A Lancet Commission report says these three co-occur, interact with each other to produce complex sequelae and share common underlying societal drivers
If you thought obesity, under-nutrition and climate change exist in isolation, the new Lancet Commission report will prove you grossly wrong. The report shows that the three “pandemics” are interplaying with each other and terms it as “global syndemic”.
A result of a three-year project led by the University of Auckland (New Zealand), the George Washington University (USA), and World Obesity Federation (UK), the new Lancet report is authored by 43 experts from 14 countries, including India. Stressing on the menace of obesity, the report states that in 2017, more than 38 million children younger than five years were either overweight or had obesity — 25 per cent and 46 per cent of these cases were in Africa and Asia.
“In low- and middle-income countries (LMICs), more and more children under the age of five are becoming overweight when stunting (28 per cent), wasting (8.8 per cent), and underweight (17.4 per cent) too are quite prevalent. The prevalence of obesity among stunted children is 3 per cent and is higher among children in middle-income countries than in lower-income countries,” says the report.
Unhealthy impact of climate change
Climate change too seems to be affecting these countries the most. “The work of the Intergovernmental Panel on Climate Change (IPCC), three previous Lancet Commissions related to climate change and planetary health (2009–15), and the current Lancet Countdown, which is tracking progress on health and climate change from 2017 to 2030, have provided extensive and compelling projections on the major human health effects related to climate change. Chief among them are increasing food insecurity and under-nutrition among vulnerable populations in many LMICs due to crop failures, reduced food production, extreme weather events, increased food-borne and other infectious diseases and civil unrest,” says the Lancet report.
The report says economic burden of the global syndemic will have the greatest effect on the poorest of the 8.5 billion people who will inhabit the earth by 2030. “The current costs of obesity are estimated at about $2 trillion annually from direct healthcare costs and lost economic productivity. These costs represent 2.8 per cent of the world’s gross domestic product (GDP)… Economic losses attributable to under-nutrition are equivalent to 11 per cent of the GDP in Africa and Asia,” the report says.
And how does climate change impact these countries? The 2.3 billion farmers, forest-dependent people, herders and fishermen are threatened by climate variability and extreme weather. One of the most direct effects is on food availability for the rural poor, the report says.
Food’s interaction with climate
The reverse effect is also quite tangible as agriculture leads to climate change with foods becoming less healthy. “Research indicates that increased level of carbon dioxide in the atmosphere are reducing level of nutrients in wheat, barley, potatoes, and rice by 10-14 per cent and in soy by 1.4 per cent,” the report points out.
Also, agricultural practices, driven primarily by industry also contribute towards climate change. Agriculture directly contributes about 15-23 per cent of all greenhouse gas emissions which is even comparable to transportation, thanks to the dependence on fertilisers.
The report also lists other quirky effects. “Increasing ambient temperatures could contribute to obesity through reduction in physical activity. Additionally, the effect of climate change on fruit and vegetable production will make these products more expensive, and might prompt a shift towards processed food and beverages that are high in sugar, fats and sodium.” What more? High prevalace of obesity will lead to increased consumption of fossil fuel as the dependence on various modes of transportation would see a spurt.
The commission also identifies the common drivers of these three pandemics. Vested industrial interest, the report says, is the prime driver spurring homogeneity in production and consumption and also externalises harms to health. “One example of such multifold damage is agriculture’s drive towards higher value products, such as processed and animal-source foods that consume great amounts of energy, generate methane and other waste products, and are heavily marketed and consumed in unhealthy quantities. Obesity is one result. Nutrient-deficiency malnutrition and climate change are others. The offence is more egregious for the half-trillion US dollars in subsidies paid to the agriculture sector every year, mostly providing cheap inputs to large food companies, and about $5 trillion in subsidies to fossil fuel companies,” the report says.
Terming the World Economic Forum as “the bully pulpit of business groups”, the report calls upon institutions such as itself and the World Bank to “harness the power of economics using development assistance funding” to act upon solutions of the problem.
The second most prominent driver is collective “policy inertia” as “no country has successfully reversed its epidemic because the systemic and institutional drivers of obesity remain largely unabated”. Casting serious aspersions on politicians’ decision making powers, the report says, “Member states met at successive World Health Assembly meetings over nearly three decades, but that has not translated into meaningful and measurable change. Such patchy progress is due to what the Commission calls policy inertia, a collective term for the combined effects of inadequate political leadership and governance to enact policies to response to the global syndemic.”
The report also rues the fact that just like Paris Agreement on Climate Change, obesity has not generated enough public outrcry thus leading to inertia. For a solution, the report suggests double-duty or triple-duty actions. “A seemingly simple example shows how challenging these actions can be. National dietary guidelines serve as a basis for the development of food and nutrition policies and public education to reduce obesity and under-nutrition and could be extended to include sustainability by moving populations towards consuming largely plant-based diets.”
However, many countries’ efforts to include environmental sustainability principles within their dietary guidelines failed due to pressure from strong food industry lobbies, especially the beef, dairy, sugar, and ultra-processed food and beverage industry sectors, the report rues with Sweden, Qatar, Brazil and Germany being the sole exceptions. Increasing public engagement with civil society organisations and diverse groups to trigger behavourial change, it says, is equally significant to address the syndemic.
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