Planet

Global Syndemic, the deadly mix of malnutrition and ecological crisis

June 7, 2019

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Global Syndemic, global epidemic syndrome. The deadly mix of malnutrition and ecological crisis poses the greatest threat to the health of the planet’s people, according to the latest report by international experts assembled by The Lancet. (1) The scenario data and the way forward.

Table of Contents

Global Syndemic, the deadly mix.

The leading cause of disease globally is malnutrition in its various forms, as declined in different latitudes. Malnutrition, i.e., excesses and/or deficiencies of nutrients and micronutrients, unbalanced diets. The scenario is likely to worsen due to climate change, which worsens conditions of access to food. The interaction of the three pandemics-obesity, undernutrition and ecological crisis-is referred to by The Lancet ‘s Commission on Obesity as‘The Global Syndemic. That is, a syndrome (or synergy of epidemics) that affects most people in every country and region of the world.

The main drivers of Global Syndemic are food and agriculture, transportation, urban design-so that people can be supplied with fresh, healthy food instead of depending on fast food and retailers of ultra-processed foods, in the ‘food swamps’ where the poorest households in developed countries are forced – and land consumption. Systems driven by short-sighted policies, subservient to the powerful, which aim to achieve maximum returns in the short term, without care of negative side effects on public health and the environment.

The interaction of the three pandemics-obesity, malnutrition and ecological crises-with the aforementioned drivers is glaring, according to the researchers. And it produces ripple effects. Some examples:

– the food production system, which is responsible for the epidemic of malnutrition (junk food, nutrient-deficient sugary drinks, unbalanced recipes), generates 25-30% of greenhouse gas emissions (more than half of which are attributed to livestock farms). It is imperative to convert food production systems to a sustainable model, (2)

– the transportation system, which is increasingly focused on automobile use, generates 14-25% of greenhouse gas emissions while promoting sedentariness, thus the risk of overweight (and other diseases),

– overexploitation of natural resources (soil, water) and the ecological crisis challenge agricultural systems. Extreme weather events such as floods and droughts destroy crops, causing prices of fresh fruits and vegetables to rise. This reduces both the food security (security of food supply) and diet quality. Encouraging the consumption of processed or ultra-processed foods.

Global Syndemic, the economic impact

Each pandemic, of the three that make up the Global Syndemic, has a colossal burden on the economies of the world’s states. Which obviously burdens LMIC(Low-Medium Income Countries) to a greater extent. The overall economic impact is evaluated in the following terms:

– the costs of obesity are estimated to be about $2 trillion annually, as far as direct health care is concerned. When productivity losses are added to health care expenditures, global obesity is attributed 2.8 percent of the world’s gross domestic product (GDP). Roughly speaking, the equivalent of the costs of smoking or gun violence and war. Childhood obesity has increased globally 8-fold among girls and 10-fold in boys over the past four decades to a prevalence of 5-6% and 7.8% (2016). Rising data also among adults, 14.9 percent of women and 10.8 percent of men obese. Overweight began to spread in the 1980s and now affects 2 billion people, causing about 4 million premature deaths each year (2015 data),

– malnutrition causes economic losses equal to 11% of GDP in Africa and Asia, about US$ 3-5 trillion annually. The World Bank considers it necessary to invest $70 billion over 10 years to achieve the second of theSustainable Development Goals (SDGs),
End Hunger
. With the prospect of an ROI(Return on Investment) of more than 1200%, or $850 billion. Severe micronutrient deficiencies now affect 2 billion individuals, chronic undernutrition 815 million. Undernutrition disproportionately affects children and adults in low-income countries, in East and Central Africa and South Central Asia especially. In 2018, the
Global Nutrition Report
found 155 million children with rickets (due to stunting) and 52 million children with wasting disease. The costs to the global economy resulting from undernutrition, micronutrient deficiency and overweight amount to $3-5 trillion annually. Paradoxically, by 2022 the prevalence of childhood and adolescent obesity may exceed that of moderate and severe undernutrition,

– the costs of the ecological crisis are estimated to affect 5-10% of global GDP. Yet, it would only take investing as little as 1 percent of the world’s GDP to turn things around. The economic effects of the climate change include, among others, costs generated by environmental disasters (e.g., droughts and fires), changes in habitat (e.g., biosecurity and rising sea levels), health effects (infections and diarrhea from malnutrition), increased costs in agriculture and fisheries, and costs of reducing greenhouse gas emissions.

Global Syndemic, the way forward

The measures outlined by The Lancet Commission to mitigate the disasters under consideration converge with the views expressed by GIFT (Great Italian Food Trade). Governments need to emancipate themselves from the influence of Big Food lobbies in order to independently manage preventive health policies, within which nutrition policies fall. In Europe, the scandal of nutrient profiles, which the European Commission should have developed 10 years ago (!), persists. At the WHO level, Ferrero’s titanic battle against synthetic nutrition labels is still ongoing. From South America is reported the testimony of Chilean Senator Guido Giradi. Who has been at the forefront of a 6-year battle against Big Food to succeed in introducing warnings on junk food labels in Chile-where 2/3 of the population is obese or overweight.

The governance of political institutions must be strengthened at the global, regional, national and local levels. To this end, experts assembled by The Lancet have made some proposals:

– introduce the universal human right to well-being, which includes the rights of children and the rights of all people to health, food, culture and healthy environments,

– stimulate global intergovernmental organizations, such as the World Trade Organization, the World Economic Forum, the World Bank, and large philanthropic foundations, and ‘regional platforms’, such as the European Union, must take action to support policies consistent with the goals of countering the Global Syndemic,

– raise at least $1 billion to support civil society organizations’ initiatives to mitigate the Global Syndemic. The Commission recalls the exemplary case of the
sugar tax
which Mexico introduced at the rate of 20 percent. Strongly promoted by the civic organization The Alliance for Healthy Food, the tax measure led, in just two years (2014-2016), to a 7 percent reduction in sugar-sweetened beverage consumption (11.7 percent in low-income groups),

– governments are recommended to redirect the more than $5 trillion in annual subsidies currently provided to the agriculture and fossil fuel industries toward more sustainable energy, agriculture and food system practices,

– it is recommended that a United Nations Global Convention on Healthy and Sustainable Food Systems (FCFS) be established, following the pattern adopted for the Framework Convention on Tobacco Control (FCTC) and the United Nations Framework Convention on Climate Change (UNFCCC). The similarities between the tobacco industry, the junk food industry, and the fossil fuel industry lie, according to the Commission, in the social harm they cause and the influence they exert on policy through their economic power.

#Égalité!

Marta Strinati and Dario Dongo

Notes
(1) The Lancet Commission on Obesity (2019).‘The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report‘. The Lancet, http://dx.doi.org/10.1016/ S0140-6736(18)32822-8. Free access document, after registration
The commission-coordinated by the University of Auckland (New Zealand), George Washington University (United States) and World Obesity Federation (United Kingdom)-consists of 43 experts from 14 countries. Scientists, in the course of the work, expanded the scope on malnutrition and climate change. Members include Olivier De Schutter, former UN special rapporteur on the right to food
(2) The Lancet Commission on Obesity defines ‘sustainable food systems‘ as those that promote human health, the environment, social equity and economic prosperity. Which are characterized by low environmental impact, support for biodiversity, contribution to food and nutrition security, and support for local food cultures and traditions.
‘Sustainable food systems promote the global outcomes of human health, ecological health, social equity, and economic prosperity. They have a low environmental impact, support biodiversity, contribute to food and nutrition security, and support local food cultures and traditions‘.

Marta Strinati

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Professional journalist since January 1995, he has worked for newspapers (Il Messaggero, Paese Sera, La Stampa) and periodicals (NumeroUno, Il Salvagente). She is the author of journalistic surveys on food, she has published the book "Reading labels to know what we eat".