As food security becomes better assured, and food supply more complex, the negative impacts of food production become more salient. Agri-food systems support life but can also contribute to poor health outcomes of both producers and consumers and have negative impacts on the environment. Environmental issues include pollution due to intensive farming systems (water pollution with excess use of pesticide and chemical fertilizers), climate change (GHG emission), and land degradation and erosion (Perry et al. 2013; Herrero and Thornton 2013).
Adverse human health issues include zoonotic diseases, antimicrobial resistance (AMR), occupational disease, unsafe food, and unbalanced diets causing malnutrition. Millions of people die from diseases that emerge from, or persist in, agricultural ecosystems: zoonoses (diseases transmissible between wildlife and domestic animals and human) and diseases recently emerged from animals make up 25% of the infectious disease burden in least developed countries and kill one in ten people who live there (Grace et al. 2012). Other urgent health problems related to agriculture include fungal toxins (mycotoxins) in crops and animal source foods, plant toxins, use of wastewater for agriculture, misuse of agricultural chemicals, and antibiotics, food adulteration, occupational hazards of food value chains; contribution of agriculture to climate change and impacts of this on disease; and health impacts of agricultural alteration of ecosystems (such as irrigation practices that promote malaria).
Agricultural systems are exacting a heavy biological cost, but health policy and programs often stop at the clinic door while agriculture initiatives rarely have ‘enhancing health’ as an articulated objective. A consensus is growing that the disconnect between agriculture, health, and nutrition is at least partly responsible for the disease burden associated with food and farming. The new CGIAR Research Program on Agriculture for Nutrition and Health is attempting to bridge this disconnect (A4NH 2018). A4NH, an Integrative Research Program, responds to the global challenge of improving food security, nutrition, and health, by taking a perspective that begins with consumption, rather than supply, of healthy, affordable, and safe foods.