Unravelling the Food-Health Nexus to Build Healthier Food Systems.

The urgent call to transform global food systems is well founded on the need to reduce the effects of food systems on human health, environment, peoples' rights, and creation of a just society. Unhealthy diets contribute significantly to the global disease burden and pose huge risks to morbidity and mortality. Efforts to transform diets are highly dependent on transformation of the food system. All countries are now affected by the various forms of malnutrition - undernutrition, overweight and obesity, micronutrient deficiencies - with progress often too slow and in some cases going into reverse. Concomitantly, the number of food insecure is increasing, and the prevalence of non-communicable disease is high. IPES-Food, in collaboration with the Global Alliance for the Future of Food, undertook a review of the scientific evidence covering a whole range of global health impacts associated with food systems. The review examined how food and farming systems affect human health, explored why the negative impacts are systematically reproduced and why we fail to prioritize them politically, and how we can build healthier food systems for all. Five categories of health impacts were examined: (i) occupational hazards; (ii) environmental contamination; (iii) contaminated, unsafe, and altered foods; (iv) unhealthy dietary patterns, and (v) food insecurity. The study confirmed that food systems affect health through multiple, interconnected pathways, generating severe human and economic costs. It also highlighted how prevailing power relations in the food system help to shape and sometimes obscure our understanding of the impacts. Five leverage points for building healthier food systems are recommended: (i) promotion of food systems thinking; (ii) reasserting scientific integrity and research as a public good; (iii) bringing the alternatives to light; (iv) adopting the precautionary principle, and (v) building integrated food policies under participatory governance.

AIDS, drought, and child malnutrition in southern Africa.

OBJECTIVE: To investigate trends in child malnutrition in six countries in southern Africa, in relation to the HIV epidemic and drought in crop years 2001/2 and 2002/3. DESIGN: Epidemiological analysis of sub-national and national surveys with related data. SETTING: Data from Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, compiled and analysed under UNICEF auspices. SUBJECTS: Secondary data: children 0-5 years for weight-for-age; HIV prevalence data from various sources especially antenatal clinic surveillance. RESULTS: Child nutritional status as measured by prevalence of underweight deteriorated from 2001 onwards in all countries except Lesotho, with very substantial increases in some provinces/districts (e.g. from 5 to 20% in Maputo (Mozambique, 1997-2002), 17 to 32% in Copperbelt (Zambia, 1999-2001/2) and 11 to 26% in Midlands province (Zimbabwe, 1999-2002)). Greater deterioration in underweight occurred in better-off areas. Areas with higher HIV/AIDS prevalences had (so far) lower malnutrition rates (and infant mortality rates), presumably because more modern areas--with greater reliance on trade and wage employment--have more HIV/AIDS. Areas with higher HIV/AIDS showed more deterioration in child nutrition. A significant area-level interaction was found of HIV/AIDS with the drought period, associated with particularly rapid deterioration in nutritional status. CONCLUSIONS: First, the most vulnerable may be households in more modern areas, nearer towns, to whom resources need to be directed. Second, the causes of this vulnerability need to be investigated. Third, HIV/AIDS amplifies the effect of drought on nutrition, so rapid and effective response will be crucial if drought strikes again. Fourth, expanded nutritional surveillance is now needed to monitor and respond to deteriorating trends. Finally, with or without drought, new means are needed of bringing help, comfort and assistance to the child population.