05 November 2018

Youth are the Future: They are also the Present

During the recent World Food Prize week in Des Moines, I was invited to give talks to 3 groups of young people: the Borlaug Fellows, the African Youth Institute, and the Global Youth Institute. I was delighted to do so. The first group was the oldest—early career researchers and policymakers, the second being young African entrepreneurs, scientists, and scholars and the third group being high school students from around the world.
The addresses were tailored a bit to each group, but they had many common elements and here they are.
  1. You are the future. But you are also the present. Too often we stop at “you are the future” and of course that is true, but whether a high school student or an early career professional, these young people are the present. They have agency. They have tools like social media to mobilise and organise and speak out, they have computer literacy to design apps that can promote accountability and transparency, they have an ability to multitask and they have numbers—the we are approaching a youth bulge in many parts of the world. Many of these young people are already entrepreneurs, leaders and consumers. Many of them will soon become voters and employees. They have power, individually and collectively. Let’s support it and help focus it.
  2. Learn your craft, but live broadly. If you hone your skill, whatever that is, people will beat a path to your door. This requires hard work, focus and dedication. Think of the dozens of performances the Beatles gave in the Cavern Club in Hamburg. But you have to live widely too. That means read outside your area of specialism (blogs, websites, newspapers, nonfiction books), talk to people who are in different locations, sectors, political spaces. Get a rounded picture of a situation because it will help you deploy your specialism. Understand how to tune into the frequency of those who do not think like you because this is the only way you will ever persuade them to think differently. Also be open to your own views being challenged. The global financial crisis of 2007-8 made me think hard about some of the assumptions economists make about development (I even wrote a paper about it).
  3. Understand how change happens and don’t be afraid to be a part of the process. If you are reading this, the chances are that you have chosen your profession because you want to leave the world a better place than you found it. That means understanding how chance happens. Sound evidence is not sufficient to spur change, it may not always be necessary, but it sure is helpful. Master it better than the person you are trying to influence. Watch for opportunities to effect change. Usually these opportunities manifest themselves if there is a change in leadership or some big crisis (i.e. every crisis is an opportunity). But to contribute to that change you need to be brave and insert yourself. Make that presentation to the group of parliamentarians, find investors for your idea that will change the world, write that op-ed, brief your local political leaders, organise that rally.
  4. Develop a wide range of skills that are not always taught in school or university. Communication—oral and written—is so important. This is about listening as well as speaking. Keep it simple. Short sentences, no jargon. Like you are writing home to your folks. Once you are in the bubble it is difficult to remember that most of the people you need to persuade to do something are not residents of said bubble. Be an entrepreneur—find people to back your ideas. Talk to them with evidence, passion but patience and they will come around. Broker relationships. It may not be easier to get things done when you are in alliances and movements and partnerships but it is more enduring.
  5. Treat people well. This sounds obvious, and often we have to work with people we do not like or respect. But as well as being the right thing to do, if you are kind, treat people like you want to be treated yourself, don’t give in to the temptations of hierarchy, and put the issue before yourself, you will find people want to work with you, listen to you, take brave decisions with you and act alongside you.
  6. Identify people who inspire you. Try to learn from them, emulate them and also don’t be afraid to challenge them. I was lucky enough to have some of these fantastic people around me and they helped me grow up fast. They know who they are.
  7. Finally, don’t forget who you work for. Ultimately it is not your teacher, parent, line manager, programme leader or even yourself. If you are reading this, you have already decided to work for and with those who are less fortunate than you in large part because of the randomness of where on the planet they were born. They are the ultimate boss. It is easy to forget this. Don’t.

Why I am driven to fight malnutrition

At GAIN we are passionate about changing the world to abolish the malnutrition that destroys lives, families and undermines communities and nations. In giving his acceptance speech for the 2018 World Food Prize, GAIN Executive Director Lawrence Haddad turned to the personal experiences that shaped commitment – we offer this as an example of the personal and human character of malnutrition – its causes and the potential resources to eliminate it.

Ambassador Quinn, the Borlaug and Ruan families, and distinguished guests, I would like to thank the Council of Advisors for selecting David Nabarro and me as this year’s World Food Prize Laureates. It means so much, to so many of us, that this community has recognised the transformative power of nutrition.

So, this speech. My first attempt at writing it reminded me of the UK civil servant who retired to write poetry, but ended up writing poems that sounded like ministerial briefings. My first speech sounded like a policy brief. But tonight is very special, and so I ditched that and decided to get out of my comfort zone and share with you some things that I rarely acknowledge to others, and perhaps not even to myself.
I was brought up by a warrior mother. She fought like a tiger for me and my sister. When we no longer had a father, she became both parents. When we had no money for new clothes she got us good used clothes. When it looked like I could not get into a good state school, she made sure I did. That is the power of mothers. Thank you mom.
I was born in Africa and raised in England. I am very proud of my African roots, but I was lucky to be brought up in a country like England with its powerful welfare system. Our small family qualified for a council flat in a London tower block, I got free school meals, free prescription glasses, and a free university education. That is the power of the state.
So to my uncle. He was the first in our family to go to university. He worked at a small flavouring company. As a teenager I would get regaled with stories of the things the food industry was doing in the 1970s: freeze dried coffee, instant mash potatoes, and ravioli in a can. If you can make ravioli in a can taste OK then anything is possible! That is the power of business.
My mother worked as a volunteer in Save the Children in London. She had no child care and so she brought me along. While helping out I talked to staff. I was inspired by their sense of purpose and their conviction that they could make a difference. That is the power of civil society.
So, by age 18, I had powerful examples of the roles mothers, governments, civil society and businesses play in shaping destiny. But 1 in 3 people on this planet are denied a say in shaping their destiny–because they are malnourished. That is outrageous, unacceptable and cannot be tolerated.
So all of these different actors have to come together to end malnutrition. That is because the things that converge to generate malnutrition are powerful—not enough food, water, sanitation, health care—and they must be vanquished by even more powerful alliances drawn from all corners of society.
But that is not enough. Those coalitions, alliances and movements need a spark: a spark to catalyse the outrage.
It was when I went to work in the Philippines and India as a young man that the fire was lit for me. The shock of seeing the skin of babies impossibly stretched across bone. The shock of hearing about farmer suicides because of the despair of failed harvests. The shock of seeing girls deprived of food that is routinely given to their brothers. The shock of seeing a mother trying desperately to care for a child with constant diarrhoea.
This was visceral: only experienced, as Dr Borlaug would say, by going to the farmer. This was when I realised that malnutrition was about injustice. And it radicalised me.
Since then I have been a monomaniac on a mission. Generating evidence on how to end malnutrition. Learning about how change really happens. Working with countless others to become a part of the change process. Many of you in the house tonight are sisters and brothers in arms — and I honour you for your generosity of spirit, time and commitment.
Working together, I believe with all my being, that we can consign malnutrition to the history books – and sooner than we think.
I have only been able to this work because of my incredible family. So my deepest thanks and love go to my wife, Frederique, and to my children, Sovanne and Raphael. They have made many sacrifices for my work. They have put up with many absences and –when present—a certain level of grumpiness, distraction, and absentmindedness. Despite all of this they have provided me with unending amounts of inspiration, support, encouragement and love. That is the power of family and that is the power of love.

08 October 2018

SUN membership is relevant for ALL countries, no matter their income level. Here’s why.

By Lawrence Haddad, GAIN’s Executive Director
Since 2010, the Scaling Up Nutrition (SUN) Movement has inspired a new way of working collaboratively to end malnutrition–in all its forms. And yet, 1000 days into the SDG era, no high-income country has become a member of the SUN Movement. Why does this matter?
First, all countries experience high levels of malnutrition in at least one of its many manifestations.  For example, according to the 2017 Global Nutrition Report, the UK has obesity rates of 27%, Germany has raised blood cholesterol rates of 70%, 28% of French men have high blood pressure and, according to the 2018 World Cancer Research Fund Report, Japan has colorectal cancer rates of 39 per 100,000 — one of the highest in the world.  And in nearly all high-income countries poor nutrition is related to 5 of the top 10 risk factors in national disease burdens. By joining SUN the high-income countries can learn from other members, share experiences of what is effective in reducing these expressions of malnutrition, and work together with other members to develop new solutions to address them.
Second, many high-income country governments do not achieve the same level of coherence across government departments in fighting malnutrition that their aid programs expect from low and middle income countries. Which European country has a whole of government approach to obesity, one that brings together urban planners, agriculture, health, education, transport and trade? I can’t think of one. Joining SUN will help high-income countries achieve greater coherence in their battle against malnutrition.
Third, nutrition affects global public goods. For example, what the high-income countries grow and eat affects the poorest in the most climate-affected countries such as Bangladesh, Pakistan and many of the nations of Africa. The high-income countries have a responsibility to fix the enormous externality that their food production and consumption choices generate for those least able to adapt to climate change. Becoming a member of SUN will empower civil society within high-income countries to champion more climate smart agriculture and consumption and guide policymakers to more win-win solutions for people and the planet.
Finally, the enrollment of high-income countries embodies the highest principles of the SDGs. The SDGs are for all countries and all people. As this century progresses we will increasingly be left with the more complex problems, and they will be the ones that affect all countries and will require a degree of cooperation not seen today if they are to be tamed.  We are talking about climate mitigation, conflict prevention, insurance against financial crises, the prevention of infectious disease pandemics — and the lowering of nutrition related non- communicable diseases.
The SDGs reject the assumption that the low and middle-income countries have a monopoly on nutrition problems and the high-income countries have a monopoly on nutrition solutions.  It is time that high-income country governments realise this and join SUN.  Citizens of the world–whether from high, middle or low-income countries–deserve no less.
Lawrence is a member of the SUN Executive Committee but this view is personal and does not necessarily represent the view of the Committee.

17 September 2018

Food Safety and Healthy Diets: Docking, Colliding or Passing in the Night?

I have been working on food security and malnutrition for 30 years and food safety issues have almost no visibility. I realised that I also am woefully ignorant personally about this topic. This is very strange – as I learned last week – on both counts.  As the presentations at the Pontifical Academy of Sciences – GAIN technical workshopin the Vatican made clear, food safety threats are on the rise as food systems modernise but the capacity to control those risks lags behind.
It is clear that food safety is a necessary but not sufficient condition for healthy diets. But many people with my background do take it for granted. We should not and this is why.
First, if, for example, we want food systems to make good things like vegetables and fruits more available, affordable and desirable there is a real risk that the price we will have to pay is greater consumption of pesticides.  That’s a price no one should have to pay. The most nutritious foods we want to promote like dairy, fish, fruit and vegetables are more susceptible to food borne diseases than, say, highly processed biscuits, snacks or sugar.
Second, food “unsafety” can generate large numbers of Disability-Adjusted Life Year (DALYs) lost. The World Health Organization (WHO) estimates that “600 million – almost 1 in 10 people in the world – fall ill after eating contaminated food and 420 000 die every year, resulting in the loss of 33 million healthy life years (DALYs).”
Third, food safety scares do not need to generate large burden of disease figures to have devastating effects on lives. For example the livelihoods of the poorest farmers can be wrecked due to the distrust generated by such scares and by the potentially exclusionary food safety standards that are put in place long after the damage has been done.
So what are the pros and cons of trying to link thinking and action in food safety with healthy diets?
On the positive side, food safety issues could enter into bigger food system conversations, to rise up the policy agenda and recruit more advocates. Food safety has to be alert to changing threats generated by climate change, new technologies, climate change and urbanisation. The healthy diets community worries about these issues a lot—they could help make those lateral connections. For the healthy diets community, the food safety community could teach us about systems thinking in food. Food safety is only as strong as the weakest link in the chain and food safety experts worry about all of them and, I suspect, understand better the unintended consequences of changing one part of the food system for other parts.
What are the downsides of closer collaboration? For the food safety community there is the risk of becoming lost within the food system/healthy diet debates and budgets. There is already some sensitivity because past attempts to link with the food security community resulted in food safety becoming the minor partner.  For the healthy diet community the risk is that food safety may appear to present an added layer of complexity in what is already a complex space.
But I would urge both communities to find ways of moving closer together.  Consider the following:
  • Individual foods can be safe, but in certain diet combinations they are deadly, generating massive DALY burdens (see the country profiles at IHME). Will unsafe diets usurp unsafe foods as a policy priority? I think this a risk for the food safety community.
  • Food safety is already at risk of becoming an orphan issue. For example, next year’s WHO/FAO International Conference on Food Safety is the “First”. The first!  In addition one of the major multilateral donors at the workshop said that food safety was not a priority for them. And I was surprised to see that there is no “food safety index” to compare different country efforts to keep their food safe and exert some pressure on them to do better. Finally I was taken aback by how little research is dedicated to food safety in the food and agriculture sphere. For example while there are over 50 flagship projects in the CGIAR–our world class international agricultural research system–there is only one in food safety, and that was started just 2 years ago.
  • No one in the healthy diets community is implementing a set of actions at allpoints in a given food system to improve diet. System thinking is not yet the default way of working of governments, donors, businesses or civil society.  Food safety experts could teach us a thing or two about working across food systems.
  • Finally, food standards and safety agencies are sometimes powerful: they are not called “authorities” for nothing. Some, like the Indian Food Standards and Safety Authority, are moving into the nutritious food/healthy diet vacuum and making things happen. They are exercising their agency. The healthy diets community needs to harness this dynamism, but they won’t be able to unless they engage.
So let’s work for healthy diets and food safety to achieve some good docking complementarities, to prevent unnecessary collisions and ensure that the two issues and communities do not blithely pass each other in the darkness. People deserve better.

13 July 2018

Making the Most of the Current Window of Opportunity for Nutrition in Pakistan

I just returned from a trip to Islamabad to meet the GAIN team and some of our partners. I’m no expert on Pakistan, but compared to 2013, the commitment to accelerate reductions in malnutrition seems to have increased significantly.
In 2013 the Institute of Development Studies (IDS) and the Aga Khan Foundation released a collection of papers by Pakistani authors entitled “Seeing the Unseen: Breaking the Logjam of Undernutrition in Pakistan” it was edited by me, Zulfi Bhutta and Haris Gazdar.  In the Introduction to that collection the editors noted “The coming together of three events: the massive flooding of 2010 and 2011, which exposed chronic as well as acute undernutrition; with the recent decentralisation of health services to the provinces; and the results from the 2011 National Nutrition Survey (NNS 2011), which show an increase in stunting, have created some momentum for nutrition”.
How have things moved on?
First, nutrition is reported to be much more prominent in the next 5 year draft National Development Plan which is waiting to be ratified by the new Government elected in late July.
Second, guided by the Ministries of Planning, Development and Reform and the National Health Services, and supported by the Scaling Up Nutrition Movement (SUN), the outgoing Federal Government has already committed 10 billion rupees (about $100m) to nutrition in this financial year, which represents a major boost.
Third, civil society is trying to replicate what was so successful in Peru—getting all the political parties to make SMART commitments to nutrition in their manifestos and then holding whichever one gets into power to those promises.
Fourth, the Provincial Food Authorities have become powerful forces for change in the Provinces. Starting out in the food safety space these Authorities are extending their interests into the nutrient dimensions of food.
Fifth, businesses really seem to be stepping up to the plate. The Sun Business Network (SBN) has revived with a new injection of resources and capacity and has 33 member businesses with plans to get to 100 in the next couple of years.
Sixth, the government officials I talked to in the Ministries of Planning, Development & and Reforms and in the National Health Services were all talking about food systems and how these systems frame the nutritious foods choices people have and how they make the choices.
Seventh, the adolescent and youth agenda is high on the development agenda with senior policy makers and development partners understanding that the current youth bulge can bring both a new set of opportunities (e.g. empowerment, entrepreneurship and a redefinition of what a healthy diet looks like) but also problems (unemployment and unrest) if the approach is not right.
Finally, the urban agenda is surfacing—with the World Bank a strong proponent of leveraging urbanization for nutrition.
Of course all of these opportunities present risks. There is “many a slip between cup and lip” when it comes to what is in development plans and what actually gets done (in all countries!). Committing to spend $100m on nutrition is good, but what will it be spent on and what is the capacity to spend it (wisely)? Party political manifestos are often not worth the paper they are written on. A food systems framing can lead to action in new areas, but also to paralysis, as policymakers are overwhelmed with data and things they could do within the system. Provincial Food Authorities can be powerful agents of change, but less so if they do not align standards to make the work of business as seamless as possible over different geographies. And we know businesses can be as much a part of the affordable nutritious food problem as it is a part of the solution. Finally, a focus on urbanisation that is detached from rural transformation will run the risk of deepening divides.
But from a non-expert perspective, I detected a steely glint in the eye of all the public and private officials I met (most of them not nutritionists, by the way) and a determination that they are not going to let this moment slip to press home the advantage for nutrition. As a recent editorial by a former Finance Minister in a leading national newspaper put it “Pakistan is one of the emerging economies of the world with a notable economic growth potential that is threatened by the burden of pervasive malnutrition. Unless immediate action is taken, the crisis of malnutrition will continue to negatively affect Pakistan’s economic performance. It also has the potential to condemn future generations to a catastrophic future of deprivation and poverty.”
I couldn’t agree more and GAIN will do whatever we can to work with all stakeholders to make sure these opportunities are seized to accelerate reductions in malnutrition — in all its forms.

02 July 2018

Adolescents as Nutrition Catalysts: a Fire has been Lit!

A couple of weeks ago GAIN and the World Health Organization (WHO) organised a consultation “Adolescents: Agents of Change for a Well Nourished World”. This was the third in four “stepping stones” towards forging a consensus on promising approaches for programming to improve adolescent nutrition outcomes. The first was hosted by SPRING (a USAID initiative), the second by ENN/London School of Hygiene and Tropical Medicine, the third by GAIN/WHO and the fourth will be in September 2018, hosted by IFAD and Save the Children.
We at GAIN wanted to learn from others as we build on our adolescent nutrition landscape reports and begin working with our partners in Bangladesh, Indonesia, Mozambique and Pakistan to design interventions that are likely to improve the nutrition status of adolescents.
There were 2 key features of the consultation that GAIN and WHO were determined to make happen: (1) we wanted to learn from those outside the nutrition ecosystem who had extensive experience of working with adolescents and (2) we wanted direct and meaningful engagement with adolescents themselves. It would have been much easier not to do this, but much less interesting and legitimate we thought.
We were able to bring in expertise from organisations such as the Shornokishoree Network Foundation (SKNF), Quantum, Restless DevelopmentONEPurpose PBCAshoka’s Centre for Social and Behaviour Change, and NCDFREE – all of whom work with young people on a regular basis. Also participating were development organisations who are beginning to do more work on adolescent issues such as the Global Finance Facility, the Overseas Development Institute, and the Young Lives Programme. In addition we had key food and nutrition stakeholders: FAOWFPIFADSave the ChildrenSPRINGENNConcern WorldwideNutrition International and the Aga Khan University.
But the x-factor in the consultation was the participation of 10 adolescents from Bangladesh, Indonesia, Pakistan and Zambia. More about them later.
I can’t possibly do justice to the richness of the meeting, but here goes.
Why focus on adolescents?
  • There are a lot of adolescents. Asia and Africa are experiencing a youth bulge as their countries go through a demographic transition. In the next 5-10 years we will be at “peak youth” as they hit the labour force and the voting rolls.
  • Despite being so prominent in the population numbers, adolescents are virtually invisible in nutrition data and in nutrition programming. We really only have data on 15-19 year old girls. Virtually nothing on girls 10-14 or boys 10-19.
  • The data we do have suggests that a very large proportion of adolescents experience at least one form of malnutrition.
  • Malnutrition in adolescence affects the development of key brain functions—there is plenty of development going on after the first 1000 days into the 4000 -7000 day period.
  • Because the transition from childhood to adolescence carries the promise of more power to make their own decisions, adolescents are catalysts for social change. Whether campaigning for stricter gun control in the USA, the prevention of child marriage or bans on single use plastics, adolescents have enormous potential agency. Adolescents can redefine norms around, say, healthy eating—if we support them in the right way.
What kinds of actions or programmes should be developed?
The specifics are less clear here. But there are some key principles:
First, as Dr. Chandra-Mouli from WHO said, we should stop doing “interventions” we know do not work in this space (e.g. high profile public meetings, and one off trainings).
Second, try to build nutrition into existing policies and programmes that seek to improve the wellbeing of adolescents.
Third, in building nutrition in, do not dilute the existing programs’ ability to talk about really difficult and awkward topics, e.g. on puberty and sexuality.
Fourth, the demand side is vital: find ways to engage with adolescents on their terms—what influences their choices (e.g. taste, convenience, privacy, looks, aspiration, sports, celebrity, superheroes)—but don’t talk explicitly about nutrition (its boring).
Fifth, what can we do to make sure healthy food is available in or near schools (our Zambian adolescents shared some heart-breaking reality about food at school) or in markets (e.g. in Java, where is the healthy fast food that tastes good and is the “cool” thing to buy and eat?)
Finally, strengthen accountability around what powerful stakeholders are or are not doing with or for adolescents, e.g. State of Youth reports, petitions, campaigns, declarations and policy scorecards.
How to design and implement programming?
First and foremost—work with adolescents in a meaningful way. As one participant said, “let them be your guide”. They best understand their reality, the opportunities and limits and how to seize and navigate them.  They can help us figure out where they are and how to get there—they will not necessarily be where the programmers want the programming to be.
Second, build the capacity of the adolescents and the rest of us to engage with each other. As one participant said the “peacocks” (adolescents) and the “turtles” (the rest of us) need to work together for change and neither group probably has much experience of doing so. They both need to learn.
Third, like any agents of change, adolescents can achieve more working together (the “power with” multiplying the “power within”). We need to support their organisation, their ability to educate and their ability to agitate.
Finally, we need to let them lead. This is potentially the most challenging aspect because we are so used to being in control. But if adults only view adolescents as instrumental to the former’s goals, they are being exploitative.
So what does all this mean?
Interestingly it seems to me that the adolescent agenda is not plagued by the usual institutional territoriality in development.  Not yet anyway.  For example, there is no obvious UN agency charged with promoting the rights and wellbeing of this age group. This creates space for duplication, but also for collaboration. Fortunately, we are more in the collaboration space at the moment.
This lack of formalised institutional leadership also gets us into a different but familiar territory, namely that “adolescents are everyone’s business and no one’s responsibility”. And because there is a bit of a vacuum of leadership around adolescent nutrition, many agencies are stepping in, in a coordinated way, and that is encouraging. Now the challenge is for the stepping stones to actually create a path towards significant commitments of resources to adolescent nutrition programs and policy.
We need the UN to come together around the adolescent nutrition agenda and call a meeting in 2019 where member state governments can shape a series of “asks” and turn them into commitments for governments, and all other investors–such as NGOs, research organisations, businesses, development donors–to make.
The one group we don’t have to ask to make commitments is adolescents—they are living their commitment. And if the rest of us do not step up to make commitments to support them, then they may just do it without us.  “Never about us without us” may become “if you don’t step up then step away”.
Fortunately, at the consultation, a large number of organisations made commitments that they will report back on publicly in June 2019 – to the adolescents attending the meeting and to everyone else.  The commitments do not involve major funding, but they do involve change.  And even though some of the commitments probably relate to actions that were going to be undertaken in any case, the most important thing is that the commitments were made public, allowing all of us to monitor them and to assess progress against them.
We are still working on finalising the wider set of specific commitments from the different organisations, but GAIN’s are as follows:
  • GAIN will not organize any meeting on adolescent nutrition without meaningful involvement from adolescents
  • GAIN will attempt to connect the Indonesian adolescent representatives with the Ministry of Health in Indonesia and set up a dialogue between the adolescents and the Ministry’s representatives
  • GAIN will set up or use existing national adolescent networks for meaningful engagement and capacity building in the design phase of adolescent nutrition programs in countries where GAIN is/will be working
Such public pledging is unusual, and I think it happened because the adolescent participants made us not only think about the issues, but to really experience feeling and emotions around the issues. And when thinking and feeling come together, action is inevitable and change is unstoppable.  A fire is lit and it cannot be extinguished!

25 June 2018

The Man Who Nourished the World

By Lawrence Haddad, GAIN’s Executive Director
My delight at being told that I was one of 2018’s World Food Prize Laureates was matched only by, well, sheer surprise. After all I have not led a team of scientists to develop a breakthrough technology like the founder of the Prize, Dr. Norman Borlaug. After talking to Ambassador Quinn, the President of the World Food Prize Foundation, it became clear that the contribution being recognised was the ability to be effective in multiple roles in order to help elevate nutrition to the “top table” of development. In other words, to help convince powerful decision makers that good nutrition is fundamental to delivering the Sustainable Development Goals.
My capacity to connect the roles of researcher, policy influencer, organisational leader and communicator of the issues to broader audiences was helped by a number of things, and  shaped by the thousands of colleagues with whom I have worked.
First, somewhat freakishly, I have been interested in both nutrition and agricultural economics from the age of 18. My undergraduate degree at the University of Reading, UK, was a joint one: in food science and food economics. I followed these dual interests throughout subsequent studies at the University of Massachusetts and at Stanford University. Being an economist, and striving to see the bigger development picture – and where nutrition might fit in – has been invaluable for me as a champion for nutrition.
Second, the first 3 years of my post PhD work was in starting up a new MSc in Quantitative Development Economics at the University of Warwick, UK. I loved the “start up” feel of setting up the course and it was there that I learned to teach properly and communicate more clearly and effectively. However, being a clear communicator is necessary but far from sufficient condition for being persuasive. Influencing is key.
So the third thing that helped elevate nutrition on the agenda was the experience of trying to convince a wide range of people that nutrition matters – learning what they are interested in and finding ways to connect nutrition to that. Interestingly, being a member of the Consultative Group on International Agricultural Research (CGIAR) at the International Food Policy Research Institute (IFPRI) in the 1990s helped develop that skill.  Back in those days there was not much interest in nutrition—just in crop and animal productivity enhancement. We had to think hard about ways to engage the agronomists and economists on nutrition. Working at GAIN involves helping to effect change with decision making constituencies working in a newer area – the way governments and businesses think about what and how they can do together to advance nutrition.
Finally, being forced to become a blogger at the Institute of Development Studies (in my role as Director) required me to write more succinctly, on a wider range of topics, and to leave the comfort zone of research to venture opinions based, as far as possible, on evidence (my Twitter accountdescriptor is “an evidence based champion of efforts to end malnutrition”).
Since the call with Ambassador Quinn, I have been refreshing my knowledge of Norman Borlaug. As Leon Hesser’s excellent Borlaug biography – The Man Who Fed the World—makes clear, Borlaug was unstoppable in his pursuit of improved varieties to stave off hunger in Mexico, Asia and Africa. His sheer hard work, relentless drive and single-minded focus –in the fields, labs, classrooms, boardrooms and Ministerial chambers – helped to bend the world to his view. His vision was forged on getting the ground level details right, always framed within a big picture political economy view. Connecting these two levels is a very unusual ability. His focus on capacity building, on organisational arrangements and on communications to help sustain his efforts is inspiring. It was a revelation to see how instrumental he was—working with the Rockefeller Foundation— in the creation of the CGIAR. Without him, IFPRI—where I learned how to be a policy researcher and was inspired by some of the great policy influencers—probably would not have existed and the course of my own career would probably have been very different.
The world that Norman Borlaug wanted to help feed in the 1950s-70s is both similar and different from today. It is similar in that, unfortunately, hunger is still with us. But while the absolute numbers of hungry people have not declined enough, they now account for a much smaller share of the world’s population and this is testimony to the work of Dr. Borlaug and many others. But it is different too. Dr. Borlaug surely could not have anticipated the explosion in obesity, diabetes, hypertension and other diet related noncommunicable diseases we have witnessed in the past 40 years. If he were alive I am sure he would now be arguing for improving the productivity of non-staple foods such as fruits, vegetables, pulses, eggs, dairy, fish and poultry. The prices of these foods, which are high in micronutrients such as minerals and vitamins, are increasing and productivity improvements would help drive their prices down. In the absence of such a focus, low and middle-income households are being priced out of nutritious food and lured into cheap, empty and unhealthy junk food calories. Good diet is fundamental to the prevention to malnutrition in all its forms.
So the central issue of our time is this: not how to feed the world, but how to nourish it. Were he here today I am sure Dr. Borlaug would have been at the forefront of this fight, perhaps recast by some as “The Man Who Nourished the World”. In his absence, we have to come together across government, research, business, foundations and civil society to pick up the mantle and focus on actions to nourish the world so we can end malnutrition by 2030.

15 June 2018

Packaged Foods—What Role Can They Play in Improving the Consumption of Nutritious Food?

By Lawrence Haddad, GAIN’s Executive Director
This was the question asked at a FReSH-organised side event at the recent EAT Forum meeting in Stockholm.
As the 2016 Global Panel Report on Food Systems and Diets noted, average households in nearly all countries in the world acquire the majority of their food from the market (as opposed to growing it or receiving it in kind). Most of these purchases are of packaged foods. In addition, we know that the sales of processed foods (which has a strong overlap to packaged foods) are flat in high-income countries (but with a switch within the static sales towards products lower in sugar, salt and fat) while increasing in middle-income countries (and I would guess, low-income countries, although we have no data on that).
So there is a big business opportunity in packaged foods in low and middle-income countries, but is there also a nutrition opportunity? Given the trends in developing country markets (more food purchases from the market and a growing purchases of packaged foods), the answer is surely yes.
The format of the side-meeting included the introduction of 4 new packaged food products with nutritious food aspirations from 4 companies. The participants were then asked whether, based on what they had heard, they thought the foods were nutritious, environmentally and socially sustainable, with a viable business model. To do this participants tested the products, asked questions about 4 dimensions of performance–health, social, environmental and business–and gave the product a highly subjective summary score from 1-8 on each dimension.
The products included (1) a new Kellogg’s “Force of Nature” granola type cereal with lower sugar, all recyclable packaging materials and a good taste, (2) a good tasting fruit smoothie (froosh) containing only fruit (the fruit fibres giving it a smoothie feel) with all recyclable materials, (3) reformulated Nesquik cereal (two versions, one to meet WHO guidelines on sugar and salt and one to meet the more stringent Chilean standards necessary to avoid the black warning labels on the front of pack) and (4) ModuMax, a “taste modulator” from DSM that helps to moderate negative organoleptic characteristics in foods that have been reformulated to have lower sugar and salt.
My takeaways:
  • Some companies have made substantial changes to their products’ profiles (e.g. towards lower sugar, higher fibre) over the past 5-10 years—and we saw some interesting data from Nesquik/Nestle. Small but frequent and persistent changes can add up to big changes. They are not transformational in a big bang sense, but they are a reaction to a transformation in consumer preferences or government regulation.  Interestingly it is very difficult to track these changes over time as the databases are not public and it is difficult to find public info on food product labels from 5 or 10 years ago. (Although it is easy enough to track if the formulations are different in different geographies.)
  • How much effort should big food companies put into reformulating existing core products versus introducing new “healthier” products? The latter are less likely to upset consumers “stop tampering with our favourite foods!” but are at risk of small sales/termination, or of simply replacing an equally healthy natural option with a more expensive processed and packaged product (e.g. if froosh replaced an apple in a lunchbox). The answer to this portfolio balance issue is obviously context and outcome specific, but it is clear that some companies are struggling with this question.
  • Are the companies that are providing business-to-business (B2B) products (like DSM with ModuMax) the ones that are going to help the whole system change given their massive indirect consumer reach via their business customers? How much effort should system changers invest in the B2B companies vis a vis the companies that sell direct to consumers? Again, context specific.
  • Packaged food companies need to be aware of the narrative: processed foods=unhealthy foods. Processed foods can provide nutrition, convenience, safety and affordability if those are the key design criteria guiding the processing. Don’t blame the technology; rather blame the bigger incentives that drive companies towards unhealthy processed foods (weak incentives—carrots and sticks– from some governments combined with weak consumer demand for nutritious foods in many contexts, together with unscrupulous behaviour from some businesses).
  • The completion of the 4-dimension assessment (health, business, environmental, social) was not easy in the absence of data (preferably independently verified data). In addition, just exactly what the social dimension means was not clear—is this where affordability comes in or is this about the working conditions in the supply chains, both, or is it about something else?
Finally, it is important to note that all the company representatives in the room (about a quarter of the participants) emphasised the need for nutritious foods to lead with flavour. If a more nutritious food is not tastier and more delicious than the less nutritious variants or brands, then it is highly unlikely to be a market success. Those of us in the public sector need to embrace this idea—typically we just focus on acceptability and palatability of nutritious foods.
That is why GAIN is exploring the development of a relationship with Firmenich to begin to focus on flavour issues in nutritious foods.
And the scores?  Wildly different among the 4 assessing groups! Delicious.