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C h a pt er 2 2 Governing the Dietary


Transition: Linking Agriculture, Nutrition, and Health


Robert Paarlberg T


he best approach to finding positive synergies among agriculture, nutrition, and health may depend on a country’s position in the dietary transition— from a diet low in both calories and micronutrients (Stage One) to a diet


that provides adequate basic energy for most people but an inadequate balance of nutrients (Stage Two) to an affluent diet that begins to provide excessive calorie energy, which can lead to health problems linked to obesity (Stage Three). As soci- eties move through this dietary transition, government’s relative importance and most essential functions will change. A common theme at all three stages is women’s essential role within households, often as food producers and almost always as the primary caregivers to small children. In Stage One countries, the best way to capture positive synergies across sectors


will be to provide missing public goods, especially rural public goods. Agricultural societies cannot advance without roads, power, transport, and rule of law—as well as schools and clinics—in the countryside. In the absence of these public goods, private investors will not come into the area, and citizens—especially smallholder farmers in the countryside—will remain caught in a poverty trap. The payoff from public goods investments at Stage One can be seen across various sectors. For exam- ple, rural roads that reduce transport costs simultaneously deliver both productivity gains for farmers (by lowering the cost of purchased inputs and reducing marketing costs) and health gains for young children (by improving access to clinics). Cross-sector links should be considered when making these public investments


(for example, when determining sites for new roads, power lines, irrigation systems, or health clinics), but most of the actual synergies between the sectors will not be “administered” by governments; instead they will be captured privately when local


This chapter is based on the author’s 2020 Conference Paper, Governing the Dietary Transition: Linking Agriculture, Nutrition, and Health (Washington, DC: International Food Policy Research Institute, 2011).


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