Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs for an active and healthy life. The COVID-19 pandemic is a significant threat to the food and nutrition security of millions globally. According to the Food and Agriculture Organization’s (FAO) State of Food Security and Nutrition in the World 2020, prior to COVID-19, two billion people did not have regular access to safe, nutritious and sufficient food, and 690 million people were already undernourished; the pandemic can add as much as 132 million people to the category of undernourished in 2020.
The World Health Organization (WHO) describes a healthy diet as one that protects against malnutrition in all its forms and non-communicable diseases (NCDs) such as diabetes, heart disease, stroke and cancer. It contains a balanced, diverse and appropriate selection of foods eaten over a period of time to ensure that the macronutrient and essential micronutrient needs of an individual are met.
However, prior to COVID-19, the food consumption patterns of the Jamaican population had already seen a shift from locally grown indigenous staples, legumes and fruits, to more high-energy dense and processed foods containing egregious amounts of added salt, saturated fats, trans-fats and added sugar. The resulting increase in obesity and NCDs have become burdensome to our health budget, to individual households, and have left many in the population vulnerable to serious illness/death if they contract the virus.
The nutritional status of the most vulnerable groups is likely to deteriorate further due to the health and socio-economic impacts of COVID-19. Jamaica’s Ministry of Health and Wellness reported that in 2015, an estimated seven out of 10 Jamaicans died from the four major NCDs. It is also of much concern that most of the reported deaths associated with COVID-19 are among persons with NCD comorbidities.
Food prices play a key role in food availability, affordability and dietary diversity. The FAO outlines that prior to COVID-19, healthy diets were estimated to be, on average, five times more expensive than diets that meet only dietary energy needs through starchy staples. In Jamaica, the prices of goods and services were already increasing at a faster rate than salaries, and the minimum wage was below the cost of the food basket for a family of five.
INSUFFICIENT RESOURCES FOR NUTRITIOUS FOOD
Jamaica’s Food and Nutrition Security Policy 2013 outlines that the weekly cost for a basket of the required 2,400 kilo calories for a family of five was raised to J$7,439 to meet the recommended dietary allowances. However, the standard minimum wage for Jamaicans is currently J$7,000.00 per 40-hour workweek, which has ramifications for the minimum standards being set. The Jamaica Health and Lifestyle III survey reported in 2018 that more than 70 per cent of the population had insufficient resources or access to safe, adequate, or nutritious foods. One in four women of reproductive age were anaemic, suggesting that micronutrient malnutrition is still a serious threat, alongside increasing incidence of overweight/obesity and related NCDs, brought about by demographic shifts in the population.
Other major risks as the COVID-19 pandemic unfolds include price gouging, evident in the doubling of prices of some commodities, and a disruption in food production and supply chains which can trigger food price increases and volatility. Jamaica, as a net importer of food with reduced agricultural production in recent years, remains vulnerable to high international food prices. According to the FAO, Jamaica experienced an overall nine per cent price increase in some main food commodities between February and September 2020.
The pandemic has also resulted in an economic slowdown, increased unemployment, loss of income and remittances, resulting in loss of purchasing power which, when coupled with increasing food prices, present an urgent food security challenge. A recent joint analysis by global health authorities, including the FAO and WHO, highlighted that diet quality worsens as the severity of food insecurity increases. Studies have also implicated that people who suffer from moderate food insecurity, including loss of purchasing power, modify their diets by consuming more convenient, often cheaper, processed foods or by reducing food consumption to a level which may be inadequate to meet dietary needs.
These coping strategies can lead to various forms of malnutrition with negative long-term effects. Preliminary results from a recent study conducted by UNICEF and CAPRI on the impact of the pandemic on children in Jamaica showed that on average four out of 10 households with at least one child experienced loss of income and food shortages, and seven out of 10 have coped by having smaller meals. Families with female household heads, in lower socio-economic groups and living in rural areas were most affected.
Hence, an increase in the availability of and access to affordable, nutritious foods must be a key component of stronger efforts to achieve overall health targets of the Jamaican population.
TRANSFORMING FOOD SYSTEMS
Food systems play a significant role in human health, directly and indirectly, especially during the current pandemic. In efforts to mitigate the immediate impacts, it is incumbent that our key decision-makers, health authorities, practitioners and food industries focus on transforming our food systems to improve nutrition and sustainable consumption and production of nutritious, affordable and healthier food options, to promote the well-being of the Jamaican population.
For countries such as Jamaica, where the food system not only provides food, but also drives the rural economy, it is crucial that the impact of shifting to healthier dietary patterns on the livelihood of smallholder farmers and the rural poor is considered. Care must be taken to mitigate the negative impact on incomes and livelihoods as food systems transform to deliver affordable healthy diets. Adoption of and adaptation to new health-focused visions, and prioritising of comprehensive and coherent policies, practices and business models that align human health will be auspicious and will demand an integrated approach involving key stakeholders including government, food manufacturers, processors, farmers, fishers, retailers, out-of-home food providers, consumers and citizens.
REDUCING THE COST OF NUTRITIOUS FOODS
A major challenge to food security is the current cost and affordability of healthy diets, which has been exacerbated by COVID-19, especially as the health impacts associated with poor diet quality are significant.
Critical policy and investment changes will be needed to transform our current food systems to ensure Jamaicans can afford healthy diets and mitigate against the unprecedented health, social and economic impacts of the COVID-19 pandemic, especially for the vulnerable in the society, who face the greatest challenges.
Reorientation of agricultural priorities towards more nutrition-sensitive food and agricultural production will include public expenditure and investment in diversification of food production to reduce dependency on imported food; research, development and technology to increase the production and availability of healthy, nutritious food; and a focus on incentivising agricultural production for young farmers, including financial aid and subsidies.
Fiscal policies to reduce the cost and encourage the consumption of healthier foods should be considered, including avoiding taxation of nutritious foods, agricultural subsidies and taxation of unhealthy foods.
Stronger policies towards more nutrition-sensitive value chains will help to retain the nutritional value of food products, rather than investing in highly processed foods, and to reduce food loss which will improve the availability of food, impact food prices and boost the income-earning potential of farmers. Key actions include investments in improved storage, processing, preservation and transportation of food.
COMPLEMENTARY POLICIES TO IMPROVE ACCESS TO FOOD
Policies that address consumer behaviour in favour of healthy diets will also be needed. Henry et al (2015) found that healthy foods cost more when commonly consumed foods in Jamaica were considered; however, when all locally available foods are considered, the healthier foods cost less. The population would benefit from health promotion programmes led by trained nutritionists/dietitians aimed at diversifying our diet, increasing the consumption of nutritious foods not normally consumed, taking into consideration the cultural context, locally available foods and dietary customs.
Social protection programmes, such as the PATH and school-feeding programmes, continue to be important during the COVID-19 pandemic and are central to increasing the purchasing power and affordability of healthy diets of the most vulnerable in the society. However, these programmes need to be revamped to meet the needs of children who are homeschooled. It is important to ensure that food used for these programmes is nutritious and, where necessary, fortified with minerals and vitamins to counteract reduced diet quality which may lead to malnutrition. Jamaicans, especially the vulnerable, should be encouraged to enrol in government programmes aimed at social protection, job creation, improving the ability to purchase nutritious food and to increase their food production through home, community or school gardens.
In response to the effects of COVID-19 on food security, there is an urgent need to implement both long- and short-term policies while adopting a multisector approach to transforming our food systems, and other complementary measures, to ensure that healthier diets are both available and affordable, especially for low-income and vulnerable populations in Jamaica.
– Dr Vanessa White-Barrow is head, School of Allied Health and Wellness and nutritionist, College of Health Sciences, University of Technology, Jamaica. Send feedback to [email protected].