Food systems are changing rapidly in low- and middle-income countries. These countries seek food-based solutions for better nutrition and health of all people while addressing challenges of sustainability, inequity, and malnutrition. The CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) works to develop evidence to support policies and actions for healthier food systems. A4NH is a consortium of seven managing partners, led by the International Food Policy Research Institute (IFPRI). This report summarizes 2019 research results from A4NH, across five research flagships, and highlights the partnerships through which research has led to outcomes in five focus and more than two dozen other partner countries.
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The urgency to transform food systems for healthier diets is growing, reflecting worries about current systems’ performance. But there is still much uncertainty about how to make these transformations, particularly in low- and middle-income countries, given that the existing systems are changing rapidly. A4NH’s experience in this field has made the Food Systems for Healthier Diets (FSHD) flagship a critical resource for stakeholders at all levels. To best share A4NH-supported food systems thinking as the CGIAR research portfolio evolves, researchers are systematically documenting lessons learned in work with current partners, while actively engaging others in shaping food systems for healthier diets. From generating systematic assessments of innovations and interventions to building awareness of and capacity to use food systems approaches through targeted trainings with national policymakers, local MSc students and advisors, and global stakeholders, A4NH remains at the forefront of food systems research. Researchers continue to focus on developing food system governance and on how transformations take place, carefully building understandings of consumer perspectives, and on the critical importance of partnerships. This flagship is led by Wageningen University & Research (WUR) with support from the Alliance of Bioversity International and the International Center for Tropical Agriculture (CIAT), the International Food Policy Research Institute (IFPRI), and the International Institute for Tropical Agriculture (IITA).
Promoting Food Systems Research Across CGIAR
A4NH has been on the forefront of food systems research and, as interest in this subject gains momentum worldwide, is using the experience built by the program’s researchers to foster collaboration across CGIAR. In doing so, A4NH researchers are guiding future food systems work, rooted in strong partnerships and addressing the global sense of urgency, to develop strategies that will lead to systemwide improvements with real impacts for consumers in low- and middle-income countries.
Events convened with scientists from across CGIAR, consultations for CGIAR Centers and other research programs, and workshops on critical topics such as the food environment are shaping and informing how CGIAR approaches food systems research. A growing collection of tools, such as a compendium of indicators and country food system briefs, accessible online through the new Food Systems Resource Center, combined with guidance based on years of experience and deep partnerships, will be critical as the system prepares to enter its next phase of research.
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Empowering Stakeholders for Country-Level Action
In 2019, A4NH continued its work in building capacity and empowering stakeholders at the national level to undertake critical work toward building food systems that support healthier diets. A key component of country ownership and leadership of food system transformation is to build the capacity of national researchers to ask relevant questions and conduct research to address them. In Ethiopia, the first two groups of MSc students to receive financial and mentoring support from FSHD completed their work. Another group of students completed their work in Viet Nam, while researchers there also worked with national policymakers and other stakeholders in pursuit of the country’s Zero Hunger National Action program. Students from the University of Ibadan in Nigeria were trained to lead a course on food systems, which they helped design, to roll out in 2020. In Bangladesh and Viet Nam, local researchers teamed up with FSHD researchers to publish analyses of each country’s food system, while in Bangladesh, a new MSc grant scheme, in partnership with icddr, b, will soon begin accepting applications.
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Promoting Transformation Through National Information Systems
In the flagship’s third year, numerous research projects came to fruition, resulting in a new set of resources and innovations for stakeholders to draw upon at every level of food system transformation. Researchers shared new knowledge on where critical data gaps lie in focus countries; a global map of food systems sustainability based on 20 indicators across 97 countries; progress in the development of food-based dietary guidelines for Ethiopia; an analysis of how food systems are transforming in rural, urban, and peri-urban sites in Viet Nam; and ways to improve fruit and vegetable consumption in Nigeria and Viet Nam. They also identified what key parts of food systems research still lack critical knowledge, including the interaction between the food environment and consumer behavior, and identified ways to begin to fill such gaps.
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Staple crop biofortification is now widely recognized as a cost-effective, sustainable, and scalable element in strategies to address micronutrient deficiency—or “hidden hunger”—among smallholder farming families and other low-resource populations. More than two billion people currently suffer from hidden hunger, which can increase susceptibility to infections and diseases and can cause stunting, anemia, impaired vision, and even death. HarvestPlus leads A4NH work on developing and promoting staple crops rich in iron, zinc, or vitamin A. In 2019, HarvestPlus collaborated with CGIAR and national agriculture research centers to release 27 new biofortified crop varieties, bringing the total released to date under HarvestPlus’s leadership to 238 varieties of 11 staple crops. These crops benefited an estimated 42 million members of smallholder farming families in 2019. HarvestPlus also supported partners in multiple sectors worldwide to catalyze scale-up of biofortification through public policy and private sector initiatives. New research expanded the nutritional evidence base for biofortification.
Research to Inform Action
An expanding evidence base on the nutritional and health benefits of biofortification, as well as research on delivery models for biofortified crops, provided further critical support for policy and programmatic action. A study in Mozambique, published in the British Journal of Nutrition in 2019, evaluated the impact of a project that introduced vitamin A orange sweet potato vines and cultivation training in a given area, three years after project implementation had been completed. The study showed that the project had sustained impact on vitamin A intakes among participating families beyond the project end date. In a study in Rwanda, iron-deficient women who consumed iron beans twice a day for 18 weeks were found to experience not only improved iron status but also improved ability to conduct everyday physical tasks. This was the first study to show that a solely food-based nutrition intervention (as opposed to taking supplements) led to an improvement in subjects’ “work efficiency”—the amount of energy needed to perform light tasks.
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Engaging the Private Sector
Private sector engagement in the seed sector is key to ensuring a sustainable supply of biofortified seed for smallholder farming families; in addition, engaging food sector businesses helps generate demand for biofortified crops so farmers are able to sell surplus for income. HarvestPlus provides capacity strengthening and technical assistance to hundreds of small- and medium-sized enterprises in Africa, Asia, and Latin America to support their work in biofortified seed and food value chains. In April, about 60 food industry representatives and business leaders from key grain value chains gathered in New Delhi to brainstorm ways to create markets for biofortified foods and stimulate Indian farmers’ biofortified crop supply. In November, at HarvestPlus Nigeria’s annual Nutritious Food Fair, food companies showed how they source biofortified ingredients from smallholder farming families. Oluwatoyin Onigbanjo, CEO of infant food company AugustSecrets, described how she uses biofortified maize in cereal products and engages a 1 million-strong community of mothers on the value of nutritious foods.
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Reaching the Most Vulnerable
The Mutwales, a family of seven from the Democratic Republic of Congo, live in the Meheba refugee camp in Zambia’s Northwestern province. They are also one of 105 refugee families participating in an initiative to help them cultivate nutritious vitamin A maize developed by the International Maize and Wheat Improvement Center (CIMMYT) in partnership with HarvestPlus. This is one example of how HarvestPlus and partners are able to deliver nutrition to some of the world’s most vulnerable populations through biofortified crops. Similarly, in partnership with Self Help Africa, more than 1,000 households in eight refugee settlements in northern Uganda are being introduced to cultivation of vitamin A orange sweet potato and iron-biofortified beans. Meanwhile, in the impoverished Indian state of Bihar, which has the country’s highest rate of stunting, two varieties of zinc wheat seeds were officially introduced on the market in 2019; zinc wheat is now expected to reach more than one million farming households in Bihar over the next five years.
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As countries move through food system transformations, not only does the focus shift from achieving food security to ensuring food safety, but also diets grow more complex and diverse, with food traveling greater distances from where it is grown. Identifying and mitigating food safety risks becomes increasingly important. From controlling aflatoxins to identifying risks along supply chains to working to ensure quality standards in informal markets, A4NH’s third flagship works to ensure policymakers, the private sector, and other stakeholders have the tools they need to take action as food systems evolve. This flagship is led by ILRI with support from IITA and IFPRI.
Supporting International Developments in Food Safety with Quality Research, Engagement
As food safety has become more prominent on the international development agenda, A4NH has provided research into the largely ignored role of food safety in informal markets, where many poor people buy and sell fresh foods. Researchers have been able to provide high-quality research and relevant trainings. In 2019, a major training effort in Cambodia offered researchers and practitioners practical tools and skills to understand food safety in increasingly complex food systems. At the first WHO/FAO/AU International Food Safety Conference in Ethiopia, the important task of working with producers, market agents, and consumers to improve food safety and livelihoods in informal markets was highlighted. A4NH researchers also contributed to the evolving discussion on food safety in Africa, through the African Union and other platforms.
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Proving Efficacy of Nigeria’s Aflatoxin Biocontrol Product: Results from a 10-Year Study
An A4NH-supported partnership led by IITA has developed, tested, and adapted aflatoxin biocontrol for Africa south of the Sahara for more than 18 years. In 2019, the team published a landmark journal article reporting on a 10-year study in Nigeria on the efficacy of Aflasafe®, a registered biocontrol product for aflatoxin management. This is the longest-running, most extensive study on efficacy of any biocontrol product or management practice for aflatoxin mitigation, combining results of efficacy trials required for registration with data from both large-scale trials to demonstrate product value and commercial use by thousands of maize farmers. The study firmly establishes Aflasafe® as a vital tool in the fight against aflatoxins.
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Developing a Food Safety Index for Africa As food systems transform and agricultural systems develop, countries need data-based evidence on their performance in critical areas such as food safety. With encouragement from A4NH researchers at ILRI and others, and support from a multidisciplinary team led by the Partnership for Aflatoxin Control in Africa (PACA), which included ILRI researchers, the African Union (AU) included a new Africa Food Safety Index in the second Comprehensive Africa Agriculture Development Programme (CAADP) Biannual Review in 2019. With a strong response rate from member states, researchers are working as part of a team to evaluate and validate the index for robustness and usefulness to AU and to each of its member states.
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Addressing malnutrition in all its forms, from undernutrition and micronutrient deficiencies to the growing global crisis of overweight, obesity, and associated noncommunicable diseases, requires a broad approach. A4NH’s fourth flagship works with a wide range of partners at all levels to build the evidence base to identify actions needed to address the presence of multiple forms of malnutrition, not only within the same countries but also within the same households and individuals. From this strong knowledge base, researchers work with policymakers to identify appropriate solutions to improve nutrition outcomes and to build an enabling environment so that those solutions may take hold. This flagship is led by IFPRI with support from Bioversity International and the Institute of Development Studies.
Critically Reviewing the Global Focus on Stunting
Over the past decade, stunting has become a global development objective. Without question, this focus has done considerable good, helping illustrate and communicate the consequences of undernutrition and providing incentives for policymakers and donors to develop and fund interventions, programs, and policies aimed at reducing the prevalence of stunting. A new A4NH study by IFPRI researchers challenges the assumptions underlying the attention to stunting and stresses the need to focus on more specific nutrition outcomes. Addressing stunting alone will not address other development issues linked to malnutrition such as delayed child development, reduced productivity and earnings in adulthood, and higher incidence of chronic diseases. Stunting is best seen as an indicator of a set of problems that needs solving, rather than stunting being the problem to solve itself.
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Engaging in Global Conversations on Food Systems, Nutrition, and Diets
In 2019, A4NH researchers worked closely with global consortia and organizations, and presented at numerous key international nutrition gatherings, to provide guidance on nutrition, equity, and other critical issues. A publication coauthored with the World Food Program (WFP), which explains the process to develop WFP’s nutrition-sensitive guidance, is now being used to design and redesign programs globally. The Scaling Up Nutrition (SUN) Movement is adopting the A4NH-developed multisectoral engagement toolkit and, with input from SPEAR researchers, plans to review and revise its private sector guidelines. A4NH researchers also participated in SUN and CGIAR events at the Eat Forum and at a follow-up CGIAR event at the Committee on World Food Security, where they discussed issues ranging from how to incorporate a strong food system and gender perspective in policy to healthy diets and food system transformation in low- and middle-income countries.
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Building Capacity at the National Level to Address Malnutrition
Under SPEAR, A4NH researchers continue to provide critical forums and tools to support national program design and policy development that address malnutrition in all its forms. In 2019, Transform Nutrition West Africa held capacity strengthening short courses, including its first francophone course, in collaboration with the African Nutrition Leadership Programme, while the Stories of Change initiative engaged with stakeholders on policy analysis in countries across Africa and South and Southeast Asia. Practical project design guidance on nutrition-sensitive value chains, developed by A4NH researchers in collaboration with IFAD, reached wider audiences, adding guides in French and Spanish to the English version published in 2018.
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At the core of A4NH’s research strategy is the understanding that agriculture, nutrition, and health are firmly linked, and that development in one area connects with and has impacts on the others. As agricultural intensification and livestock production transform landscapes globally, they also impact human health, from the way diseases emerge and spread to how communities respond and protect themselves to growing multisectoral threats like antimicrobial resistance. A4NH’s fifth flagship focuses on the intersection of agriculture and health, with an eye toward understanding their impacts on one another, identifying interventions to reduce disease risk and improve human health, and fostering a collaborative environment across sectors for future research in this critical area. This flagship is led by the London School of Hygiene and Tropical Medicine (LSHTM) and ILRI, with support from IITA.
A4NH Joins Partners to Launch New CGIAR Antimicrobial Resistance Hub
Antibiotics and other antimicrobial drugs are among the most important tools available to medical and veterinary professionals for curing human and animal diseases and improving human and animal welfare, yet these drugs are increasingly failing. Development of resistance to these drugs in disease-causing bacteria and other microbes poses a major threat to global development; the World Bank estimates it could reduce annual global GDP by more than US$1 trillion by 2030. To combat this growing threat, A4NH joined a coalition of other CGIAR Centers and CGIAR Research Programs to form the new CGIAR Antimicrobial Resistance Hub. Through the Hub, researchers will work to foster learning from past experiences, support research excellence in the Global South, and ensure a critical mass of coordinated research to find suitable and sustainable solutions.
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Harmonizing Agricultural Intensification and Climate Change Mitigation
Climate change and food security are often seen as problems that compete for attention, rather than opportunities for collaborative thinking and strategies to address both. As rice growing intensifies in Africa, and irrigation schemes expand to accommodate it, is it possible to find rice-growing methods that can reduce both the production of greenhouse gases, particularly methane, and the proliferation of malaria-transmitting mosquitos that often accompanies rice intensification? A4NH researchers have been working with AfricaRice in Côte d’Ivoire in West Africa on cutting-edge research to address these issues together, and plan to initiate collaboration with the International Rice Research Institute in East Africa in the coming year. The objective is to develop “win-win-win” interventions minimizing both greenhouse emissions and mosquito breeding while improving rice yield. In the longer run, the aim is to ensure that, from now on, measures to avoid the unintended and harmful side effects will be built into the development of new rice-growing methods, and new rice-growing schemes, in Africa.
Connecting Research with Policy to Achieve Results on Critical Diseases
In 2019, A4NH researchers supported policy development to help reduce the impacts of numerous tropical diseases on health. Researchers convened high-level stakeholders with the national neglected tropical disease task forces in Kenya and Rwanda for discussions on the prevalence, distribution, and burden of cysticercosis in smallholder livestock systems, resulting in national prioritization of this issue. They also worked with policymakers in Kenya on a draft national policy document on brucellosis diagnosis and control, held a national-level meeting of public sector stakeholders in Kenya to disseminate value chain and transmission mapping of zoonotic diseases, with workshops for dairy and meat industries, and developed a statistical model for forecasting dengue fever incidence in Viet Nam.
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Issues of gender, equity, and empowerment are so central to all aspects of the A4NH research portfolio that they are addressed as a Cross-Cutting Unit of the program. This approach enables the team to support researchers across A4NH as they seek to incorporate and address issues of equity related to gender, age, geography, and social standing, among others, in their work.
Impact of Pro-WEAI grows
In 2019, the Gender, Agriculture, and Assets Project, Phase 2 (GAAP2), which aims to develop quantitative and qualitative tools to measure women’s empowerment in agricultural development projects, moved forward with the release of the pilot version of the project-level Women’s Empowerment in Agriculture Index (pro-WEAI). Pro-WEAI is the first comprehensive, standardized tool for measuring women’s empowerment in agriculture at the project level. The team conducted trainings on the tool at the Seeds of Change gender conference in Canberra, Australia, and at the Agriculture, Nutrition, and Health Academy Week in Hyderabad, India. Pro-WEAI’s development was chronicled in a paper published in World Development in October, which helped build momentum and awareness as the overall suite of WEAI tools reached 100 users.
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Empowering New Veterinarians in Malawi to Incorporate Gender and Equity into Their Work
A4NH’s mandate to develop capacity and ensure that gender and equity are considered in agriculture, nutrition, and health work involves supporting researchers to include these issues in all stages of their work. In 2019, researchers at the International Livestock Research Institute developed and implemented a two-day training, with the support of A4NH, for the first class of veterinarians at Malawi’s University of Agriculture and Natural Resources. The training improved the new veterinarians’ understanding of equity issues in veterinary medicine and how inequalities affect the livestock owners and managers with whom they will interact. The students also learned about practical examples and received suggestions on incorporating gender and equity considerations into their work. This knowledge can be put to immediate use in the research proposals they are currently preparing.
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Analyzing Equity in Agriculture, Nutrition, and Health Research
To understand what is needed to tackle different aspects of inequity in agriculture for better nutrition and health, it is critical to identify what research already exists and what is missing. Doing so will help identify how issues of marginalization and inequity are addressed in research and are shaping progress toward better nutrition. To this end, researchers at the Institute of Development Studies, supported by A4NH, undertook a scoping review of existing academic literature to pinpoint knowledge gaps that are preventing researchers, policymakers, activists, and others from ensuring that, as the UN Sustainable Development Goals stress, no one is left behind.
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