The Virtuous Emulsification of Business and Nutrition:

Why bother and some ways forward

Martin J. Forman LectureDecember 2016

Lawrence Haddad

Global Alliance for Improved Nutrition

Already a fan of Dr. Forman’s work

Why this topic?

• For development to be sustainable, the powering of it also has to be sustainable – more governments and businesses, less ODA

• But we are at a stalemate on how to engage business & this is locking up potential

• We need more open and honest dialogue, thinking and action on this issue

• And….

I’m at GAIN

Relevance of business for nutrition?• Diet quality is central to the prevalence of all forms of

malnutrition

• Diets are poor quality for about 1 in 3 people

• People get most of their food through market purchases

• Urbanization and income growth driving these trends forward

• The nutritional quality of food supply and demand in markets is shaped by businesses

Six of the top 11 risk factors driving the global burden of disease are related to diet

http://www.glopan.org/news/foresight-report-food-systems-and-diets

Percentage of household value of food consumed by source of acquisition

Even in low income

countries, most people

get food from the market

http://www.glopan.org/news/foresight-report-food-systems-and-diets

Urbanization is driving the consumption of highly processed foods

http://www.glopan.org/news/foresight-report-food-systems-and-diets

What businesses? They come in all shapes and sizes

15%52%

Share of worldwide sales, top 10 packaged food companies

Share of worldwide sales, top 10 soft drink companies

Alexander E, et al. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy. Globalization and Health. 2011;7:26. doi:10.1186/1744-8603-7-26.

Where are we right now?

How do you see the world?

Business can do no wrong

Business has no business in nutrition

Silent majority trying to figure out when and how to engage with businesses to advance nutrition

• Business can do positive and negative things for nutrition

• How do we expand the former and minimize the latter?

We need to collect and use evidence to navigate the

maze

Positive things: Fortification

Fortification routinely shows benefit-cost ratios of 6-9 (& much higher for salt iodization)

Hoddinott, Torero and Rosegrant 2012 Copenhagen Consensus paper

Fortification is paid for mostly by businesses

Cost of scaling up multiple food vehicles in 25 countries:Donors $135m | Governments $149m | Private Sector $2,519m

http://www.hki.org/sites/default/files/attach/2015/09/Final%20Arusha%20Statement%20on%20Food%20Fortification%2011%2009%202015.pdf

Arusha Summit 2015 Statement

Access to Nutrition Index Report 2016

Negative things

Compliance with Code on marketing of breastmilk substitutes

Nestle 36% | Danone 31% | FrieslandCampina 24%Heinz 17% | Abbot 7% | Mead Johnson 5%

(100% = full compliance)

Pow

er im

bal

ance

sW

orl

d v

iew

s

Missedopportunities

We are missing opportunities to advance nutrition

So what is holding us

back?

Weakly governed space

High risk of doing harm

Significant reputational risk

Examples of how businesses could do more

• Help shape demand for nutritious foods

• Bring nutritious and safe foods to market at lower costs – at scale

• Reformulate products to make them less harmful and higher nutrient density

• Bring more resources to the table

• Comply with legislation and codes of conduct

Can we do better in creating demand for healthy diets?

Salt + Fat2 x Pleasing Mouth Feel Satisfying Crunch

= A Food Designed to Addict

http://www.nytimes.com/2013/02/24/magazine/the-extraordinary-science-of-junk-food.html

Can this kind of “cloak and dagger” know how be utilized to generate desirability in

healthier foods?

The Extraordinary Science of Junk Food

2.5

8

14

20

2015 2016 2017 2018

Servings

/$

25 105 245 445

Millions of additional chicken serving sales generated by a one time $100,000 public investment.

Chicken Choice, Kenya

Note: blank columns are hypothetical sales

Marketplace for Nutritious FoodsAccelerate nutritious food to market by

allowing SME’s to break the barriers to

market entry

http://www.gainhealth.org/knowledge-centre/bringing-nutritious-food-closer-home/

• Power of Nutrition (DFID & CIFF)

• Amsterdam Initiative Against

Malnutrition (Government of

Netherlands)

• Global Development Alliances (USAID)

• Business Platform for Nutrition

Research (Government of Canada)

Business

Resources Can

Be Leveraged by

Public Funds

One Way Forward: A Modest Proposal

• Need Virtuous Emulsification

– Emulsification

• Mixing Business and Nutrition

– Virtuous

• But Mixing to create Healthy, not Unhealthy, outcomes

• We can get this by Building the Enabling Environment for Public Private Engagement

– De-risk the space for public & private organizations

Build the Enabling Environment

1. Strengthen Accountability Infrastructure

– Governments set goals and codes of conduct

– Conflicts of interest declared (primary interest is influenced by a secondary interest)

– Contractual arrangements behind PPPs are put in a public register

– SMART indicators are set by all stakeholders, independently monitored and results shared widely

Build the Enabling Environment, contd

2. Expand Public Dialogue

Don’t – intimidate people for talking

Difficult to change behavior without –

communication

3. Work Together

Working together is the best way to establish –

trust and to identify any bad behavior

Build the Enabling Environment, contd

4. Build Capacity – Governments (set and enforce norms)

– SMEs (to overcome barriers)

– Civil Society (to monitor)

– Development Partners (to identify the opportunities)

5. Evaluate – Always open access, independent, appropriate rigor

– Funded by those without a direct vested interest, or if a vested interest, clearly declared in a highly visible way

Two Recommendations to USAID from the

review….

1. Consider the principal interventions points in

the national food system to determine whether

there are opportunities for improvement of

foods

1. Encourage greater involvement of the private

sector in the local production and marketing of

nutritious foods

A final word

Thank You