1. Food Systems and Health in Sub-Saharan Africa Per Pinstrup-Andersen Cornell University Presentation at the UN Headquarters in New York and Organized by the UN University Office in New York November 12, 2010

2. Life Expectancy Source: HDR 2006

3. Under Five Mortality Rate (per 1000) Source: HDR 2006

4. Prevalence of Underweight in Preschool Children? Source: UNICEF 2006

5. Prevalence of Low Birth Weight Source: UNICEF 2006

6. Health and Nutrition Food Systems Health and Nutrition

7. A Food System Health and Nutrition Consumption Transport, Storage, and Exchange Secondary Production Transport, Storage, and Exchange Primary Production Natural Resources and Inputs

8. Food System HH Incomes - level - fluctuations - composition - control Relative Prices Time Allocation Care, Breastfeeding Preferences HH and Individual Behavior Health Status

9. Food Systems Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Interactions Between Food Systems and Human Health Health Status

10. Deaths Associated with Malnutrition

11. The Triple Burden of Malnutrition: 1.Energy and protein deficiencies: Hunger 2.Specific nutrient deficiencies: Hidden Hunger 3.Excessive net energy intake: Overweight & Obesity

12. Hunger Prevalence in Sub- Saharan Africa Source: FAO 2006

13. Change in the Number of Hungry People in SSA Countries Source: FAO 2006

14. Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health

15. Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health

16. Agricultural Diversity On-Farm Consumption Availability in Local Markets Relative Prices Diet Diversity Health and Nutrition

17. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health

18. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens

19. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens Zoonotic Pathogens

20. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens Zoonotic Pathogens Drugs and Medicinal Plants

21. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens Zoonotic Pathogens Drugs and Medicinal Plants Occupational Hazards

22. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens Zoonotic Pathogens Drugs and Medicinal Plants Occupational Hazards HIV/AIDS

23. Water-borne Diseases Production and Processing Systems Food Systems Health Status Contamination Microbial Chemical Toxic Metals Energy and Nutrient Balance Growth Retardation Reduced Disease Resistance Anemia Blindness Chronic Diseases Food Safety Water Safety Sanitation Hygiene Interactions Between Food Systems and Human Health Toxins and Allergens Zoonotic Pathogens Drugs and Medicinal Plants Occupational Hazards HIV/AIDS Indoor Air Pollution

24. Challenges to Achieve Intersectoral Collaboration  Single-sector orientation of:  Policy making institutions  Funding  Training  Research  No incentive to focus on intersectoral issues  Sector-specific paradigms

25. Challenges to Achieve Intersectoral Collaboration (Continued)  Competition between sectors  Complexity and capacity constraints Source: von Braun, Ruel and Gillespie (Chapter 14)

26. Suggested Action  Health-oriented food systems research and policy  Biofortification  Host-plant resistance  IPM, ecological production methods  Health implications of added chemicals post harvest  Socio-economic and political economy analyses on trade-offs and multiple-wins  Apply most appropriate research methods

27. Suggested Action (Continued)  Institutional changes  Inter-sectoral problem solving institutions  Multidisciplinary training