From food to nutrition security: The role of food policies

From food to nutrition security: The role of food policies Derek D. Headey Senior Research Fellow The International Food Policy Research Institute d.headey@cgiar.org 1

LOOKING BACK Green Revolution a landmark achievement Early 1960s saw the spectre of famine looming large over Asia s millions of poor people The Green Revolution package of seeds, chemical inputs and irrigation dramatically raised yields Brought together good intentions, good science and for the most part, good economic development Many scientific studies find large complex benefits: mostly focused on incomes & poverty reduction Beyond poverty, likely that countless millions of lives were saved, and much political upheaval averted

Rice yields (mt per hectare) 6,0 5,0 Figure 1. Rice yields in Indonesia 1967: IRRI s IR8 rice variety released 4,0 3,0 2,0 1,0 0,0

LOOKING BACK The Green Revolution increased food security, but often assumed it also improved nutrition In reality, nutritional benefits perhaps quite limited In Bangladesh we find that rice yields improved child weight gain, but not child height (preferred metric) Evidence from India that increased use of chemicals harmed maternal nutrition & reduced birth weight But many other reasons why Green Revolution was, at best, necessary but not sufficient for nutritional gains In the past 20 years we have learnt a lot about human nutrition: a complex and multidimensional problem

LOOKING BACK Six fundamental insights from nutrition studies: 1. Early childhood malnutrition>>>long-lasting impacts: cognitive & learning outcomes, adult wages, etc 2. Low availability of micronutrients a major contributor to impaired physical and cognitive development 3. Low absorption of micronutrients due to disease a major contributor to stunting and cognitive development 4. Inequities mean that adequate national & household supply does not equal adequate individual supply 5. Countries can rapidly transition from undernutrition to obesity, even at fairly early stages of development 6. Undernutrition can be sticky, overnutrition irreversible

LOOKING FORWARD These insights yield some critical policy implications: 1. Focus more attention on nutrition, especially once basic national food security is achieved 2. View food policies as one component of a broader nutrition strategy, with sanitation, water, health, education/bcc, safety nets, and other sectors 3. Within food sector, focus on increasing availability of nutrient-rich foods via production, trade, safety nets 4. Do-no-harm: ensure food policies have no harmful health effects: e.g. farming practices; obesity/ OCDs

LOOKING FORWARD Cutting across all these policy implications is a core question we don t have a good grasp on: How can polices shape a healthier food system? Let s start with a definition of such a system: A healthy food system is one in which (un)healthy foods are (dis)encouraged through various price and non-price mechanisms. Simple definition, but quite a useful one Notes that prices are a key mechanism influencing diets, but not the only one

LOOKING FORWARD A precondition for policy intervention is that healthy food systems rarely emerge organically. Why? 1. In poor countries value chains for perishable vegetal and animal products have many bottlenecks 2. People do not perceive micronutrient deprivations, but strongly perceive macronutrient deprivations 3. Hence policies also focus on calorie deprivation 4. We have strong innate preferences for unhealthy foods 5. Processed foods have lots of information asymmetries 6. Due to economies of scale in production, producers of unhealthy foods have strong lobbying power

0 500 1000 1500 2000 Fig 2. Calories from different food sources by total consumption per capita 0 5000 10000 15000 20000 Consumption per capita, constant PPP$ Staples Fruits & Vegetables Animal products Unhealthy "condiments"

10 20 30 40 50 60 70 Fig 3. Dietary diversity rises with consumption per capita, but with diversity around the mean Brazil Costa Rica Ecuador Albania Kazakhstan Armenia ColombiaUkraine Jamaica Venezuela Serbia Paraguay Malaysia Romania Moldova Jordan Panama Mongolia Honduras Guatemala Libya Cuba Pakistan Saudi Arabia Mauritania Botswana Nicaragua Thailand BIH China El Salvador Tunisia Kyrgyzstan IranSouth Africa BoliviaNamibia STP Algeria Georgia CAR Kenya Uzbekistan Zimbabwe Sri Lanka Uganda Turkmenistan Senegal Niger Cameroon Haiti Vietnam India Peru Tanzania Iraq Tajikistan Morocco Philippines Azerbaijan Sierra Burkina Faso Angola Rwanda Leone Egypt Guinea Nigeria Chad Mali Liberia Nepal Benin Zambia Indonesia Togo Côte d'ivoire Cambodia Malawi Mozambique Laos Ethiopia Afghanistan Ghana Madagascar Lesotho Bangladesh 0 2000 4000 6000 8000 Consumption per capita, constant PPP$

Dietary diversity (% ) 50 40 30 Pakistan: 1966-1980 India 1961-1990 Nepal: 1992-2010 20 Bangladesh: 1985-2010 10 0 0 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 Household consumption per capita (2005 international dollars)

Dietary diversity (% ) 50 40 Philippines: 1966-1982 Thailand: 1961-1984 30 20 Indonesia: 1966-1984 10 0 0 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 Household consumption per capita (2005 international dollars)

Dietary diversity (%) 50 40 China: 1977-2007 Vietnam: 1980-2010 30 20 Egypt: 1967-1986 10 0 0 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 Household consumption per capita (2005 international dollars)

LOOKING FORWARD Why does dietary quality vary so much across countries? Preferences: e.g. special role of rice in Asian diets? Some cultures also values large bodies! Agricultural systems: e.g. land-constrained irrigated rice systems not conducive to livestock production (Bangladesh, Egypt, Indonesia) Trade systems: Infrastructure bottlenecks prevent trade of perishable products Pricing policies: e.g. subsidization of calorie-rich staples in India, Egypt and many other countries

LOOKING FORWARD Why does dietary quality vary so much? Preferences: e.g. special role of rice in Asian diets; Some cultures also values large frames! Agricultural systems: e.g. land-constrained, irrigated rice systems not conducive to product diversification Trade systems: Infrastructure bottlenecks prevent trade of perishable products Pricing policies: e.g. subsidization of calorie-rich staples in India, Egypt and many other countries Education: Complex relationship in poor countries more educated=more obese; reverse in rich countries

LOOKING FORWARD: What should we do? Systematically monitory the food system - Better measurement of dietary quality - Pay closer attention to prices - Wiggins & Keats (2014) show that prices of healthy foods rising and prices of unhealthy foods falling - One explanation may be changes in quality, but in many poor countries these trends are likely very real - In Bangladesh, land constraints limit livestock supplies, and Green Revolution in rice crowded out fish - Rising incomes raise demand, but supply response weak - Lower prices of sugar & processed foods a global story

Figure 1. Price changes in Bangladesh 25% Annual change in prices, 1995-2010 20% 15% 10% 5% 0%

Test every lever MOVING FORWARD Agriculture: Incentives for producing healthy foods? Major overhaul of R&D and extension systems? Infrastructure & Trade: Remove supply chain bottlenecks for nutritious perishables Pricing: Subsidize healthy food, tax unhealthy food? Education & behavioral change: Teach nutrition in schools, especially future mothers Income support for the poor: food, cash, vouchers?

Lastly, we can speculate on the returns to healthier food systems, but they are likely enormous. Why? MOVING FORWARD 1. Returns to eradicating undernutrition are very large 2. Many interventions could simultaneously reduce undernutrition & prevent overnutrition 3. Overnutrition has so far proved all but irreversible 4. Combined health & productivity losses from malnutrition are very large, even statistically 5. Dynamically, stream of future costs very large In short, much better for poorer countries to act now

Thank you