12 October 2013
Going Dutch: The nutrition comparative advantage of the Netherlands
The first day was spent at Wageningen University with their Human Nutrition Division. I gave a talk with some ideas on how to bring nutrition and agriculture together. I met some of the Masters and PhD students and several of the faculty, including Inge Brouwer and Alida Melse-Boonstra. I was impressed. They have built a very supportive research and teaching community and are looking to connect with others outside of the nutrition department to bring a wide angle lens to what is essentially a development problem. They are also very entrepreneurial while not forsaking high quality research. They also have a new campus with some spectacular new buildings.
The following day I was at a meeting organised by the Netherlands Working Group on Nutrition (a collective of nutrition professionals from academia, NGOs, business and the government) at the Ministry of Foreign Affairs to discuss the implications of the recent Lancet series on nutrition. Bob Black (paper 1 and series lead), Zulfi Bhutta (paper 2) and I were there (I presented paper 3 for Marie Ruel and Harold Alderman as well as paper 4). There were some nice presentations from Bonnie McClafferty of GAIN and Martin Bloem from WFP, both reflecting on what to do about nutrition-sensitive interventions. In the afternoon there was a panel discussion well facilitated by Prof. Franz Kok of Wageningen.
My takeaways from the 2 days:
1. The Dutch to lead in bringing public and private together to reduce malnutrition
According to the HANCI donor index the Netherlands has been in the doldrums on nutrition and hunger reduction commitments (16th out of 25 donor countries), but these data are from 2011-12 and things seem to be picking up under the leadership of Paulus Verschuren, the Government's Special Envoy on Food and Nutrition. Given the Netherlands' past contributions it seems very well placed to be a leader on the connections between nutrition and agriculture. A more recent comparative advantage has been built up around institutional models for bringing the public and private sectors together in the service of public health nutrition goals (e.g. Public Private Partnerships, PPPs).
2. Deal with the Remaining Nutrition Community Hangups
Paulus Verschuren put it nicely, saying that the nutrition community had put many of its squabbles behind it (food vs nonfood, chronic vs acute, micronutrients vs food, supplementation vs fortification etc) but that it had not yet come to terms with the role of the private sector. I agree with this, but I was struck by how at ease this Dutch audience was with the private sectors. I made the point that there is very little evidence that PPPs advance child and maternal nutrition (there is some in fortification), but that this should not stop them going ahead. This is because there is evidence from the wider health literature that in certain conditions they do work, nevertheless any new PPPs in nutrition had to be properly evaluated by independent third parties. Donors, please fund these--gut feelings can only get us so far.
3. Agriculture and Nutrition: Cohabitation, Shotgun Marriages or Wedded Bliss?
A number of strategies for bringing agriculture and nutrition together emerged over the course of the day. Do we simply colocate agriculture and nutrition efforts in terms of regions, individuals and delivery platforms? Do we try to bring nutrition into agriculture in ways that it does not fundamentally shift the goals of agriculturalists or do we go for full union whereby agricultural programmes are determined to have an impact on nutrition and are designed from the start to do so? The latter is probably the hardest, but perhaps has the biggest impact when successful. The former is probably the easiest but might not have the largest action. But all of this is hypothetical--we don't know which approach is easiest and best--research is needed.
4. Go Dutch
The term "Going Dutch" originated from Dutch farmhouse doors being split equally at the top and the bottom--only when both were open at the same time could progress be made. This is a nice euphemism for the new contributions they can make: when the public and private doors open together around the links between agriculture and nutrition, then real progress could be made. We look to our Dutch friends to lead the way. They might even move up in the HANCI rankings...
Posted by Lawrence Haddad at 15:03