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The past 50 years have been a period of extraordinary food crop productivity and growth. Despite these massive gains in productivity and agricultural development, malnutrition has persisted across certain regions of the developing world. In India, these challenges, which range from micronutrient malnutrition and the emergence of over-nutrition, have created a challenging landscape of health and human nutrition. Despite exceptional economic growth, high rates of childhood stunting and micronutrient malnutrition persist. Improved agricultural policies that can change nutritional outcomes require a better understanding of the links between agriculture and nutrition, as well as complimentary policies in water, sanitation, and household behavior change. This lecture presents international lessons learned in successfully using agricultural pathways to reduce malnutrition with important implications for the Indian context. Distinguished Lecture given at the Institute of Economic Growth, University of Delhi, India, on March 10, 2014.
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Agricultural Pathways to Improved Nutrition: Getting Policies Right!
Prabhu Pingali
Professor of Applied Economics
Director, Tata-Cornell Initiative for Agriculture & Nutrition
Cornell University
College of Agriculture and Life Sciences Tata-Cornell Agriculture and Nutrition Initiative (TCi)
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• Persistence of under weight births & Childhood stunting
• Rising inequality in food & nutrition access• Increasing incidence of obesity• Growing food safety concerns
TCi 2013©
Global Nutritional Challenges
3TCi 2013©
The nature and magnitude of the nutritional challenge varies by the stage of structural transformation of a country
Structural Transformation: what is it?
Four inter-related processes define structural transformation:• A declining share of agriculture in GDP and
employment• A rural to urban migration that stimulates the
process of urbanization• The rise of a modern industrial and service sector• A demographic transition from high to low rates
of births and deaths
TCi 2013©
Structural transformation: what is it?
TCi 2013©
Structural Transformation is a Historical and Universal Phenomenon
Low Income
Lower Middle Income
Upper Middle Income
High Income
0
10
20
30
40
50
60
70
80
-1,000 4,000 9,000 14,000 19,000 24,000 29,000 34,000 39,000 44,000 49,000 54,000
GDP (US$ per Capita)
Share of Agriculture
(% GDP)
High Human DevelopmentMedium Human DevelopmentLow Human Development
TCi 2013©
Structural Transformation, Human Development, and Agricultural Performance
7Webb P , and Block S PNAS 2012;109:12309-12314
Structural Transformation and Nutrition
NCDs Account for Growing Share of Total Deaths Around the World
Source: Nikolic 2011http://www.prb.org/Publications/Articles/2011/youth-and-chronic-diseases.aspx
Under nutrition and Obesity by the Level of GDP Per Capita
Source: WHO, 2006
Map of Global Stunting
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The first 1,000 days of life…
~9 months in utero
~6 months breastfeeding
Early childhood
Message: to impact child nutrition and safeguard cognitive and physical development, targeting women and girls during childbearing years (ages 15-45) is essential.
TCi 2013©
12TCi 2013©
So what does agriculture have to do with it?
13Webb P , and Block S PNAS 2012;109:12309-12314
Effect of policy support for agriculture versus non-agriculture on the prevalence of stunting
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Nutrition is multidimensional
©Tata-Cornell Agriculture and Nutrition Initiative (TCi), 2013
15©Tata-Cornell Agriculture and Nutrition Initiative (TCi), 2013
For rural households, agriculture is central to food access
Agricultural policies are central for influencing:• Rural household
income (food affordability)
• Female labor use (agriculture vs household activities)
• Regional/local food supply (productivity and food diversity)
INCREASED MATERNAL HEALTH AND REDUCTION IN CHILDHOOD STUNTING
TCi 2013©
16©Tata-Cornell Agriculture and Nutrition Initiative (TCi), 2013
Agriculture is only part of the equation, complementary policies are essential
Complementary policies for behavior change and environmental change are essential components:• Behavior (education,
women’s empowerment, etc.)
• Water, sanitation, and hygiene efforts
INCREASED MATERNAL HEALTH AND REDUCTION IN CHILDHOOD STUNTING
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Food system classification
Characteristics
Low productive systems
• Little to no Green Revolution gains• Low per capita income• Low agricultural productivity• Low diet diversity• High under nutrition & micronutrient malnutrition
Modernizing Systems
• Green Revolution gains• Low-medium per capita income• Moderate agricultural productivity• Moderate diet diversity• Persistent micronutrient malnutrition
Commercial/export systems
• Medium-high per capita income• Higher opportunity for agricultural productivity• High diet diversity• coexistence of under nutrition and over nutrition
One size does not fit all… contextualizing ag-nutrition policies
TCi 2013©
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Vicious cycles of low productivity systems…
TCi 2013©
Low diet diversity
High relative price of non-staples
Poverty
Micronutrient malnutrition
Low productive staple crop systems
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Low productive agriculture: policy recommendations
Context-specific focus Specific policies
• Cereal-based intensification strategies
• Productivity-focused investments for smallholder farmers
• Biofortification of staple crops• Fortification of staples
• Complementary interventions
• Kitchen gardens for year-round access to micronutrient-rich foods
• Backyard livestock and poultry • Social safety net programs for the
most vulnerable
TCi 2013©
Bio-fortification can make a difference
But not always a success, challenges exist
• Bt cotton huge in India, but golden rice not accepted
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Modernizing systems and dietary change: how could the story go?
TCi 2013©
Income increases
Increasing productivity for staples
Demand for non staples increases
Increases in cereal (calorie)supply and reduced cereal prices
Farmers diversify into new, developing markets for micronutrient and protein-dense foods
Food supply diversity increases
Agriculture commercialization continues
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Effective policies and market incentives must be in place to generate food supply and nutritional change
TCi 2013©
Income increases
Increasing productivity for staples
Demand for non staples increases
Increases in cereal (calorie)supply and reduced cereal prices
Farmers diversify into new, developing markets for micronutrient and protein-dense foods
Food supply diversity increases
This link depends on policy and market environment
Agriculture commercialization continues
24TCi 2013©
When policies and market incentives don’t enable farmers to meet a growing demand for non-staples, the the result is: • Limited supply of micronutrient and
protein-dense foods • Impacts for dietary diversity
• Sustained high relative prices of non-staples
• Impacts for dietary diversity affordability
• Agriculture incomes lag behind• Impacts for total food budgets
All too often, poor policy and market environments halt or disable diet transformation…
Demand for non staples increases
Farmers diversify into new, developing markets for micronutrient and protein-dense foods
This link depends on policy and market environment
Percent Change in Monthly Per Capita Cereal Consumption in Rural and Urban India: 1993/94 and
2004/05
Source: NSSO Reports: Household Consumption Expenditure in India
Rising GDP per capita is associated with a larger share of supermarkets in food retail
0%
20%
40%
60%
80%
100%
0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000
GDP per Capita, PPP, 2002
Sh
are
of
Su
pe
rma
rke
ts i
n F
oo
d R
eta
il
Source: data from Traill (2006) and World Bank World Development Indicators (2006)
Rapid Growth in Fast Food Restaurants
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Modernizing Agricultural Systems: policy recommendations
TCi 2013©
Context-specific focus Specific policies
Linking farmers to markets
• Investments in infrastructure• Investments in essential institutions (credit, insurance,
land rights, etc.)• Investments in public-private partnerships
Strengthening demand for micronutrient and protein-rich foods
• Policies that establish product standards and better trading relationships
• Policies improving food safety
Supporting agriculture as a business
• Upgrading traditional markets and investing in informal actors
• For poorest populations in Africa and South Asia• Health and well-being in rural areas lag far behind urban areas• Productivity effects more serious where physical labor critical input
• Women are particularly vulnerable- Employment patterns:
- women play a predominant role in the production of food crops ; especially in Africa.
- Biological vulnerabilities: - women have special vulnerabilities related to reproductive health and
they are adversely affected by health and nutrition risks. - Life responsibilities:
- women have a set of unique responsibilities in the home, particularly in terms of the care of children.
Role of Health and Nutrition in Agricultural Development
TCi 2013©
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Complementary policies
Behavior change:• Education,
extension
Harnessing the power of women’s groups.• Nutrition
messaging through women’s groups
Water, sanitation, hygiene• Clean water technology
development• Sanitation technologies
TCi 2013©
Nutrient Absorption and Utilization
• Almost 50% of the world’s population – 2.5 billion people – lack improved sanitation facilities
• Over 884 million people use unsafe drinking water sources
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The continuing relevance of agriculture in all stages of development: key policy priorities
Investments in enhancing of food supply• Investments in technology, research and development for productivity and nutrition
enhancement• Investments in post-harvest technologies and infrastructure
Agri-market investments• Investments necessary to connect farmers to markets• Policies aimed at opening up foreign direct investment in food value chains• Modernization of extension • Broadening extension to include nutrition messaging
Investments in health and social environment• Investments in sanitation (toilets) and access to clean water• Empowerment of women and incentivizing women’s self-help groups
Investments for food affordability and access• Relative price changes• Continuation of safety net programs that target vulnerable populations
Thank you!
Website: tci.cals.cornell.edu
Blog: blogs.cornell.edu/agricultureandnutrition/
Thank you!
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Key policy principles • Continuing relevance of agriculture through all stages of development
– Agriculture as an engine of growth and poverty reduction– Agriculture as a supplier of dietary diversity– Agriculture as a profitable business for feeding urban populations
• Investments in technology, research and development for productivity and nutrition enhancement– Post-green revolution productivity gains for neglected crops– Enhancement of nutritional traits through biofortification and food-fortification.
• Investments in post-harvest technologies – Enhancing food safety and expanding market reach
• Investments necessary to connect farmers to markets– Credit, input markets, infrastructure, contracts, land rights, etc.
• Policies aimed at opening up foreign direct investment– Regulatory reform– Public-private partnerships
• Modernization of extension – Using ICTs and leveraging community organizations – Women’s empowerment
• Broadening extension to include nutrition messaging• Investments in sanitation (toilets) and access to clean water• Continuation of safety net programs that target vulnerable populations
– Programs focusing on providing micronutrients for women and children• Relative price change
– Poor support for course grains, legumes, lentils, etc.– Lack of attention to micronutrent dense foods