29 June 2013

Making the Private Sector Public in Hunger and Malnutrition

This week saw the Delhi launch of the Lancet Nutrition series. Ahead of the launch a group of senior nutrition experts and paediatricians in India wrote an open statement that contained the following sentence.  

"The call for engaging with the "private sector" and unregulated marketing of commercial foods for preventing malnutrition in children raises serious concerns. The inherent conflict of interest will ensure that commercial considerations override sustainable nutritional goals." 

The series said nothing of the sort.  

Paper 4 of which I was a co-author says we should engage with the private sector, but on the public sector's terms (i.e. in the areas they want, for the groups they want and with the regulation and risk assessment they demand). Unfortunately this private sector stuff is pretty much only what the Indian newspapers wanted to talk about. They should be asking why the Government has not collected any national nutrition data for 7 years.   

The inability to have a debate on the rules of engagement with the private sector is costing children's lives and wellbeing. And the stand-off is so pointless because the private sector is already incredibly influential (nearly a quarter of all Indian kids in the upper income quintile are stunted--these households use the market to provide for most of their food, water, health and sanitation needs).   

Relatedly, President Obama was in Africa to promote the G8's New Alliance for Food Security and Nutrition. The Alliance is a trio of commitments from African leaders, private sector partners and the G8.  

I was interviewed about this for the LA Times. I said that New Alliance could be a good thing but only if it passes three tests:
(a) is it targets to smallholder farmers (see the new High Level Panel of Experts report on smallholder farming),
(b) who can actually afford to engage with it (if it does not leave them in too much debt),
(c) if governments are willing and able enough to specify the conditions under which alliances with the G8 and private sector are formed and then:
(d) enforce them.  

The imbalances of power between the public and private sector in food and agriculture makes the meeting of these conditions difficult but not impossible. Underpinning all of this is transparency. I don't believe transparency is sufficient, but in this area of power imbalances around hunger and nutrition, I feel it is necessary.  

Whenever the public sector engages with the private sector, the agreements, conduct, profits and impacts on  hunger and malnutrition have to be public.   


Vivica Kraak said...

Well said Lawrence. I agree the central issue is the inability of national governments to have a productive and honest debate about the rules of engagement between public and private entities.
The taking of the account (which transparency facilitates) to identify what is happening is relative easy compared to the sharing of the account, holding key stakeholders to account, and responding to the account to strengthen system-wide accountability structures.
Yet it is the persistence of undisclosed or difficult to document, behind the door, private-sector practices (notably industry’s privileged access to policymakers that permits commercial interest lobbying to trump public health goals), combined with weak governance and regulatory oversight, which influences policy development and fuels distrust among public-interest advocacy watchdogs and civil society groups who refuse to engage. Whether you are talking about undernutrition or obesity or NCD prevention and control, this is the heart of the issue. Who sets the rules of engagement, and who holds whom to account for what, and the credibility and trustworthiness of the accountability process.
Vivica Kraak, Deakin University, Australia

Mamunur said...

Worth reading! We are raising the flag from Bangladesh in support your ideas. Mamunur, Gender Expert, EU