Agri-Food, Nutrition and Health: Capturing the Synergies Dr. Ballayram Food Economist Caribbean Food and Nutrition Institute/ Pan American Health Organization CARIBBEAN WEEK OF AGRICULTURE October 17-23, 2010 Grenada

A fundamental set of questions: What is the aim of: increasing agricultural investments and productivity? agricultural and rural development? Developing agro-processing? Etc, etc…..? A Plausible Answer: We all want to enhance the well-being for everyone! We can do this many ways—increase, income, employment.. We can do it also by good nutrition—w/o conflicting other aims

Objectives To articulate the Agri-Food-Nutrition-Health Link To identify synergies in agri-development and nutrition Initiate a discussion on how to advance the agri-food-health agenda

FOOD AVAILABILITY & SAFETY Globalization DETERMINANTS OF NUTRITION & PATHWAYS LINKING AGRICULTURE AND NUTRITION Agri/Food Policy Incentives Investments Local Production Imports FOOD AVAILABILITY & SAFETY Globalization SES Income Price Distribution FOOD ACCESSIBILITY Poverty Food Preparation Age, Gender Nutrition Education FOOD CONSUMPTION Urban Development Transportation Genetics Physical Activity Health Policy Disease Status NUTRITIONAL & HEALTH STATUS

WHAT IS THE PROBLEM ?

The shape of things to come The Economist, Dec. 2003

Infectious Diseases/ Undernutrition 10- 50 % of Total deaths Chronic Diseases 25- Infectious Diseases/ Undernutrition 10- 1970 1990 1950 Data on epidemiological transition in the Caribbean—diet-related diseases are the major health problems in the Caribbean

Main Causes of Death in the Caribbean 1980 (%) Heart Disease* - 20 Cancer * - 12 Stroke* - 11 Injuries - 8 Hypertension* - 6 ARI - 5 Diabetes * - 4 *Food/Nut related = 53% 2000 (%) Heart Disease * - 16 Cancer * - 15 Stroke * - 10 Diabetes * - 10 Injuries - 7 HIV/AIDS - 6 Hypertension * - 6 *Food/Nut Related = 57%

Cost of Nutrition-Related diseases NCDs are twice as costly to treat compared to other diseases Direct cost of treating everyone with diabetes and hypertension in the region: US$691 million/annually (2% of GDP or 66% of current expenditures on Public Health) Cost of diabetes and hypertension attributable to obesity is US$ 336 million annually (1 % of GDP or 32% of current expenditures on Public Health)

Cost of Nutrition-Related diseases (con’d) If nothing is done the developed countries nutrition/health experience could be a good proxy of where we will end up In the USA: half of the citizens suffer from one or more chronic disease 75 cents of every dollar spent on health care is on NCDs 80% of costs major public health programs is on NCDs for the seven most common chronic diseases, 80 percent of expenditures are for indirect cost while 20 percent is for direct cost

Current vs. Recommended Consumption of Foods in the Caribbean Deficits: (1) Staples (8%); (2) legumes (4%); (3) Vegetables (6%); Excess: (1) Food from animals (5%); (2) Fats/oils (4%); (3) Sugar (9%) Deficits: (1) Staples (8%); (2) legumes (4%); (3) Vegetables (6%); Excess: (1) Food from animals (5%); (2) Fats/oils (4%); (3) Sugar (9%) QUESTION: HOW DO WE MOVE FROM CURRENT TO RECOMMENDED?

HOW CAN WE EAT HEALTHY FOODS WHEN……….. Our domestic agriculture policy lacks adequate incentives for the production of indigenous staples, fruits and vegetables Our food import encourages the consumption of high energy dense, processed foods Many schools canteens and vendors promote high energy dense foods with little nutrient value Our local and cable networks heavily advertize fast foods, especially on children’s programs

CAPTURING SYNERGIES IN THE AGRI-FOOD-NUTRITION-HEALTH LINK

VISION OF AGRI-FOOD & NUTRITION & PARTNERS PRIVATE SECTOR RELATED AGENCIES PUBLIC SECTOR FAO IICA CARDI CTA UWI CARICOM MANUFACTURERS PROCESSORS FOOD ESTABLISHMENTS FARMERS DISTRIBUTORS AGRI EDU TRADE FIN OTHERS

Capturing the Synergies

Capturing Synergies At the policy level there is the urgent task to establish health-oriented food policies at the national level Establish national food and nutritional goals for agriculture and the food systems to deliver adequate and nutritionally appropriate quantities of food This would require: The recognition by the health sector that health-prevention strategies have to be a collaboration with partners from many sectors (multi-sectoral); A recognition at the national level that the food and agriculture sector is one of the crucial partners in any policy aimed at addressing the region’s main public health problems; Support to facilitate the passage through to Cabinets, of National Plans of Action for Food and Nutrition Security (NPANS); and The development and aggressive promotion of Food-Based Dietary Guidelines at national and community levels.