Can the EAT-Lancet diet work for the global south?

STOCKHOLM — In January, researchers unveiled a global reference diet designed to address the twin problems of rising malnutrition rates and the food system's contributions to climate change.

This month’s EAT Stockholm Food Forum centered on the hard work of translating that diet into reality, and how governments can develop healthy, sustainable food systems while maintaining popular support.

But some participants noted that there was little discussion of issues that particularly affect countries in the global south. That includes how governments can ensure communities are still able to afford food if prices rise to reflect higher nutrition and sustainability standards — or what happens if they don’t.

“The shift from low-price, cheap, and not-so-good food to healthy food that internalizes all these costs [of sustainability] will inevitably make food more expensive,” Jean Balié, platform leader on agrifood policy for the International Rice Research Institute, told Devex. “But magically, people will not become richer in these countries.”

That left some forum participants emphasizing the need to integrate perspectives and knowledge from the global south as the work of transforming the reference diet into actual diets begins.

More than 30 researchers were involved in mapping out the EAT-Lancet Commission’s universal guidelines, of whom about a third were either from countries in the global south or have extensively focused on it during their careers. The guidelines aim to meet the nutritional requirements for most of the world's projected population of 10 billion people by 2050, while significantly reducing the climate impact.

The researchers distilled the guidelines into the image of a plate of food, more than half of it reserved for fruits and vegetables, but with segments for grains, dairy, meat and other proteins. What actually ends up filling that plate and how it is grown, will differ from community to community and from meal to meal.

"It does not give us the answers for each country or culture, nor the specific pathways for how to get there," Gunhild Stordalen, founder and president of the EAT Foundation, said at the conference.

Even in its basic composition, though, it may already be out of reach for many. While many people living in higher-income settings will need to eat less — and particularly less animal-sourced protein — people in lower-income countries would struggle to meet the standards the reference diet has set.

The recommendation of one to five eggs each week, for instance, will not be possible for many people in sub-Saharan Africa, said Jan Low, principal scientist for the International Potato Center, who has spent much of her career in sub-Saharan Africa working on integrating nutritional concerns into agriculture programs.

She said there are opportunities for flexibility within the guidelines — such as focusing on products that make the best use of soil and water resources — which may allow communities to achieve some of the recommendations.

More broadly, though, the diet’s focus on quality over quantity means lower-income countries will need to chart a different trajectory from the one the industrialized world has followed, Balié said. That comes with significant challenges, not least of which is ensuring that people are actually able to afford food.

Whereas the path to development has traditionally favored making cheap but unhealthy food available to urban workers, countries in the global south will need to favor policies that encourage the availability of healthy, sustainably-grown foods — from investing in infrastructure to improve farmers' access to markets, to more extreme measures such as blocking the import of foods that are deemed unhealthy or unsustainable.

This will have long-term payoffs in terms of reducing environmental damage and curbing the spread of noncommunicable diseases, but it will also come at an actual cost to consumers, who will see much of their budget continue to go on food. That's because food costs will need to reflect externalities like the cost of water or soil regeneration — costs that higher-income countries have "passed to the next generation," Balié said.

It will require a paradigm shift that researchers and global institutions cannot impose on countries, who must work with their citizens to set up policies that reflect local realities and priorities instead.

"We can help articulate these tradeoffs and make sure these scenarios are well-assessed to help governments make these decisions," Balié said. "But that has to be a democratic process," which begins with making sure that governments and members of civil society are integrated into the discussions.

Some noted there was limited representation from the global south at the Stockholm Food Forum, though. Mameni Morlai, who is Liberia's government focal point for the Scaling Up Nutrition movement, said the EAT Foundation has made an effort to reach out to representatives in Asia and Africa. But in her own country of Liberia, she said, knowledge about the EAT-Lancet report remains low. Other experts at the forum also acknowledged the problem.

Fabrice DeClerck, EAT's science director, said the forum's location in Stockholm can make it difficult to engender participation, because of visa restrictions and travel costs. But he said they have made efforts to take the report elsewhere, including a launch event at the African Union in Addis Ababa, Ethiopia, in early February.

"We see Africa as a priority of the next five years and expect intense focus on that region," he told Devex. Ultimately, he said the goal is to create an African Food Forum, headquartered on the continent.

Representatives from the global south said they also expect to see high-income countries and corporations putting equal energy into reforming their practices to meet the guidelines — and they pointed to opportunities for mutual learning.

Bioversity International, a research-for-development organization, used the forum to launch its first-ever Agrobiodiversity Index. Juan Lucas Restrepo, the organization's director general, said agrobiodiversity is critical to the sustainability of farming efforts, boosting soil health, and increasing resilience, but it is not widely followed.

Of the 10 countries the organization considered for the index, though, India and Kenya had the highest scores in sustainable production, having made commitments and taken actions to implement agrobiodiversity.

"We will see, over time, the developing countries setting the new bar and the examples on how we can mainstream agrobiodiversity over time," Restrepo said. "It's going to be south to north and that would be fantastic."

Update, June 25: This story was updated to correct the spelling of Bioversity International.

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