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Q&A with Alessandro Demaio on the True Cost of Food: Climate Change, Hunger and Framing the Problem

By: Christine Grillo

BALTIMORE—Oct. 23, 2019. When Alessandro Demaio visited the Johns Hopkins Center for a Livable Future, we had a chance to talk with him about how climate change is increasing the hunger gap, the externalized costs of the food system, how to communicate the challenges and what scientists have to offer. Demaio is a former medical officer with the World Health Organization, the former chief executive of EAT, a science-based, global platform for food systems transformation, and is the new Chief Executive Officer of the Australia-based Victorian Health Promotion Foundation. He believes that food could be the Trojan horse that allows us to address one, concrete problem at a time, while also quietly tackling more abstract problems that are harder to rally public support for. (This interview has been edited for length.)

Q: You’re a skilled communicator. How do you communicate the concept of externalities, especially to audiences who aren't so wonky?

When we think about an externality, it's the idea that when we do something, there are effects that are not necessarily borne into the transaction that we see. So for example, if we buy a can of soda, there will be environmental costs. There's carbon that's produced in the production of that soda. There might be health consequences that come from drinking—we might put on a bit of weight. That means we have to buy new pants, or eventually we develop a chronic disease because we're drinking so much soda. But none of those costs are built into the actual price of the can of soda, which costs 99 cents. But changing your pants, the recycling of the can, the carbon that's produced in the process, and potentially the disease that results—those are externalities from the transaction at the price of purchase.

Q: You’ve said that hunger is one externality of the food system. How is it that globally we make so much food, and it causes hunger?

After decades of reductions, world hunger is again on the rise. A major reason for the increase in global hunger is actually two things: climate change and conflict. About 30 percent of global greenhouse gases that are a major driver of climate change come from our food system. So the way that we consume in many parts of the world diets that are rich in processed foods, and red meat and sugar and salt and fat, is actually causing hunger in other parts of the world, because [that food produces] carbon, which increases climate change—and it also drives global conflict, which is in turn causing hunger.

Q: Could you connect the dots on how climate changes affects hunger?

Let’s consider the 500 million smallholder farmers—individuals in low and middle income countries, producing the majority of the world's food on very small plots of land, often living just above the poverty line. For them, if there is a sudden shift in the weather patterns, if rain comes a month later, or summers are five degrees hotter, these all impact the ability of our farmers to produce food. And we know that our oceans are getting warmer, which redistributes fish stocks, and that we're depleting those numbers because we're overfishing. But in addition to that, if the currents change or the weather increases the temperature of the water, fish actually move. So fish will move from one country's fisheries to another, which leads to conflict because countries suddenly say, “Well, hang on a second, that was our fish, we need access to fish.”

Q: You’ve mentioned loss of biodiversity as problem particularly in light of climate change.

The picture becomes even more complicated when we start thinking about biodiversity loss, because—and this is a very simplified sort of view—by clearing land, we lose the diversity of all the different fruits and vegetables, but also the insects and other pollinators. By clearing land, we deplete the soil health. We lose the diversity of different crops that we have. Then suddenly the climate's changing, and we've only been investing in a very few number of types of plants to grow the majority of our food, and we don't have the biodiversity left to be able to go and find different strains or even different plants that once grew there on the land that we've now cleared to be able to rely on to grow the future of food.

Q: You mentioned in a lecture that social isolation is one of the biggest threats that we're facing. Does that tie into the food system?

In Australia, we're seeing an increase in social isolation, and particularly social isolation and social anxiety in young people. .... Many of us are not cooking our own food anymore. We're eating while we're doing other things, and we're even having food delivered to our own homes in many high-income societies. And so all of the practices that we know are really important for building interpersonal relationships like cooking together, shopping together, but particularly eating together with others, we're now kind of building out of our lives, and an indirect cost of that process may in fact be that it's coming at a cost of our interpersonal relationships.

Q: Some societies are responding to the issue of social isolation as a health threat?

What we're seeing is that in fact countries are now integrating some of these issues into even their dietary guidelines. Traditionally those guidelines were focused simply on nutrients. And then it became focused on foods and food groups, and we got the food pyramids. In the 80s and 90s, then it became about dietary patterns. But now actually the latest dietary guidelines are not just focused on the food, but also on the way you eat food. So it's reminding us to put our phones down, it's reminding us to eat with others, it's about how you get that food to your plate, and what you do afterwards and even connecting it to big things like climate change.

Q: This is in Brazil?

Brazil was one of the first countries in the world to connect dietary guidelines to environmental sustainability and food systems sustainability. But Canada is really the most recent to integrate social aspects into the guidelines as well.

Q: Can we talk about the role of science and scientists in fixing the food system?

Science is still of critical importance, and I think we have to remind ourselves of that particularly in 2019. We need to be making sure that what we do is informed by the evidence, and by the best quality evidence, independent from coercion or conflicts of interest. But evidence alone is not going to solve the world's problems. I often think of it as "evidence is necessary but not sufficient." We're getting bigger trials on bigger numbers of populations. We're getting sharper instruments. But once you have the evidence, that's really only a fraction of the process to creating impact‚—but we're not going beyond the science enough. Publishing in a scientific journal, if it just sits as 5,000 words across 35 pages in a big pile of journals, is not going to have the impact that we need to have. We need to be working with communicators, working with journalists so they understand it accurately and can report it in a really clear and simple way … and we need to integrate the science translation process into the metrics by which we remunerate and assess our scientists, so that they also can invest time and be recognized for investing time in science translation, not just science creation.

Q: Practically speaking, how could we use the concept of externalities to make change?

We've got an economic model that is based around money. It's a concept we kind of made up, but it works, and it's the way our global system is built. You look at things like a carbon tax that tries to build the cost of your emissions into the price of the product when you buy it, and that alone, it makes a lot of sense. You wouldn't go to the store and buy a chocolate bar but not expect for the cost of the sugar or the cocoa to be built into the product. But when you're ignoring a big part of the cost of that product, which is the cost it has on the environment, that is a very real cost that we will have to pay if we're not already paying for it. It's a cost that's often borne by others and it's borne by the most vulnerable people in our societies and the most vulnerable people across our world. … So if we build the true cost of the product into the price at purchase, then individuals can make an informed choice.

Q: You’ve talked about using the language and framing that resonates with people, and that sometimes talking about a problem in humanitarian and moral terms—that may not be what anyone's interested in. So then you have to pick another way to frame the problem.

Creating behavior change in the population is not an easy thing to do, and particularly to sustain behavior change is even harder. As a doctor, [with a patient] I think, “Well, to me, improving their health and not getting heart disease in 30 years’ time, that sounds pretty important to me”—but to an individual who's struggling to pay their rent, who's working two jobs, who has three kids, and he's living on the poverty line, worrying about heart disease in 30 years is not a is not a top priority. … For many individuals the financial argument is the most powerful. For young people it's much more about the now than the future because they're not even sure there will be a future … In Australia, they're really worried about making ends meet. And so, you need to say, “Well, you know, these issues affect you, these issues will affect our jobs, these issues will affect our livelihoods. And this is not about you doing anything wrong, this is not about shame or blame.” This is about a system that's largely stacked against the individual and particularly against poor individuals.

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