Urgent fixes needed for global food systems

In this article, Stuart Gillespie, senior research fellow at the International Food Policy Research Institute, writes that the coronavirus disease pandemic presents a huge challenge for food systems, as well as exposing the inequitable way in which these

Malnutrition is by far the biggest driver of ill-health and premature mortality in every region of the world. A slowburn attritional problem, it does enormous damage.

The coronavirus disease (COVID-19) pandemic that is sweeping the world, meanwhile, brings a series of massive short-wave shocks.

Both the pandemic and malnutrition will generate longwave impacts for years to come. They are also likely to interact with each other, resulting in even worse outcomes.

This will be particularly true in countries in sub-Saharan Africa and South Asia. Many of these countries’ governments, health and food systems, communities and households have limited capacity to respond to nutritional challenges or to an epidemic. This means that the potential exists for malnutrition to exacerbate the health consequences of COVID-19, and vice versa.

A year before the coronavirus appeared on the world stage, a pioneering Lancet Commission called for “a radical rethink of business models, food systems, civil society involvement, and national and international governance” to address the interlinked crises of obesity, undernutrition and climate change. Now COVID-19 can be added to that list.

To address these interacting crises, a comprehensive multisectoral response is needed that revolves around strengthening community and state capacity, as well as resilience to future shocks.

Undeniable links

‘ malnutrition is common in urban populations’

Malnutrition comes in several forms. These include undernutrition, overweight and obesity, along with associated diet-related non-communicable diseases. The vicious cycle between undernutrition and immune health has been known for half a century. That’s when the term ‘nutritionally acquired immune deficiency syndrome’ was first used. Undernutrition can heighten the severity and duration of several diseases, especially pneumonia. Ill health can exacerbate undernutrition in several ways, including the compromised absorption of nutrients.

On the other side of the spectrum, obese adults, whose immune systems are chronically activated to respond to inflammation, are also likely to be at greater risk of severe COVID-19 symptoms. Excess weight can compromise the ability of lungs to take in oxygen; people living with obesity tend to have poor cardiovascular health, to be less physically active and to be diabetic.

It is early days in terms of what scientists do and don’t know. But new data from the UK and the US suggest obesity

these foods cause to nutrition and health. This harm may now translate into greater risk of severe COVID-19 symptoms.

The response to these interlinked crises needs to be comprehensive and crosssectoral, and has to be rapidly mobilised from national to grass-roots level. Countries in the global south will also need support from the international community.

In addition to proven health interventions for controlling viral spread, there is a critical need to develop, strengthen and ‘COVIDproof’ social protection systems to protect the most vulnerable households. With regard to food systems, the state has to take the lead in highlighting healthy diets. Here it can relearn the lessons from past AIDS epidemics about the importance of human rights. Not only will this help protect populations, it will pave the way for a more equitable and sustainable food system on the other side of the pandemic.

• This article was first published by theconversation.com.