In October 2022, I gave a talk at the Uppsala Health Summit, where I told a story of the food system going from sickness to health. This blog is an adapted and shortened version of the talk, which can be viewed here.

​One day, the food system went to the doctor. Up until then the food system had felt happy. It knew its purpose: to produce as much food as cheaply as possible, as competitively as possible, and to make money for the people who controlled that food system. As the food system liked to say, calories and cash. The food system was tremendously proud of this. Think of all that food, it often thought to itself, flying around the world. Products like wheat and soybeans and corn grown in the places they could be produced most efficiently then exported so people could buy foods more cheaply. A source of economic growth for those countries, a source of profit for the companies involved. Lots of by-products for animals to eat, lots and lots of them. Ingredients that manufacturers could use to create an amazing array of ultra-processed foods that people seem to love. Yes, the food system was very proud indeed. 
 
But something started to happen. The food system began to feel unwell. The muscles of the food system started to weaken. The amount of energy the poor food system had started to decline. The resources it had to make sure enough food could be produced started to dwindle. And the weather started to do all weird things that made it more difficult to produce food. The food system became sick. 
 
So the food system went to see the doctor (quite an unusual doctor). The food system said to the doctor: what’s wrong? And the doctor said: you’re exhausted. You need to take a few years off to regenerate yourself. Otherwise, it’s only going to get worse. The food system said: but I can’t. I need to feed people. If I don’t produce food, people will go hungry. People will die. I can’t afford to take time off to regenerate. And besides, I’m proud of what I do. I work hard. I’m proud that I stop the world from going hungry and help it be healthy by producing all those calories and cash.
 
And the doctor looked hard at the food system and said, listen, I’m sorry to break this to you, but you’ve been working really hard to produce food and it’s actually been making people sick. In fact, most of the people I see are people who’ve been made sick because of food. I see kids who are wasted because they are not having enough food. I see kids who are stunted because they are not having enough nutritious foods. I see people who are ill because of foodborne disease. I see people who are affected by overweight and obesity and are suffering from cancers, from heart disease and hypertension because of the food they eat. And that’s most of the people I see.
 
The food system was shocked. The food system hadn’t realised this. It became sad and started to cry.
 
After a minute or two, the food system, who was good old soul, said, I’ve got to do something about this. What am I wearing myself out for? I am not resilient. I am not sustainable. And I am making people sick. What’s the point? Why bother wearing myself out when I’m not even helping people be healthy? 
 
So the food system said to the doctor, who was wise: what should I do? And the doctor said, well, first of all, remember the reason you’ve become sick is because you failed to see yourself as a whole body. You have not been thinking about all of these different parts of your body in a holistic way. You failed to see that what is produced affects what is consumed. You failed to link your health with your environment and with your economy. So I advise you to think more holistically about the approach you are taking.
 
The second piece of advice I have is this: there are lots of people out there who can help you. There are lots of people who are trying to make change. There are lots of people in all parts of you who can help. Go and gather them together and work together for change. Engage the whole of you while managing these different aspects of your body to move together in forward motion. 
 
Then the doctor said: remember, though, those people will have different interests, incentives, solutions and levels of power. So there’s going to be conflict and disagreement. There’s going to be people pulling at your body in all kinds of different directions. That’s part of the reason you’re facing the problems you’re facing. You need to acknowledge and manage all those tricky power relations and conflict while at the same time make sure that everybody with a stake is involved.
 
So the food system went off and tried to do this. It wasn’t easy. But the food system discovered that once they found ways of working together, people with very differing perspectives managed to come up with shared agendas. They found shared objectives. There was a lot of conflict, but they found a way through. They found places where they could create co-benefits to bring different parts of the system together, to align towards health and sustainability. 
 
Now, after this had been happening for awhile, the food system felt a lot better and went back to the doctor. The doctor examined the food system and said, you know what, you are getting a bit better in different parts of your body. But it’s still a bit isolated, a bit here and there. It’s good here and not so good there. It’s kind of like you’re beginning to regenerate in different parts but it’s not quite the whole yet. And the food system said, well, maybe I need to wait a little longer. And the doctor said, how’s your heart? And the food system said: please examine it and tell me. The doctor examined the food system’s heart and said: there’s something not quite right at the heart of your system. 
 
So the food system thought for a bit: what really is the problem? Why am I still coming up against barriers? Why is it that people are still saying, well, I’m doing this and I’m doing that - but there are all of these things that are trying to stop me and get in the way?
 
To get an answer the food system decided to go and talk to the people who really seemed to be in control: the big corporations of the world, the big governments; the big banks. And the food system realised just how much they had been economically benefitting from the way the food system was designed, and how the costs had been born by the food system getting all exhausted and worn out. The incentives were all wrong, creating economic benefits for some but horrible inequalities for others. So the food system said to these big powerful actors: look, why are you putting all these incentives and policies into place that are making me behave in a certain way? And these big powerful actors said: well, you know, we’re stuck too. Modern forms of capitalism aren’t working for us either. 
 
So the food system said: what can be done to change it? It turned out there was plenty that could be done: financing, competition law, corporate governance, investor metrics, food environment regulation to level the playing field. Once some of these actions started to work, the food system’s heart started to pump in a different way. Things started to flow and connect much better; there were no longer so many blockages getting in the way.
 
The food system realised, too, that it hadn’t yet spoken to the people who eat.. The food system wanted to understand their experience of food, why they eat what they eat, and all the many factors that shape what they eat. The food system realised that unless people had the capacity and opportunity to eat better, there would not be any more demand for the healthier, more sustainable food the food system was now better designed to supply. 
 
So the food system started to speak to the people who eat all over the world and discovered all kinds of possibilities and opportunities to help them eat more healthily and sustainably: actions to help make people more financially secure, to reduce the burden of food work, to improve household and transport infrastructure. There were lots of things to do. There were issues around social norms and networks, around gender. There were issues of access. There were enticements in the food environment that diverted people in the wrong direction. You could do something about that. There were issues of trust and the meanings and status of food. 
 
Wow, there were so many different actions that could be taken to make this happen. And people rolled up their sleeves; they understood their role, they took responsibility and they began to take action and make change.
 
After all of these things started to happen, the food system began to feel a lot, lot better and went back to the doctor and said: I think I’m almost better. The doctor was shocked. The doctor happened to know that they’d been trying to take all of these actions for years. People went to summits, to conferences, did research, undertook all kinds of good things, but change never really happened. The doctor said: what was the magic ingredient? What made this change happen? How come people started to act, accepted their roles, took responsibility, did things for collective impacts? 
 
And the food system thought for a moment and said, well, you know, I did happen to notice there were lots of women in charge. And lots of other marginalised and minoritized groups took power to make decisions too. They were making decisions. And what was really interesting was that they and all the others involved were making decisions in particular ways. They prioritised social purpose over things that matter less to people. They were utterly committed to what they were doing. They persisted in their commitments.
 
Yes, they made mistakes. But they learned from those mistakes. They were happy to talk and be open about those mistakes. They adapted to them. They were happy to stand up, to deviate from the norm. Though they didn’t spend time pushing themselves forward. They were about lifting others up. They listened to unheard voices, listened with curiosity to the people that they even disagreed with. They reflected individually and collectively on what they could do, and they connected with those who they really felt they could work with for collective action. They communicated with each other openly and authentically. In other words, said the food system, it was about leadership. Yes, that was it. That was the magic ingredient: leadership.

With thanks to the Uppsala Health Summit 2022 for inviting me to give this talk, which can be viewed here. The details and other talks at the Summit, which focused on food systems, can be found here. The figure of the food system is courtesy of the Centre for Food Policy. The points made about leadership echo those made in Achieving a Well-Nourished World: A Manifesto for Leadership (Next Gen(D)eration Leadership Collective, 2022).

Food systems decision-making is currently more battlefield than balancing act. This must change. As another World Food Day passes, a new mindset for food systems transformation is needed

​As the current spate of international summits and meetings is making clear, the food system is in a profound state of crisis. At the FAO Asia-Pacific Symposium on Agrifood Systems Transformation I attended two weeks ago, the talk was all of the “4Cs” of conflict, climate change, COVID-19 and cost of living, collectively creating chaos for the “5Fs” of food, feed, fuel, fertilizer and finance. Doubtless the tone was similar last week at the 50th plenary session of the Committee on World Food Security. Coordinating the global policy response to the global food crisis was top of their agenda. 

In his address at another conference in early September, the African Food Systems Forum (AGRF), President Paul Kagame of Rwanda posed the critical question: “How did we get to this point?” Indeed, how did we get to the situation where the system most needed to sustain human life lacks adequate resilience to shocks? Where the billions of people who work in the food system – from farm to supermarket – are so vulnerable? Where despite their fundamental role keeping the food system going, women are marginalised? Where despite huge investment in productivity, millions of people remain undernourished (new estimates out last week showed even micronutrient deficiencies are far higher than previously thought). Where obesity and non-communicable diseases journey relentlessly upward? Where biodiversity, soil and water journey relentlessly down?  And where it seems that every week there is a new flood, hurricane or drought related to climate change? 

In my own presentation to the FAO conference, I tried to come up with some kind of answer. I boiled it down to four aspects of decision-making. First, over past decades, decisions have favoured productivity of low-cost calories over environment, livelihoods and nutrition - delivering calories and cash, not multiple food systems solutions. Second, decisions have favoured food systems globalization without the complementary policies needed to manage risks. Economic development is of course an important goal, but the downsides for livelihoods, land use, obesity and diet-related disease need attention too. Third, decisions were made in siloed spaces about single issues with little consideration for the risks and benefits for other food system objectives. Fourth, decisions were made without understanding the experiences of people affected by the problem, meaning policies and practices are less likely to work on the ground.

​This unholy quaternity of decision-making has meant positive benefits for some dimensions of food systems, but undermined others. Let’s look at some evidence from specific policy decisions:. 

• Government subsidies for fertilizers are associated with higher agricultural productivity, at least in the short-term, and land allocation to staple crops. But they are also associated with draining public budgets, excessive fertilizer use, and less crop diversity. Some benefits for sure, but hardly a route to achieving economic, environmental and nutrition goals.  
• Policies permitting (or failing to restrict) commercialization of collective land and large-scale investments. Yes, these can bring the economic upsides of higher export earnings and competitiveness in international markets. But evidence shows they can also compromise earnings and agency among women involved in production, clearly undermining gender equality.  
• Policies to support rural road development can bring multiple benefits - higher productivity, farm income and diet diversity. But at the same time, they can have negative impacts on wildlife and availability of unhealthy and ultraprocessed foods. 
• Food safety policies can do good not just by reducing the risk of foodborne disease but by increasing trust and acceptability of nutritious foods with upsides for healthy diets. Yet, depending on what they are, they also introduce risks for access and affordability of nutritious foods and for livelihoods of smaller players (e.g. formalization of markets; food safety certification).

There is a certain inevitability to this. The food system is inherently interconnected; there will always be reverberations from any decision elsewhere in the system. The evidence shows, for example, that much needed strategies to protect health and environment create risks too, such as measures to protect the sustainability of marine capture fisheries impact negatively on livelihoods in poor coastal communities, or sugary drinks taxes on the lowest-income families. 

The challenge is how to balance these things out. At the moment, it seems like a game - often times more like a battlefield - of “who is most powerful wins.” What needs to be done if we really are to – as the FAO conference discussed - “transform” the food system to meet multiple goals? There is no easy answer, but rebalancing food systems decision-making is part of it. 

First, decisions should aim to optimise not maximise.  Attempting to balance out the different tradeoffs for economy, livelihoods, food security, environment, nutrition is a tough thing to do. But it is the only way to move towards systems efficiency, rather than maximizing benefits for one goal or stakeholder at the expense of others.

​Second, decision-making should consciously and creatively aim to craft co-benefits, always taking context into account. This is the process of asking the question: how can the policies or actions support other goals as well as their primary intention? Who can benefit and how? What complementary actions are needed to make that happen? There may not be a clear answer but the process of asking the question itself, with the right people in the room, could lead to creative, innovative ideas and solutions and a sense of a shared agenda. 
 
Third, decision-making needs to engage the sectors and institutions with a stake in the outcome, in whatever appropriate form that takes.  This is needed not only to better understand how decisions might affect others and spark innovative solutions, but also to manage the inevitable conflict and ever present power relations.
 
Fourth, decision-making should always consider the experiences of those affected. That’s where the tradeoffs are experienced and, therefore, can be really understood. The voice of the people who have to live with the upsides and downsides of decisions on the ground must be heard if the system is to be more of a balancing act than the battlefield it is now.
 
Making decisions differently for food systems transformation will take a new mindset. It will mean embracing uncertainty and an ever-ongoing process of reflecting, learning and adapting. Balancing rather than battling may sound rather timid, compromising, even weak. Too much being nice. Yet if we are to learn the lessons from the past,  we need to recognise that we got to this point by failing to balance. And it will take courage for the powers that be to see the whole system for what it is. It will take courage, not timidity, to skilfully manage the conflict, create a sense of collective problem-solving and make different decisions.

​The thoughts aired in this blog benefited from three pieces of work conducted at the Centre for Food Policy: Taking a Food Systems Approach to Policymaking, in collaboration with R4D; Aligning Food System Activities with Healthier Diets for Low-Income Households: A Guidance Note, commissioned by the UK Foreign, Commonwealth and Development Office;  and (as yet unpublished) a project funded by the Swiss Agency for Development and Cooperation to identify environmental actions in food systems, in support of the Food Systems Dashboard.