For more than 50 years, the U.S. -- which accounts for half of global food aid supplies -- has played an important role in alleviating malnutrition and hunger, esp. during emergencies. In FY 2010, the U.S. spent $1.5 billion on emergency food aid that reached 46.5 million beneficiaries. To preserve the nutritional value of food aid, quality controls are in place throughout the supply chain. This report assessed U.S. efforts to: (1) meet the nutritional needs of intended recipients; and (2) maintain the quality of commodities throughout the food aid supply chain. The auditor interviewed agency officials and their implementing partners, and conducted fieldwork in the U.S. and four countries in Africa. Charts and tables. This is a print on demand report.