World Bank – Harvesting Nutrition Contest Award Ceremony Keynote by Derek Yach

SecureNutrition

Keynote address at the Harvesting Nutrition contest award ceremony

By Derek Yach, Executive Director, Vitality Institute

World Bank Group, Washington DC, February 19, 2015

[Watch webcast live here]

Aligning interests to promote sustainable agriculture

Until we develop techniques for producing organic, non-human Soylent Green, our long-term food security will continue to depend heavily on agriculture. Evidence is increasing that current agricultural practices contribute to a range of environmental threats. Despite dramatic declines in global levels of undernutrition, there are still 161 million children less than 5 years of age who are stunted and more than 2 billion people who suffer from deficiencies in micronutrients such as iodine, vitamin A, zinc, and iron.[1] Nobel Prize winner Robert Fogel reminded us how private and publically supported agricultural progress, together with global expansion of food and retail companies, has led to steadily improving nutrition over generations, with positive impacts on economic development.[2] However, these successes have come at a cost.

Food production focuses on a relatively small number of crops that become ubiquitous across major markets. Corn, soy, wheat, and rice dominate the plates of billions and form the basis for many ultraprocessed foods. Palm oil dominates the oil-seed market, with soy not far behind. Dietary diversity has diminished. In Korea, more than 4000 varieties of rice used to be grown. Today, only 12 varieties can be identified. Similarly, in Thailand, where around 16,000 varieties of rice were once grown, only 37 varieties can be identified now; 50% of rice-cultivation areas produce only 2 varieties.[3]

Recent reports such as the UK Foresight Report on the Future of Food and Farming 2050 highlight the negative consequences, for the environment and human health, of such intense focus on so few crops.[4] Corn and soy are increasingly used as livestock feeds and biofuel.[5] The combined effects of massive monoculture of these crops and of the livestock they feed pose significant dangers to forests, in greenhouse gas production, and in water use. For example, beef, which requires more land than any other food group, accounts for 56% of greenhouse gas emissions associated with the typical US diet.³ A 75% reduction in meat consumption would result in a 27% reduction in land use, a 46% reduction in greenhouse gas emissions, and a 31% reduction in water use.³ Producing 1 kg of animal protein requires 100 times more water than does producing grain protein.[6] Palm oil production is expanding into vulnerable rainforests from Asia to West Africa at exactly the time when evidence clearly highlights the negative consequences of this for the environment and health. Alarming changes in palm oil consumption have occurred in many low- and middle-income countries. In China, consumption increased 640% between 1980 and 2003.[7]

Simultaneously, global levels of obesity and associated diseases, such as diabetes, are increasing in almost every country in the world. In 2014, more than 1.9 billion adults were overweight and more than 600 million were obese.[8] Nine percent of the global adult population has diabetes, and numbers are expected to increase.[9] In Africa, the estimated increase from 2013 to 2035 will be 110.[10] All countries face problems of overconsumption of nutrient-poor, calorie-rich foods in place of nutrient-dense ones.[11]

We should ask how it is possible that we have allowed our food-production systems to be so poorly aligned with human health and nutrition and what this means for the future when land and water are increasingly scarce.

In the mid-1990s, Lester Brown, head of Worldwatch Institute, warned of the dire consequences  of global hunger and national instability as the Chinese increased their consumption of meat.[12] He was regarded as overly alarmist, and although he triggered a debate that has accelerated over the years, the topic played a minimal role in influencing global policies. Just last month, The Economist restated his fear, devoting a major article to the consequences of dramatic increases in pig consumption in China.[13]

When I was at the World Health Organization 15 years ago, David Nabarro and I shared responsibility for WHO’s nutrition policy. On a visit to the Food and Agriculture Organization, in an effort to find a way for the world’s leading specialized agency for agriculture to work more closely with the world’s leading specialized agency on health, we proposed a joint initiative to ask, What should the world’s supply of food look like in 25 years if its primary function iis to meet the optimal nutritional needs of all? We thought that developing a set of scenarios and comparing them to our trajectory at the time would prompt a valuable discussion about how best to close the gaps. Using a long-time horizon would reduce resistance among those who might be losers and allow time for transition. The proposal was rejected in favor of narrower short-term work, but this remains a major need.

Since then, many initiatives have addressed the thorny issue of aligning food-production systems with long-term nutritional needs. The International Food Policy Research Institute’s 2011 meeting, “Leveraging Agriculture for Improving Nutrition and Health,”[14] sought to increase consensus favoring cross-sector actions that promote agricultural productivity for nutrition and health. The Chicago Council on Global Affairs has launched a new initiative, “Healthy Food for a Healthy World,”[15] exploring how all parts of the food system can work simultaneously to improve health while boosting the economy and ensuring environmental sustainability. The Clinton Giustra Enterprise Partnership, along with Unilever and Acumen, has launched the Enhanced Livelihoods Investment Initiative, a 3-year program to facilitate economic growth among smallholder farmers and alleviate poverty in low-income communities in the developing world.[16]

The damaging environmental effects of meat overconsumption have been well publicized, but we must not ignore the effects of overfishing, pollution, and pesticide/herbicide runoff on aquatic ecosystems.[17] These have led to increased focus on alternative sources of essential fatty acids and protein, from phytoplankton[18] and duckweed to edible insects.[19] The need for tangible examples has never been greater. Any reader of the Stockholm Resilience Center’s update on planetary boundaries would be left with no doubt as to its urgency. Climate change and loss of biosphere integrity can destabilize the Earth system, driving a shift towards a new geological era much less hospitable to human development. Limits at which Earth systems can continue to function have been identified, and we already are at high risk in some critical areas.[20]

These reports all indicate that the current direction of agriculture will not meet the world’s future nutritional needs.

We are here today not only to focus on the crisis but to highlight ongoing change. I have seen a real stirring of action in many areas.

The World Economic Forum’s New Vision for Agriculture, launched in 2009, emphasizes that to meet the world’s needs, agriculture must simultaneously deliver food security, environmental sustainability, and economic opportunity.[21] It sets a goal of 20% improvement in each area per decade until 2050. Achieving that goal requires a transformation of the agriculture sector, leveraging market-based approaches through a coordinated effort by all stakeholders, including farmers, government, civil society, and the private sector. The key success factors for transformation at the national level include setting the right direction through effective leadership, strategy and investment models, and scaling the transformation through finance, infrastructure, institutions, and monitoring.

The initiative engages more than 350 organizations to strengthen collaboration. At a global level, it has partnered with the G7 and G20, facilitating informal leadership dialogue and collaboration. At the regional and country level, it has catalyzed multistakeholder partnerships in 16 countries in Africa, Asia, and Latin America. Together, these efforts have mobilized more than $10 billion in investment commitments, of which $1.2 billion have been used, reaching more than 3.6 million smallholder farmers.

Many food, retail, and agriculture companies are testing innovative partnerships as a means to tackle nutrition issues. For example PepsiCo reviewed the long-term implications of climate change for procuring crops essential to its portfolio, such as oats, oranges, corn, potatoes, and apples. It became clear that investment in sustainable agriculture and more flexible procurement systems was a business imperative. Many initiatives resulted that aimed not only to secure long-term supply but also to align better nutrition with agriculture. These included the following:

1. PepsiCo’s commitment to improving the nutritional quality of its products by replacing palm oil with more healthful vegetable oils led to a partnership with the Inter-American Development Bank to expand commercial sunflower production in Mexico. Purchasing contracts with small farmers guaranteed the price of produce, creating a mutual benefit whereby PepsiCo has a steady supply of sunflower oil and farmers can secure the necessary capital for equipment, seeds, and fertilizer.[22]

2. In 2011, PepsiCo, the World Food Programme, and the US Agency for International Development began developing an innovative market-based solution to economic, food, and nutritional insecurity in Ethiopia. The outcome was a locally sourced, chickpea-based supplementary food product for severely malnourished children, and manufacturers were encouraged to purchase the necessary commodities from smallholder farmers. The product is due for pilot distribution in the fall of 2015.[23]

3. The cashew apple, the highly nutritious part of the cashew tree, is often discarded because of its acrid taste and short shelf life. PepsiCo’s interest in the apple for a new beverage led to the Clinton Foundation’s establishing the Accesso Cashew Enterprise, which works with farmers to improve cultivation, yields, and processing. Some farmers have reported a 20% higher income as a result.[24]

All benefit local agriculture and farmers. All benefit health, the environment, and the long-term profitability of the company. All demonstrate that alignment between conflicting goals is possible.

Today’s winners powerfully complement these examples.

In the Most Scalable Approach category, “N2Africa-putting nitrogen fixation to work for smallholder farmers” simultaneously addresses many interrelated crises: reversing depleted soil nitrogen, establishing more sustainable sources of protein, supporting the employment of women, providing a source of cash to rural farmers, and, critically, doing so in ways that ensure local food sustainability.

Early results from their Ghana study showed multiple benefits for families and children at N2Africa sites not seen by nonparticipants. The project is now active across countries of east, west, and central Africa and has the potential to be transformative for agriculture and health. Deeper consideration of using market forces and private-public partnerships is needed to ensure long-term sustainability.

The Zambian project, “Re-aligning Agriculture to Improve Nutrition (RAIN),” won the prize in the Greatest Potential Impact on Nutrition category. RAIN supports agricultural interventions to increase year-round access to good-quality food through improved home production. Early results suggest that household production of a more diverse set of crops, including highly nutritious leafy green vegetables, is under way. The project will be considered a success if it contributes to reduced child stunting, women’s empowerment, and long-term food security.

“Shamba Shape-Up,” winner of the Most Innovative Approach award, is an edu-entertainment agricultural TV show reaching 10 million east Africans. It provides farmers with technical solutions aimed at improving their productivity and income. A key component involves the use of interactive support services via SMS and video clips viewable on cell phones. No doubt they are learning from advances in a health-focused edu-entertainment program, Soul City, that has run in South Africa for almost 2 decades and from the explosion of innovation in information communication through cell phones.

Let me conclude with our own experiences in improving people’s diets and the health of the planet. In South Africa, Vitality’s Healthy Food program offers subsidies to members through a cash-back rebate of up to 25% for healthful food purchases. This has resulted in a shift in purchasing patterns.[25] Estimates of the environmental impact of this shift, specifically  purchases of more fruit and vegetables and less beef and pork, show an 8% to 13% decrease in land use, a 7% to 12% decrease in water use, and an 8% to 10% decrease in greenhouse gas emissions.³

Though this example featuring urban middle-class South Africans might seem remote to the poorest rural parts of the world, where poverty dominates and many structural barriers impede progress, that is not the case. People living in urban areas are not immune to psychological, social, and cultural influences on decision making. The World Bank Group’s Development Report on Mind, Society and Behavior cited numerous examples of situations in which behavioral economics has been used to improve health, for example, in India, where providing free lentils and plates incentivized women to immunize their children, and in the Philippines, where greater success with smoking cessation was achieved by those who deposited money into accounts, agreeing to forfeit it if they failed to quit.[26] The use of conditional cash transfers can improve uptake of preventive services, such as for women who receive payments for visiting antenatal clinics and forfeit them for failing to attend.

The cognitive burden of poverty and its implications on progress and development are often underappreciated. Indian sugar cane farmers who typically receive payment only once per year at the time of harvest perform worse on a number of cognitive tests preharvest than they do postharvest. This can be attributed to financial distress and poor nutritional status.¹²  These and other insights can help shape policies and interventions that enable those living in the poorest areas to make the best decisions for themselves and their families that will result in better health and financial development.

Advances in science and technology can be transformative for many aspects of agriculture.
At a recent talk at the University of California, Berkeley,[27] Bill Gates noted that humans cannot continue to cultivate more land; thus, the only way we will be able to feed a population of 9 billion by 2050 is through scientific improvements in crop productivity via the use of genetically modified technology.

We cannot address the food needs of the poorest populations of the world without seeing how they link to the consumption trends of the burgeoning middle class in the growing cities of Africa, Asia, and the Middle East. This slowly-emerging reality is propelled by the increasing disease burden and environmental consequences of current diets. Sustainable solutions are arising from global collaborations, with benefits to health, environment, and business. Your work is critical to meeting the health and environmental needs of future generations.

I commend SecureNutrition, Save the Children UK, and GAIN for their leadership in moving from talk to real action. Mirrors modest efforts under way within other corporations.

[1] Feeding the World Sustainably. Lancet. 2014; 384 (9956): 1721

[2] Floud R, Fogel RW, Harris BH, Hong SC. The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700. Cambridge: Cambridge University Press; 2011..

[3] Institute of Medicine. Sustainable Diets: Food for Healthy People and a Healthy Planet Workshop Summary. 2014. Washington DC: The National Academic Press. Accessed at https://www.iom.edu/Reports/2014/Sustainable-Diets-Food-for-Healthy-People-and-a-Healthy-Planet.aspx.

[4] Foresight. The Future of Food and Farming. The Government Office for Science, London; 2011..

[5] US Environmental Protection Agency. Major Crops Grown in the United States. 2013. Accessed at http://www.epa.gov/agriculture/ag101/cropmajor.html.

[6] Pimentel D, Pimentel M. Sustainability of meat-based and plant-based diets and the environment. Am J Clin Nutr. 2003;78(suppl):660S-663S.

[7] Institute of Medicine. Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. 2010. Washington DC: The National Academic Press. Accessed at http://www.iom.edu/Reports/2010/Promoting-Cardiovascular-Health-in-the-Developing-World-A-Critical-Challenge-to-Achieve-Global-Health.aspx.

[8] World Health Organization. Obesity and Overweight Fact Sheet. 2015. Accessed at http://www.who.int/mediacentre/factsheets/fs311/en/.

[9] World Health Organization. Diabetes Fact Sheet. 2015. Accessed at http://www.who.int/mediacentre/factsheets/fs312/en/.

[10] Peer N, Kengne AP, Motala AA, Mbanya JC. Diabetes in the Africa region: an update. Diabetes Res Clin Pract. 2014;103(2):197-205.

[11] International Food Policy Research Institute. Global Nutrition Report 2014: Actions and Accountability to Accelerate the World’s Progress on Nutrition. 2014. Washington, DC.

[12] Brown LR. Who will feed China? Wake up call for a small planet. London: Earthscan; 1995..

[13] The Economist. Swine in China: Empire of the Pig. 2014. Accessed at http://www.economist.com/news/christmas-specials/21636507-chinas-insatiable-appetite-pork-symbol-countrys-rise-it-also.

[14] International Food Policy Research Institute. Impact Assessment: IFPRI 2020 Conference on Leveraging Agriculture for Improving Nutrition and Health. 2012. Accessed at http://www.ifpri.org/sites/default/files/publications/ia34.pdf.

[15] The Chicago Council on Global Affairs. Healthy Food for a Healthy World: Economic costs of global malnutrition. 2015. Accessed at http://www.thechicagocouncil.org/blog-entry/healthy-food-healthy-world-economic-costs-global-malnutrition.

[16] Clinton Foundation. Unilever, Acumen, and the Clinton Giustra Enterprise Partnership announce USD $10 million Clinton Global Initiative Commitment to Action to support smallholder farmers. 2015. Accessed at https://www.clintonfoundation.org/press-releases/unilever-acumen-and-clinton-giustra-enterprise-partnership-announce-usd-10-million.

[17] Bowermaster J. Oceans: the threats to our seas and what you can do to turn the tide. 2010. New York, Public Affairs.

[18] Martins DA, Custodio L, Barreira L, et al. Alternative sources of n-3 long chain polyunsaturated fatty acids in marine microalgae. Marine Drugs. 2013;11(7):2259-2281.

[19] Van der Spiegel M, Noordam,MY, Van der Fels-Klerx HJ. Safety of novel protein sources (insects, microalgae, seaweed, duckweed, and rapeseed) and legislative aspects for their application in food and feed production. Compr Rev Food Sci Food Saf. 2013;12:662–678.

[20] Steffen W, Richardson K, Rockstrom J, et al. Planetary boundaries: guiding human development on a changing planet. Sciencexpress. Published online Jan 15 2015. Accessed at http://www.sciencemag.org/content/early/2015/01/14/science.1259855.

[21] World Economic Forum. New Vision for Agriculture. Accessed at: http://www.weforum.org/projects/new-vision-agriculture

[22] Strom, S. For Pepsi, a business decision with social benefit. New York Times. 2011. Accessed at http://www.nytimes.com/2011/02/22/business/global/22pepsi.html?pagewanted=all&_r=2&

[23] Feed the Future: the US government’s global hunger and food security initiative. US Agency for International Development and PepsiCo. Accessed at: https://www.feedthefuture.gov/model/usaid-and-pepsico

[24] Strom S. Cashew juice, the apple of Pepsi’s eye. New York Times. 2014. Accessed at http://www.nytimes.com/2014/08/09/business/international/cashew-juice-the-apple-of-pepsis-eye.html.

[25] Sturm R, An R, Segal D, Patel D. A cash-back rebate program for healthy food purchases in South Africa: results from scanner data. Am J Prev Med. 2013;44(6):567-572.

[26] World Bank. World Development Report 2015: Mind, society and behavior. 2015. Washington DC: World Bank.

[27] Smart Planet. Bill Gates tackles controversy over genetically-modified crops at UC Berkeley. 2015. Accessed at https://www.youtube.com/watch?v=sxsf4MGDRVk