Bringing back community agriculture services

With food insecurity rising worldwide and nutrition-related illnesses proliferating, countries want to encourage healthier eating. But how can they ensure people are able to buy and prepare diverse, nutritious foods when farmers produce so little of them? National agricultural policies are generally designed to support the cultivation of staple grains such as corn and rice, some oils, and sugar. A recent paper shows that 1/3 of global farms cultivated maize and 1/5 cultivated wheat alone! These foods feed the world amply, and cheaply, but some in the form of highly processed foods.

@FAO

Another issue is the significant loss and waste of perishable fruits and vegetables, meat and dairy products because of inadequate food storage, poor roads, and people’s lack of access to modes of preserving food for long-term storage. Such inefficiencies along the food supply chain drive up the cost and limit the supply of nutritious, fresh foods in rural and urban areas alike.  In Ethiopia for example, perishable foods such as eggs, dairy, and fish are 8-10 times more expensive than starchy staple calories due to supply constraints.

Turning around such entrenched food systems may seem daunting. But it can be done, beginning at the grass-roots level by improving community-based agriculture extension programs. Extension workers are “door-to-door” or farm-to-farm advisers who translate agriculture science into practical applications for farmers. They help solve problems and provide the training and technology farmers need to improve their operations profitably. Extensionists, as they are called, can also be critical mediators in times of natural disasters or outbreaks of disease among livestock.

A study done in 2014 by the Global Forum for Rural Advisory Services estimated there are 1,059,528 extension agents worldwide, but that could be an underestimate. The range of extension agents in each country varies, with some countries having very few—Barbados has 6—whereas other countries have more—China has 615,000. But, of course, that depends on the number of farmers in the country and how many people each extension agent serves.

Ideally, extensionists can steer farmers toward cultivating more nutritious foods and help them do so profitably. They can guide farmers to save heirloom seeds and improve agronomic practices to produce nutritious crops such as horticulture and raising poultry and goats. They can provide training to farmer families on food preparation and nutrition. They can help farmers adopt cultivation and fertilization practices that protect the environment, limit greenhouse-gas emissions, and help store carbon in the soil. And last, they can advise on post-harvest and storage technologies to minimize food loss on farms.

However, in many countries, they lack the training, tools, transportation, and communication tools to reach farmers. Nutrition training provided to extension agents at agricultural technical schools and universities is ineffective and inadequate, which impedes the ability of agents to identify nutritional needs and provide advice or solutions. They also do not have tools to share with communities nor the training to raise awareness of nutrition as a priority.

In many countries, extensionists also lack the tools that would help them work efficiently with more farmers. For example, in some parts of rural Africa, extension agents do not have mobile phones (or top-ups) to contact farmers about real-time issues like food prices in regional markets or motorbikes to reach far-flung communities. With COVID-19, many extensionists cannot get out to the field, so in places like China and Iran, extensionists are using smartphones and the radio to communicate market information and technical support along with public health safety. Farm Radio International is working with 1,000 stations in Africa to help get out information through extension agents.

It starts at the university level—improving extension curricula in universities or after high-school technical training schools. Investments in refresher certification programs for extension agents are needed in most places globally as technologies change and the latest science and technological know-how on agronomy, nutrition, and climate science tools become available. Continual updates to training modules of extension agents such as the New Extensionist Nutrition Learning Kit developed in Rwanda can strengthen training in nutrition within agriculture. Many local non-governmental organizations can provide this training along with the Food and Agriculture Organization in partnership with Ministries of Agriculture.

Techniques employed by extension agents such as peer-to-peer engagement through model farmers, community champions using a “train-the-trainer” approach, or the “walk-and-talk” methodology, wherein agents interact with client farmers through hands-on demonstrations. One example could be forest walks with farmers. Extension agents could teach farmers how to harvest wild, nutrient-dense foods, followed by demonstrations in preparing and incorporating the food into conventional dishes. The International Fund for Agriculture Development (IFAD) has a program, The Last Mile, which is expected to engage 15,000 extension agents in 18 countries to provide business and market-oriented skills to over 1.5 million smallholder farmers over the next five years. 

Last, women extension agents should be promoted and empowered. Only 15% of extension agents are women, and only 5% of women farmers reap the benefits from extension services. Most extension services have traditionally targeted their resources and interventions towards male farmers. Women extensionists understand the needs and challenges of women farmers, particularly in low- and middle-income countries where 45% of the agriculture workforce is made up of women. They should be invested not only to jumpstart careers but also to support the many women working in food systems that ultimately feed us.

Investing in the people who best understand their communities' needs, be it health or agriculture community workers, is critical to address the challenges that farmers face. However, it won’t be enough to transform global agriculture. Governments, international organizations and the private sector must invest in infrastructure along the entire food supply chain to help farmers grow, store and deliver perishable, nutritious foods. In addition, there is a need to provide farmers the latest climate-smart technologies and tools that would allow them to be resilient when facing natural disasters and other shocks. Insurance and credit are also crucial as safety nets in these uncertain times. That said, face-to-face contact with people exchanging ideas, advice, and knowledge isn’t a bad place to start. So let’s reinvigorate and invest in extensionists.

Food Bytes: February 10th Edition

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

2020 is off and running and the world finds ways to fill in the gaps it makes.

There is lots of interesting stuff being published or planned for publishing in the food systems space.

There are new journals out there. Nature Food released its inaugural issue called “silos and systems” (with a corn silo on the cover) and it is really great so far. Highly recommend reading it - all open access articles to boot! While it has been around about two years, Nature Sustainability is high-quality and publishes a lot on food systems. Colleagues at Cornell are working with the Journal to come up with evidence-based innovations across food supply chains ready for scale-up. More on this project can be found here. The prestigious Cell Journal now has a sister journal called “One Earth.” While it focuses on climate and earth sciences, there are lots of food gems in each issue thus far.

I am also serving as the Editor in Chief of the Global Food Security Journal. We publish:

1. Strategic views of experts from a wide range of disciplinary perspectives on prospects for ensuring food security, food systems, and nutrition, based on the best available science, in a clear and readable form for a wide audience, bridging the gap between biological, social and environmental sciences.

2. Reviews, opinions, and debates that synthesize, extend and critique research approaches and findings from the rapidly growing body of original publications on global food security and food systems.

I am also serving as an Associate Editor of Food Systems and the Environment for the American Journal of Clinical Nutrition. We published our 10-year vision. In that, we highlight that the Journal will be soliciting cutting-edge papers that disentangle research that spans food system activities and actors, environmental change, and health and nutrition outcomes, taking into account the rapid socioeconomic, political, and societal transitions in the 21st century. The research space is complex and requires a convergence of new disciplines to understand the benefits and trade-offs of evidence so vital to improving diets and nutrition. We are looking for agriculture, food value chains, climate, environment, and diet themes to come together to answer the many evidence gaps that impact nutrition and human health.

The Lancet series on the double burden came out in late 2019 basically showing that there is a significant increase in low- and middle-income countries struggling with both undernutrition and overweight and obesity. The second and third papers on the etiology and actions to address the double burden stand out.

There is some controversy brewing in the nutrition world. But what else is new? JAMA published a pretty scathing article about conflicts of interest stemming from the series of articles that meat is actually not detrimental, or at least, neutral for health. JAMA argues that another group of scientists basically bullied the journal into retracting the articles, which did not happen. The JAMA called it “information terrorism.” What a mess.

A few of us from GAIN and Johns Hopkins University presented the Global Food Systems Dashboard at IFPRI last week. Check out the video and highlights here. The Dashboard brings together extant data from public and private sources to help decision-makers diagnose their food systems and identify all their levers of change and the ones that need to be pulled first.  Follow updates and announcements of the official launch on Twitter.

Food Bytes: Weekly Nibbles from Mar 4 - 24

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

The Chicago Council on Global Affairs released their annual report. This year focuses on water: From Scarcity to Security: Managing Water for a Nutritious Food Future. There are lots of nuggets on the links of water to food and nutrition. Definitely worth a read.

IFPRI has also launched a new book: Agriculture for improved nutrition: Seizing the momentum. I contributed a chapter on biodiversity and its importance for food and nutrition security.

I always like what Bee Wilson writes. She recently wrote a great piece in the Guardian on how modern food is killing us. The grape story is an interesting analogy of how our food system has changed.

I just can’t help myself, but the EAT Lancet continues to get press. This article hones in on how it spurred a global debate. Great. It did its job. Keep debating! The Guardian is going a bit nuts on the diet side. They also published a recent piece on “peak beef.” And the Hopkins HUB, published an article on proteins of the future where they warn us to “get ready for a menu of lab-grown steaks, "bleeding" plant burgers, and cricket smoothies!”

Speaking of animal source foods, eggs seem to be bad for us once again. The nutrition science field is just one big teeter totter. This JAMA study shows that eggs increase cholesterol and cardiovascular mortality.

If Africa doesn’t have it tough enough these days, my heart goes out to Mozambique with the cyclone devastation, the armyworm seems to be eating its way across the continent destroying staple crops like maize. Let’s hope R & D can be ramped up quickly with solutions.

I am a closet Chipotle lover and Tamar Haspel outlines the woes the chain has been dealing with.

Two other interesting papers came out last week. One is unpacking stunting - faltering of linear growth in children. The other is a paper in the journal I edit, Global Food Security, on the use and interpretation of dietary diversity indicators in nutrition-sensitive agriculture literature.

In the world of food ethics, with colleagues at Hopkins and Columbia University, we published two papers. The first is in the Oxford Handbook of Public Health Ethics. The chapter focuses on three key ethical challenges in the nutrition public health sphere: the prioritization of key actions to address the multiple burdens of malnutrition, intergenerational justice issues of nutrition-impacted epigenetics, and the consequences of people’s diet choices, not only for humanity but also for the planet. In the second paper, we unpack the meaning of nutrition and demonstrate that a standalone right to adequate nutrition does indeed exist in international human rights law as a sum of other rights. This right to nutrition is, essentially, the sum of the human rights to food, health, education, water and sanitation, a healthy environment, information, political participation, and social security, along with rights ensuring adequate protection of and nondiscrimination against specific groups, such as women, children, and indigenous peoples.

Nutrition and Agriculture Research: Some Thoughts

I recently was asked to provide some commentary at the International Food Policy Research Institute (IFPRI) at the ARENA-II (Advancing Research on Nutrition and Agriculture) project policy seminar. I thought I would post my speaking notes on what I think is a really fascinating set of research findings stemming from the project. The seminar presented new research on food markets and nutrition including cross-country studies of the costs of nutritious foods and nutritious diets as a whole, and case studies of fish, dairy, and poultry products. The event can be watched here.

ARENA is trying to understand markets in low-income contexts. Markets play a key role in delivering food and nutrition, even for poor and remote rural households. But nutrient-rich foods, especially animal-sourced foods, are very expensive in poor countries, suggesting that markets for perishable but nutritious foods are not functioning well. Both scientific research and real-world programs have largely focused on farm-level interventions to diversify household production and consumption, not recognizing the important role of market purchases.

The major findings coming out of ARENA:

1. Nutritious foods are typically very expensive sources of calories in low income countries, although there are exceptions.

2. Consumption patterns are strongly associated with prices - price variations explains a LOT of the gap between low and high consumers.

3. Indirect evidence that non-price factors (also implicit price factors) matter a lot: e.g. refrigeration and water quality.

4. No single solution for improving affordability or increasing consumption:

• Eggs: domestic productivity is key, often improving feed sectors (maize, soybean, fishmeal).

• Dairy: production in some countries, but trade in others. Markets work incredibly badly in rural areas.

• Fish: cheap and nutritious but under-appreciated by consumers.

• Domestic and international value chains very important, but also important to think about industrial policy: e.g. How do we create a viable modern dairy industry that delivers affordable safe milk to both rural and urban consumers?

My talking points:

Diets are significant risk factors of morbidity, disability and mortality

The Global Burden of Disease based out of the University of Washington in Seattle has recently assessed the burden of malnutrition in all its forms for the Syndemic commission report in the Lancet. Globally and in the lower income countries, malnutrition in all its forms (shown as the contributions of undernutrition, high. body-mass index, and dietary risks) contributes as much disease burden as high blood pressure, tobacco, high fasting blood glucose and water, sanitation and hygiene combined. For countries with a low Socio-demographic Index, undernutrition incurs a much higher burden both in absolute terms and relative to the other leading contributors. The recognition that undernutrition and obesity are both due to poor diet quality and a low variety of healthy foods is a more helpful perspective to resolve nutrition problems collectively.

Our knowledge of diets is still a black box

Understanding what people are eating is important to shape food system and nutrition policies, including dietary guidelines. However, determining what people are eating, remains somewhat of a black box. We don’t know key questions such as, what are people actually eating? Where do they get their food from and how much do they pay, or are willing to pay for food? What influences their dietary choices? Does health or even the environment factor into their decision making? Data on diets and their sourcing and costs are developing with better use of metrics and surveys that feed into larger databases. We are learning more and more with each passing year. We still have significant gaps in low-income settings on many of these questions.

Diets are inequitable

We are really living in a time of haves and have nots. Globally, there is a significant debate going on about the impacts of animal source foods (mainly large ruminants) on climate change, the environment and on human health. Clearly, this debate sits with high-income countries and those countries which produce and consume vast quantities of meat that do not align with the sustainable development goals. However, we know that the production and consumption practices of some, will impact the many living in low-income countries who do not have the resources to adapt and change rapidly and are limited in their options. The inequities are staggering - the rural, the poor, the geographically isolated struggle to get enough animal source foods that are important, particularly for young children who are growing and developing and need nutrient-rich foods high in iron, zinc, protein, D, B12 etc. The ARENA study advances are understanding of the challenges that rural populations face in getting access to these critical foods – eggs, dairy and fish, rich in important nutrients and other health promoting properties – through both informal and formal markets. While the evidence is growing on the impacts of on-farm production to dietary diversity of households, we know rural peoples, smallholder farming families and day labor workers are net buyers of food and they need market that work.

 My questions

I know the ARENA is meant to of course shed and shine a light but it is also meant to set out a research and policy agenda. Here are some of my questions that I was left wondering about for future research:

• Infrastructure is so important. Not just roads but technology and innovation along supply chains. What would be the role of the private sector or PPPs to accelerate action and get over the barriers to access?

• We cannot think about commodities as stand alone. They interact (the ARENA shows how important feed sectors (maize, soybean, fishmeal) are critical for the growth of animal source foods). How do we grapple this with land use changes?

• The enabling environment is key. What should policies focus on? Subsidies? Trade?

• Changing food environments or markets. How shall we measure changes and rapid shifts that we are seeing in many rural places, with the encroachment and influence of urban hubs? I would be keen to see how processed, packaged foods are changing the diets and market landscape in rural places.

• Many consumers all over the world are driven by the same issues - price, convenience, taste. Other factors matter too like reliability and safety. How do we get consumers to care more about nutrition or is that completely unrealistic? What are the trade-offs?

• Eggs: Can these rural areas shift from scavenging systems to intensive systems? How realistic is that? How much does that cost? Is there infrastructure and investment to do this? There is new evidence showing eggs increase cholesterol and heart disease risk - once again, eggs are deemed to not be god for us. Should we be worried about future burdens if we are promoting these foods to children to improve nutrition?

• Dairy: Lactose intolerance. The expression of lactase which digests lactose from milk in humans is generally lost after weaning, but selected mutations influencing the promoter of the lactase gene have spread into the human populations. This is considered a classical example of gene-culture co-evolution, and several studies suggested that the lactase gene has been under strong directional evolutionary selective pressure in the past 5000 to 10,000 years. These data indicate that a combination of socio-economic, ethnic and evolutionary factors converged to shape the genetic structure of lactase persistence in East African populations. A Lancet systematic review study in 2017 showed that lactose malabsorption is widespread in most of the world, with wide variation between different regions and an overall frequency of around two-thirds of the world's population. 63% (54–72) in sub-Saharan Africa. Lactose malabsorption was also widespread in Africa. including northern Africa (53–84%) and sub-Saharan Africa (77–100%), with the exception of Niger (13%), Kenya (39%), Sudan (55%), and Tanzania (45%) - pastoralist populations. I am keen to learn more about this?

• Fish: What would be the strategies to improve the status of fish among consumers as they get wealthier? What role does aquaculture play in these areas and ensuring feed is affordable and more sustainable? What about alternative feeds?

• Are there gender links to any of these commodities as they become commercialized and how does that change household intake of these foods?

• How do we ensure these rural places thrive? Someone needs to feed this growing urban population. Who will it be and how if rural places struggle to feed themselves?