contaminants, including bacteria, fungi, viruses, or para­sites, has increased significantly over the past few decades [Global Chapters 1, 3, 5]. In developing countries, food-borne diseases can cause and/or exacerbate malnutrition. Together, these cause an estimated 12 to 13 million child deaths; survivors are often left with impaired physical and/ or mental development that limits their ability to reach their full potential [Global Chapter 1].
     There is increasing public concern over new AKST technologies, including GMOs and food irradiation. There is no clear scientific consensus whether these technologies affect population health. Significant knowledge gaps limit the assessment of the human health risks of GMOs. Food irradiation although useful in reducing the risk of microbial foodborne illness, could pose dangers to consumers, work­ers, and the environment [Global Chapters 1, 2, 5].

Occupational impacts on health. Worldwide, agriculture accounts for at least  170,000 occupational deaths each year. This number accounts for half of all fatal accidents worldwide and is likely an underestimate as most injuries are underreported in developing countries [Global Chapter 3]. Machinery and equipment, such as tractors and harvest­ers, account for the highest rates of injury and death [Global Chapters 1,3]. Other health hazards include agrichemicals; transmissible animal diseases; toxic or allergenic agents; and noise, vibration, and ergonomic hazards (related to heavy loads, repetitive work, and inadequate equipment). Exposure to pesticides and other agrichemicals constitutes a major hazard to occupational health (and also wider com­munity environmental health), with poisoning leading to acute, sub-acute, and chronic adverse health impacts (e.g., neurotoxicity, respiratory, and reproductive impacts), par­ticularly among vulnerable populations, and to death in­cluding suicide [Global Chapters 2, 3; SSA]. The WHO has estimated that between 2 to 5 million cases of pesticide poi­soning occur each year, resulting in approximately 220,000 deaths. This figure is widely recognized to be an underesti­mate based on empirical research [Global Chapters 2, 3, 7]. Even when used according to manufacturers specifications, following best practice and all protective measures, pesticide exposure cannot be avoided entirely and therefore some ele­ment of risk will remain particularly with highly toxic prod­ucts. This is particularly relevant for developing countries, where conditions of poverty and lack of effective controls on hazardous compounds are the norm [Global Chapters 1, 2, 3]. In less developed countries, the risks of serious ac­cidents and injury from a range of sources are increased, for example, by the use of toxic chemicals banned or restricted in other countries, unsafe techniques for chemical applica­tion or equipment use, the absence or poor maintenance of equipment, and lack of information available to the worker on the precautions necessary for minimizing risks during handling of agrichemicals, livestock, and machinery.
     It is estimated that 70% of all child laborers (150 mil­lion) work in agriculture, which affects education, devel­opment, and long-term health. In addition to improving occupational health and safety, intersectoral action is needed to reduce and protect child labor through mechanisms such as access to education and health, poverty alleviation, and enforcement of child labor laws.

Emerging infectious diseases. Emerging and reemerging in­fectious diseases, including pandemic HIV/AIDS and malar­ia, are among the leading causes of morbidity and mortal­ity worldwide [Global Chapters 1, 3, 5, 6, 8; SSA Chapter 3]. The incidence and geographic range of these infectious diseases are influenced by the intensification of crop and livestock systems, economic factors (e.g., expansion of in­ternational trade and lower prices), social factors (changing diets and lifestyles), demographic factors (e.g., population growth), environmental factors (e.g., land use change and global climate change), microbial mutations/evolution, and the speed with which people can travel around the globe. Serious  socioeconomic  impacts can  arise when  diseases spread widely within human or animal populations (such as H5N1), or when they spill over from animal reservoirs to human hosts; farming intensification often increases these risks. Even small-scale animal disease outbreaks can have major economic impacts in pastoral communities.

Future Challenges and Options for Improving Human Health through AKST

Malnutrition. Adequate nutrition requires a range of inter­related factors to be in place including food security, access to adequate supplies of safe water, sanitation, and educa­tion. AKST should be seen as a primary intervention to improve nutrition and food security, through development and deployment of existing and new technologies for pro­duction, processing, preservation, and distribution of food [CWANA; ESAP; Global Chapters 2, 3, 5, 8; LAC; NAE; SSA]. For example, evidence is beginning to accumulate that breeding biofortified crops may help address some human micronutrient deficiency and improve amino acid composi­tion in major staples; use of targeted fertilizers, such as zinc, selenium, and iodine, on soils low in these essential human nutrients to correct deficiencies. Developing environmen­tally sustainable, food-based solutions to under-nutrition should be a priority. In both local and national food sys­tems, policies and programs to increase crop diversification and dietary diversity will help achieve food security.

Dietary-related chronic diseases. There are well established mechanisms and tools for monitoring community nutrition status. These need to be used systematically to improve sur­veillance systems for both under- and over-nutrition, and of chronic disease rates, to ensure that governments appro­priately address the rapidly changing nature of nutrition-related diseases in each country. Strategies for tackling the rises in overweight, obesity, and non-communicable diseases are needed in all world regions. Policies that simply rely on public health education and changing individual behaviors have  been ineffective.  Tackling nutrition-related chronic disease requires coordinated, intersectoral policy responses that include public health, agriculture, and finance minis­tries, as well as food industry, consumer organizations, and other civil society participation [Global Chapter 3; NAE].
     There  are  often tensions  between  agricultural  food policy and population health improvement goals. Despite claims that consumers determine the market, the actual health needs of consumers are seldom the driving factors in production decisions and agricultural policies [Global