27 April 2015

New: Healthy Food for a Healthy World (But how to make it happen?)

The influential Chicago Council on GlobalAffairs has produced a new report “Healthy Food for a Healthy World” with an analysis and recommendations for the US Government on how agriculture and food can better leverage improved nutrition.

The report does a good job of outlining a series of outcomes that we would like to see along the food system chain: from natural resources and inputs (e.g. secure land tenure for women) to health and nutrition (e.g. coordinate food system interventions with health and social protection programmes).

The report notes that (1) the improvements in agricultural productivity, if focused on smallholder farming families, can lead to income generation that is very pro-poor and if women in the food system can be empowered then this is doubly good for nutrition, (2) the food system is much too tolerant of lots of food waste—much of it affecting foods that are rich in micronutrients but which need cold storage such as animal products, fruits and vegetables, (3) only ¾ of harvests are not contaminated by the poisonous fungus mycotoxin, (4) the food system is tending towards producing more and more ultraprocessed foods which are, in large part, unhealthy and (5) climate change and urbanization are challenges for--but also opportunities to rethink--our food systems.

I also really liked the panels from Roger Thurow, breaking through the statistics to let us see the stories and hear the voices of those most affected by malnutrition.  The inspired use of photographs to bring home the paucity of diets in many parts of the world is also hard hitting.

So far, so good.  What are the recommendations for the US Government?

The first set of recommendations is very pragmatic—what should be done within existing instruments?  Have a whole of government approach to healthy food systems—not just USAID but USDA and other agencies.  Make food aid more efficient (untie from US shipping, allow more food to be purchased locally) and support efforts to make social protection more nutrition sensitive (as in Ethiopia with the Productive Safety Net Programme). Align all interventions around the 6 World Health Assembly targets.  Encourage more trans-disciplinary research, i.e. mash ups of existing approaches to address complex issues such as nutrition. This is all good sense—first change things that are more under US government control (although untying aid is far from “simple”).

The second set of recommendations is around research.  Incentivise international and national agricultural research to do more work on fruits and vegetables to increase profits and lower their cost in the marketplace.  Close data gaps between agriculture and nutrition surveys.  Invest more in biofortification.  Measure the nutrition impact of agricultural interventions, and so on.  This is important set of recommendations—how can we begin to get a sense of which agricultural investments, under which circumstances, are most nutrition enhancing?  Vital information.

The third set is perhaps the most exciting because while important it is usually ignored—develop leaders for whom making the link between food systems and nutrition is second nature.  Invest in research centres in the US and overseas that are committed to this.  Invest in leadership programmes that stress whole of society working.  Invest in innovation awards that set new norms about what agriculture is for.  Train Peace Corps volunteers in what nutrition sensitive development looks like. 

Finally, develop public-private partnerships that can incentivize businesses towards healthier food systems: support infrastructure to reduce food losses and promote food safety, support entities that monitor firm behaviour, support budding nutrition-oriented SMEs, increase technical assistance on monitoring food safety in Africa, and support stronger global advocacy of voluntary guidelines on nutrition sensitive marketing to children.

For me, the thing that is missing from the analysis is the political economy of it all.  

Why should members of the Congress and the Senate support these measures to promote voluntary guidelines on marketing unhealthy food to children if they risk upsetting businesses who have located in their state?  What is in it for agricultural and nutrition researchers to work together more closely?  How can infrastructure investments that will promote fresh fruit and vegetable access be made more attractive? If food aid has been tied for decades, why might it become untied now?  Having a whole of government approach to a healthy food system is great, but why has it not happened before? How can we encourage trans-disciplinary research when most journals prefer disciplinary research?

I’m not suggesting these questions are easy to answer.  Far from it. But I would have liked to have seen some recognition of this and some ideas for moving forward. 

Nevertheless, I very much enjoyed reading this report—it is a thoughtful analysis, well written, and contains many pragmatic good ideas. If its recommendations were acted on they would make a big difference to nutrition status the world over.  

I hope the Council will maintain a scorecard and tell us which of its recommendations have been taken up and which have not.  And explain why. 

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