Ethics and Democracy in Access to Food. The Venezuelan Case

Introduction

Amartya Sen, Nobel Peace Prize winner (1998) established a thesis in which he affirms that, in functional democracies, with free and uncensored information, there are no famines or food crises. As will be seen in this work, democracy in Venezuela is under severe scrutiny, looking far from functional, and information does not circulate freely. While democracy in Venezuela is challenged, the population suffers from an unprecedented food insecurity crisis among other hardships derived from the lack of freedoms.

The Bolivarian Republic of Venezuela, re-founded in 1999 from the promulgation of the first constitution voted in a popular referendum since independence in 1811, became a State governed by a regime that has become every time more authoritarian, which violates human rights, without full guarantee of civil liberties, including freedom of expression and information, as has been denounced by several agencies and organizations. Various United Nations reports, which have been published consecutively in recent years, especially from the [Office of the United Nations High Commissioner for Human Rights (OHCHR), 2017, 2019], have recorded these multiple violations and have made severe warnings and recommendations to the government to stop the transgressions. The regime, self-proclaimed as “21st century socialism” by president Hugo Chávez in 2005 at the V World Social Forum of Porto Alegre or Forum of São Paulo in Brazil, promoted a constitutional amendment to remove presidential term limits that even if not approved in a national referendum in 2007, was circumvented, presented again and in 2009, the indefinite presidential reelection was approved. As stated by Grijalva Jiménez and Castro-Montero (2020), the indefinite presidential reelection is an institutional scheme that can distort and even eliminate the alternation of a presidential and democratic government. Factors as hyper-presidentialism, lack of judicial independence and flexible rules for amending constitutions are instrumental for allowing the president to avoid constitutional limitations and remain in office. The evasion of constitutional term limits can thus be seen as a way of collapsing democratic regimes as stated by the cited authors.

This affected the holding of elections, with the balance and autonomy of powers that characterizes a democracy, with the persecution and imprisonment of the main leaders of the opposition, in addition to the judicialization of political parties opposed to the regime who are disqualified or conditioned on their participation in electoral events. It also affected the opinion of Venezuelans as shown in a study by Latinobarómetro (2018) that indicates that the perception of “a government for the well-being of the entire people” reached a peak of 55 percent precisely in 2005, to drop to 39% at the end of the Chávez government period and dropped even further to 17 percent in 2018 with Nicolás Maduro in office since 2013 (to the present). The “21st century socialism” was proposed as an alternative model to capitalism and market economy (Guerra, 2006; Biardeau, 2007; Contreras, 2007).

In this context, we believe that Sen's thesis is verified. In closing this investigation, Venezuela was considered among the 5 countries in the world that could suffer a famine in 2020, aggravated by the Covid-19 pandemic according to the United Nations World Food Program (WFP) from the ONU. The other countries that accompany Venezuela in this unfortunate situation projected by the WFP are: Afghanistan, Democratic Republic of the Congo, South Sudan, and Yemen [BBC News Mundo, 2020; WFP (Programa Mundial de Alimentos), 2020a]. This registry is the corollary of a series of reports by the Food and Agriculture Organization of the United Nations (FAO) on the food and nutritional situation of Latin American and Caribbean countries, which have been warning of the deterioration of food insecurity in Venezuela, reaching 80% of the population, and therefore violating the right to food.

The situation has triggered a true regional crisis due to the magnitude of migrations to neighboring countries and beyond, which has been classified as a humanitarian emergency. Free, transparent, competitive, internationally supervised elections, conditions requested by the representative and legitimate opposition, and supported by the vast majority of the population, which allows the transition to a reinstitutionalization of democracy in the country, would change peacefully this state of affairs, significantly improving food security and moving the country away from the risk of famine, if Sen's thesis is correct. Behind the WFP figures there are persons suffering severely from hunger and children who eat well below their caloric requirements, aspects that collide with the ethical foundation of a political regime of full freedom. Only the return to functional democracy in the country, which fully guarantees, among other rights, freedom of expression and information could significantly improve food security in the country and, consequently, the right to food. The lack of official information, its deliberate outdating or manipulation to the convenience of the government, as the reports and studies also point out, although it makes analytical work very difficult, has not impeded, however, rigorous scrutiny, not only by specialized agencies of the United Nations or by non-governmental organizations, but by researchers and academies, all of whom coincide in registering the institutional collapse of Venezuela and its adverse effects on the economy and society, but especially on the availability of food for the population that has reached extreme levels of need and emergency (Tapia et al., 2017). As stated and demonstrated by Tapia et al. (2017), for many years, Venezuela was recognized as a country with solid infrastructure, not only in nutrition and food safety policies but also in terms of education, health services, roads, electricity, and potable water. Unfortunately, during the last 20 years under the “21st century socialism,” Venezuelans have witnessed the progressive destruction of a wide range of institutions: public organizations, public and private industries, cattle and crop farms, universities and research facilities, and the national electric, domestic gas, and tap water networks. Also, in the 1999 Venezuelan Constitution, “Food Security” was explicitly included for the first time (Article 305). Subsequently, the government approved various laws and guidelines to regulate the right to food of the population. However, decreeing many laws related to food and nutrition is not enough and does not guarantee the Food and Nutrition Security of the Venezuela, with a declared a Complex Humanitarian Emergency and the installation in 2019 of the international humanitarian coordination architecture of the UN, composed by OCHA (United Nations Coordination Office for the Coordination of Humanitarian Affairs) and a humanitarian country team with eight clusters activated, food security and livelihoods; health; nutrition; water, sanitation, and hygiene among them (OCHA, 2019).

Venezuela's Institutional Collapse: From Autocratic Drift to Food Insecurity and The Risk of Famine

Venezuela reached its democracy in 1958 with the overthrow of the last military dictatorship. Between 1958 and 1998, Venezuela experienced the longest period of political stability, human and institutional, and economic development that the country has known after its independence achieved in 1811. In 1999, the Republic was re-founded with the promulgation of the current Constitution, the product of a constituent process and approved by way of a referendum, the first in national history for a constitution. What should have been the transition from a system based on principles that guaranteed all the freedoms proper to a democracy, such as that founded on the Constitution promulgated in 1961, to an even better one, more elaborate from the point of view of constitutional theory and which constituted the country in a democratic and social state of law and justice, when the current political charter came into force in 1999, has resulted in an unfortunate process of deinstitutionalization of Venezuelan democracy that today is reaching signs of institutional collapse (Rachadell, 2015).

Venezuela is a cause for concern because of the authoritarian deviation that the leadership of the state has taken, and it has been the subject of questioning in the United Nations system. Recent reports from the specialized body for human rights question the flagrant violation of fundamental rights in the country, the lack of civil, political and economic liberties, the arrests for political reasons and a serious deterioration of the social conditions of the population. The UN commissioners have made recommendations to the Venezuelan State so that the situation changes without the suggested reforms taking place. At the same time this is happening, the food insecurity crisis in Venezuela is recognized by specialized agencies of the United Nations such as the FAO, which have warned of the consequences on the population, especially vulnerable groups. The magnitude of the crisis, the reports indicate, is reflected in the region and causes destabilization of health and food systems in neighboring countries, due to the large number of displaced people that the crisis has generated. There has been the destructuring of all public powers and this has led to an authoritarian, interventionist, autocratic military-style political regime, which cornered the public with arbitrary arrests of citizens for expressing their political opinions, imprisonment of opposition political leaders and journalists, who has suspended broadcast licenses to radio and television stations, torture detainees, carry out murders by security officials in the framework of citizen protests, which constitutes a constant violation of human rights by the Venezuelan State [Office of the United Nations High Commissioner for Human Rights (OHCHR), 2017, 2019]. Some studies report the use of hunger as a mechanism of political control and discrimination under an apparatus of domination that corresponds to the totalitarian logic, in societies where power has no counterweights or these are systematically annulled, as is the case in Venezuela today (Cartay and Dávila, 2020). The vicious practice of criminalizing citizens claims using the courts has become general, through sentences accommodated to the exercise of autocratic power, especially from the constitutional chamber of the Supreme Court of Justice, the highest court, and formally the guarantor and ultimate interpreter of the constitution [Brewer-Carías, 2012, 2017; ICJ (International Commission of Jurists), 2017, 2019]. A report by [IDEA (International Institute for Democracy and Electoral Assistance), 2017] on the state of democracies in the world, corroborates with respect to Venezuela a declining process of its democratic institutions, to the point of being one of the few cases in the world of a democracy of more than 40 years that as of 1999, it entered a reversion process with clear autocratic tendencies due to the extremist and populist leadership of the so-called 21st century socialism that has eroded the system of freedoms. Despite the votes, there are serious questions about the integrity and impartiality of the body that serves as electoral referee. The gradual concentration of power that began under the Chávez administration (1999–2013) and continued under the presidency of Nicolás Maduro, who has governed since 2013, seeks the displacement of parliament and its replacement by bodies made up of unelected allied members or designated through the manipulation of electoral laws that are interpreted in an interested way and manipulated by the courts of justice, among which, in 2016, the Supreme Court of Justice, usurped the functions of the National Assembly. Venezuela has significantly regressed in its democracy, both from the qualitative point of view and in the measurement indexes, the report states.

The institutional deterioration of the country has coincided with a series of erroneous macroeconomic and agri-food policies that, seeking to improve the food production, distribution, supply and consumption system, have caused, on the contrary, a progressive but accelerated worsening of the availability of food, generating as a result, a severe crisis of food insecurity suffered by large sectors of the population, which is only comparable to what happened in other regions of the world as a consequence of natural disasters or war conflicts (Morales, 2019). To the extent that the government has reinforced repression and intervention in the economy, the well-being of the people has also declined, especially, access to food. The decline of the economy has become clear, especially since 2012, with a fall in the Gross Domestic Product (GDP) that exceeds two digits, estimated in 2018 at a value of a third of the year 2013 and a remarkably high rate of inflation. An [IMF (International Monetary Fund), 2019] report indicated that deep humanitarian crisis and economic implosion in Venezuela had a devastating impact, and the economy was expected to shrink about 35 percent in 2019.

Possibly the most obvious reflection of this situation, which is configured as an indicator, is the exodus of almost 4 million Venezuelans in the last 5 years. It is the largest migration in the recent history of Latin America according to the Office of the United Nations High Commissioner for Refugees and mainly linked to the food insecurity crisis according to the FAO. Half of the citizens, 53 percent according to the Latinobarómetro report (2018), express that they would migrate to another country with their family. The situation in Venezuela reaches levels of complex humanitarian emergency, as recognized by the United Nations Human Rights Council in 2018, when the Venezuelan State was asked to grant access to international humanitarian assistance to face the shortage of food and medicines due to increased malnutrition and the resurgence of infectious diseases that had been eradicated or under control (FAO and OPS, 2017; FAO et al., 2018; Fundación Bengoa, 2018; ACNUR. Agencia ONU para Refugiados, 2019; IFPRI (International Food Policy Research Institute), 2019; Raffalli and Castro, 2019). According to FAO et al. (2019) Venezuela shows a significant increase in the prevalence of malnutrition in recent years, going from 6.4 percent in the 2012–2014 period to 21.2 percent in 2016–2018, being one of the Latin American countries whose economic decline and increase in malnutrition has negatively affected regional figures (Table 1). This report also refers that during the same recessive period (2016–2018) Venezuela reached hyperinflation levels of 10 million percentage points and the GDP went from −3.9 percent in 2014, to an estimated −25 percent in 2018. Eighty six percent of people state that the salary and the total family income does not allow them to satisfactorily cover their needs, in comparison with 50 percent of those surveyed for Latin America, according to a report by Latinobarómetro (2018). For the third consecutive year, eight out of 10 people do not have subjective income, in such a way that the economic and food crisis encompasses almost the entire population, says the report. According to the Living Conditions Survey (ENCOVI, 2020), 93.4 percent of households are food insecure, reaching moderate to severe levels in 62.1 percent of cases.

TABLE 1

Table 1. Undernourishment (%) and population in millions.

The main findings of a field study, evaluating food security in Venezuela, carried out between July and September 2019 by the United Nations World Food Program [WFP (World Food Programme), 2020b], recorded the following: 32.3% of the population, the equivalent of 9.3 million people are food insecure. Of this number, 7 million people (24.4%) are moderately food insecure and 2.3 million (7.9%) are severely food insecure. It should be noted that the report defines moderate food insecurity as a state in which there are significant gaps in food consumption or is marginally able to meet minimum food needs only with irreversible coping strategies. Whereas, severe food insecurity means that you have extreme gaps in food consumption, or you have extreme loss of livelihood assets that will lead to gaps in food consumption, or worse (Table 2). Another significant result of the study shows that Venezuelan families consume cereals, roots, or tubers daily and supplement the daily intake of cereals with legumes (beans, lentils) 3 days a week and dairy products 4 days a week. The total consumption of meat, fish, eggs, vegetables, and fruits is <3 days a week for each of these food groups. The lack of dietary diversity and the consumption of protein of animal origin below the requirements, is an alarm signal because it indicates an inadequate nutritional intake. The report also records that hyperinflation is affecting the capacity of families and other basic needs to the point that 59% of households do not have enough income to buy food and 65% do not have the possibility of acquiring other essential goods such as hygiene products, clothes, and shoes. Although seven out of 10 Venezuelans according to the study perceive that food is available, however, access is difficult because prices are too high when compared to the income of families. The situation in Venezuela according to the respondents has impacted the sources of household income. Fifty one percent declare a partial loss of their income due to a reduction in salary or the loss of one or two jobs and 37% of those who responded have experienced a total loss of their income such as losing their only job or losing their business. The results also show that 18 percent of households depend on government assistance and social protection systems. Permanent emigration allows families to depend on remittances, but it translates into a worrying loss of human capital and social capacity, which includes teachers, doctors, scientists and other skilled workers among the migrants, the report says.

TABLE 2

Table 2. Food insecurity.

The Role of Democracy in Preventing Extreme Food Crises

When a famine or an acute food crisis occurs, it is wrong to think, as Sen (1981) has pointed out, that the phenomenon is simply due to a mechanical imbalance between the amount of food and the volume of the population. Famines and the consequent suffering from hunger and malnutrition, can even occur with an abundance of food if the economic power of individuals and families to buy food is lost, or in other words, as the author proposes, the fundamental freedom that it allows the right to own a sufficient quantity of food, either because it is obtained by growing it or because it is acquired in the market, it has been lost or disappears. Losing the purchasing power is losing the economic right to buy food and in such a situation, even with food stocks, one can die of hunger. Hunger is a chain of deprivation of qualifications to which one is entitled, since to reach a situation of famine, rights have been lost, especially the rights to property between the subject and the goods that serve as food. In the referred work, Sen questions that hunger, starvation and malnutrition, have to do mainly with the expansion of agriculture and total food stocks. Rather, it is the functioning of the entire economy and political institutions that have a decisive influence on people's abilities to acquire food; and ends by stating that individuals suffer from hunger when they cannot demonstrate their economic right to a sufficient amount of food. FAO (1996) agrees by emphasizing that, despite the existence of sufficient food supply, many people may be food insecure because they do not have the income or lack the resources to produce or buy the food they need to lead an active and healthy life. In urban areas, the accessibility of the population will depend on having enough jobs and real income to obtain food. In rural areas, especially in the poorest communities or those groups whose economic base is family farming, self-consumption, eating food that these same groups produce, is an important part of food intake and therefore of their food security.

Hence, the corollary of the reasoning behind this approach is that the prevention of famines largely depends on the political mechanisms that exist to protect the rights of individuals and their families. Any measure that contributes to economic expansion through increased production, diversification and growth reduces the need to protect economic rights, but increases the resources to protect them, especially when necessary. Among the successful measures that Sen (1981) refers to avoid or prevent famines, are incentives to increase production and incomes, such as the creation of jobs to increase employment, whether the production of food increases. This is the point where the role of democracy as a political system and, of course, the design of successful policies to combat poverty, begins to be perceived and understood, as the author claims. Democracy acts as a protective shield against inequalities, and Sen's approach to capabilities works best under a regime of freedoms, not only political but also economical, since his approach to ownership focuses on people's capabilities to have access to food through the legal means available in society, either through their own means to produce food, the purchase in the market, through trade in exchange for other products, by means of their own work or by rights granted by the State such as pensions or subsidies. The link with human rights and well-being becomes clear, when we observe the need for citizens to effectively exercise their rights, preventing deprivations that lead to hunger and malnutrition, when you cannot have access to food for precisely the reason of denials in access to rights and therefore ownership of food (Pérez, 1996; Vizard, 2006).

The central idea of Sen (2006) around the issue that links a government regime with the nutritional status of the population, is that the system of political, economic, and social freedoms that better adjusts to the form of government that we know as democracy, is of cardinal importance in the prevention of extreme food crises and particularly famines and in any case in correcting these when they occur. For the author, the value of democracy resides in that it functions as an early warning system for famines and other food security crises, as long as it is in the presence of a democracy with a balance of powers, respect for individual rights and guarantees, particularly in this case, those of freedom of expression and information. Following the line of his thinking, a government responds to the demands of its people largely by the pressure employed on the exercise of political rights through voting, criticism and protest, in such a way that the opposition can make a real difference and profoundly influence government performance. There is no evidence that refers to the existence of famines in those countries of the world where there is a functional democracy. There are no known famines that have occurred in an independent and democratic country enjoying relative freedom of the press. On the contrary, the evidence of famines all points to dictatorial, autocratic countries, where freedoms, in particular that of opinion and information in the media, are seriously limited or non-existent, as the historical cases of freedom have been in the 20th century. Soviet Union in the 1930s, in China of the “Great Leap Forward” (1958–1961) under Mao Tse Tung or India under imperial rule. More recently, in the 21st century, the evidence of the famines in Ethiopia, Somalia, and North Korea all point to a common thread: regimes without freedoms of any kind, especially of the press.

However, not only the lack of freedom of the press is responsible for the limitations in access to food. From a broader point of view, integral development is not possible without freedoms and even less with repression. Sen (2000) himself had already pointed this out when he refers that development requires eliminating the main sources of deprivation of freedom, which are poverty and tyranny, the scarcity of economic and social opportunities, intolerance or the intervention of the repressive states. The lack of fundamental freedoms, the author points out, is causally related to economic poverty that deprives individuals of the freedom necessary to satisfy hunger. He adds that is misleading to assert that to eradicate poverty and hunger, economic rights and material needs must first to be met before political freedoms and human rights. The links between political freedoms and the satisfaction of economic needs must be understood, which for the author are, on the one hand, instrumental, because they contribute to improving the capacities of individuals to express and defend their political demands for the satisfaction of their economic needs, and on the other, constructive, because they allow the conceptualization of those economic needs in the social context. Not to mention the role that democracy itself has in human life and that is related to basic capacities, such as political and social participation. The practice of democracy, the researcher points out, must be conceived as the creation of opportunities for individuals, which in turn are related to the practice of political rights, the success of which will depend on how these freedoms are used and exercised. The political freedoms and the guarantees of human rights that are achieved in a functional democracy have proven effectiveness against economic disasters and these are avoided with the right measures, even if they are problems as serious as hunger.

The relationship between democracy and the role it plays in development is even consolidated as a general principle of the United Nations since it is recognized that democratic institutions create the possible environment for citizen control, demanding that the government and its entities surrender their accounts and the correction of their actions, establishing the necessary link for those responsible for policies to act in accordance with the general interest (Tommasoli, 2013). There seems to be no doubt about the positive links between democracy and development, and in a certain way Sen has contributed to making this issue part of the global agenda of the commitments under debate. Democracy and development are complementary and mutually reinforcing. The link between the two is all the stronger because it stems from people's aspirations and their rights. Historical evidence shows that when democracy and development have fallen apart, the result is mostly failure. The legitimacy of democracy as a political system and its consolidation go through the design of economic and social measures that favor development and any development strategy must be ratified and reinforced by democratic participation in order to be implemented (Boutros-Ghali, 2002).

Democracy seems, then, to be the best political system to provide a solution to the problem of food insecurity and hunger, also clearing the path to human development. Even so, democracy should not be confused only with an electoral act. Universal suffrage, certainly, is a necessary condition, but it is not enough for the existence of a democratic regime. Elections are not a sufficient condition as they can be a fallacy if they take place in a framework where the different parties do not have an adequate opportunity to present their views and programs, or if the electorate does not have the freedom to inform themselves and consider the approaches of the contestants in the election. Democracy is a demanding system and not just a mechanical condition such as that referred to a majority rule taken in isolation (Sen, 2006). The contribution of political pluralism that is characteristic of democracies and that manifests itself as contradictory or adversarial politics and social criticism, is related to the possibility of influencing state decisions to correct wrong policies and achieve greater sensitivity to the welfare of the population, as has been pointed out by Drèze and Sen (1989). These authors have also pointed out that the scope for an effective and decisive influence on the actions of the State occurs in systems where there is greater space for opposition and criticism, and when this is considered. To which they also add a leadership committed to change and to effective social transformations.

Hence when referring to democracy, the outline is that of a system that functions as expected of it, that is one where at least, as indispensable preconditions are met, that the entire society can participate, in each decision-making level and can maintain control, where there is full observance of human rights, freedom of expression and thought, in addition to the promotion of those rights and respect for differences. Without independent public powers and especially without an autonomous judicial system, there can be no democracy, nor can there be without institutions that guarantee freedom of expression and the existence of free media. Likewise, the power to legislate must be exercised by legitimately elected representatives of the people and the laws emanating from parliament must be implemented by legally responsible persons and the entire administrative apparatus must be accountable to the elected representatives (Boutros-Ghali, 2002).

Ethics in Access to Food and the Right to Food

Food was enshrined as a fundamental right in the Universal Declaration of Human Rights (United Nations, 1948). In the chart food is especially recognized as a means to achieve an adequate standard of living, which in itself already forms part of the rights of the human being. This declaration has an ethical value and of binding content for the signatory states, which would later sign the International Covenant for Social, Economic and Cultural Rights (United Nations, 1966) as a way to bind compliance agreed in 1948. In addition to food, this agreement recognizes the fundamental right of every person to be protected against hunger. Unfortunately, the 142 signatory states of the Pact established progressivity for the fulfillment of the rights preserved there, including that of food, so such fulfillment is conditioned on the economic resources that each country has (Prosalus, 2009). Venezuela has validly signed and ratified both international conventions, that is, both the Universal Declaration and the Pact, for which the Venezuelan State is committed to guaranteeing their compliance in the territory of the Republic, in particular, evidently, the right to food.

The right to food is closely linked to what is possibly the most important of all human rights, which is the right to life, for the simple reason that without food there is no possibility of guaranteeing it. It can be stated that since life depends on food, it is not only linked to, but also conditional on, the overriding fulfillment of the right to food, so the violation of this right is not only a formal transgression of international law to any signed covenant. In this regard, it is also an axiomatic contravention of ethical principles. The ethical element linked to food, therefore, becomes visible and understandable if we see it from the perspective of human rights and in this sense Borghi et al. (2004) categorically points out that the right to food is the most sensitive and ethically significant of human rights. Vizard (2006) recognizes Sen's contribution to both ethics and economics and particularly the enormous influence that he has had on current international debates, in which, based on his research, the themes of poverty and hunger have been introduced from the ethical perspective of human rights. In particular, Sen has put at the center of the debate for several decades the fact of whether adequate food and a standard of living can be substantially and consistently analyzed as basic human rights, a matter that he has considered not only as possible but necessary as part of a global human development agenda, concentrating its vision around the capabilities approach that links quality of life and well-being with freedom (Pressman and Summerfield, 2000). Some attribute to Sen's ideas even having inspired the Human Development Report published annually by the United Nations Development Program (UNDP) since 1990 (Fukuda-Parr, 2003), something that the economist himself has humbly denied claiming that he has just been one of many who have contributed to giving relevance to the idea of human development with a focus on the richness of the entire human life with predominance over the economy in which human beings live, which is just a part of that (Shaikh, 2006).

At present, it is common to see more frequently in the global development schedule the ethical considerations in relation to the food issue, especially the aspects that arise regarding production and consumption, within the framework of sustainable practices and management, that guarantee environmental biodiversity and respect for the customs and culture of each society, to guarantee food security. The international debate and integration programs currently discuss reflections on ethical issues raised by food production and consumption. This should be done in the context of food security, sustainable use of agricultural resources, safeguarding biodiversity, and a balanced mix of traditional and modern technologies to increase food security and promote sustainable agriculture (FAO, 2001a,b,c, 2006). Food security, however, is not a guarantee of nutritional security by itself, since it depends on non-food factors such as water quality, infectious diseases, access to health services, among other factors (Pinstrup-Andersen, 2009). In this sense, food security, is the means to achieve nutritional security, when there is sufficient, permanent and stable availability and access to safe food and whose quantity and quality allow meeting the requirements of food and nutrients to lead a healthy life. Other elements to consider and assess the state of family food security or insecurity are the conditions in which these foods are consumed, including the health status of each individual (FAO, 2011).

Now, as Savater (1999) points out, ethics is an attitude, an individual reflection on one's own freedom, individual, in relation to the freedom of others and with respect to the social freedom in which we move. Hence, as this author points out, the ethics that underpin democracy is a reflection on freedom, which implies a deep knowledge of what it means to be human, which goes through recognizing the other, the humanity of others, privileging our relationship with the subjects above the goods or objects. What would be the contribution of ethics within democracy, it is worth asking. For the author, it would be none other than what a person within the system can ask for, that he is not denied and that he can continue to be a person. Those would be ethical claims that any country can afford regardless of its degree of development, no matter how poor it may be, because these demands do not depend on resources but on the way of organizing social life and the will to be based on principles. Democracy is the guarantee that human rights will not be subjected, says the author. Many of the individual and social demands depend on the economy, hence the criticism of Sen (1987) that the distancing of the economy from ethics has impoverished the welfare economy and weakened a good part of its bases, especially descriptive and predictive economics. This distance can be shortened through mutual enrichment, which is useful and necessary for both disciplines. In this, Gabás (2016) agrees when he states that, indeed, ethics and economics need each other, since both focus on the good, since it is not possible to provide well-being to citizens, what this author calls as good life, as it corresponds to the ethical demands, without the help of the initiatives and human activities that are proper to a solid economy. For its part, ethics makes strong demands on the economy, since it acts as a brake on it insofar as it distinguishes between licit and illicit activities and censors certain forms of wealth distribution to that extent as it creates areas that this author calls of public shame, that economic activities must avoid such as air pollution or poverty. Therefore, ethics without the activities of the economy is incapable of carrying out what it demands, at was stated previously.

Food would fall within the framework of these possible, enforceable demands, to which the aforementioned authors refer, which, following the logical sequence of Sen's ideas, can only be met and satisfied within the framework of freedoms provided by a functional democracy. This is where another cardinal idea is articulated in Sen's thought, when he points out that, to guarantee social objectives, they must necessarily be integrated as rights within the legal system and in this way the normative order is filled with moral content, in such a way that the ethical principles underlying the system be vindicated through legal or political mechanisms that the system itself establishes to achieve the capabilities that allow access to rights that in turn allow access to food in an otherwise correct way (Sen, 2002). The right to adequate food is primarily the right to eat with dignity and this should not be confused with a welfare duty of the State, but rather it should be understood that the State is obliged to: (i) that no one suffer from hunger or serious malnutrition; (ii) provide sufficient, safe and nutritious food to those who cannot do it themselves; (iii) prevent all forms of discrimination in access to food or the resources used to produce it, such as land; (iv) adopt measures to guarantee that all individuals and their families can feed themselves in a dignified way (FAO, 2013). Eide (1987) agrees with Sen in pointing out that food is a human right and must be viewed from this perspective. He calls for conscience on the subject, using a dramatic image when he points out that we rarely realize that many of those who seek their daily food do so by searching through the garbage, standing in long queues or simply ignoring the origin of what they consume and this violates the moral requirement to obtain food in a way that is not contrary to human dignity.

If food is a human right, then the State has a fundamental role in ensuring that this right is effectively materialized and that citizens can make it justiciable, that is, that they can enforce that right before the administration or before the courts if necessary. The State must guarantee the justice of the right to food, which also requires expanding Sen's thesis, guaranteeing an efficient and fair rule of law, and this also goes through a functional democracy. The ideal state for this is one of the democratic types. A question for discussion arises: is it possible to enforce the right to food, reverse the malnutrition of vulnerable sectors, reassure the food security of the population under the current political regime in Venezuela, characterized by censorship and repression?

Discussion

This research reviews the relationship between functional democracies and extreme food insecurity crisis in a population. The starting point was the analysis of the institutional decline of Venezuela under the so-called 21st century socialism that was progressively established from the promulgation of the current constitution, linking it with a cardinal contribution from Amartya Sen that relates the prevailing government regime with the nutritional status of the population. In his long career on the economics of development, Sen has established that the system of political, economic and social freedoms that best adjusts to the form of government that we know as democracy, is of capital importance in the prevention of extreme food crises and, in particular, of famines and in any case, it is the system that works best to correct them when they occur. Sen shows that it is not the decline in food availability that is the cause of famines or acute food insecurity crises, but that it is insufficient income or its total absence that compromises economic access to food and, consequently, its physical access. Sen, however, goes further in his analysis, pointing out that it is the lack of capabilities of some social sectors or families to produce food or acquire it in the market that causes inaccessibility to food, and this inability is due to the fact that they suffer or simply do not have what the author calls the entitlement to the food, which in short is nothing other than a right of access to the food or the inputs necessary to produce it. In turn, for Sen, the limitations to entitlement are a consequence of a severe democratic deficit, the product of a prevailing political system that does not allow the exercise of fundamental freedoms, especially those of expression and discussion, since they are not only decisive for inducing social responses to economic needs, but essential in the conceptualization of those needs. Hence the importance of democracy for the economist, as the most effective system to correct extreme food situations that occur as a consequence of both wrong policies and disrespect for political and economic rights, being the latter in the causal axis of the former.

Here appears another fundamental contribution of Sen by linking hunger and malnutrition as a serious violation of human rights, in particular the right to food. In this review, it was stated that since life depends on food, the right to food is intricately linked to the most important of all human rights, which is the right to life. Therefore, the violation of the right of access to food also violates the international law of any agreement signed in this regard and contravenes ethical principles. The concepts of capabilities, entitlement and human rights are at the center of Sen's research as a welfare and development economist, especially in dealing with poverty and hunger, having challenged the neoclassical approach to the utility of consumers in economics. In this sense, Desai (2001) recognizes his contributions to development economics, imposing a rigorous and intensive line of research that led to the concept of entitlement, addressing toward the study of the real causes of poverty and deprivation, with transdisciplinary foundations of economic science and philosophy, which place human concerns at the center of his studies. Amartya Sen's ideas constitute central principles of a paradigmatic approach to development that has influenced and evolved in the United Nations Human Development Reports, which are now based not so much on planning or the delivery of public services, but on political empowerment of people, as previously referred to in the review in the recognition made by Fukuda-Parr (2003).

On the other hand, Sen's defense of democracy has its roots in the role that the researcher assigns to freedom, because the democratic practice of participating in decision-making processes is not understood without such processes being based on the freedom. Only under a regime that recognizes and guarantees fundamental freedoms and human rights, citizen scrutiny is possible and effective. The investigation noted that Sen incorporates democracy as part of his system of analysis due to its instrumental role in advancing the cause of freedom, as expressed in his famous observation that hunger has never occurred in a well-functioning democratic society. Sen is not only a researcher of democracy, but a militant committed to its cause, who is recognized for his respect for the diversity of values and for people's preferences. It is only through a democratic process that the choice between policies and institution building can be made with respect for diversity. Diversity deference requires that the social choice between alternative policies, institutions, and rules, be determined through a democratic process, as Osmani (2009) points out, explaining Sen's ideas. In short, Sen assigns three essential virtues to democracy that for the author make it a political system of universal value. The first of these virtues refers to the value that participation and political freedom have in human existence. The second virtue is the importance of the political participation of citizens as an effective tool to guarantee the responsibility of governments and accountability. The third virtue is the constructive value of democracy in the formation of values and for the achievement of agreements for the understanding of needs, rights, and obligations.

The early warning system against famines and food crises, an instrumental role that Sen assigns to democracies, has not worked in Venezuela since freedom of the press is highly restricted, and the work of the media is conditioned on messages that only please to the regime. The exercise of freedom of expression has serious consequences for those who exercise it, be they journalists or media owners. The investigation cited various reports that point to the autocratic drift of the once stable and thriving Venezuelan democracy. All freedoms have been violated and among the most conspicuous assessments used in the review to support this assertion, the reports of the United Nations High Commissioner for Human Rights stand out, which, together with the revisions of different institutions and investigations also cited, coincide in pointing out the progressive decline of the country's democratic institutions to levels that are persistently violating human rights. Food insecurity, which affects almost 90% of the population and the drop in GDP is −35% at the end of 2019 [IMF (International Monetary Fund), 2020], have generated a forced migration for this cause of more than 4 million people, a little more than 10% of the population, according to references from specialized United Nations agencies such as FAO, UNHCR and various investigations, also cited in the review.

The figures that denote the patent degeneration of Venezuelan democracy toward an autocratic regime, are too manifest to allow it to pass unnoticed. To the extent that the regime has infringed the guarantees of freedoms on which the democratic governments born in 1958 were based, the evidence indicates that an acute crisis of food insecurity, hunger, and malnutrition, has occurred and it will surely continue if the regime does not open itself to respect for essential freedoms or continues to criminalize the demands of the population, many of them containing solutions to the causes of food insecurity.

In the world of economics and politics, a door was opened for several decades with Amartya Sen's research, which is not only useful to understand what is happening in Venezuela, but even more useful to provide a solution. The democratic deficit in Venezuela must be discovered and revealed to the international community, since the consequences come at an extremely high cost for the population. Ignoring it would be unethical.

Author Contributions

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

ACNUR. Agencia ONU para Refugiados (2019). Situación en Venezuela. Available online at: https://www.acnur.org/situacion-en-venezuela.html (accessed September, 20, 2019).

Google Scholar

BBC News Mundo (2020). Coronavirus: 5 de los países que corren más riesgo de sufrir una “hambruna bíblica” a causa del covid-19 (y uno está en Latinoamérica). Available online at: https://www.bbc.com/mundo/noticias-internacional-52402210 (accessed April 24, 2019).

Biardeau, J. (2007). El proceso de transición hacia el nuevo socialismo del siglo XXI?: un debate que apenas comienza. Rev. Venez. de Econ. y Ciencias Sociales. 13:6. Available online at: http://www.ucv.ve/fileadmin/user_upload/faces/problemas_sociales_contemporaneos/CESOC/MAYO_AGOSTO_2_2007__SOCIALISMO_DEL_SIGLO_XXI.pdf (accessed April 30, 2019).

Google Scholar

Borghi, M., Postiglione, L., Papini, R., et al. (2004). El Derecho a la Alimentación. Temas Seleccionados. Caracas: Instituto Internacional Jacques Maritain y Fundación Polar.

Google Scholar

Boutros-Ghali, B. (2002). The Interaction Between Democracy and Development. Paris: UNESCO.

Google Scholar

Brewer-Carías, A. (2012). Práctica y distorsión de la justicia constitucional en Venezuela (2008-2012). Caracas: Editorial Jurídica Venezolana.

Brewer-Carías, A. (2017). Práctica y distorsión de la justicia constitucional. Tomo XIII. Caracas: Fundación de Derecho Público. Editorial Jurídica Venezolana. Available online at: http://allanbrewercarias.com/wp-content/uploads/2017/01/BREWER-TRATADO-DE-DC-TOMO-XIII-9789803652982-txt.pdf (accessed September 25, 2019).

Cartay, R., and Dávila, L. (2020). Anatomía política del hambre: dominación y control en Venezuela. Agroalimentaria 26:50. Available online at: http://erevistas.saber.ula.ve/index.php/agroalimentaria/article/view/16541/21921927682 (accessed January 10, 2021).

Google Scholar

Contreras, M. (2007). Socialismo del siglo XXI. Al debate. Rev. Venez. de Econ. y Ciencias Sociales. 13:6. Available online at: http://www.ucv.ve/fileadmin/user_upload/faces/problemas_sociales_contemporaneos/CESOC/MAYO_AGOSTO_2_2007__SOCIALISMO_DEL_SIGLO_XXI.pdf (accessed January 15, 2019).

Google Scholar

Desai, M. (2001). Amartya Sen's contribution to development economics. Oxford Dev. Stud. 29:3. doi: 10.1080/13600810120088831

CrossRef Full Text | Google Scholar

Drèze, J., and Sen, A. (1989). Hunger and Public. Action. New York, NY: Oxford University Press.

Google Scholar

Eide, A. (1987). El derecho a una alimentación adecuada como un derecho humano. New York, NY: Naciones Unidas. Centro de Derechos Humanos. E/CN, 4/Sub.2/1987/23. Informe del Relator Especial a la Subcomisión de Prevención de Discriminaciones y Protección a las Minorías, sobre el derecho a una alimentación adecuada como derecho humano.

ENCOVI (2020). Encuesta Nacional de Condiciones de Vida 2019-2020. Universidad Católica Andrés Bello. Instituto de Investigaciones Económicas y Sociales (IIES). Available online at: https://assets.website-files.com/5d14c6a5c4ad42a4e794d0f7/5f0385baa2370b542549a958_Presentaci%C3%B3n%20%20ENCOVI%202019%20SA%20y%20Nutricion_compressed.pdf (accessed July 15, 2019).

FAO (1996). Cumbre Mundial sobre la Alimentación. Roma: Food and Agriculture Organization of the United Nations. Available online at: http://www.fao.org/3/x2051s/x2051s00.htm#P47_74 (accessed May 10, 2019).

FAO (2001a). Cuestiones éticas en los sectores de la alimentación y la agricultura. Roma: Organización de las Naciones Unidas para la Agricultura y la Alimentación. Available online at: http://www.fao.org/docrep/003/x9601s/x9601s07.htm#P0_0 (accessed September 19, 2019).

FAO (2001b). Informe del Cuadro de Expertos Eminentes sobre la Ética en la Alimentación y la Agricultura. Primera Reunión. Roma: Organización de las Naciones Unidas para la Agricultura y la Alimentación. Available online at: http://www.fao.org/3/x9600s/x9600s00.htm (accessed September 19, 2019).

FAO (2001c). Informe del Cuadro de Expertos Eminentes sobre la Ética en la Alimentación y la Agricultura. Segunda Reunión. Roma: Organización de las Naciones Unidas para la Agricultura y la Alimentación. Available online at: http://www.fao.org/3/X9602s/X9602s00.htm (accessed September 19, 2019).

FAO (2006). Informe del Cuadro de Expertos Eminentes sobre la Ética en la Alimentación y la Agricultura. Tercera Reunión. Roma: Organización de las Naciones Unidas para la Agricultura y la Alimentación. Available online at: http://www.fao.org/3/a0697s/a0697s.pdf (accessed September 19, 2019).

FAO (2011). Una introducción a los conceptos básicos de la seguridad alimentaria. Roma: Organización de las Naciones Unidas para la Alimentación y la Agricultura. Available online at: http://www.fao.org/3/al936s/al936s00.pdf (accessed September 18, 2019).

FAO (2013). Guía orientativa: integración del derecho a una alimentación adecuada en los programas de seguridad alimentaria y nutricional. Roma: Organización de las Naciones Unidas para la Alimentación y la Agricultura. Available online at: http://www.fao.org/3/a-i3154s.pdf (accessed September 18, 2019).

Google Scholar

FAO, IFAD, UNICEF, WFP, and WHO. (2019). The State of Food Security and Nutrition in the World 2019. Safeguarding against economic slowdowns and downturns. Rome: Food and Agriculture Organization of the United Nations.

Google Scholar

FAO and OPS (2017). Panorama de la Seguridad Alimentaria y Nutricional en América Latina y el Caribe. Santiago de Chile: Organización de las Naciones Unidas para la Alimentación y la Agricultura y Organización Panamericana de la Salud.

Google Scholar

FAO OPS, WFP, and UNICEF. (2018). Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2018. Santiago de Chile: Organización de las Naciones Unidas para la Alimentación y la Agricultura.

Google Scholar

Fukuda-Parr, S. (2003). The human development paradigm: operationalizing Sen's ideas on capabilities. Fem. Econ. 9, 2–3. doi: 10.1080/1354570022000077980

CrossRef Full Text | Google Scholar

Fundación Bengoa (2018). Emergencia Humanitaria Compleja en Venezuela. Derecho a la Alimentación. Reporte Nacional. Available online at: https://www.fundacionbengoa.org/noticias/2019/Reporte%20Nacional%20EHC%20Derecho%20a%20la%20Alimentaci%C3%B3n%20y%20Nutrici%C3%B3n%20diciembre%202018%20Espa%C3%B1ol.pdf (accessed November 20, 2019).

Gabás, R. (2016). “Puede la ética convertirse en reina de la economía?,” in Construir nuevas sociedades, ética y economía, eds J. L. Da Silva and M. D. Giacomo (Caracas: UCAB ediciones), 43–74.

Grijalva Jiménez, A., and Castro-Montero, J. L. (2020). La Reelección Presidencial Indefinida en Venezuela, Nicaragua, Ecuador y Bolivia. Estud. Constit. 18, 9–49. doi: 10.4067/S0718-52002020000100009

CrossRef Full Text | Google Scholar

Guerra, J. (2006). Qué es el socialismo del siglo XXI?. Caracas: Librorum Editores.

ICJ (International Commission of Jurists) (2017). Achieving Justice for Gross Human Rights Violations in Venezuela. Baseline Study. Geneva: International Commission of Jurists. Available online at: https://www.icj.org/wp-content/uploads/2017/08/Venezuela-GRA-Baseline-Study-Publications-Reports-Thematic-reports-2017-ENG.pdf (accessed September 15, 2019).

ICJ (International Commission of Jurists) (2019). No Room for Debate. The National Constituent Assembly and the Crumbling of the Rule of Law in Venezuela. Geneva: International Commission of Jurists. Available online at: https://www.icj.org/wp-content/uploads/2019/07/Venezuela-No-room-for-debate-Publications-Reports-Fact-finding-mission-reports-2019-ENG.pdf (accessed September 15, 2019).

IDEA (International Institute for Democracy and Electoral Assistance) (2017). The Global State of Democracy. Exploring Democracy's Resilience. First Edition. Stockholm: International IDEA. Available online at: https://www.idea.int/gsod-2017/files/IDEA-GSOD-2017-REPORT-EN.pdf (accessed February 20, 2019).

IFPRI (International Food Policy Research Institute) (2019). Global Food Policy Report. Washington, DC: Available online at: https://doi.org/10.2499/9780896293502 (accessed February 15, 2019).

IMF (International Monetary Fund) (2019). World Economic Outlook Update. Available online at: https://www.imf.org/en/Publications/WEO/Issues/2019/07/18/WEOupdateJuly2019 (accessed January 20, 2021).

IMF (International Monetary Fund) (2020). Real GDP Growth (Annual Percentage change). Available online at: https://www.imf.org/en/Countries/VEN (accessed March 20, 2020).

Latinobarómetro (2018). Informe 2018. Corporación Latinobarómetro. Available online at: http://www.latinobarometro.org/latdocs/INFORME_2018_LATINOBAROMETRO.pdf (accessed January 15, 2019).

Morales, A. (2019). El Abastecimiento Urbano de Alimentos y la Situación Alimentaria y Nutricional en Venezuela Durante la V República. 1999 - 2017. Revista Venezolana de Análisis de Coyuntura 25:2. Available online at: http://saber.ucv.ve/ojs/index.php/rev_ac/article/view/17962/144814484371 (accessed March 10, 2020).

Google Scholar

OCHA (2019). Venezuela: Humanitarian Response. Situation Report N° 2as of July 2012. Available online at: https://reliefweb.int/sites/reliefweb.int/files/resources/20190823_VEN_SITREP2_ENG_FINAL_0.pdf (accessed November 20, 2019).

Office of the United Nations High Commissioner for Human Rights (OHCHR) (2017). Human rights violations and abuses in the context of protests in the Bolivarian Republic of Venezuela from 1 April to 31 July 2017. Geneva: United Nations Human Rights Office of the High Commissioner. Available online at: https://www.ohchr.org/Documents/Countries/VE/HCReportVenezuela_1April-31July2017_EN.pdf (accessed February 15, 2019).

Office of the United Nations High Commissioner for Human Rights (OHCHR) (2019). Report of the United Nations High Commissioner for Human Rights on the situation of Human rights in the Bolivarian Republic of Venezuela. Available online at: https://www.ohchr.org/Documents/Countries/VE/A_HRC_41_18.docx (accessed October 15, 2019).

Osmani, S. R. (2009). “The Sen system of social evaluation,” in Arguments for a Better World. Essays in Honor of Amartya Sen, Volume I: Welfare, Ethics and Measurement, eds K. Basu and R. Canbur (New York, NY: Oxford University Press Inc.), 15–34. doi: 10.1093/acprof:oso/9780199239115.003.0003

CrossRef Full Text | Google Scholar

Pérez, K. (1996). “Causas del hambre y teoría de la “titularidad” al alimento de Amartya Sen,” in El incendio frío. Hambre, alimentación y desarrollo, eds B. Sutcliffe (Barcelona: ICARIA editorial, S.A.), 95–111.

Pinstrup-Andersen, P. (2009). Food security: definition and measurement. Food Secur. 1, 5–7. doi: 10.1007/s12571-008-0002-y

CrossRef Full Text | Google Scholar

Pressman, S., and Summerfield, G. (2000). The economic contributions of Amartya Sen. Rev. Polit. Econ. 12:1. doi: 10.1080/095382500106830

CrossRef Full Text | Google Scholar

Prosalus, Cáritas e Ingeniería sin Fronteras (2009). Reflexiones en torno al Derecho a la Alimentación. Madrid: Prosalus y Comunidad de Madrid. Available online at: https://prosalus.es/sites/default/files/publicaciones/6_reflexiones_en_torno_al_derecho_a_la_alimentacion.pdf (accessed October 26, 2019).

Rachadell, M. (2015). Evolución del Estado Venezolano 1958-2015: de la conciliación de intereses al populismo autoritario. Colección Estudios Políticos N° 11. Caracas: Editorial Jurídica Venezolana.

Raffalli, S., and Castro, J. (2019). Salud y alimentación en Venezuela. Colapso y propuestas 2019. Revista de Occidente. N° 458–459, 111–126.

Savater, F. (1999). Ética y ciudadanía. Caracas: Monte Ávila Editores Latinoamericana.

Sen, A. (1981). Poverty and Famines. An Essay on Entitlement and Deprivation. Oxford: Oxford University Press.

Google Scholar

Sen, A. (1987). On Ethics and Economics. Oxford: Basil Blackwell.

Google Scholar

Sen, A. (2000). Desarrollo y libertad. Buenos Aires: Planeta.

Sen, A. (2002). El derecho a no tener hambre. Colombia: Universidad Externado de Colombia. Available online at: http://www.oda-alc.org/documentos/1341939221.pdf (accessed Janury 16, 2020).

Sen, A. (2006). El valor de la democracia. España: El Viejo Topo.

Google Scholar

Shaikh, N. (2006). Desarrollo como libertad. Entrevista a Amartya Sen. Cuadernos del CENDES 23:63. Available online at: https://www.redalyc.org/articulo.oa?id=40306305 (accessed August 16, 2020).

Tapia, M., Puche, M., Pieters, A., Marrero, J., et al. (2017). “Food and nutritional security in Venezuela. The agrifood abduction of a country: vision and commitment,” in Challenges and Opportunities for Food and Nutrition Security in the Americas: The View of the Academies of Sciences, eds M. Clegg, E. Bianchi, J. McNeil, L. Herrera, and K. Vammen (México: IANAS Regional Report), 566–607. Available online at: https://www.ianas.org/docs/books/FN01_Ven.html (accessed December 15, 2019).

Tommasoli, M. (2013). Democracy and Development: the Role of the UN. Discussion paper. Stockholm: International IDEA. Available online at: https://www.idea.int/sites/default/files/publications/democracy-and-development-the-role-of-the-united-nations.pdf (accessed October 16, 2019).

United Nations (1948). Universal Declaration of Human Rights. General Assembly resolution N° 217 A (III). New York, NY: UN. Available online at: https://undocs.org/A/RES/217(III) (accessed April 01, 2019).

Google Scholar

United Nations (1966). International Covenant on Economic, Social and Cultural Rights. General Assembly resolution N° 2200A (XXI). Geneva: UN Human Rights Office of the High Commissioner. Available online at: https://www.ohchr.org/Documents/ProfessionalInterest/cescr.pdf (accessed April 10, 2019).

Google Scholar

Vizard, P. (2006). Poverty and Human Rights. Sen's “Capability Perspective” Explored. New York, NY: Oxford University Press. doi: 10.1093/acprof:oso/9780199273874.001.0001

CrossRef Full Text | Google Scholar

WFP (Programa Mundial de Alimentos) (2020a). La COVID-19 duplicaría el número de personas que hacen frente a crisis alimentarias si no se actúa con rapidez. Available online at: https://es.wfp.org/noticias/COVID-19-duplicara-numero-personas-hambre-si-no-se-actua (accessed April 21, 2020).

WFP (World Food Programme) (2020b). Venezuela Food Security Assessment. Main Findings. United Nations: OCHA services. Available online at: https://reliefweb.int/report/venezuela-bolivarian-republic/wfp-venezuela-food-security-assessment-main-findings-data (accessed August 15, 2020).

Google Scholar