Describe the changes in Sub-Saharan Africa between 1990 and 2015.

Identify the region with the greatest relative change in mortality rate between 1990 and 2015.

Outline why HALE is a better indicator of a nation’s health than child mortality.

Explain how the application of two named barriers to limit the spread of disease has reduced child mortality rates.

Evaluate the relative importance of fair trade and food aid in overcoming food shortages in low-income countries.

Decreased from about 170–180 to about 70–80 deaths per thousand [1].

Eastern Asia [1].

Health-adjusted life expectancy, based on life expectancy at birth but including an adjustment for time spent in poor health [1]; it refers to the whole population rather than just a subset of the population [1].

Or any other valid suggestion.

Possible barriers include:

• introduction of bed nets
• anti-retrovirals reducing mother–child transmission
• spraying of still water sources
• introduction of vaccination/immunization programmes.

Other valid factors should be credited.

NB. “physical” barriers are not valid as they are not “applied”.

Award [1] for each valid point and [2] for further development or explanation.

For example: Increased access to anti-retrovirals [1] in South Africa, which has a high incidence of HIV/AIDS [1], reduces mother to child transmission of disease, enabling more children to survive past the age of five [1].

The aim of fair trade is to help producers in low-income countries achieve better trading conditions, markets and higher prices for their produce and to promote sustainability. The focus is typically on agricultural produce that is typically exported to high-income countries, such as coffee, tea, bananas. It promotes sustainable development and seeks to improve the working conditions and rights of small-scale farmers. A higher income means more money available to purchase food and the ability to invest in food production, and thus overcome long-term food shortages.

Food aid is concerned with providing food to tackle problems of hunger in emergency situations, or to alleviate longer-term hunger and achieve food security. Although useful in overcoming emergency food shortages in times of disasters such as famine or earthquakes, or civil wars and refugees, it is questionable whether it offers a long-term solution to food security. Sustainable development is not necessarily food aid’s long-term objective. Also food aid has been criticized for food dumping and maintaining low prices for farmers in low-income countries.

Good answers may evaluate the degree to which food shortages might be localized or widespread, short-term or long-term. Answers may evaluate whether fair trade is mainly focused on the export of food crops, or also seeks to promote sustainable development; higher farm incomes might result in increased investment in the production of food crops and thus alleviate local food shortages. Answers may evaluate whether food aid is essentially an emergency strategy designed to alleviate food shortages. The disadvantages of food aid in solving long-term shortages might be considered, and whether or not it is a sustainable strategy.

For band D, expect some description of the role of food aid and fair trade in overcoming food shortages.

For band E, expect either a more in-depth explanation of the usefulness of food aid and fair trade, or some structured evaluation of how successful they have been in overcoming food shortages.

For band F, expect both of these elements.

Marks should be allocated according to the markbands.