A father, prolific writer and researcher, co-founder of the Global Nutrition Report, a former research director at the International Food Policy Research Institute (IFPRI) and representative to the UN – British economist Lawrence Haddad, who currently sits at the head of the Global Alliance for Improved Nutrition (GAIN), is one of those people who seems to have had more hours in the day than everyone else. Ask him, though, and he’ll tell you that he’s been strategic with that time, first building his portfolio as a researcher and “going deep,” then “going broad” by using that backbone of knowledge to combat malnutrition through the lens of development economics.
Now, at the height of his career, he is entering into a new phase fueled by outrage and optimism, one in which he is determined to see food systems change to make nutritious food available and affordable to everyone in the world.
“One in three people on this planet are denied a say in shaping their destiny, because they are malnourished,” he said in his recent acceptance speech of the prestigious 2018 World Food Prize. “That is outrageous, unacceptable and cannot be tolerated.” Here, he tells Landscape News how he got to this point, and what’s coming next.
Tell me about your own food and nutrition choices.
I’m not a nutritionist, I’m an economist who works on nutrition. So I try not to overcomplicate what guides my own consumption choices. I try to eat a diversity of foods, I’m very careful about portion size – a lot of us eat more than we want – and I try to eat fish, fruits and vegetables. I’m a bit of a sugar addict, so I try to regulate sugar as much as I can. I’m not into absolutes when it comes to diet; I try to practice what we preach at GAIN.
How did you get into this field?
I’ve always been interested in big-picture things, in connecting science, social science, actions, policy, public and private, agriculture and nutrition. I always liked science, but then I started getting interested in economics – I think I started reading The Economist or the Wall Street Journal or something. I’m also a bit of a nerd and began reading and enjoying journals on food and nutrition policy in university.
You served as chair for the first three issues of the Global Nutrition Report. What surprised you from the findings during this time?
I thought I knew a lot about nutrition going in, but I learned much more. For example, I learned a lot about coverage of nutrition specific programs. There’s one bucket of programs that are nutrition-sensitive, often in agriculture or education, social protection or climate. These have a primary action, with a secondary goal of nutrition improvement. I was always interested in this set of actions – how can we get the development process to be more nutrition sensitive? And then there’s another bucket of programs –the nutrition specific–whose primary goal is to improve nutrition, and they tend to work through the health system.
I learned a lot about that the programs in that second bucket, and what low percentage coverage they have of the people that actually need them. I was shocked to find that only 25 percent of kids between the ages of 6 and 24 months – a very critical period because they’re leaving exclusive breast feeding and moving onto complementary foods – in Asia and Africa are getting a minimum diet diversity. Flip that around: 75 percent of kids aren’t even getting the minimum. Shocking. We don’t make a big enough deal of this.
We also did a lot of work documenting how much aid money is spent on nutrition, and I was shocked that it was, I think, USD 1 billion out of 130 billion dollars for nutrition specific actions, and another 5 billion for nutrition sensitive actions. When you think that 45 percent of all child deaths under the age of 5 are linked to undernutrition, something just doesn’t add up.
And what do you do with that information?
I enjoyed looking at those numbers and trying to use them to point out big blind spots. I think nutritionists, myself included, tend to get very focused on the details and overlook the big numbers. What we really tried to do with this report is say that malnutrition is an economic issue, not just a health issue. We commissioned some top researchers who found that for every USD 1 you spend scaling up nutrition programs, you get 16 back through improved school outcomes, labor productivity and reduced illness burden. All that adds up to an economic benefit as well as a human benefit.
You were raised on welfare in England, a low societal rung in a globally rich country. How does growing up with this dichotomy affect your work today?
It gave me a sense of the important role the state can play. Economics is quite a conservative discipline relative to other social sciences, so I often battled against the idea that welfare is simply a state handout. I always say that it can be a hand up – it’s just how you design it. If you design it in a way that builds skill, builds asset, builds capabilities, then people can get off welfare. They want out of that situation, because it’s not exactly great for your self-confidence. I think I was lucky in that my mom shielded me from a lot of that stigma, but I know she felt it, and was quite ashamed. It also made me realize that inequality is a really important shaper of people’s confidence and drive, and appreciate the relativeness of inequality – if I have a safe, dry, warm house and decent diet, but someone who I consider my peer has much better than me, chances are I will still feel bad.
So, I think my feelings around inequality, gender issues, and a sensitivity about stigma – I think all of those things are reflected in my work.
You said earlier that it’s the ‘big picture’ that interests you. Can you expand on this?
If you’re interested in health, you should be interested in diet. At the core of all forms of malnutrition – stunting, wasting, anemia, diabetes, overweight, hypertension – diet’s there. And yet we know very little about it, very little about what shapes diet. You have to look within food systems, the systems that guide the relationships between what’s grown on the farm and what you eat .
And if you’re going to look at food systems, you have to look at businesses, because businesses are the main investors in food systems. You have to find ways of engaging businesses that flip them from a big part of the problem to a big part of the solution. The price of nutritious foods – fresh fruit, fruits and vegetables, nuts, beans, eggs – is going up. For cereals, the price is going down. And junk food is winning the desirability war.
We have to find ways to help government and business engage to make nutritious food more available, affordable and desirable. This is central to quality of diet, and quality of diet is central to health and productivity.
Now well established as a leader in your field, what are you most interested in addressing going forward?
I’m well reconciled to not being a researcher anymore. I will always be an avid consumer of research and will write the occasional piece like the one I did in Nature earlier this year. But what I’m really committed to now, what really keeps me going is finding ways to combat the increasing price of nutritious foods. This really is the moonshot territory. We don’t need to bring the price of nutritious food down by 10 percent; we need to bring it down by tenfold. And I don’t know (yet) how we’re going to do that.
This is the big issue GAIN is working on and the issue I encourage others to work on. How are we going to do this? There was a study in The Lancet Global Health a couple years ago that said if every household in India, Bangladesh, Zimbabwe and Pakistan was going to buy five fruits and vegetables a day for every household member, which is pretty generic recommendation, it would cost 50 percent of their household income. That’s crazy. At most it should cost 5 percent, and even that would be a big amount. A lot of people say this price drop is impossible, but I think there are a lot of levers within food systems to make it possible. We just have to make it a priority.
So you are optimistic that this can happen?
I believe this will happen within the next ten years, we will turn the corner and we will get policymakers and businesses to focus on not just feeding the world but on nourishing the world. It takes a while to change that mindset, because we’ve been trying to feed the world for so long. But now we need to nourish it too.