The Day the Food System Went to the Doctor

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).