Chapter 5 On the national level: If a country has a production deficit (for definition see section 2 of Annex 1) and depends on food imports to complement supplies from domestic production, then access to sufficient food for the country as a whole is determined by the availability of foreign exchange to pay for the necessary food imports. The factors which have contributed to the macro-economic imbalances, the chronic balance of payments deficits and the increased indebtedness and debt service burdens of many developing countries (see sections 1 and 2 of Chapter 4) have inhibited the import capacities of the countries concerned and the achievement of food security on the national level. All policies aiming at re-establishing macro-economic balance and economic growth will therefore, if successful, increase the import capacity of the countries and implicitly serve the purpose of improving access to food at the national level. This applies, in principle, to structural adjustment programs but also depends, as outlined in section 9 of Chapter 4. on a number of other factors which are beyond the reach of individual countries' policies, e.g. the international trade and financial environment. Increasing access to food on the aggregate national level requires therefore, a two-sided approach: 1) Economic reform programs by and within the countries themselves along the line of macroeconomic, structural and sectoral adjustment policies discussed in Chapter 4, 2) International co-operation and appropriate policies at global level, e. g. in the field of international financial and trade relations. The latter issues will be addressed in Chapter 6. If the overall impact of this approach enables the country to achieve economic balance and sustainable growth in the medium and longer term, this will not only help to solve the problem of access to food at the aggregate national level but through employment and income creation also at the household level. At the household level: At the household level, access to food depends on the means available to the households to obtain the food and other essential items required for a decent living. Food insecurity occurs if the means are insufficient and is, therefore, closely related to wide-spread poverty. The households may lack the means (e.g. land, manpower, access to water, knowledge, technology) to produce enough food on their own, and/or the purchasing power to buy the food they need on the market. In tracing the effects of macro-economic policies down to the factors determining household food entitlement, we have seen that certain vulnerable groups are prone to suffer a further aggravation of their food security situation under adjustment. The capacity to attain access to the food required may be further eroded by a nominal and/or real income decline, resulting from general food price increases, a removal of general food subsidies, or a decrease in employment and cash-income. Under such conditions, targeted approaches are required to support those groups of the population who, due to poverty and insufficient access to food, are exposed to food insecurity. Targeted assistance may consist of measures to enhance the capacity of the people - 200 -