Being realistic about the contribution of private businesses to public nutrition objectives

Nigel Poole; Jessica Agnew; Natasha Ansari; Bhavani R.V.; Mar Maestre Morales; Rashid Mehmood; Rohit Parasar

doi:10.3362/2046-1887.19-00013

Being realistic about the contribution of private businesses to public nutrition objectives

This article concerns the role of the state and the private sector in addressing Sustainable Development Goal 2, which is to end hunger, achieve food security and improve nutrition, and promote sustainable agriculture. We critique the ‘food environment’ focusing on the strategies and policies of the public and private sectors which shape agri-food production and consumption. We use evidence from studies in South Asia to suggest more realism about the contribution of major businesses to public nutrition objectives. We conclude that business policies are dynamic, and for most firms and in many markets, there are genuine challenges in reaching the ‘bottom of the pyramid’ of consumers with nutritious foods. For policy-makers there should be no assumption that public and private sector objectives are aligned. Policy recommendations include stronger direct intervention such as through taxation, subsidies, regulatory incentives, and controls on advertising and distribution with appropriate monitoring and sanction mechanisms, and indirect interventions to facilitate the pro-nutrition operations of small and medium size enterprises.

Agnew, J. and Henson, S. (2018) ‘Business-based strategies for improved nutrition: the case of Grameen Danone Foods’, IDS Bulletin 49(1): 39–56 <http://dx.doi.org/10.19088/1968-2018.103>.

Ansari, N., Mehmood, R. and Gazdar, H. (2018a) ‘“Milk for milk, water for water”: analysing Pakistan’s Dairy Innovation’, IDS Bulletin 49(1): 91–106 <http://dx.doi.org/10.19088/1968-2018.106>.

Ansari, N., Mehmood, R. and Gazdar, H. (2018b) ‘Going against the grain of optimism: flour fortification in Pakistan’, IDS Bulletin 49(1): 57–71 <http://dx.doi.org/10.19088/1968-2018.104>.

ATNF (2018) Global Access to Nutrition Index 2018 [pdf], Access to Nutrition Foundation (ATNF), Utrecht, The Netherlands <https://accesstonutrition.org/app/uploads/2020/02/GI_Global-Index_Full_Report_2018.pdf> [accessed 10 June 2020].

Batis, C., Rivera, J.A., Popkin, B.M. and Taillie, L.S. (2016) ‘First-year evaluation of Mexico’s tax on nonessential energy-dense foods: an observational study’, PLOS Medicine 13(7): e1002057 <http://dx.doi.org/10.1371/journal.pmed.1002057>.

Bhavani, R.V. and Parasar, R. (2018) ‘Food distribution value chain under the Integrated Child Development Services’, IDS Bulletin 49(1): 73–90 <http://dx.doi.org/10.19088/1968-2018.105>.

Bíró, A. (2015) ‘Did the junk food tax make the Hungarians eat healthier?’ Food Policy 54: 107–15 <https://doi.org/10.1016/j.foodpol.2015.05.003>.

Caro, J.C., Ng, S.W., Taillie, L.S. and Popkin, B.M. (2017) ‘Designing a tax to discourage unhealthy food and beverage purchases: the case of Chile’, Food Policy 71: 86–100 <https://doi.org/10.1016/j.foodpol.2017.08.001>.

FAO, IFAD, UNICEF, WFP, and WHO (2019) The State of Food Security and Nutrition in the World 2019: Safeguarding against Economic Slowdowns and Downturns [pdf], FAO, Rome <http://www.fao.org/3/ca5162en/ca5162en.pdf> [accessed 01 April 2020].

GAIN (2018) Fortification Assessment Coverage Toolkit (FACT) Survey in Afghanistan, 2017 [pdf], Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland <https://www.gainhealth.org/sites/default/files/publications/documents/fortification-assessement-coverage-toolkit-afghanistan-2017.pdf> [accessed 10 June 2020].

Global Panel (2018) Improving Diets in an Era of Food Market Transformation: Challenges and Opportunities for Engagement between the Public and Private Sectors [pdf], Policy Brief No. 11, Global Panel on Agriculture and Food Systems for Nutrition, London <https://www.glopan.org/sites/default/files/Downloads/GlobalPanelPrivateSectorBrief.pdf> [accessed 01 April 2020].

GoIRA (2016) Women’s Economic Empowerment: National Priority Programme [pdf], Government of the Islamic Republic of Afghanistan (GoIRA), Kabul <http://policymof.gov.af/home/wp-content/uploads/2016/07/Women%E2%80%99s-Economic-Empowerment-Program.pdf> [accessed 01 April 2020].

Goldberg, R.A. and Herman, K. (2007) ‘Nestle’s milk district model: economic development for a value-added food chain and improved nutrition’, in V.K. Rangan, J.A. Quelch, G. Herrero, and B. Barton (eds), Business Solutions for the Global Poor: Creating Social and Economic Value, pp. 183–9, John Wiley & Sons, Hoboken, NJ.

Haddad, L. (2019) ‘How can businesses operating in the food system accelerate improvement in nutrition?’ in S. Fan, S. Yosef, and R. Pandya-Lorch (eds), Agriculture for Improved Nutrition: Seizing the Momentum, pp. 113–21, International Food Policy Research Institute (IFPRI) and CABI, Wallingford, UK.

Haddad, L. (2020) ‘Viewpoint: a view on the key research issues that the CGIAR should lead on 2020–2030’, Food Policy 91: 101824 <https://doi.org/10.1016/j.foodpol.2020.101824>.

Hawkes, C. (2007) ‘Regulating and litigating in the public interest’, American Journal of Public Health 97(11): 1962–73 <http://dx.doi.org/10.2105/AJPH.2006.101162>.

Henson, S. and Agnew, J. (2020) ‘Are market-based solutions a viable strategy for addressing micronutrient deficiency? Lessons from case studies in sub-Saharan Africa and South Asia’, Development Policy Review. Epub ahead of print, 19 January 2020 <http://dx.doi.org/10.1111/dpr.12492>.

Lalani, B., Bechoff, A. and Bennett, B. (2019) ‘Which choice of delivery model(s) works best to deliver fortified foods?’ Nutrients 11(1594): 1–27 <https://doi.org/10.3390/nu11071594>.

Law, C., Cornelsen, L., Adams, J., Penney, T., Rutter, H., White, M. and Smith, R. (2020) ‘An analysis of the stock market reaction to the announcements of the UK Soft Drinks Industry Levy’, Economics & Human Biology. Epub ahead of print, 17 February 2020: 100834 <https://doi.org/10.1016/j.ehb.2019.100834>.

Lawrence, M.A. and Baker, P.I. (2019) ‘Ultra-processed food and adverse health outcomes’, British Medical Journal 365: l2289 <http://dx.doi.org/10.1136/bmj.l2289>.

Maestre, M. and Poole, N. (2018) ‘Value chains for nutrition in South Asia: who delivers nutritious foods, how and to whom?’ IDS Bulletin 49(1): 1–20 <http://dx.doi.org/10.19088/1968-2018.100>.

Maestre, M., Poole, N. and Henson, S. (2017) ‘Assessing food value chain pathways, linkages and impacts for better nutrition of vulnerable groups’, Food Policy 68: 31–9 <http://dx.doi.org/10.1016/j.foodpol.2016.12.007>.

Monteiro, C.A., Cannon, G., Moubarac, J.-C., Levy, R.B., Louzada, M.L.C. and Jaime, P.C. (2018) ‘The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing’, Public Health Nutrition 21(1): 5–17 <http://dx.doi.org/10.1017/S1368980017000234>.

Parasar, R. and Bhavani, R.V. (2018) ‘Private business-driven value chains and nutrition: insights from India’, IDS Bulletin 49(1): 21–38 <http://dx.doi.org/10.19088/1968-2018.102>.

Poole, N. (2018) ‘Building dairy value chains in Badakhshan, Afghanistan’, IDS Bulletin 49(1): 107–27 <http://dx.doi.org/10.19088/1968-2018.107>.

Poole, N., Echavez, C. and Rowland, D. (2018) ‘Are agriculture and nutrition policies and practice coherent? Stakeholder evidence from Afghanistan’, Food Security 10(6): 1577–601 <http://dx.doi.org/10.1007/s12571-018-0851-y>.

Reardon, T. (2015) ‘The hidden middle: the quiet revolution in the midstream of agrifood value chains in developing countries’, Oxford Review of Economic Policy 31(1): 45–63 <http://dx.doi.org/10.1093/oxrep/grv011>.

Sardana, G.D. (2013) ‘Social business and Grameen Danone Foods Limited’, Society and Business Review 8(2): 119–33 <https://doi.org/10.1108/SBR-01-2013-0002>.

Agnew, J. and Henson, S. (2018) ‘Business-based strategies for improved nutrition: the case of Grameen Danone Foods’, IDS Bulletin 49(1): 39–56 <http://dx.doi.org/10.19088/1968-2018.103>.

Smed, S., Scarborough, P., Rayner, M. and Jensen, J.D. (2016) ‘The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation’, European Journal of Clinical Nutrition 70(6): 681–6 <http://dx.doi.org/10.1038/ejcn.2016.6>.

The Lancet (2016) ‘No ifs, no buts, no follow-on milk’, The Lancet 387(10033): 2064 <https://doi.org/10.1016/S0140-6736(16)30599-2>.

Ansari, N., Mehmood, R. and Gazdar, H. (2018b) ‘Going against the grain of optimism: flour fortification in Pakistan’, IDS Bulletin 49(1): 57–71 <http://dx.doi.org/10.19088/1968-2018.104>.

Toman, C. (2018) ‘Danone investigates claims baby milk makes some infants ill’ [online], ShareCast <https://www.sharecast.com/news/international-companies/danone-investigates-claims-baby-milk-makes-infants-ill--3386355.html> [accessed 9 June 2020].

Turner, C., Kadiyala, S., Aggarwal, A., Coates, J., Drewnowski, A., Hawkes, C., Herforth, A., Kalamatianou, S. and Walls, H. (2017) Concepts and Methods for Food Environment Research in Low and Middle Income Countries. Agriculture, Nutrition and Health Academy Food Environments Working Group (ANH-FEWG) [pdf], Innovative Methods and Metrics for Agriculture and Nutrition Actions (IMMANA) programme, London <https://anh-academy.org/sites/default/files/FEWG_TechnicalBrief_low.pdf> [accessed 01 April 2020].

Ul Kabir, A., Islam, S. and Reza, M.H. (2018) ‘A study on milk value chain for the poor in Bangladesh’, IDS Bulletin 49(1): 129–46 <http://dx.doi.org/10.19088/1968-2018.108>.

Bhavani, R.V. and Parasar, R. (2018) ‘Food distribution value chain under the Integrated Child Development Services’, IDS Bulletin 49(1): 73–90 <http://dx.doi.org/10.19088/1968-2018.105>.

UN Global Compact (2018) ‘Making Global Goals Local Business’ [website] <https://www.unglobalcompact.org/sdgs> [accessed 01 April 2020].

Bíró, A. (2015) ‘Did the junk food tax make the Hungarians eat healthier?’ Food Policy 54: 107–15 <https://doi.org/10.1016/j.foodpol.2015.05.003>.

Vandevijvere, S., Jaacks, L.M., Monteiro, C.A., Moubarac, J.-C., Girling-Butcher, M., Lee, A.C., Pan, A., Bentham, J. and Swinburn, B. (2019) ‘Global trends in ultraprocessed food and drink product sales and their association with adult body mass index trajectories’, Obesity Reviews 20(S2): 10–9 <http://dx.doi.org/10.1111/obr.12860>.

Veerman, L. (2017) ‘The impact of sugared drink taxation and industry response’, The Lancet Public Health 2(1): e2-e3 <https://doi.org/10.1016/S2468-2667(16)30039-1>.

WHO, UNICEF, and IBFAN (2016) Marketing of Breast-milk Substitutes: National Implementation of the International Code. Status Report 2016 [pdf], World Health Organization (WHO), Geneva <https://apps.who.int/iris/bitstream/handle/10665/206008/9789241565325_eng.pdf?ua=1> [accessed 03 April 2020].