Planetary Health and One Health Approaches in Securing Sustainable Food Systems and Nutrition at the World Health Summit
Melvine Anyango Otieno - Founder, Planetary Health Eastern Africa Hub & PHAs Senior Next Generation Fellow
The World Health Summit (held on October 16–18, 2022 at Hotel Berlin Central District, Berlin, Germany & Digital) brought together several experts, stakeholders, and global health actors from diverse backgrounds from all over the world to facilitate joint, internationally coordinated action. It was impressive to see over 4,000 participants sitting in one same room to hear political and influential health leaders discussing the most pressing global health challenges of today’s society.
The central topics discussed cut across investment for health and well-being, climate change and planetary health, architecture for pandemic preparedness, digital transformation for health, food systems for health, health systems resilience and equity to global health for peace.
Engaging Globally For Planetary Health
It was an honor to be invited as one of the speakers and a panelist during the Workshop (WS 14) — North America on “Engaging Globally for Planetary Health”. In this session, we aimed at inspiring and engaging the audience with a focus of sharing successful integration of the Planetary Health narrative when interacting with different sectors of society, different scientific disciplines, different knowledge systems and different levels of policy-making for innovative co-creational and engaging joint endeavors to address both the environmental and the human health crisis.
“Planetary Health is so important because we have what we call the 4 C’s (COVID, Climate and Conflict and the unprecedented Cost of living crisis) and also the 4 F’s (Food, Feed, Fuel, Fertilizer and lack of Finances). Planetary Health is a framework that encourages us to use evidence-based policies to promote human health and shared prosperity while also preserving the environment which is fundamental to our wellbeing” — Nicole De Paula, Founder, Women Leaders for Planetary Health and Senior SDG expert, FAO.
She went ahead and shared some important light concerning the food system, stating “We see 3 billion people who cannot afford a healthy diet where one out of ten people go to bed hungry every day and at the same time we are wasting one third of the food that we produce. It’s not only the food but also the natural resources we use, the land to produce we are contaminating, hence stretching Planetary health boundaries beyond safe limits. Research shows that if we do more sustainable agriculture, if we have healthier diets, if we invest, reduce food loss, protect and restore nature we are going to have better lives, more jobs, economic gains. However, we are not using our resources in a smart way. 600 billion dollars each year on agricultural subsidies but 70% goes to direct income support, and 5% of the support goes for conservation or sustainable growth. The paradox here is that cheap food these days is expensive for people and the planet. We see that only 15 crops provide 90% of our food energy intake, two-thirds (rice, wheat and maize) and 30,000 edible plant species in the world and more than 6,000 crops have been cultivated in human history but only 200 make it into this global market.”
A very concrete and practical example was shared by Dr. In Susanne Hecker’s on “How can public engagement support Planetary Health in the area of the food system?” A pilot study was conducted by her team from Museum für Naturkunde in partnership with European Science Citizen Association during the International conference of Citizen Science in Berlin, with the aim of bringing together scientists, people of society and industry startups. The outcome had concrete measures for education between people and stakeholders, creating connections and developing new practices. “People don’t engage if you only focus on the negative side of things. Talk about healthy food, not environmental damage by current systems.” “Planet friendly foods need to be easy and cheap, food which is bad for the planet should be more expensive.”
I also had an opportunity to share about our ongoing SOPHEA project- Strengthening One and Planetary Health in Eastern Africa as we continuously act locally and engage the East Africa community inPlanetary Health. Nutrition being key thematic topic under Planetary Health that we are also focusing on, through one of our activities, Summer School programme, I was able to share the practical example of engaging the student community in Planetary Health diet, where they conducted a cooking session focusing on sustainable vegetable diet throughout the programme, based on shared nutrition projects presentation in order to help them apply knowledge into action that we can all take to contribute to the Great Food Transformation. This was based on the Eat-Lancet Commission on healthy diets from Sustainable food systems that presents a global Planetary Health diet that is healthy for both people and the planet.
One Health in Action
One Health concept “is an integrated unifying approach to sustainable balance and optimize the health of people, animals and ecosystems (health of humans, domestic and wild animals, plant and environment) closely linked and interdependent. The one health approach mobilizes multiple sectors and disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems while addressing the collective for clean water energy and air, safe nutritious food, taking action on climate change and contributing to sustainable development”.
This panel offered an opportunity to learn how One Health approach can be integrated in projects worldwide, shared by One health experts; Dr. Sunita Narain, Janetrix Helen Amuguni, Ebere Okereke, Dr. Andrea Winkler and Jochen Flasbarth based on their experiences in the form of lessons learnt and challenges in the implementation of One Health programme.
Emphasis on the need to know the actors of One Health, their priorities, and their incentives as practitioners was tabled. Experiences from the ground should set the standard, it should be context specific, strive for continuity for sustainability. Community engagement is critical, on the practical side of working with grassroots communities especially, and it’s clear women are the main actors of One Health as they play a bigger role: they buy antibiotics for their children and animals, for example. Gender, social, cultural, and communities interface between AMR, food systems and climate change in Africa, India and other Global South countries. One Health not integrated more into action. A challenge is food production is increasing, issue of access and issue of excess. Critical view at the intensive the food systems, coming from the backyards of the industrialized countries by radical transformation format of reinventing how we do things in our parts. One Health from theory to practice 4 C’s; the Coordination, Collaboration, Communication and Capacity building on the ground need to be explored. Cohesion that we can create when we build everything on trust, engaging the cmmunities, co-designing, co-advancing, co-reaping the benefits and convergence on important issues that we have to solve like decline of biodiversity, climate change and not the least of all pandemics. NCDs can benefit majorly by One Health approach. Be vigilant and go according to the principle of One Health, gender equity in every corner, bringing community together, holism and system approach.
We didn’t invest enough in a healthy ecosystem. Illegal wildlife trade is a booster for pandemics potentially and wildmarkets. Health systems were completely disconnected to this debate. A holistic approach is required (integrated ecosystem health, animal health and human health together) and has to be reflected and enhanced in our program work. Powerful women should be supported for a solution. There is a lack of education, therefore, knowledge is required. Fragmentation of the system, lack of coordination between human health, animal health, environments (educational system we need an environmental health, health offices, public health ppl in health sector, local authority and animal health all separate). Additionally, there is no legislative framework mechanism to allow working together. Vertical programs of working in silos we see across the health system being a challenge in implementation of our ambition of one health. Therefore there’s a need for disrupting the existing system to break silos. There is a need for a single plan that everybody from diverse fields have shared and performance indicators and core roles to do this task to create solutions, work collectively to drive a common purpose. Create bridges, political mechanisms, communication and common training by bringing together a joint action plan to move forward. Agriculture, food systems, biodiversity, climate change and AMR agenda all converge. All governments, scientific networks and global scientific institutions (such as FAO, UNEP, WHO) need to bring convergence and understanding of the prevention of pandemics, and support countries to rewrite code for prevention to avoid confusion if AMR for treatment against use for general prevention of disease management. Having a list of antimicrobials which are too important for humans and cannot be minimized for their use in animals and food. Lobby for fundings to support one health activity at National level in Global South Africans.
“One health is about prevention of pandemics, according to WHO health is not only the absence of disease and one health concept needs to think of Planetary Health that goes simply beyond prevention of disasters”- Dr. Francesco Branca (Director, Department of Nutrition for Health and Development in the World Health Organization, Geneva).
Food security and nutrition: Essential ingredients to build back better
This session explores the current challenges to food security and nutrition posed by global threats and innovative and evidence-based solutions to meet immediate needs without compromising on the long-term solutions to build resilient food systems to deliver healthy diets for all were discussed. The importance of addressing malnutrition in all forms, such as stunting wasting and micronutrient deficiencies as well as overweight, obesity and diet related communicable and non-communicable diseases as they are often connected, we need to address this using a systemic, multi-sectoral approach through health food and social protection systems.
Dr. SK Mdd Mamunur Rahnan Malik, WHO Country Representative, Somalia presented on “Food security and nutrition emergency in Somalia and impact of COVID-19, Climate Change and Conflict”. He shared about the climate crisis happening in Somalia in Eastern Africa, where he mentioned, “Somalia being one of the poorest, worst affected by climate change and crisis over the past 30 years now, its facing the worst drought in it’s history as a result of four consecutive failed rainy seasons almost half of the country’s population is affected over, a million are displaced, (84% are women, children and elderly people). In 2022 (October to December), as many as 300,000 people face the risks of famine. At the moment, we are seeing a high number of children who are malnourished, close to 1.8 million. We need to prevent this at any cost. Famines are not natural phenomena, these are catastrophic failures of the political system to invest in building a resilient food crop and agricultural land use that can prevent drought, climax shock and its consequences. In the past 25 years, Somalia has experienced multiple droughts, at least two famines and several flooding events, this pattern is predicted to intensify as the country continues to pay the price of global warming and climate change. Nearly 260, 000 people died in Somalia during the famine in 2011, half of them were children. A study of the United Nations system, clearly indicated the world was too slow to respond and people paid with their lives.”
“Reversal of progress in development, needless suffering, increased hunger and poverty, a spike in disease and deaths cannot be an option for Somalia which is one of the most fragile countries in the world. We need to combat the effects of climate change but we can’t win on one front only. Use of sustainable and renewable energy should be the focus in our economic development and inclusive societal agenda. We should scale up social protection programs but link them to recovery in food, agriculture, health, water and nutrition. We must make health and nutrition parts of our inclusive economic and social recovery to offset the effects of conflicts, climate change and Covid-19 pandemic. We must promote durable solutions that benefit the population in a displacement setting and ensure resilient livelihood opportunities and sustainable use of land. We must stimulate markets and provide livelihood opportunities for rural people. To prevent migration, advocate for the inclusion of women and youth as food systems actors. We must win on all fronts against hunger, poverty, disease and malnutrition. Above all we must win against our greatest enemy climate change.” — Dr. SK Mdd Mamunur Rahnan Malik
Transforming food systems for healthy and sustainable diets
This panel session dove into the challenges, needs and opportunities required to transform food systems including addressing commercial determinants of malnutrition and leveraging them towards healthy and sustainable diets. “The current food systems provide needed food security nutrition and health for all, this is clear from the high prevalence of all forms of malnutrition and nutrition such as stunting waste micronutrients deficiencies as well as overweight obesity and diet related noncommunicable diseases. The 2021 United Nations food system summit called for urgent transformation of our food systems to deliver healthy diets from sustainable food systems for all many countries that have developed food systems transformation pathways that require changes in public and private investments and in policies regulating for the environment “ — Dr. Francesco Branca.
Policy action point:
Ensuring public food procurements, investing in healthy foods and beverages using fiscal instruments such as taxation and subsidies to make healthier foods more affordable and marketing regulations to shape consumer purchasing decisions. These measures have proven to be effective enablers of food system transformation.
One of the speakers, Dr. Tom Frieden (President and CEO, Resolve to Save Lives organization) clearly stated “Our food environment is deeply unhealthy and unless we change that, millions of people will suffer from avoidable illnesses and die from preventable death. Hundreds and millions of children and adults are undernourished and this has increased in recent years. We know that undernutrition of women leads not only to avoidable health problems in women themselves but also Next Generation being condemned to a less healthy phenotype. Childhood malnutrition can have a lifelong impact on health micronutrient deficiencies affect in the case of Vitamin A more than 100 million children around the world iodine and folate deficiencies among pregnant and women of childbearing age are the norm rather than an exception in many countries and Vitamin D deficiency is common and near Universal in some parts of the world. Furthermore, obesity really is a reflection of poor quality nutrition, more food is not better, better food is better as with health care so, with nutrition. We need quality not necessarily quantity although certainly we need a sufficient quantity of macro and micronutrients for every person in the world. We also need to have humility about what we know and what we don’t know and if we’ve learned anything from the pandemic is that public health can be most effective at bringing communities along when it listens, engages and is clear about what we know, how we know it, what we don’t know and what we’re going to do to try to find that out .Now the plain reality is that the market does not solve nutrition problems today, the market can be an important part of the solution and there are companies.’’
Dr. Geetha Sethi, advisor in global lead, food systems of World Bank in her presentation stated clearly that “Food systems today have multiple responsibilities that are central to sustainable development today more than ever. First, food systems need to deliver healthy people. Food systems need to ensure people can afford access to healthy diets. International poverty line today is hovering at 90 usd. Some extreme poverty is 2.17 usd, healthy diets us about 4 usd per capita. There is a big disconnect in terms of what we are asking people to eat and what they can afford. The government needs to step up on affordability. Today as we speak, billions of people are suffering from some elements of malnutrition, either too little calories or no calories or too many calories or wrong types of calories. Covid 19 has exposed the relevance of food systems and reduced immunity and comorbidities that add to the burden of infectious diseases. The role of malnutrition is defined to be consumption of ultra processed food to mental health particularly of youth worldwide and this has huge implications for humans when capital goes forward. Secondly, food systems need to deliver a healthy planet. Today millions of hectares of tropical forest are lost to agricultural expansion,the vanishing of water into irrigation, pollution of our ocean, disappearing biodiversity, increasing pandemics, zoonotic in nature (Covid was a start). What about GHG emissions, 25 % of total Global greenhouse gas emissions and IPcc report says 58 % increase with business as usual where the food sector will be the biggest emitter. The third contribution of food systems is towards a healthy economy. Why are 500 farmers today that produce food not able to feed themselves? ”
She went ahead and stated “The environmental, social governance standards, why are companies not moving to mandatory from voluntary living income living wages and this is why we need to get a table ready 3 billion more than we have today. With all this scenario on the food system shockingly we waste about one third or 30% of food that’s produced. Not only are we wasting food but we are also wasting land, water, forests, minerals, fertilizers, human efforts etc.This food generates global greenhouse gas emissions. If food loss and waste for the country would have been the 3rd highest emitter, arable land of China is harvested with food never making it to the tables. So the current food systems are quite massive and I would even dare to say with the turmoil in Europe, food systems need to lean in much more if we do want to make our commitment to Paris given the energy security that Europe is going to be looking for in the coming months. We need a very different kind of financing, one that worries about the global public goods and pervasive externalities, one that eliminates poverty, one that does not mortgage the future of our children.”
Conclusion
A holistic and integrated approach (both Planetary Health and One Health frameworks) involving the whole society is needed that is keen on not only addressing human and environmental risks associated with food supply but also context-specific nutrition to secure a sustainable food system. Practical interventions must be underpinned by interdisciplinary research and planning around all aspects of food and nutrition. The World Health Summit brought together experts from diverse backgrounds to bring forth an interdisciplinary and multi-sectoral approach to strengthen the global transformation of the food system which is urgently needed. The goal was also to promote global health as a key political issue and to strengthen exchange in the spirit of the UN Sustainable Development Goals.
