Apr 20, 2010

Global Philanthropy Forum: Nutrition

by Tim Ogden

One of the major foci of the conference is on food and nutrition. At a panel titled “Business Solutions to Improving Nutrition”, Peter Singer (no, not that Peter Singer) McLaughlin-Rotman Centre for Global Health presented some of the most actionable ideas that I’ve heard at a philanthropy conference. First some background.

Nutrition is one of the areas of global health that needs less innovation as Alana Shaikh has suggested is the case in many areas of public health Nu. The point is that we already know the need and we know what works. Dealing with micronutrient deficiency costs a maximum of $1/day/person for the inputs (delivery is a different cost) and is generally recognized as one of the most cost effective interventions per Disability Adjusted Life Year (the metric that health wonks use). DSM Nutritional Products, a Dutch company, has developed a food additive that can be added to any food without changing taste, texture or color and deliver all the needed micronutrients at a cost of less than a dollar. As Singer noted in his opening remarks, if you wanted to lock a generation in poverty, the easiest way to do that would be to deny newborns micronutrients for 2 years—it would kill a significant number of children and those that survived would never reach their full physical or mental capacity.

So why is this a problem we haven’t fixed?

As Singer pointed out, it’s because delivery of nutrition requires cooperation between governments, civil society and the private sector is necessary—and in this field these three groups have huge enmity toward each other (for reasons like Nestle’s promotion of infant formula and denigration of breast feeding in the 1960’s and 70’s; and irrational opposition to improved seed varieties by some civil society groups). As a result we can’t get even basic things done like fixing agricultural policies in the developed world, or widely distributing improved seeds to allow the poorest farmers to increase yields and be less susceptible to pests, disease and drought. One object lesson in this dysfunction is that during the plenary session on Food Security none of the panelists even mentioned agricultural policy or transgenic seeds—these topics are such a third rail that no one will go near them publicly.

Singer suggested we take lessons from a variety of sources to start to build trust between the three parties that need to start trusting each other and cooperating if we are to fix the nutrition problem and presented a four step action plan:

1) Create a shared of code of ethics that recognizes that the private sector is a useful and valuable part of the solution to nutrition issues. The existing code of ethics is too old and is now largely perceived as irrelevant.

2) Create a transparency index for food companies to judge how the behave in relation to the poorest consumers of their products. There are lots of transparency initiatives in other industries, including environmental policy, Publish What you Pay, corruption, labor practices, corporate social responsibility, etc. So this is clearly something that can be done.

3) Start social audits of the behaviors of companies in the field. For instance a number of the large agri-businesses have committed to providing royalty-free improved seeds in the poorest countries. Social audits could tell us if this was actually happening. Again there are plenty of analogs for social audits of companies in other industries—and they have worked to change behavior.

4) Create a body similar to the Ethical Trade Initiative to be a neutral arbiter of adherence to the codes. The ETI has had a huge impact in improving labor practices by multinational companies in developing countries. As Singer pointed out to me later, the annual budget of ETI after several years of development is only 2 million GBP, half of which is provided by its members.

The most important thing about Singer’s steps is that they are all modeled on successful, cheap initiatives in other industries that didn’t require everyone to come to the table and agree in the first place. They are examples of individuals and organizations just starting their work and then getting others to join them. If we can replicate those successes in the nutrition space, we can fix this problem. We don’t need new innovations in nutrition, we just need to use the ones that are already there.