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Tackling the global syndemic

A photo of author Samuel Oji Oti

Samuel Oji Oti

Senior program specialist, IDRC

Sarah Czunyi

Program Officer, IDRC

The COVID-19 pandemic brought the world to a standstill but it also brought the world together — through the collective recognition of a problem that affected global health and through collective efforts to address it. 

Yet COVID-19 was not the only pandemic affecting the world in 2020. In fact, there are several ongoing and co-existing pandemics that the world has yet to adequately address.  

In 2019, a “global syndemic” of silent killers was identified by the Lancet Commission — one of obesity, undernutrition and climate change — that together represent the leading causes of death in the world. But what is a syndemic, you might ask? It refers to several interrelated pandemics happening at the same time that share common causes and need to be addressed together.

Without collective global action, it is estimated that this syndemic has the potential to reverse much of the global economic and health gains achieved over the past 50 years and cause even more damage than that better-known pandemic. Addressing the syndemic requires the type of collective will and widespread action demonstrated by the global community in the past three years in response to COVID-19.

How the syndemic negatively affects the global food system 

The syndemic can be seen through the lens of our global food system — a system fraught with many challenges that need fixing. The following symptoms are indicative of the syndemic’s negative impacts on human and planetary health:  

  • 2 billion people (including 40 million children under five years) are overweight or obese.   
  • 820 million people, mostly in the Global South, are undernourished.   
  • Over one-third of global greenhouse gas emissions are generated by food systems, with agriculture and land use accounting for 71% of these emissions.

Not only are our food systems unhealthy, they are also unsustainable and inequitable.

Malnutrition in all its forms is increasing, with overweight and obesity underrecognized and misunderstood in low-income communities. Women and children are the most at-risk groups, with far-reaching negative consequences. For example, malnourished women are at higher risk for unsafe pregnancies and malnourished children have weakened immune systems that threaten their long-term development, both of which have compound and long-term effects on population health.

The prevalence of malnutrition is exacerbated by a global food system that increasingly promotes unhealthy and highly processed foods, leading to a significant shift in diets worldwide. Despite offering sufficient calories, processed foods, while increasingly cheaper and more easily accessible, have minimal nutritional value.

Unhealthy diets are, in turn, one of the leading causes of non-communicable diseases (NCDs). Diabetes, cancer and cardiovascular diseases are on the rise and pose significant challenges to Global South health systems. In Africa alone, it is projected that deaths from NCDs will surpass those of infectious diseases by 2030.

Moreover, the effects of the COVID-19 pandemic compounded by conflict, climate shocks and the rising costs of food, fuel and fertilizer have contributed to increased food insecurity and undernutrition on a global scale, impacting the most marginalized in all societies. When we add the ongoing and worsening climate crisis into the mix, it becomes apparent that climate change is not just having a negative impact on food systems and contributing to diet-related health issues, but it is also a consequence of our problematic food systems.

In the year 2050, it is projected that there will be 500,000 additional deaths (mostly in poorer countries) attributable to the impact of climate change on food systems. Climate change is expected to decrease both the quantity and quality of food production, while increasing the scarcity and price of staple crops. These compounding factors will further reduce access to nutritious food for many and increase the vulnerability of low-income populations.

We are caught in a vicious cycle: our food system makes us eat too much or too little and contributes to climate change. And climate change, in turn, worsens food production and consequently worsens diet-related outcomes.

IDRC is supporting Southern leadership in tackling the global syndemic

The global syndemic illustrates how interconnected these pandemics are and how critical it is to recognize that solutions require a systemic approach: we cannot isolate single parts when all parts are so intrinsically linked. The Lancet Commission called for double-duty or triple-duty actions — that is, policy actions that can drive down multiple causes of the syndemic simultaneously. IDRC is investing in several initiatives and projects aimed at developing evidence and action towards policies that can address these food system challenges on several fronts. For example, building on IDRC’s experiences supporting efforts to address the intersection between food, the environment, and health, one of our key investments is the Catalyzing Change for Healthy and Sustainable Food Systems (CCHeFS) initiative, co-funded by the Rockefeller Foundation, with the vision of tackling the global syndemic in Africa.

Under this initiative, two projects in Ghana and Kenya are led by research teams working with policymakers and stakeholders across various sectors such as health, finance, and agriculture, to develop national nutrient-profiling systems. The goal of a nutrient-profiling system is to provide a standardized and objective way of evaluating the nutritional quality of foods and beverages, so that consumers can make informed choices. Nutrient-profiling systems are then used by policymakers and government authorities to determine how interventions such as food labels, taxes and advertising restrictions will be applied to different foods and beverages. Kenya and Ghana will be among the first countries in Africa to develop their own nutrient-profiling systems.

Another project under the CCHeFS initiative developed a toolkit to enable national governments in Ghana, Malawi, and Rwanda to assess their own food systems and diagnose challenges such as inadequate or ineffective public policies. The project involved developing a set of food-system indicators, mapping stakeholders and identifying policy gaps. Ultimately, the goal is to enable national governments to develop multi-sectoral policies and interventions that will make their food systems healthier and more sustainable. The toolkit developed through this project is available as an open access resource and is already being used in other countries.

Learning and acting together  

The COVID-19 pandemic and ongoing global crises such as the war in Ukraine have exposed the vulnerability of our food systems. At the same time, the world’s relatively effective response to the COVID-19 pandemic shows what is possible if we truly want to address the global syndemic. Still, there are many lessons to be learned from what did not go well, including inequitable access to COVID-19 treatments and vaccines that disproportionately affected lower-income countries and communities.

Let us now use this opportunity and the lessons from COVID-19 to truly build back better. While global climate change conversations are slowly bringing in food systems perspectives, we can and must do more. The food we eat and the way it is produced will greatly impact human and planetary health over the next decades and we must act collectively to tackle the global syndemic of obesity, undernutrition and climate change. IDRC is committed to supporting the cadre of Southern leaders who can make that change happen and we must continue to invest in research that produces evidence that empowers decision-makers around the world. The future well-being of our planet will largely depend on how well and how soon we fix our global food systems.