The Global Syndemic of obesity, undernutrition and climate change
Led by the University of Auckland (New Zealand), the George Washington University (USA), and World Obesity Federation (UK), the new Lancet Commission is the result of a three-year project led by 43 experts from a broad range of expertise from 14 countries. The report focuses on the Global Syndemic of obesity, undernutrition and climate change, highlighting the fact that these three pandemics co-exist and are driven by dysfunctions within the same systems – food, transport, urban design and land use. Focusing on the intersect between these three global health challenges, the report highlights triple duty actions that can address all three of these global health challenges which in turn presents us with a real opportunity to protect human health, the environment and our planet. The report follows the publication (17 Jan) of the Lancet-EAT Commission, which provided the first scientific targets for a healthy diet within planetary boundaries Now, the new report analyses the wider systems underpinning the global obesity pandemic, and identifies solutions to address decades of policy failure.
The new Commission defines The Global Syndemic as the global interactions of the pandemics of obesity, undernutrition and climate change, which are linked through common drivers and shared solutions. Driving The Global Syndemic are food and agriculture policies, transportation, urban design and land use systems – which in turn are driven by policies and economic incentives that promote overconsumption and inequalities.
Among the actions recommended, the Commission calls for the establishment of a Framework Convention on Food Systems (FCFS) – similar to global conventions for tobacco control and climate change – to restrict the influence of the food industry in policy making and to mobilise national action for healthy, equitable and sustainable food systems.
The costs of #malnutrition and #climatechange affect poor people and low-income countries disproportionately. The good news is that they have shared solutions. Read: https://t.co/kMPTLbOvnb @theLancet #GlobalSyndemic pic.twitter.com/HlpRqfZWOi
— World Bank (@WorldBank) February 4, 2019
Economic incentives must be redesigned, and USD 5 trillion in government subsidies to fossil fuel and large agricultural businesses globally should be redirected towards sustainable, healthy, environmentally friendly activities. Additionally, a global philanthropic fund of USD 1 billion must be set up to support civil society in advocating for change.
“The prevailing business model of large international food and beverage companies that focus on maximising short-term profits leads to overconsumption of nutrient-poor food and beverages in both high-income countries and increasingly in low and middle-income countries. The coexistence of obesity and stunting in the same children in some countries is an urgent warning signal – and both will be exacerbated by climate change. Tackling The Global Syndemic requires an urgent rethink of how we eat, live, consume, and move, including a radical change to a sustainable and health-promoting business model fit for the future challenges we face today,” says Dr Richard Horton, Editor-in-Chief, The Lancet.
The Global Syndemic: common drivers require shared solutions
The Global Syndemic represents a synergy of pandemics that co-occur in time and place, interact with each other, and share common underlying societal drivers. For example, food systems not only drive the obesity and undernutrition pandemics but also generate 25-30 per cent of greenhouse gas emissions (GHGs), and cattle production accounts for over half of those. Car-dominated transportation systems support sedentary lifestyles and generate between 14-25 per cent of GHGs. Underpinning all of these are weak political governance systems, the unchallenged economic pursuit of GDP growth, and the powerful commercial engineering of overconsumption.
The outcomes of obesity, undernutrition, and climate change also interact. For example, climate change will increase undernutrition through increased food insecurity from extreme weather events, droughts, and shifts in agriculture. Likewise, fetal and infant undernutrition increases the risk of adult obesity. Climate change may also affect prices of basic food commodities, especially fruit and vegetables, potentially increasing consumption of processed foods.
“We must recognise these connections and implement double-duty actions that address both obesity and undernutrition and triple-duty actions that influence multiple parts of the syndemic simultaneously,” says Commissioner Professor Corinna Hawkes, City University London (UK). Guidelines for a sustainable diet, the restriction of commercial influences, the right to wellbeing legislation, and policies for healthy, equitable, environmentally sustainable, economically prosperous food systems would all have an impact across obesity, undernutrition and climate change (ie, triple-duty, or triple-win actions).