Policies to Support Nutrition-Sensitive Food Systems

Autumn of 2021 will be remembered as a season of groundbreaking, international events. Each month has seen at least one major event for food systems: the UN Food Systems Summit (UNFSS) in September, the UN Convention on Biodiversity in October, the UN Climate Change Conference (COP26) in November, and finally the upcoming Nutrition for Growth Summit in December. Convening in Tokyo, the Nutrition for Growth Summit will encourage governments, businesses, multilaterals, and donors to make commitments in three focus areas: health, food, and resilience.

The inclusion of food as a core agenda item reflects a move in the global agriculture community to better integrate nutrition into food security concerns. For decades, the sole focus was increasing the quantity of calories produced to end hunger. But growing the world’s pile of grain is insufficient for ending hunger; calorie quality matters too. Micronutrient deficiency, even if consuming an average number of calories, can inhibit the body’s production of enzymes and hormones necessary for proper growth, and cause serious health conditions.

The Chicago Council’s 2015 report, Healthy Food for a Healthy World, offered four key recommendations for the US government and private sector to address the realities of malnutrition in all its forms and better integrate nutrition into policy, research, and agriculture. In the coming weeks, the Chicago Council will review each of these recommendations to assess what progress has been achieved and what work remains for the Nutrition for Growth Summit.

Global Nutrition, Then and Now

At the publication of the report, about 653 million people were undernourished globally, and as many as an estimated two billion suffered from micronutrient deficiencies, called hidden hunger. Presently, an estimated additional 67 to 158 million are undernourished. The number of people currently suffering from hidden hunger is not well known due to a persistent lack of reliable data on the issue, but given that global hunger has risen every year since 2015, it would be surprising if hidden hunger has decreased in that time. Additionally, the COVID-19 pandemic both increased rates of hunger and highlighted how chronic malnutrition can leave people more vulnerable to serious illness.

Policies to Support Nutrition-Sensitive Food Systems

Health Food for a Healthy World’s first recommendation is to “strengthen policies to support nutrition-sensitive food systems.” This could be achieved through three tactics: committing to a global food and nutrition security strategy across bureaus and agencies; ensuring that food aid and social protection programs expand access to and incentivize consumption of healthy food; and align US government investments in nutrition and ramp up collaborative, transdisciplinary research, and programs.

A Global Nutrition Strategy

The 2016 passage and subsequent 2017 reauthorization of the Global Food Security Act (GFSA) implemented the sub-recommendation for a cross-bureau, cross-agency global food and nutrition security strategy. The report identified smallholder farmers’ incomes and postharvest value chains promoting fruits and vegetables as two core components of the proposed strategy. The GFSA codified existing US agricultural development efforts implemented via Feed the Future, which focuses on improving the incomes, productivity, and livelihoods of smallholder farmers, with particular attention to women’s empowerment.

Food Aid and Social Protection Programs

Healthy Food for a Healthy World identifies using food aid and social protection programs to expand access to and incentivize the consumption of healthy foods as a second pathway for nutrition-sensitive policies. In 2015, US international food aid was bogged down by inefficiencies—less than 50 cents of every tax dollar spent on food aid ever reached the intended beneficiaries. Healthy Food identified reforms to improve US food aid, including allocating more funds to local food purchase, eliminating monetization (the sale of US food aid in low- and middle-income countries, or “LMICs”), addressing transportation restrictions, and focusing on nutrition. The most important proposed reform is supporting LMICs in their own efforts to develop nutrition-sensitive social protection programs, including school feeding programs.

Food aid reform is a thorny issue, but there has been some movement towards implementing Healthy Food for a Healthy World’s recommendations. Market-based assistance, such as cash transfers, vouchers, and locally-procured food, now make up about 59 percent of US food assistance. The 2018 Farm Bill removed a monetization requirement, which specified that 15 percent of US donated food aid must be first sold by aid organizations, but kept the requirement that half of US food aid commodities be shipped on US vessels. Micronutrient delivery is still a persistent problem, but school feeding programs have received sustained support and the US joined the School Meals Coalition at UNFSS.

Collaboration and Alignment

To effectively implement the global food and nutrition security strategy, efforts across US government agencies and bureaus must be aligned, sharing information and using common metrics. Additionally, Healthy Food for a Healthy World called for transdisciplinary research and programs that work across disciplines through shared frameworks and integrated approaches. Federal agencies like the National Institute for Food and Agriculture, National Institutes of Health, and USAID should develop proposals for new solutions to health and food system challenges with a focus on nutrition.

The report’s third sub-recommendation was implemented through the adoption of the first US Government Global Nutrition Coordination Plan in 2016. Co-developed by representatives from eight agencies and departments, the plan sets out coordination mechanisms to ensure better communication and collaboration for US international nutrition efforts and links research to program implementation.

What does this mean now?

With two-thirds of Recommendation 1 implemented, it can be considered a success. Yet food aid inefficiencies have not been fully addressed. Nutrition still has yet to be fully integrated into agriculture concerns, although the newly established Feed the Future Innovation Lab for Food Systems Nutrition should help move in that direction. Next week, the Center will review Recommendation 2: expand the research agenda for nutrition-sensitive food systems.