The Global Alliance for Improved Nutrition (GAIN) works to make healthier food choices more affordable, available and desirable across the world. Its executive director explains to Tom Collins how governments and the private sector can work together to boost nutrition in Africa.
Improving nutrition is a much more complex endeavour than combating hunger. It often runs counter to existing market structures. GAIN calls these structures “food systems”. How are current food systems arranged in Africa with regard to nutrition?
Food systems relate to the rules, regulations and incentives that determine how various actors – governments, businesses and consumers – behave when it comes to seeking nutrition and profit. Like most food systems the world over, the ones in Africa are set up for profit.
How can these food systems and supply chains be disrupted for the benefit of nutrition?
The food systems can better work for nutrition if governments do diagnostics to understand where their food systems work against nutrition or miss opportunities to improve nutrition. Is it in production, storage, distribution, processing, marketing, retailing or demand creation? Governments can also review whether they create the right sticks and carrots to incentivise businesses to do better things for nutrition and stop disincentivising companies. Businesses understand the options they have when it comes to making profit and improving nutrition and the associated tradeoffs.
Food production subsidies should also be targeted to improve the production and productivity of fruits, vegetables, eggs, fish, nuts, pulses – foods that are naturally nutritious. Food processing needs to be regulated and incentivised so that products are lower in sugar, salt, certain types of fats. And food marketing needs to be responsible, that is, not targeting children with sugary products.
Moving from considerations of subsistence to the question of health, the private sector is yet to throw its weight behind nutrition in Africa. How should nutrition be presented to the private sector? How can nutrition become an asset class on the continent?
Make no mistake, the private sector shapes nutrition in Africa in terms of nutritious food availability, affordability and desirability. It just does not do so in a knowing way. Nutrition improvement is an opportunity for businesses in Africa. The demand for healthy food is only going to grow stronger as cancers, diabetes, high blood pressure and obesity grow rapidly in Africa – on top of all the problems with micronutrient deficiency, stunting and wasting. Businesses need to make this trend work for them and not fight it.
Is there yet enough consumer demand for nutrition in Africa to provide the private sector with a sufficient market?
Probably not yet, but it is growing fast, driven by social media and social aspiration. Governments have to make healthy eating campaigns fun, engaging and culturally cool. At the moment they are worthy but dull as dishwater.
It’s also a question of cost for the African consumer. Nutritious food will only trump everyday staples if offered at a similar price. This presents problems for the private sector. How can they be overcome?
I totally agree. Healthy must be as cheap as non-healthy. The price of nutritious food is very high in Africa – it needs to come down to a fifth of its price. Government can do this by creating a stronger demand for healthy food and supporting companies with tax breaks and subsidies that want to produce nutritious foods at a lower cost. Also governments should procure healthy foods for schools, hospitals and prisons which will strengthen demand for nutritious food from the private sector and it will give them more credibility when advocating for healthier food consumption and production.
Access to finance is a major bottleneck for improving agriculture and, indeed, nutrition on the continent. How can we unlock finance in these key areas?
Government finance is unlocked by citizen pressure. Governments have many priorities and often respond to those who shout loudest and smartest. Business finance is best unlocked by businesses having investible propositions – being able to generate a return to investors. This increases the availability, affordability and desirability of nutritious food.
Much of Africa’s nutritious food perishes between the field and the market due to a lack of decent storage and transport facilities. Do you see any easy fixes to developing basic infrastructure along the food supply chain?
Yes, basic infrastructure is key. A two-pronged approach is needed. First, all new infrastructure needs to be designed with economic growth and health in mind. This requires strong voices for nutrition in ministries of finance and planning. Second, existing infrastructure can be augmented by relatively simple innovations in refrigeration, crating and collection points. This requires incentivisation from government.
How can governments, development institutions and the private sector better work together to boost nutrition in Africa?
First, they have to realise the extent of the poor diet problem – six of the top 10 causes of the global burden of disease are related directly to poor diet. Second, they have to realise the solution is not just the consumer’s problem – their choices are framed and constrained by governments and businesses. Third, they have to understand the potential returns to their collective engagement. Fourth, they need platforms to engage. Engagement is the precursor to the first three points. Finally, they need to evaluate lessons learned, impacts generated – or not – and then share those with the wider field.
How exactly is GAIN planning on bringing nutritious food to over 1bn people within the next five years?
GAIN has two-pronged approach. First, help add nutrients to what people are already eating. For example, fortification with iron, zinc, vitamins A, D, B and by helping to reduce sugar, salt and transfats in what people are already eating. Second, make fresh foods like fruits and veg, fish, eggs, pulses, nuts, poultry, dairy more available, affordable, and desirable by supporting citizens to demand more from their governments and businesses when it comes to nutritious foods. Also supporting governments to incentivise businesses and consumers to make more nutritious foods available, affordable and desirable. Finally, by supporting businesses to expand their sales of nutritious foods at lower prices.