The United Nations Food Systems Summit (UNFSS) has just wrapped up a three-day pre-summit – a hybrid conference involving participants in Rome and thousands more online.
The goal of the summit is to transform the global food
system.
The UNFSS has been heavily criticized for months and many movements,
organizations and individuals have boycotted it. A counter
mobilization of hundreds of grassroots organizations has emerged. Several
multi-signatory open
letters and statements
have elaborated on its shortcomings – including opaque governance, weak or
absent principles of engagement with the private sector, an inability to address
(or even acknowledge) conflicts of interest, the sidelining of existing UN institutions,
and the marginalisation of human rights (this is a United Nations
conference remember!), and the silence of UNFSS leaders in the face of this
criticism.
In this short blog, I focus on one core concern – the Summit’s
approach to engaging with multinationals whose products and practices have been
shown to drive malnutrition (e.g. Nestle, PepsiCo, Coca Cola).
A few days ago, Carlos Monteiro and colleagues published A Call to the UN Food Systems
Summit to reshape global food processing. Carlos is a legend in nutrition,
with whom I was lucky to work thirty years ago when he contributed a case
study on child stunting in Brazil to a UN Standing Committee on Nutrition initiative:
How
Nutrition Improves. As the Brazilian malnutrition challenge shifted from
under to over, Carlos switched gears. He has since pioneered the NOVA classification and contributed
to many studies that have shown how ultra-processed foods generate malnutrition,
various non-communicable diseases and premature mortality. Scarcely a week goes
by now without more studies emerging highlighting the damage UPFs cause. It’s
not only papers — Dr Chris van Tulleken followed his groundbreaking BBC
documentary with this podcast
on UPFs.
Many of us hoped that the Summit would take the challenge of
ultra-processed foods (UPFs) head-on — if not now, then when?
So, what’s happening?
Well, not much. It’s not as if the glass is half-full, or
half-empty – the problem is the glass is cracked and the water’s leaking out. We
really need a new glass.
Jeff Sachs made this point in this barnstorming speech the
other day — “we have a system but we need a different system” –
reminding us that we turned food systems over to the private sector a hundred
years ago.
Private sector involvement in the Summit is managed by the
Private Sector Guiding Group (PSGG) run by World
Business Council for Sustainable Development. The WBCSD is an association that prides itself
on its open
membership – a group that includes tobacco giant Philip Morris among its
members. It invited two of these companies – Nestle and PepsiCo to speak the
other day in a 50-minute session on “private sector priorities for the UNFSS”. I
naively tuned in thinking there would be a discussion of private sector
priorities for the UNFSS. There wasn’t. Instead
there were 10 presentations by individual companies and organizations on their
own priorities. Better to email promotional
flyers next time.
Yesterday, WBCSD ran another session in which a speaker from
EUFIC suggested that ultra-processing of
food was an ambiguous and hotly debated notion. EUFIC count Coca Cola, Cargill and
Bunge among their Board members.
Way back in the mists of time, I raised a question in a UNFSS
pre-consultation about the involvement of malnutrition-causing behemoths in a
global conference aimed at reducing malnutrition. I’ve worked on principles of engagement
while at IFPRI (including IFPRI’s own), and I wanted to hear about the Summit’s
principles of engagement. I was told that no single company is in a position of
influence in steering the UNFSS process and outcomes. On asking why PepsiCo was
invited to speak at these consultations, I was blocked on twitter by a UNFSS
leader who then accused me of spreading malicious lies (not sure how a question
can be a lie, but anyway…). Many other commentators with similar questions have
had similar responses.
The fact is that the Summit
principles remain as they were at the start. There is no “do no harm”
principle. Instead we get vague
exhortations to “recognize complexity” and — irony of ironies — to “build
trust”.
Looking back, a day after the pre-summit, and two months before
the main Summit, the only reasonable conclusion is that the UNFSS is operating
under a similar set of engagement principles as the organization who runs its Private
Sector Guiding Group (PSGG) – WBCSD — and therefore anyone can join up.
This dovetails with the inclusion rhetoric – that this is a “people’s
summit” open to all. Power asymmetries
don’t exist in this world — all voices are equal, everyone’s welcome to the
party….all we need to do is keep talking to each other.
Over two years ago, Nick Nisbett and I wrote about principles
of engagement and the need for clarity on red lines. We were concerned about companies doing “minor
goods” with their left hand, while continuing to do “major bads” with their right
hand. Minor goods include small-scale
boutique corporate social responsibility initiatives and projects. Major bads are the core business practices that
generate huge profits from selling junk food and drinks.
Anand Giridharadas wrote about this too here cautioning
us to be wary of side salads!
José Graziano da Silva – former FAO Director General and architect of Fome
Zero, launched 20 years ago — tweeted his concern yesterday about
sugary drinks companies being part of Zero Hunger, Nourish the
Future Pledge.
In this session, I asked whether there was a “do no harm” principle
for the Pledge. The response (min 33.50) was “yes, there
will be”. I guess this means that PepsiCo are not perceived as being harmful to
nutrition, or they will be relegated once the principle shows up.
This is not trivial. It opens up a whole new can of worms
that could be described as ‘nutri-washing’ – when companies play off one form
of malnutrition for another.
Companies whose ultra-processed foods, drinks and marketing practices
generate obesogenic environments now have a new ‘get out of jail’ card to play.
They can now gain kudos, profile and acceptability by
pledging to fight hunger and undernutrition while continuing to drive
overweight and obesity.
Big step backwards.
Of course, there’s a different way. Why not employ clear principles,
including “do no harm”, from the start? Why not determine eligibility to pledge
by using independent benchmarking and monitoring tools — such as the new FACT
transparency index developed by Feed the Truth?
Meanwhile, in all this corporate carousing, the most
successful public-private partnership of all time – taxation — has been relatively
sidelined. Jeff Sachs again: “To private sector leaders
— behave, pay your taxes, follow the rules — that’s what you should do”.
The UNFSS may, or may not, take on board some of
these concerns proactively and transparently – there’s still time. But whatever happens the level and type of
discourse has changed this year.
In the midst of a pandemic that has highlighted the
imperative for transparency, leadership and trust – big issues affecting people
and planet, hitherto shrouded or back-burnered, have been surfaced and debated.
At the turn of the year the UN Food Systems Summit leadership
had been talking a lot about the need for trust to make progress on food
systems. I agreed, and wrote this blog: rebuilding trust in nutrition.
Six months later, in the UNFSS Science Days session today the issue
of trust came up again in questions to the panel.
The panel responded as if the issue was a
mistrust of science.
I’m not sure why this was side-stepped, but
the big issue – and the focus of the questions – related to the science-policy
interface. More broadly, it relates to the issue of governance of food
systems – present and future – and more immediately, governance of the UNFSS
process itself.
IPES-Food recently
brought out this briefing note
and this podcast
was released today. The brief questions the Scientific Group
of the UN Food Systems Summit, suggesting it “falls short in several respects:
it is nontransparent; is imbalanced in its composition and biased in its
perspectives and sources of knowledge; is unreflexive about the relationships
between food systems and society; and is pursuing a business-oriented
‘technology and innovation’ agenda.” This led to an open
letter “no new science-policy interface for food systems” with multiple
signatories.
Then there’s the open
letter from the Ad-Hoc Committee on UN
Food System Summit (UNFSS) Governance to the UN Secretary General and UNFSS
leaders. This letter was written following several meetings, a review of publicly
available UNFSS documents, expert input, a crowdsourcing survey and an
Independent Dialogue in mid-June.
The conclusion? Though this is a UN summit, the UNFSS decision-making
process has yet to implement adequate transparency and accountability
principles in line with best practice followed in other UN processes. The
crowdsourcing exercise raised issues around conflict of interest, weak
principles of engagement and the widespread perception of a lack of trust. Again,
multiple signatories.
Many of us who seek to amplify these
concerns on social media are either met with silence or we are blocked by UNFSS
leadership — as has happened to me twice now.
The UNFSS for months has positioned
itself as a ‘people’s summit’. It has prided itself on gazillions of hours of
consultation time – and yet so much decision-making remains unexplained and opaque.
We don’t know how the hundreds of ‘game-changing solutions’ were whittled down
to 50 odd solution clusters, and we don’t know how these clusters map conceptually
and operationally to the bigger picture in terms of the summit’s vision and
goals. Many have asked to see details of the decisionmaking and selection process
and criteria made available online.
Trust
is downstream from transparency. To earn it, any public process would need to broadly
adhere to the seven (Nolan) principles of selflessness, integrity, objectivity,
accountability, openness, honesty and leadership.
Earlier this week, Duncan Green published
this excellent blog
on building and maintaining trust at the interface of policy and research, with
this useful chart of 14 trust-building strategies, along with a stepwise process
for repairing damaged trust.
Fourteen strategies identified
through a case study of ICES for building trust at the interface of
environmental science and policy, as published in Cvitanovic et al (2021).
Trust is researchable, and much work has been done
on trust theory and its various applications e.g. in natural
resource management.
If a lack of trust is seen as such a
big challenge, why doesn’t
the UNFSS systematically investigate what is needed to build trust and maintain
it? Why not commission an independent social network analysis of actors,
processes and outcomes?
Why
continue to decry the lack of trust – or any major obstacle or constraint –
while doing so little to address it?
Over the last year, the resurgence of the Black Lives Matter movement has been paralleled by an accelerating movement to decolonise development. Among the many papers and blogs, this Lancet Perspectives article is one of the best. Seye Abimbola and Madhu Pai not only highlight the colonialist roots of global health, they go on to envision a decolonised future where equity, justice, humility and respect replace supremacy.
Supremacy goes well beyond ‘pale, male and stale’. It manifests in what does (or does not) happen
between countries, and groups and individuals within those countries.
In research, it governs who sets the research question, who
pays for the work, who decides on methods, who does the work, whose names are
on the paper, who publishes it, who reads it and who decides on the next study
to be done – or the next research program to be set up and funded. In a word, everything.
Much of the impetus on decolonisation in recent years has
come from global health thinkers and doers like Abimbola and Pai, as the reading
list below shows. But of course it transcends any one discipline. Last week,
Arvind Subramanian and Devesh Kapur wrote about absent
voices in development economics. They cited Kazuo Ishiguro’s 2017 Nobel
lecture in which he urged the broadening of “our common literary world to include many more voices from beyond our comfort
zones of the elite first-world cultures.”
The decolonisation movement has shone a light on questions of agency,
power, human rights, equity and justice in the midst of a pandemic which has also brought these issues
to the fore. Not only has COVID-19 exposed different forms of
inequity, it has amplified them. People who are poor, marginalized and exploited
are more likely to be dependent on fragile livelihoods that cannot be
outsourced to Zoom meetings. It has led to the loss of livelihoods and lives.
The word
‘crisis’ comes from the Greek noun ‘krisis’ which means ‘to separate, decide….a
turning point’
A year ago, Erica Nelson, Nick Nisbett and I decided to look
into this potential ‘turning point’ in the light of past histories of global
nutrition. Like global health, global nutrition has roots in colonialism and
supremacy. We like to repeat the mantra that nutrition is both a marker (of
deprivation) and a maker (of development) but we are far less likely to hark
back to a history when nutrition was a discipline that propped up colonialism,
racism,
inequality and injustice.
Nutrition has always operated at the interface of health and
food systems which have deep roots in colonialism. For global nutrition to move
forward, it needs to confront its shady past – the overt and disguised racism,
the systems of food apartheid and the massive power imbalances within health
and food systems. Vaccine nationalism, global food trade terms are just two
examples — there are many more.
Credit: Martin Karumwa
Twenty years ago, just after I joined IFPRI, I worked on ‘strengthening capacity for nutrition’. At that time the finger of blame for the failure of large-scale nutrition programs often pointed to insufficient/unsustainable capacities within communities and organizations responsible for implementing them.
But many of us then failed to take the next step. Inadequate
capacity is not just the cause of failure, it’s the symptom of a larger failure
that has its roots in colonisation and intergenerational injustice. The proper
response to capacity gaps or weaknesses is not simply to initiate a capacity
development program – it is to dig deeper, to respect, protect and fulfil the
human right to food and health, and to work towards intergenerational equity
and justice.
A recent article in the New
Humanitarian shows how much work remains to be done. The EU’s
commissioner for crisis management recently stated: “What
is actually the biggest barrier to localisation is the capacity of local
actors. Most often, the local organisations lack the capacity to fulfill all
the criteria with regard to accountability, transparency, sound financial
management…”
Just as ‘community-based’ does not equate with ‘community-driven’,
localisation — defined and driven by global northern organisations — is far
from decolonisation.
For those of us in the global north, decolonisation
requires us to get out of
the way – or ‘lean out’. It requires us to become better allies
and enablers, not leaders.
The UNFSS promotes itself as a ‘people’s summit’ where everyone
is welcome at the table. Current past UN human rights commissioners have written:
“Coming to the table to discuss ‘solutions’ is not as simple as it sounds. What
if the table is already set, the seating plan non-negotiable, the menu highly
limited?” In their Lancet article, Abimbola and Pai also remind us, in a
broader context, that “what is on the table is as important as who is
around the table.”
In a seminar last week, the UN Secretary General’s Special Envoy,
Agnes Kalibata provided assurances that human rights will be foundational to
UNFSS processes, and that corporate capture is not an issue.
The big question remains – how will such an open-door policy
address the huge power asymmetries between actors that underpin and enable dysfunctional
food systems? If human rights are foundational to the Summit process and
deliberations, then issues of power, agency and justice must be ‘on the table’
too. As far as I can see, there has been little open public discussion of these
issues. Without this, the notion of transformation based on ‘game changers’ is
meaningless.
In our brief review of global
nutrition histories, we concluded that it is not enough to listen to
different perspectives, we have to learn from them, and act
differently as a result. To dig deeper, well below the surface to better
understand the ‘causes of the causes’ so we’re better able to address them.
And for this to happen, we need humility (not
hubris), we need creativity and honesty and — if we are to work together– we
need trust.
Here are a few other key readings on decolonisation:
For some reason – unlike our health counterparts — nutrition
professionals tend to shy away from research and action on the commercial
determinants of (mal)nutrition. They don’t
want to be involved in polarizing discussions on the role of the private sector
in nutrition.
A big part of the problem is the way the narrative is
shaped. We constantly hear clichés like
“the private sector should be part of the solution”, or simplistic questions
like “how do we work with the private sector?”.
A good start is probably to ban the phrase “private sector”. It’s just not
helpful. There are many forms of private business, including many small
companies who are trying to improve access and affordability to healthy diets. We
need to do better in differentiating those whose products and practices harm nutrition
from those who (actually or potentially) support good nutrition. The former include the ultra-processed food
and beverage industry which controls much of the global food system. They want
to be loved by the nutrition community, so they target influential individuals,
organizations and conferences and woo them in various ways. Adapted from Big
Tobacco, this corporate playbook has been described and used many times. Being
seen to be part of the nutrition community is huge as it confers tacit approval
of actions – a soft-power ‘get out of jail card’ that reduces the pressure to
change damaging products and practices.
And these tactics clearly work.
The nutrition community has made progress in differentiating
good and bad corporate behaviors and even ranking them. Much of this however draws on statements of
intent, rather than action on the ground.
There are different sets of principles that define good (pro-nutrition) behaviour.
But what’s missing is clarity and consensus on what this looks like in
practice, where the red
lines are, and the implications of crossing them.
This is not trivial.
We currently have a divide between some who believe that it’s perfectly
fine to ‘talk to anyone’ and others (myself included) who believe that actions
need to precede words. The ‘talk-first’ group think they can persuade
malnourishing companies to change their ways – as if they were somehow still not
clear on what to do. The ‘walk-first’
group believe it’s perfectly clear to everyone what’s needed, it just needs to
be done – or at least, there needs to be clear, tangible, independently
verifiable progress first. This needs to be large-scale – it’s just not good
enough to have a few showy small-scale CSR projects dotted around, here and
there. Boutique projects and the media
froth they generate are distractions at best. At worst, they’re dangerous side salads
that confer legitimacy on core business practices that may run in a very
different direction.
Malnutrition is a large-scale problem, it needs large
companies to act at large-scale, in the long term, to be seen to be serious.
This year we have not one but two big talking events – the UN Food Systems Summit (UNFSS)
and the Nutrition
for Growth Summit. The rules for engagement in these summits are not
entirely clear. I have been told there are guidelines but they’re not visible
on the web. There is a Private Sector Guiding Group for the UNFSS but again – it’s
not clear who is in this group, or whether it’s open to anyone.
In the various consultations in different Action Tracks for
the Summit there has been a lot of discussion about the importance of enabling
environments, trust and responsibility. On 23 November, the UN Special Envoy, Agnes
Kalibata stated: “One of
the most broken pieces of our food system is our trust in each other. There
isn`t a high level of trust in the system right now, and that is preventing us
moving forward.”
She’s right — it’s crystal clear that many stakeholders see
trust as a big issue.
The UNFSS has put out a call for game-changing solutions. One
that would go a long way to rebuild trust would be an unequivocal position on
the part of the UNFSS regarding the role of the ultra-processed food industry
in the challenge of addressing malnutrition. In general terms, and specifically
with regard to the Summit process.
In his 2019 book “Upheaval: How Nations Cope with Crises and Change”, Jared Diamond starts by interrogating the word ‘crisis’. Coming from the Greek noun ‘krisis’ and the verb ‘krino’ there are several meanings — to separate, decide, a turning point. Crises differ in terms of the way they emerge, their scale, duration, and impact. Some come as a shock, some are slow-burn — though in reality this distinction may be blurred once we look below the surface.
The COVID-19 pandemic is a sudden-onset crisis, while climate
change is slow-burn (albeit linked to increasing shocks like floods and
droughts). The biggest cause of global ill-health and premature mortality – malnutrition
— is also slow-burn. All three crises are
massive in scale, they overlap and interact, and they share many drivers. In
2019, a Lancet Commission delivered an incisive analysis of the global syndemic of obesity, undernutrition, and climate change. This was a year
before the pandemic. COVID-19 has since added another crisis into this toxic mix.
Crises heighten our awareness of time, and they generate new
understandings or worldviews, often elevating neglected issues to centre-stage.
Equity is one such issue.
The COVID-19 pandemic not only exposes inequities of different forms,
it amplifies them. We have seen this clearly in
the experience of Black, Asian and Minority Ethnic (BAME) communities in the UK
and elsewhere, who are disproportionately exposed to the virus, and more likely
to become seriously ill or die. A similar situation plays out with regard to climate
and malnutrition crises. Syndemics are fuelled by inequity.
Equity was the central theme of the 2020
Global Nutrition Report. The introductory chapter succinctly unpacked the
concepts of inequity and inequality, highlighting the core ingredients of unfairness,
injustice and social and political exclusion.
But we also need to take account of another dimension – time. What we do (or don’t do) now — as individuals,
organizations and governments – has immense implications for future
generations.
This is the subject of a powerful new book by Roman Krznaric “The Good Ancestor: How to Think Long-term
in a Short-term World”. While many activists are driving a decolonization
agenda in global health, Krznaric argues that we have also colonized the future.
Starting in the 18th century, Britain colonized Australia,
considering it to be ‘terra nullius’ (‘nobody’s land) ignoring indigenous
peoples’ claims. We are now behaving in
a similar way with time. Political and economic systems consider the future to
be tempus nullius (‘nobody’s time’). Our time horizons have collapsed
inwards, driven by short-term dopamine-triggered feedback loops.
Krznaric distinguishes between the marshmallow brain —
routinely hijacked by the digital distraction industry that has weaponized
smartphones and social media platforms to steal time – and the acorn brain,
that thinks long-term, considering the intergenerational consequences of
actions taken today.
His analysis of intergenerational injustice and the ‘dark art of
discounting’ is compelling. As a method for weighing up the costs and benefits
of investment decisions over different time spans, discounting has spread from
finance into many spheres of development, including public health and
climate-related policymaking.
Why, Krznaric asks, are the lives and well-being of future
generations considered to be of ever-declining value? Using a ‘progressive’ 1.4% discount rate, adults
alive two generations from now would be assigned the value of half a human
today – an ‘iconic expression of the colonization of the future’. Why isn’t the welfare of a child born 100
years from now treated as equal to the welfare of a child born today? Are we to accept that future generations will
continue to be disenfranchised, like slaves and women in the past?
Intergenerational inequity plays out in different ways. Politically, it came to the fore, for
example, in the 2016 Brexit referendum, when young people (overwhelmingly
pro-Remain) accused the older generation (overwhelmingly pro-Leave) of stealing
their futures.
So, what does this have to do with nutrition?
A lot.
A growing body of research in the last few decades has shone a
light on the way in which malnutrition persists through the life cycle – and even
across generations. Epigenetics
is showing that what we do now has major implications for the health of future
generations. A recent
review states:
“Early insults during critical
periods of brain development, both pre- and postnatal, can result in epigenetic
changes that may impact health and behavioral outcomes over the lifespan and
into future generations. There is ample evidence that these early stages of
brain development are sensitive to various environmental insults, including
malnutrition, childhood trauma and drug exposures. The notion that such
changes, both physiological and behavioral, can also carry over into subsequent
generations has long been recognized, especially in the context of experimental
studies. However, epigenetic mechanisms capable of explaining such phenomena
were not available until relatively recently.”
Nutritional disadvantage, driven by inequitable factors and
processes, can last for many decades.
Meanwhile, as we continue to learn more about long-term
consequences, the ultra-processed food industry continues to exploit the short-term,
addictive and impulsive traits of our marshmallow brains — one of the main
reasons why obesity has rocketed in the last two decades. In evolutionary
terms, we’re still very close to hunter-gatherers who were adapted to consuming
food whenever and wherever they could.
What used to be a survival mechanism to bridge over times of scarcity, however,
has become a maladaptation to the obesogenic environments we now live in.
What to do?
Following the Global Nutrition Report’s call, we need to develop and
invigorate a pro-equity nutrition agenda that includes intergenerational
justice.
Security is a start point. How can anyone ‘think long’
or plan for the future if they cannot even nourish their families today? Food,
health and nutrition security are foundational pillars for building a future –
at all levels.
Second, nutrition researchers and activists need to become politically
adept in analysing and challenging political and governance systems that colonise
the future. For too long, the nutrition community considered politics
and political economy as beyond their remit. We have a special challenge
given that the full benefits of addressing malnutrition will take many more
years than a politician’s term in office.
Third, institutional mechanisms that ‘look long’ and consider
interests of future generations need cultivating – especially youth
movements, such as the Scaling
Up Nutrition (SUN) Youth Leaders for Nutrition. A Lancet Planetary
Health commentary,
released alongside International Youth Day last week, argues: ‘It is time to democratise [planetary health], balance the
asymmetrical power structures, and leverage
fearless voices challenging the status quo’. The authors outline a pragmatic roadmap based on three
pillars: governance structures enabling young people’s participation, funding
that supports inclusion and compensation of young people from all backgrounds,
and capacity building for young people.
Another example of long-termism, as highlighted in the Lancet
syndemic commission report, is the Iroquois concept of ‘seven generation
stewardship’. This urges the current generation to live and work for the
benefit of the seventh generation into the future. To this end, the Commission
proposed the establishment of a ‘Seven Generations Fund for Traditional
Peoples’ Science’.
Nutrition advocacy that emphasizes the foundational
aspects of nutrition, and its central role within holistic strategies for
achieving the Sustainable Development Goals
will be more important than ever. In this context, #BuildBackBetter has become a
bit of a cliché in 2020. Many also question use of the word ‘back’. Why go back to economic systems that target
short-term gains, and profit over people? Why not go forward?
The SDGs rightly focus on sustainability and on equity – leaving no-one
behind. In this context, the title of the postponed ‘Nutrition for Growth’ summit is
looking ever more dated. Yes, we know that $1 invested in nutrition generates
$16 in returns. The economic investment case needed to be made a decade ago,
and it’s been made. Now we need to make the case in terms of nutrition’s
pivotal role as a driver of sustainable and equitable development. ‘For Growth’
is just not a compelling rationale any more. The world has changed.
Finally, we face a challenge of public perception that can
perhaps be best illustrated by a mythical fable about frogs and hot water (don’t
try this at home!). If you drop a frog into boiling water it hops straight out.
If you drop a frog into tepid water and heat it to boiling, it will not react
until it’s too late. The COVID-19 pandemic is a rapid-onset global emergency
that has generated an unprecedented sense of crisis and a large-scale response.
The climate and nutrition crises, on the other hand, are slow-burn crises that proceed
incrementally, month by month. They kill
many more people than COVID-19 but they do not generate a sense of crisis that
leads to action on the scale and intensity required. It’s reflected also in the
terminology – the notion of climate ‘change’ is a little like referring
to an earthquake as a ‘land movement’!
So, the overarching challenge is to generate a sense of urgency that leads to concerted large-scale action. One opportunity lies in showing the connections (through data and research) within the syndemic. During the southern African HIV epidemic in the 2000s, a similar approach was taken with nutrition, following research that showing that antiretroviral therapy did not work well unless people were adequately nourished. A recent example comes from the UK where evidence of the higher risks of COVID-related hospitalization and death of people who were obese led quickly to a strategy (flawed, but a start) to address obesity.
At long last, equity – including transgenerational justice – is central
to the nutrition agenda.
As the COVID-19
pandemic generates waves of impact across the globe, “resilience” is bouncing
back into the development spotlight.
Whether linked to
health (e.g. AIDS, Ebola) or economic (food prices), climate or conflict shocks
and stresses, resilience has come to be seen as a useful organizing principle.
A conveniently fuzzy, all-embracing, cross-sectoral goal around which we can all
align.
There are many
definitions out there. Most refer to the ability – in the face of a shock or
stress — to recover or bounce back to a past state. A type of buoyancy or toughness in the face of adversity — the capacity to weather the storm, to
cope. The Intergovernmental Panel on Climate
Change, for example, defines
resilience as the ‘ability of a system and its component parts to
anticipate, absorb, accommodate, or recover from the effects of a hazardous
event in a timely and efficient manner’.
In the face of
COVID-19, at an individual level, resilience is ultimately the ability to
survive. For households, it’s the ability to withstand multiple social and
economic impacts.
Alongside the
return of resilience, we see another emerging discourse that argues for the
need to jettison business-as-usual in a post-COVID world. We need to create a “new normal”. This sounds
very like transformation — quite different to coping.
So, can these two
goals – resilience and transformation – actually co-exist?
But first, even
before we ask questions about resilience, we need to consider resistance.
The front-line of resistance to a new virus like SARS-CoV-2 is an individual’s
immune system. We can go further back to ask why s/he was exposed to the virus
in the first place — was she working or living in an environment in which she
had more contact with potential carriers? Was she in control, could she reduce
the risk of exposure? If her ability to avoid exposure – her resistance — is
overwhelmed and she becomes infected, then we’re in the realm of resilience.
In 2003, in the
early years of RENEWAL, we conceptualized both resistance
and resilience in the context of AIDS epidemics to help understand the
different layers and waves of HIV risk and AIDS impacts. In the top left
quadrant (of the diagram below) we can see the different drivers of risk of
exposure to the virus, from macro to micro.
In the top right quadrant, we can see the waves of impact, from micro to
macro. The bottom half shows potential
responses – resistance to the left, resilience to the right.
As we learn more
about COVID-19, we can develop similar maps to help situate a comprehensive
response. Here’s a simplified illustrative
version, including potential key factors (some as yet unproven):
Much has been
written about resilience in recent years. In May 2014, IFPRI convened an
international conference “Building Resilience for Food and Nutrition Security”
in Addis Ababa, Ethiopia that led to a book
of key papers.
Where is agency?
One criticism of
resilience in the past has been its perceived inability to capture issues of
power, agency and social justice. It’s seen as an apolitical concept that is
not necessarily pro-poor. It is quite conceivable, for example, for a household
to demonstrate resilience (using a certain metric) but for this to entail major
costs. A household may remain “food-secure” in the face of climate shocks or
seasonal stresses, but there may be a big price to be paid (e.g. to the nutrition
and health of women working dawn til dusk transplanting rice, and/or to young
children who are not adequately cared for during peak labour demand).
Clearly there are
potential trade-offs. We need to ask questions about equity, about the cost
of resilience, and who pays? We need to consider scale (individual,
household, community etc) and timeline (e.g. does resilience endure?).
Pelling (2011), for example, argues that the notion
of resilience as “buffering” is too limited as it simply reinforces the status quo. Bene et al (2012) suggest a more organic way to bring
power and agency into resilience thinking is to incorporate them directly into
the conceptualization, as per their “3-D framework”.
Beyond the
limited notion of the capacity to cope by absorbing shocks (on the left), there
is the capacity to adapt, and even to transform. At a systemic level, this refers to a
fundamentally new food or health system.
Agency, power and
politics are thus captured in this framework. We can also see how the ability
to absorb a shock ensures stability, which in turn provides the potential for
incremental adjustments and even transformational change.
We could apply such
a framework to individuals, households and communities — and we could apply it
to health and food systems. Bringing in the related concept of vulnerability,
we can see how certain food systems — in which wild animals, domestic animals
and humans are in close proximity in wet markets — are vulnerable
to zoonotic emergence. The virus crossed species and now it’s crossing
entire systems. Emerging from a food system, it has gone on to overwhelm health
systems, and to undermine global economic systems in a way that’s not been seen
for more than a century.
Societies and
economies will survive — in some form. In the aggregate, they are
resilient. But the COVID-19 pandemic is
exposing and amplifying many forms of inequity. We need to differentiate
actions and impacts within households and health or food systems and ask
questions about the cost of resilience, and who actually pays?
In the UK, for
example, it is front-line health workers who — day after day, separated from
their own families for weeks on end — put their lives at risk to keep people
alive. The resilience of the health system (in this case, the NHS) derives from
the actions of these individuals. They are paying the price of resilience — not
the politicians who, for years, have argued against raising their wages, and
who dithered for weeks before responding to the pandemic.
In sum, resilience
can be a useful common goal across sectors and systems — so long as it is
treated comprehensively, and so long as it includes an analysis of equity. And
it is possible to strive for resilience and to pave the way for transformation
into a more sustainable, more equitable future. These two goals are not mutually
exclusive. But it will require actions that strengthen all three components of
resilience (absorptive, adaptive and transformative) together, at multiple
levels (individual, household, community).
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