systems (e.g., small-scale farmers in the Global South) become increasingly marginal in diagnosing the problems and identifying the solutions.
Power – to achieve visibility, to frame narratives, to set the terms of debate, and to exploit complexity as an excuse for inaction – is therefore at the heart of the food-health nexus. The concentration of power in the hands of a relatively small number of players is a key factor keeping industrial food systems in place, despite their spiraling impacts on human and planetary health. It combines with other “lock-ins” – path dependency, export orientation, and the use of narrow productivist narratives and measures of success – to hold back the paradigm shift that is urgently required [24].
Leverage Points to Contribute to Transformation to Healthier Food Systems
IPES-Food identified five leverage points for moving towards a new basis of understanding and action to build healthier food systems. First is the continued need to promote food systems thinking at all levels – connections between different health impacts, between human health and ecosystem health, between food, health, poverty, and climate change, and between social and environmental sustainability. Health risks must be viewed in their entirety, across the food system and on a global scale. We note that food systems thinking is gaining traction. Since publication of the IPES-Food report on the Food-Health nexus in 2017, several reviews and publications have been undertaken emphasizing a food systems approach and broadening discussion to socioeconomic conditions and planetary health [10, 25, 26].
Second is the need to reassert scientific integrity and research as a public good. Research priorities, structures, and capacities need to be fundamentally realigned with principles of public interest and public good, and the nature of the challenges we face (i.e., cross-cutting sustainability challenges and systemic risks). Specific measures are needed to counter the influence of vested interests in shaping scientific knowledge on the health impacts of food systems, and to reduce the reliance of researchers on private funding, for example new rules around conflicts of interest in scientific journals, initiatives to fund and mandate independent scientific research, and independent journalism on the health impacts of food systems. Different forms of research involving a wider range of actors and sources of knowledge are also required to rebalance the playing field and challenge prevailing problem framings.
Third, we need to know more about the positive health impacts and positive externalities of alternative food and farming systems (e.g., agroecological crop and livestock management approaches that build soil nutrients, sequester carbon in the soil, or restore ecosystem functions such as pollination and water purification). It is crucial to document and communicate the potential of alternative systems to: reconcile productivity gains, environmental resilience, social equity, and health benefits; strengthen yields on the basis of rehabilitating ecosystems (not at their expense); build nutrition on the basis of access to diverse foods; and redistribute power and reduce inequalities in the process.
Fourth, we need to adopt and apply the precautionary principle. The negative health impacts identified above are interconnected, self-reinforcing, and systemic in nature. However, this complexity cannot be an excuse for inaction. Disease prevention must increasingly be understood in terms of identifying specific risk factors by the accumulation of evidence from many different studies, from many different disciplines, as well as in terms of the collective strength, consistency, plausibility, and coherence of the evidence base. In this light, there is a clear need to call upon the precautionary principle – developed to manage these complexities and requiring policymakers to weigh the collective evidence on risk factors and act accordingly – to protect public health.
Fifth, we need to build integrated and coherent food policies under participatory governance. Policy processes must be up to the task of managing the complexity of food systems and the systemic health risks they generate. Integrated food policies and food strategies are required to overcome the traditional biases in sectoral policies (e.g., export orientation in agricultural policy) and to align various policies with the objective of delivering environmentally, socially, and economically sustainable food systems. Integrated food policies allow trade-offs to be weighed up, while providing a framework for long-term systemic objectives to be set (e.g., reducing the chemical load in food and farming systems, and devising strategies for tackling emerging risks such as antimicrobial resistance). These processes must be participatory. The general public must become a partner in public risk management and priority setting, and buy into the rationale and priorities underpinning it.
Disclosure Statement
The authors declare no conflicts of interest.
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