NCDs, Agriculture and Food

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Policy Seminar presentation by Tim Lang at IFPRI on September 7, 2011 "Leveraging Agriculture to Tackle Noncommunicable Diseases"

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NCDs, Agriculture and Food

Tim Lang

Centre for Food Policy, City University Londont.lang@city.ac.uk

Paper to IFPRI seminar

Washington DC

Sept 7, 2011

1. The Problem

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NCDs• Well documented problem for decades

– Academics: Ancel Keys et al since 1970– WHO et al since 1980s– WHO & FAO in joint position since 2003

• Need for some honesty– It’s not been taken seriously by Developing

Country food and farming perspectives– Seen as ‘Western’ / rich society problem– Complicates the ‘productionist’ policy paradigm– Lacked serious champions

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Yet strong evidence on NCDs (WHO Global Status 2011 report)

http://www.who.int/nmh/publications/ncd_report2010/en/

• NCDs caused 63% of deaths in 2008 worldwide– c.80% of those were in low & middle income countries

• Main causes of premature death: – cardiovascular (17 m), cancer (7.6 m), respiratory disease

(4.2 m), diabetes (1.3 m).

• NCDs have 4 common risk factors: – tobacco

– exercise

– alcohol

– poor diets4

WHO’s mooted ‘solutions’‘Best Buys’• Smoking restrictions• alcohol access, ads,

costs;• Reduce salt intake• Replace trans-fats by

polyunsaturated fat• Promote public

awareness about diet and physical activity

Also….• Restrict marketing of

foods and soft drinks• Food taxes to favour

healthy diets• Healthy school enviro’t• Built enviro’t to

encourage activity

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2011 UN High Level meeting• To be welcomed

• Follows up on:– 2002/3 WHRs– Global Strategy 2004

• but could be another case of…– Mismatch between evidence and policy– already subject to lobbying– See concerns in The Lancet

• We must not let a mess happen6

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2. What’s driving this food world?

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The Productionist Paradigm(the success of 1930s science)

Lang & Heasman (2004) Food Wars

Science + capital + distribution output cheaper food health

= progress

Linking food, health, income & justice

John Boyd Orr (1880-1971)

public health researcher1st D-G of FAO

Sicco Mansholt (1908-1995)

1st European AgricultureCommissioner for 1958-1972

This doesn’t fit the 21st century

• It addressed the Malthusian problem, but…– Relied on oil to raise production– Mined the environment– Assumed more food is good for health– Assumed humans eat rationally– Assumes ever expanding choice = public good– Focused policy attention on the farm– Ignores how power has shifted down the supply

chain traders and retailers

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NCDs are cultural problems too

• Nutrition Transition is cultural not just nutrients

• Importance of social aspirations – e.g. meat = wealth / social status

• Impact of ‘consciousness industries’:– marketing, advertising, media

• Forms of waste have changed

• Food is more than nutrients + eco-footprint

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Fat is overproduced yet consumers are told to eat less

Source: WHO/FAO (2003) Diet, Nutrition and the Prevention of Chronic Diseases. WHO TR 916 p.18

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3. What is needed?

Battle of 5 policy positions• ‘It’s all dangerous, so avoid, ignore & resist’

– Neo-cons, trading nations, some (not all) big business

• ‘Business-as-usual’ (consumer responsibility):– Pragmatists, slow incrementalism

• ‘Leave it to companies’: (single company action)– Eg Unilever 2010, PepsiCo (bits), SAI

• ‘Sustainable intensification’: (production focus)– UK Foresight (Jan 2011), FAO Sust’ble Crop Intensific’n Div

• ‘Whole system change’: (structural focus)– Policy outer circle, NGOs, green businesses 14

C21st food system faces complex demands a world ‘omni-standards’ and ‘poly-values’

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Quality Social values• Taste• Seasonality• Cosmetic• Fresh (where appropriate)• Authenticity

• Pleasure• Identity • Animal welfare• Equality & justice• Trust • Choice • Skills (citizenship)

Environment Health• Climate change• Energy use• Water• Land use• Soil • Biodiversity• Waste reduction

• Safety• Nutrition• Equal access • Availability • Social status/ affordability• Information & education

Economy Governance• Food security & resilience• Affordability (price)• Efficiency• True competition & fair returns• Jobs & decent working conditions• Fully internalised costs

• Science & technology evidence base• Transparency • Democratic accountability• Ethical values (fairness)• International aid & development

Facing reality

• It’s taken 60-70 years to build the current unsustainable food system

• We need to start big change over c 30-40 yrs• No one solution will fit everywhere• Some new frameworks & principles are

emerging• But there’s a danger of neo-Malthusianism

panicking the governments into neo-productionism– Eg FAO arguing 70% more food needed by 205016

4 key realities of contemporary food and health governance

1. Food Policy is multi-sectoral

2. Multi level governance is both above and below the nation state

3. Private sector governance of food supply chains is now more important

4. Health is weak compared to other interests

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Messages to IFPRI• Think Sustainable Food Systems, not just

farms

• More emphasis on consumption not just production

• More on plants, less on meat & dairy

• New forms of waste (contracts & specific’ns)

• Equitable distribution means less in the West

• Full cost accounting for food prices

• Poly-value approach to food systems18

Mind- and data-shifts required

From... To....

How to increase output for current diets

What do bodies need and how can farming grow it

How to mine resources for food

How to build production on ecological principles

How to lower prices How to reflect full costs

How to be more efficient

How to redefine what is meant by efficiency

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change what & how we eat = sustainable diets

FOOD WHY WHAT

Meat Cancer; water; land use

Offer less; mainly or only grass-fed

Coffee / tea Water; labour conditions

Less; only fair trade; drink water

Fruit All year round? Seasonal

Fish Health vs. fish stock collapse

Eat less; only accredited – wild catch & farmed

Vegetables Health; water; GHGs; Kenyan beans?

Seasonal greens

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Conclusions

• We have much to do

• No simple solutions

• Different solutions for different locations

• UN High Level Meeting offers a pause moment

• The current policy discourse is too focussed on production

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