes. This symbolized the reality that a hunger-related death occurs every four seconds. After each of the 50 silhouettes had been toppled, they were set back up again, and the process was repeated.

The Congressional Hunger Center, a bipartisan anti-hunger training and awareness organization co-chaired by Rep. Jo Ann Emerson (R-MO) and Rep. James P. McGovern (D-MA), helped us arrange this event, and Rep. McGovern, a fifth-term Congressional veteran, spoke fervently at the rally about the challenge posed by world hunger.

OUR iNvALUABLE vOLUNTEERs

We are deeply grateful for the professional and general support we receive from our growing network of volunteers who help us in more ways than we can count. In 2005, for example:

• Diverse professionals gave us legal advice, while others kept our computers running.

• Professional newscasters volunteered to assemble video reports on our operations in the field and managed to get their reports highlighted in media newscasts worldwide.

• Other pros designed and edited our annual report, our brochures, our website, and our e-newsletters. They lent their expertise to our marketing and fundraising, helping us produce a 15-fold increase in our online donations between 2004 and 2005.

• In January, restaurateurs volunteered a portion of their receipts in support of our rescue efforts in response to 2004’s tsunami that devastated Indonesia and Sri Lanka.

• And general support volunteers arrived daily in our offices to assist us with such tedious chores as data entry and envelope stuffing.

During 2005, interest in helping our programs grew so intense that we initiated semi-monthly volunteer nights at which we describe our work and explain how newcomers can help us. The generosity of all our volunteers who contribute their time and labor was and continues to be of incalculable value.

Father and Daughter amid the aftermath

of the earthquake in Pakistan.

51,550severely and moderaTely malnourished paTienTs were TreaTed aT our TherapeuTic and supplemenTary feeding cenTers in 2005

These ‘before-and-after’ photos are of a little girl named Habiba who was treated for 30 days at an ACF therapeutic feeding center in Mandera, Kenya—a powerful visual illustration of the life-saving work our teams carry out every day. Staff and

beneficiary at an ACF Therapeutic

Feeding Center in Kinshasa,

Congo.

Photographs (clockwise from left): jAMES POMERANTz, GlENN HUGHSON (2) Photographs (from left): BURGER/PHANIE, TINA BUCkMAN ACTION AGAINST HUNGER2005 ANNUAL REPORT �ACTION AGAINST HUNGER

2005 ANNUAL REPORT�

ACTION AGAINST HUNGER2005 ANNUAL REPORT10 ACTION AGAINST HUNGER

2005 ANNUAL REPORT 11

With programs and staff in more than 40 countries, Action Against Hunger is well-positioned to respond quickly.

For example, when the catastrophic tsunami of 2004 ripped through South and Southeast Asia, killing hundreds of thousands and wreaking unprecedented destruction, our emergency teams arrived within 48 hours in the hardest-hit areas of Sri Lanka and Indonesia. In the first 15 days, we dispatched five aircraft that delivered 150 tons of supplies. Our water-and-sanitation teams helped restore water supplies by providing emergency fresh water as well as cleaning water sources polluted by the tsunami waves. We also established disaster preparedness programs in Aceh designed to reduce the vulnerability of Indonesians to future floods.

RAPid REsPONsE cAPABiLiTiEs: POsT-EARThqUAKE PAKisTANWith emergency teams on call, and essential supplies stored at staging grounds

in Europe, we can travel swiftly to anywhere in the world when the need arises. Our emergency response team is made up of highly trained professionals, experts in disaster relief and rapid response. Our team members are on-call 24/7, ready to act as soon as they’re needed. Once dispatched to an emergency, the response team undertakes rapid assessments, defining where and how to distribute relief, and to evaluate what kind of aid is most needed.

Action Against Hunger tested its emergency response capabilities following the devastating 7.6-magnitude earthquake that struck Pakistan in October 2005. Within hours, we dispatched a surveyor to the scene and began assembling a team to assist the estimated 2.5 million Pakistanis in need of aid to feed themselves and to survive the severe Himalayan winter. The team first embarked on an assessment of two areas within the damaged region. Answering logistical questions, such as how to transport food aid, supplies, and staff, as well as how

Our International Network maintains an emergency response team with an array of capabilities in surveillance, rapid response, and emergency preparedness.

Disasters often strike repeatedly in the same region, because of recurring weather patterns, political instability, poor infrastructure, and poverty. The most vulnerable and impoverished countries generally suffer the most from such emergencies.

Through disaster surveillance and rapid response systems, we can monitor emergency hot spots, build buffer stocks of potential supplies, and put staff on the ground, often before a crisis hits. We carry out this monitoring in part with a Geographic Information System (GIS) that produces a computerized analysis of factors such as available pasture, agricultural production, population movements, market prices of staple foods, and water sources. GIS integrates this complex data into illustrative maps of our program areas.

cycLicAL EmERgENciEs: REsPONdiNg iN mALi ANd NigERIn late 2004 our GIS data warned us of a looming nutritional crisis in Mali, and by early 2005 we had alerted Mali’s government of trouble ahead. At the time, Action Against Hunger’s nutritional surveys found rates of global acute malnutrition at 15%. Internationally, a rate of 10%

constitutes an emergency. The “hunger gap,” a span of months between the depletion of last year’s harvest and the reaping of this year’s crops, is a chronic problem in Mali and many other countries. For Mali in 2005, the hunger gap began much earlier than usual, and Action Against Hunger joined other humanitarian organizations in calling on the international community to address the situation before it turned into a crisis.

We’ve been present in Mali since 1996, and we responded to the growing malnutrition rates with programs in emergency nutrition and food security targeted at the most vulnerable populations in the regions of Gao and Kidal. We also expanded our emergency services in neighboring Niger, a country facing a similar nutritional crisis, far in advance of broad action by the international community. Our surveillance and response efforts helped successfully mitigate the impact of the crisis, and our emergency programs reached more than 276,000 beneficiaries.

cATAsTROPhic EmERgENciEs: TsUNAmi-AffEcTEd AsiAWhile some emergencies, such as a hunger gap, are cyclical and possible to anticipate, others arrive with no warning, often causing catastrophic damage. When disaster strikes, the most effective aid delivers immediate relief—the first 24 to 48 hours are critical for people displaced, injured, or otherwise affected by natural disasters and large-scale emergencies.

ARTIClES

After more than 25 years of responding to situations arising from war, conflict, and natural disaster, Action Against Hunger has learned that the most effective response to an emergency is to be there before it happens.

EmERgENcy REsPONsE

(Clockwise from top) Malnourished children being treated at an ACF Therapeutic Feeding Center in Malawi; ACF staff prepare the pre-mix for the nutritional food at a Supplementary Feeding Center in Malawi; Boxes of the therapeutic F-100 milk arrive for beneficiaries in south Sudan; ACF airlifts vital supplies to earthquake-ravaged regions of Pakistan.

to coordinate information and resources with other aid organizations working in the region, is central to the implementation of effective, efficient programs.

Through an assessment of the damaged region, our team of experts identified the hard-hit and difficult-to-access areas surrounding Battagram and Bala Kot and the mountain valleys of Allai and Kaghan as most appropriate for our emergency relief programs. Our logistics coordinators had to determine the fastest, safest way to transport food and supplies to desperate beneficiaries. With the rugged, mountainous terrain further compromised by landslides and other earthquake fallout and many of our target areas far from roads and unreachable by truck in the best circumstances, helicopters proved the best option to carry out short-term distributions. We distributed emergency hygiene kits, blankets, and tents, in addition to food and water supplies. Like the choice of helicopters for transport, our emergency response team had to use the results of their assessments and expert knowledge to make swift decisions in all aspects of program formation, a process that usually requires months of careful planning under non-emergency circumstances.

Action Against Hunger’s emergency response initiatives proved to be a significant part of our work in 2005. Disaster surveillance, rapid-response mechanisms, and emergency preparedness capabilities place Action Against Hunger at the forefront of disaster relief. All of our emergency response programs include longer-term components designed to provide training and to help local communities better prepare for and mitigate future crises. For survivors of natural disasters as well as chronic emergencies of drought and malnutrition, self-sufficiency is the most powerful tool for rebuilding after disaster. n

276,000beneficiaries assisTed by acf in niger

43counTries currenTly hosT acTion againsT hunger relief and developmenT programs

150meTric Tons of emergency supplies, waTer-saniTaTion equipmenT, and food raTions were airlifTed To indonesia and sri lanka wiThin 48 hours of The devasTaTing 2004 Tsunami

Beneficiaries of ACF’s life-saving programs in Mali

Photograph: HEdy IP Photographs (clockwise from top): ATwOOd/AGENCE VU (2), BlAzE j MIkUlA, RICHARd MOSS

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On January 9, 2005, a peace agreement between the Government of Sudan and the main southern rebel organization, the Sudan People’s Liberation Movement, ended a fierce civil war that ravaged southern Sudan for 21 years. An estimated two million Sudanese lost their lives during the civil war while some four million have been displaced.

And while the peace agreement has raised hopes for greater peace and stability in southern Sudan, restoring self-sufficiency has proved to be a daunting task. Action Against Hunger’s teams have long carried out extensive surveys documenting the nutritional problems in the south; indeed, our teams provide the only comprehensive understanding available of malnutrition in southern Sudan, which forms the basis of our broader advocacy efforts in the region. Our surveys have consistently uncovered global rates of malnutrition that rank among the highest in the world, and whereas the peace process is a crucial development, it hasn’t meant greater health and security as of yet—in fact, thousands of Sudanese have begun returning home only to find new problems and scarce resources.

Acknowledging the challenge, in 2005 Action Against Hunger began extensive nutritional training of local and international non-governmental humanitarian organizations, teaching our state-of-the-art protocols for curing and preventing malnutrition to

international and national aid workers alike. In addition, we opened facilities in southern Sudan with two new Therapeutic Feeding Centers (TFCs) and Home Treatment Centers in the Bahr-el Ghazal region.

Malnutrition is life-threatening because it’s often associated with other complications such as dehydration, hypoglycemia, hypothermia, and infection. Malnourished patients are particularly vulnerable to infection because of the poor inflammatory response, changes in body composition, loss of energy reserves, and vitamin and mineral deficiencies associated with hunger.

To treat these conditions, our TFCs form the core of our emergency rescue programs in southern Sudan and elsewhere. At our TFCs, treatment is divided into three phases:

• Initial Acute Phase: We begin feeding patients immediately with the F-75 therapeutic milk, which is the only food a malnourished child’s system can tolerate. (Sugar water is sometimes given to children as an initial stop-gap while the F-75 formula is being prepared.) Small doses of F-75 are given eight to 12 times a day which restores the body’s basic metabolic functions without overtaxing weakened bio-cellular mechanisms. If diseases are present, the patient receives appropriate medications. This phase can last a week or more.

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• Intermediate Phase: This phase lasts for four days and involves five to eight meals daily. The only food given is F-100 therapeutic milk, which has a greater concentration than F-75 has of energy-supplying nutrients, lipids, and proteins. Both the F-100 and F-75 formulae were developed by members of our Scientific Committee and field tested by ACF.

• Rehabilitation Phase: This lasts for 15 to 20 days. A patient’s meals are cut back to six a day, and patients one-year-old and up are given, along with F-100 milk, a porridge most commonly made from corn flour, soya flour, oil, and sugar.

Typically, these three phases together last for one month. Then, if weight-gain has been satisfactory (patients weigh at least 85% of their expected weight), patients are discharged to their homes and asked to return periodically for monitoring during the following three months. Discharged patients are also enrolled in our Supplementary Feeding Centers (SFCs)—for the treatment of moderate malnutrition—where they and their family receive supplemental food rations to augment the household diet, thereby ensuring that the discharged patient continues to recover.

In 2005, our TFCs in southern Sudan cured more than 80% of their beneficiaries, most of whom were on the brink of death when they arrived. Some 3% of the children in our TFCs suffered from severe medical complications and were referred to other medical care facilities because of underlying

diseases (malaria or respiratory tract infections being the most common). Other patients simply left our program in mid-stream against our advice—individuals for whom our home treatment options may be better suited.

Because we require a caretaker to remain with a child throughout treatment in a TFCs, family demands on the caretaker (usually a child’s mother) can sometimes make 30 days of treatment impossible. So in recent years, we’ve initiated home treatment programs. A malnourished child must remain at a TFC for the first week of treatment, but after that, the child’s mother is instructed how to feed her recovering child at home according to our therapeutic regimen of either BP-100 or Plumpy’nut—two ready-to-eat products with the same nutritional composition as F-100. Action Against Hunger workers visit the child at home to ensure that recovery is continuing, and the child must return to the TFCs weekly so that his or her weight gain can be measured accurately. In south Sudan during 2005, our home care programs produced a cure rate higher than 90%.

We’ve seen substantial success at our centers and in our training of other humanitarian workers in southern Sudan, but malnutrition remains at dangerously high levels. Meanwhile, in addition to curing beneficiaries, we’re training local residents to take over our operations so that the community can meet its own needs without our assistance. In all our programs in southern Sudan and elsewhere, we work to support municipal health structures, coordinate with existing government services, and build capacity in local institutions to ensure that our programs are sustained over the long run—long after we’ve left the area. We’ll cede administrative control just as soon as we feel confident that local institutions will be able to continue the work we’ve begun, thus, recruiting and training local staff is an integral part of all of our nutrition programs. n

Action Against Hunger’s methods for identifying and rescuing starving populations have become the world’s standard. The World Health Organization, for example, recommends our therapeutic rescue protocols in the treatment of malnutrition. We replicate these procedures everywhere we operate, and the thoroughness of our approach can be seen in our efforts in southern Sudan in 2005.

In 2005, our TFCs in southern Sudan cured more than 80% of their beneficiaries, most of whom were on the brink of death when they arrived.

percenT cure raTe produced by acTion againsT hunger’s home care programs in souThern sudan in 2005

million displaced by The civil war in sudan, which ended in 2005 afTer 21 years4 90Beneficiaries in Malawi await a

meal at an ACF Supplementary Feeding Center.

Photograph: ATwOOd/AGENCE VU

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In developing countries, 2.2 million people, most of them children, die every year from diseases associated with unsafe drinking water, inadequate sanitation, and poor hygiene.

(1) Displaced communities in northern Uganda celebrate the inauguration of a new ACF hand pump; (2) ACF’s water and sanitation teams operate a drilling rig to create a borehole for clean water in Uganda; (3) Our teams construct water sources and distribution networks for hurricane-affected communities in Haiti; (4) ACF’s emergency interventions ensure access to clean water, a first line of defense in mitigating a natural disaster.

A community’s health and nutrition require a lasting supply of clean water and the knowledge of how to use and care for it properly. People, of course, as well as farm animals and crops, require water to avoid dehydration—which in a few hours can kill a child locked in a hot car or an athlete exercising vigorously in intense sun. Equally important, the water must be clean because communicable diseases thrive in dirty water. Contamination spreads cholera, hepatitis A and E, meningitis, polio, shigella, and typhoid fever. Intestinal parasites lurk in impure water waiting to colonize the intestines of unsuspecting drinkers, and mosquito-borne illnesses including malaria and yellow fever can spread when stagnant ground water allows insects to breed. And as every medical professional knows, the single most effective way to prevent the spread of disease is to scrub your hands thoroughly using soap and clean water. One study concluded that simply having people wash their hands could save the lives of more than a million children each year.

All of our programs at Action Against Hunger require the availability of clean water. When it isn’t available, we bring it in—by truck, if necessary, but also by tapping natural sources such as springs, aquifers, lakes, and streams. Our teams dig wells (when water is

near the surface) or boreholes (when it’s deep), and even construct distribution networks.

Water and sanitation is at the core of all our programs, but during 2005 we responded swiftly to emergencies caused by hurricanes in Haiti and Guatemala that destroyed water-and-sanitation infrastructure in many communities.

During July, Haiti endured winds and torrential rains that caused mudslides and demolished local water-and-sanitation networks—which were already damaged from rains earlier in the year. In the hardest-hit communities, Haitians had no safe drinking water, and drainage systems were overwhelmed. During 2005 in Port-de-Paix, for example, Action Against Hunger set up 37 water sources and 77 latrines to serve 40,000 beneficiaries. There and elsewhere in Haiti, we also installed wastewater treatment plants and drinking water fountains, and we distributed kits for house-cleaning and hygiene.

In October, a hurricane struck Guatemala, severely damaging local infrastructure and leaving isolated communities without safe water, food, or basic health care. In response, we sent 10 water tanks, 100 kilograms of water-treatment chemicals, electric generators, and water pumps. We were at one point supplying

five liters of water per day to 50,000 people.Years of experience, however, have taught us

that simply creating and rehabilitating water structures is insufficient. In order to ensure that a source of clean water is sustained and that the water is used effectively, we must also educate communities about keeping their water, hands, and environment sanitary. In both Haiti and Guatemala, therefore, in addition to building and rehabilitating water-and-sanitation systems, we organized and trained local water committees to manage and maintain those systems independently.

Though each of our humanitarian interventions presents its own particular challenges, our response in Haiti and Guatemala typifies our approach everywhere, which combines rescue, rehabilitation, and training to ensure self-sufficiency. Year after year, those procedures prove successful. n

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ACF water source serving

beneficiaries in hurricane-

ravaged Haiti.

40,000beneficiaries in porT-de-paix, haiTi, had clean waTer and basic saniTaTion resTored when acf seT up 37 waTer sources and 77 laTrines afTer a hurricane.

WATER ANd sANiTATiON iN hAiTi ANd gUATEmALA

liTers of waTer per day were provided To 50,000 guaTemalans by our emergency waTer-and-saniTaTion programs afTer a hurricane severely

damaged local infrasTrucTure. acTion againsT hunger airlifTed criTical supplies, waTer-TreaTmenT chemicals, waTer Tanks, elecTric generaTors, and waTer pumps To The region To supporT communiTies lefT wiThouT safe drinking waTer, food, or basic saniTaTion

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Photographs: (1, 2) MIkE wOlF. (3, 4) ACF-FRANCE Photograph: ATwOOd/AGENCE VU

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Action Against Hunger has been active in Uganda since 1997, and in 2004 we launched a pilot project in microgardening at two local camps, which we expanded to five camps during 2005. The project involved planting vegetable seeds in large polyethylene grain sacks, which are abundant in the camps and inexpensive. Gardeners received as many as five sacks and placed banana stems in each, propped upright with rocks. After filling the bags with soil, gardeners removed the stems and planted seeds in the top of the bag as well as in the sides, maximizing the productive surface of the bag.

Altogether, more than 2,800 sack gardens were planted during 2005. We trained participants using a demonstration garden in each camp, teaching construction of microgardens, maintenance, and vegetable harvesting. After the training, we gave each household a watering can and a kit containing seeds for carrots, climbing beans, onions, spinach, and tomatoes. The climbing beans were intended as a solution to the lack of space in displacement camps: Beneficiaries used their huts as supports for the tomato and bean vines.

Nearly all the participants were women, each of whom constructed sack gardens near her household. The gardeners took soil and rocks from nearby areas and built fences using local materials, such as thorny bushes or bamboo.

Maintenance was minimal. Watering, planting, and weeding typically required little more than two hours a week. ACF food security staff made weekly visits to monitor the gardens and help troubleshoot.

The project had three primary goals:

• To decrease beneficiaries exposure to insecurity by reducing travel times (i.e., traveling from homes to adjacent sack gardens rather than to fields in the countryside, where there is risk of assault or abduction by rebels is great)

• To decrease the time spent on farming (e.g., the need for weeding was minimized)

• And to increase the food security options for households (i.e., they could sell the vegetables they grew, they could improve their own diets, and they could provide a bit of work for landless or idle families).

Camp residents found the project to be odd, but they participated nonetheless, and the gardens proved notably successful. Spinach, carrots, and onions grew especially well. All participants used the produce from their gardens to improve their families’ diets, and nearly half were able to sell some. The most successful gardeners prepared as many as 60 meals from their gardens, and the majority of

participants plan to continue sack gardening in the future. Many reported that they had no other land to plant and were relieved to have more food for their children. They also praised the ease of maintaining the gardens and of monitoring them to prevent loss of their produce to thieves. Many participants also found the sack gardens to be decorative.

Among the seeds we distributed, carrots were new to many recipients, but children loved them. Some parents reported that their children ate more enthusiastically whenever carrots were part of the meal. When we first introduced carrot recipes into our training, the mothers cheered.

Our project in Uganda wasn’t the first to introduce farming in sacks, but in the wake of its success, we intend to initiate similar programs elsewhere. n

hEALTh: WE AdvOcATE BREAsTfEEdiNg

The nutritional and disease-preventing benefits of breastfeeding are beyond question. Yet the practice is often distrusted in developing communities.

The simplest path to healthy nourishment for infants worldwide is complicated by each community’s attitudes toward breastfeeding. Even in the United States, the acceptability of breastfeeding seems to change every generation or so. The World Health Organization’s protocols stress that infants should be breastfed for at least the first six months of life, even while adding other liquids and solid foods after six months. Yet some cultures frown on breastfeeding a child who is older than six months, even though a longer regimen is likely to produce healthier children.

In Tajikistan, for instance, our team has organized a breastfeeding support group that advocates breastfeeding among our beneficiaries. In one village, a woman who was in labor asked an Action Against Hunger midwife to deliver her fourth baby. The midwife persuaded the mother to allow other women from her community to witness “skin-to-skin” contact after delivery. Immediately following the birth, the midwife placed the newborn on the mother’s abdomen. The baby started to seek the breast, and with guidance from the mother and the midwife, the baby started nursing. The women who were watching had been skeptical when the midwife described a newborn’s breastfeeding instinct, but this demonstration convinced them. Now the

witnesses are helping to educate other mothers in the community. The skin-to-skin mother, in turn, had bottle-fed her previous three children, but she’s successfully breastfeeding her fourth baby.

One complication in persuading mothers to breastfeed is that numerous cultures in the developing world mistrust colostrum. During the first three or four days after a child is born, a mother’s breasts produce milk that’s high in antibodies, carbohydrates, and protein called colostrum. It’s easily digestible, and the nutrition it contains is highly concentrated. It jump-starts a baby’s digestive system and protects the child from disease. In addition, when children suckle colostrum, the action helps prevent engorgement of the mother’s breasts and prompts them to produce milk more abundantly in the following weeks and months.

But colostrum is thicker and more yellow than the milk that comes later, and many cultures are suspicious of it. Until a mother’s milk becomes more “normal,” they believe that breastfeeding their children is unhealthy, though in fact newborns benefit more from colostrum than from any other food they could be given.

Often, teams organized by Action Against Hunger are able to change community opinions about colostrum. In one culture, for example, herders periodically lead their livestock away from their homes in search of food and water, but traditionally a herder will leave one animal behind for each member of his family. Sometimes this leads to female livestock being separated from their newborns. When this happens, no matter how the newborn is nourished, it grows with less hardiness than if it had fed on its mother’s colostrum, and villagers know it. When our teams point out that the same debility can result from human mothers depriving their newborns of colostrum, understanding often dawns and minds are changed.

The nutritional and disease-preventing benefits of breastfeeding are beyond question. Yet the practice is often distrusted in developing communities and sometimes in developed communities as well. Nonetheless, none of our efforts is as effective in forestalling disease and malnutrition among infants than persuading beneficiaries to breastfeed for the first 6 months. n

Beneficiaries in south Sudan learn the virtues of breast milk.

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fOOdsEcURiTy:fARmiNgiN BAgs

An estimated 100,000 people have died as a result of two decades of conflict in northern Uganda, with another 20,000 abducted by rebels roaming the bush. As a result, roughly two million displaced people are crowded into camps with little access to their former farmlands. ACF’s food security programs offer unique solutions to this problem.

ACF’s innovative food security programs offer a broad range of solutions for generating income and boosting food production—like this farming association in the Congo.

number of breasTfeeding supporT groups creaTed under acTion againsT hunger’s healTh iniTiaTives in TajikisTan

minimum number of monThs ThaT infanTs should be breasTfed according To The world healTh organizaTion’s proTocols6 25

Photograph: BURGER/PHANIE Photograph: BlAzEj MIkUlA

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ENTER hUmANiTARiAN AdvOcAcy: Acf REAssERTs ThE NEEd fOR dEPOLiTicizEd AidAs a humanitarian organization, Action Against Hunger’s mandate is to improve the lives of communities trapped in humanitarian crises—helping families get back on their feet through our nutrition, water-and-sanitation, food-security, and health interventions.

But if the larger political context undermines a population’s health and well-being or prolongs a vulnerable community’s exposure to life-threatening conditions, then ACF is compelled to address the setting in which our humanitarian programs takes place. This is an essential role of humanitarian advocacy.

Humanitarian advocacy enables non-political organizations such as ACF to operate in broader political arenas while maintaining the core values that make humanitarian action unique: independent, impartial, non-discriminatory, needs-based assessments of conditions on the ground. These are the values that should ground and inform international assistance—not the shifting agendas of political adversaries.

In Zimbabwe, relief agencies found themselves trapped between the government and the international community’s mutual mistrust while being further hobbled by the politicized conditions on the ground. The result: Humanitarian aid had become so politicized that it was no longer possible to present impartial data on the scope of the crisis, let alone to

AdvOcAcy: WORKiNg iN POLiTicALLy chARgEd zimBABWE

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Delivering more than assistance: engaging in advocacy to ensure long-term humanitarian outcomes

In short, the basic health and nutritional needs of the population were being sacrificed for political ends.

The past half decade has been particularly cruel for Zimbabwe. A debilitating mix of drought, hyperinflation, plummeting food production, soaring unemployment, shortages of consumer goods, among other setbacks have exacerbated a steep economic and social decline. Add to this a burgeoning health crisis—a sharp drop in health and social services coupled with an HIV/AIDS pandemic—and you have a recipe for a horrifying new reality: Life expectancy in Zimbabwe has plunged from 61 to 34 years in a mere decade and a half.

To make matters worse, the humanitarian dimensions of this crisis have been completely obscured by its politics: Divisive land reform has produced an impasse of hardened national and international positions, mutual suspicions, and finger-pointing that has aggravated the social emergency. The resulting polarization has had ruinous consequences for Zimbabwe’s shaky economic health, its already vulnerable populations, and its ability to access international assistance given its deteriorating relationships with the West.

ThE POLiTicAL dimENsiONs Of A hUmANiTARiAN cRisisAction Against Hunger (ACF) began its food-security and water-and-sanitation programs in Zimbabwe in 2002, during the height of a regional food crisis that extended well beyond Zimbabwe’s borders. Since then, thanks to

ample food assistance from the international community, Zimbabwe has managed to avoid a spike in its malnutrition rates even though much of its population remains precariously vulnerable. And while Zimbabwe’s problems are still largely framed as a “food crisis,” the real threat to the lives and livelihoods of poor Zimbabweans is the decimating health crisis and AIDS pandemic that currently claim some 170,000 lives a year.

Yet even as the health and economic contributions to this social emergency must be addressed, the political context needlessly prolongs and deepens the crisis.

ACF’s teams began to realize that the

political climate surrounding Zimbabwe and its international reputation was making the humanitarian situation worse. Regardless of who was ultimately to blame for the crisis, its underlying causes were not being addressed. Instead, they were overshadowed by the ongoing turmoil and political tensions stemming from the land-reform controversy. Zimbabwe’s emerging status as a pariah state and its strained relationship with the West began to color the international community’s response to the humanitarian crisis, prioritizing political considerations over needs:

• The cooperation and development funding normally available to Zimbabwe was curtailed, and international assistance was limited to emergency relief.

• Humanitarian assistance has been channeled exclusively through international organizations, bypassing support for Zimbabwe’s government services (despite the evidence of what this has meant for poor Zimbabweans).

• The areas resettled during land reform were excluded from the main aid packages, despite the areas’ central role in food production, the decimation of needed agricultural supports, and the resettled population’s ongoing vulnerability.

• Despite a devastating health crisis—an HIV/AIDS pandemic with one of the highest death rates in the world—the health sector remains acutely under-funded, even by regional standards.

In short, the basic health and nutritional needs of the population have been sacrificed for political ends, and ACF feared the crisis would deteriorate further if the overall climate were not addressed.

influence the design and direction of the humanitarian response in Zimbabwe.

What was needed, our analysis said, was to reassert a “shared understanding of the challenges faced by the communities and the priorities of assistance,” lest the vulnerable people of Zimbabwe continue to be victimized. ACF’s behind-the-scenes advocacy aims to do just that. We hope to reshape the debate on Zimbabwe’s crisis so that humanitarian action will be shielded from politics, and the international community’s priorities can tackle the underlying causes of the crisis rather than spar with the regime.

AcTiON AgAiNsT hUNgER’s REcOmmENdATiONs fOR mORE EffEcTivE AssisTANcEAction Against Hunger’s advocacy made three general recommendations for revitalizing the humanitarian response in Zimbabwe:

• To the International Community

Western governments must not impose sanctions on governments which adversely affect populations already weakened by economic crisis and climate constraints. Western governments must promote a non-discriminatory approach for assistance programs.

• To Government Donors

Rather than react to Zimbabwe’s political issues, donor strategies should integrate socioeconomic analyses and avoid any form of discrimination in assistance. The community of donors should promote humanitarian programs and recovery activities aimed at improving living conditions sustainably for all of Zimbabwe’s vulnerable communities.

• To Non-Governmental Organizations

Relief agencies must strive to get out of the political arena and give priority to relief, assistance, and recovery activities. This can be achieved through compliance with humanitarian principles such as non-discrimination and impartiality, and through sharing information and analyses related to livelihood situations.

Engaging in humanitarian advocacy ensures that organizations such as ACF can address the tensions inherent in any political context, and in the end, deliver not only direct assistance but broader humanitarian outcomes as well. n

Thousand aids-relaTed deaThs occur every year in zimbabwe, obscured by The poliTical crisis

years is The average life expecTancy in zimbabwe afTer a decade of crisis

34 170

Zimbabwean beneficiaries pose in front of a new source of clean water, built through

Action Against Hunger’s programs

Our food security and water-and-sanitation

programs in Zimbabwe are vital to the vulnerable

communities pictured here, but we can only be effective

if the overall context ensures humanitarian

outcomes.

All Photographs: ACF-FRANCE

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John DzelkalnsKevin EberlyFrancisco EchegarayKatherine EggemeierJonas FajgenbaumJeffrey FiarmanGabe FinkeSteven and Allison FischLaura FisherRandall FisherAdam and Olivia FlattoJody FleischerClaudia FlemingHeather FoleyRoger and Mary Lou FosterSteven Cancro and Lidia FoutoBurt FujishimaShawna GageJean-Louis GalliotAdam GarciaJed GarfieldElisa GattiStanley and Dorothy GawleWendy GelbartYetta and Irving GeszelRaymond GietzLucille GigantiClarice GilesTom and Beverly GillettDolores GluckRonald GoldbergerMireille and Hubert GoldschmidtMaynard GravesNicholas GroombridgeErik and Christiane GrotnessIrene HabernickelRobert HallThomas and Diana HallDavid L. HamiltonRobert HarrisonWilliam and Aline HaynesKeith Gollust and Barbara HemmerleDavid HendersonCatherine HerkovicDavid Alexander HickersonDouglas HickeyArthur and Eleanor HofferRobert and Irene HollwegDouglas Schloss and Alison HoltzschueSeth HoytRobert Spring and James HuddleDonald HultgrenEdwin HustonBradley HutchisonAlice HymanSamina IshtiaqLawrence IvesChris JacksonKatherine JacobsonScott JamesDaniel and Deborah JanesChristopher JanishJonathan Abrams and Sandra Jean-LouisGeorgios KabakisRoberta KanterKimberly Kargman

cONTRiBUTORsClifford KellerBradley and Linda KentNona KerrJason KesslerJohn MacArthur and Renee KhatamiAnthony KhuriAngelique KidjoJeffrey KingsleyBrian KinkadeMichael and Janice LallyAlain LeCoquePaul LeeNancy LeedsYves LeperlierStephanie LevaughnGianfranco and Rita LavoroneMark David LewisMichelle LewisJudith LidskyChun Ta LinPaul LindbladEmily LizcanoMichel and Odile LongchamptLisa LovedayLiliana LovellJ. Harry LynchMitzi MacDonald-LawsStephen MaimanMarita MakinenCharles-Henri and Marguerite ManginBennet Manning, Jr.Carrie MarsylaDavid MartocciaLiz MarxStephen and Patricia MasceriAndy MaunderRuth and Nathan MazurekJane McDonaldSandra McEnteeJohn McDermott and Victoria McManusStacey MednickDavid MelnikCharles Merrill, Jr.Laurie MillerMary Frances MillerAlison MinerMarti and David MinkerGerd MittmannRichard MoffittRichard and Beverly MoodyRebecca MoreyJean-Marc MorianiMargaret MoyersMegan MoynihanEnrica MurmuraDave NapeRaya NovakPatricia PacelliKara ParkerHasmukh and Bhanuben PatelMukeshkumar and Lataben PatelJay PatidarJames and Gloria PaulThomas PetersonGuy Phillips

Darcy PollackB.A. PowellCatherine PricesFrederic and Maria RagucciAnnapurna Ramanarayanan, MD.Farzad and Neda RastegarDaniel RiessMatthew RobbinsJordan RobertsThomas and Mary Alice RobertsAndrew Hamilton and Anne RobinsonDaniel RootenbergJeffrey RosemanJames and Alice RossStuart RossGreg RothDavid RouseDavid RushSharon RussellJames SageWilliam SamuelsJoan SaundersFuad SawayaOle ScheterCharles SchlangenJill SchreinerRandy SeeleyEdward and Virginia SermierMeredith and Anthony ShepherdSusan ShroyerRobert SiegelCoralis SierraLisa SilvaRonald SimonsAnna SinclairDavid SirotaLai Shan SiuJeffrey SmithQuade SmithGarrett and Jeannine SnipesMichael SnyderMiriam and Israel SoibelmanDaniel SokolnickiRon and Annette SoufrineAshley SpicerSheila SpradlinJill StanskyBrian SteinwurtzelRonald StevensJoyce StoneEdward StuartCaren SturgesErica and Patricia SugdenCarol SugimoriRobert and Sharon SwindlerJeffrey and Karen TanenbaumMatthew TateAli TayarMadeline ThomasRobert ThompsonPhornanan ThungkasemvathanaLoren TibbittsCarole TillmanMark UtayJoseph ValerioWilliam and Melinda Vanden Heuvel

Deborah VanderHeydenHenry and Margaret VosswinkelJoe WagnerRubina WahidRobert WeaverDavid WeeksHenry and Laura WeilWendy WeilerStephan WesselsChristopher Flowers and Mary WhiteRobyn WittlederEthan WohlBarry WolfP. Garrett WyckoffMichael YanceyDiana YatesMyth YorkRobert and Jeanne ZabelleWalter ZalenskiMike ZoiHossein Amirsaleh FoundationAshken Family Charitable Foundation, Inc.Carlson Family FoundationSimon & Eve Colin Foundation, Inc.Community Foundation of New JerseyCunningham-Wright Family FundDeutsche Bank Americas FoundationDJRJ fund at Fidelity Charitable Gift FundFribourg Family FoundationGlaxoSmithKline FoundationJames C. Hormel Revocable Living TrustHolland and Knight Charitable Foundation, Inc.Kenneth A. Lattman FoundationLeonard & Evelyn Lauder FoundationNaval Station Religious Offerings Funds (ROF)The News Corporation FoundationPfizer Foundation Matching Gifts ProgramPoncelet Family FundKenneth G. Prior FoundationRebold Family FundRimerman Family FoundationRyan Family TrustJennifer L. Schiff Charitable TrustSchwab Fund for Charitable GivingCharles Schwab FoundationJane Schwartz FoundationSusan Stein Shiva FoundationSeth Neiman & Lauren Speeth FoundationStrong-Cuevas Foundation Inc.Sun Microsystems FoundationVanguard Charitable Endowment Program

Weingart Family FundArlington High School Activity FundAthena GroupASAP Personnel Services, Inc.Back Office Support Systems, Inc.Bakersfield Christian High SchoolBethel Baptist ChurchBoston Copley Place MarriottBristol-Myers SquibbCapri Institute of New JerseyCentral Lafourche High SchoolClyde A. Erwin High SchoolChemcentral HQConcentra Preferred SystemCurves DimondCurves RockridgeDance Space Center, Inc.DaylilyEquus Real Estate Management Inc.Falcone & Truman Plumbing and HeatingFifth Avenue Elementary SchoolFlushing Hospital Medical CenterHenry Gunn High School Key ClubHOPE SudburyIl BucoIntegrated Management, Inc.Interior Building ServicesITG Software Solutions, Inc.Jim Boyd Construction, Inc.Joy Wok ExpressKips Bay Boys and Girls ClubKrinos Foods, Inc.Mahalaxmi Inn CorporationNemet MotorsNick & Toni’s RestaurantSkyview Tenants AssociationNorthrop Grumman CorporationNorth Shore Catamaran ChartersOakton Community CollegeO’Brien Law FirmPathways for Youth, Inc.Perelson Weiner, LLPRotary Club of Pomton LakesPMK GroupPruzan & Co., LLCRiverdale-Yonkers Society for Ethical CultureSoundToysThings RememberedThe College of New Jersey Student Government AssociationTowery Homes, Inc.UNAUSA Riverdale ChapterUnited DirectoriesWest Hillsborough SchoolThe Womens Club of New SeaburyYosemite High SchoolZodiac Pioneer Aerospace Corporation

ACTION AGAINST HUNGER2005 ANNUAL REPORT22 ACTION AGAINST HUNGER

2005 ANNUAL REPORT 2�

iNdividUALs

Angela AlstonAndrew ChenTimothy CrespiJonathan DienstKiran KhalidFiorella LavadoMatt MasonMitzi MacDonaldCynthia MejiasBlazej MilukaMargarita PecesNancy PennerJames PomerantzTraer PriceMat NortonReed RobbinsMary O’Neil BerryKaren ShunickDavid SirotaErica Zelfand

cORPORATiONs / iNsTiTUTiONs

Avenue A / RazorfishInterrupciónJ&D Labs, Inc.Lillian Lincoln FoundationThe Newspark GroupNYU Capstone ProgramPeace CerealPuppet PSA PeopleSmashing Ideas, Inc.StarChefs.comThelen Reid & Priest, LLPVrankenWeil, Gotshal & Manges LLP

2005 WORLd fOOd dAy gALA sUPPORTERs

Benefit Committee

Henry H. ArnholdDaniel BarthMarcel and Marlise BiedermannOlivier CassegrainRobert B. ChavezCharles-Henri CousinAriane DaguinOlivier GiugniDavid and Liz HindenAlison Holtzschue SchlossIda KowitValerie KriegerOlivier LebretPeter and janet LeyDeanna LittellNicholas and Charlotte MacLeanJuan Pablo MolyneuxJessica PackerJoel and Yuta PowellMarla SaboRobert and Julie SchafferBarbara Cirkva Schumacher and John SchumacherPaul and Ursula StrikerJessica WeberWendy C. Weiler and Donald E. Chappell

Epicurean Committee

Rick Smilow, The Institute of Culinary EducationChef Cornelius Gallagher, OceanaChef Andrew Gold, The Institute of Culinary EducationChef Deborah Snyder, Lever HouseAriane Daguin, D’ArtagnanChef Karl Schmid, The Metropolitan Club

sPEciAL ThANKs TO

BernardaudChanel, Inc.Chateau Lafite RothschildChateau Mouton RothschildChristain Dior, Inc.Susan EngGivenchyHermes de Paris, Inc.Hotel Plaza AtheneeJohn HardyJessica Weber Design, Inc.La Maison du ChocolatLalique North AmericaLanson ChampagneL’Olivier DowntownLuxottica GroupAlexandra LeclercLongchampThe Macallan Scotch WhiskyNicholas F. MacLean, Christie’s Auction HouseMonsieur Touton Selections, Ltd.Ruth C. Schwartz & Co. Public Relations and Events SolutionsSal AnthonySal Anthony Pilates StudioThe Scottish GourmetSmashing IdeasSwiss International AirlinesVirginie SommetStarchefs.comThe Thomas Group Printing

iN-KiNd cONTRiBUTiONs Of gOOds OR sERvicEs Acf-UsA’s sTATEmENT Of AcTiviTiEs ANd chANgEs iN NET AssETs fOR ThE yEAR ENdEd dEcEmBER 31, 2005 TEmPORARiLy UNREsTRicTEd REsTRicTEd TOTAL

REvENUE ANd sUPPORT Contributions $1,651,495 $ 1,921,308 $ 3,572,803 Grants (Note 5): U.S. Government 133,372 6,750,748 6,884,120 Non-U.S. Government 33,227 11,416,304 11,449,531 Interest 24,621 - 24,621 Other 474 - 474 Net assets released from donor restrictions (Note 6) 17,121,970 (17,121,970) -

Total revenue and support 18,965,159 2,966,390 21,931,549

ExPENsEs Program Services: Democratic Republic of Congo Programs 5,192,713 - 5,192,713 South Sudan Programs 2,033,458 - 2,033,458 Uganda Programs 3,124,967 - 3,124,967 Pakistan Programs 1,753,885 - 1,753,885 Tajikistan Programs 1,058,250 - 1,058,250 Kenya Programs 760,867 - 760,867 Chad Programs 1,403,845 - 1,403,845 Sri Lanka Programs 821,656 - 821,656 Guinea Programs 311,087 - 311,087 Mali Programs 345,073 - 345,073 Niger Programs 27,000 - 27,000

Total program services 16,832,801 - 16,832,801

Supporting services: Management and General 1,399,513 - 1,399,513 Fundraising 358,133 - 358,133

Total supporting services 1,757,646 - 1,757,646

Total expenses 18,590,447 - 18,590,447

Changes in net assets before other items 374,712 2,966,390 3,341,102 Provision for unanticipated losses (200,000) - (200,000) Exchange gain (loss) (92,605) (462,323) (554,928) De-obligated awards and funds returned to donors (20,288) (40,342) (60,630)Changes in net assets 61,819 2,463,725 2,525,544Net assets at beginning of year 1,649,078 2,540,851 4,189,929

NET AssETs AT ENd Of yEAR $ 1,710,897 $ 5,004,576 $ 6,715,473

ALL OTHERS 9%

CHAD 8%

KENYA 5%

TAJIKISTAN 6%

PAKISTAN 10%

fUNds WE cOmmiT TO ALL OUR PROgRAms

DEMOCRATICREPUBLICOF CONGO 31%

SOUTH SUDAN 12%

UGANDA 19%

Action Against Hunger’s international relief and development programs provide immediate assistance and long-term relief to malnourished children and their families. As a world leader in the treatment of malnutrition, ACF’s programs are informed by over a quarter century of cutting-edge activities in the fight against global hunger, delivering effective assistance in a wide range of countries and cultural contexts, as exemplified by these photos.

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Photographs: (1) ClAUdINE dOURy; (2) lAURENCE lEBlANC, AGENCE VU; (3) BURGER/PHANIE; (4) BlAzEj MIkUlA; (5) jANE EVElyN ATwOOd, AGENCE VU; (6) BlAzEj MIkUlA

hOW WE UsE OUR fUNds

FUNDRAISING 2%MANAGEMENT AND GENERAL 7.5%

TOTAL PROGRAMSERVICES

90.5%

AcTiON AgAiNsT hUNgER, fRANcE 4 rue Niepce 75014 Paris, FranceTel: +33 1 43 35 88 88 Fax: +33 1 43 35 88 00lgrosjean@actioncontrelafaim.org www.actioncontrelafaim.org President: Jean-Christophe RufinDirector: Benoit Miribel

AcTiON AgAiNsT hUNgER, UsA 247 West 37th Street Suite 1201New York, NY 10018 USATel: +1 212 967 7800Fax: +1 212 967 5480info@actionagainsthunger.org www.actionagainsthunger.org President: Burton K. HaimesDirector: Cathy Skoula

AcTiON AgAiNsT hUNgER, sPAiNC/Caracas, 6, 1°28010 Madrid, SpainTel: +34 91 391 53 00Fax: +34 91 391 53 01ach@achesp.org www.accioncontraelhambre.org President: Jose Luis Leal MaldonadoDirector: Olivier Longue

AcTiON AgAiNsT hUNgER, UNiTEd KiNgdOmFirst Floor, rear premises,161-163 Greenwich High Road, London, SE10 8JAUnited KingdomTel: + 44 208 293 6190Fax: + 44 208 858 8372info@aahuk.orgwww.aahuk.orgPresident: Sir Ronald GriersonDirector: Jean-Michel Grand

AcTiON AgAiNsT hUNgER, cANAdA7464 rue St DenisH2R 2E4Montréal, Quebec, Canada Tel: +1.514.279.4876info@actioncontrelafaim.cawww.actioncontrelafaim.caPresident: Diane BussandriDirector: Anne-Sophie Fournier

ThE Acf iNTERNATiONAL NETWORK

(1) Our programs reach vulnerable populations in far-flung areas like this man’s village in southern Sudan. (2) Poverty, deprivation, and chronic malnutrition are all too common, but our programs restore dignity and health, as this photo from Mongolia suggests. (3) Much of our work focuses on children under the age of five because of their susceptibility to health complications from hunger and malnutrition, as these images from Congo (3) and Malawi (4) depict. (5) This photo is of the ready-to-eat nutritional product, “plumpy’nut,” that we often use during the initial phase of a nutritional crisis. (6) We rely on the support of all kinds of people, including these young students who participate in our annual “Run Against Hunger,” raising awareness and funds for ACF’s global efforts. (7) Our therapeutic feeding centers (TFCs) take on many forms, from tents, to wooden structures, to actual hospital rooms—like this photo of a TFC in Malawi—but they all operate as intensive care units, despite their homey appearance.

OUR iNTERNATiONAL chARTER: A cOmmiTmENT TO PRiNciPLEd hUmANiTARiAN AcTiON

All members of the Action Against Hunger International Network adhere to the following humanitarian principles.

IndependenceAction Against Hunger acts according to its own principles in order to maintain its moral and financial independence. Action Against Hunger’s actions are not defined in terms of domestic or foreign policies, nor does the organization act in the interest of any government.

NeutralityAction Against Hunger maintains a strict political and religious neutrality. Nevertheless, Action Against Hunger can denounce human rights violations it witnesses as well as obstacles put in the way of its humanitarian activities.

Non-DiscriminationA victim is a victim. Action Against Hunger rejects all discrimination based on ethnicity, nationality, opinion, race, religion, sex, or social class.

Free and Direct Access to VictimsAction Against Hunger demands free access to victims and direct control of its programs. Action Against Hunger uses all means available to achieve this goal, and will denounce and act against obstacles that prevent the organization from doing so. Action Against Hunger also verifies the allocation of its resources in order to ensure that they reach those individuals for whom they are destined. Under no circumstances can partners working together with or alongside Action Against Hunger become the ultimate beneficiaries of Action Against Hunger’s aid programs.

ProfessionalismTo maximize its efficiency and use of resources, Action Against Hunger bases the assessment, conception, management, and realization of its programs on the highest professional standards and its years of experience.

TransparencyAction Against Hunger is committed to respecting a policy of transparency and disclosure for its beneficiaries, donors, and partners by making available all information on the allocation and management of its funds, and by providing independent verification of its good management.

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Photographs: (1) BlAzEj MIkUlA; (2) ClAUdINE dOURy, AGENCE VU; (3) BURGER/PHANIE; (4) jANE EVElyN ATwOOd, AGENCE VU; (5) HEdy IP; (6) jEAN lAPEGUE; (7) jANE EVElyN ATwOOd, AGENCE VUACTION AGAINST HUNGER2005 ANNUAL REPORT2� ACTION AGAINST HUNGER

2005 ANNUAL REPORT 25

Special thanks to Peter Noah for the design and production of this publication.

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51,5503.9

1,200people in The democraTic republic of congo die every day, largely from disease and food shorTages linked To six years of war and The subsequenT collapse of The congo’s healTh sysTem and economy

counTries currenTly hosT acTion againsT hunger relief and developmenT programs

million people in The world suffer from malaria, which kills one million people each year, mosT of whom are children under The age of five. simple, cosT-effecTive soluTions, however, exisT for prevenTing The needless Toll ThaT malaria exacTs on poor communiTies

people were TreaTed in acf’s TherapeuTic and supplemenTal feeding cenTers in 2005, mosT of whom were on The brink of deaTh when They arrived. acf’s humaniTarian inTervenTions resTore life, digniTy, and self-sufficiency, uniquely bridging urgenT relief wiTh longer-Term developmenT

billion people lack basic saniTaTion Today—an asTounding forTy-Two percenT of The world’s populaTion. unsafe drinking waTer, inadequaTe saniTaTion, and poor hygiene lead To a hosT of infecTious diseases and chronic malnuTriTion ThaT ulTimaTely kill over Two million children a year

million congolese have died as a resulT of conflicT since 1998, mosTly from hunger and disease

acf head-quarTers make up our inTernaTional neTwork 396 1.1

BILLION

million people suffer from hunger around The world, in boTh iTs chronic and acuTe forms. hunger and malnuTriTion kill over five million children every year, induce Tremendous suffering, and cosT poor counTries billions of dollars in naTional income and losT producTiviTy

85243 5 26

years of acf experTise in humaniTarian acTion

people lack access To safe waTer around The world, leaving Them vulnerable To daily indigniTies and frighTening raTes of deaTh and debiliTaTion

AcTiON AgAiNsT hUNgER 247 WEST 37TH STREET SUITE 1201NEW YORK, NY 10018 USATEL: +1 212 967 7800FAx: +1 212 967 5480INFO@ACTIONAGAINSTHUNGER.ORG WWW.ACTIONAGAINSTHUNGER.ORG