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Eating for (global) health — whose responsibility is it?

Food preferences and dietary patterns around the world are evolving rapidly. Incomes are rising, more people are living in urban areas, and markets are offering an increasingly wide variety of foods, including processed and prepared foods. But the global trend is not toward the better nutritional status. Diets are changing but not always in healthy directions. While hunger remains a challenge for an estimated 800 million people, nearly 2 billion are now overweight or obese.

Without decisive actions to build food systems that promote good nutrition, and ensuring that the foods available provide affordable, appealing and healthy eating choices, governments will pay a heavy price in terms of their populations’ mortality, physical health, mental well-being, economic losses and degradation of the environment.

To promote good nutrition, partnerships between governments, the private sector and consumers are essential. New research identifies several ways that governments and their partners can intervene to strengthen food systems. Step one is to encourage healthy eating.

Government engagement with private sector actors in the food system (including agribusinesses, food manufacturers and retailers) is fundamental to shape the quality of the food environment in which consumers make their decisions. Using various economic policy tools, as well as targeted interventions and regulations, governments can provide incentives — or disincentives — to private sector actors that will promote the availability, affordability, and consumer appeal of healthier, high-quality diets. Here are a few insights.

1. Producer subsidies and public extension services have long been important elements of government support for increasing food production on farms. To prioritize the nutritional quality of food supply, however, government may need to direct attention to the production of nutrient-dense vegetables and fruits, seafood, or other animal source products, as well as emphasize public and private research initiatives to improve the nutrient profiles of staple commodities through breeding efforts.

2. Increasing the efficiency of food supply chains can also promote healthier eating. Government investments in providing the necessary transport and energy infrastructure are critical to incentivizing private sector marketing of nutritious, often perishable, products that require complementary private investments in logistics and supply chain management.

3. Processing of foods often increases the convenience, appeal, and year-round supply of foods demanded by customers. However, evidence points increasingly to poor nutritional and health outcomes associated with excessive consumption of processed foods (often called “ultraprocessed” foods). These foods contain high levels of added sugars, fats and salt that contribute to ill health. Initiatives to reduce intakes of these foods include imposing taxes on specific food products to reduce excessive consumption, prohibiting or restricting advertising to children, and removing distribution points in schools to prevent the formation of unhealthy eating habits by impressionable youth. On the positive side, many governments are taking steps to improve the quality of foods provided in public school meal programs in order to boost access to improved nutrition.

4. Governments also play a constructive role in guiding food system to offer healthier eating opportunities. Food safety standards — fundamental to protecting health — are often tweaked as new scientific information emerges. Public institutions and private businesses need to work together to ensure the effective surveillance and testing for food quality that underpins consumer confidence in the food supply. The Partnership for Aflatoxin Control in Africa, for example, provides leadership across the food system to reduce the prevalence and impact of this harmful toxin in food. Elimination of trans fats from products as well as reduction of sodium/salt content have been addressed by both public and private initiatives in a number of countries.  

5. Government regulations are often complemented by guidelines intended to nudge private corporations to take greater responsibility for the nutritional outcomes associated with their processes and products. Initiatives regarding labeling, for example, are often developed jointly by governments and private sector market actors to ensure that consumers have access to important information about nutritional qualities, as well as other facts they value, such as locally produced, use-by dates, sustainably grown, etc. Consumers themselves are increasingly demanding improvements in the nutritional quality of products flowing through the food system.

So promoting good nutrition — and healthy eating — is a shared responsibility. It is shared by consumers who are responsible for making nutritionally sound dietary choices from among the options provided within the food environment. Private sector actors who produce, process and market foods as a matter of livelihood and business profit share the responsibility of ensuring food safety, quality, availability and affordability. Governments must be concerned with ensuring the safety, health and productivity of their populations. Healthy eating is an action that requires everyone to take action.

This article has been written by Panel Member Emmy Simmons, co-chair of AGree, in occasion of the launch of the Panel's latest policy brief: "Improving nutrition through enhanced food environments" 

Children having a meal at school in Ghana. Photo by: Arne Hoel / The World Bank / CC BY-NC-ND