The world today faces a complex challenge – improving nutrition for all. Contrary to how malnutrition is often portrayed in western media, it is not a separate problem for the poor (undernutrition) and for the rich (overnutrition). Around the world, this double burden of food-related illness is very much a challenge for the poor, simply because nutritious foods tend to be more difficult obtain or more expensive.
So if we are concerned about development, poverty reduction and economic growth, we should be thinking about malnutrition in this broad sense, as well as the food and agricultural systems that influence what is available, affordable and consumed.
A range of specific agricultural interventions for better nutrition have been trialled, but it's not yet clear how effective they are. In a recently published paper, the Leverhulme Centre for Integrative Research on Agriculture and Health and the University of Aberdeen looked at 150 agriculture programmes, ranging from breeding staple crops with higher micronutrient levels, to encouraging home gardening and small animal and fish production in households and communities. They showed that, while these programmes were promising, the majority were not measuring nutritional outcomes effectively. For example, just producing more nutritious food does not mean it will be consumed by people suffering from malnutrition. Similarly, efforts to address unhealthy, energy-dense and nutrient-poor diets have had some promising results, but research is still limited and methods need improvement.
Most agriculture interventions for nutrition have focused on specific foods and communities. For instance, providing households with cows to increase income and milk production, both of which can improve nutrition. But there is another, complementary approach to this problem which has been profoundly under-explored. This approach involves understanding how existing national agricultural and food policies affect nutrition and how they might be changed. Not all policies are nutrition-enhancing. In its guidelines paper on prioritising nutrition in agriculture, The Food and Agriculture Organisation of the United Nations stresses the need to "do no harm" and avoid unintended negative consequences of agricultural policies.
Even the most successful policies can have their downsides. For example, the global investment in improving productivity of cereal crops in the last century, now known as the green revolution, lifted millions of people in Asia from poverty and undernutrition, but also focused research investment on energy-dense rather than micronutrient-rich crops. This led to differences in price that make nutritious foods more expensive today.
As governments facing new food security challenges focus their agricultural policies on improving production, we must heed the advice of 2001 World Food Prize winner Per Pinstrup-Andersen. He said: "It matters for health and nutrition how the increasing food supply is brought about, what it consists of and what happens to it in the food system". But what makes for a nutrition-enhancing policy needs to be better understood – is it a nutrition-unfriendly policy to prioritise export cash crops as opposed to nutritious food crops if it increases incomes of the poor, allowing them to buy more nutritious foods?
In late 2013, with the support of the UK Department for International Development and the Bill and Melinda Gates Foundation, the Global Panel on Agriculture and Food Systems for Nutrition was established "to provide effective guidance to decision-makers, particularly governments, on generating nutrition-enhancing agricultural and food policy and investment in low and middle income countries".
The panel comprises senior leaders in agriculture, health and development from national and international organisations, under joint chairmanship of Sir John Beddington, the former UK government chief scientific adviser, and John Kufuor, the former president of Ghana. Working with other initiatives, the Global Panel will help those responsible for agricultural and food policies to become "part of the solution" of this complex challenge to improve nutrition.
It is encouraging to see a growing global commitment to improved nutrition, with better interventions and more evidence on what works. However, even the best technical interventions are not going to make a difference until policymakers fully understand and play their role in making agriculture work for nutrition.
Jeff Waage is the director of the London International Development Centre and technical adviser to the Global Panel on Agriculture and Food Systems for Nutrition