Harnessing public-private partnerships to improve diets
Public sector actions alone will not be enough to effect the level of change necessary to address the systemic flaws within the food system that make healthy diets unavailable, unaffordable or inaccessible for too many people around the world.
Our latest policy brief “Improving diets in an era of food market transformation: Challenges and opportunities for engagement between the public and private sectors”, presents evidence and poses a series of questions for policymakers and the private sector to help them develop a common understanding of ways to improve the food environment, to enable better dietary choices.
Poor diets are posing a greater global health risk than air pollution, alcohol, drug and tobacco use combined. Over 50 million children are wasted, and 2 billion people suffer from micronutrient deficiencies. In addition, 1 in 10 people fall ill every year from eating contaminated food, leading to 420,000 deaths. At the same time, more people are becoming overweight or obese, risking associated diet-related non-communicable diseases such as diabetes and heart disease.
As a result, policymakers in sub-Saharan Africa, South Asia and Latin America are faced with the unprecedented challenge of resolving multiple forms of malnutrition.
The growing population in Africa and Asia, projected to increase from 5.6to 7.8 billion by 2050, increasing urbanization, climate change and economic growth are all contributing to the preponderance of poor diets. Between 1960 and 2016, GDP per capita in low- and middle-income countries rose from $0.3 trillion to $27.3 trillion. While this welcome trend can provide opportunities for people to purchase and consume more healthy foods, evidence suggests that consumption of less healthy foods increases even more.
The shifting dietary pattern in many low- and middle-income countries is characterized by two key trends. First, a decreasing dietary diversity and greater reliance on starchy staples is leading to the consumption of fewer nutrient-rich foods, such as fruits, vegetables, whole grains and legumes. Secondly, traditional foods are being replaced by ultra-processed foods that are high in sugar, fat and salt, and lack essential vitamins and minerals. Between 2000 and 2013, sales of ultra-processed foods and beverages in all Latin American countries increased by 48 percent. We are also seeing a change in food consumed in informal markets. A review of 23 studies (mostly conducted in Africa) found that the daily energy intake from street foods was 13–50 percent in adults and 13–40 percent in children.
Historically, the food industry has been criticized for producing and promoting products that make food environments unhealthier, leading to shifts in consumption patterns and an increased intake of ultra-processed foods and beverages. While the fault may lie with some actors in the private sector, food companies also have considerable potential to reverse these negative dietary trends.
There are many examples of the food industry’s positive contribution to food and nutrition security: innovation in agricultural technology to increase yields; food processing to make food cheaper and safer; ready-to-use therapeutic foods (RUTF) to treat the severely malnourished; and commercial food fortification to provide essential micronutrients to “at risk” populations. Salt iodization, for example, could be worth $570 million in healthcare savings and increased productivity to South Asia and sub-Saharan Africa, according to the Copenhagen Consensus.
Going forward, however, the food industry needs to do more to support public health goals by facilitating the supply, marketing, processing and retail of a diversity of nutrient-rich foods at accessible prices.
Before the private sector can act, the public sector must drive efforts by creating the right conditions for business. For example, governments can influence interest rates on productive loans, improve infrastructure and access to perishable foods, and build consumer knowledge through targeted public campaigns. It can also create and enforce regulations to set standards and restrict the marketing of less nutritious foods.
For effective public-private partnerships, it is first crucial to take into account the needs, objectives and goals of actors within both the public and private sectors, but we believe there is much common ground, and tremendous opportunity. Producing healthier food does not mean less profit. With the right mix of incentives to promote confidence in companies to take the necessary risks in investing in safer and more nutritious foods, and with policy that regulates the production and consumption of ultra-processed foods, the private sector can profit from healthier diets.
We have seen some progress in high-income countries, with companies voluntarily removing or reducing certain ingredients (such as sodium, sugar and trans fats). For example, between 2001 and 2008, French manufacturers voluntarily reduced sugar in breakfast cereals by 10 per cent. Food companies have also moved to incorporate “health-promoting ingredients” (for instance, vitamins, “healthier” fats and prebiotics), either voluntarily or in response to new regulations. Our new policy brief also shows numerous successful examples by small and medium-sized enterprises in low- and middle-income countries.
The time to act is now. At the current pace, we will not achieve the 2025 World Health Assembly Targets or the 2030 Sustainable Development Goals. International momentum is building and we are witnessing pressure on the private sector, mainly through social media campaigns and editorials, to act on issues of health and sustainability to help achieve these critical global targets.
The considerable collective expertise of Global Panel members is calling on the public and private sectors to move forward together, in partnership, to shift the balance in favor of food and food products that are more nutritious, affordable and accessible. This dialogue must be free from subjective bias, serving both social and economic needs. Together we can get the “win-win” we all so desire.
Image: a local man selling street food in Ampefy, Madagascar. Getty.