these local products, and in turn producers fail to invest in quality control or wide distribution. Introducing quality certification for infant foods would allow new entrants and small produc- ers to compete with heavily advertised global brands, and thereby help families meet more of their infants’ nutritional needs at a lower cost.11


Social Levers Social levers involve bringing people together across sectors and within communities to jointly work toward improving nutrition and health. Experiences from a number of countries and the private sector offer some useful lessons. For example, Luiz Inácio Lula da Silva, Brazil’s former president, launched the “Zero Hunger” program in 2003 to fight extreme poverty and ensure the human right to adequate food. The program initiated a number of actions and im- proved synergy among public policies, including income transfers, school feeding, and support for public restaurants and food banks. Among the lessons learned is that agricultural growth based on large-scale agribusiness does not necessarily lead to hunger reduction, especially if agricultural growth leads to concentration of land ownership.12


Whereas Brazil’s experience highlights the


importance of a national strategy to mobilize people, elsewhere social mobilization has arisen at the community level. In Afghanistan, for example, a project designed to bring sectors


together to improve nutrition provided nutri- tion education—including recipes for comple- mentary foods for infants—through myriad groups in Afghan society, including poultry groups, community health workers, school gardens, agricultural coops, and thousands of literacy circles.13


In the Indian state of Andhra


Pradesh, the Society for Elimination of Rural Poverty has stimulated social mobilization on a large scale to help raise farmers’ incomes and reduce infant mortality by organizing 11 mil- lion poor women—90 percent of poor rural women—into self-help groups. The groups set up nutrition centers where women, especially pregnant and lactating women, get three hot, nutritious meals each day. By providing food for the program, small farmers have seen their profits rise. Better nutrition and health are thus driving agriculture.14


Business can also act as an important social


lever when it empowers communities to im- prove their diets through improved access to information, increased incomes, or greater access to high-quality foods. Companies are increasingly recognizing that a large potential market lies at the “base of the pyramid.” Ac- cording to one definition of this group—people living on less than US$8 a day—this market encompasses nearly 4 billion people who spend more than US$1.3 trillion a year on food and 70 percent of whom rely upon the food value chain for their livelihoods as either producers or


Governing the Dietary Transition How can governments promote positive synergies among agriculture, health, and nutrition? The answer may de- pend on where a country is along the dietary transition.


For a country where people’s diets are low in both calories and micronutrients, the most effective govern-


ment action is to provide missing public goods, especially rural roads. Agricultural societies cannot advance without roads, power, transport, and rule of law—as well as schools and clinics—in the countryside. At the next stage of the dietary transition, when most people in a country get adequate basic calories, some are left behind and others have an inadequate balance of nutrients, so government’s task shifts to targeted delivery of ser- vices, such as income and nutrition safety nets for the urban poor and extension services for small farmers. At the third stage of the transition, the problem can become excessive calorie consumption and health problems linked to obesity. The private sector provides most goods and services at this stage, so government’s task is to supply public health and safety regulations to encourage appropriate responses from commercial farmers, food companies, food retailers, restaurants, pharmaceutical companies, hospitals, and medical insurers. The chal- lenge at this stage is to prevent the “capture” of regulators by the private industries being regulated.15


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