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Improving the Consumption of Nutritious Foods: What Can Business and Government Do Together? Lawrence Haddad Global Alliance for Improved Nutrition (GAIN) SDC, September 20, 2018 The Problem 1 in in 3 3 people le 2 world rldwid ide
Improving the Consumption of Nutritious Foods: What Can Business and Government Do Together?
Lawrence Haddad Global Alliance for Improved Nutrition (GAIN) SDC, September 20, 2018
Overweight
1.9 billion
Deficient in vitamins or minerals
SOFI 2018
Deficient in vitamins or minerals
2 billion
Chronic Hunger
821 million
51m wasted
38m under 5’s over weight151m stunted
1 in in 3 3 people le world rldwid ide are maln lnouris ished
The Problem
Inadequate food consumption is the common denominator in all forms of malnutrition
Type 2 Diabetes Poor Diets
Source: IHME, http://www.healthdata.org/results/country-profiles
Poor diet contributes to 2016 Risk Factors 1, 3, 4, 5, 8 & 9
India
Poor diet contributes to six of the top 10 burden of disease factors in India
..and five of the top ten in Switzerland
Switzerland
But food consumption does not automatically improve with income growth
8 5 6 1
12
2 20 13 19 8
37
4
16 5
18 40
131 39 96
Vegetables & Pluses Seafood Sugar sweetened beverages g/day
% change in consumption,1990-2010
Source: Global Dietary Database estimates for GAIN
Guardian August 15, 2018
Brighton Beach, UK 1976
So what is going on?
Have we all become worse at making choices?
East Asia Africa South Asia
From data in Fig 6.3 Global Panel report
quality quantity
Food Availability Has Diversified Very Weakly
Healthy foods like fresh fruits & vegetables are unaffordable for large parts of the world
Share of per capita household income to buy 5 fruits and vegetables /day/person
Bangladesh India Pakistan Zimbabwe
Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study. Miller, Victoria et al. The Lancet Global Health , Volume 4 , Issue 10 , e695 - e703
And the prices of nutrient rich foods are increasing….
61.9 34.1 33.4 26.9 26.2 22 18.8
Dark green leafy vegetables Eggs Flesh foods and small animal protein Dairy products Legumes and nuts Other fruit & veg Other Vitamin A rich veg & fruits
Ethiopia: % Change in real prices 2007-2016
Sugar and honey Grains, roots & tubers Oils and fats
Source: from Kalle Hirvonen, IFPRI
$ 1 billion Advertising spend of Hershey and General Mills in 2016
$50m
Aid spending on Diet Related NCDs in 2014 (2016 GNR)
https://www.nature.com/articles/d41586-018-03918-7
But desirability is also key. The public sector is always going to be outspent on making nutritious food desirable… ..so what it does spend has to be engaging
Public Service Announcements for nutritious foods are overwhelmed by commercial ads—persuasively and financially
But nutritious foods are losing the desirability war
The Solutions
business to support improved consumption of nutritious foods
X X
Percent of 23,000 product lines that are "healthy" 32% Percent of products that meet WHO EURO standards for marketing to children 14% Number of companies that cover all media in their responsible marketing commitments to children 6 Number of companies that extend responsible marketing to children in the 13-18 year group 1 Top score on Marketing of Breast Milk Substitutes (Danone) 60% Results from Access to Nutrition Index 2018
(22 largest food and beverage companies)
https://www.accesstonutrition.org/sites/gl18.atnindex.org/files/resources/atni_report_global_index_2018.pdf
Businesses: a big part of the problem
…food supply chains are almost 100% private…
Transporters, aggregators, warehouses, distributors Basic processing, industrial processing, packaging Wholesalers and markets, retailers (formal & informal), restaurants Farms, ranches, fisheries, Agricultural input companies (seeds etc.) Source: HLPE 2017
But they have to be part of the solution, because…
The food environment is also partly shaped by the private sector
Source: HLPE 2017 Business finance institutions; Infrastructure companies Private employers; Traders and speculators Media (traditional & social); Marketing companies Refrigeration, preservatives, Testing equipment
demand for nutritious foods
To Shift Norms: use hybrids of public and private approaches
Public sector
logical, linear, health messaging Private sector
emotional and aspirational messaging
Example in Kenya from GAIN work
Like a Healthy Gossip Campaign in Indonesia
Price incentives
What does the evidence say?
Nutrition 31 (2015) 787–795
“To maximize success and effect, this review suggests that food taxes and subsidies should be a minimum of 10 to 15% and preferably used in tandem”.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/709008/Sugar_re duction_progress_report.pdf
The UK sugar levy had an impact on reformulation even before it went into effect in April 2018
SWA = sales weighted average
Nutritious Foods
45% 21%
mandate the fortification
and ghee
Percent of countries that …
mandate at least one kind of cereal grain fortification
Fortification is a basic way of making foods more nutritious
Source: Global Fortification Data Exchange http://www.fortificationdata.org
99 100 98 99 98 96 90 98 89 36 23 95 93 89 98 24 8 7 34 54 54 Côte d'Ivoire, Abidjan India, Rajasthan Nigeria, Kano Nigeria, Lagos Senegal Tanzania Uganda
Fortification of edible oil: FACT surveys
Household uses vehicle* Vehicle is fortifiable** Vehicle is fortified***
And there is a big unfinished fortification agenda
Source: Global Repository for FF
“During the 2008–2009 financial crisis, US firms with high social capital, as measured by corporate social responsibility intensity, had stock returns that were 4 – 7 % higher than firms with low social capital.”
Social Capital, Trust, and Firm Performance: The Value of Corporate Social Responsibility during the Financial Crisis. Lins et al. 19 March 2017
But businesses need to realize that being purpose driven is the smart thing to do
There are many pathways to pressuring companies to be more purpose driven
44 52 53 61 68 76 77 Suppliers and vendors Investors and shareholders Regulators and policymakers Other stakeholders Customers Current employees New Hires
% demanding US company is more purpose driven
i3 (ignite, imagine, innovate) Index, a national survey of C-Suite Executives commissioned by Covestro in USA https://www.agilitypr.com/pr-news/public-relations/profit-driven-vs-purpose-driven-business-ceos-stand/
But for older infants and younger children commercial solutions remain elusive
29
There is no proven business model for fortified complementary foods
Appropriate complementary feeding remains one of the most important life-saving nutrition interventions, and must be aggressively promoted across the world.
FAO infographic
http://www.fao.org/europe/news/detail-news/en/c/447069/
Reducing food loss is a clear business opportunity
Lack of cold transportation from farm to retail Lack of cooling facility in the market Lack of proper crating/Packaging
Cold Chain Packaging & Crating
Tomato Supply Chain Opportunities in Nigeria
GAIN in NIGERIA: SOME PROBLEM-SOLVING INTERVENTION ACTIVITIES
Businesses to Act Positively for Nutrition
Promote Accountability of Business to Identify Responsible Businesses
“It is proposed to provide for exemption from sales tax on premixes to fight growth stunting.”
Hidden barriers
Finance – get slide on access to finance for SMEs
Address the “Missing Middle” of Finance
World Bank Enterprise Surveys http://www.enterprisesurveys.org/data/exploretopics/firm-characteristics
Access to finance as a barrier: Dark red=most important barrier
Un-investible business propositions in nutritious foods or a lack of finance?
Improive nutrition environment at work
Workplace Programs are Missing Opportunities to Focus on Diet & Nutrition
Labels and Symbols Can Make a Big Difference to Inform Choice
Enable Consumer Movements
“Companies in nearly all sectors will see increasing demands from investors to address environmental and social issues.”
https://www.activistinsight.com/research/TheActivistInvesting.AnnualReview.2018.pdf?x45687
Activist Investors can also create an environment for change
Not all F&V are equal when it comes to natural resource tradeoffs
4400 3000 1600 1200 860 700 460 200 180 130
Global average water footprint (litres/kg)
http://waterfootprint.org/media/downloads/Hoekstra-2008-WaterfootprintFood.pdf
And we have to do all this sustainably
…and the first step to transforming food systems is to be open to the transformation of our own ideas
Demand creation
Affordability of nutritious foods Enabling environment
To make all this happen, multi-stakeholder dialogue is essential
Recap: The Solutions
business to support improved consumption of nutritious foods
Overweight
1.9 billion
Deficient in vitamins or minerals
SOFI 2018
Deficient in vitamins or minerals
2 billion
Chronic Hunger
821 million
51m wasted
38m under 5’s over weight151m stunted
1 in in 3 3 people worldwide are malnourished
Overweight or Obese Deficient in vitamins or minerals Deficient in vitamins or minerals Chronic Hunger
wasted
under 5’sstunted
1 in in 2 people world ldwide maln lnourished by 2030?
Overweight
Deficient in vitamins or minerals
Deficient in vitamins or minerals Chronic Hunger
wast ed
under 5’s1 in in 5 5 people world ldwide maln lnourished by 2030?
Thank you!