Event: Public-Private Partnerships and the Nutrition Agenda: Challenges and Opportunities

On Tuesday, October 31, A4NH hosted a conversation about the challenges and opportunities for public and private-sector actors in improving nutrition, including where there are openings for working together in new and innovative ways.

How can the private sector's expertise be leveraged to improve nutrition for consumers worldwide? How can private sector business leaders be involved in the policy conversation to bring their perspectives to the fore? How can the public sector work collaboratively with the private sector to promote much healthier food options?

Given the nature of food systems today, the private sector plays a significant role in determining the quality and costs of food options offered for sale to consumers at all income levels. By working with the private sector, policymakers seeking to improve nutrition can address a host of opportunities for market innovation and change. The tensions between organizations prioritizing profit motives and those promoting public health must be recognized in order to identify areas where collaboration, including through public-private partnerships, is possible and even desirable. To delve into this topic, the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) convened a discussion which brought together researchers, policymakers, and industry experts to outline the situation, and explore options for moving forward.

A4NH Director John McDermott (presentation) opened the session by framing the issues. He acknowledged the conflicts that have arisen in the past as private sector food solutions were found to be inconsistent with good science and public health goals. For example, private sector initiatives to provide breast milk substitutes, to add sugar for consumer appeal, and to use ultra-processing have not been viewed by the public health community as supportive of nutritional goals. However, he noted, one very successful area of partnership has been food safety; this offers hope for further positive collaborations in the future.

A4NH is particularly focused on the food systems and nutritional challenges of low and middle-income countries, McDermott noted. These countries are changing rapidly, with food system transformation being shaped by consumer demands associated with rising incomes, greater urbanization, and integration into regional and global markets. These dietary changes are having an impact on all forms of malnutrition (undernutrition, micronutrient deficiencies, and overweight and obesity) and a rise in the prevalence of noncommunicable diseases of concern to the public health and medical communities. To better align dietary trends with the goals of improved nutrition and health, public and private sector actors alike will need to consider the affordability of food, changing food preferences, sustainability of production systems, the efficiency and reach of value chains, and individuals' needs for nutrients.

With this framing, Derek Headey, Senior Research Fellow, Poverty, Health and Nutrition, International Food Policy Research Institute (presentation), provided remarks on food consumption patterns and prices in low and middle-income countries. As incomes rise, he noted, consumption of processed food also rises, in both rural and urban areas. However, people in urban areas already purchase large amounts of processed foods, regardless of income level. He drew attention to the problem of low dietary diversity among infants, which highlights the challenge poor households face in purchasing healthy and fortified complementary foods: in India, he said, a calorie of fresh milk is six times as expensive as a calorie of rice.

Following these remarks, Michael Taylor, a consultant with the Global Food Safety Partnership at the World Bank, drew upon his experience at the US Food and Drug Administration, noting that FDA has worked on nutrition and food safety for decades, making major advances because of public-private partnerships. He observed that these partnerships tend to work when consumers express demand for a public good, such as nutrition and menu labeling, and there can be strategic alignment between the government and the private sector. Taylor concluded by saying he believes much of the food safety work ahead in Africa will rely on strengthening public-private partnerships.

Rebecca Hamel, with the Alliance for Food and Health and Managing Director of Georgetown Resource Mobilization wrapped up the first panel discussion by sharing her perspectives and experience in the private sector working with nonprofits. She cautioned that the private sector should not be considered as one monolithic entity, and that it’s important to remember that the perspectives are often more similar than we think. The private sector has many priorities, she said, not just resources or profits. She also suggested framing public-private partnerships as “multi-stakeholder” partnerships, that include the private sector, government, and NGOs.

The second portion of the discussion shifted to consider experiences and lessons in private sector engagement. To set the stage, Nelly Fezé, Senior Industry Specialist for Global Agribusiness with the World Bank Group’s International Finance Corporation (IFC), laid out the wide range of needs companies have, with diverse business models and at varying stages of development. Their situations in each of these areas dictate what tools they have at their disposal, and what investments are needed. Accordingly, there are different investment strategies for different firms and development stages. She illustrated this by providing examples of where IFC operates, what circumstances they work with, and why business sustainability, which varies with context, is of utmost importance.

Fezé’s remarks were followed by a series of invited short responses on experiences with public-private partnerships from across the spectrum of sectors involved in nutrition. Inge Brouwer, Associate Professor of Nutrition at Wageningen University & Research (WUR) and leader of A4NH’s flagship research program on Food Systems for Healthier Diets, commented on challenges in managing differences between public and private sector procedures, including communications and speed in decision making and executing procedures. She also stressed the need for clarification of roles and responsibilities in partnerships, including for risk mitigation and exit strategies. Victor Manyong, Agricultural Economist with the International Institute of Tropical Agriculture (IITA), framed his remarks around IITA’s experiences with Alfasafe®, a biocontrol product they have developed. Their efforts to expand access to the product across Africa and parts of Asia have raised questions around trade and marketing issues that might benefit from public-private partnerships.

Presentations from differing perspectives were a hallmark of this discussion. Kristen Scott, Director of Health and Nutrition Policy at the Grocery Manufacturers Association, shared U.S.-based experiences with front-of-pack labeling and their partnership work, including with Share Our Strength to increase label usage among low-income families. Harley Stokes, Food Security Policy Analyst with Catholic Relief Services (CRS), then offered an international perspective, citing CRS’s experiences working with small-business owners in Kenya. Djeinam Toure, Senior Associate for Monitoring, Learning, and Research for Agriculture with the Global Alliance for Improved Nutrition observed that most enterprises in sub-Saharan Africa are small and medium scale, and offer unique opportunities for partnerships in supporting and shaping food market environments. Shifting views to Asia, Eric Trachtenberg, Director of the Food & Agriculture Sector with McLarty Associates, profiled the growth in the cold chain in China, as government and private-sector interest in improving this area came together. Benjamin Uchitelle-Pierce, Program Analyst with HarvestPlus, wrapped up this portion of the program by highlighting the need for understanding demand, as HarvestPlus has experienced in its efforts to drive seed adoption and increase consumption of biofortified foods.

During an open discussion, moderated by Ruerd Ruben, Research Coordinator of Food Security, Value Chains, and Impact Analysis at WUR, audience members and panelists alike grappled with issues including defining, reaching, and educating consumers across the income spectrum; incorporating dietary quality and guidelines; and creating a systematic way for the public and private sectors to communicate and work together.

What the session made clear, noted Emmy Simmons, former Assistant Administrator at the United States Agency for International Development, in her closing remarks, was that this must be just the start of the conversation – that the many issues and experiences raised during the day’s discussion highlight the urgent need to continue the dialogue to facilitate collaborative approaches for improving food systems and nutrition worldwide.