DECEMBER 13, 2013
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About the Authors:
Prabhu Pingali is a Professor in the Charles H. Dyson School of Applied Economics and Management and the Founding Director of the Tata-Cornell Agriculture and Nutrition Initiative. Prior to joining Cornell in June 2013, he was the Deputy Director, Agriculture Development Division of the Bill & Melinda Gates Foundation, based in Seattle, Washington, from 2008 to May 2013. Pingali was elected to the US National Academy of Sciences as a Foreign Fellow in May 2007, a Fellow of the American Agricultural Economics Association (AAEA) in 2006, and a Fellow of the International Association of Agricultural Economists (IAAE) in 2009. He served as the President of IAAE from 2003–2006, and was named the 2010 Outstanding Alumnus of North Carolina State University. He has received several international awards for his work, including the Research Discovery Award from the AAEA. Pingali has over three decades of experience working with some of the leading international agricultural development organizations as a research economist, development practitioner, and senior manager. He was the Director of the Agricultural and Development Economics Division of the Food and Agriculture Organization (FAO) of the United Nations from 2002–2007, and the Director of the Economics Program at CIMMYT, Mexico, from 1996–2002. Prior to joining CIMMYT, he worked at the International Rice Research Institute at Los Banos, Philippines, from 1987 to 1996 as an Agricultural Economist, and at the World Bank’s Agriculture and Rural Development Department from 1982–1987 as an Economist. Professor Pingali has written 10 books and over 100 referred journal articles and book chapters on food policy, technological change, productivity growth, environmental externalities, and resource management in the developing world.
Katie Ricketts is a Research Associate with the Tata-Cornell Agriculture and Nutrition Initiative (TCi) at Cornell University. Her research scope for TCi focuses on food value chains and household access to adequate nutrition and dietary diversity in India. Additionally, Katie continues to work and publish on private sector and public-private models for integrating smallholder farmers and local processors in global value chains across a variety of crops and commodities, including fresh and frozen horticulture products, coffee, and cocoa. Much of this work has looked at the evolution around extension systems and participation patterns impacting rural producers and processors. Prior to working for the Tata-Cornell Initiative, Katie worked for Cornell Cooperative Extension on various domestic and international projects and for the International Center for Tropical Agriculture (CIAT) in Colombia.
David E. Sahn is an International Professor of Economics in the Division of Nutritional Sciences and the Department of Economics. From 2011–2013, was also a Visiting Professor at Centre d’Etudes et de Recherches sur le Développement International (CERDI), l’Université d’Auvergne, France. He has a PhD from the Massachusetts Institute of Technology and a Masters of Public Health from the University of Michigan. His main academic interest is in identifying the solutions to poverty, malnutrition, and disease in developing countries, as well as the determinants of human capital and the role of cognitive and non-cognitive skills in labor market outcomes. In addition to teaching and mentoring of graduate students, he devotes considerable efforts to training and capacity building of research institutions in Africa and working with government officials and international organizations to integrate research findings into policy. Before coming to Cornell in 1988, Professor Sahn was an Economist at the World Bank, and prior to that, a Research Fellow at the International Food Policy Research Institute. He has been a Visiting Scholar at the International Monetary Fund, a visiting Distinguished Professor at l’Université d’Auvergne, visiting researcher at both the Département et Laboratoire d’Economie Théorique et Appliquée, École Normale Superieure (DELTA) and Laboratoire d'Économie Appliquée de Paris, Institut National de la Recherche Agronomique in Paris, and a Visiting Professor at Kenyatta University in Nairobi. He has also worked extensively with numerous international organizations, such as the Hewlett Foundation, the African Development Bank, Organization for Economic Cooperation and Development (OECD), and several UN agencies such as UNICEF, the UN Development Program, the Food and Agricultural Organization, the United Nations University, and the World Health Organization. He has also worked as a consultant for various governments in Asia, Africa, and transition economies in Eastern Europe.
Agricultural Pathways to Improved Nutrition:
Getting Policies Right!
The past 50 years have been a period of extraordinary food crop productivity growth, despite increasing land scarcity and rising land values, largely due to the Green Revolution, and more recently, advances in biotechnology. Despite these massive gains in productivity and agricultural development, malnutrition has persisted across certain regions of the developing world. Although Southeast Asia has witnessed dramatic declines in undernourishment (insufficient calorie and protein intake) and micronutrient malnutrition, far less progress has occurred in much of sub-Saharan Africa and South Asia. And, more recently, the emergence of overnutrition (excess calories leading to obesity and overweight) has extended beyond Europe and North America and is increasingly affecting middle-income and even some low-income countries. These challenges and the changing landscape of health and nutrition problems can only be addressed through designing and implementing enlightened agricultural policies in association with complementary policies for improved health, water and sanitation, and household behavior change.
Over the past decade, the health and nutrition community has coalesced around two concepts. The first is the early origins of disease, particularly the period in utero and the related concern over fetal programming leading to disease and reduced performance later in life. The second is the idea of a critical period, roughly corresponding to the first two years, where the interaction of malnutrition and infection will have long-term deleterious effects over the life course. Many questions of the role of agriculture in redressing these problems remain. Our paper argues that although there is a critical role of food systems and agriculture in this regard, problems such as undernutrition in utero and childhood stunting are inextricably linked to interventions more broadly in the health sector, especially with an emphasis on vulnerable groups of young children and women of childbearing age, as well as improvements in care and nurturing which require efforts such as improving education and empowerment of women in their roles, as not only food producers but as mothers and decision-makers.
In the specific domain of food systems and agricultural interventions, we would argue that there is still a great deal of work to orient policy and programs driven by nutritional goals, particularly with a focus on rural women and children. More specifically, we need to better understand and establish pathways between agricultural interventions and nutritional outcomes, particularly maternal malnutrition, childhood stunting, and micronutrient deficiencies. We argue that the agriculture–nutrition pathway can expand rural incomes and enable relative food affordability; increase farm productivity, expand calorie access, and reduce poverty; and generate access to a diversity of micronutrient-dense foods through on-farm diversification and links between farmers and markets. We introduce a typology of agricultural systems that reflect the particular stage of agricultural development and highlight the necessary agricultural initiatives capable of impacting micronutrient malnutrition, undernutrition, and overnutrition. Our typology includes subsistence agriculture systems, such as those prevalent in sub-Saharan Africa; intensive cereal crop systems, primarily found in Asia; and commercial/export-oriented systems, typically seen in Latin America.
Subsistence agricultural systems include those that experienced little or none of the staple-crop productivity gains experienced during the Green Revolution (GR). In Africa, much of the GR strategy was inappropriate for the region, and GR-targeted crops tended not to be foods eaten or commonly produced in the region. Likewise, new technologies did not fully account for the paramount need of the food systems to generate employment and stable incomes for the rural poor. These technologies often overlooked key concerns, such as limited exposure to risk, or seasonal labor constraints that both limit adoption of new technologies and their benefits. As a consequence, many sub-Saharan countries are characterized by high rates of poverty, low agricultural productivity, and high rates of hunger and micronutrient malnutrition. Productivity growth and basic research and development (genetic improvements, biofortification, extension efforts, etc.) for the foods commonly produced and consumed by the poor remain a critical priority for increasing the local food supply and rural income opportunities.
The focus of R&D for subsistence systems should be on traditional African food crops, such as millets, sorghum, cassava, and other roots and tubers, which have often been ignored by research and development agencies. These crops can provide high levels of some essential micronutrients (e.g, iron). Rapid growth in population makes several parts of sub-Saharan Africa conducive to investments in intensification. The challenge, however, is to promote sustainable intensification based on crops (and livestock) that are important to the food systems of the poor, rather than crowding them out, as happened during the Green Revolution in Asia. Identifying policies that promote crop-neutral intensification, i.e., providing the conditions for yield enhancement, while maintaining crop and food system diversity, ought to be a priority for these countries. Since women are the primary food producers in sub-Saharan Africa, identifying opportunities for reducing the labor burden in pre- and post-harvest operations would contribute significantly to their health. Likewise, agricultural systems and related labor demands need to be designed to discourage the use of child labor and reduce the likelihood of children leaving school, even seasonally, since temporary absences usually lead to permanent withdrawal.
Given the continued importance and the large share of staple crops in the diets of the poor, identifying mechanisms for enhancing the micronutrient density of grains through bio-fortification can potentially be a high return strategy. The work that is ongoing through HarvestPlus with respect to vitamin A and other micronutrient enhancement holds enormous promise for tackling micronutrient deficiencies. For example, in the case of the orange-fleshed sweet potato, early results indicate significant gains in vitamin A intake among children in Mozambique and Uganda.
Countries, that experienced strong productivity gains in staple crops, described here as intensive cereal systems, have succeeded in increasing staple food crop supply and expanding smallholder incomes as well as off-farm employment opportunities, particularly in the processing and marketing of crops. However, many of these countries have seen a significant drop in the cultivation of traditional micronutrient-rich crops, such as lentils and pulses. The relative price of animal source foods, beans and fresh vegetables, and fruit is high and deters diversification of diets of the poor. Sustained investments in productivity growth and diversification out of staple cereals towards micronutrient dense foods remains an area of agricultural policy that can have a direct impact on the availability (supply) and affordability of dietary diversity. Much of this diversification away from cereal crops requires policy attention in infrastructure and extension as well as market access. We highlight the policy opportunities and evidence for pro-poor integration of smallholders and domestic/global markets through modern food value chains and various public-private partnerships. Similarly, we discuss how such policies can help create and promote forward and backward economic linkages that provide off-farm employment opportunities in rural areas. Meanwhile, kitchen gardens and backyard livestock production remain critical areas of policy promotion, and we provide examples of successful implementation in South Asia and elsewhere.
Our third typology includes countries with growing commercial/export-oriented systems, including much of Latin America and high-growth areas in Asia. These systems have made measurable gains in average productivity, average household income, and other aggregate welfare indicators, and yet high levels of inequality between sectors, regions, and demographic groups often characterize these systems. In fact, some of these lagging pockets and sectors may require interventions similar to those previously described for subsistence systems or intensive crop cereal systems. We focus on such efforts to target these lagging areas and sectors and review initiatives undertaken in emerging commercial and export powerhouses like Brazil and Peru, as well as areas in Asia, such as those populated by ethnic minorities in rural areas of China who have largely been left behind by the economic transformation that has lifted much of the country out of poverty.
We also highlight policy efforts to curb rising obesity and overnutrition levels, observed in many of these commercializing systems. Sedentary lifestyles, changing preferences, and time constraints associated with urbanization are contributing to increased consumption of processed and packaged foods, with implications for obesity/overweight malnutrition. By the same token, however, modern food value chains and food manufactures are also contributing to reducing micronutrient deficiencies by offering a wide assortment of products year-round for a diverse diet, but often only for urban households with relatively high incomes. In our paper, we emphasize that there is considerable opportunity for modern value chains to play a positive role by providing year-round access to micronutrients and facilitating dietary diversity through fortified-food offerings for the rich and poor alike. However, there is a need for creative efforts to achieve this goal, including dealing with elevated product standards and quality parameters, and physical locality that often make these foods unattainable and unattractive for poor consumers. The increased demand for inexpensive processed and packaged foods, however, especially among the poor, is not limited to the role of urban supermarket retailers; increasingly, foods high in fat, sugar, and salt are available in traditional markets, roadside stands and vendors, and corner stores in both urban and peri-urban areas, as well as remote and rural towns and villages. We look at policy efforts that promote access to dietary diversity, including distribution and safety net programs, as well as upgrading of local (traditional) markets, and partnerships with food manufactures to promote food fortification and micronutrient access.
Following this discussion on agriculture–nutrition policy efforts, we provide a brief review of necessary complimentary policies, including efforts directed at labor-saving technologies, and more generally, labor market policies that focus on the needs of rural women and children. We also briefly discuss rural development efforts around access to clean water, access to toilets, and sanitation education. Without these policy priorities, intestinal inflammation and infection due to water contaminated with worms, parasites, viruses, and bacteria can lead to sickness and partial or complete malabsorption of essential nutrients or calories, in addition to life-threatening dehydration. Efforts to influence behavior change and intrahousehold allocation are also briefly described. We conclude this paper by discussing key agricultural policy recommendations for tackling nutrition challenges within the various agricultural systems described.
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