How to engage across sectors: lessons from agriculture and nutrition in the Brazilian School Feeding Program

ABSTRACT OBJECTIVE To provide insights for nutrition and public health practitioners on how to engage with other sectors to achieve public health goals. Specifically, this study provides lessons from the example of integrating family farming and a nutrition into a legal framework in Brazil on how to successfully shift other sectors toward nutrition goals. METHODS The study analyzed policy processes that led to a Brazilian law linking family farming with the National School Feeding Program. Main actors involved with the development of the law were interviewed and their narratives were analyzed using a well-established theoretical framework. RESULTS The study provides five key lessons for promoting intersectorality. First, nutrition and health practitioners can afford to embrace bold ideas when working with other sectors. Second, they should engage with more powerful sectors (or subsectors) and position nutrition goals as providing solutions that meet the interests of these sector. Third is the need to focus on a common goal - which may not be explicitly nutrition-related - as the focus of the intersectoral action. Fourth, philosophical, political, and governance spaces are needed to bring together different sectors. Fifth, evidence on the success of the intersectoral approach increases the acceptance of the process. CONCLUSIONS This study on policy processes shows how a convergence of factors enabled a link between family farming and school feeding in Brazil. It highlights that there are strategies to engage other sectors toward nutrition goals which provides benefits for all sectors involved.

Implications of the Central America-Dominican Republic-Free Trade Agreement for the nutrition transition in Central America / Implicaciones del Tratado de Libre Comercio entre Centroamérica y República Dominicana sobre la transición alimentaria en Centroamérica

OBJECTIVES: To identify potential impacts of the Central America-Dominican Republic-Free Trade Agreement (CAFTA-DR) on food consumption patterns associated with the nutrition transition, obesity, and diet-related chronic diseases. METHODS: Examination of CAFTA-DR agreement to identify measures that have the potential to affect food availability and retail prices. RESULTS: CAFTA-DR includes agreements on tariffs, tariff-rate quotas (TRQs), and sanitary and phytosanitary regulations with direct implications for the availability and prices of various foods. Agreements on investment, services, and intellectual property rights (IPR) are also relevant because they create a business climate more conducive to long-term investment by the transnational food industry. Trade liberalization under CAFTA-DR is likely to increase availability and lower relative prices of two food groups associated with the nutrition transition: meat and processed foods. These outcomes are expected to occur as the direct result of increased imports from the United States and increased production by U.S. companies based in Central America, and the indirect result of increased domestic meat production (due to increased availability of cheaper animal feed) and increased production of processed foods by domestic companies (due to a more competitive market environment). CONCLUSIONS: CAFTA-DR is likely to further the nutrition transition in Central America by increasing the consumption of meat; highly processed foods; and new, non-traditional foods. The public health community should be more aware of the implications of trade agreements for dietary health. Governments and related stakeholders should assess the coherence between changes fostered by specific trade agreements with national policies on diet and nutrition.

OBJETIVOS: Identificar el posible impacto del Tratado de Libre Comercio entre Centroamérica y República Dominicana (TLCCA-RD) sobre el patrón de consumo de alimentos relacionados con la transición alimentaria, la obesidad y las enfermedades crónicas asociadas con la alimentación. MÉTODOS: Se examinó el TLCCA-RD para identificar las medidas que podrían afectar a la disponibilidad de alimentos y los precios al consumidor. RESULTADOS: El TLCCA-RD contiene acuerdos sobre tarifas, cuotas arancelarias y regulaciones sanitarias y fitosanitarias con implicaciones directas sobre la disponibilidad y los precios de varios alimentos. Los acuerdos sobre inversión, servicios y derechos de propiedad intelectual son también importantes debido a que crean un ambiente de negocios más favorable a inversiones a largo plazo de empresas transnacionales de la industria alimentaria. La liberalización del comercio por el TLCCA-RD podría incrementar la disponibilidad y reducir los precios relativos de dos grupos de alimentos asociados con la transición alimentaria: las carnes y los alimentos procesados. Esto podría ser resultado directo del aumento en las importaciones desde los Estados Unidos de América y de la producción de las compañías estadounidenses basadas en Centroamérica, y resultado indirecto del aumento en la producción local de carne (por la mayor disponibilidad de alimentos más baratos para animales) y el aumento en la producción de alimentos procesados por compañías locales (debido a un ambiente comercial más competitivo). CONCLUSIONES: El TLCCA-RD podría reforzar la transición alimentaria en Centroamérica al elevar el consumo de carne, alimentos muy procesados y alimentos nuevos no tradicionales. La comunidad de salud pública debe estar más atenta a las implicaciones de los acuerdos comerciales sobre la salud alimentaria. Los Gobiernos y las entidades relacionadas con el tema deben evaluar la coherencia entre los cambios propiciados por los acuerdos...