Policy ForumPUBLIC HEALTH

Cutting World Hunger in Half

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Science  21 Jan 2005:
Vol. 307, Issue 5708, pp. 357-359
DOI: 10.1126/science.1109057

The Millennium Project [HN1] was commissioned by the United Nations Secretary-General to recommend the best strategies for meeting the Millennium Development Goals (MDGs) [HN2] (1). In October 2002, the Hunger Task Force was established to determine how to meet the hunger MDG [HN3]—to reduce the proportion of hungry people in half from 1990 to 2015. Task Force members came from diverse backgrounds in science, policy, the private sector, civil society, U.N. agencies, and government, with broad representation from developed and developing countries (2). After analysis, stakeholder consultations, and observation, the Task Force has just produced its report (2), which is summarized here.

Diagnosis

There are 854 million people in the world (about 14% of our population) who are chronically or acutely malnourished. [HN4] Most are in Asia, but sub-Saharan Africa is the only region where hunger prevalence is over 30%, and the absolute numbers of malnourished people are increasing (3). More than 90% are chronically malnourished [HN5] (4), with a constant or recurrent lack of access to sufficient quality and quantity of food, good health care, and adequate maternal caring practices. Acute hunger [HN6] (the wasting and starvation resulting from famines, war, and natural disaster) represents 10% of the hungry yet receives most of the media coverage and attention. In addition, hidden hunger from micronutrient deficiencies [HN7] affects more than 2 billion people worldwide. Chronic and hidden hunger deserve much more global attention and support.

Roughly 50% of the hungry are in smallholder farming households; 20% are the landless rural; 10% are pastoralists, fishers, and forest dwellers; and 20% are the urban hungry [HN8]. The Task Force has identified hunger hot spots, defined as the subnational units where the prevalence of underweight children (4) less than 5 years of age is at least 20%. The 313 hunger hot spots identified (see the figure below) indicate priority regions, as they cover 79% of the hungry.

Hot spots of world hunger.

The importance of different causes of hunger varies among regions. Low agricultural productivity [HN9] is likely to be the primary reason in tropical Africa and remote parts of Asia and Latin America, whereas poverty and unemployment are the main causes in most of South and East Asia, Latin America, Central Asia, and the Middle East.

Economically, hunger results in annual losses of 6 to 10% in foregone Gross Domestic Product (GDP) due to losses in labor productivity. Economic growth alone is insufficient for eliminating hunger, because so many hungry people live in deep poverty traps, beyond the reach of markets (5). People affected by HIV/AIDS become unable to grow food or work for a living. Malnourishment weakens their immunity and strength, making them succumb more quickly to disease (6). [HN10] Similarly, nearly 57% of malaria deaths are attributable to malnutrition (7). The challenge of halving hunger is, therefore, closely linked with that of achieving other MDGs.

Recommendations

The Task Force calls for simultaneous action at global (recommendation 1), national (recommendation 2), and local levels (recommendations 3 to 7) (see the figure below).

Hunger Task Force recommendations (2).

1. Move from political commitment to action. A commitment to halving world hunger was made by all member countries of the United Nations at the World Food Summits of 1996 and 2001, the Millennium Summit of 2000, the 2002 World Summit on Sustainable Development, and the 2002 Monterrey Summit on Development Finance. The message for political leaders is that halving hunger is within our means; what has been lacking is action to implement and scale up known solutions.

The Secretary-General of the United Nations reinforced this message when he called for a “uniquely African green revolution for the 21st century” (8) [HN11].

2. Reform policy and create an enabling environment for hunger reduction. Government policies in poor countries can make or break efforts to end hunger. Good governance, including the rule of law, low levels of corruption, and respect for human rights, is essential for achieving food security. Policies conducive to ending hunger and poverty need to be put in place at all levels, from the local to the national.

The Task Force proposes that poor countries integrate hunger reduction action plans into their Poverty Reduction Strategies [HN12] or equivalent national planning process. Poor countries need to adopt a multisectoral approach to hunger reduction. African governments should invest at least 10% of their national budgets specifically in agriculture and nutrition, in addition to making investments in rural energy, infrastructure, health, education, and other sectors. Building capacity at all levels should be the central goal of national government and donor-funded activities. Linking nutritional and agricultural interventions, which are so often implemented separately, would be a powerful means of creating more effective hunger reduction programs.

Clearly assigned and enforceable rights for women to own, inherit, and trade land must be guaranteed. Women and girls need better access to services such as credit, health care, and education, as well as to technologies that will ease the workload of rural women, such as rooftop water harvesting and growing trees for firewood close to home. [HN13]

Agricultural research has been a major driver of hunger reduction. The Task Force recommends doubling investments in national research to at least 2% of agricultural GDP by 2010. It also recommends that donors increase funding to the Consultative Group on International Agricultural Research to US$1 billion by 2010. [HN14]

3. Increase agricultural productivity of food-insecure farmers. Small-scale farming families represent about half the hungry worldwide and probably three-quarters of the hungry in Africa. Raising the productivity of their crops, livestock, fish, and trees is a major priority. [HN15]

Restoring soil health is often the first entry point for increasing agricultural productivity, because soil nutrient depletion is extreme in most areas where farmers have small holdings, as in Africa (9). Applying appropriate combinations of mineral and organic fertilizers, using leguminous green manures and agroforestry fertilizer trees, returning crop residues to the soil, and using improved methods of soil conservation can restore soil health and double or triple yields of the cereal staple crop. Making mineral fertilizers available at affordable prices and using them efficiently remain major challenges. As an emergency short-term measure, targeted subsidy programs should be designed to supply mineral and organic fertilizers (as seeds) to farmers. Tamper-proof “smart cards” redeemable at private agrodealers are one promising way of administering targeted subsidies, avoiding many of the pitfalls of past fertilizer subsidy schemes. When combined with similar vouchers for farmers to sell their products to school and community feeding programs, the demand side can be also addressed, avoiding price crashes when production increases.

In subhumid and semiarid areas, improving water management can be at least as important as improving soil fertility. Various water harvesting and small-scale irrigation techniques can be used to transform crop and livestock production in these regions. Investments in small-scale water management can also be financed with targeted subsidies.

The provision of genetically superior crop, pasture, tree, livestock, and fish germ plasm can greatly increase the productivity of small-scale farms. The Task Force supports both conventional breeding and transgenic research with appropriate biosafety measures. The traits that will benefit poor farmers in more marginal areas are tolerance to stresses (drought, salinity, poor soil fertility, pests, and diseases) and improved nutritional value.

After farmers attain food security, they can begin to diversify their farming systems to produce high-value products. Livestock, farm trees, aquaculture, and vegetables are attractive options for diversifying their diets and sources of income. Increases in milk production, for example, can reduce malnutrition in rural and urban settings. In South Asia and Africa, farming systems integrating crops and livestock are very important in strengthening household nutrition and income. Small-scale farmers could emerge as major timber suppliers of the 21st century in many tropical regions.

Breathing new life into the moribund extension services of many poor countries is vital if the benefits of new knowledge and improved technology are to reach farmers. The Task Force recommends that every village in a hunger hot spot have paraprofessional extension workers trained in agriculture and nutrition, with counterparts in health and energy. They should be supported by professional services and enhanced research institutions.

4. Improve nutrition for chronically hungry and vulnerable groups. Adequate nutrition lies at the heart of the fight against hunger. As the primary care providers for children and families, women are particularly important in improving nutrition for vulnerable groups. Particular attention should be focused on children under the age of two and on supplemental feeding for pregnant and lactating mothers. [HN16] The Task Force recommends that, where possible, locally produced foods be used, rather than imported food aid.

To break the intergenerational cycle of undernutrition, the Task Force recommends supplemental feeding for underweight pregnant women and nursing mothers. Exclusive breastfeeding up to 6 months of age is the best way of ensuring optimum nutrition for babies, although the decision may be complicated by the risk of transmitting HIV through breast milk.

To reduce malnutrition in children under five, the Task Force recommends providing fortified or blended supplementary foods, clean drinking water, and therapeutic care for all seriously malnourished children and women, especially in remote rural areas. Community extension workers should take the lead in raising awareness and implementation.

The Task Force recommends that malnutrition be reduced among school-age children and adolescents by providing free, nutritionally balanced school meals from locally produced foods for all poor children. This will improve learning, attract the 40% of primary school age children who are currently out of school in Africa (mostly girls), empower girls with good nutrition and knowledge before they become mothers, and create a steady demand for local foods. We estimate that if this is practiced in half of the primary schools in Africa, the local demand for maize alone could increase by as much as 25%. Systematic deworming; micronutrient supplementation; education about HIV/AIDS, health, nutrition, and hygiene; and provision of safe drinking water and take-home rations should be part of the program.

Vitamin and mineral deficiencies should be reduced by increasing consumption of micronutrient-rich foods such as fruits and vegetables; improving food fortification; and increasing micronutrient supplementation when necessary. Village extension workers should promote these mutually reinforcing actions.

Parallel health measures are also needed to eliminate the diseases that rob people of nutrients. All children should be fully immunized and receive prompt treatment for common infections such as diarrhea, pneumonia, malaria, and helminthes, as well as appropriate nutritional care provided for people living with or affected by HIV/AIDS.

5. Reduce vulnerability of the acutely hungry through productive safety nets. While investing in agriculture, education, and health remains critical to long-term food security, past gains can be threatened if people's vulnerability to short-term disasters and shocks are not addressed. To address acute hunger, the Task Force recommends strengthening (i) national and local early warning systems to take advantage of advances in climate prediction; (ii) the capacity to respond to emergencies; and (iii) investments in productive safety nets (food for work; cash for work).

The Task Force recommends, whenever possible, the substitution of cash for program food aid, so that governments can invest more flexibly in reducing hunger. The additional resources needed to reduce vulnerability to shocks must not draw funds away from long-term development.

Safety nets should be both an effective protector of last resort during shocks and economically productive in years without crisis. This involves investing in community activities that reduce vulnerability while increasing productive potential. Large injections of cash or food aid can distort the local economy unless they are targeted toward development objectives.

6. Increase incomes and make markets work for the poor. Properly functioning markets are critical in ensuring that farmers are able to earn a decent income, obtain the inputs they need to raise crop yields, and sell their produce at fair prices.

The Task Force proposes that major investments be made in developing and maintaining market infrastructure. Markets will not develop without public investment in transport and communications. [HN17] A major effort is needed to increase road building, including paved roads and all-weather feeder roads, in large parts of Africa where there is high prevalence of malnutrition. Every village should have a vehicle for transporting products to markets and health emergencies. Effective grain storage capacity at the local level would enable farmers to obtain fairer prices for their crop surpluses and would reduce postharvest losses to pests. Investments in small-scale processing should quickly yield benefits in terms of increased employment opportunities.

Networks of trained rural agrodealers are needed to allow essential agricultural inputs to reach remote areas, especially in Africa. Access to credit and other financial services is particularly problematic for food-insecure farmers. Community groups established to take on loans on behalf of their members could mitigate risk and make lending more attractive to financial institutions.

Lack of market information negatively affects the terms of trade for poor farmers. Governments and donors should continue investing in information technology, including combinations of mobile phones, radio, and the Internet to bring information to producers. For example, fishermen in India are now using mobile phones to seek the best price from dealers before deciding where to land their catch.

There are opportunities for increasing on-farm and off-farm income by encouraging farmers to switch part of their farms from staple food crops into higher value livestock, vegetable, and tree products and to add value through processing. Farmers can grow crops for large-scale producers. Supermarkets are becoming dominant buyers in much of the developing world. Governments should encourage them to pursue socially responsible policies and to stimulate local production.

7. Restore and conserve natural resources essential for food security. Degradation of natural resources directly threatens the food security and incomes of poor people. Reversing degradation requires both community- and national-level interventions. Local ownership, access, and management rights should be secured for forests, fisheries, and rangelands. Natural resource-based “green enterprises” should be developed. Poor farmers should be paid for environmental services they provide, including biodiversity protection, watershed stability, and carbon sequestration.

Entry Points

Community nutrition programs, homegrown school feeding programs, and investments in soils and water are local initiatives that can serve as “entry points” in the battle against hunger. A combination may constitute an attractive new integrated program in rural areas facing the dual challenge of high chronic malnutrition and low agricultural productivity. The increased local production will have a ready market in the homegrown feeding programs, and the joint facilitation by community extension workers will create a virtuous cycle. The resulting synergies will open the way for other interventions.

Resources Needed

The Millennium Project estimates that hunger reduction interventions to increase agricultural productivity and address chronic malnutrition will cost about 6 to 10% of the additional development assistance envisioned for attaining all the MDGs (1). That amounts to about $8 billion a year for 2005, between $10 and $11 billion a year for 2010–15, or an average of 60 U.S. cents per month for every person living in a developed country.

It Can Be Done

The Task Force concludes that the hunger MDG can be achieved by 2015 and hunger can eventually be eliminated. This will require focused and unprecedented levels of effort that are well within our financial and technological capability. Currently, more than 5.5 million children are dying of malnutrition-related causes each year. The actions outlined here, taken up by a broad coalition of stakeholders and applied in every poor country, can change that.

HyperNotes Related Resources on the World Wide Web

General Hypernotes

Dictionaries and Glossaries

A glossary of world hunger is provided for a course at Georgia State University.

Web Collections, References, and Resource Lists

The Development Gateway offers links to resources on food security.

HungerWeb is a resource provided by the Friedman School of Nutrition Science and Policy, Tufts University. A collection of links to Internet resources is provided.

Bread for the World provides links to other anti-hunger and poverty organizations.

Hearts and Minds' Change.net provides links to information and action on world hunger and poverty.

The Food and Nutrition Technical Assistance (FANTA) Project provides links to Internet resources related to nutrition and food security.

Online Texts and Lecture Notes

The Eldis Gateway to Development Information provides a food security resource guide.

The International Food Policy Research Institute (IFPRI) has as its mission to provide policy solutions that cut hunger and malnutrition. It makes available a collection of publications related to its 2020 Vision for Food, Agriculture, and the Environment and a collection of discussion papers on food consumption and nutrition.

The Hunger Project is a strategic organization and global movement committed to the sustainable end of world hunger.

Feeding Minds, Fighting Hunger is an international classroom for exploring the problems of hunger, malnutrition, and food insecurity.

M. M. Cody, Department of Nutrition, Georgia State University, offers resources for a course on world hunger.

The Department of Nutritional Sciences, University of Wisconsin, makes available lecture notes and other resources for a course on world hunger and malnutrition.

Teaching and Learning for a Sustainable Future is a multimedia teacher education program offered by UNESCO. A presentation on understanding world hunger is included.

General Reports and Articles

The 12 December 2003 issue of Science had a Viewpoint by M. W. Rosegrant and S. A. Cline titled “Global food security: Challenges and policies” and a collection of related Web resources.

Halving Hunger: It Can Be Done (full report in PDF format) is the final report of the Task Force on Hunger of the United Nation's Millennium Project.

The State of Food Insecurity in the World 2004 is published by the UN's Food and Agricultural Organization (FAO).

The Economic Research Service of the U.S. Department of Agriculture makes available a 2003 report by B. Meade et al. titled “Food security assessment” and a 2003 report by K. Wiebe titled “Linking land quality, agricultural productivity, and food security.”

The No. 3, 2001 issue of the UN Chronicle had an article by G. McGovern titled “The real cost of hunger” and other articles on world hunger.

The November-December 2004 issue of World Ark, from Heifer International, had an article by J. D. Sachs and P. A. Sanchez titled “We can end hunger now” and other articles related to world hunger.

J. D. Sachs, Earth Institute, Columbia University, makes available in PDF format the 2004 article from Brookings Papers on Economic Activity by J. D. Sachs et al. titled “Ending Africa' s poverty trap” (5).

Documents and other resources from the 2002 World Food Summit are made available by FAO.

The May 2003 issue of the UN's Africa Recovery offered a special feature titled “Africa beyond famine” that included an article by E. Harsch titled “New strategies needed to combat hunger, disease and rural poverty.”

IFPRI makes available an essay by J. von Braun, M. S. Swaminathan, and M. W. Rosegrant titled “Agriculture, food security, nutrition and the Millennium Development Goals.”

Numbered Hypernotes

1. The Millennium Project of the United Nations. The Millennium Project of the United Nations provides background information about the project and links to core documents and related Web sites. The Millennium Declaration, adopted by 189 UN member nations on 18 September 2000, outlines the signatory countries' commitment to achieving the Millennium Development Goals.

2. Millennium Development Goals (MDGs). The Millennium Project Web site summarizes the goals. The World Bank's Millennium Development Goals Web site, provides information about the goals and the partner organizations. The United Nations Development Agency provides a resource page on MDGs. The Development Gateway offers a special feature on the MDGs with a section on food access and availability.

3. The hunger goal and the Hunger Task Force. The Earth Institute of Columbia University provides information about the Hunger Task Force of the Millennium Project. The Millennium Project Web site summarizes target two of MDG goal one and provides information on the Hunger Task Force and its members. The World Bank's Millennium Development Goals Web site provides information about the goal to end malnutrition and hunger. J. D. Sachs makes available in PDF format a February 2004 lecture titled “Meeting the Hunger Millennium Development Goal.” The Carnegie Council on Ethics and International Affairs makes available a November 2003 paper by T. W. Pogge titled “The first UN Millennium Development Goal.” The presentations from the 5 July 2004 seminar titled “Innovative approaches to meeting the hunger MDG in Africa” are made available by the Millennium Project.

4. World hunger. World Hunger Facts 2005 is provided by World Hunger Education Service as part of their Hunger Notes. WomenAid International provides an overview of hunger. The UN World Food Programme offers hunger facts and reports on hunger in countries of the developing world. The American Dietetic Association presents a position paper titled “Addressing world hunger, malnutrition and food insecurity.” A world nutrition overview is provided by SUSTAIN. F. R. James, Department of Biology, University of Wisconsin, Stout, offers lecture notes on food, hunger, and nutrition for a course on environmental science.

5. Chronic malnourishment. The Nutrition Home at the World Health Organization (WHO) offers a presentation titled “What do we mean by malnutrition.” WHO provides the Global Database on Child Growth and Malnutrition and makes available the 2000 brochure titled “Turning the tide of malnutrition: Responding to the challenge of the 21st century.” The eMedicine Web site provides an article by D. G. Grigsby on malnutrition. Nutrition: A Foundation for Development from the UN Standing Committee on Nutrition is a compilation of briefs on of the latest research findings in nutrition as they relate to other development sectors.

6. Acute hunger and famine. The FAO's Global Information and Early Warning System (GIEWS) provides warnings and information about food emergencies; a December 2004 report on sub-Saharan Africa is available. The Famine Early Warning Network provides alerts on hunger emergencies in Africa. Famine in Africa is a presentation of BBC News. The Bread for the World Institute provides an African famine update. The U.S. Agency for International Development (USAID) provides an 11 June 2002 background paper on famine.

7. Micronutrient deficiencies. WHO's Nutrition Home provides information about micronutrient deficiencies. HarvestPlus provides an introduction to micronutrient malnutrition. UNICEF issued a 24 March 2004 press release titled “Lack of vitamins and minerals impairs a third of world population” about the report titled “Vitamin and mineral deficiencies: A global progress report.” The November 2003 issue of Food Technology had an article by T. van den Briel and P. Webb titled “Fighting world hunger through micronutrient fortification programs.” The No. 32, 2003 issue of the FAO's Food, Nutrition and Agriculture was a special issue on micronutrient deficiencies; included was an article by G. Kennedy, G. Nantel, and P. Shetty titled “The scourge of ‘hidden hunger’: Global dimensions of micronutrient deficiencies.” The Micronutrient Initiative, a organization specializing in addressing micronutrient malnutrition, provides country reports.

8. Urban hunger. The IFPRI provides a resource page on its research theme titled “Urban challenges to food and nutrition security” and makes available a 2020 Focus 3 publication titled “Achieving urban food and nutrition security in the developing world.” The FAO Newsroom provides a 2004 focus article titled “Food insecurity in an urban future.”

9. Low agricultural productivity and hunger. FAO's GIEWS issues “Foodcrops and Shortages” reports. The Agriculture-Nutrition Advantage Project investigated and promoted greater linkages between agriculture and nutrition. The VITAA Partnership makes available in PDF format a paper by C. Johnson-Welch titled “Linking agriculture and nutrition: The human dimension.” USAID provides an introduction to the Initiative to End Hunger in Africa.

10. HIV/AIDS and food security. FAO provides an HIV/AIDS and food security Web site. The UN World Food Programme offers a presentation on food and HIV/AIDS. The FANTA Project provides information on HIV/AIDS and nutrition. IFPRI issued a 21 November 2002 statement titled “Nutrition is critical in the war against AIDS” and provides a resource page on HIV/AIDS and food security. The 2003 IFPRI discussion paper by S. Kadiyala and S. Gillespie titled “Rethinking food aid to fight AIDS” (6) is available in PDF format. The May 2003 issue of the UN's Africa Recovery had an article by J. Nyamu titled “Famine and AIDS: A lethal mixture.”

11. The speech by Secretary-General Kofi Annan calling for a “Uniquely African green revolution” is included in a 6 July 2004 UN press release.

12. Poverty Reduction Strategies. FAO provides information about country plans to reduce hunger. The World Bank's PovertyNet offers information on Poverty Reduction Strategies. Poverty Reduction Strategy Papers are provided by the International Monetary Fund. The Institute of Development Studies, University of Sussex, Brighton, UK, provides a 2001 policy briefing titled “Poverty Reduction Strategies: A part for the poor?” Eldis offers a resource guide titled “Watching the Poverty Reduction Strategies process.”

13. Women's rights. IFPRI makes available in PDF format a presentation titled “Women: The key to food security.” The M. S. Swaminathan Research Foundation makes available a presentation by P. Medrano titled “Women, food for work, and human development.” WomenWatch is an initiative of the Inter-Agency Network on Women and Gender Equality (IANWGE). Gender Equality and the MDGs—a collaborative effort of the UN IANWGE, the OECD/DAC Network on Gender Equality, and the Multilateral Development Bank Working Group on Gender—provides books, articles and other resources relevant to women's rights. IFPRI's 2020 focus 6 publication titled “Empowering women to achieve food security” includes a brief on land rights by E. Crowley.

14. Agricultural research. The Consultative Group on International Agricultural Research is an alliance of countries, international and regional organizations, and private foundations supporting 15 international agricultural centers that has as its mission to contribute to sustainable improvements in the productivity of agriculture, forestry, and fisheries in developing countries in ways that enhance nutrition and well-being, especially for low-income people. IFPRI makes available an October 2003 discussion paper by R. Meinzen-Dick, M. Adato, L. Haddad, and P. Hazell titled “Impacts of agricultural research on poverty: Findings of an integrated economic and social analysis.” The World Bank's Agriculture and Rural Development Department provides a resource page on agricultural research.

15. Restoring soil health and other measures to increase agricultural productivity. ITDG (Intermediate Technology Development Group) offers a presentation on food production. The 5 July 2004 seminar titled “Innovative approaches to meeting the hunger MDG in Africa” includes a presentation by P. Sanchez titled “Innovative investments in healthy soils and better land management.” The FAO's State of Food Insecurity in the World 2002 includes a section on rehabilitating degraded lands. The Pew Initiative on Food and Biotechnology makes available in PDF format a 2004 issue brief titled “Feeding the world: A look at biotechnology and world hunger.” The FAO's Land and Water Development Division provides resources related to meeting present and future food and agriculture demands on a sustainable basis; the FAO gateway to land and water information offers country profiles. The 15 March 2002 issue of Science had a Policy Forum by P. A. Sanchez titled “Soil fertility and hunger in Africa” (9). The 21 February 2003 issue had a Policy Forum by G. Conway and G. Toenniessen titled “Science for African food security.”

16. Improving nutrition for vulnerable groups. The FANTA Project provides a presentation on strengthening maternal child health/nutrition programs and a presentation on women's nutrition. The Population Reference Bureau makes available a July 2003 article by E. I. Ransom and L. K. Elder titled “Nutrition of women and adolescent girls: Why it matters.” WHO's Nutrition Web site makes available a collection of publications on maternal and child nutrition. The Center for Human Nutrition at Johns Hopkins Bloomberg School of Public Health provides information on the center's worldwide research studies related to maternal and child nutrition.

17. Improving rural infrastructure. The September 2003 issue of the IFPRI Forum had an article by A. Lewis titled “Revitalizing the drive for rural infrastructure.” The id21 Web site offers a presentation titled “On the move—New approaches to improving rural transport.” The World Bank's Rural Transport Web site makes available in PDF format the 2002 technical paper titled “Improving rural mobility: Options for developing motorized and nonmotorized transport in rural areas.”

18. Pedro A. Sanchez is in the Tropical Agriculture Program at the Earth Institute of Columbia University.

19. M. S. Swaminathan is at the M. S. Swaminathan Research Foundation, Taramani, Chennai, India.

References and Notes

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