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Option F: Food and Health

1. Measuring food and health

Food & Nutrition Indicators

Global Patterns
- 850 million people worldwide suffer from severe undernourishment, 820 of which live in the
Southern Hemisphere
- 80% of the undernourished population consists of farmers and their families
temporary hunger → a short term need for food triggered by psychological responses where there is a
desire for food and absence of food
chronic hunger → an extreme desire of food due to prolonged food deprivation, affecting normal
bodily functions

Global Food Security Index (GFSI)

- the affordability, availability and quality of food, with 28 indicators across 113 countries
- adjusts for a country’s resilience and adaptability to climate change

Global Hunger Index (GHI)

- 3 dimensions equally weighted: inadequate food supply, child mortality, child
undernourishment
- indicators: undernourishment, under-five mortality rate, wasting, stunting
→ wasting: acute short-term malnutrition (low weight)
→ stunting: long-term malnutrition (small height)
- children are the most sensitive to nutritional deficiencies, these indicators consider quality of
diet beyond caloric availability

Calories Per Capita

- the average daily per capita caloric supply in kilocalories/person/day
- shows quantity of food but not a nutrition balance between carbs, proteins, fats
- creates a standardised amount of calories needed regardless of demographic
differences, making comparing countries difficult
- whole of Europe 3,750 kcal/capita vs. 1750 in Central Africa

Health Indicators
HALE (health-adjusted life expectancy)
- the average number of expected years of life equivalent to years lived in full health.
- Calculated using life table (probability of dying, death rate, # of survivors)
Advantages:
- Creates a measure of disease/disability within the population and the relative harm it causes
- Overall picture of mortality and life-expectancy, more specific than ‘regular’ life expectancy
Disadvantages:
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- raises questions about how disability (‘less than perfect health’) is defined and measured

IMR (infant mortality rate)

- The number of infant (>1 year olds) deaths per 1000 live births
- ([#deaths / live births] *1000 per year)
- a country’s data collection practices & discrepancies should be understood before using IMR as
a holistic indicator
Advantages:
- an effective measure of a country’s healthcare and healthcare education
Disadvantages:
- measurements skewed by miscarriages, stillbirths, health complications from premature
births
- - each country calculates and defines live births & infants differently

Maternal Mortality
- The number of women who die from pregnancy-related causes per 100,000 live births
- data collected from civil registration systems
Advantages:
- links hygiene, quality of healthcare and survival of mothers as an indication of post-pregnancy
care, education and facilities of the country
- strong correlation between economic development and maternal mortality
Disadvantages:
- birth data unreliable, especially in LICs (home births)

Access to Sanitation
- WASH (water, sanitation and hygiene)
- Classified into basic, limited & no service
- not direct indicator of health, instead shows how external conditions might lead to health
Advantages:
- types of sanitation levels are clearly defined
- household questionnaires include both qualitative and quantitative data
Disadvantages:
- waste treatment in poor urban areas difficult to quantify

Physician to Population Ratio

- The number of physicians per 1000 people in a population
- can include practicing physicians or all registered physicians, generalists or specialists
Advantages:
- definition of physician reasonably clear
Disadvantages:
- fails to consider traditional or paramedical medicine
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- data comparability is limited by differences in definitions and training of medical personnel

varies.

The Nutrition Transition

- The changes in food consumption patterns as income increases in LICs, where populations
transition from large carbohydrate, small fat and protein proportions to a better balance
between carbs, fat and proteins.
- An overall shift towards affluent food consumption patterns - small increases in
income lead to large increases in calorie intake
- Reflects a strong positive relationship between level of income and consumption of
animal protein, negative relationship with staple foods
Malnutrition
- a state of poor nutrition resulting from a deficiency of proteins, energy or minerals that can
lead to a range of diseases
- Not always a result of the lack of access to food, rather the quality and variety of food.
Famine
- a legal definition required to declare a state of emergency in a country
- acute malnutrition exceeds 30% among children
- More than 2 people per 10,000 dying per day due to a lack of access to food

Impacts of Hunger
- organ failure, muscle weakness, poor immune system, decreased workforce productivity,
reduced FDI, the continuation of the poverty cycle

Epidemiological Transition
- the shift from contagious and infectious communicable diseases (epidemics) to
non-communicative degenerative diseases
Morbidity
- the condition of being ill, sick or unhealthy. Expressed as the prevalence or incidence of a
particular illness of disease.
Mortality
- the condition of being dead. Expressed as death rates to show number of deaths, or as deaths
from a morbidity.
Incidence of Disease
- the inputs of disease into a population: how many people are getting ill?
Prevalence of Disease
- the outputs of disease into a population: do people die or get cured?

Diseases of Poverty → communicable, infectious diseases, in LICs

- waterborne, parasites, bacteria (malaria, e-coli, dengue fever)
- Due to poor diet and public health (tuberculosis, leprosy)
- Due to poor hygiene and facilities (typhoid, cholera, dysentery)

Diseases of Affluence → non-communicable, degenerative diseases, in HICs

- related to environment (depression)
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- longevity diseases (heart disease, alzheimer’s, dementia)

- lifestyle related (alcoholism, type ii diabetes, AIDs, obesity
- cancers

Endogenetic
- Diseases originating from within a population - congenital diseases from birth, degenerative
diseases resulting from age
Exogenetic
- Diseases originating from external factors - social habits, environmental conditions, varying
spatially and between different countries
- in LICs: nutrition, unsafe environment (water, poor living standards), social norms and
education
- in HICs: stress and high blood pressures, physical inactivity, overconsumption, recreational
choices (drugs etc)

Disease Burden → a measure of an illness expressed in the form of cost, morbidity or mortality
- 23% of global burden of disease is attributed to disorders in people aged 60+
- Ageing/degenerative diseases represent 50% of the health burden in HICs and 20% in
LICs/MICs
- Population ageing is driving the worldwide epidemic of chronic diseases - there is an increased
proportion of morbidity and a decreased proportion of mortality
- Costs for age-dependent disorders arise from disability and long-term care rather than
mortality
Example: Alzheimer’s
- a chronic neurodegenerative disease (subset of dementia)
Pattern & Distribution
- impacts 44 million worldwide, most common in Western Europe, the US & least
prevalent in Sub-Saharan Africa
- far more prevalent in high income countries, women have a higher risk of dying (2 in 3
people)
- ageing populations: when baby boomers reach 85 in 2030, projected 3m people in US
will have Alzheimer’s

Impacts
- Social
- estimated 50% of all seniors by 2050 will have Alzheimer’s; disease prevalence
predicted to triple
- symptoms of language, memory loss, disorientation, withdrawal from society, loss of
bodily functions, increasing reliance on caregivers
- no treatments to reverse or prevent progression, only temp palliative treatment (eg.
exercise programs, treatment w/ antipsychotics)
- psychological and emotional burden of caregivers (usually loved ones)
- Economic
- global cost of $605 bil, estimated costs associated w/ dementia to $1.1 tril by 2050
- direct & indirect medical costs (nursing homes & day care), loss of productivity of
patients and caregivers especially when living at home
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2. Food systems and spread of diseases

Sustainable Agriculture
- the efficient production of safe, high quality agricultural products in a way that protects and
improves the natural environment, the social and economic conditions of farmers, their
employees and communities, and safeguards the health and welfare of all farmed species.
- agriculture employs 37% of the world’s population, using 70% of the world’s water and
producing 30% of all GHG
- → 97% of agricultural workers live in developing countries; v effective at reducing poverty
- 3 pillars of sustainability
- social: food quality, crop and animal welfare etc
- economic: profit and food for farmers
- environment soil, water, energy and biodiversity security
- System inputs
- solar energy, seeds, fertilisers, pesticides, water, labour, machinery
- System processes
- methods of farming (conservation tilling, sowing seeds, harvesting), transportation
and storage methods
- System outputs
- food, biofuel, food waste

Subsistence Farming Commercial Farming

→ small family consumption & trade, LIC → production for profit maximisation
→ reliant on labour, w/ low capital input → large scale, low labour, high capital input
→ low irrigation and chemical input → highly mechanised, high synthetic input
→ outputs of pastoral and arable farming (automated irrigation, climate control)
providing a range of products → outputs of a specialised range of products

Measuring Sustainability
- Through energy, water, food
- Energy sustainability
- energy efficiency ratios (calculates amount of energy needed on a farm in proportion
to the outputs produced)
- energy outputs / energy inputs (ratio equal to or above 1 is efficient), agriculture is
temp carbon sink
- energy inputs (direct / indirect) include: labour, capital, machinery / pesticides,
irrigation)
- energy input lower than output = high EER
- energy input higher than output = low EER
- subsistence farming has low EER, depending on the quantity and quality of food
produced
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- large intensive farms have high EERs, producing large amounts of food with varied
inputs
- Water sustainability
- water footprints (total amount of water used in production)
- differing locations & climates will have different evapotranspiration rates and different
soil efficiencies
- global food trade can lead to water conservation (growing crops best suited to
climates)
- trade saves water (crops from humid climates transported to drier ones where it
would’ve been harder to grow)
- still raises sustainability issues if crops have to be transported around the
world
- exported crops still contain embedded water, therefore local production not
always best
- Food sustainability
- food miles (the distance food travels from its source to its consumer - can be actual
distance or energy consumed during transport)
- an represent the environmental impact of the food we eat, but:
- food grown closer consumer does not mean farming practices are sustainable
- other countries could grow the crop better
- fuel and packaging
- still creates socio-economic sustainability for local producers (income +
quality food)

Increases in Food Production & Availability

- amount of land used for cultivation has increased
- productivity of existing land has increased

The Green Revolution

- growing populations and famine in the 1960s lead to scientific and technological innovations
to increase agricultural productivity, involving mechanised cultivation, agro-chemical usage
and development of GMOs
- began in Mexico, started by Norman Borlaug who developed semi-dwarf, high yield, disease
resistant wheat and introduced it to Mexico, Pakistan and India (HYVs)
- by 1963 in Mexico, harvests were 6 times larger than 2 decades ago, with 95% of fields
growing HYV
- Borlaug’s HYV credited with saving over 1 bil people from starvation
- R8, a HY semi-dwarf rice developed by International Rice Research Institute, bred to
have higher nitrogen absorbing potential, rust-resistance for extreme weather and
semi-dwarf genes (decreasing the growing time)
- HYVs lead to increased need for energy intensive practices (eg. Haber process for fixing
nitrogen fertilisers consumes fossil fuels)
- large amounts of water needed (monocultures), depleting soil of nutrients and biodiversity
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- → Green Revolution II seeks to balance increased crop yields with combating environmental
effects, returning to more traditional methods of farming like crop rotation
-
-
Changes in Agricultural Systems
- changing scale of agricultural operations and inputs into the system
+ increasing scale can bring together fragmented land holdings, creating productive
areas where there were previously none
- competition over land between food crops and biofuels/cash crops

- more GMO crops/seeds, fertilisers and chemicals to increase productivity

- projected 50% of world’s land unusable by 2050

- aeroponic tech allowing plants to be grown in places originally unsuited for crop growth
(indoors/vertically/in urban areas)
+ root misting reduces water consumption by 85%, no herbicides etc used
+ climate control & LED lighting allows plants to be grown year round

Scientific & Technological Innovations

- modern irrigation
+ allows crops to be grown in arid / semi-arid areas
+ eg. North Sinai Canal irrigates 62,000 sqkm of desert along the Nile
- unsustainable use of water resources prevents water security in arid areas
- biotechnology & GMOs
+ HYVs increase food productivity per hectare, allowing multiple harvests per year
+ Biofortification can increase micronutrient value of crops
+ rapid adoption: eg. 80% of US corn, cotton, soy are GMOs
- GMO controversy (companies controlling seed stocks for financial exploitation)

Growth of Agribusiness
- large scale, profit driven corporations involved in farming; often convince LIC farmers to
abandon food production in favour of non-food crops
+ Cash crops can be sold to make surplus income, particularly in LICs
- Export prices for cash crops can fall short; farmers unable to buy same amount of food
they had previously grown
- Contractual obligations leave small stakeholders in power of agribusinesses
- Agribusinesses concerned with catering to trade markets rather than providing LIC
populations with food
- staple crops need to be imported if subsistence harvests are lost to cash crops
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Global Political & Economic Systems

- food aid: international concessional flows of food/cash to provide food related assistance to
tackle hunger (can be emergency or long-term security)
- note overall reduction of global food aid
- effectiveness reduced if ‘strings attached’ conditions benefit donor countries and
multinational food companies rather than the beneficiaries

- economic and political changes (economic development, urbanisation)

+ Changes to cash crops can provide jobs and income for LIC farmers
- Outsourcing of labour for non-food items from HICs to LICs, increasing their
dependency on food imports from other areas
- eg. Kenya’s cropland now used to grow flowers which are exported to UK
supermarkets
- eg. a crop 3 tonnes of rice annually in China has become 120,000 trousers
- Urbanisation destroys arable land (eg. China 1 mil ha/year lost to real estate &
factories)
- Rural-urban migration draws people away from high yield farmland
- political instability prevents countries from investing in skills and vocational education that
would increase productivity of a population in the long term

Decreases in Food Production & Availability

Factors Leading to Food Insecurity
- SOCIAL
- Food waste (HIC vs LIC)
- dietary homogenisation & nutritional transition = more demand for same types of
foods
- rural vs. urban deficiencies in access, landlocked vs. coastal
- urbanisation and loss of agricultural land
- ECONOMIC
- agribusiness and corporations monopolising food production and distribution
- cash crops
- expropriation of land to foreign firms and countries
- ENVIRONMENTAL
- minimal energy security, water security (eg. 6k litres of water needed to produce beef)
- long term environmental degradation of soil due to unsustainable practices
- commonly occurs in areas vulnerable to changes in food supply, decreased resilience
- climate change (weather events disrupting production chain)
- POLITICAL
- trade embargoes, taxes, tariffs, makes food more difficult to purchase
- corruption = less focus on dealing with food and poverty
- revolutions and conflict destroy food resources and people with agricultural
knowledge
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Processes Impacting Reduced Food Production

Factor Case Study

Climate Change → mean temp in Ethiopia risen by 1.3°C between 1960

→ higher temps increase pest prevalence and reduce yields of and 2006
desirable crops → rain fed agriculture projected decline by 50% in Africa
→ changes in precipitation patterns increase likelihood of long by 2020
term declines (affects growing season) → Ethiopian farmers grow crops sensitive to irrigation
→ weather + temp extremes impact livestock (droughts, floods, (eg. coffee)
fires etc) → 2006 flood reduced maize productivity by 20% due to
→ lowered resilience and adaptability of farmers waterlogging
→ agriculture contributes to ~20% of GHG emissions, worsening
climate change

Urbanisation → currently ~ 4:1 rural to city dweller in Asia and Africa,

→ city dwellers cannot produce their own food projected 2:1 by 2040
→ the urban poor suffer from poor nutrition → if managed, increasing urban population presents an
→ rapid urbanisation leads to food insecurity (supply chains, opportunity to shift economic activity from rural
storage infrastructures) agriculture to the larger and more diversified urban
industrial and service sectors, therefore enhancing
resilience for Ethiopia

Soil Degradation → 1/2 of the whole planet’s topsoil has been lost in the
→ prevalent at tropical latitudes (forests cleared for agricultural past 150 years
land); rainforest soil lacking in nutrients and degrades v easily → soya plantations in Paraguay - entire country
→ increased river pollution and sedimentation due to runoff depends heavily on cash crop
→ over-reliance on chemicals degrades soil → forests cut down to make way for soya plantations;
→ impacts 840 smallholders exported to China to feed pigs
→ poor soils = poor nutrients in crops = malnutrition in people → soil repeatedly depleted of same nutrients
consuming the food
→ causes forced migration of farmers

Natural Hazards → UK imports 90% of their fruits and vegetables, bans

→ La Niña causes severe droughts that affect rainfall, the on air travel in UK due to volcanic eruptions leave
production of food and as a result inflate food prices supermarkets understocked quickly
→ volcano eruptions impact nations that rely heavily on → loss of exports for Kenya of ~$1.3 million
imported food → hailstorms reduce productivity of Ethiopian enset
(seen as a pillar of food security), a staple half yearly for
Ethiopians

Rising Middle Class → 21% of the Ethiopian population is classified as

middle class
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→ as people become wealthier, and dietary homogenisation → wheat prices are twice as high as the average for the
becomes more prevalent, land & water resources per calorie past two decades
increases
→ leads to increased food waste as people become more
affluent
→ growing more meat leads to less grain reserves, increasing the
prices of staple foods

Global Interactions → Senegal’s specialisation in nuts encouraged by

→ increased competition for land for biofuel production as land Portuguese in the 16th century
is sold to TNCs → loan from the World Bank to support an industry
→ prolonged food crises fatigue HIC donor countries, who focus in nuts
decrease relief funding in favour of other humanitarian crises → supply of nuts increased (viewed as a stable export
crop), but demand did not
→ Senegal fell into debt (reduced tariffs on nuts and
reduced public spending)

Population Growth → Ethiopia has a population growth rate of 3.2%

→ more mouths to feed with the same or a decreasing amount
of land
→ developing populations rely heavily on agriculture for
livelihood (2.5 bil people)
→ 70% of the world’s poor live in rural areas

Conflict → 8 million people in Ethiopia receiving humanitarian

→ displaces people into neighbouring countries assistance in the first quarter of 2017
→ conflicts are the main cause of famines and lead to high food → Yemen: govt using starvation as a method warfare
prices, increasing the risk of civil conflicts, protests, rioting and against its military opponents by blocking food from
upheavals in the food supply chain entering the country
→ the more fragile the state, the more households rely upon
food imports and thus the more vulnerable to price volatility

Diffusion
- infectiousness: the likelihood of something spreading
- resistance: how resistant the are nodes to infection by other nodes
- topology: network structure and the degree of connectivity increases rate of diffusion
- strategy: random or strategically aimed to affect nodes with high connectivity?
- distance decay: those closer to the source are more likely to be affected by it

Expansion diffusion → expanding disease has a source and diffuses outwards into new areas
Contagious diffusion → rapid, widespread diffusion through direct contact, affecting uniformly
Hierarchical diffusion → diffusion through ordered sequence of classes/places (eg. rural urban)
Network diffusion → disease spreads via social networks and transportation
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Relocation diffusion → disease moves into new areas leaving behind the origin or source of disease,
moving to new locations

Factors Affecting Diffusion of Technology

Social → levels of education and skill in once place promotes fast flow of ideas, low skill levels prevent
economic advancement

Economic → level of wealth slows/speeds up innovation • access to foreign loans can improve
agricultural infrastructure • privatisation policies allow for greater competition of technology • TNCs
control investment and research development of certain technologies

Physical → strong environmental protection can create a culture of guarding against degradation •
proximity of one place to another allows fast transfer of ideas • extreme climates restrict flow of ideas

Political & Cultural → values and beliefs slow down rates of innovation • global integration into
communities like the UN creates partnerships and investment opportunities • civil war and bad
governance removes opportunities for investment

Diffusion of Vector-Borne Diseases: Malaria

- General Info
- Mosquito, the vector for the parasite, thrives in tropical areas (~32°C), in stagnant
water, estuaries or densely populated agricultural regions
- Successive death 24h after no treatment, with symptoms appearing 10-15 days after
bite
- Africa home to 93% of malaria deaths

- Ethiopia
- 5 mil cases a year, 70k deaths a year
- Transmission peaks bi-annually during harvesting seasons (large migrations from
highlands to lowlands for agricultural work)
- Lack of comms tech to communicate epidemic info
- Changes from rain-fed agriculture to large scale irrigation agriculture increases river
damming for hydroelectricity and increases stagnant water
- Irrigated crops eg. cotton and sugarcane require lots of water and warm
tropical temperatures increases breeding of malaria vectors
- Impacts:
- reduction in productivity of adult workforce and ability of children to attend school
(Ethiopia highly dependent on labour-intensive agricultural sector)
- overwhelmed healthcare sector, lacking in skills, resources and staff training

- Human Factors Allowing Diffusion

- Urbanisation/population growth
- Creation of mosquito breeding sites (garbage dumps, tires, discarded
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containers)
- High population density, allows for rapid spread of disease
- Low educational levels
- Failure to receive adequate guidance regarding prevention and dosage and as
such, fail to adhere to prescription
- Improper use of drugs results in adaptation of resistance in mosquitoes
- Economic status
- Malaria is easily treatable and preventable if funds are present, so disease is
concentrated on the poor

- Geographical Factors Allowing Diffusion

- Climate
- Concentrated on tropical areas as mosquitos can only survive in said areas
- Landforms
- In areas of Ethiopia, malaria is found only around rivers as the rest of the
country is quite dry
- Transmission is reduced due to lack of proper breeding sites for mosquitos

- Prevention
- Vector control by long-lasting insecticide-treated mosquito nets and indoor residual
spraying
- sleeping under a bed net reduces child mortality by as much as 20%
- Spraying with insecticides (DDT), fully effective when >80% of houses in targeted areas
are sprayed
- Environmental management, favoured in Ethiopia (destroying breeding sites, digging
proper toilets to prevent water accumulation)
- Increased govt primary health care initiatives, introducing up to 30,000 HCW by 2009

- Barriers
- Antimalarial drug and insecticide resistance (nets and cheap drugs require routine
monitoring)

Diffusion of Water-Borne Diseases: Cholera

- General Info
- Acute diarrheal disease (vibrio cholerae) transmitted through oral routes (water, food);
often found in estuary ecology
- Strikes in pandemics in LICs and NICs, can be brought to other countries through
network/relocation diffusion.
- 3-5 mil cases annually, killing 100,000, but reported cases only represent 5-10% of
actual cases
- One current active pandemic, fueled by conflict and crisis (eg. Rwandan migration)

- Ethiopia
- deaths of 684 people and infection of nearly 60,000 others in less than a year (2007)
- 33,000 cases of cholera and 776 deaths (2017)
- Forced migration due to drought and below average rains (El Nino); refugee camps
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with poor infrastructure and crowded conditions

- WFP needed $268 million to provide food assistance in Ethiopia from Jan 2017 until
July

- Factors Enabling Spread

- SOCIAL
- Hunger leading to weakened immune systems, lack of sanitation and food
safety, high living density in urban areas, low diffusion of education
- ECONOMIC
- Corruption prevents sanitation and medical supplies to reach those in need

- ENVIRONMENTAL
- Irrigation and water insecurity in the area (epidemics begin during the end of
the dry season when people are forced to accumulate at fewer water
resources)

- POLITICAL
- Difficulty of access to rural areas to conduct govt censuses

- Practical Barriers, Treatment & Prevention

- Treatment: reducing deaths
- Rehydrating patients and replacing electrolytes lost through vomiting and
feces
- Chlorinated, boiled water
- Prevention: preventing new cases
- Intensive public education, environmental sanitation campaigns (eg. latrine
safety)
- Surveillance, allowing healthcare personnel to detect cases early and to assess
size, density of outbreak to distribute resources
- Rapid response team (lab techs to identify symptoms, environmental health
experts to identify causes, creating stockpiles of oral rehydration salts)

3. Stakeholders in food and health

Food Insecurity
- when people do not have physical or economic access to sufficient, safe and nutritious food at
all times, that meets their dietary needs and preferences for an active and healthy life.
- [can be chronic or acute, occurring at a variety of scales]

World Food Programme

- established 1961, providing food aid in emergencies and to aid the development of countries;
the largest humanitarian agency fighting hunger.
- delivers food to other aid agencies (Red Cross etc)
- funded voluntarily from governments, or from individual donations of food
- four objectives: protect livelihoods and lives in emergencies, rebuild following emergencies,
reduce risk an enable communities to meet their own needs, break the cycle of hunger
- in Sudan: targeting IDPs displaced by conflict, giving food vouchers, connecting smallholder
farmers to the economy, treating acute micronutrient deficiency (free school meals for
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children, large scale climate resilience initiatives)

Food and Agriculture Organisation

- 194 member states, specialising in trying to defeat hunger
- to eliminate hunger, malnutrition and poverty in a sustainable manner (reducing rural poverty,
encouraging sustainable management of forestry, fisheries and other resources)
- to increase the resilience of communities to threats
- majority of funding comes from voluntary contributions from members
- established Codex Alimentarius (1963) - an international body for food standards and fair
practices in food trade. Ensures safe and quality food globally
- eradicated river blindness in 2002, large scale treatment and insecticides preventing 40 million
people from being infected

World Health Organisation

- concerned with international public health
- combats diseases (communicable and non-communicable), identifying outbreaks early
- ensuring availability of modern contraceptives, pre and postnatal maternal care and child
growth monitoring
- conducts World Health Report providing policymakers, govts the necessary information to
make health policy and funding decisions
- contributed to a 40% decline in the number of deaths from tuberculosis
- successfully reduced polio cases by 99%, due to a Global Vaccination Drive

NGO: Trussell Trust

- aiming to help those in the UK living below the poverty line
- 400 food banks across the nation, 1.2k global, free emergency food (three days’ worth
nutritional, non-perishable food)
- healthcare professionals to identify people in crisis
- 1.3 million people provided with emergency food in 2017-2018, an increase of 13% from the
previous year

Agribusinesses
- Cargill
- established 150 years ago with annual profits of $120 billion in 2011
- 130,000 worldwide employees
- largest fleet of exporting dry bulk commodities, stopping at 6,000 ports around the
globe
- processes 1.5 million carcasses per year
- answers primarily to their shareholders - actions are often driven by profit rather than
environmental sustainability
- invested billions into aquaculture (300mil profit from fish feed alone in 2015)
- advantage = during environmental crises, production can be moved from place to
place
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- expanding markets of the global middle class (dietary homogenisation = more

intensive beef)
- intensive animal production doesn’t help chronically undernourished
- opportunities to address malnutrition and obesity through alternatives to basics - sugar, salt
and oil (eg. Truvia - zero-calorie alternative to sugar)

Role of the Media

- The rise of the avocado: promotion by World Avocado Organisation & farmers in Mexico
- endorsements from public figures and ‘clean eating’ trends; promoting avocado as a
superfood with “75% unsaturated fat”
- annual avocado consumption in the US increased from 0.5kg in the 80s to 3kg+ in 2016
- China’s avocado imports 2t in 2010 to 25kt in 2016
- buyer proportions in the higher income bracket and white (72% of purchases in US)

Gender, Food & Health

- 1.1 billion female farmers could feed 150 million people & produce 20-30% more food if gender
disparities were reduced
- women need:
- equal access to land, education, agricultural training, seeds, water/tools, technologies,
credit, legal rights decision making
- Poor Women in the UK
- poorest 10% of the UK are living 7.9 years less than the UK life expectancy (heart
disease, respiratory disease, lung cancer, dementia)
- public health initiatives are more accessible to the wealthy
- growing reliance on food banks for families struggling financially

Famine
Characteristics of Famine
- → 20% of households in a given country face extreme food deficits
- 30% children are acutely malnourished
- mortality rates exceed 2 people per 10,000 population per day as a result of food deficit
- currently 4 countries on the brink of famine, 5-10 mil people acutely food insecure f
- food (or lack thereof) used as a weapon
- $4 bil needed by UN to alleviate the four famines, only 14% of funds available

Yemen & Famine

Causes - Violent Conflict
- Arab Spring in 2011 → power shift from authoritarian president (a Hadi) → rebel Houthi Muslim
movement took control of capital city → Saudi and other states (backed by US) bomb the
Houthis to try and restore Hadi
- Proxy war killed nearly 10,000 people since 2015, 2 mil IDPs
- international proxy with US, UK & France lending military assistance to subdue Houthis
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- Strategic location of Yemen neighbouring ME nations which enables geopolitical conflict

Causes - Climate Change

- Yemen naturally dry and dusty; >3% of its land supports 28 million people
- Less rainfall means less harvest and shorter growing seasons, so minimal (if any) food is stored
for periods of crisis and people are less likely to survive during conflict
- Depletion of groundwater

Impacts
- Economic
- Yemeni economy will be unable to generate sufficient foreign exchange, depreciating
the currency and continuing to increase food prices/inflation
- 12k/14k schools in Yemen shut down

- Shortfall in Food Availability & Health

- Main reason: Saudi naval, land and air blockade on Yemen’s ports, blocking Iranian
and international food/humanitarian aid
- 85% of food supplies prevented from entering
- 1.26mil suspected cholera cases, 1.5m malnourished children
- Resurgence of preventable diseases like malaria and cholera

- Environmental Degradation
- bombing targets power generation sites, causing blackouts and impacting water
supplies
- direct & indirect pollution from destruction of infrastructure (heavy metals and
particulates)

- Governance
- failure to reach ceasefire agreement by the political parties involved leads to the proxy
war

- Access to Aid
- collapse of health system, largest global cholera outbreak
- hospitals, schools, food-storage facilities targeted in bombings (19 MSF personnel killed, all
international staff withdrawn from the region)
- 600 health facilities out of action due to fighting
- 50kt of WFP wheat prevented from reaching 3.7 mil people
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4. Future health and food security and sustainability

Food Waste
- Globally, about 1/3 of food produced is thrown away or lost
- 25% of that 1/3 is enough to feed the hungry
- waste in HICs (consumerism, physical standards) vs. loss in LICs (inefficiencies, limited storage)
- combat waste through the rise in ‘ugly food’

Short Term Mid Term Long Term

→ maintain food aid programs (though → free trade & → support access to fertilisers and
may come w/ strings attached, lack of liberalisation markets to avoid food loss in HICs
ability to sustain long term) (better access to → green revolution 2.0/gmos
→ reduce land fallow & traditional world market and → increases output & profits,
farming (but improper education of stable supply of money can be reinvested
farmers can lead to soil degradation) food goods, → possibility of overexploitation
→ improve access to seeds & fertilisers connections w/ → investment in female farmers
(though may become reliant on HICs) → lifestyle changes
external organisations)

Food Insecurity due to Depleting Fish Stocks

- Nearly 70% of the world’s stocks are in need of management (Cod stocks in the North Sea are
less than 10% 1970 levels)
- World wild food fish supply increased from average of 9.9 kg per capita to 19 kg per capita

European Union: Fish Stocks (Biotic Resources of the Ocean)

- Management of biotic resources of oceans in the EU under the Common Fisheries Policy (CFP)
- management can be input control, output control or a combination
- input controls:
- Limiting the number of vessels in certain waters: fishing permits
- fishing effort controls limiting capacity of vessels
- technical measures: Small meshed nets, minimum landing size → protect juveniles
- output controls:
- limiting catches through total allowable catches and quotas, matching supply to
demand
- surveillance: check landings by EU → apply penalties to overfishing and illegal
landings
- tariff policy: Minimum import prices → to ensure EU preference
- as a result, pressure on European stocks in 2013 declined by 50%, though later than other
countries 74% of the stocks previously below MSY are rebuilding
- Development of aquaculture practices
- Aquaculture now accounts for ~20% of fish production
- Aim to double aquaculture by 2030
- conservation measures & environmental legislation (Marine Strategy Framework Directive) to
safeguard biodiversity & address human activities (fisheries) affecting the oceans
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GMOs
+ Advantages: Increased efficiency: increase in yield (through larger plants and reduced crop
loss due to protection against pests and insects), higher nutritional value for humans
- Disadvantages: Risk of creating herbicide resistant weeds, risk of cross-contamination,
threatens crop diversity
Vertical Farming
+ Advantages: Low external risk (no weather risk, no pests) hence secure, advantage in use of
space, year-round crop production, reduction of occupational hazards of traditional farming,
food can be grown on already developed land, increase domestic food production
+ can produce up to 200% more than a traditional greenhouse
+ 70-95% less water used (hydroponics)
- Disadvantages: Uncertain financial feasibility of the market, manual pollination needed (is
labour intensive and costly), must be large scale to be commercially viable, higher energy
usage due to artificial lighting and climate control systems (making up 98% of energy use)
In Vitro Meat
+ Advantages: health benefits (cholesterol-free, antibiotic-free, lower in saturated fat), less
emission of GHGs, reduction of deforestation & land degradation needed for traditional cattle
- Disadvantages: highly specialised equipment needed - stem starter cells, growth medium,
edible scaffold for cells to grow on etc.

Pandemic Management
Epidemic → sudden increase in cases above the norm of disease outbreaks in an area
Pandemic → epidemic spread over countries/continents
Endemic → constant presence of disease in a population
Epidemiology → the incidence, distribution and control over diseases

Ebola
- Description: Often fatal illness contracted through infection with the Ebola virus, transmitted
through human-to-human contact. Extremely prevalent 2014-2016 in Liberia, Sierra Leone,
Guinea
- Epidemiology: transmitted through human-to-human contact & infected wild animals; through
bodily fluids, organs etc of infected persons (blood, dead bodies, sweat etc)
- Symptoms: 8-10 days incubation highly flu-like (fever, fatigue, muscle pains), extreme
escalation in the 2-3 days after (internal bleeding, vomiting, diarrhea)

- Temporal Dispersal: began in Guinea 2013 after a boy died at a regional trading point from
contracting the virus from a bat
- boy’s family became infected & died, disease spread to other villages when people
travelled
- traditional burial practices in West African culture involves evacuating the body of
bowels, food etc.
- not reported till March 2014 as it was tradition for sick relatives to be cared for at home
- 28,657 reports of infection, of which 11,325 died (a mortality rate of 39.5%)
- pread to slums of capital cities, causing rapid spikes in # cases / day
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- Social Marginalisation: extreme tension between communities due to lack of awareness about
how the disease spreads and infects others
- borders & markets between Liberia and neighbouring countries have closed, even
though cross-border trade and relationships are vital for border economies and
building trust
- survivors & their quarantined families completely shunned due to fear of infection
- role of local governments key in minimising stigma - District Platforms for Dialogue
(DPD) educated villagers in the local dialect
- forums and discussions facilitated by DPD, town chiefs, women leaders, healthcare
workers to remind communities of life before Ebola (though no actual treatment is
received)

- Social Media
- ‘Africa Stop Ebola’ used well-respected public figures with social weight & music to
perform a song in French and other local languages vs. Western media very slow to
report on initial outbreak
- social media penetration 14% in Africa vs. 66% in NA and 54 in Europe
- reporting in US only after an American fell ill in 2014, widespread European reporting
only after Spanish nurse fell ill
- newspaper media coverage crucial to frame emergencies (initially framed as localised
African crisis
- transitioned to focusing on danger to Western countries rather than
humanitarian disaster in Africa, limiting donations for medical equipment &
travel of volunteer health workers
- human interest stories shown to be effective, amplified panic on social media
micro-posts can be used to detect real time emergence of crises
- semantic data mining
- Prevention & Cure
- steps taken to control: diagnosing, tracing and isolating contact of every single Ebola
patient to prevent new chains of transmission
- how to treat?
- chlorine concentrate to treat food, water, clothes etc
- Biosecure Emergency Care Units for Outbreaks (cubes) cost $USD17,000 but
allow workers to administer care externally, and for families to communicate
with patients without risk of contamination
- how to prevent Ebola in first place?
- Household prevention kits containing soap, chlorine, masks etc distributed by
WHO, UNICEF
- educating public on transmission, using personal protection equipment
effectively, ebola transmission campaigns aired on radio & television
- ensuring free treatment in isolated regions essential for early detection &
eradication
- barriers to prevention: fear amongst communities (never seeing loved ones again),
poor infrastructure & communication, cultural beliefs, ebola suspect’s dilemma
- overall mortality risk for staying at home vs treatment is 35% to 40%. suspects
can maximise chance of survival by staying at home, but risk becoming sub
spreaders of the virus
- pervasive messaging that Ebola has no cure