54 | IAASTD Synthesis Report

the problem between and within countries. Between 1981 and 2003, 97 developing and 27 transitional countries had a poor Global Hunger Index [GHI].12 [Global Chapter 2] In Africa, particularly sub-Saharan Africa, chronic food short­ages meant that trends in malnutrition continued or wors­ened over the past decades [SSA Chapters 1, 2, 3].
     Although the world food system provides an adequate supply of protein and energy for over 85% of people, only two-thirds have access to sufficient dietary micronutrients [Global Chapters 1,3]. The supply of many nutrients in the diets of the poor has decreased due to a reduction in diet diversity resulting from increased monoculture of staple food crops (rice, wheat, and maize) and the loss of a range of nutrient dense food crops from local food systems. Micro-nutrient deficiencies lower productivity, in both developed and developing countries, due to compromised health and impaired cognition. [CWANA; ESAP; Global Chapters 1,2, 3; LAC; SSA].

Dietary-related  chronic  diseases.   The   success  of AKST policies and practices in increasing production and in new mechanisms for processing foods have facilitated increas­ing rates of worldwide obesity and chronic disease through negative changes in dietary quality [Global Chapters 1, 2, 3, 6; NAE]. Worldwide changes in food systems have re­sulted in overall reductions in dietary diversity, with low population consumption of fruits and vegetables and high intakes of fats, meat, sugar and salt [Global Chapters 1, 2, 3; NAE]. Poor diet throughout the life course is a ma­jor risk factor for chronic diseases (including heart disease, stroke, diabetes and cancer) [Global Chapters 1,3,6; NAE Chapter 2] that comprise the largest proportion of global deaths. Together with environmental factors such as rapid urbanization which result in increased sedentary lifestyles (motorized transport, etc.), dietary changes contribute to continuing global increases in chronic diseases, overweight, and obesity affecting both rich and poor in developed and developing countries. The most dramatic rises in obesity are now occurring in low- and middle-income countries [Global Chapters 1, 2, 3; NAE Chapter 2]. These nutrition-related chronic  diseases coexist with  under-nutrition in many countries causing a greater disease burden in lower income countries [Global Chapters 1, 2, 3]. Unless action is taken to reduce these trends, all countries will see an in­crease in the economic burden due to loss of productivity, increased health care and social welfare costs that are al­ready seen in developed countries [Global Chapter 3; NAE]. Many national and international actors have been slow to understand and adapt their policies to address these world­wide changes occurring in diet, nutrition, and their health impacts [Global Chapters 1, 2, 3; NAE Chapter 2].
     Policies, regimes and consumer demands have tended to increase production (especially in the US and Europe) of, and processing incentives for, foodstuffs that are risk fac­tors for chronic disease (high fat dairy, meat, etc.) [Global

12 GHI captures three equal weighted indicators of hunger: insuffi­cient availability of food [the proportion of people who are food en­ergy deficient]; short fall in nutritional status of children [prevalence of underweight for <5 years old children] and child mortality [<5 years old mortality rate] which are attributable to undernutrition.


Chapter 3; NAE Chapter 2]. AKST has focused on adding financial value to basic foodstuffs (e.g., using potatoes to produce a wide range of snack foods). This has resulted in cheap, processed food products with low nutrient density (high in fat, refined sugars and salt), and that have a long shelf life. Increased consumption of these food products that are replacing more varied, traditional diets, is con­tributing to increased rates of obesity and diet-related chronic disease worldwide. This has been exacerbated by the significant role of huge advertising budgets spent on unhealthy foods. There are a few examples of agricultural food policies that have been developed due to population health concerns; e.g., formation of the EU common agri­cultural policy whose original objectives included food security. In contrast, recent national and international ag­ricultural trade policies/ regimes have not addressed the changing global health challenges and do not have explicit public heath goals.

Food safety. Although subject to controls and standards, globalization of the food supply, accompanied by concen­tration of food distribution and processing companies, and growing consumer awareness, increase the need for effec­tive, coordinated, and proactive national food safety sys­tems [CWANA Chapter 5; ESAP Chapters 2, 3, 5; Global Chapters 2, 3, 5, 6, 7, 8; LAC Chapter 1; NAE Chapters 1, 2; SSA Chapters 2, 3]. Issues include accountability and lack of vertical integration between consumers and producers. A food hazard is a biological, chemical, or physical contami­nant, or an agent that affects bioavailability of nutrients. Food safety hazards may be introduced anywhere along the food chain with many hazards resulting from inputs into production and handling of commodities [Global Chapter 2]. As food passes through a multitude of food handlers and middlemen over extended period of time through the food production,  processing,  storage,  and  distribution  chain, control has become difficult, increasing the risks of exposing food to contamination or adulteration. Concerns that could be addressed by AKST include heavy metals, pesticides, safe use of biofertilizers, the use of hormones and antibiotics in meat production, large-scale livestock farming and the use of various additives in food-processing industries. In gen­eral, developed countries, despite long food chains, guar­antee a high level of consumer protection of imported and domestic food supplies; the capacity and legislative frame­works of public health systems quickly identify and control disease outbreaks. In developing countries, safety concerns are compounded by poverty; inadequate infrastructure for enforcement of food control systems; inadequate social ser­vices and structures (potable water, health, education, trans­portation); population growth; high incidence and preva­lence of communicable diseases including HIV/AIDS; and trade pressure [CWANA Chapter 5; ESAP Chapters 2, 3, 5; LAC Chapter 1; NAE Chapters 1, 2; SSA Chapters 2, 3].
     AKST control of food contamination creates social and economic burdens on communities and their health systems through market rejection costs of contaminated commodi­ties causing export market losses, the need for sampling and testing, costs to food processors and consumers, and associ­ated health costs [Global Chapters 2, 5, 7, 8]. The incidence of foodborne illnesses caused by pathogenic biological food