October 27, 2020
By Douglas Taren
I’ve been around a while and can remember the second half the 20th century when important independent developments took place to improve the nutrition and health of the world’s poor. The Green Revolution focused on increasing the production of grains in order to supply energy and protein to the world’s poor and the World Health Organization’s 1978 Alma Ata Declaration encouraged primary care as the main pathway for improving nutritional status and developing economic growth in low and middle income countries. On its own, agricultural production (animal and plant) provides jobs and essential food and bioavailable nutrients to poor populations but that is only one part of the equation. On the other side, health and nutrition programs prevent and treat illnesses but they do not directly increase income and decrease poverty, the root cause of malnutrition. Over time, these separate approaches did have an impact but significant problems still remain.
Now, 40 years later, there is a convergence of new ideas on how agriculture, health and nutrition-based interventions can work together through a broader lens of food systems in order to have the goals of the past century come to fruition. This is a natural progression since agriculture, nutrition and health are related. They naturally bring together synergistic strategies to create more sustainable community-based programs with greater impact and they need each other. Nutrition programs need agriculture to provide the food that is part of safety net programs to prevent undernutrition or to increase the consumption of fruits and vegetables to prevent chronic diseases. Similarly, health and nutrition agencies are helping set regulatory and certification standards for safe agricultural practices which protect farmers as well as consumers and help them take their products up a value chain to increase their household income.
However, there are still many gaps that need to be filled regarding what is known about how agricultural programs can affect the nutritional status and health of smallholders. It is important to have future studies provide evidence on how new technologies and policies reduce poverty and improve nutritional status at the community level. For example, questions that need to be answered include: does the introduction of biofortified foods, animal husbandry, and small-scale irrigation programs decrease community poverty rates and improve community nutritional status and if so, how? Also, what is the additional benefit from adding nutrition education to agricultural programs and how can community support programs in agriculture and nutrition be combined? It is also important to find better ways for smallholders to get their products into domestic and international markets along a value chain that benefits producers and consumers.
Fortunately, each sector can learn from the other. Both have successfully used local level support personnel such as community health workers and agricultural extension workers to meet their individual goals. Both sectors use education and social marketing campaigns to increase outcomes. Both sectors are adopting modern information education and communication technology to meet their goals. Both sectors use incentives to change behavior with either subsidies or conditional cash transfers. Both sectors need to work with women and both are using more community based participatory research to help develop, implement, monitor and evaluate programs. Both sectors need to be in the community and can serve as conduits to bring health information and services to communities. Both sectors serve the same population. Feed the Future (and now I would add the Center for Regional Food Studies) is working toward this ideal.
Therefore, I believe there will be a time when integrated programs in agriculture, nutrition, health, water, sanitation, and education are bound by a common thread with millions of people participating in activities that simultaneously improve income and health.
I believe.