Select Page

10% less junk is still junk

A few days ago, the Food Foundation tweeted a disturbing clip showing how – if current trends continue – one in four children born in 2022 will suffer overweight or obesity by the time they start school. By the time this cohort reaches age 65, only 18% would have a healthy weight.

Yesterday, Nesta – the UK’s innovation agency for social good – launched a report: The future of food: opportunities to improve health through reformulationat an event in London that I attended.

Nesta set out to uncover the food categories that could be reformulated to reduce excess calorie consumption, and to figure barriers and opportunities to doing so.

Calorie-density of foods was considered to be the big challenge. If this could be reduced by reformulation of a select group of commonly-consumed foods that were amenable to reformulation, then, in theory, the consumer would consume fewer calories every day, without noticing it and without looking for more calories elsewhere.

Their model suggests we would consume 38 kcals less per person per day, on average.

To halve obesity by 2030, we would, on average, needs to consume 216 kcals less per day – so this would get us around 17% of the way to that goal.

The report recommends government-mandated calorie-reduction targets for specific foods, backed up by legislation to punish failure to meet them, a public ranking of shops/supermarkets (to ensure transparency) and mandating of industry to reformulate their main products (rather than creating two tiers of products where one is the healthier alternative.)

This is not a magic bullet, as Lauren Bowes Byatt suggests in this blog, but a potential big step forward.

What to make of this?

The pivotal assumptions are that the main issue is excess calories, that these foods could be reformulated to reduce their calorie content by 10%, and that consumers would not look elsewhere for the extra calories.

What if there was something else in these foods – in addition to a lot of calories – that was leading to excess consumption? 

The Nesta report completely fails to mention the growing body of evidence of the panoply of harms caused by ultra-processing and the possibility there is something else about ultra-processed foods (UPFs) that make us consume more calories.

Kevin Hall and colleagues, however, suggests there is.  

In a one-month randomized controlled trial of ad libitum food intake, they investigated whether ultra-processed foods affect energy intake. Subjects were randomized to receive either ultra-processed or unprocessed diets for two weeks followed by an alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fibre. Subjects were instructed to consume as much or as little as desired.

Results – energy intake was significantly greater with the ultra-processed diet. More than 500kcals per day, which seems like a huge difference.

Other studies have pointed to significant differences conferred by ultra-processing e.g. Dicken and Batterham who conclude by suggesting the adverse consequences of UPFs are independent of dietary quality or pattern, “questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.”

And Bonacchio et al who conclude: A significant proportion of the higher mortality risk associated with an elevated intake of nutrient poor foods was explained by a high degree of food processing”

These differences seem to exist with UPFs but we don’t yet know what causes them, or why people over-consume UPFs – whether it’s something to do with hydrogenation, additives, emulsifiers, sweeteners, compounds released by packaging or something else…

People crave UPFs and, as with any craving, they will find ways to satisfy it.

How does the Nesta research address this?

In her blog, Bowes Byatt cites two papers to support her contention that substitution is unlikely to be a big issue. The first — a systematic review – finds that people who consume less calorie-dense foods don’t fully compensate by eating more. although there is no significant difference with weight. The second suggests that foods substituting a sweetener for sugar suggests that reformulation leads to a significant reduction in body weight.  But…surprise, surprise…many of these authors have been funded by the sugar industry…so we can safely discount this one.

The key indicator has to be weight, as weight (or BMI) will determine any impact on overweight and obesity. And, as the first study concludes: Future research will therefore be needed examining the effect that manipulations of energy density have on body weight in order to understand whether mass reformulation of the energy density of food products is likely to benefit population level obesity.”

What’s really surprising is that the Nesta report doesn’t mention UPFs at all, and when a question was asked about ultra-processing at the launch, it was ducked.

In a twitter exchange prior to the launch, a Nesta deputy director suggested to me that UPFs were a distraction.

This is puzzling – especially when two years earlier, Nesta had this blog on their website just over a year ago.

Two questions:

  1. What’s changed, and why are UPFs now considered to be a distraction?
  • How will a 10% cut in calories deal with the craving that leads to excess consumption, as we continue to live in an obesogenic food environment flooded with UPFs?

At the beginning of the launch, Henry Dimbleby spoke forcefully about the situation we’re in right now.

Last year, in the US, he said, 73,000 limbs were amputated due to poor diet. He reminded the audience about Dolly Theis’ excellent work on the hundreds of anti-obesity policies that had been drafted in the UK over the years.

And yet ‘f**k all has happened!’

His biggest fear was that, unless we get to grips with the food environment, the only way out of this crisis will be a needle – perhaps half the population will be on a prescription for weekly semaglutide jabs.

Is that the future we want?

A monofocus on calorie-reduction of selected foods seems to me like a magic bullet (calorie-cutting) within a magic bullet (nutrient-focus). After nearly four decades in the world of nutrition, I haven’t come across one single convincing bullet.

Reducing calories in selected foods, while ignoring ultra-processing seems to me a little like trying to prevent deaths from shark attacks by reducing the size of their teeth (…but then again, that’s a little harsh on sharks.)

Perhaps it’s more like deck chairs on the Titanic — not rearranging them, but throwjng them overboard to reduce the speed at which it sinks.

Baby steps.

But that time has long gone.  We need to make big strides to turn things around.

The rising wave of orange and red figures in the Food Foundation graphic are caused by the ‘business as usual’ approach of a handful of immensely powerful transnational food companies, coupled with the persistent failure of governments to rein them in through comprehensive regulation.

Government must get tough with Big Food and wield the big stick to shut down the upstream drivers of the fake food we’re drowning in.

Granted, in the UK, we have a bit of a fake government right now that’s become distracted by itself. So, then let’s make sure that access to a healthy diet for all is an election issue.

I hope I’m wrong but it seems to me that mandating the cutting of a few calories from foods – even if it was successful – risks being the bigger distraction than draining the ultra-processed food swamp.

Dracula, blood banks…and getting serious about malnutrition

It’s World Obesity Day!

Yes, there are more “World Days” in the year than there are actual days…but let’s hope today’s words and actions strengthen and accelerate actions to tackle the growing problem of obesity, across the world.

I was late in reviewing the UK government’s National Child Measurement Programme (NCMP) for the 2020/21 school year, published at the end of last year. Covering children in Reception (aged 4-5 years) and Year 6 (aged 10-11 years) in mainstream state schools in England, the report contains analyses of Body Mass Index (BMI) classification rates by age, sex, ethnicity and geography.

The results were a huge shock, for two main reasons – the trend and the growing disparity.

The worsening trend:

Graphical user interface, text, application, email

Description automatically generated

The stark disparity:

Graphical user interface, application

Description automatically generated

[note: based on BMI centile above/below reference population using the British 1990 growth reference (UK90):  BMI centile >=85 and <95: Overweight; BMI centile >=95: Obese; BMI centile >=99.6 Severely obese]

We are learning more and more each week about the ways in which obesity is generating chronic diseases that sicken and kill people. Heart and lung disease, cancer, depression, diabetes, dementia, auto-immune disease – the list is long, and getting longer as research uncovers the links.

Humans have never changed so fast.

We’re stepping into unknown territory. We were adapted to forage and hunt and to find and consume food when we could. Feasting in times of plenty allowed us to survive in times of want…the latter a lot more common than the former. A strategy dictated by (and suited to) the environment in which we lived. Evolution’s good at that.

Now that the food environment has change in an evolutionary nanosecond, our bodies and their metabolic systems are struggling to cope. We’re maladapted. In a dangerous place. What used to be an advantage – our ability to harvest and store calories from whatever food we could find — has become a massive liability.

The scam of the century and the main reason obesity has rocketed is the way in which the ultra-processed food (UPF) industry has figured how to get people addicted to fake food and drink which they can mass-produce, incredibly cheaply. 

The behemoths of the food industry — companies like Nestle, Coca Cola, PepsiCo — each have revenues larger than half the countries in the world. The top ten control 80% store-bought products, with combined annual profits well over US$100 billion.

Ultra-processed foods are junk foods that are not really foods at all. Ultra-processing involves adding more and more steps to the processing chain, to add more and more profit. Sugar, salt, fat and carbs are combined with emulsifiers, sweeteners, stabilisers and preservatives in ways that maximise ‘bliss point’, ‘mouthfeel’, ‘flavour burst.’

The industry has developed a whole new language of addiction. It has harnessed the biology of desire to generate products that exploit the short-term, impulsive traits of our dopamine-wired brains. Cheap, addictive, long-lasting and four times more profitable than real food, these fake foods are extremely dangerous.

Ultra-processed foods are not only dangerous to people, they also wreck the planet.

The corporate playbook

When the spotlight is turned on the UPF industry, and difficult questions are asked, they have an array of tactics to respond, well-honed by Big Tobacco who walked this path before them.

They are experts in the dark arts of distortion, dispute, doubt, disguise, distraction, deflection and delay…

Lots of D words…

  • They distort the narrative/problem (reframing it as one of individual responsibility and/or physical inactivity), promote disinformation via carefully-cultivated media connections.
  • They dispute the science showing the multiple harmful consequences of UPFs.
  • They cast doubt on this research and often on the researcher/s who do these studies – and they often pay biddable ‘scientists’ to do pseudo-research into red herrings, and/or confer awards upon them.
  • They distract through ‘corporate social responsibility’ campaigns and projects, and funding a few ‘good causes’. Small-scale boutique projects and the media froth they generate are designed to confer legitimacy on large-scale core business practices that run in a very different direction. Nutri-washing, greenwashing, whitewashing, sportswashing…you name it…they’re really into laundry!
  • They deter and delay government regulation (bans, taxes etc) by promising to regulate themselves (a scam within a scam), and by hiring lawyers to appeal legislation. This buys them time for the other tactics to bear fruit.
  • They disguise themselves by hiding within ‘non-profit’ front organizations that have names that include the word ‘global’ or ‘sustainable’ or ‘development’. A Trojan-Horse tactic allows them to get to the policy table, by proxy. Once there — whether in the main discussions, the corridor meetings or the cocktail parties they throw – they get to make friends and influence people.

Ultimately, they just want to be loved. Being seen to be part of the nutrition and health community is a huge deal for the UPF industry, as it confers tacit approval of their products and practices…a highly valuable ‘get out of jail card’. 

So, they target individuals — many of whom have been offered thousands of dollars to write essays for their annual reports – and they swarm around conferences. If you want to understand their power, just look at the participants list for COP26 in Glasgow last year…just look at the activity around the UN Food Systems Summit before it.

It’s like Dracula being asked to manage the new community blood bank.

The latest ‘D word’ I’ve come across, and one of the most sinister, was described in an excellent paper published earlier this week – the dark nudge. Companies are now using artificial intelligence (including social listening, facial recognition, augmented or virtual reality) to alter products availability, to manipulate the position of products on menus, and for a whole new approach to immersive marketing that is targeted and aggressive.

These tactics needs to be revealed, resisted and reversed. At all levels and by every organization that’s serious about nutrition and health.

In doing so, we need both carrots and sticks.

  • Governments need to regulate malnutrition-generating companies, set parameters for their operation (using policy, legislation, tax, regulations on labelling, advertising, ingredients), and hold them accountable for harms they cause.
  • Civil society needs to continue to shine a light on harmful practices, challenge governments to do the right thing, and work to generate wider public awareness of UPF harm.
  • Academia and policy research organizations need to get more involved in political economy research and in studies of the commercial determinants of malnutrition. There is real scope for stronger advocacy/activism that’s fuelled by the results of such studies and disseminated through all channels (…far more than simply publishing a journal article),
  • And the food industry needs torespond to these signals and initiatives and get serious about producing food that is affordable, accessible and healthy.

After a year of conferences – whether online or otherwise — many of us are weary with the usual parade of pledges and promises. When there’s little transparency and accountability, commitments mean very little and again serve to distract and deflect.

We need to see real action…at a scale that matches the problem.

Inflamed — a review (…and a question)

Every now and again a book stops you in your tracks.  

Inflamed: Deep Medicine and the Anatomy of Injustice by Rupa Marya and Raj Patel is one such book.

Inflamed brilliantly links globalization with biology — and everything in between — highlighting the dynamic links between inflamed bodies, inflamed societies and an inflamed planet. Step by step, going back into deep history, the authors plot the causal origins of disease and ill-health “in the multifunctional spaces around and beyond the individual body – in histories, ecologies, narratives and dynamics of power.”

Inflammation is a process, triggered by the damage or threat of damage to cells, that mobilises resources to heal injured tissue. In a balanced system, once the damage has been repaired, inflammation subsides.  But if the damage returns, over and over again, the inflammatory response goes into overdrive and starts to create harm. The ultimate source of damage is not the pathogen that infects you – the true source can only be found in deeper and wider systems and processes that render an individual more likely to be exposed (to the pathogen) and, if exposed, more likely to fall sick or die as a result. Structural racism, violence, economic deprivation, pollution, contaminated water and poor diet all combine to generate chronic inflammation.

The authors remind us that ‘diagnosis’ comes from ‘dia’ (apart) and ‘gnosis’ (to know). A diagnosis is a story pulled apart.  Conventional diagnostic narratives are out of joint because the story begins in the middle with a symptom. Doctors then go back in time to try and uncover the immediate causes, before going forwards from the symptom to prescribe a treatment. But often this doesn’t work because the story doesn’t go far back enough in time, isn’t deep enough.

The colonial worldview – on which modern medicine is based – is ahistorical, emphasizing individual health and disconnecting illness from its social and historical contexts. Modern medicine patches up bodies broken by the same system that produces the medicine.  A similar thing could be said of the global food system, which we’ll come to….

As well as being comprehensively researched and written in a style that pulls you in for hours, Inflamed is an impassioned call for justice for people who have been, and continue to be, exploited, oppressed and marginalized.

The COVID pandemic has thrown intergenerational and colonial injustice into sharp relief. In May 2020, in the UK, nearly all of the medical staff who had died of COVID-19 were from black, Asian and minority ethnic communities. Throughout the pandemic, individuals from these communities were at greatest risk.  

Individuals who were hospitalized or died of COVID-19 were a) more likely to be more infected with SARS-COV-2 in the first place (being dependent on livelihoods that put their bodies at risk of exposure, without any safety nets), and b) more likely to fall sick, become hospitalized and die (because their bodies had suffered chronic inflammation due to poor living conditions, poor healthcare, unhealthy diets, chronic stress etc).

Marya and Patel use the concept of an ‘exposome’ – the sum of a lifetime’s exposure to non-genetic drivers of ill-health – to show how such individuals are far more prone to chronic inflammation and illness than others.

Colonialism isn’t a thing of the past – it’s happening today and threatening the lives of the 370 million Indigenous people living in over seventy countries, while many states continue with their ‘policy of amnesia’.  You may not be one of them, the authors argue, but you’re affected by them — their ideologies are alive and well…and they’re making you sick. Non-communicable diseases (NCDs) like heart disease, lung disease, obesity, depression, diabetes, Alzheimer’s, auto-immune diseases — are all diseases of colonization – they didn’t exist before.

“Le microbe n’est rien, le terrain est tout”

Eleven years ago, the philosopher, David Abram wrote “the body is itself a kind of place…a terrain through which things pass, and in which they sometimes settle and sediment”

One hundred and sixty years ago, Louis Pasteur wrote “the microbe is nothing, the terrain is everything”

I first came across this amazing quote, in 2000 when researching HIV, food and nutrition security.  Later, we brought the concept of enabling (or disabling) environments into the fourth paper of the Lancet Nutrition Series (2013) and subsequent papers and blogs – showing how these environments operate at all levels from the ‘milieu interieur’ of the human body to food and health environments to social, political, economic systems. I remember the analogy of an onion with its many layers from another ground-breaking book ‘Rakku’s Story’ that I read nearly forty years ago while working in a village in southern India. Like Marya and Patel – Sheila Zurbrigg locates the causes of the death of a child (Rakku) in multidimensional spaces and colonial histories.

Each chapter of Inflamed describes a system (circulatory, respiratory, immune, reproductive, digestive, nervous, endocrine), as Marya and Patel brilliantly highlight the way they generate inflammation, how they’re linked to themselves and ultimately to human health.

This book was written by a physician and a political economist.  Its focus is on health but it is wide-ranging analyses are directly relevant to all of us who work in the food system. The chapter on the digestive system highlights the importance and links between diversity of the gut microbiome and soil biodiversity – two enabling (or disabling) environments. Mediating both are food systems.

Which brings me to the question…

The global health ‘community’ seem to be way ahead of the food and nutrition ‘community’ when it comes to digging deeper to locate the drivers of ill-health and malnutrition that originate in wider structures, systems and colonial histories.

Decolonisation and the commercial and political determinants of ill-health are being discussed, researched and, in many cases, acted upon. And yet, the nutrition and food ‘community’ remains relatively silent on these issues. Some nutrition researchers and activists work on commerciogenic causes of malnutrition, but relatively few.  Issues of power and equity are similarly neglected.  And hardly anyone is working on historical perspectives, including the influence of structural racism and colonial legacies.

In a few weeks, there’s a major United Nations Food Systems Summit (UNFSS) in which the multinational food industry is actively involved — around the ‘table’ where ‘game changing solutions’ are being discussed and decided. It does not seem to matter that many of their core businesses are major drivers of malnutrition. These new colonials are happily engaged in shaping the future in ways which are more amenable to their interests and objectives. They will continue to ‘talk the talk’ about healthy diets, as evidence mounts about their failure to act. The fox is ensconced in the chicken coop and no-one in the UNFSS inner circle seems to think this is a problem (when was the last time the tobacco industry showed up at a World Health Assembly?)

UNFSS principles of engagement are cursorily listed but are weak and do not include the crucial ‘do no harm’ principle. Big multinationals just hide behind business associations (like WBCSD) who provide cover. Yes, protests have been aired, open letters signed and many have boycotted the summit altogether. And yet, summit leaders just carry on, sounding out their mantra that this is a “people’s summit”. Silence is the main response to criticism – as if there’s ‘nothing to see here’ and that somehow our normal expectation of critical engagement and debate among peers is to be suspended this time.

Why is this?

But the bigger question is — why aren’t we, in the food and nutrition policy community, more actively engaged in the decolonisation debate, and in research and action/activism around the commercial and power-related drivers of the problem we’re (supposed to be) focused on?

Echoing Marya and Patel’s call for a ‘deep medicine’ approach, isn’t it about time we engaged in some ‘deep nutrition’?

Stuart Gillespie, 26 August 2021

[‘Inflamed’ is published by Allen Lane and available at all good non-amazonian bookshops]

Beware the nutri-washers

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, 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 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 (UPFs) 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 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.

That has to be a step forward.

Rebuilding trust in food systems and nutrition (part 2)

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.

Chart, radar chart Description automatically generated

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?

Digging deeper

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
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.”

Malaria Commission of the League of Nations, Geneva. Photograph by Poesch photographic agency, 1928. Credit: Wellcome CollectionAttribution 4.0 International (CC BY 4.0)

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 colonialismracism, 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.

Coming back to the notion of a turning point, 2021 has been declared a Year
of Action for Nutrition
— a year when there is not one but two major summits – the UN Food Systems Summit and the Nutrition for Growth summit.

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:

The foreign gaze: authorship in academic global health

The problem of ‘trickle-down science’ from the Global North to the Global South

Foreign Aid Is Having a Reckoning, New York Times, 13 February 2021

Dreams Of A Beloved Public Health: Confronting White Supremacy In Our Field

Governance in Conflict Network: (Silent) Voices blog

Parasitic and parachute research in global health

Closing the door on parachutes and parasites

Global health: who tells the story?

Global health needs to be global and diverse

Decolonising Global (Public) Health: from Western universalism to Global pluriversalities

Is global health neo-colonialist?

Does global health still have a colonial mindset?

Decolonizing global health: if not now, when?