8

REDUCING INEQUALITIES
FOR FOOD SECURITY
AND NUTRITION

JUNE 2023
Cover photo: ©IFAD/Francesco Cabras

HLPE-FSN Steering Committee

Chairperson: Bernard Lehmann
Vice-chairperson: Jennifer Clapp
Steering committee members:
Olanike Adeyemo; Barbara Burlingame; Ruben Echeverría; Hilal Elver;
William Moseley; Nitya Rao; Elisabetta Recine; Jose María Sumpsi Viñas;
Akiko Suwa-Eisenmann; Stefan Tangermann; Shakuntala Thilsted;
Patrick Webb; Iain Wright.

Experts participate in the work of the HLPE-FSN in their individual capacities,

not as representatives of their respective governments, institutions or
organizations.

HLPE-FSN drafting team

Team leader: Bhavani Shankar
Team members: Jane Battersby; Jody Harris; Christina Hicks; Mariaelena
Huambachano; Swetha Manohar; Nicholas Nisbett.
Research support: Rebecca Namara.

HLPE-FSN Secretariat
Coordinator: Évariste Nicolétis
Programme officer: Paola Termine
Administrative support: Massimo Giorgi
Communication specialist: Silvia Meiattini
Interns: Élize Dushime; Louna Maria Hardan

Viale delle Terme di Caracalla

00153 Rome, Italy
Tel: +39 06 570 52762
www.fao.org/cfs/cfs-hlpe
[email protected]
The views expressed do not necessarily reflect the views of the CFS, of its members, participants, or
of the Secretariat. The mention of specific companies or products of manufacturers, whether or not
these have been patented, does not imply that these have been endorsed or recommended by the
HLPE-FSN in preference to others of a similar nature that are not mentioned. Boundaries, names
and designations used on maps do not imply the expression of any opinion whatsoever on the part of [ iii
the CFS nor its HLPE-FSN concerning the legal status of any country, territory, city or area or of its
authorities, or concerning the delimitation of its frontiers and boundaries.

This report is made publicly available and its reproduction and dissemination is encouraged. This
report may be copied, redistributed and adapted for non-commercial purposes, provided that the
report is appropriately cited. Reproduction for resale or other commercial purposes, including
educational purposes, may incur fees.

Third-party materials: Users wishing to reuse material from this work that is attributed to a third
party, such as tables, figures or images, are responsible for determining whether permission is
needed for that reuse and for obtaining permission from the copyright holder. The risk of claims
resulting from infringement of any third-party-owned component in the work rests solely with the
user.

Referencing this report: HLPE. 2023. Reducing inequalities for food security and nutrition. Rome, CFS
HLPE-FSN.
 HLPE Reports series

#1 Price volatility and food security (2011)

#2 Land tenure and international investments in agriculture (2011)

#3 Food security and climate change (2012)

#4 Social protection for food security (2012)

#5 Biofuels and food security (2013)

#6 Investing in smallholder agriculture for food security (2013)

#7 Sustainable fisheries and aquaculture for food security and nutrition (2014)

#8 Food losses and waste in the context of sustainable food systems (2014)

#9 Water for food security and nutrition (2015)

#10 Sustainable agricultural development for food security and nutrition: what roles forlivestock? (2016)

#11 Sustainable forestry for food security and nutrition (2017)

#12 Nutrition and foodsystems (2017)

iv ]
#13 Multi-stakeholder partnerships to finance and improve food security and nutrition in the framework
of the 2030 Agenda (2018)

#14 Agroecological and other innovative approaches for sustainable agriculture and food systems that
enhance food security and nutrition (2019)

#15 Food security and nutrition: building a global narrative towards 2030 (2020)

#16 Promoting youth engagement and employment in agriculture and food systems (2021)

#17 Data collection and analysis tools for food security and nutrition: towards enhancing effective,
inclusive, evidence-informed, decision making (2022)

#18 Reducing inequalities for food security and nutrition (2023)

All reports by the HLPE-FSN are available at https://www.fao.org/cfs/cfs-hlpe/publications/en.

CONTENTS

FOREWORD xv
ACKNOWLEDGMENTS xvii
ACRONYMS xviii
SUMMARY xx
INTRODUCTION 1
CHAPTER 1. CONCEPTS AND FRAMEWORKS 4
1.1 Why focus on inequality and its relationship to inequity? 5
1.2 The case for transformative over incremental action 6
1.3 Concepts and definitions 7
1.3.1 Food security 7
1.3.2 Equality and equity 7

1.4 Conceptual framework 9

1.5 Approaches to equity research and practice 11
1.5.1 Forms of knowledge and evidence 11
[v
1.5.2 A dialogue with human rights 12

CHAPTER 2. PATTERNS AND TRENDS OF INEQUALITY IN FOOD

SECURITY AND NUTRITION OUTCOMES 14
2.1 Global and regional FSN inequalities 15
2.2 Global and regional inequalities in food security and hunger: status and trends 16
2.2.1. Gender gaps in global and regional food security patterns 16
2.2.2. Acute food insecurity and inequality 16
2.2.3. Average incomes, income inequality and links to food security globally 17
2.2.4. Place and space considerations related to FSN inequalities globally 22
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

2.3 Global, regional and country-level inequalities in diet and nutritional status 22
2.3.1. Disparities in nutritional status and the double burden of malnutrition 22
2.3.2. Diets and child feeding 24

2.4 Long-run trends in inequality 26

2.5 A deep dive: within-country inequalities 27
2.5.1 Food insecurity inequalities within countries along different axes of inequality 27
2.5.2 Nutrition and diet inequalities within countries along different axes of inequality 31

CHAPTER 3. PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD

SYSTEMS AND OTHER RELEVANT SYSTEMS 38
3.1 Food-production resources 39
3.2 Food supply chains 42
3.2.1 Access to financial services 42
3.2.2 Access to information and technology 42
3.2.3 Labour and time use 43
3.2.4 Producer engagement with value chains 44
3.2.5 Storage, distribution and processing 46
3.2.6 International food trade 47

3.3 Food environments and consumer behaviour 50

3.3.1 Food affordability 50
3.3.2 Physical access to food 51
3.3.3 Food promotion and commercial determinants of health 52
3.3.4 Food safety 53

3.4 Other systems relevant to FSN 53

3.4.1 Health care systems and services 54
vi ]
3.4.2 Housing, water, sanitation, energy and infrastructure 54
3.4.3 Education 55

CHAPTER 4. THE SYSTEMIC DRIVERS AND ROOT CAUSES

OF FSN INEQUALITIES 56
4.1 Biophysical and environmental drivers 58
4.1.1 Biodiversity loss, water and soil depletion, and pollution 58
4.1.2 Climate change 59
4.1.3 Environment–human health linkages 61

4.2 Technology, innovation and infrastructure 62

4.3 Economic and market drivers 63
4.3.1 International trade 63
4.3.2 Market making, speculation and concentration 65
CONTENTS

4.4 Political and institutional drivers 67

4.4.1 Violence and armed conflict 67
4.4.2 Policies and governance 68

4.5 Sociocultural drivers 71

4.5.1 Cultural norms 71
4.5.2 Gender-based violence 73

4.6 Demographic drivers 73

CHAPTER 5. ACTIONS TO REDUCE INEQUALITIES IN FOOD AND

OTHER SYSTEMS TO IMPROVE FSN 76
5.1 First principles to follow when designing equity-specific actions 77
5.1.1 Adapt to context 77
5.1.2 Focus on agency and work to undo inequitable norms 78
5.1.3 Address power imbalances 78

5.2 Actions to reduce inequalities in food production 78

5.2.1 More equal access to food-production resources 78
5.2.2 Agroecological principles across production and broader food systems 80
5.2.3 Inclusive producer organizations 81
5.2.4 Equity-sensitive public agricultural and food-systems research and
other rural public investments 82

5.3 Actions to reduce inequalities in food supply chains 84

5.3.1 Inclusive value chain approaches 84
5.3.2 Labour protection and rights throughout the food system 85
5.3.3 Territorial approaches in food systems and regional development planning and policy 85
5.3.4 Equity-sensitive storage, food processing and distribution 86
5.3.5 Improved information systems, leveraging digital technologies 88 [ vii
5.4 Actions to reduce inequalities in food environments and consumption 89
5.4.1 Food-retail environment planning and governance 89
5.4.2 Incorporating behavioural insights into policymaking to reduce inequalities for FSN 90
5.4.3 Social protection 91

5.5 Enabling environments, broader context and governance 93

5.5.1 Food and nutrition sensitive policy, planning and programming 93
5.5.2 Addressing corporate power asymmetries in governance 94
5.5.3 Universal health care with integration of nutrition care 96
5.5.4 Transformative action: a holistic approach to climate and sustainability 97
5.5.5 Inclusive and sustainable FSN growth and policy that goes beyond growth 98
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

CHAPTER 6. RECOMMENDATIONS 100

6.1 Principles for equity-sensitive policy and action that reduce FSN inequalities 101
6.2 Recommendations for equity-sensitive actions to address FSN inequalities 103
6.3 A roadmap to equity-sensitive policy to reduce inequalities 111

REFERENCES 114
ANNEXES 161
Annex 1 Glossary 161
Annex 2 Definition of FSN-related SDG 2 indicators 168

viii ]
CONTENTS

LIST OF TABLES

TABLE 1 SUMMARY OF INEQUALITIES IN FOOD SECURITY AND NUTRITION ACROSS

AND WITHIN REGIONS 18

TABLE 2 DIFFERENT FORMS OF SOCIAL PROTECTION AND THEIR RELEVANCE

TO REDUCING FSN INEQUALITIES 92

TABLE 3 SUMMARY REPRESENTATION OF RECOMMENDATIONS AND HOW THEY ADDRESS

REPRESENTATION, RECOGNITION AND REDISTRIBUTION 108

LIST OF FIGURES

FIGURE 1 STRUCTURE OF THE REPORT IN RELATION TO THE FOOD SYSTEMS FRAMEWORK 3

FIGURE 2 CONCEPTUAL FRAMEWORK: ENGINE OF EQUITY FOR FSN 11 [ ix

FIGURE 3 GLOBAL AND REGIONAL MEAN ABSOLUTE DIFFERENCES IN ALTERNATIVE HEALTHY
EATING INDEX COMPONENT SCORES IN ADULTS, BETWEEN 1990 AND 2018 25

FIGURE 4 GINI COEFFICIENTS OF GLOBAL FOOD/NUTRIENT SUPPLIES

AND NUTRITION OUTCOMES 27

FIGURE 5 UNDERWEIGHT IN WOMEN BY DECILE OF WEALTH 32

FIGURE 6 OVERWEIGHT/OBESITY IN WOMEN BY DECILE OF WEALTH 33

FIGURE 7 GOVERLAPPING POPULATION-WEIGHTED QUARTILES OF OVERWEIGHT AND WASTING

PREVALENCE IN CHILDREN UNDER 5 ACROSS LMICS IN 2017 35
 LIST OF FIGURES

FIGURE 8 INEQUITY BETWEEN ETHNIC MAJORITY AND MINORITY COMMUNITIES

FOR UNDERLYING DETERMINANTS OF CHILD UNDERNUTRITION, 2000–2010 37

FIGURE 9 LAND INEQUALITY TRENDS (MEASURED BY GINI COEFFICIENTS) SINCE 1975 40

FIGURE 10 IMPORT DEPENDENCY (IMPORTS AS A SHARE OF DOMESTIC FOOD SUPPLY) FOR

CEREALS, AVERAGE OF 2015–2017 48

FIGURE 11 PUBLIC AGRICULTURAL RESEARCH SPENDING IN DIFFERENT COUNTRIES

BY INCOME GROUP 83

FIGURE 12 PRINCIPLES FOR EQUITY- AND EQUALITY-SENSITIVE POLICY AND ACTION 102

FIGURE 13 ROADMAP TO EQUITY-SENSITIVE POLICYMAKING 112

LIST OF BOXES
x]

BOX 1 KEY DEFINITIONS 8

BOX 2 HOW INTERSECTIONAL IDENTITIES COMPOUND FSN OUTCOMES –

INSIGHTS FROM THE UNITED STATES OF AMERICA 29

BOX 3 IMPORTANCE OF AN INTERSECTIONAL APPROACH IN UNDERSTANDING

WHY PROGRAMMES MAY DIFFERENTIALLY BENEFIT DIFFERENT GROUPS 34

BOX 4 SUPERMARKETS CONTRACTING WITH FARMERS IN NICARAGUA:

DO ALL FARMERS BENEFIT? 45

BOX 5 FOOD AFFORDABILITY – A CASE STUDY FROM SOUTH AFRICA 51

BOX 6 CLIMATE JUSTICE AS A TOOL TO ANALYSE FSN INEQUALITIES –

THE CASE OF THE LOWER MEKONG 61
CONTENTS

BOX 7 “BIG FOOD” POWER AND IMPLICATIONS FOR FSN 66

BOX 8 THE EMERGENCE OF FOOD SOVEREIGNTY AS A MOVEMENT 69

BOX 9 FREE YET STILL BONDED AND INVISIBLE: THE CASE OF NEPAL 70

BOX 10 SUCCESSFUL LAND REGISTRATION AND CERTIFICATION IN ETHIOPIA 80

BOX 11 SUCCESSFUL ORGANIZATION OF SMALL-SCALE PRODUCERS:

THE COLOMBIAN NATIONAL COFFEE FEDERATION 82

BOX 12 TERRITORIAL APPROACHES: THE CITY REGION FOOD SYSTEM IN QUITO, ECUADOR 86

BOX 13 SMALL-SCALE, SOLAR-POWERED TECHNOLOGIES TO CUT

FOOD LOSS AND IMPROVE OUTCOMES FOR PRODUCERS, TRADERS AND CONSUMERS 87

BOX 14 VIDEO-BASED EQUITY-SENSITIVE AGRICULTURAL EXTENSION SERVICES

IN ETHIOPIA, INDIA AND KENYA 89

BOX 15 SPOTLIGHT ON SOCIAL PROTECTION PROGRAMMES 93

BOX 16 SUGAR-SWEETENED BEVERAGES TAX IN MEXICO 95

BOX 17 CLIMATE RESILIENCE PROJECT IN RURAL COMMUNITIES OF NORTHEAST BRAZIL 98

[ xi
FOREWORD

T
he High Level Panel of Experts on Food exacerbated by fast-evolving climate change
Security and Nutrition (HLPE-FSN) is and conflicts, disproportionately affecting
the science-policy interface of the United already vulnerable populations. Furthermore,
Nations Committee on World Food Security unequal FSN outcomes have contributed to
(CFS), the foremost inclusive and evidence-based political unrest, sparking protest and food riots.
international and intergovernmental platform Addressing these inequalities is at the heart of
for food security and nutrition (FSN). The the 2030 Agenda for Sustainable Development,
HLPE-FSN offers independent, comprehensive which is based on a human rights approach and
and evidence-based analysis and advice at the pledge to “Leave no one behind”.
the request of the CFS. It prepares its reports
through a scientific, transparent and inclusive Against this backdrop, the report provides a
process, involving extensive consultations and comprehensive analysis of inequalities in food
incorporating diverse forms of knowledge and systems, their deep, systemic drivers, and
expertise, as well as a rigorous scientific peer the ways in which they affect food security
review process. and nutrition outcomes. FSN inequalities
exist throughout the food system, from farm
The report, Reducing inequalities for food security to fork. They include inequalities in access
and nutrition, has been produced by the HLPE- to food production resources and market [ xiii
FSN at the request from the CFS to analyse opportunities for small-scale producers,
quantitative and qualitative evidence regarding unequal power dynamics between large food
how inequalities within food systems impede
corporations and food producers, as well as
opportunities to overcome food insecurity and
unequal access to adequate and nutritious food
malnutrition. The report seeks to identify ways to
among consumers. Indeed, food security goes
address those inequalities and their drivers and
beyond food production and encompasses six
provides recommendations.
dimensions: food availability, access, utilization,
Inequalities in food security and nutrition, stability, sustainability and agency. Agency is
leading to hunger and all forms of malnutrition, key to reducing inequalities in food security and
exist in all regions of the world both among nutrition. It refers to “…the capacity of individuals
and within countries. Even in rich countries, or groups to make their own decisions about
low national prevalence of food insecurity may what foods they eat, what foods they produce,
mask large local disparities. Inequalities in FSN how that food is produced, processed and
reduce people’s life chances and quality of life, distributed within food systems, and their
lower their productivity, perpetuate poverty, and ability to engage in processes that shape food
reduce economic growth. These inequalities are system policies and governance” (HLPE 2020).
 Inequalities in FSN are often accompanied by a Bold efforts are required in the face of
lack of agency in food systems, especially among persistent FSN inequalities and rapid climate
marginalized people. change. The CFS and its members can use this
report to increase public awareness of FSN
The report adopts an intersectional lens and
inequalities and their drivers and to catalyse
considers FSN inequalities in a systemic way.
the implementation of equity sensitive and
Often, multiple disadvantages are compounded
transformative strategies and policies.
along the dimensions of gender, education,
economic and social status, location or ethnicity. On behalf of the HLPE-FSN Steering Committee,
These multiple dimensions interact and have I would like to thank the international experts
cumulative effects. Thus, inequalities in FSN, of the drafting team, led by Bhavani Shankar,
while affecting people in every country in the whose expertise and dedication, and impressive
world, tend to systematically disadvantage (and pro bono) work on this report, have played
certain groups: women, farmworkers and a crucial role in shaping this comprehensive
migrants, Indigenous peoples, informal workers analysis of FSN inequalities as a call for action.
and persons with disabilities. This finding has
I would also like to express my sincere
important implications for policy: progress
appreciation to the many experts, including the
in one dimension or driver of FSN inequality
members of the HLPE-FSN Steering Committee,
might be constrained or exacerbated by another
and institutions who participated in the public
dimension. The report shows these cumulative
consultations and commented on the report
effects and potential trade-offs and the need for
in its previous drafts, as well as to the peer
a holistic approach.
reviewers whose careful reading and suggestions
Because of the intersectional nature of have greatly helped to improve the report. Finally,
inequalities in food systems, the report makes I wish to thank the HLPE-FSN Secretariat for its
the case for a transformative agenda that would tremendous support.
address the systemic drivers of FSN inequality.
The HLPE-FSN mission is to produce scientific
It highlights a set of principles for designing
reports to inform the debate among CFS
equity-oriented policies along the entire food
stakeholders and provide recommendations to
system, addressing power imbalances and
policy convergence processes. Thanks to the
raising agency through the recognition and
work of the CFS, it is hoped that this report on
representation of marginalized groups, and
FSN inequalities can have effective and long-
redistribution of income and resources. The
lasting impact in eliminating hunger and all
xiv ] report proposes a set of actions and real-world
forms of malnutrition. Beyond the CFS, this
examples of how to embed equity principles into
report will surely be useful to advance the
policymaking; provide more equal access to food
understanding of inequalities and how to address
production resources; make public agricultural
them for every individual or institution involved
research sensitive to equity considerations
in food systems, agriculture, nutrition, health,
and the needs of marginalized groups; develop
environment and other related disciplines.
inclusive value chains; and implement territorial,
multisector approaches to food system
development. The report emphasizes social
protection as a key instrument for responding Yours sincerely,
to food crises and reducing FSN inequalities.
It also calls for the integration of universal
health care into nutrition initiatives. The
resulting recommendations are addressed to
the CFS, governments, the United Nations and Bernard Lehmann
international agencies, the private sector and Chairperson of the HLPE-FSN
civil society, as well as academia.
ACKNOWLEDGMENTS

T
he High Level Panel of Experts on Food The following individuals have also contributed,
Security and Nutrition (HLPE-FSN) of in different capacities, to this report: Gregory
the Committee on World Food Security Cooper, Stephen Devereux, Keetie Roelen,
(CFS) expresses heartfelt gratitude to all the Matthew Fisher-Post, Emily Fivian, Suneetha
individuals who made valuable contributions Kadiyala, Helen Harris-Fry, Winnie Bell, Keith
and provided insightful inputs and comments Lividini, Rikin Gandhi, Jessica Fanzo, William
during the two open e-consultations. The Masters.
HLPE-FSN works to address the many issues
facing both policymakers and food and nutrition The HLPE-FSN also acknowledges Dianne
practitioners alike and these valuable insights Berest for the meticulous editing of the
have been fundamental in the working process, English version, and Gianluca Giulini and the
to guarantee legitimacy and scientific quality, as Translation team at FAO for translating the
well as to ensure the incorporation of diverse report into all six official UN languages.
forms of knowledge and expertise. The first
The partnership with Visiontime International
consultation, focusing on the report’s scope,
LLC for the design and layout of the report was
received contributions from 38 participants,
both enjoyable and productive.
while the second consultation, on the “V0” draft
of the report, involved 87 contributors working It is important to note that the HLPE-FSN
in different fields of expertise, affiliations and reports are independent collective scientific
countries. These contributions were channelled endeavours focused on topics requested by the
through the FAO’s Global Forum on Food Committee on World Food Security Plenary.
Security and Nutrition (FSN Forum). All these These reports are considered global public
contributions can be accessed on the FSN goods, all the experts involved are working on
Forum website: https://www.fao.org/fsnforum/ a pro-bono basis and the process is entirely
partners/high-level-panel-experts-food- funded through voluntary contributions. The
security-and-nutrition-hlpe-fsn
[ xv
HLPE-FSN expresses gratitude to the donors
who have contributed to the Trust Fund since
Furthermore, the HLPE-FSN extends its
appreciation to all the peer-reviewers for their 2010 or provided in-kind contributions, enabling
precious feedback on the “V1” draft of the the panel’s work while fully respecting its
report. The list of all HLPE-FSN peer reviewers independence. Since its establishment in 2010,
is available on the HLPE-FSN website: the HLPE-FSN has received support from the
https://www.fao.org/cfs/cfs-hlpe/en following countries and other donors: Australia,
the Province of Québec, China, Ethiopia, the
Participants in the CFS public event on 22 European Union, Finland, France, Germany,
November 2022 on “Reducing Inequalities Ireland, Monaco, New Zealand, Norway, the
for Food Security and Nutrition” also deserve Russian Federation, Slovakia, Spain, the Sudan,
a warm thank for their valuable and timely Sweden, Switzerland and the United Kingdom of
inputs, which can be found on the CFS website: Great Britain and Northern Ireland.
https://www.fao.org/cfs/events/events-details/
en/c/1618469/
 ACRONYMS

AHEI Alternative Healthy Eating Index

ASF Animal-source food
CFS Committee on World Food Security
COP Conference of the Parties
COVID-19 Coronavirus disease 2019
DBM Double burden of malnutrition
FAO Food and Agriculture Organization of the United Nations
FEDCAFE Colombian National Coffee Federation
FIES Food Insecurity Experience Scale
FSN Food security and nutrition
GBV Gender-based violence
GDP Gross domestic product
GFF Global Financing Facility
GNI Gross national income
GNP Gross National Product
HIC High-income country
HIV/AIDS Human immunodeficiency virus/acquired immune deficiency syndrome
HLPE High-Level Panel of Experts
IFAD International Fund for Agricultural Development
ILC International Land Coalition
ILO International Labour Organization
xvi ] IPCC Intergovernmental Panel on Climate Change
IPES-Food International Panel of Experts on Sustainable Food Systems
LIC Low-income country
LMIC Low- and middle-income country
MDB Murry Darling Basin
MSME Micro, small and medium-sized enterprise
NCD Non-communicable disease
NGO Non-governmental organization
NSA Nutrition-sensitive agriculture
 OECD Organization for Economic Co-operation and Development
PLA Participatory learning and action
PO Producer organization
PoU Prevalence of undernourishment
R&D Research and development
SDG Sustainable Development Goal
SSB Sugar-sweetened beverage
UN United Nations
UNDP United Nations Development Programme
UNDRIP United Nations Declaration on the Rights of Indigenous Peoples
United Nations Declaration on the Rights of Peasants and Other People Working in
UNDROP
Rural Areas
UNEP United Nations Environment Programme
UNICEF United Nations Children's Fund
UPAVAN Upscaling Participatory Action and Videos for Agriculture and Nutrition
UPF Ultra-processed foods
WASH Water, sanitation and hygiene
WFP World Food Programme
WHO World Health Organization
WTO World Trade Organization

[ xvii
 SUMMARY
T
he report “Reducing inequalities for food by social, economic and geographical position).
security and nutrition” has been developed The latter are underpinned by inequities,
by the High Level Panel of Experts on Food defined as the avoidable reasons why uneven
Security and Nutrition (HLPE-FSN) following the distribution exists and why disadvantage accrues
request by the United Nations Committee on World systematically, based on asymmetries in social
Food Security (CFS) as included in its Programme position, discrimination and power.
of Work (MYPoW 2020-2023).
The report is developed within a broader framing
In particular, the CFS requested the HLPE-FSN to of human rights and it draws on diverse forms
develop a report to: (i) analyse evidence relating to of evidence and data. This includes academic
how inequalities in access to assets (particularly research and reports; qualitative and ethnographic
land, other natural resources and finance) and in evidence; quantitative and modelled approaches;
incomes within food systems impede opportunities and Indigenous, local, situated, and tacit knowledge.
for many actors to overcome food insecurity and It draws on different framings for action on
malnutrition; (ii) analyse the drivers of inequalities inequality and inequity in FSN, including economic
and provide recommendations on entry points to redistribution, human rights, and social justice.
address these; and (iii) Identify areas requiring
The conceptual framework describes how
further research and data collection.
inequalities in FSN outcomes are best reduced
This report will inform the ensuing CFS thematic by addressing inequalities in food systems and
workstream on inequalities, aiming at addressing in other related systems. Sustainable change
the root causes of food insecurity with a focus on requires understanding and addressing the
those “most affected by hunger and malnutrition”. systemic drivers and root causes of inequity in
context. Understanding inequity and inequality
involves recognizing who is marginalized from
RATIONALE AND food and nutrition opportunities, and how and
why. In coming to this understanding, it is
CONCEPTUAL FRAMEWORK vital to consider how inequity is intersectional
The report is organized around six chapters. (inequalities interact), intergenerational
Chapter one explains the report’s focus on (inequities are passed on over time), and
xviii ] inequalities and inequities. Inequalities in food interterritorial (inequities are spatially and
systems underlie inequalities in food security and geopolitically determined). In addressing
nutrition (FSN). It is vital to address inequalities inequality and inequity, actions must work
because they threaten progress on FSN. through processes of recognition (acknowledging
Reducing inequalities is mandated in human the specifics and history of inequity in each
rights covenants that states have committed context), representation (ensuring that
to. Doing so corresponds to a natural sense of marginalized groups are genuinely empowered
human justice and fairness that is embodied in to have agency over the choice of actions to
the 2030 Agenda for Sustainable Development address inequity), and redistribution (ensuring
to “Leave no one behind”. The report contributes the opportunities and resources are allocated
to a common understanding of key concepts and fairly and that costs do not fall on those with less
terms such as inequities and inequalities in the political power). Actions to address inequalities
context of FSN. It defines inequalities in food in FSN outcomes and the inequities that underpin
systems as the observed differences in FSN them should work through human rights and
outcomes, or related food systems factors (such justice principles, and consider the range of
as access to food production resources), between knowledges and evidence available in framing
individuals and groups (when disaggregated issues and actions.
FIGURE 2:
CONCEPTUAL FRAMEWORK: ENGINE OF EQUITY FOR FSN
Consider intersectional, intergenerational, interterritorial inequity

Address Agency
inequalities Sustainability
within food
systems Stability
Understand Recognition Redistribution Improved
systemic FSN
drivers of outcomes
inequity for all
Address Availability
inequalities in
other systems Accessibility
Utilization
Representation

Work towards human rights, inclusive knowledges, justice

Source: Authors’ own elaboration.

MAJOR FINDINGS More qualitative (lived experience data) and

adequately disaggregated data along gender,
Chapter two leverages existing data to describe
location, economic status, ethnicity, other
[ xix
patterns and trends of inequality in FSN
outcomes. While inequalities in food security social group and physical ability is required
are particularly seen to affect populations in to systematically quantify and track FSN
Africa, South Asia and the Caribbean, inequality inequalities. Finally, it is recognized that many
in nutritional status exists globally. Further, important inequalities are intersectional,
despite gains made in reducing undernutrition in but insufficient data exist to characterize this
LMICs, the global rise in overweight and obesity intersectionality and to identify those most
among both adults and children undermines the
vulnerable in a timely and consistent manner.
past progress made in nutrition and since 2015,
food insecurity has worsened is most regions of Chapter three examines the proximate drivers
the world. of FSN inequalities within food systems and
in other systems relevant to FSN. Within
Context motivates the variability seen in
the factors that contribute to within-country food systems, it explores three broad areas: (i)
inequality, except for certain consistently inequalities in food production resources; (ii)
marginalized groups – women, those without inequalities in food supply chains (iii) inequalities
education, Indigenous Peoples and the poor. in food environments and consumer behavior.
 Within food systems, large, persistent, and making power and ownership. These changes
often increasing inequalities that constrain have altered dietary patterns in complex ways
FSN exist across the food chain. This includes and curtailed the agency of most food system
inequalities in distribution of food production workers. While some nutritional benefits accrue,
resources, access to knowledge and finance, there are concerns about the impacts of a
ability to engage with and gain from modern transition towards a Western obesogenic diet that
value chains and markets, storage, processing exacerbate FSN outcomes, initially affecting the
and distribution, and international food trade. wealthiest in society but then gradually becoming
Moreover, size and economic status (for instance, a problem for the most marginalised or socio-
small vs large farms) and gender are major economically disadvantaged sections of society.
inequality dimensions across the food chain, but
other sources of inequality, such as Indigeneity Policies related to different dimensions and
and geographical location, are also frequent actors in the food systems have remained
constraints to FSN. Food environments also siloed, and seldom focus on the needs of
provide highly unequal opportunities for FSN, the most marginalized. In many cases, this
with low-income populations and minority has exacerbated pressures and created
groups particularly impacted by the inequalities. vulnerabilities. Violence and conflict are the
main drivers of acute and chronic hunger,
Inequalities in other relevant systems, which undermining people’s agency and exacerbating
affect FSN, such as education and health poor FSN outcomes for the most vulnerable.
systems, contribute to inequalities in FSN Geopolitical interests often determine whether
outcomes. As a consequence, multisectoral the impacts of conflict on FSN outcomes
governance of FSN provides opportunities to are exacerbated or ameliorated, and where.
reduce FSN inequality, but requires careful Reaffirming the right to food in all geopolitical
rules of engagement to mitigate power conflicts can help reduce inequalities
imbalances. in FSN outcomes.
Chapter four takes a broader social and Sociocultural drivers intersect with all
historical perspective and examines the categories of drivers, to create barriers that
deeper systemic drivers and root causes of produce and reinforce existing inequalities.
FSN inequalities. It is essential to view the Historical inequities will therefore persist,
vast inequalities in FSN outcomes not just as unless explicitly challenged with equity-sensitive
outcomes of inequalities in food and related policies and practices.
xx ] systems, but also as the result of deeper,
systemic drivers. Many drivers that act on food
systems have underlying drivers within food
systems themselves. For example, climate
AREAS FOR ACTION
Chapter five presents actions that can be
change and environmental decline harm food
taken within food and other systems to
system workers and are a threat to FSN,
improve FSN. These actions are not meant to
particularly where people and places are most
be exhaustive, but they present priority areas
vulnerable to change. However, food systems
that hold significant potential for reducing
themselves are major drivers of climate change.
FSN inequalities. Equity-informed policy and
Breaking this harmful feedback has considerable
programmes must be informed by these first
potential for reducing inequalities in FSN
principles: being adaptive to context; focusing
outcomes.
on agency and working to undo inequitable
Economic and market drivers have norms; and addressing power imbalances.
fundamentally changed food systems, by Business as usual, including incremental action,
shaping market dynamics, flows of finance, and is too slow to address the scale of injustice
patterns of global trade to consolidate decision- in food systems and the rate of change in
relation to climate and environmental threats: considering territorial approaches in food system
transformative change that explicitly addresses and regional development planning; (iv) investing
inequality and inequity is needed now. in equity-sensitive storage, food processing and
To be adapted to local contexts, a variety of distribution infrastructure; and (v) investing in
actions to address inequalities are necessary improved information systems, leveraging digital
across food and related systems. These are technologies.
clustered into four broad categories: food
Under food environment and consumption, the
production; food supply chains; food environment
and consumption; and enabling environment, main action areas include: (i) food-environment
broader context and governance. planning and governance; (ii) incorporating
behavioural insights into policymaking and
Within food production, major action areas to
programming; and (iii) strengthening social
reduce inequalities for FSN include: (i) enabling
protection.
more equal access to land, forests, livestock and
fisheries; (ii) applying agroecological principles Several action areas pertaining to the enabling
across production and broader food systems; (iii) environment, broader context and governance
establishing inclusive producer organizations;
include: (i) food- and nutrition-sensitive policy
and (iv) investing in equity-sensitive public
and planning; (ii) addressing corporate power
agricultural and food- systems research and
asymmetries in governance; (iii) universal health
other rural public investments.
care that integrates nutrition care; (iv) a holistic
The action areas in food supply chains include: approach to climate and sustainability; and (v)
(i) adopting inclusive value chain approaches; (ii) inclusive growth for FSN, and policy that goes
developing labour-protection policies, strategies,
beyond growth.
and programmes for food-system workers; (iii)

[ xxi
INTRODUCTION

[1

© FAO/Antonello Proto © Dji–Agras

 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

T
he High Level Panel of Experts on Food In particular, the CFS requested the HLPE-
Security and Nutrition (HLPE-FSN) Note FSN to develop a report to: (i) analyse evidence
on critical and emerging issues from 2017 relating to how inequalities in access to assets
(HLPE, 2017a) described the relevance of (particularly land, other natural resources and
inequalities for food security and nutrition in very finance) and in incomes within food systems im-
clear terms. During its 46th plenary session (14– pede opportunities for many actors to overcome
18 October 2019), the Committee on World Food food insecurity and malnutrition; (ii) analyse the
Security (CFS) adopted its four-year Programme drivers of inequalities and provide recommen-
of Work (MYPoW 2020-2023), which included dations on entry points to address these; and
a request to its High Level Panel of Experts (iii) identify areas requiring further research and
on Food Security and Nutrition (HLPE-FSN) to data collection (CFS 2019/46/7, 2019, p.10).
produce a report on “Reducing inequalities for
This report will inform the ensuing CFS thematic
food security and nutrition”, to be presented at
workstream on inequalities, aiming at address-
the 51st plenary session of the CFS in 2023 (CFS,
ing the root causes of food insecurity with a
2019). focus on those “most affected by hunger and
In the rationale of the CFS request for this re- malnutrition”, with a focus on inequalities within
port, it was stated that: food systems. The workstream will provide an
analysis, based on this HLPE-FSN report, on
Sustained disparities between vulnerable and drivers of socioeconomic inequalities between
other social groups – reflecting inequalities actors within food systems that influence food
between and within countries - can slow growth security and nutrition outcomes.
and lead to political instability, migration fluxes,
with related adverse consequences on food se-
curity and nutrition. Stark inequalities – includ- CONTENT OF THIS
REPORT
ing between rural and urban areas – in access to
basic services and assets lead to unequal pro-
cesses of economic growth and transformation. This report is a snapshot of the current state
These inequalities affect households’ prospects of knowledge regarding inequality and inequity
for overcoming rural poverty, food insecurity and related to FSN. Much of the evidence presented
malnutrition (CFS 2019/46/7, 2019, p. 9). is contemporary, illustrating inequalities among
population groups using the most recent data.
The report will provide recommendations to the Building back from the present time, we focus
CFS workstream on inequalities. where possible on change in inequalities over
2]
INTRODUCTION

time (mobility); on how inequities are passed on vides key concepts and definitions, as well as
over time (intergenerationally); and on the his- a conceptual framework, the following three
torical drivers of current inequities. Building for- chapters describe inequalities in FSN outcomes
ward, we also focus on important future trends and examine their drivers. CHAPTER 2 character-
in inequalities, such as those driven by climate izes the major inequalities in FSN outcomes
change, and on how action on equity could mit- across and within countries. CHAPTER 3 examines
igate these trends. It is not possible in a single major inequalities within food systems and other
report to consider every inequality and inequity FSN-relevant systems that influence unequal
that relates to food systems and FSN outcomes. FSN outcomes. CHAPTER 4 examines the deeper
Rather, we focus on key issues and populations
layer of structural drivers fundamental to under-
that particularly highlight these issues, and call
standing inequity, including sociocultural, eco-
for further research and context-specific action.
nomic and political aspects. Then chapters 5 and
This report has six substantive chapters, orga- 6 discuss solutions: CHAPTER 5 examines actions
nized according to the HLPE-FSN food systems within food systems and other FSN-relevant sys-
framework (HLPE, 2020), that probe issues and tems as well as approaches to broader transfor-
solutions for inequalities and inequities across mation, and CHAPTER 6 concludes the report with a
the system (FIGURE 1). After CHAPTER 1, which pro- prioritized set of recommendations.

FIGURE 1:
STRUCTURE OF THE REPORT IN RELATION TO THE FOOD SYSTEMS FRAMEWORK
Inequitable drivers
of FSN outcomes
Chapter

BIOPHYSICAL AND TECHNOLOGY,

ENVIRONMENTAL INNOVATION AND ECONOMIC AND POLITICAL AND SOCIO-CULTURAL DEMOGRAPHIC
DRIVERS INFRASTRUCTURE MARKET DRIVERS INSTITUTIONAL DRIVERS DRIVERS DRIVERS
e.g. e.g. e.g. e.g. e.g. e.g.
Natural resource Data-driven innovations Livelihoods and income Governance frameworks Social norms and traditions Urbanization
degradation New plant breeding Markets, firms and trade institutional support Social stratification Changing age profiles
Climate change technologies Land tenure Civil strife and conflict Women’s empowerment Migration
Disease vectors Post-harvest infrastructure

SYSTEMS SUPPORTING FOOD SUPPLY CHAINS CONSUMER DIETS

[3
NUTRITION AND
FOOD PRODUCTION • Production systems BEHAVIOURS • Quantity HEALTH OUTCOMES
• Ecosystems • Storage and trade • Choosing where and • Quality
• Human systems • Packaging and what food to acquire, • Diversity Chapter Unequal FSN
2
prepare, cook, store
Inequalities •
•
Energy systems
Economic systems
processing
• Retail and marketing and eat
•
•
Safety
Adequacy outcomes
in proximate Chapter • Heatlh systems • Awareness of impact
of choices
BROADER IMPACTS:

3
Economic
drivers of FSN Social equity
FOOD SYSTEMS FOOD ENVIRONMENTS
Environment
• Production support systems • Availability and physical access
• Supply chain activities •
• Food environments • Acceptability
• Consumption behaviours • Information, guidelines and advertising
• Diets • Food quality and safety
• Outcomes • Policy conditions

Action to POLICY AND GOVERNANCE

reduce Chapter
inequalities
and inequities
5 AVAILABILITY - ACCESS - UTILIZATION - STABILITY - AGENCY - SUSTAINABILITY
RIGHT TO FOOD FRAMEWORK

Chapter Chapter

6 1
Actions and Concepts,
recommendations definitions and scope

Source: Adapted from, HLPE 2020. Food security and nutrition: building a global narrative towards 2030. A report by the High Level Panel of Experts on Food
Security and Nutrition of the Committee on World Food Security. Rome.
 Chapter 1
CONCEPTS AND
FRAMEWORK

4]

©FAO/Luis Tato
1 CONCEPTS AND FRAMEWORK

KEY INSIGHTS
• Inequalities in food systems underlie inequalities in food security and nutrition (FSN). It is vital to address
inequalities because they threaten progress on FSN, and because this is mandated in global goals and
human rights covenants that states have committed to. Doing so corresponds to a natural sense of human
justice and fairness that is embodied in the 2030 Agenda for Sustainable Development to “Leave no one
behind”.
• This report defines inequalities as the observed differences in FSN outcomes, or related food
systems factors (such as access to food production resources), between individuals and groups (when
disaggregated by social, economic and geographical position). The latter are underpinned by inequities,
defined as the avoidable reasons why uneven distribution exists and why disadvantage accrues
systematically, based on asymmetries in social position, discrimination and power (BOX 1).
• The analysis intentionally draws on diverse forms of evidence, including academic research and reports;
qualitative and ethnographic evidence; quantitative and modelled approaches; and Indigenous, local,
situated and tacit knowledge. It draws on different framings for action on inequality and inequity in FSN,
including economic redistribution, human rights, and social justice.
• The conceptual framework describes how inequalities in FSN outcomes are best reduced by addressing
inequalities in food- and in other related systems. To do this sustainably entails tackling root causes:
understanding marginalization in context and pursuing policies of recognition, representation and
redistribution for marginalized groups and others, both directly in food systems and in related areas of
policy and governance.

1.1 WHY FOCUS ON are not distributed equally across countries, or

across social groups. For example, child stunting
INEQUALITY AND ITS prevalence is highest in Melanesia, central Africa
and among poor people in rural contexts globally.
RELATIONSHIP TO In contrast, child overweight is highest in certain
[5
INEQUITY? populations of Australia and Aotearoa New
Zealand, and adult overweight falls heavily on
The world is characterized by inequalities
socioeconomically disadvantaged communities
in both opportunities and outcomes. Such
in many wealthy contexts.
inequalities are particularly stark within food
systems (BOX 1), where they exacerbate already Inequalities carry considerable economic,
alarming conditions of hunger and malnutrition, environmental and social costs, which through
presenting a serious impediment to any various pathways constrain FSN. Poor FSN in
successful transformation. One in five children turn reduces people’s life chances and quality of
under five years is stunted. One in three people life, lowers their productivity, perpetuates poverty
lacks access to adequate food (Development and reduces economic growth both directly (such
Initiatives, 2021). At the same time, three billion as through medical costs) and indirectly (such
people are unable to afford a healthy diet and, as through lost productivity) (Kleinman et al.,
as of 2016, obesity affects 671 million adults 2014; World Obesity Federation, 2017). Indirect
and 124 million children (FAO et al., 2021; costs related to obesity, for example, have been
Herforth et al., 2020; The GBD 2015 Obesity estimated to reach 8 percent of gross national
Collaborators, 2017). Crucially, these outcomes product (GNP) in some countries (Popkin et
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

al., 2006) and costs related to micronutrient if inequalities create human rights violations,
deficiencies can reach 11 percent of GNP such as barriers to achieving the right to food,
(Horton and Steckel, 2013). Inequalities in food states have a legal obligation to correct those
distribution and consumption contribute to an inequalities (OHCHR, 1966).
estimated one-third of food produced for human
This report tackles the issue of inequality and its
consumption going to loss and waste, costing
determinants, both within and across countries
USD 70 billion annually, and the unnecessary
and regions. It builds on previous work of the
loss of land, water and biodiversity (FAO, 2013).
HLPE-FSN and draws on multidisciplinary
Biodiversity and dietary diversity are inextricably
linked, and the loss of one affects the other, both evidence and forms of knowledge to strengthen
impacting most heavily the most marginalized the ways in which the global community might
populations (Harris et al., 2022b). In addition to acknowledge, assess and address inequalities
the environmental and economic impacts, these in FSN. As such, the report sets out to: i) clarify
vast inequalities have historically led to political meanings and definitions around inequality and
unrest, with hunger and uncertain food security its determinants, in order to facilitate clearer
sparking protest and food riots (Bush and debate and action (CHAPTER 1); ii) describe
Martiniello, 2017). the state of inequality in FSN outcomes
(CHAPTER 2); iii) depict how inequalities in food
Inequalities affect people in every country in systems and other related systems drive these
the world, and often multiple disadvantages FSN outcomes (CHAPTER 3); iv) expand on the
are compounded. For example, being female deeper systemic drivers of these inequalities
in a place where women are disadvantaged by (CHAPTER 4); and v) establish how these inequalities
society may be even more difficult for women can best be addressed (CHAPTER 5), providing a
who are also of a marginalized ethnicity or caste set of recommendations for more equal and
– a compounding of negative effects known equitable food systems for FSN (CHAPTER 6).
as “intersectionality”. This means that the
most marginalized people in society also tend
to be those most left behind in food systems
(Development Initiatives, 2021; Harris et al., 2021;
1.2 THE CASE FOR
Nisbett et al., 2022). TRANSFORMATIVE OVER
These multifaceted and dire impacts of inequality INCREMENTAL ACTION
underscore why addressing inequality is at Transformative action on inequality in FSN has
6] the heart of the 2030 Agenda for Sustainable been framed in different ways, from enacting
Development, applicable to high- and low- significant changes within the existing policy space
income countries alike. Any goal that aims (such as improving access to knowledge and
to reduce all forms of malnutrition, non- technology, and supporting consumers to afford
communicable diseases (NCDs), hunger and and choose healthy foods) (Ruben et al., 2021), to
food insecurity must embrace the principle of significant changes in structures of power and
leaving no one behind (UNSDG, 2023). FSN is politics (to reduce resistance by powerful vested
addressed in human rights frameworks where, interests, or the misapplication of incremental
through several international conventions, change in ways that only exacerbate inequalities)
states universally affirm that “All human beings, (Béné et al., 2021; Newell et al., 2021). It is clear
regardless of their race, colour, sex, language, that the scale of the challenge in food systems (and
religion, political or other opinion, national or various other human and natural systems covered
social origin, property, birth or other status have in the 2030 Agenda for Sustainable Development)
the right to adequate food and the right to be free requires thinking that integrates consideration of
from hunger” (UNHCR, 2010). There are calls human and planetary health and well-being, and
for a strengthening of the relationship between these complex challenges are best addressed
human rights and inequality (De Schutter, 2023): through actions designed to tackle the root causes
1 CONCEPTS AND FRAMEWORK

of food security and malnutrition in all its

forms at the same time (Hawkes et al., 2020). 1.3 CONCEPTS AND
Now is the time for multiple actions that work
simultaneously on the interrelated and systemic
DEFINITIONS
drivers that concentrate negative food system 1.3.1 FOOD SECURITY
impacts on the most marginalized populations Since the first FAO widely-accepted definition of
(Swinburn et al., 2019). food security in 1974, which focused on food supply,
Transformative change is needed for three reasons: the concept of food security has continued to
evolve. Most recently, the four previously identified
1) the rate of progress towards global targets,
dimensions of food security – availability, access,
working through incremental actions, is too slow;
utilization and stability – have been extended to
and a failure to focus on inequality is delaying
include agency and sustainability; and the right
progress overall because FSN outcomes are
to food has been acknowledged as central to food
slower to change for more marginalized groups
security (Clapp et al., 2022; HLPE, 2020). Previous
(Development Initiatives, 2021; GloPan, 2020;
definitions of food security had not adequately
Harris et al., 2021; HLPE, 2020). 2) Eco system
engaged with the conditions within which food was
services and biodiversity provided to food systems
produced or distributed, nor with who was hungry
by natural systems are under unprecedented
or malnourished and why (Development Initiatives,
threat, adding urgency to transformation (ILC,
2021; Sunam and Adhikari, 2016). Framing food
2020; Steffen et al., 2015; UNCCD, 2019), and the
systems through a lens of agency signals the need
impact of natural resource degradation is felt most
for policy and programmatic responses that place
acutely by those most marginalized within the food
power in the hands of those most affected by poor
system, including Indigenous Peoples, smallholder
FSN and marginalized in the systems that produce
farmers, fishers, landless labourers and migrants
our food; and that people are supported to demand
who together produce a majority of the world’s food accountability from those with the duty to support
(UNCCD, 2019). 3) The pace of human-induced them. The incorporation of the sustainability
climate change has outstripped earlier predictions dimension explicitly links food security outcomes
(UNEP, 2022) and has fundamental impacts on to the nature of food systems and calls for radically
the ability of humans to produce food in the ways transformed systems that are “empowering,
we have been doing, with greater impacts on the equitable, regenerative, productive, prosperous”
most marginalized producers – those who have and that “boldly reshape the underlying principles
contributed least to climate change in the first from production to consumption” (HLPE, 2020).
place (UNEP, 2022). Both agency and sustainability require that policies [7
and practices address systemic unfairness,
This report defines transformative change in
injustice and exclusion in food systems (described
FSN as actions taken across the entire food and
in this report as “inequity”) to address systematic
economic system, entailing fundamental changes
differences in FSN outcomes (described in this
to food systems governance and to wider political
report as “inequality”). BOX 1 provides definitions for
systems to redress power imbalances that
key terms related to inequality and FSN. (See Annex
have normalised high rates of food insecurity
1 for further key definitions used in this report.)
and malnutrition (Devereux et al., 2022).
Transformative change needs to happen at a
pace that matches scientific consensus on rapidly 1.3.2 EQUALITY AND EQUITY
escalating and fundamental threats to human Differences between people and populations
and planetary health, but without exacerbating have always existed, due to natural variations
existing inequalities or placing the burden on associated with where people live and the resources
future generations. available to them. For example, differences in
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

BOX 1:
KEY DEFINITIONS
A food system represents all the elements (environment, people, inputs, processes, infrastruc-tures, institutions,
etc.) and activities that relate to the production, processing, distribution, prepara-tion and consumption of food, and
the outputs of these activities, including socio-economic and envi-ronmental outcomes (HLPE, 2014).

Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe,
nutritious food that meets their dietary needs and food preferences for a healthy and active life (FAO, 2001). The key
dimensions of food security are availability, access, sustainability, agency, utilization and stability (HLPE, 2020).

Inequalities are the observed differences in nutritional or food security outcomes or related food system factors
(such as access to finance) between individuals an groups, based on social, econom-ic, and/or geographical position
(for instance, socioeconomic status, race or ethnicity, sex or gender (Nisbett et al., 2022).

Inequities are the socially, economically or politically driven reasons why systematic differences in food system
opportunities or the distribution of food security and nutritional outcomes exist, related to how social groups are
seen and treated by the rest of society, both within and outside the food system (WHO, 2008).

Agency has been defined in previous HLPE-FSN reports as “what a person is free to do and achieve in pursuit of
whatever goals or values he or she regards as important” (Sen, 1985, p.203). Empow-erment is a key aspect of
agency, such that people can participate and engage in society, and con-tribute to shaping and bettering their own
lives and well-being (Alsop and Heinsohn, 2005).

Source: Authors’ own elaboration.

geography and natural resource endowment is sometimes referred to as affirmative action

mean that people living in some locations have (Romany and Chu, 2004).
8] less freshwater, less fertile soils or smaller areas
The focus of this report is on cases where the
of land, forest and marine resources available
action (or inaction) of society either creates
to them, resulting in a lower capacity to directly
variations or makes natural variations worse
produce or catch food. Natural differences are
(WHO, 2008). For instance, the impact of poorer
often not the major impediments to FSN, however:
natural resource endowment on FSN is worsened
differences are also created and exacerbated by
by a consistent lack of oversight and investment in
society. For example, women have historically been such places, as well as a lack of representation of
excluded from economic and political processes these subpopulations when it comes to decision-
and opportunities, and the result is that measures making. Thus, the natural variation (endowments)
of economic engagement, health outcomes and becomes an avoidable inequality (difference in
educational attainment remain lower for women outcomes), when the actions of society allow such
than for men across all countries (Nussbaum, 2000; differences to endure or even exacerbate them.
UNDP, 2015; WEF, 2021). There is, therefore, a need This may be further compounded when particular
to support some populations differently, or more, to social groups are relocated from traditional lands
achieve the same outcomes – whether differences to less favourable environments, as has happened
are due to ‘natural’ variation or man-made. This to many Indigenous communities. Thus, even a
1 CONCEPTS AND FRAMEWORK

seemingly “natural” inequality in FSN, driven by at three levels: systemic drivers of inequality;
natural resource endowment, may well have a inequalities within food systems and in other
socially driven cause as well. related systems; and unequal FSN outcomes.

The actions of society (including social, political Understanding and addressing the deepest
and economic actions) are shaped by how a drivers of unequal FSN in context is the most
society sees itself and sees the different people transformative way to reduce inequalities in
within it. In every society, cultural norms and FSN. Doing this requires, first, recognizing which
values shape social position based on identities economic or social groups are most marginalized
such as gender, ethnicity, race, religion, age, (for instance, small-scale producers, the urban
disability and other socially-determined and rural poor or those discriminated against
characteristics. Different groups hold different
on the basis of their identity; and recognizing
positions of power within societies based on
why that is the case (for example, because
these ideas. Some hold power to shape policy
they lack access to information or to decision-
and society, whereas others are marginalized
making processes and power, or because their
from these processes. When social norms
values, cultures and systems of knowledge are
systematically disadvantage or marginalize
not represented in the dominant institutions
certain groups based on their characteristics, this
and systems of governance). In the conceptual
is defined as inequity (WHO, 2008).
framework of this report, this is labelled
This set of variations, inequalities and inequities “recognition”: that is, recognition of who is
creates a cyclical and intergenerational situation marginalized, why and how (Fraser, 2009).
of marginalization and disadvantage accruing to
certain social groups in certain contexts, which Next, understanding and addressing the core drivers
is hard to break without direct intervention to of unequal FSN requires asking who is represented
create more equitable conditions and decrease in decision-making at multiple levels, from the local
inequalities. Marginalization directly affects level to national policymaking and beyond; and,
FSN outcomes in a similar cyclical pattern importantly, how they are included or excluded.
because poverty and other forms of disadvantage However, having a seat at the table is not enough if
are directly linked to food insecurity and poor recognition (above) is incomplete or if resources to
nutritional status, and poor FSN can also drive participate fully are insufficient. In the framework
further poverty and marginalization, including we call this “representation”: representation of
through intergenerational mechanisms (for marginalized groups themselves, or their chosen
instance, malnourished mothers give birth to low representatives, in making decisions that affect [9
birthweight children) (Perez-Escamilla et al., 2018). them, a principle often expressed as “nothing about
us, without us” (Charlton, 1998).
These definitions are informed by extensive
research spanning different disciplines (including Addressing the systemic drivers of unequal FSN
sociology, public health and health equity, then requires asking why economic opportunities
economics, human rights and public health and resources are distributed in the way they are,
nutrition) so that different disciplinary points of
and how redistribution of these can be achieved
view are reflected in this report.
in favour of marginalized groups (for instance,
directing investment towards previously under-

1.4 CONCEPTUAL represented areas; or ensuring social protection

reaches groups previously not recognized as
FRAMEWORK marginalized). In the framework we call this
The conceptual framework for this report “redistribution”: redistribution of resources,
(FIGURE 2) is rooted in diverse literatures on justice, opportunities or whatever has been denied to
inequality and inequity (CSDH, 2008; Fraser, 2009; those marginalized groups that has held them
Nisbett et al., 2022) which anchor the framework back from reaching their FSN potential.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

This process of recognition, representation and of resources or opportunities to enable those

redistribution (the circle in the middle of FIGURE 2, groups to participate on a level playing field
the “engine of equity”) is important in ensuring with others. Working through the classic FSN
full redressal of the multiple social and political pathways of food availability, accessibility and
disadvantages that drive FSN inequalities. utilization, alongside food systems stability and
Each part of this engine needs to work with
sustainability, and the agency of all those affected,
the other parts to bring about fundamental
the “engine of equity” can lead towards improved
transformations in the unequal experience of
FSN outcomes for all.
FSN. Beyond addressing these issues at their
most fundamental social roots, they can also be An overarching principle is that inequity is
addressed within food systems, for example by frequently intersectional in nature# (several
acting to reduce inequalities in access to food
inequalities interacting in detrimental ways) and
production resources, finance, information and
that its impacts are intergenerational (affecting
value chain opportunities.
the same social groups repeatedly over time)
Given the multisectoral basis of FSN, there are and interterritorial (while they may play out
also opportunities to address these inequalities differently in different contexts, we see the same
within other related systems such as economic, equity issues across all places). These aspects
health and education systems, and in the context of inequity appear at the top of FIGURE 2 and should
of other fundamental rights, such as housing and always be considered when thinking through
water. Such multisectoral action is important in
solutions in context. A key and established goal of
improving FSN as there are synergies between
equitable systems that should not be forgotten as
actions to reduce inequalities in across systems.
we work towards reducing inequality and inequity
Addressing inequalities in the other systems
is working towards the progressive realization
requires the same process: recognition of who
is affected by marginalization and inequity of human rights, and through the inclusion of
within the system, and why and how; genuine different bodies of knowledge and framings of
representation of marginalized groups alongside issues of inequality and FSN. These appear along
others in framing solutions and finding ways to the bottom of FIGURE 2, and are discussed in the
address unequal power; and often, redistribution next section.

10 ]
1 CONCEPTS AND FRAMEWORK

FIGURE 2:
CONCEPTUAL FRAMEWORK: ENGINE OF EQUITY FOR FSN
Consider intersectional, intergenerational, interterritorial inequity

Address Agency
inequalities Sustainability
within food
systems Stability
Understand Recognition Redistribution Improved
systemic FSN
drivers of outcomes
inequity for all
Address Availability
inequalities in
other systems Accessibility
Utilization
Representation

Work towards human rights, inclusive knowledges, justice

Source: Authors’ own elaboration.

1.5 APPROACHES TO EQUITY The report also draws on diverse ways of

knowing, such as knowledges of Indigenous
[ 11
RESEARCH AND PRACTICE Peoples and local communities and traditional
ecological knowledge, to understand and address
FSN inequities. Recognition and support of
1.5.1 FORMS OF KNOWLEDGE diverse knowledge systems helps to acknowledge
AND EVIDENCE different epistemologies, ontologies and ethical
This report incorporates multiple forms considerations in addressing the complex
of scientific knowledge and approaches to equity and equality issues in food systems
understanding inequity and inequality in FSN, (Huambachano et al., 2022; Kennedy et al., 2022;
from the Gini coefficients and Lorenz curves Vijayan et al., 2022), and is crucial to sustainably
transforming food systems and increasing
familiar to economists; to population-level
the agency of marginalized populations within
outcome data disaggregated by subpopulation
their historic and natural environments (Coté,
familiar to epidemiologists; to qualitative 2022a; Huambachano, 2020) . Excluding these
ethnographies of people’s lived experience of bodies of knowledge has deepened food security
inequity familiar to anthropologists. inequalities by disregarding marginalized people’s
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

own solutions. However, care must be taken to to equality and equity, we adopt global lessons,
avoid removing this knowledge from its cultural from the North and the South, from high-income
context, distilling and synthesizing it to the extent and low-income countries.
that its original meaning and ongoing capacity for
validation, change and adaptation are undermined
(Casimirri, 2003).
1.5.2 A DIALOGUE WITH
HUMAN RIGHTS
Furthermore, the report acknowledges a range Human rights are an established principle of the
of approaches to understanding equity, equality United Nations, and the Voluntary Guidelines of
and justice. The conceptual framework draws the United Nations Committee on World Food
predominantly on concepts of justice (Fraser, Security (CFS) draw on principles of human
2009; Rawls, 1999) and human rights (De rights such as human dignity, non-discrimination,
Schutter, 2012) from Western thought traditions. participation, accountability, transparency,
However, the report interprets these ideas not empowerment and the rule of law (CFS, 2021).
only in terms of individual rights and wellbeing, Specifically, the right to food as inseparable
but also in terms of living well relationally, and from other rights has been recognized since
concepts of interconnectedness, interdependence 1948 and gradually specified and strengthened
and community, which are embodied in African over time through various international
Ubuntu (Jecker, Atuire and Kenworthy, 2022), instruments endorsed by most UN Member
Indigenous socio-ecological values and principles States. International human rights covenants
(Huambachano, 2018) and Asian ideas of justice have been signed and ratified by most countries
(Norden, 2013). The report takes a universal in the world and have shaped national legislation
development approach (Longhurst, 2017), in many contexts; the right to food has also been
meaning that in defining issues and approaches recognized and incorporated into national law in

12 ]
1 CONCEPTS AND FRAMEWORK

many countries (De Schutter, 2012; Harris et marginalized groups, and their representation
al., 2022a) and is covered in the constitutions of and participation in issues concerning them),
well over 100 countries (Knuth and Vidar, 2011). overlaps substantially with definitions of equity.
The right to food gives rise to legal obligations However, it has been suggested that in focusing
of states to respect, protect and fulfil the right on achieving minimum standards for a dignified
to food. existence, human rights have not engaged
sufficiently with issues of wealth inequality, and
Human rights have established a ‘floor’ of with the distribution aspect of equity (Brinks,
decent living for many, but have been less Dehm and Engle, 2020). Foundational concepts of
involved in addressing the ‘ceiling’ of economic both human rights and equity overlap significantly,
inequality (Ragnarsson, 2020), so there is and human rights bring a useful legal and
further scope for rights to consider equity. multilateral strengthening of the moral and
Rights already intrinsically incorporate “status ethical calls to action of movements working to
equality”, meaning that discrimination based advance equity, equality and justice. But rights
on social attributes (such as those of commonly approaches will be stronger when combined with
marginalized groups outlined above) is prohibited a strong equity focus, to achieve improved FSN for
(UNGA, 1948). In this way, the focus of human all
rights-based approaches (on recognition of (Braveman, 2010).

[ 13
 Chapter 2
PATTERNS AND TRENDS
OF INEQUALITY IN FOOD
SECURITY AND NUTRITION
OUTCOMES

14 ]

©Myriams-Fotos
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

KEY INSIGHTS
• While inequalities in food security are particularly seen to affect populations in Africa, South Asia
and the Caribbean, inequality in nutritional status exists globally. Despite gains made in reducing
undernutrition in LMICs, the global rise in overweight and obesity among both adults and children
undermines progress made in nutrition.
• Context motivates the variability seen in the factors that contribute to within-country inequality, except for
certain consistently marginalized groups – women, those without education, Indigenous Peoples and the
poor.
• More lived experience data as well as adequately disaggregated data along gender, location, economic
status, ethnicity, other social group and physical ability is required to systematically quantify and track FSN
inequalities.
• Many important inequalities are intersectional, but insufficient granular data exist to characterize this
intersectionality and to identify those most vulnerable on a consistent basis.

T
his chapter discusses inequalities in FSN race and socioeconomic status, and their
outcomes across and within regions and intersections, with heavier emphasis on some
countries (ultimately underscoring that than others, due to data availability.
the right to food has not yet been fully realized
by duty bearers in many contexts). While
inequalities in FSN outcomes are presented 2.1 GLOBAL AND REGIONAL
here, with subsequent chapters describing
inequalities in more proximate factors that drive FSN INEQUALITIES
these FSN outcomes (CHAPTER 3), and the historic Unequal distributions of food insecurity and
and systematic structural drivers (CHAPTER 4), malnutrition in all its forms, in adults and children,
many of these inequalities often overlap and is present across the world, even if the axes of
are mutually reinforcing. The chapter draws on inequality differ. This inequality in FSN is revealed
existing literature and evidence; new analyses from global and regional perspectives using the key
have not been undertaken as per the mandate of SDG 2 indicators depicted in TABLE 1 and explained [ 15
the HLPE-FSN. in Annex 1, informed primarily by the latest
representative data available and recent trends,
Metrics and indicators of nutritional status from the 2022 State of Food Security and Nutrition
and diet-related dimensions of food security, in the World report (FAO et al., 2022) and from Joint
specifically availability, access and utilization, Child Malnutrition Estimates, 2021 Edition (UNICEF,
serve as the primary FSN outcomes of focus WHO, and World Bank Group, 2021). A confluence
here (FAO and Intake-Center for dietary of these unequal distributions with globalization,
assessment, 2022; INDDEX Project, 2022). In urbanization, conflict and war, pandemics, climate
addition, the components of food security related change and other environmental crises, as well
to quality, quantity, preference and sustainability as systemic and institutional drivers, has created
are addressed, as appropriate. Inequalities are conditions in which no region or country in the
examined across global populations, between world is exempt from vulnerability to hunger,
regions and countries and within countries, food insecurity or malnutrition inequalities (FAO
along the primary axes of inequality including et al., 2022; Swinburn et al., 2019). From a global
geographies, gender, place (urban vs rural), perspective, the prevalence of food insecurity
income and poverty, ethnicity, indigeneity, (measured by the Food Insecurity Experience Scale
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

[FIES]), undernutrition in women (underweight further widened everywhere, except Africa, between
and anaemia) and undernutrition in children under 2020 and 2021 (TABLE 1). Around the world, more
five years of age (stunting) is highest in the African women than men are experiencing food insecurity,
continent. The same indicators are lowest in the and women experience more severe food insecurity
regions of Europe, North America, Australia and than men (FAO et al., 2021). Within-region estimates
New Zealand, which, in contrast, have among the show that the same gender patterns hold, except
highest burdens of overweight (Body Mass Index for a slightly higher prevalence of severe food
>25) and obesity (Body Mass Index >30). insecurity among men vs women in Eastern,
Southern and Western Europe; Australia and New
Zealand; and Central, Eastern and Southeast
2.2 GLOBAL AND REGIONAL Asia. A notable data gap is the lack of gender

INEQUALITIES IN FOOD disaggregated data in subregions with the highest

food insecurity prevalence, such as Middle Africa
SECURITY AND HUNGER: (FAO, 2022e).

STATUS AND TRENDS Gender gaps in food security do not narrow as

country income levels increase. Evidence shows
Beyond the disparities between regions in the
prevalence of food insecurity (moderate/severe), that GNI plays a minimal role in attenuating
within regions there are significant variations in the inequalities by gender. Regardless of country
levels of severity of food insecurity. Within each of income status, women are consistently the most
the major regions (Africa, Northern America and food insecure, spanning up to a 19-percentage
Europe, Latin America and the Caribbean, and point difference between men and women within
Asia), the highest burden of severe food insecurity countries (Broussard, 2019). Gender inequality
is found in Middle Africa (37.7 percent), Southern frequently intersects further with ethnic and
Europe (2.8 percent), the Caribbean (30.5 percent) geographical divides and indigeneity, producing
and Southern Asia (21 percent). Furthermore, there further vulnerability to food insecurity (Lemke and
is pronounced inequality in trends of worsening Delormier, 2018).
food insecurity within regions between 2015 and Finally, both qualitative and quantitative evidence
2019 (TABLE 1). At the other end of the food security from a meta-analysis shows that in LMICs,
distribution, the prevalence of mild food insecurity food insecurity is associated with higher odds
and food security is observed in South Africa of reported violence against women and girls
(75.5 percent), Western and Northern Europe (Hatcher et al., 2022). While the mechanisms of
(>95 percent), Central America (65.9 percent) and
16 ] Eastern Asia (93.8 percent). In Africa, within-region
this relationship are unclear, this study found that
possible reasons for how and why food security and
trends for the prevalence of undernourishment violence against women and girls are related are:
(PoU), or hunger, and the prevalence of food inequitable gender norms, economic deprivation
insecurity follow similar patterns. PoU increased and social isolation. This gives further weight to the
sharply between 2019 and 2020, and, to a lesser precarity of women and girls as it relates to food
extent, during the following year. Over 60 percent insecurity.
of undernourished people on the continent reside
in Middle and Eastern Africa; a statistic consistent
since 2005. TABLE 1 describes pertinent differences 2.2.2. ACUTE FOOD INSECURITY
within and across regions. AND INEQUALITY
Globally, populations identified in crisis (Phase
3), emergency (Phase 4) or catastrophe/famine
2.2.1. GENDER GAPS IN GLOBAL AND (Phase 5) situations are those with the most
REGIONAL FOOD SECURITY PATTERNS urgent needs of livelihoods protection and among
Gender differences in food insecurity trends whom the risk of mortality due to food insecurity
(2014–2019) are consistently noted over time both is highest, as characterized by the Integrated
globally and between regions; a gap that has Food Security Classification (IPC, 2022). The most
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

recent estimates indicate that 258 million people Experience Scale (FIES) and find a Kuznets curve
living in 58 countries are experiencing acute food (inverted U-shaped curve) relationship between
insecurity. The countries with the highest numbers food security prevalence in the population and
include Afghanistan, the Democratic Republic of inequality in food security within the population.
the Congo, Ethiopia, Myanmar, Nigeria, Pakistan, They conclude that within-population inequality in
Syrian Arab Republic, Sudan, Ukraine and Yemen food security is highest in middle-income countries.
(FSIN and Global Network Against Food Crises, Their findings suggest that countries aiming to
2023). Data gaps exist in monitoring acute food reduce food security inequality should invest in
insecurity across countries, as well as which safety nets and other social protection policies and
groups within countries are most vulnerable, one institutions rather than simply relying on growth in
of the reasons being non-standardized approaches average incomes.
to data collection and reporting. However, based on
Beyond increases in average income, actions to
existing data, those groups consistently classified
reduce income inequality can help improve FSN
as IPC Phase 3 or above include displaced persons,
and reduce inequalities in FSN across groups, but
those living in conflict areas, pregnant and lactating
are unlikely to be sufficient by themselves. The
women, children under five years of age (FSIN and
potential for economic growth to lift people out
Global Network Against Food Crises, 2023).
of poverty is compromised by high or increasing
levels of income inequality (World Bank, 2016). In
2.2.3. AVERAGE INCOMES, INCOME this situation, the poorest people may face food
INEQUALITY AND LINKS TO FOOD insecurity in the face of strong country or regional
SECURITY GLOBALLY economic growth. (Holleman and Conti, 2020)
Economic growth and increase in average incomes analyse the associations between food insecurity
at the country level may not be sufficient to ensure (FIES) at the individual level and GDP per capita
prevalence of food security nor high levels of and Gini coefficients at the country level. They find
equality in food security across groups. that individuals living in countries with high income
inequality have a significantly higher probability
Despite a steady decline in global poverty since of facing moderate or severe food insecurity,
1990 (World Bank, 2020, 2023a), hunger has compared to individuals living in countries with
increased since 2010, worsened recently by the lower income inequality. They also find that high
COVID-19 pandemic and the war in Ukraine (CGIAR, income inequality erodes the potential of higher
2022; FAO et al., 2022). This suggests that factors GDP per capita to reduce individual food insecurity
beyond average income and poverty prevalence are (Holleman and Conti, 2020). However, Alao et al.
important in driving FSN outcomes. Income poverty (2021) in their systematic review conclude that the [ 17
only partially reflects the multifaceted nature of literature linking income inequality with nutrition
hunger, food insecurity and the biological (among outcomes is too slight to make firm conclusions.
other) aspects of nutritional outcomes (Barrett, Although there is some indicative evidence on the
2010; Prydz, Jolliffe and Serajuddin, 2021; Webb et intuitive notion that high income inequality worsens
al., 2006). A global analysis of individuals across 134 food insecurity and malnutrition, the evidence base
countries shows that, regardless of country income is surprisingly thin, and this is an important area for
level classification, salient factors associated with a future research (Alao et al., 2021).
higher likelihood of food insecurity are: low levels of
education, weak social networks, less social capital Thus, the evidence from these studies suggests
and low household income (Smith, Rabbitt and that, for countries aiming for a high level of food
Coleman- Jensen, 2017a). security prevalence as well as low inequality in
food security within their population, income
Even where food security prevalence improves with (including low-income inequality) matters, but it
income, inequalities in food security across groups is not enough. Policies and action in a range of
may persist or even grow. (Wesselbaum et al., 2023) complementary areas, and consideration for other
examine global data based on the Food Insecurity dimensions of disadvantage, are important.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

TABLE 1:
SUMMARY OF INEQUALITIES IN FOOD SECURITY AND NUTRITION ACROSS AND WITHIN REGIONS
FOOD SECURITY OR NOTABLE DISPARITIES RECENT CHANGE NOTABLE INEQUALITIES
NUTRITION METRIC ACROSS AND WITHIN (2015—2019, UNLESS ACROSS GENDER AND
REGIONS OTHERWISE SPECIFIED) OTHER GROUPS

PREVALENCE OF • Africa has the largest • Asia was experiencing a • Longer-term downward
UNDERNOURISHMENT hunger prevalence slow but steady decline trends in hunger in
(HUNGER) at 20.2 percent of in hunger between 2015 countries of all income
population, compared to and 2019 (↓0.6 pp), while levels from 2004–2006
(SDG Indicator 2.1.1)
less than 10 percent in hunger had increased to 2021 have been noted,
Asia and Latin America, in Africa (↑1.6 pp), except for high-income
and less than 2.5 percent Latin America and the countries where the
in North America and Caribbean (↑0.9 pp) prevalence has remained
Europe (FAO et al., 2022). (FAO et al., 2022). unchanged (FAO et al.,
2022).
• Eastern (29.8 percent) • However, all regions
and Middle Africa experienced an increase
(32.8 percent) have in hunger between 2019
particularly high and 2021: Africa (↑2.8
prevalence, but South pp), Asia (↑1.7 pp),
Asia has the highest Oceania (↑0.2 pp) and
numbers of hungry Latin America and the
people (331.6 million) Caribbean (↑1.9 pp)
(FAO et al., 2022). (FAO et al., 2022).

• Northern America and • Southern Asia has

Europe, in contrast, has experienced a steeper
the lowest prevalence increasing trend (↑4.5
(<2.5 percent), followed pp) since 2017, compared
by Oceania (5.8 percent) to any other Asian
(FAO et al., 2022). subregion (<0.3 pp).

• The disproportionately
higher PoU in Eastern
and Middle Africa,
Southern Asia and the
Caribbean contribute
to the overall regional
burden of hunger in
Africa, Asia and Latin
America and the
Caribbean, respectively
(FAO et al., 2022).

18 ] PREVALENCE OF • Africa has the highest • Food insecurity has • In every region of the
MODERATE OR SEVERE prevalence (57.9 percent increased between 2014 world, food insecurity is
FOOD INSECURITY of population), compared and 2021 across Africa higher and more severe
to just under 25 percent (↑13.5 pp), Asia and among women than men
(SDG Indicator 2.1.2)
in Asia, 40.6 percent in Latin America and the (FAO et al., 2022).
Latin American and the Caribbean (↑16 pp)
Caribbean and 8 percent since 2014 (FAO et al.,
in North America and 2022).
Europe (FAO et al., 2022).
• There were particularly
• Eastern (66.9 percent) sharp increases
and Middle Africa in Western Africa
(75.3 percent) and the (↑23.9 pp), followed
Caribbean (64 percent) by Central Asia
have particularly high (↑11.7 pp), Southern
prevalence (FAO et al., Asia (↑13.3 pp), Latin
2022). America (17.1 pp) and
South America (↑22.5
• Southern Asia and sub-
pp) (FAO et al., 2022).
Saharan Africa have the
highest number of people • In Northern America and
experiencing moderate/ Europe food insecurity
severe food insecurity decreased during this
(FAO et al., 2022). period (↓0.7 pp) (FAO et
al., 2022).
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

FOOD SECURITY OR NOTABLE DISPARITIES RECENT CHANGE NOTABLE INEQUALITIES

NUTRITION METRIC ACROSS AND WITHIN (2015—2019, UNLESS ACROSS GENDER AND
REGIONS OTHERWISE SPECIFIED) OTHER GROUPS

PEOPLE UNABLE TO • In Eastern, Middle and • The recent increase in • Women, girls and
AFFORD A HEALTHY DIET Western Africa, more food prices, accompanied rural populations are
than 85 percent of the by income shocks during especially unable to
(FAO et al., 2022)
population is unable to the pandemic, have afford a healthy diet (Bai,
afford a healthy diet, worsened the affordability Herforth and Masters,
followed by Southern of diets in almost all 2022; FAO et al., 2022;
Asia, with 70 percent regions (FAO et al., 2022). Raghunathan, Headey
(FAO et al., 2022). and Herforth, 2021).
• Countries with
• Less than 2 percent of persistent unaffordability
the population in Europe (>90 percent of
and North America face population unable to
this challenge afford a healthy diet)
(FAO et al., 2022). since 2017: Angola,
Burundi, Central African
• Unaffordability of healthy
Republic, Congo, Guinea,
diets follows a monotonic
Madagascar, Malawi,
pattern by country income
Mozambique, Nigeria,
group status – 88 percent
Sudan (FAO et al., 2022).
in LICs, 69.4 percent
in LMICs, 15.2 percent
in UMICs, 1.4 percent
in HICs (Bai, Herforth
and Masters, 2022;
Raghunathan, Headey
and Herforth, 2021).

PREVALENCE OF ANAEMIA • Anaemia prevalence • There has been little • Anaemic women are
AMONG WOMEN among women is highest progress in anaemia more likely to be poor, to
in Western Africa reduction among non- have no formal education
(SDG indicator 2.2.3)
(51.8 percent), followed pregnant women in the and to be from rural
by Southern Asia last decade (Development areas (FAO et al., 2022).
(48.2 percent) and Middle Initiatives, 2020).
Africa (43.2 percent) (FAO
• Among pregnant women,
et al., 2022).
most recent estimates
• Inadequate data is reveal a decreasing trend
available to evaluate from 41 percent (in 2000)
the burden of anaemia to 30 percent (in 2019)
in HICs (Bai, Herforth (Stevens et al., 2022).
and Masters, 2022;
• Between 2000 and 2009
Development Initiatives,
and 2010 and 2019, only
2020; Raghunathan,
Headey and Herforth,
Guatemala and the [ 19
Philippines have made
2021).
sufficient progress to
meet the World Health
Assembly target for
anaemia reduction
(Stevens et al., 2022).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

FOOD SECURITY OR NOTABLE DISPARITIES RECENT CHANGE NOTABLE INEQUALITIES

NUTRITION METRIC ACROSS AND WITHIN (2015—2019, UNLESS ACROSS GENDER AND
REGIONS OTHERWISE SPECIFIED) OTHER GROUPS

PREVALENCE OF ADULT • Adult obesity prevalence • Adult obesity has trended • Overweight women are
OBESITY is highest in North upwards in all regions more likely to be urban
America, Europe and of the world over the last and from wealthier
Australia and New two decades. households. Overall,
Zealand. wealthier countries have
• Sex-specific and age-
overweight and obesity
• Asia and Africa have standardized global
rates that are five times
significantly lower obesity trends show an increase
those of poorer countries
prevalence, although in prevalence of obesity
(Development Initiatives,
some countries in the of ↑7.6 pp and ↑8.5 pp
2021).
Middle East and North in men and women,
Africa have prevalence respectively, between
comparable to that of the 1975 and 2014.
Western nations.
• The top 3 countries with
the highest country
prevalence of obesity (41
• In high-income countries
to 65 percent) among
– Australia, Canada,
males and females are
New Zealand, the United
the island states of
States of America – and
Micronesia, Melanesia
among Indigenous
and Polynesia (Global
Peoples, there is a
Obesity Observatory,
disproportionately higher
2023).
prevalence of obesity
• Over one-third of men (Batal and Decelles, 2019;
in Australia, Canada, Goins et al., 2022; Thurber
Kuwait, Malta, New et al., 2018).
Zealand, Qatar, Saudi
Arabia and the United
States of America are
obese. Among women,
over two-fifths of women
in Bermuda, Egypt,
Jordan, Kuwait, Libya,
Palestine, Puerto Rico,
Qatar, Saudi Arabia,
South Africa, Türkiye and
the United Arab Emirates
are obese.

20 ]
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

FOOD SECURITY OR NOTABLE DISPARITIES RECENT CHANGE NOTABLE INEQUALITIES

NUTRITION METRIC ACROSS AND WITHIN (2015—2019, UNLESS ACROSS GENDER AND
REGIONS OTHERWISE SPECIFIED) OTHER GROUPS

PREVALENCE OF • Stunting prevalence is • Child stunting has • Stunted children are

STUNTING IN CHILDREN highest in Melanesia declined steadily in more likely to be male,
UNDER 5 YEARS (40.6 percent), followed the last two decades live in rural areas, be
by Middle Africa and has become poor and have mothers
(SDG indicator 2.2.1.)
(36.8 percent), Eastern more concentrated in with no formal education.
Africa (32.6 percent), LICs. However, some
Western Africa countries in Northern
(30.9 percent) and Africa, Oceania and the
Southern Asia Caribbean have had a
(30.7 percent) (FAO et al., recent uptick in stunting.
2022).
• In contrast, stunting
prevalence is only 3 to
5 percent in Europe and
North America.
• The largest numbers of
stunted children are in
Southern Asia. Of the
three countries that
are home to almost
half (47.2 percent)of all
stunted children, two are
in Southern Asia, namely
India and Pakistan
(Development Initiatives,
2020).

PREVALENCE OF WASTING • Child wasting prevalence • Wasting reduction is • Child wasting shows
IN CHILDREN UNDER 5 is highest in Southern occurring at a rate relatively weak
YEARS Asia (14.1 percent) insufficient to meet the associations with
followed by Oceania 5 percent global target socioeconomic groupings.
(SDG indicator 2.2.2.)
(Melanesia, Micronesia even if some countries However, those in poorer
and Polynesia) are making progress. This rural households and
(9.0 percent). is especially concerning with mothers with no
given the association formal education are
• The countries with high
between wasting and more vulnerable to
prevalence of wasting
mortality and that 1 in wasting (Development
(>15 percent) are
every 5 under-five deaths Initiatives, 2020).
Djibouti, India, Niger,
can be attributed to
Sri Lanka and Sudan
severe wasting. Worse
(Development Initiatives,
2020).
still, wasting worsened
during the pandemic,
[ 21
• Wasting is negligible which is especially of
in Europe and North concern for South and
America. Southeast Asia, where the
burden is high (FAO et al.,
2022).

PREVALENCE OF • Child overweight • Overweight prevalence • Overweight children are

OVERWEIGHT IN prevalence s highest is increasing in many more likely to be from
CHILDREN UNDER 5 in Australia and New countries in Southern wealthier households
YEARS Zealand (16.9 percent), Africa, Southeast and have mothers with at
followed by Northern Asia, Oceania and least secondary school
(SDG indicator 2.2.2)
Africa (13 percent) South America and the education (Development
and Southern Africa Caribbean (FAO et al., Initiatives, 2020).
(12 percent), Eastern 2022).
Europe (9.9 percent)
and North America
(9.1 percent) (FAO et al.,
2022).

Note: Definitions of food security and nutrition metrics can be found in ANNEX 1.
Source: Authors’ own elaboration.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

2017b). The global forest area has declined by 81.7

2.2.4. PLACE AND SPACE million hectares, a loss contributing to the more
CONSIDERATIONS RELATED TO FSN than 60 percent decline in global forest area per
INEQUALITIES GLOBALLY capita (Estoque et al., 2022). This loss threatens
Place (urban vs rural) and space (spatial variation
biodiversity and impacts the lives of 1.6 billion
or location) are associated with FSN inequalities.
people worldwide as well as their food security and
Place-based food security inequalities may reflect
water, most of whom live in the Global South, in
issues of structural inequality, with some areas
remote areas (Louman et al., 2015). These findings
receiving less political attention and investment.
highlight the importance of considering context and
Remoteness, arising either from challenging
examining within-country inequalities in FSN.
geophysical features or due to disadvantages in
investment, is especially detrimental to nutrition
(Headey, Hoddinott and Park, 2017).
2.3 GLOBAL, REGIONAL
Global-level analysis of urban–rural differences in
food security are sparse (Ruel et al., 2017) but more
AND COUNTRY-LEVEL
such analyses are now available by pooling national INEQUALITIES IN DIET AND
survey data that employ the FIES module to allow
for sufficiently powered disaggregated estimates. NUTRITIONAL STATUS
One such analysis, shows that living in a rural area
vs a large city increases the probability of food 2.3.1. DISPARITIES IN NUTRITIONAL
insecurity (Smith, Rabbitt and Coleman- Jensen, STATUS AND THE DOUBLE BURDEN
2017b). In LMICs, evidence shows that not only do OF MALNUTRITION
women have a higher probability of experiencing
food insecurity compared to men but that this
inequality is more pronounced among rural women
Child undernutrition
Middle Africa and Eastern Africa not only face the
compared to rural men (D’Souza and Jolliffe, 2013;
challenge of high prevalence of hunger and severe
Sinclair et al., 2022). However, disaggregating
food insecurity but, additionally, a high proportion of
countries by their development status, we see that
their populations are unable to afford healthy diets
urban populations are not always protected against
(>85 percent) and one-third of their under-five child
food insecurity. A study that analysed FIES data
population is stunted (FAO et al., 2022). Southern
from 146 countries collected in 2014-2015, found
Asia also endures a high prevalence of child stunting
that in least-developed countries 50 percent of
and wasting, although gains have been made in
22 ] urban populations were food insecure, compared
reducing stunting between 2000 (48.3 percent) and
with 43 percent in rural areas (Tefft et al., 2017).
2020 (30.7 percent) (Development Initiatives, 2022).
Similarly, evidence from a country-level analysis of
More broadly, a study of 67 countries shows that
twelve African countries that assessed food security
globally, between 1993 and 2014, there has been a
using energy availability per capita found that, in
consistent reduction in the prevalence of stunting
most of the countries, energy availability per capita
(da Silva et al., 2018). However, the rate of decline
was lower in urban vs rural areas (Smith, Alderman
was faster for rural compared to urban children
and Aduayom, 2006). Poverty intersects with place
and wealth-related inequalities in stunting have
rendering the urban poor more vulnerable to food
increased in low-income countries. A systematic
insecurity. During food, fuel and financial crises,
review (Alao et al., 2021) of the evidence on global
the urban poor are among the groups (together
and regional economic inequality in malnutrition,
with the rural landless and net buyers) made most
and the associations between economic inequality
vulnerable to food insecurity, malnutrition and
and malnutrition, shows that food insecurity and
economic shocks (Ruel et al., 2010).
child undernutrition are concentrated among low-
Worldwide, forest communities are often in a income households globally, even if moderately high
situation of FSN vulnerability, given their high stunting prevalence has been revealed to persist
dependence on a dwindling resource (HLPE, in wealthier households in certain contexts, such
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

as Ethiopia and India (Nguyen et al., 2021). Another

study, primarily representative of LMICs, showed
The double burden of
that the major axes of inequality in child malnutrition malnutrition
are wealth (being poor), location (rurality), and low The double burden (DBM) is defined as the
maternal education. Differences by these factors, coexistence of undernutrition (stunting and wasting)
including gender, were negligeable for wasting and along with overweight, obesity or diet-related non-
overweight (Development Initiatives, 2020). communicable disease at all levels of population
from individual to household to community and
country. Underlying the DBM phenomenon is
Anaemia and underweight rapid economic growth and a globalized food
among women system, accompanied by changing dietary patterns
towards less healthy diets and more sedentary
Western and Middle Africa and Southern Asia
lifestyles (Malik, Willett and Hu, 2013; Popkin,
have the highest prevalence of anaemia among
Corvalan and Grummer-Strawn, 2020a; Wells,
women. Moreover, inequality in the prevalence
2020). Popkin, Corvalan and Grummer-Strawn,
of anaemia among women is modest by location
(2020) report that sub-Saharan Africa, South Asia
(rural – 41 percent, vs urban – 38 percent) (UNICEF,
and East Asia and the Pacific carry particularly
2023). The burden of anaemia is higher among
large burdens of DBM (Popkin, Corvalan and
pregnant women (Development Initiatives, 2020).
Grummer-Strawn, 2020b). Since 1990, much of
Global trends show some gains in reducing the
the growth in DBM has happened in countries in
prevalence of anaemia in pregnant women from
the lowest income quartile, while fewer countries
2000 (41 percent) to 2019 (36 percent), but there
from the higher income quartiles have significant
has been insignificant change among non-pregnant
DBM. This is driven by increasing overweight in
women (Stevens et al., 2022). The prevalence of
low-income countries that have not managed to
underweight among women and adolescent girls
reduce undernutrition rapidly enough (Popkin,
is high (>10 percent) in most of Africa (apart from Corvalan and Grummer-Strawn, 2020a). Another
Northern Africa) and South Asia. Underweight study (Seferidi et al., 2022) shows that, in countries
in adolescent girls is disproportionately high in with a lower GNI, mother–child pairs from higher-
South Asia (19 percent) (UNICEF, 2023). Limited income classes were more likely to have DBM. But
nutritional status data on adolescent boys and men as the country GNI increased, the highest-income
is available to evaluate gender differences in status. class mother–child pairs were less likely to have
DBM, compared to the poorest wealth quantiles.
A regional analysis of adolescent girls and adult
[ 23
Overweight and obesity women in sub-Saharan Africa shows that, since
Europe, North America, Australia and New Zealand 2000, DBM patterns are emerging (defined as
have among the highest prevalence of child coexistence of underweight, anaemia, overweight
overweight and adult obesity. However, the problem and obesity within a country), with a rapid rise in
of overweight and obesity is not exclusive to these overweight and obesity, alongside declining but
regions. The prevalence of child overweight in persistently high rates of underweight and anaemia
Northern as well as Southern Africa is very high, as (Jiwani et al., 2020).
is the prevalence of adult obesity in some countries
Groups at high risk of DBM identified in different
in the Middle East and North Africa (TABLE 1) (FAO
settings include Indigenous, First Nation and ethnic
et al., 2022). Prevalence of overweight and obesity
minority populations in Australia, Canada and the
is concentrated among high-income households
United Kingdom of Great Britain and Northern
in many parts of Asia and Africa, whereas it is
Ireland, respectively. African Americans in the
concentrated among low-income households in
United States of America and tribal populations in
Europe and North America (Alao et al., 2021).
India are also at high risk of DBM, linked to higher
levels of low birthweight and increased risk of
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

obesity and non-communicable diseases (Wells, low mean exclusive breastfeeding prevalence
2020). Women are also at higher risk of DBM. (<25 percent). Suriname has a particularly low
breastfeeding prevalence, at ~6 percent, which has
Communities that live in or rely entirely on forests
been the rate for close to a decade ((Neves et al.,
are harder to reach and often may not be captured
2020; Victora et al., 2016). There have been notable
in larger surveys. Characterizing the extent of
trends of improvement in exclusive breastfeeding
their dependence on forests for food security in
prevalence over a decade in certain LMICs,
different geographies is critical. There is, however,
particularly Cambodia, Democratic Republic of the
evidence of the links between forest exposure or
Congo, Guinea-Bissau, Lesotho, Liberia, Sudan and
proximity and child nutritional outcomes. In 27
Turkmenistan (Bhattacharjee et al., 2021).
developing countries in Africa, Central and South
America, Southeast Asia and Eastern Europe, The practice of breastfeeding carries time, energy
forest cover is associated with a >25 percent higher and cost burdens on mothers, even if considered
dietary diversity among children with high versus “free”. Inequalities in feeding practices, specifically
low forest cover exposure, but the relationship continued breastfeeding (up to 2 years), the
is moderated by market access and roads introduction of solid and semisolid or soft foods,
(Rasolofoson et al., 2018), implicating remoteness and minimum meal frequencies, are present by
as an important consideration. In Africa, rurality location (worse in urban areas), wealth (worse
also is a consideration, where proximity to higher among the poorest), maternal education (worse
forest cover is associated with better nutritional among no or primary education) (Development
outcomes in urban areas and worse outcomes in Initiatives, 2020).
rural areas. (Pienkowski et al., 2018). Overall, forest
Diet quality is a critical link between food security
conservation is essential, but it is insufficient in
and nutritional well-being. But there is a lack of
alleviating FSN inequalities.
recent individual-level dietary data, limiting the
ability to make comparisons between countries.
2.3.2. DIETS AND CHILD FEEDING Recently, more countries have invested more in
Disparities in child-feeding practices for infants dietary surveys, but there remains a large gap
and young children, particularly in relation to in overall dietary data, especially in dietary data
exclusive breastfeeding which is a “first food” for specific marginalized subpopulations (FAO,
must be addressed. Aggressive marketing of 2022e). There have been efforts, however, to create
formula in all settings, but especially in LMICs, databases with existing individual-level dietary data
coupled with unsupportive environments and and modelled estimates, to examine global dietary
24 ] policies for breastfeeding, threatens displacement patterns (FAO and WHO, 2023; Miller et al., 2021).
of breastmilk, further driving inequalities in FSN Global dietary quality is revealed to be moderate at
outcomes (Champeny et al., 2019). best, as measured by the Alternative Healthy Eating
Index (AHEI) – a validated diet quality metric that
A lower proportion of infants belonging to rich assigns a score – from low (0) to high (10) – based
versus poor households in LMICs are exclusively on adherence to a dietary pattern (comprised of
breastfed, and breastfed in general, highlighting (un)healthy components). The healthy components
that suboptimal feeding practices do not follow the include fruit, non-starchy vegetables, legumes/
income/wealth gradient often observed (Neves et nuts, whole grains, polyunsaturated fatty acids and
al., 2020). UNICEF reports that one in five babies seafood omega-3 fat. The unhealthy components
in HICs, compared to one in twenty-five in LMICs, include red/processed meat, sugar-sweetened
are never breastfed (UNICEF, 2018). Across LMICs, beverages (SSBs) and sodium. Low AHEI scores
there is high variation in national breastfeeding have been shown to be associated with the risk of
rates, ranging from 2 percent in Chad to 88 percent NCDs, namely cardiovascular diseases, diabetes
in Rwanda, based on 2018 data (Bhattacharjee and cancer (Schwingshackl, Bogensberger and
et al., 2021). The Dominican Republic, Tunisia, Hoffmann, 2018). Differences in dietary quality exist
Thailand and Yemen have had persistently
 2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

globally and regionally, driven by consumption of sodium. An increasing trend in the average AHEI
different food groups (Miller et al., 2022). score (indicating healthier diet patterns) between
1990 and 2018 is observed in five of seven regions,
Among both adults and children, the average AHEI
with no change in South Asia and a decreasing
score was highest among the populous countries
of the India, Indonesia, the Islamic Republic of Iran trend in sub-Saharan Africa (FIGURE 3).
and Viet Nam; and lowest in Brazil, Mexico and
Notably, diet quality scores were found to be
the United States of America. Regionally, patterns
higher among women than men. This finding
show that South Asia and sub-Saharan Africa have
was primarily seen in HICs. AHEI scores did not
a relatively higher consumption of healthier foods,
differ by rural–urban residence of individuals,
with low intake of SSBs and red and processed
meats. Central and Eastern Europe, Northern but there were inequalities by educational
Africa, Central Asia and the Middle East consume attainment: Individuals with a higher level of
relatively high amounts of healthy foods, such as education in all regions, except for the Middle
fruits, legumes and omega-3 fats, but also relatively East, Northern Africa and sub-Saharan Africa,
high amounts of red and processed meats and had higher AHEI scores.

FIGURE 3:
GLOBAL AND REGIONAL MEAN ABSOLUTE DIFFERENCES IN ALTERNATIVE HEALTHY EATING INDEX
COMPONENT SCORES IN ADULTS, BETWEEN 1990 AND 2018
AHEI score Vegetables Legumes/nuts SSBs Seafood omega-3
Fruit Whole grains Red/processed meat PUFA Sodium

5.0

2.5
Absolute difference (1990 –2018)

0 [ 25

-2.5

-5.0

World Southeast/ Central/ High-income Latin Middle South Sub-Saharan

East Asia Eastern countries America/ East/ Asia Africa
Europe Caribbean North
and Africa
Central Asia

Notes: The Alternative Healthy Eating Index (AHEI) score comprises nine components, scored from 0 to 10, and scaled to ten components (correction not shown).
The absolute difference by time was computed as the difference at the stratum level and aggregated to the global and regional mean differences using weighted
population proportions for 2018. SSB: sugar sweetened beverages. PUFA: polyunsaturated fatty acids.
Source: Miller, V., Webb, P., Cudhea, F., Shi, P., Zhang, J., Reedy, J., Erndt-Marino, J., Coates, J. and Mozaffarian, D. 2022. Global dietary quality in 185 countries from
1990 to 2018 show wide differences by nation, age, education, and urbanicity. Nature Food, 3(9): 694–702.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

Adolescence is a critical life stage where optimal Animal-source foods (ASFs) and fruits and
nutrition is crucial. Recent studies reveal vegetables are particularly important sources
that diet quality decreases between infancy of vitamins, minerals and energy, but they are
and adolescence globally, especially in sub- generally expensive. Accordingly, the supply
Saharan Africa and South Asia (Miller et al., of these foods across countries is much more
2022). Further, low dietary diversity is observed, unequally distributed than supplies of starchy
especially in adolescent girls and women from staples and food in general (proxied by overall
poor households, with nutrient-rich foods being energy intake). However, country-level food
prohibitively costly for this group (Headey and availabilities across the globe have become more
Alderman, 2019; UNICEF, 2023). equal over time, particularly in the case of ASFs,
even though these are not always accessible to
The 2022 global report, ‘Measuring what the world
the poorest populations (Bai et al., 2021; Headey
eats’ (Global Diet Quality Project, 2022), which
and Alderman, 2019). With dietary patterns
covers over 40 countries, uses a rapid Dietary
worldwide changing to include more meat and
Quality Questionnaires (DQQ) tool to assess diet
ASF, environmental sustainability and health and
quality. The report reveals that most people are
nutrition benefits, which often are not correlated,
not consuming diets that even minimally adhere
must be considered, along with the trade-
to dietary guidelines. In 34 of the 41 countries in
offs of promoting and restricting ASFs in the
the report, less than 50 percent of the population
development and revision of food-based dietary
consume all five recommended food groups –
guidelines (Fanzo, 2019; Weis, 2013).
starchy staples, vegetables, fruits, pulses, nuts
and seeds, and animal-source foods. China, As food supplies across the globe have become
Indonesia, Mexico, Nicaragua, Sri Lanka and more equal over the decades, country-level
Tajikistan are the only countries where most of the nutrient supplies have also become more equal
population consumes all food groups (Global Diet (Bell et al., 2021). With the gradual convergence
Quality Project, 2022). of food supplies across the world, the prevalence
of overweight and obesity has also become less
confined to a limited number of countries, that
2.4 LONG-RUN TRENDS is, it has become more equally distributed within

IN INEQUALITY populations – a negative outcome. Stunting

prevalence is the only metric shown in FIGURE 4
The discussion above suggests there are that has witnessed an increase in the cross-
significant disparities in FSN outcomes country Gini coefficient, as more countries
26 ] across countries. An examination of long- have made progress in reducing the prevalence
running trends, however, shows movement of stunting, and stunting is increasingly
towards cross-country equalization in some concentrated in a smaller number of countries.
indicators. Bell, Lividini and Masters, (2021) As Bell, Lividini and Masters (2021) note, the
present Gini coefficients (0=perfect equality; reduction in cross-country inequalities in food
1=maximum inequality) for a range of food and nutrient supplies and in nutrition outcomes
supplies (availability), nutrient supplies and over the decades implies that inequalities are
nutrition outcomes based on country-level increasingly concentrated within countries and
data from across the world (Bell, Lividini and populations.
Masters, 2021). These are illustrated in FIGURE 4. In
interpreting these results, it is important to note
that the food and nutrient data used are based
on national-level supplies and are not derived
2.5 A DEEP DIVE: WITHIN-
from information on individual diets. As shown COUNTRY INEQUALITIES
in FIGURE 4, although inequality persists, countries As with between-country inequalities, within-
have become more similar over the period of country FSN inequalities are closely tied to
1970 to 2010 with respect to food supplies and inequalities in wealth and income (Restrepo-
certain nutrition outcomes. Méndez et al., 2015; Victora et al., 2021),
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

FIGURE 4:
GINI COEFFICIENTS OF GLOBAL FOOD/NUTRIENT SUPPLIES AND NUTRITION OUTCOMES

1970 2010
0.60

0.50

0.40
GINI COEFFICIENT

0.30

0.20

0.10

0.00
Energy Starchy staples Animal Fruit Protein Fat Vitamin A Iron Stunting Overweight Overweight
(kcal/capita) (kcal/capita) Source and (g/capita) (g/capita) (µg/capita) (mg/capita) (% of under-5s) and obesity: and obesity:
Foods Vegetables men (%) women (%)
(kcal/capita) (kcal/capita)

Source: Bell, W., Lividini, K. and Masters, W.A. 2021. Global dietary convergence from 1970 to 2010 altered inequality in agriculture, nutrition and health. Nature
Food, 2(3): 156–165.

geographic location (urban/rural) (Ruel et al., an example of a HIC, while hunger is low (as
2017) and education (see CHAPTER 3, Section 3.6.3). measured by prevalence of undernourishment at
Additionally, significant inequalities in FSN arise the country level, food insecurity estimates from
between groups distinguished by ethnicity, caste, a representative sample of private households
religion, gender, disability and age. Children in 2022 showed that, nationwide, ~16 percent
under the age of five are particularly vulnerable of households experienced food insecurity [ 27
to food insecurity and malnutrition (Ahmed, in the previous 6 months, but ~43 percent
Hossain and Sanin, 2012; FAO et al., 2022). experienced food insecurity in Blackburn with
Illustrative examples portray that the most Darwen borough. Further, disproportionately
important basis for inequality may vary from higher proportions of food insecurity were seen
observed across persons with disabilities vs
country to country and is context specific.
those without (10.4 percent among persons
without disability vs 36 percent among persons
2.5.1 FOOD INSECURITY with disability), and across white vs non-
INEQUALITIES WITHIN COUNTRIES white populations (15.7 percent among white
ALONG DIFFERENT AXES populations vs 34.5 percent among non-white
populations) (Food Foundation, 2023; University
OF INEQUALITY of Sheffield and Food Foundation, 2021).
There is significant geographic variation in
food security within countries. This has been People with disabilities are at greater risk of
captured by leveraging routine national surveys. food insecurity given they are also more likely
Low national prevalence may mask large local to be living in poverty (Schwartz, Buliung and
disparities. Taking the United Kingdom as Wilson, 2019) and may face special challenges
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

in acquiring food. Disabilities span physical, Black non-Hispanic households have a higher
mental, cognitive, sensory and psychiatric proportion of food insecurity (22.7 percent)
issues. In the United States of America, adults compared to White non-Hispanic households
with disabilities have twice the odds of those (8.7 percent) (D’Souza and Jolliffe, 2013).
without disabilities of being food insecure BOX 2 provides insights on how the intersection
(Brucker and Coleman-Jensen, 2017), while in of multiple identities shape food insecurity
Trinidad and Tobago, those needing assistance experience among vital members of our food
with daily living activities had three times systems – temporary immigrant farmworkers -
higher odds of being food insecure than those and immigrants in the United States of America
not needing assistance (Gulliford, Mahabir and more broadly.
Rocke, 2003).
Another study from Canada shows that
Relative disadvantage in FSN defined by social First Nations, Métis and Inuit people have
groupings and, oftentimes, their intersectionality disproportionally higher prevalence of food
with place, is also evident in many HICs. In insecurity, compared to the general population.
remote rural areas of Australia, for instance, Further, the study reports barriers related to
there is often inadequate availability of and the ability to obtain traditional foods as well as
access to healthy foods (Whelan et al., 2018). high food prices. Coping mechanisms include
Older Indigenous adults in Australia have five changing their traditional diet, rationing, sharing
to seven times higher risk of experiencing food and changing purchasing patterns (Skinner
food insecurity than their non-Indigenous et al., 2013).
counterparts (Temple and Russell, 2018). In
There is evidence that, in some parts of
North America, inequality in food security
the world, certain religious minorities
is evident along the axes of race, ethnicity,
experience barriers to food access arising
indigeneity and wealth. In 2021, the national
from discrimination, although which religious
prevalence of household food insecurity in
minorities are discriminated against depends
the United States of America was 10 percent,
on the country context. Lived-experience
compared to 32 percent among households
research illustrates some of the ways in which
under the poverty line (USDA ERS, 2021).

28 ]
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

BOX 2:
HOW INTERSECTIONAL IDENTITIES COMPOUND FSN OUTCOMES – INSIGHTS FROM THE UNITED STATES
OF AMERICA
Approximately one-third of farmworker families are food insecure in the United States of America, and immigrant
populations in the country have disproportionally higher food insecurity compared to the general population
(Coleman-Jensen et al., 2022). In a study conducted by Quandt et al. on household food security among migrant
and seasonal Latino farmworkers in North Carolina, they found that almost half (47.1 percent) the households
interviewed were food insecure and the levels of food insecurity were even higher in households with children (56.4
percent vs. 36.2 percent). Leveraging in-depth interviews, the study revealed how, to spare children, adults would
adopt different strategies, with the parents ultimately enduring further deprivation. One study (Quandt et al., 2004,
p.572) participant reported:

I told my wife to eat what she could while I would go with my cousins and friends. I would
do it sometimes just to leave. I would eat lunch and stay gone all day in the fields so my wife and
children would have more to eat. We have had to do this at times [FW23—male, age 38].

Mothers with low levels of education, the existence of children, and the use of the Special Supplemental Nutrition
Program for Women, Infants and Children (a social protection programme),a were found to be significant predictors
of household food insecurity. Most mothers in the study population (>70 percent) had a primary level of education or
less. Coping strategies included informal borrowing to be able to pay for food for their families (Quandt et al., 2004,
p.573).

We have borrowed money from other people and then bought food. Then when we returned to
work, we would pay this money back [FW06—female, age 33].

Similar outcomes in food insecurity among regular immigrants in California, Texas and Illinois were reported by
(Kasper et al., 2000). That study found that households faced a higher risk of food insecurity if their income was
less than the federal poverty level, if respondents had poor English-speaking ability, or if there were children in the
household (Kasper et al., 2000). This evidence shows that the intersectionality of different identities such as gender,
ethnicity, migration status, education level and having children can greatly impact food security outcomes among
marginalized populations.

Note:
a
https://www.fns.usda.gov/wic [ 29
Sources: Coleman-Jensen, A., Rabbitt, M.P., Gregory, C.A. & Singh, A. 2022. Household Food Security in the United States in 2021. Economic Research Report. 309.
U.S. Department of Agriculture, Economic Research Service; Kasper, J., Gupta, S.K., Tran, P., Cook, J.T. & Meyers, A.F. 2000. Hunger in legal immigrants in California,
Texas, and Illinois. American Journal of Public Health, 90(10): 1629–1633; Quandt, S.A., Arcury, T.A., Early, J., Tapia, J. & Davis, J.D. 2004. Household food security
among migrant and seasonal latino farmworkers in North Carolina. Public Health Reports (Washington, D.C.: 1974), 119(6): 568–576.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

discrimination leading to FSN inequality 1991; Harris-Fry et al., 2018). An added layer
is experienced by religious minorities in in gender inequalities within countries is the
certain settings: attacks on the community shift in inequality throughout the life course
while farming, high food prices in their of women within households. As girls become
neighbourhoods, gender-based violence against older and become adolescents, they sometimes
women while they are acquiring food for their transition into experiencing food insecurity and
families, and lack of access to public services malnutrition. For example, female adolescents
and public protection (Howard et al., 2021). These from households that are food insecure were
findings provide evidence that FSN inequalities shown to be two times more likely to have excess
are often deeply rooted in social hierarchies that weight, compared to those from food secure
are very context specific. households in Brazil, a relationship not apparent
in childhood (Schlüssel et al., 2013). In Ethiopia,
Gender is at the core of intrahousehold
among households with high food insecurity,
dynamics in how resources are distributed
and comprised of adolescent boy-girl sibling
within the household. Estimates of food
pairs, 40% of girls reported experiencing food
insecurity prevalence by gender within countries
insecurity while their brothers did not (Headey and
may be underestimated, as food insecurity is
Alderman, 2019).
often measured at the household, rather than
the individual level. There is a lack of sex- There is also evidence of FSN inequalities among
disaggregated, individual-level food insecurity transgender and non-conforming gender groups.
data to ascertain gender differences in FSN, In the United States of America, for example,
and most analyses are restricted to the use of one-third of transgender people live in poverty,
aggregate data to draw conclusions about food compared to 12 percent of the general population.
insecurity (Barrett, 2010). Nevertheless, within A qualitative study of transgender individuals
many countries there is evidence of nutritional reported gender-based discrimination and
deprivation within households among the most stigmatization, limiting economic opportunities
vulnerable (women and children) regardless of and ultimately impacting their ability to afford
household wealth (Brown, Ravallion and van adequate quantity and quality of food, often
de Walle, 2017). Studies have shown that foods involving frequent skipped meals (Russomanno,
and nutrients are inequitably allocated within Patterson and Jabson, 2019).
households, with men typically consuming more
nutrient-rich foods and having higher dietary Gender frequently intersects with other drivers
adequacy compared to women. The latter is of food insecurity, such as conflict. In the post
30 ] a consistent finding over time in Bangladesh, conflict setting of Colombia, for example,
Nepal and Senegal (De Vreyer and Lambert, rural areas experienced a disproportionally
2021; D’Souza and Tandon, 2015; Gittelsohn, high prevalence of food insecurity, especially
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

concentrated among women whose opportunities There is a higher prevalence of overweight/

were particularly curtailed by armed conflict (50 obesity among the higher wealth deciles in
percent food insecurity among rural women vs 40 LMICs, as shown in FIGURE 6, along with a wide
percent in the general population) (Sinclair et al., difference in prevalence between the higher
2022). Other intersectional disadvantages related and lower wealth deciles as compared to these
to FSN suffered by women include belonging to same patterns for underweight in FIGURE 5. This
lower socioeconomic groups, not having formal difference is attenuated when the national
education, ethnicity and indigeneity (Botreau and prevalence of overweight/obesity is high (>20
Cohen, 2020; Munro, Parker and McIntyre, 2014). percent), in countries such as Honduras,
Broader social forces also shape FSN inequalities Gabon, Ghana, Lesotho and Peru (Reyes
faced by women through patriarchal societal and Matos, Mesenburg and Victora, 2019), but the
cultural norms (Akter, 2021; Jung et al., 2017). inequalities in overweight/obesity are still
significant.

2.5.2 NUTRITION AND DIET Other evidence supports these findings in

INEQUALITIES WITHIN COUNTRIES the context of LMICs. However, although the
ALONG DIFFERENT AXES prevalence of overweight/obesity is highest
among the wealthiest households, there seems
OF INEQUALITY to be a tipping point in the overweight/obesity
Wealth and income are a common basis of
and wealth gradient as economies grow (Jones-
within-country inequalities in nutritional
Smith et al., 2012; Neupane, K.C. and Doku,
outcomes. In the case of childhood stunting
2016). This signals that FSN inequalities exist
in LMICs, cross-sectional analyses, further
within countries regardless of national economic
supported by large cohort studies, show
status. This pattern has been observed in both
that children belonging to higher quartiles
men and women in studies that have included
of wealth have lower likelihood of being
countries of multiple income ranges (HICs and
stunted (Schott et al., 2019). Among women,
LMICs) (Masood and Reidpath, 2017).
inequalities in underweight have been shown
to have a strong wealth basis, particularly in Moving beyond wealth and income, recent
LMICs with high prevalence of underweight intersectional gender analysis from India
(Reyes Matos, Mesenburg and Victora, 2019) highlights the importance of addressing
(FIGURE 5). Bangladesh, Kenya, Pakistan and different aspects of identity and socioeconomic
Yemen are among the countries showing the disadvantage – gender, caste, education and [ 31
most pronounced inequalities in underweight socioeconomic status – in order to improve diet
prevalence according to wealth status. outcomes (BOX 3).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

FIGURE 5:
UNDERWEIGHT IN WOMEN BY DECILE OF WEALTH
Egypt
Peru
Jordan
Guatemala
Honduras
Colombia
Lesotho
Armenia
Zimbabwe
Ghana
Dominican Republic
Kyrgyzstan
Gabon
Benin
Comoros
Liberia
Rwanda
Côte d'Ivoire
Malawi
Togo
Cameroon
Mozambique
Tanzania
Kenya
Sierra Leone
Uganda
Tajikistan
Nigeria
Zambia
Haiti
Mali
Guinea
Namibia
Cambodia
Congo
Niger
Democratic Republic of the Congo
Gambia
Myanmar
Pakistan
Burkina Faso
Nepal
Chad
Bangladesh
Burundi
Senegal
India
Yemen
Ethiopia
32 ]
0 20 40 60 80 100

PREVALENCE (%)
D1 D3 D5 D7 D9
D2 D4 D6 D8 D10

Source: Reyes Matos, U., Mesenburg, M.A. & Victora, C.G. 2019. Socioeconomic inequalities in the prevalence of underweight, overweight, and obesity among
women aged 20–49 in low- and middle-income countries. International Journal of Obesity, 44(3): 609–616.
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

FIGURE 6:
OVERWEIGHT/OBESITY IN WOMEN BY DECILE OF WEALTH
Ethiopia
Burundi
Burkina Faso
Chad
Democratic Republic of the Congo
Mozambique
Niger
Mali
Cambodia
Sierra Leone
Guinea
Rwanda
India
Malawi
Bangladesh
Senegal
Nepal
Gambia
Zambia
Uganda
Myanmar
Nigeria
Côte d'Ivoire
Benin
Haiti
Congo
Liberia
Yemen
United Republic of Tanzania
Togo
Tajikistan
Cameroon
Kenya
Namibia
Zimbabwe
Pakistan
Kyrgyzstan
Comoros
Ghana
Armenia
Gabon
Lesotho
Colombia
Dominican Republic
Honduras
Guatemala
Peru
Jordan
Egypt
[ 33
0 20 40 60 80 100

PREVALENCE (%)
D1 D3 D5 D7 D9
D2 D4 D6 D8 D10

Note: The wealth index is divided into deciles (D1-D10) reflecting a gradient of wealth. The first decile (D1) is the poorest 10 percent, and the tenth decile (D10)
indicates the wealthiest 10 percent of all households in the sample.

Source: Reyes Matos, U., Mesenburg, M.A. and Victora, C.G. 2019. Socioeconomic inequalities in the prevalence of underweight, overweight, and obesity among
women aged 20–49 in low- and middle-income countries. International Journal of Obesity, 44(3): 609–616.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

Intergenerational inequalities of undernutrition early, do not complete secondary education and

are well documented in the literature, with are from lower socioeconomic status groups
undernourished (and young) mothers having (Aizer and Currie, 2014; Perez-Escamilla et al.,
a higher likelihood of not only low birth weight
2018). Further, evidence from Bulgaria and Kenya
infants but also stunted children, and this
reveals that female adolescents and women
intergenerational cycle of undernutrition is noted
in higher magnitude among women who marry of reproductive age with disabilities have been
noted to have worse nutritional status, compared

BOX 3:
IMPORTANCE OF AN INTERSECTIONAL APPROACH IN UNDERSTANDING WHY PROGRAMMES MAY
DIFFERENTIALLY BENEFIT DIFFERENT GROUPS
There is a lack of understanding of how intersectional inequities impact nutrition. A recent systematic review finds that
most of the literature on this is limited to the United States of America (Fivian et al., 2023). The review also reveals a
stark absence of literature on how nutrition programmes reach and affect various intersectional groups.

An analysis of data from the Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) project,
which aimed to improve nutrition and agricultural outcomes in rural India, demonstrates the importance of taking
an intersectional approach. UPAVAN worked with an existing government platform of women’s self-help groups and
was designed to enhance the inclusion of marginalized women (Kadiyala et al., 2023). Of relevance in this setting is
how women’s caste and education intersect to influence outcomes. Analysis along a single dimension, education,
showed that dietary improvements were equal among women with high vs low education. However, when looking at the
intersection of education and caste, among women from the non-scheduled tribe group, women with low education had
greater increases in dietary diversity than those with high education, narrowing diet inequality between these caste–
education intersectional groups by 12 percentage points. However, among women from the scheduled tribe group (the
most disadvantaged caste group), the opposite occurred: women with high education had greater dietary benefits than
those with low education.

This intersectionality analysis highlights two important takeaways. First, analyses looking only at a single equity
dimension mask how and why nutrition programmes benefit various groups differently. Intersectional analyses are
34 ] needed to understand the experiences of the most marginalized members of society. This requires better data systems.
Second, programmes must be deliberately designed to reach and benefit groups at the intersection of multiple
vulnerabilities to ensure equitable nutrition outcomes.

Sources: Fivian, E., Harris-Fry, H., Shankar, B., Pradhan, R., Mohanty, S., Parida, M., Padhan, S. et al. (forthcoming). An intersectionality investigation of nutrition-sensitive
agriculture interventions on women’s dietary inequalities in rural Odisha, India; Kadiyala, S., Harris-Fry, H., Pradhan, R., Mohanty, S., Padhan, S., Rath, S., James, P. et al.
2021. Effect of nutrition-sensitive agriculture interventions with participatory videos and women’s group meetings on maternal and child nutritional outcomes in rural
Odisha, India (UPAVAN trial): a four-arm, observer-blind, cluster-randomised controlled trial. The Lancet Planetary Health, 5(5): e263–e276.
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

to their counterparts without disabilities thus compared to Siyanda had notable reductions
highlighting the potential for intergenerational in poverty (ZF MGCAWU District Northern
transmission of these poor nutritional outcomes Cape, 2020) which is hypothesized to be explain
to their offspring (Groce et al., 2013; Kuper et these observed inequalities beyond place.
al., 2015). While limited research exists in this Mapping of subnational estimates of DBM,
area, issues not only of food access but of overall here defined as co-occurrence of child wasting
nutrition are a hurdle for people with disabilities. and overweight, shows 70.5 percent of LMICs
have moderate prevalence of DBM (≥5 percent
Place-based inequalities are apparent in child
estimated prevalence of both conditions), 11.44
nutritional status within LMICs, even where
percent have high prevalence (≥10 percent of
progress has been made in reducing the
both overweight and wasting) and 2.9 percent
overall undernutrition burden over time. For
have very high prevalence (≥5 percent and ≥15
example, South Africa has high geographic
percent prevalence of wasting and overweight,
variability in malnutrition in children. The
respectively) (FIGURE 7).
national prevalence of overweight was 24.9
percent in 2017. However, while Siyanda in Place-based nutrition inequality can be
the Northern Cape, a remote rural district, observed in a granular way when data are
had 12 to 14 percent of overweight children, available at subregional level. For example,
Ugu in the Eastern Cape, bordering Durban, in the Indian state of Maharashtra, which
reported 32 to 36 percent prevalence of child fares well overall on economic and social
overweight (LBD Double Burden of Malnutrition development indicators, regional stunting
Collaborators, 2020). While not part of the study’s prevalence ranges from 40 percent of children
analysis, district profiles of these areas reveal in North Maharashtra and Marathwada to 22
racial differences, but more significantly, Ugu

FIGURE 7:
OVERLAPPING POPULATION-WEIGHTED QUARTILES OF OVERWEIGHT AND
WASTING PREVALENCE IN CHILDREN UNDER 5 ACROSS LMICS IN 2017

[ 35

Notes: Prevalence of moderate-to-severe overweight and wasting among children under 5 years of age in 2017 at a 5 × 5-km resolution. Quartile cut-offs were 0–5
percent, ≥5–10 percent, ≥10–15 percent and ≥15 percent. Maps reflect administrative boundaries, land cover, lakes and population; grey-coloured areas have grid
cells classified as ‘barren or sparsely vegetated’ and had fewer than ten people per 1 × 1-km grid cell in 2017 or were not included in these analyses. Maps were
generated using ArcGIS Desktop 10.6.

Source: LBD Double Burden of Malnutrition Collaborators. 2020. Mapping local patterns of childhood overweight and wasting in low- and middle-income countries
between 2000 and 2017. Nature Medicine, 26(5): 750–759.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

percent in West Maharashtra. Illustrating the inequalities these groups face (Poverty Inequality
issue of intersectional inequality, we see these Commission, 2017). Even in countries where
geographic inequalities in Maharashtra overlap substantial progress has been made in reducing
with undernutrition concentrated in rural areas malnutrition, progress in the aggregate can
and between certain social groups, namely mask uneven benefits across social groups, for
scheduled tribe and caste groups (Khadse and instance, with less progress being made among
Chaurasia, 2020). With regard to diet in India, ethnic subpopulations. In Viet Nam, for example,
we see an improvement in diet quality since the there is evidence of important reductions in
1990s but with large heterogeneities by state, stunting over the past 15 years, but also of
with improvements largely driven by better masked inequalities in stunting reduction for
diets in the eastern and southern states (Tak, ethnic minority groups compared to the ethnic
Shankar and Kadiyala, 2019). majority population (Harris, 2020) (see FIGURE 8).
Urban–rural inequalities in diet and nutrition Guidance emanating from this chapter to
outcomes are frequently reported. In examining
address data gaps includes more representative
rural–urban disparities in child height-for-age
food security data of the Middle Africa, Oceania
in Bangladesh and Nepal, (Srinivasan, Zanello
and Eastern European regions and populations
and Shankar, 2013) it was found that these
in fragile and conflict settings; dietary data at
disparities, especially for children with the worst
the individual level for adults and adolescents
nutritional outcomes, are primarily driven by
that allows for sex-disaggregation; nutritional-
parental education, wealth and the availability
status data for men, adolescents and school-
of water and sanitation. In Morocco and Peru,
aged children; and nutritional status and
and diet quality is worse (lower consumption of
anaemia data from HICs more broadly. Pertinent
fruits, vegetables, nuts and grains, meat and
social groups, such as Indigenous Peoples and
fish) in rural vs urban areas (McCloskey et al.,
context-specific ethnicities, must be adequately
2017; Nabdi, Boujraf and Benzagmout, 2022).
A study conducted in South Africa highlighted sampled, and data disaggregation is needed to
the importance of not overlooking peri-urban systematically track inequalities pertaining to
communities, who often live in informal them. Further, more qualitative data, highlighting
settlements and are subject to changing food lived experiences and intersectionality as it
environments. Using oral histories, peri-urban relates to FSN, and other forms of knowledge
residents shared the precarity of their diets – (traditional ecological knowledge and Indigenous
how they were both inadequate (due to economic and local knowledge) is recommended.
36 ] constraints) and of inferior quality (poor-quality
Finally, given that FSN inequalities exist along
fruits and vegetables), compared to when they
the lines of the multiple identities a person
lived in rural areas (Hunter-Adams, Battersby
embodies (gender, social group, age, etc.),
and Oni, 2019). Furthermore, as described
we see some examples of the intersectional
further in CHAPTER 3, food availability and access
nature of identity compounds the inequalities
are often constrained by geography, with unequal
experienced (Barak and Melgar-Quiñonez, 2022;
physical access to affordable and nutritious food
Riley and Dodson, 2016). These interconnections
being a feature of food environments, particularly
in many HICs. and their resultant impact are not always
evident, however, through the kinds of data
Earlier in the chapter, we noted that place and generated and the modes of data disaggregation
ethnicity intersect to reinforce food security employed. Data which captures these
inequalities experienced by social groups. interconnections and impacts would further
Nutrition inequalities between social groups enable policymakers to monitor FSN inequalities
are closely tied to economic and political and tailor policy interventions.
2 PATTERNS AND TRENDS OF INEQUALITY IN FOOD SECURITY AND NUTRITION OUTCOMES

FIGURE 8:
INEQUITY BETWEEN ETHNIC MAJORITY AND MINORITY COMMUNITIES FOR UNDERLYING DETERMINANTS
OF CHILD UNDERNUTRITION, 2000–2010

ETHNIC MINORITIES
KINH (ETHNIC MAJORITY)
Indicators Years
Women education (≥ grade 10) 2000
2010
Improved drinking water sources 2000
2010
Improved sanitation facilities 2000
2010
Hygienic disposal of stools 2000
2010
Access to electricity 2000
2010
Using fuel as gas/electricity 2000
2010
Owning a motorbike 2000
2010
Owning a refrigerator 2000
2010
Owning a television 2000
2010
High quality housing floor 2000
2010
SES (≥ median) 2000
2010
0 10 20 30 40 50 60 70 80 90 100
%

Source: Harris, J., Huynh, P., Nguyen, H.T., Hoang, N., Mai, L.T., Tuyen, L.D. & Nguyen, P.H. 2021. Nobody left behind? Equity and the drivers of stunting reduction in
Vietnamese ethnic minority populations. Food Security, 13(4): 803–818.

[ 37
 Chapter 3
PROXIMATE DRIVERS OF
FSN INEQUALITIES IN FOOD
SYSTEMS AND IN OTHER
RELEVANT SYSTEMS

38 ]

© WFP/Rein Skullerud (2017)

3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

KEY INSIGHTS
• Large, persistent and often increasing inequalities that constrain FSN exist in food production resources,
including in the distribution of these resources, access to knowledge and finance, ability to engage with
and gain from modern value chains and markets, storage, processing and distribution, and international
food trade.
• Size and economic status (for instance, small vs large farms) and gender are major inequality dimensions
across the food chain, but other sources of inequality, such as indigeneity and geographical location, are
also frequent constraints on FSN.
• Food environments provide highly unequal opportunities for FSN, with low-income populations and
minority groups particularly impacted by the inequalities.
• Inequalities in relevant areas beyond the food system, such as education and health systems,
contribute to inequalities in FSN outcomes. Multisectoral governance of FSN provides opportunities to
reduce FSN inequality.

B
uilding the depiction in FIGURE 1 on food diversification possibilities are limited and
systems, this chapter organizes the food production remains the mainstay of
discussion of inequalities in food systems rural livelihoods and income and, thereby,
and their FSN implications in three broad areas: of FSN. Even where non-farm opportunities
(i) inequalities in food production resources; (ii) are available, access to food-production
inequalities in food supply chains (incorporating resources may be important for FSN as a
information, finance, labour, value chain major secondary source of livelihoods, or
participation, storage, distribution, processing, as the primary source of livelihood for some
markets and trade); (iii) inequalities in food members of the household (for instance,
environments and consumer behaviour. A when men engage in off-farm work while
last section is devoted to inequalities in other women engage in food production).
systems that are relevant for FSN. [ 39
2. Food-production resources provide direct
access to own-sourced food and nutrition
3.1 FOOD-PRODUCTION for many poor people, particularly where
local markets are deficient. For example,
RESOURCES Hoddinott, Headey and Dereje, (2015) find
Food security in rural agricultural settings is driven that cow ownership raises children’s milk
by the interplay between a number of factors, consumption and reduces stunting in
including food production resources, access to Ethiopia. Local sources of aquatic foods
markets, agroecological potential and non-farm are often among the top sources of priority
opportunities (Giller et al., 2021). Access to and use micronutrients in LMICs (Beal and Ortenzi,
and control of food-production resources, such 2022).
as arable land, livestock assets and fishery and
forest resources, are centrally important for FSN, 3. Food-production resources provide a
particularly in rural areas, in several ways: range of additional services and products
beyond income and food that make further
1. Resource rights become particularly critical contributions to livelihoods and FSN. For
in settings where non-farm job creation and example, livestock provide draught, manure,
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

fibre, transportation and financial and social 6. Some food-production resources gain particular
capital; and forest resources provide fuelwood prominence for FSN in times of special need
for cooking and ecosystem services such and crisis. For example, Zanello, Shankar and
as climate and water regulation (Gitz et al., Poole, (2019) find that in Afghanistan, diversity
2021). in livestock holdings increases in importance for
dietary diversity during the harsh winter season,
4. Food-production resources provide collateral
and a basis for access to credit and financing when cropping possibilities diminish. The
for production as well as consumption. disposal or lending of food-production assets,
particularly land and large livestock, often helps
5. Some food-production resources have a sustain food consumption in times of crisis,
particularly valuable role to play in promoting such as illness or droughts. Forest resources
agency and equity along gender or other provide a safety net to poor people in times of
dimensions. For example, livestock are global shocks (such as epidemics or economic
important for gender equality because access
crises) and thus are a buffer against deepening
to livestock poses fewer entry barriers for
inequalities (Miller et al., 2021).
women than land, and animals are typically
governed by simpler property rights (Njuki Large inequalities in access to food-production
and Miller, 2019). In many contexts, women resources exist and persist. A prominent example
have greater access to and control over small is seen in the high and increasing inequality in land
species, such as poultry and small ruminants ownership globally. Gini coefficient (0=no inequality;
(Njuki and Mburu, 2013). Forest resources 1=maximum inequality) estimates illustrating
hold particular importance for the identities land inequality compiled by the International Land
and livelihoods of many Indigenous Peoples. Coalition (ILC) are shown in FIGURE 9. Globally and in

FIGURE 9:
LAND INEQUALITY TRENDS (MEASURED BY GINI COEFFICIENTS) SINCE 1975

0,75

40 ]
0,70

0,65

0,60

0,55

1975 1980 1985 1990 1995 2000 2005 2010 2015

World Latin America Africa Asia and the Pacific Europe North America

Note: Gini coefficients showing distribution of size of landholding in private ownership.

Source: ILC. 2020. Uneven ground: land inequality at the heart of unequal societies. International Land Coalition.
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

most regions of the world other than Africa, land resource, based on customary norms (ILC, 2020).
inequality as measured by the Gini coefficient has These systems of management can be beneficial
been on an increasing trend since 1975. to the management of fragile ecosystems (IFAD,
2018). However, with large-scale land acquisitions,
Inequalities in access to food production resources
encroachments and conflict over resources,
should be understood not only in terms of
these customary rights have increasingly come
ownership or tenure security, but also in terms
under threat. Not only does this have negative
of disparities in access, in land quality and in the
implications for Indigenous Peoples’ food access
ability to control the use of the resource. (Oberlack
and agency, it also limits their important role in
et al., 2020; Wegerif and Guereña, 2020).
conservation, potentially constraining the FSN of
Gender-based inequalities in the control of food other rural communities and the wider population.
production resources have been documented
An important contextual factor in the deep
widely. For example, the share of agricultural
inequalities in the right to food-production
landholdings managed by women reaches a peak
resources is the increasing interest in the
of 29 to 31 percent in Lesotho, Panama and Peru,
acquisition of valuable food-production resources
but is significantly lower in many other countries
by large commercial interests. A factor in high
(FAO, 2022a). In some settings, women do not
land-related inequality is the increasing large-
traditionally have the right to own land, and use
scale acquisition of land by corporate entities and
rights are dependent on male benefactors (Kameri-
international investors, particularly in Africa and
Mbote, 2005). Even when women have formal title
Asia (further discussed as a structural driver in
to or control over land, the de facto control can be
CHAPTER 4). Large-scale land acquisitions frequently
weak or the land they have control over may be of
target the commons (Dell’Angelo et al., 2021),
poor quality (Guereña and Wegerif, 2019). Gender
particularly impacting the FSN of groups most
inequalities may be wider for higher-value food
reliant on the commons, including pastoralists and
production resources. In many settings, crops
Indigenous Peoples. Large and corporate farms
traditionally under the control of men correspond
may help deliver food or nutrients affordably and
to higher-value crops, attracting greater extension
may generate tax revenue and foreign exchange
and financial support (Hillenbrand and Miruka,
and enhance food availability. However, although
2019). In many ocean fisheries, higher-value
small farms are increasingly also engaged in
species are controlled by men, while women are
cash and export crop production, they are more
restricted to fishing for nearshore, low-value
likely than large farms to produce and support the
species (Bradford and Katikiro, 2019; Fröcklin et al.,
availability of diverse, locally relevant foods (FAO
2014).
and IFAD, 2019; HLPE, 2020), and are more likely to [ 41
Significant disparities are also found across groups, harbour biodiversity (Ricciardi et al., 2021).
varying by ethnicity, caste or indigeneity. In India,
Unequal power relations governing access to
the National Family Health Survey records that
forested land and conversion of forested land by
about 62 percent of disadvantaged, scheduled-caste
development projects constrain the FSN potential
households are landless, compared to 40 percent
of forest resources (IUFRO, 2020). This unequal
of non-disadvantaged castes (Rawal and Bansal,
power may originate from afar. For instance,
2021). Disadvantaged castes have also historically
foreign direct investments by the global super-
faced challenges in exercising agency over the use
wealthy have been linked to the expansion of
of the food production resources that they nominally
areas under flex-crops such as oil palm and soy
have access to. For Indigenous Peoples, the right
in Latin America and Southeast Asia, resulting in
to land and other natural resources is critical,
deforestation (Ceddia, 2020). Such unequal power
not only for sustaining livelihoods but also for the
relations also impact access to ocean-based food
cultural and spiritual values that they embody.
production resources. The increasing governance
Frequently, these rights are held as collective,
of the blue economy for economic growth brings to
community-based rights to manage and use the
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

the fore many power asymmetries and resulting Women are frequently disadvantaged compared
challenges, particularly for small-scale fishers, to men in their ability to access credit and other
including negative environmental impacts, ocean- financial services. Highlighting the intersectionality
grabbing and increasing threats to the welfare of small size of enterprise and gender, the
of women and Indigenous communities engaged International Finance Corporation (IFC, 2017)
in the sector, with implications for their FSN has estimated that across 128 mostly LMICs,
(Gustavsson et al., 2021; Nangle, Masifundise, and women-owned businesses account for 28 percent
FIAN International, 2023). of MSMEs, but they account for 32 percent of
their finance gap (the gap between the demand
for credit and the supply), even though women’s
3.2 FOOD SUPPLY CHAINS enterprises are smaller than those of men.
Social norms, insufficient property rights, control
3.2.1 ACCESS TO FINANCIAL over assets and institutional bias in lending are
SERVICES some of the major reasons for women’s unequal
Small-scale food producers and small businesses access to credit (Fletschner and Kenney, 2014).
along food supply chains have long faced significant Although microfinance initiatives have typically
obstacles in accessing or taking up credit, focused on women, they are often not tailored
insurance and other financial products. This is to agricultural investments, for example failing
particularly the case with formal financial services to match repayment schedules to agricultural
such as banks and microfinance institutions. calendars (Quisumbing and Doss, 2021). Ethnicity,
The volatile incomes, lack of collateral (often the caste and indigeneity are also relevant in this
result of lacking land registers and unrecorded regard. For example, in India there is caste-based
land-use rights) and credit history, fragmentation disparity in loan applications, and the historically
and informality of these actors results in their disadvantaged scheduled castes are less likely to
exclusion from the lending portfolios of many have loans approved (Kumar, 2016).
financial institutions (FAO and IFAD, 2019; IFAD, The inability to access credit to finance inputs or
2015). Instead, in many LMICs, informal finance undertake investments can limit productivity and
operators, ranging from moneylenders, merchants influence food availability. Income losses from lost
and traders to savings and credit groups provide a productivity limit food access for the particularly
high proportion of rural finance. disadvantaged groups, even where informal finance
Formal finance nevertheless has an important may help bridge short-term consumption gaps.
role to play, particularly in longer-term financing The unequal access to credit faced by women
42 ] for investment in agriculture or value-chain may also constrain the important role that women
participation. In recognition of this, regional and play in nutrition-friendly household decision-
multilateral development banks (MDB) have scaled making, particularly relating to food consumption
up their efforts to meet the financing needs of (Fletschner and Kenney, 2014). Additionally, lack of
small-scale farmers and other micro, small and finance for undertaking longer-term investments,
medium-sized enterprises (MSME) in rural areas. in soil health for instance, may constrain
However, the needs of the sector are vast, and there sustainability.
is an unmet financing demand from smallholders
of almost USD 170 billion (IFAD, 2015; IFAD and 3.2.2 ACCESS TO INFORMATION
EU, 2022). IFAD (2015) notes several inequalities
in financing of MSMEs in the food sector, including
AND TECHNOLOGY
The ways in which small-scale producers obtain
where they are located in the value chain
information and update their skills has changed
(input provision and farming being particularly
considerably in recent decades. Traditional public
disadvantaged), location, gender and commercial
agricultural extension services have shrunk, and
orientation.
a much more pluralistic system, involving public,
private as well as NGO providers of information
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

has emerged (Norton and Alwang, 2020; Davis, are negatively associated with the adoption of
Babu and Ragasa, 2020). Traditional farm visits by many technologies (Ruzzante, Labarta and Bilton,
extension agents are less important now than they 2021). The spread of some technologies can also
used to be, with digital provision of information create wider inequalities, as is the case with
becoming much more commonplace. These historical concerns about the displacement of
changes have likely helped reduce some old labour and the consolidation of small farms as
inequalities in information access (Deichmann, a result of mechanization (Baudron et al., 2015).
Goyal and Mishra, 2016). For instance, remote The emergence of “smart food production”, digital
or conflict-affected areas have more access to technologies using big data, increased automation
information through the use of information and and artificial intelligence offers productivity-
communication technologies, and a diversity of enhancement possibilities. However, concerns have
providers may help reach a more diverse audience. been raised over corporate capture and multiple
inequalities arising from these technologies,
However, these changes in information provision
including inequalities in control over technology
may also embed new inequalities. Private extension
development and use, in the distribution of benefits
services may exclude smaller, poorer farmers who
from the technologies, and in sovereignty over data
are unable to pay for the service (Davis, Babu and
(FIAN and Brot für die Welt, 2018; Hackfort, 2021).
Ragasa, 2020). Also, although mobile phones are
now widespread in LMIC rural settings, digital
exclusion remains a factor, and more sophisticated 3.2.3 LABOUR AND TIME USE
digital information services will struggle to reach Food systems around the world harbour many
less-resourced and less-educated groups. Many inequalities related to labour. Agricultural labourers
digital services reach a large audience at low cost are frequently among the very poorest and most
but remain inadequately tailored to local contexts food insecure in LMICs (Bhuyan, Sahoo and Suar,
(for example, lacking information in local languages 2020) and, even in HICs, food systems workers
or dialects). Many traditional inequalities persist as engaged in areas ranging from farm harvests
well. Women are less likely to receive information to logistics to food retail services often face
and extension services, and available services often precarious and minimally remunerative livelihoods
lack gender-sensitivity, including consideration (Klassen and Murphy, 2020). Food systems labour
of the conditions under which women farmers is frequently marked by high asymmetry of power
farm and best practices in working with women between employers and labourers (Friesner, 2016).
farmers (Doss and Quisumbing, 2021; Quisumbing Child labour is a major issue. Approximately 60
and Doss, 2021; Ragasa, 2014). As in the case of percent of labourers in the world aged 5 to 17 work [ 43
finance, lost productivity and income arising from in agriculture, and almost 60 percent of children
these inequalities may hold FSN implications. in hazardous work are also working in agriculture
(ILO, 2022a). Food systems in many countries are
The development as well as the adoption and
dependent on migrant labour, yet migrant labourers
implications of new agricultural and post-harvest
have minimal employment rights and are often
technologies are subject to numerous inequalities.
subject to human rights violations (Klassen and
A high proportion of private-sector agrifood
Murphy, 2020). The often ill-paid, precarious and
research and development (R&D) expenditure
sometimes hazardous nature of food systems
originates in HICs, and overall private R&D
labour poses a constraint on the FSN of a sizeable
expenditure has largely focused on a relatively
workforce.
narrow set of commodities. At the same time,
country-level public agricultural investments in Agricultural work also often imposes unequal time
LMICs, other than China and India, have been burdens on women compared to men. Findings of
low and relatively stagnant (Stads and Rahija, multiple studies and reviews confirm the gendered
2019). Extensive literature also shows that less nature and impact of working in agriculture and
education, small size of operation, insecure food systems on FSN outcomes. Specifically, the
tenure and poor access to credit and extension evidence shows that:
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

• Women play a key role in agriculture, and

this is reflected in their time commitments to
Engaging with modern value
these activities, whether as farmers or farm chains
workers. Over the past several decades, economic growth,
urbanization and dietary transition has spurred
• Women are important actors in the uptake many food value chains to restructure. Simpler,
and response to agricultural interventions. local chains of transactions have often been
replaced by longer value chains involving large
• Agricultural interventions tend to increase traders, assemblers and modern retailers.
women’s, men’s and children’s time burdens. Restructuring value chains can offer significant
opportunities for agricultural producers and
However, the studies included in this review do
labourers to benefit from the higher value
not provide clear-cut evidence on the nutritional generated. However, the challenges to participation
implications of agricultural practices and in modern value chains are considerable.
interventions, even when these result in increased
Large traders, processors and retailers prefer
time spent on agricultural activities. Nutritional
not to incur the transaction costs of buying small
impacts are varied because households and
quantities from many smallholders. Thus, they
members of households respond to increased often stipulate minimum volume requirements
time burden and workload in different ways. The and/or quality standards that small producers
reasons for this depend on a number of important may struggle to meet, especially if upgrading
differentiating factors that include income and and investment in inputs requires financing and
the possibility to purchase food, household better information. In recognition of the challenges
socioeconomic status (Rao et al., 2019), household posed by certification standards for small-scale
producers, the UN Declaration on the Rights of
type and composition (in particular the presence
Peasants (UNDROP) has called for fairer systems
of members who can take up domestic work),
of quality standards and evaluation involving the
and the types of indicators used to assess food
participation of small-scale producers (UN, 2019a).
consumption, security or nutrition (Johnson et al., The overall evidence on the impact of smallholder
2015). participation in contract farming (where food
production is carried out on the basis of an
agreement between buyer and producer) is mixed.
44 ] 3.2.4 PRODUCER ENGAGEMENT WITH A systematic review of contract farming impacts on
VALUE CHAINS smallholder incomes notes that smallholders can
Value chains refer to the stakeholders and the benefit from participation, but that “…the poorest
interlinked value-addition processes involved as farmers are rarely included … in 61 percent of the
a food product moves from primary production to cases, the contract farmers had significantly larger
final consumption and disposal (FAO, 2014). The landholdings or more assets than the average
farmers in the region.” (Ton et al., 2018),(P.46).
value chain concept is conceptually similar to the
BOX 4 discusses the bias towards better-resourced
supply chain concept, but with a greater emphasis
farmers (Michelson, 2013).
on how value is created and distributed among
different stakeholders in the chain.
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

BOX 4:
SUPERMARKETS CONTRACTING WITH FARMERS IN NICARAGUA: DO ALL FARMERS BENEFIT?
In Nicaragua, supermarket food retailing is dominated by retail giant Walmart. To supply its large network of
outlets, Walmart has established purchasing relationships with hundreds of individual farmers. This relationship
has been found to have a positive effect on the household welfare of participating farmers over time, by increasing
their household productive-asset holdings, which in turn positively impacts poverty outcomes among participating
households.

Despite the positive outcomes, the relationship embeds fundamental inequalities in terms of participation. Predictors of
household inclusion include residence in regions of higher agricultural potential and geographical advantages such as
access to year-round water and closeness to the closest supermarket or retail outlet. Walmart supermarket produce
buyers indicated that easy access by roads and phone, and access to year-round water, were the primary attributes
for entering into a supply relationship. Such attributes could exclude poor farmers living in geographically constrained
areas with poor infrastructure.

Source: Michelson, H.C. 2013. Small Farmers, NGOs, and a Walmart World: Welfare Effects of Supermarkets Operating in Nicaragua. American Journal of
Agricultural Economics, 95(3): 628–649.

For producers who are able to participate, contract the impact on food security is likely to vary by
farming offers the potential to improve income setting.
through multiple pathways: better prices, ability to
Nevertheless, some evidence does suggest that
sell large quantities to the same buyer, and yield
participation in contract farming improves food
enhancements arising from inputs and information,
which are often part of the contract. However, the security. In their study of contracting for food
literature shows mixed results in terms of income crop production in Madagascar, (Bellemare
– varying by region, commodity and contractual and Novak, 2017) show that the duration of the
arrangement. The systematic review by Ton et al., hungry season is shortened due to contracting
(2018) collates the evidence to estimate an income (thus also suggesting an influence on the stability [ 45
effect of contract farming of between 23 percent dimension of food security), and that this likely
and 55 percent (although they indicate that this happens because households can save increased
could be an overestimate since research does not income from harvest time until the hungry season.
pick up schemes that collapse early). Furthermore, Chege, Andersson and Qaim (2015),
studying supermarket contracting of vegetable
However, there is no guarantee that food security smallholders in Kenya, find that participation in
will improve with incomes generated through contracting improved micronutrient consumption.
commercialization for a number of reasons:
increased incomes may be spent on non-food In summary, (a) the weight of evidence indicates
priorities such as health or education, income that the smallest farmers are often (but not always)
growth may be captured by men who may prioritize unable to participate in contracts with actors
food security less than women (Mitra and Rao, downstream from them in modern value chains,
2019), and it is difficult to save incomes from and (b) farmers who do participate are often (but
harvest time until the next preharvest hungry not always) able to gain income, and potentially,
season (Bellemare, Bloem and Lim, 2022). Thus, improve food security.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

Unequal power and exploitation on household consumption. However, the women

lost control of the income earned when milk was
in value chains sold to chilling plants, as weekly cheques were sent
For those who do manage to participate in modern to the household head, typically the male (Njuki and
value chains, there is potential for inequality related Miller, 2019).
to asymmetrical power between contractors and
Although women often face difficulties in accessing
farmers and farm labourers. On the one hand,
contract farming opportunities, some studies,
contractors in modern value chains operating in a
such as the one by Maertens and Swinnen (2012),
competitive environment may find it advantageous
find that they play an important role as wage
to offer good terms to contractees. Or it may
labourers in global value chains, with good income-
be that large traders, processors, retailers and
earning opportunities, compared to other wage
other contractors dominate or collude to dictate
employment. In such cases, food security may
the terms of relationships with typically small,
be enhanced not only due to higher household
geographically scattered farmers (Montalbano,
income, but also due to women’s improved
Pietrelli and Salvatici, 2018; Swinnen and
bargaining power in the household. For example,
Vandeplas, 2014). An important concern is that,
in Ethiopia’s rural Oromia, Getahun and Villanger
in some cases, the funds and in-kind assistance
2018) report that the employment of women in the
offered by contractors, both large and small, may
cut rose industry has had a positive impact on their
implicitly come at a high cost, as farmers are
bargaining power within the household, and on
obliged to sell contracted produce at low prices
household income, poverty and food security.
(Bellemare, Bloem and Lim, 2022). Large food
service establishments and modern retailers may
consolidate power on the selling side by driving out 3.2.5 STORAGE, DISTRIBUTION AND
local competition, and may do so on the buying side PROCESSING
by using market power to lower the prices offered
to farmers (Bellemare, Bloem and Lim, 2022). The
evidence base addressing unequal power and FSN Storage and distribution
implications is limited, however, and more research Efficient post-harvest storage and distribution is
is needed to enable a systematic understanding. critical to providing consumers with access to safe
and nutritious foods and to enabling adequate
livelihoods for producers and traders. At present,
Gender inequalities in accessing inadequate storage and distribution contribute
46 ] value chains to an estimated 14 percent of food production
being lost along the supply chain, and a further 17
Women face greater challenges in participating percent being wasted in consumption (UNEP and
in modern value chains as resources are often FAO, 2022).
a prerequisite for inclusion in such value chains
(Doss and Quisumbing, 2020) and women have Inadequate cold chains pose a particular challenge
less access to resources than men. In some for nutrition security and food safety as many of
contexts, social norms (addressed in more detail the most nutrient-dense foods, such as vegetables,
in CHAPTER 4) may play a role. For instance, where fruits, aquatic foods, milk, meat and eggs, are also
men have the traditional role of income earners highly perishable and prone to safety compromises
and women of caregivers, opportunities for high- (HLPE, 2017b). Major inequalities in cold chain
return cash cropping may accrue to men, with availability create inequalities in nutrient-dense
women focusing on food crops (Doss, 2002; Qian, food availability and affordability. HICs are
2008). Commercialization may also raise the estimated to have 10 times the cold-storage
prospect of income capture by men. Njuki and capacity per 1 000 people compared to LICs (UNEP
Miller (2019) note the case of East African women and FAO, 2022). In many LMICs, sophisticated
dairy farmers who used to sell dairy products in private cold chain facilities enable the distribution
informal markets for cash, which would be spent of high-quality, safe, nutrient-dense foods to
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

higher-income urban consumers via supermarkets power structures that drive the trajectories and
and modern retail, while cold chains may be absent growth rates of health-promoting vs health-limiting
or rudimentary in marketing channels serving rural food processing (Wood et al., 2023).
and low-income consumers. In contrast to foods involving less processing,
Such divides across urban and rural, and UPFs are almost exclusively the domain of large
economically better- and worse-off areas, are also corporations. Markets for UPFs are characterised
apparent more generally in rural transport and by high levels of concentration, with corporate
market infrastructure in LMICs, contributing to strategy geared towards maximizing returns for
inequalities in access to nutrient-dense foods. Poor shareholders, at considerable cost to dietary and
road links and high transport costs in remote areas environmental health (Wood et al., 2023). Large
can mean that markets in such areas are poorly marketing and R&D resources are devoted to
integrated with other markets, with traders less developing and promoting UPFs in the global
likely to move perishable food into such markets marketplace (discussed as a driver of FSN
even if local prices are high (Cooper et al., 2021; inequalities in CHAPTER 4) (OECD, 2021), while there
Filmer et al., 2023). is comparative underinvestment in food processing
methods that boost nutrition.

Food processing 3.2.6 INTERNATIONAL FOOD TRADE

Food processing is important for FSN in several
ways. Innovations in processing, including
milling, drying, packaging, canning, freezing and
Cross-border trade and its role
fortification, can boost nutrition by retaining or in FSN
enhancing the nutrient content of foods, enhancing Although only about 23 percent of food is
food safety and lowering the cost of making traded internationally (D’Odorico et al., 2014),
nutrients available over time and across space international food trade has grown considerably
(HLPE, 2017b). Food processing is important for in importance, doubling in real value between
employment, and small-scale processing and value 1995 and 2018 (FAO, 2020). There is great variation
addition can enhance livelihoods and, thereby, FSN. across countries in terms of the foods for which
On the other hand, ultra-processed foods (UPFs) they depend on imports, and the extent of import
– frequently high in fats, salt, sugar and unhealthy dependence. FIGURE 10 illustrates disparities in
ingredients – are now available plentifully in all import dependency for cereals and highlights
the importance of international trade for the [ 47
parts of the world and are being increasingly linked
to negative health effects (OECD, 2021). About half FSN of food-deficit countries. Several countries
the dietary energy consumed in HICs now comes in the Middle East and North Africa, as well as
from UPFs, with populations living in disadvantaged in Southern Africa, are seen to be highly reliant
areas often particularly exposed (Monteiro et al., on grain imports. The importance for FSN was
2019; Scrinis and Monteiro, 2022). Worryingly, underscored during the phase in the Ukraine war
many LMICs are showing much higher growth when trade was severely curtailed.
rates of consumption of UPFs than previously Among the most consequential developments in the
experienced in HICs (Monteiro et al., 2019). There last few decades in the global food system has been
are inequalities in the incentives, budgets and the liberalization of trade and foreign investment
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

FIGURE 10:
IMPORT DEPENDENCY (IMPORTS AS A SHARE OF DOMESTIC FOOD SUPPLY) FOR CEREALS,
AVERAGE OF 2015–2017

Net exporters
Net importers
0 20 40 60 80 >= 100 No data
PERCENT

Notes: Red shaded areas show the share of imports in domestic food supply for net food importers, computed from FAOSTAT Food Balance Sheets. Net exporting
countries shown in blue.

Source: FAO. 2020. The State of Agricultural Commodity Markets 2020. Agricultural markets and sustainable development:
Global value chains, smallholder farmers and digital innovations. Rome, FAO. https://doi.org/10.4060/cb0665en

that was kick-started in the 1980s. Facilitated by The evidence does broadly indicate that agricultural
the General Agreement on Tariffs and Trade and trade liberalization has boosted national incomes
then by the World Trade Organization (WTO) after in both HICs and LICs (Anderson, Cockburn and
the adoption of the 1994 Agreement on Agriculture,
48 ] liberal trade policies have included lowering import
Martin, 2011; Traill et al., 2014). The evidence also
suggests that trade over the last few decades
tariffs and easing a range of non-tariff measures
has helped equalize the cross-country national
(such as import quotas, import licensing and export
availability of key foods (both healthy and unhealthy)
subsidies) (Staiger, 2012).
and nutrients (Bell, Lividini and Masters, 2021).
Economics suggests that liberalization could Comparing trade in the current global food system
impact FSN through multiple pathways, including: with no-trade scenarios, Wood et al., 2018 similarly
(i) specialization and trade enable efficiencies to be find that no-trade scenarios would imply less
reaped compared to a situation of self-sufficiency,
equality in cross-country nutrient distributions,
resulting in income growth that improves access
with low-income countries being particularly
to food; (ii) trade boosts the availability of a diverse
disadvantaged, and conclude that “Protectionist
range of foods via imports; (iii) trade acts to lower
trade policies could … have serious negative
prices and (iv) trade helps diversify supply lines for
key foods, increasing the stability of food availability consequences for food security” (Wood et al.,
and lowering the volatility of prices (although 2018, p. 34). That noted, we turn to the inequalities
dependence on global markets may also a provide a embedded in the global trade regime that have
transmission mechanism for volatility) (FAO, 2015a). implications for FSN.
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

Inequality in trade and FSN has the effect of lowering prices in the global
market, which could potentially benefit global food
implications: inequality in security. However, these lower prices may well
groups able to benefit from trade negatively impact the livelihoods and food security
of small-scale farmers in LICs that compete in
Although more liberal trade can boost FSN in
the production of those subsidized commodities.
the aggregate (at national level), it also inevitably
LICs may lack the resources to support their own
creates winners and losers within countries.
producers to a similar extent, even if they wish
For example, groups that can take advantage of
to provide such support. The rules-based trade
new export opportunities stand to gain and have
system developed under the WTO made substantial
improved incomes, whereas groups that engaged in
progress in bringing down the levels of support in
import-competing sectors stand to lose relatively as
HICs and encouraging any support to be less trade-
they face competition from imports. These winners
distorting (Matthews, 2014). However, progress
and losers may well end up being defined based on
has levelled off in recent times, and furthermore,
size and wealth or social bases for disadvantage,
agricultural support has been increasing in
such as ethnicity and indigeneity. For example,
emerging countries such as China and India (Smith
large farmers and urban consumers may be much
and Glauber, 2019).
better positioned to benefit from opportunities
created by global value chains. Other important FSN-relevant inequalities that
have become increasingly prominent in the global
On the other hand, small farmers or labourers
food-trade system, including the influence of large
engaged in producing products that suddenly
multinational food companies and commodity
face a tide of competition from imports may not
trading firms, are discussed in CHAPTER 4 as systemic
have the resources to withstand the surge. These
drivers of FSN inequality.
livelihood impairments have the potential to lower
access and compromise food security for the food
producers left behind (Matthews, 2014). Food
consumers and producers who are net buyers,
Trade policy and the right to food
on the other hand, can benefit from lower prices In a critique of the global trading system, the
when imports flow freely into the country. In a study UN Special Rapporteur on the Right to Food
linking liberal trade policies with household-level (Fakhri, 2020) has noted that the trade system has
food security outcomes (as measured by the self- cemented longstanding inequalities, benefiting
reporting-based FIES), Barlow et al. (2020) find state and corporate actors that already have good
access to resources, credit and infrastructure
that liberal trade policies are not associated with
over the historically disadvantaged. The critique
[ 49
an improvement in the food security of the poorest
across the world Barlow et al. (2020). describes the concentration of corporate power
throughout the food system, facilitated by the global
trading and financial systems, and urges a move
Inequality in trade and FSN towards a system based on the human-rights
principles of dignity, self-sufficiency and solidarity.
implications: unequal support
levels for domestic producers
A longstanding disparity that has cast a shadow 3.3 FOOD ENVIRONMENTS
over international agricultural trade is the level
to which HICs have supported their domestic
AND CONSUMER BEHAVIOUR
The food environment is where the consumer and
producers, to the detriment of competing producers the food system interact. The HLPE-FSN identifies
in LICs. Many HICs have historically subsidized key entry points for food environment improvement:
their producers in ways (for example, via payments availability, physical access (proximity), economic
tied to levels of production or use of inputs) that access (affordability), promotion, advertising and
result in increased domestic production. This information, food quality and safety (HLPE, 2017,
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

p.107). These food environment components of food chain logistics that increase both the cost
interact with people’s personal food environment of food and the variability of the cost of food as it
(accessibility, affordability, convenience and moves from central markets (often located in urban
desirability) (Turner et al., 2018), which in turn centres) to more remote markets and households
inform consumer behaviour. It is therefore (Zimmer, 2022). This is particularly marked in
important to focus on both inequalities that are remote, geographically isolated locations, often
embedded within the food environment (external) populated by marginalized Indigenous Peoples and
and the way in which these inequalities interact rural communities, such as in Northern Canada
with other inequalities (personal food environment) (Veeraraghavan et al., 2016). However, in net food
to produce unequal FSN outcomes. Addressing exporting areas, rural residents may have greater
these inequalities will increase consumer agency access to cheaper, locally produced goods than
and provide pathways for improved FSN outcomes urban residents. Although rural food prices are
for all. often higher than urban prices, it is important to
note that these relatively higher food prices may not
translate into significant differences in affordability,
3.3.1 FOOD AFFORDABILITY as the cost of living is higher in urban areas due to
Food affordability is one of the foundational
higher rent and transport costs. Subnational food-
challenges in achieving FSN and a key source of
price monitoring is an important tool by which to
inequality in FSN outcomes. Long-term trends
identify price bottlenecks that limit accessibility in
around the world indicate that the price of fruits
certain areas and, as such, threaten year-round
and vegetables has risen substantially over time,
food security.
but that relative prices of processed foods have
fallen (Wiggins and Keats, 2015). A systematic The cost of accessing a healthy diet is informed by
review of 27 case studies from 10 countries found wider inequalities in food environments (Section
that purchasing a diet based on healthier, rather 3.5.2) and beyond. Households experiencing
than less-healthy options of comparable foods, income poverty and income precarity generally
would cost USD 1.48 more per day (Rao et al., have limited access to private transportation and
2013). These differences in the cost of healthy diets storage capacity. As such, they often buy in smaller
compound the impacts of income inequality on FSN unit sizes, which tend to be more expensive by
outcomes. volume. Furthermore, households with insecure
In real terms, healthier diets are generally more access and utilization of stable energy supply for
affordable in HICs than in LICs, with food making cooking, and poor sanitation and water access, may
50 ] up a greater proportion of household expenditure depend more on processed foods that have lower
in LICs (BOX 5). In 2020, 42.0 percent of the world’s food-safety risks or on purchasing cooked food
population could not afford a healthy diet, with (Battersby, 2019). The unaffordability of a healthy
considerable regional differentiation – 88.3 percent diet is exacerbated by infrastructural costs in these
of residents of LICs were unable to afford a healthy households. These conditions of multidimensional
diet, compared to just 1.4 percent of residents poverty have provided opportunities for small
of HIC (FAO et al., 2022). This has recently been scale, informal actors to play an important role in
confirmed by modelling costs of the EAT-Lancet the food environments of the poor, but they have
reference diet in countries in different income also provided a new entry point for major global
categories (Hirvonen et al., 2020). processing companies to gain traction in these
markets by marketing highly processed foods in
Inequalities in food pricing exist within countries as small, individually packaged units, which have
well, producing further unequal access to healthy negative implications for nutritional health and food
diets (Herforth et al., 2020). Globally, food prices system/environmental sustainability.
are generally higher in rural areas than urban
areas, although there are often significant intra-
urban food-price differences. This is the outcome 3.3.2 PHYSICAL ACCESS TO FOOD
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

BOX 5:
FOOD AFFORDABILITY – A CASE STUDY FROM SOUTH AFRICA
Healthy diets are beyond the budgets of many households. The Bureau for Food and Agricultural Policy calculates
the cost of a “thrifty healthy food basket” quarterly. This is based on the costs of a “nutritionally balanced combination
of 26 food items from all the food groups” (BFAP, 2022, p. 1) and assumes a four-person household consisting of
two adults, an older child and a younger child, with both adults earning a full-time minimum wage and the children
receiving government Child Support Grants and benefitting from school feeding programmes. The most recent (June
2022) calculation of the cost of the food basket was ZAR 3 621 (approximately USD 223), which is 31.1 percent of total
household income. Each month, the Pietermaritzburg Economic Justice and Dignity Project calculates the cost of
a typical household food basket, based on food-price data collected at point of sale from a range of retailers. Their
basket is based on the food items and the volumes of those foods that women living in a family of seven members (the
average size of low-income households) indicate that they typically try to secure each month. This yields very different
figures. The latest figures (August 2022) show that the cost of this diet for a seven-person household would be ZAR 4
775.59 (approximately USD 263), but the cost of the cheapest food basket meeting minimum nutrition requirements
for a household would be ZAR 5 617.31 (approximately USD 331). Currently, 55.5 percent of South Africans live below
the upper-bound poverty line of ZAR 1 335 (approximately USD 78.72) per month, and 25.2 percent live below the food
poverty line of ZAR 624 per month (approximately USD 36.79).

Source: PMBEJD. 2022. Household Affordability Index: Johannesburg, Durban, Cape Town, Springbok, Pietermaritzburg. South Africa, Pietermaritzburg Economic Justice
& Dignity Group [PMBEJD].

Unequal physical access to affordable and Stern, Ng and Popkin, 2015; Wertheim-Heck,
nutritious food is an important determinant of Raneri and Oosterveer, 2019). This is particularly
inequalities in FSN outcomes, with considerable important in countries with more diverse food-retail
research and policy focus on the issue of “food environments that have not yet been replaced by
deserts” since the mid-1990s. Food deserts supermarkets as the dominant source of food,
are commonly defined as neighbourhoods and where farmers’, peasants’ and fishers’ markets
communities that have limited access to affordable remain key sources of healthy and diverse foods.
[ 51
and nutritious foods (ver Ploeg et al., 2009). This
In much of Africa, Asia and South America
food retail environment inequality intersects with
informal traders and traditional markets remain
income poverty, race, limited mobilities and other
the dominant source of physical access to food
markers of structural inequality (Shannon, 2014;
for the majority of the population, particularly
Spires et al., 2020; Walker, Keane and Burke, 2010).
lower-income residents. These markets provide
Efforts to identify and address food deserts have important economic, physical and social access to
tended to focus on the presence or absence of food, offering smaller-unit sizes, informal credit
large grocery retailers, that is, supermarkets. arrangements and long operating hours; and
However, supermarkets are not the only source of selling culturally appropriate foods (Wegerif, 2020).
affordable, nutritious foods, and it has been argued Physical access to healthy foods from informal
that the conflation of physical access with the vendors and markets has been demonstrated to
presence or absence of supermarkets potentially increase the purchase of these foods. For instance,
undermines long-term FSN for vulnerable those living closer to informal vegetable vendors
populations – increasing access to “junk food” in the United Republic of Tanzania were found to
and crowding out other channels of food retailing
that provide local fresh produce (Battersby, 2019;
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

be more likely to buy vegetables (Ambikapathi et nutrition outcomes in children, but increased
al., 2021). Small-scale and informal retailers play overweight in adults.
an underacknowledged role in providing access
to affordable, nutritious food, particularly for low-
income residents. More recently, the idea of food 3.3.3 FOOD PROMOTION AND
swamps, defined as areas with a high-density COMMERCIAL DETERMINANTS
of establishments selling high-calorie fast food OF HEALTH
and junk food, relative to healthier food options, FSN outcomes are shaped by a number of
has been gaining traction (Cooksey-Stowers, commercial determinants of health within the food
Schwartz and Brownell, 2017). Research in North environment, including the formulation, packaging,
America has found that both food swamps and design, marketing and promotion of products.
food deserts have been associated with racial, In terms of marketing and promotion, it has been
ethnic and socioeconomic disparities in obesity noted that food advertising tends to focus on less-
rates (Cooksey-Stowers et al., 2020). However, nutritious foods more than on nutritious foods.
both the food desert and food swamp concepts For example, research conducted on television
have been critiqued by researchers arguing that advertisements in 11 countries found that less-
there is a need for greater nuance in analysis of healthy foods were more commonly featured
lived experience as physical access to affordable than healthy foods, and that this proportion
healthy food does not necessarily impact nutrition increased during children’s programming hours
inequality (Allcott et al., 2019). (Kelly et al., 2010). Similarly, research on food
There has been a massive increase in online advertising in magazines in South Africa found
grocery and food-delivery purchasing, particularly that almost 60 percent of food advertisements
in the wake of the COVID-19 pandemic. This may were for unhealthy foods (Abrahams et al., 2017).
improve physical access to food for some previously Furthermore, food advertisements promoting
marginalized groups, such as the elderly, people unhealthy foods are not equally placed and target
living with disabilities and people without access particular demographic groups. Children from
to private transport. However, there are concerns minority and socioeconomically disadvantaged
backgrounds, for example, are disproportionately
that less-affluent customers may be excluded
exposed to unhealthy food advertising (Backholer
by not being able afford the minimum-spend
et al., 2021). Additionally, unhealthy food brands
requirements for grocery purchases, nor be able
reinforce their position through sponsorship of
pay delivery costs, nor take advantage of the cost
sporting events, schools, scholarships and other
52 ] savings associated with bulk purchasing (Cummins
corporate social responsiveness activities (Beder,
et al., 2021). Furthermore, residents of poorer or
Varney and Gosden, 2009; Bragg et al., 2018; Harris
more remote areas may not be served by retailers
et al., 2019a). These marketing strategies have
offering online purchasing and delivery. In South
the strongest impact on lower-income, ethnic
Africa, the major retailers do not deliver to urban
minority populations in the Global North and are
townships due to safety concerns (Odendaal, 2023).
becoming increasingly prevalent in the Global
Physical access to food in the food environment South (Harris, 2020; Scrinis, 2016). One area
must be viewed through an intersectional lens as that has been of particular concern has been the
the impact of changed physical access to different marketing of formula milk to mothers, violating
types of food retailing is not uniform across the International Code of Marketing of Breastmilk
populations. Using the same panel data from urban Substitutes (The Lancet, 2023; UNICEF and WHO,
households in Kenya, (Debela et al., 2020; Demmler, 2022). Food discounts and promotions play an
Ecker and Qaim, 2018) found that the impact of the important role in the food security strategies of
arrival of supermarkets has different FSN impacts low-income households. These households are
for different household members, with positive therefore particularly vulnerable to the impacts of
the advertising, promotion and marketing of less-
healthy foods.
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

food system (Zhang and Xue, 2016). These trends

3.3.4 FOOD SAFETY are reflected in many low-income countries and
Unsafe foods have considerable impacts on
have been further attributed to weak governance,
FSN outcomes. Positive nutrition outcomes are
poor surveillance systems, economic constraints
undermined by food-borne diseases, which disrupt
and demand exceeding supply (Gwenzi et al.,
food utilization. The 2015 WHO Global Estimates of
2023). Rapid demographic and food system
the Global Burden of Foodborne Disease identified
transitions, coupled with weak regulatory capacity,
31 different food-borne hazards, which in 2010
means that food fraud safety risks are greatest in
caused 600 000 food-borne illnesses and a further
low-income countries.
420 000 deaths (Havelaar et al., 2015).
An additional dimension of food safety relates to
The distribution of the burden of food-borne
mycotoxin contamination of the food supply, which
disease is highly unequal around the world, with
is almost ubiquitous across tropical regions with
LMICs, particularly those in Africa, bearing most
high temperatures and moisture levels. Mycotoxins
of the burden (Pires et al., 2021). Within countries,
are naturally occurring toxins appearing in many
the experience of food-borne disease centres on
foods as a result of the growth of fungal spores.
particular population groups: those who are young,
Poor quality seeds, inefficient on-farm practices,
old, malnourished, pregnant or immunosuppressed
lack of crop drying, and ineffective local storage
(Grace, 2015). Indeed, the WHO found that children
solutions, which are greater challenges for poorer,
under the age of five accounted for 40 percent of
more remote and other marginalized households,
the disease burden of food-borne disease (Havelaar
all contribute to mycotoxin growth. In countries like
et al., 2015).
Nepal and Uganda, pregnant women who consume
Food-borne diseases perpetuate the cycle foods contaminated by various mycotoxins have
of poverty by causing short- and long-term poorer birth outcomes, which leads to suboptimal
illnesses that undermine health and livelihoods. growth and development of infants and young
Malnourished children are at greater risk of serious children (Andrews-Trevino et al., 2019; Lamichhane
food-borne diseases, which in turn exacerbate et al., 2022; Lauer et al., 2019).
malnutrition, limiting their development (WHO,
2015). Poor food safety disproportionately impacts
poor and vulnerable populations, due to both 3.4 OTHER SYSTEMS
higher exposure to the hazard of unsafe food and
water (See Section 3.6 below) and to underlying RELEVANT TO FSN
health vulnerabilities that increase the risk to The experience of FSN is fundamentally shaped
health and exacerbate poor FSN outcomes. by factors outside the food system. While these [ 53
Additionally, climate change is exacerbating have not historically been focal areas of food
food safety problems, further compounding the security policy, there is increasing interest in
disproportionate impact on poor and vulnerable more transversal (or intersectoral) governance
populations (Duchenne-Moutien and Neetoo, 2021). approaches to FSN policy and programming
(Battersby, 2022; Cohen and Ilieva, 2021; IPES-
There are also concerns about longer-term Food, 2017). Cognizance of these wider drivers of
food safety issues resulting from soil and water FSN provides opportunities to improve the efficacy
contamination, as well as the impact of pesticides, of existing policies and programmes, but also
hormones and food preservatives accumulating provides novel entry points to improve FSN while
in the body over long periods of time. The risk working towards broader development goals.
associated with these hazards is unequally
distributed, both geographically and economically
(Alita, 2022; Elvar and Tuncak, 2017). Food fraud is 3.4.1 HEALTH CARE SYSTEMS
another emerging food safety challenge. In China, AND SERVICES
this has been associated with rapid urbanization, Access to health care is fundamental, particularly
industrialization and rapid transformation of the for nutrition outcomes. It was identified as a key
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

part of the UNICEF conceptual framework on child Access to and use of basic infrastructure have
malnutrition in 1990 (UNICEF, 1990), and lack also been identified as determinants of FSN
of consistent access to quality health services is outcomes. The importance of adequate access to
consistently associated with malnutrition (UNICEF, water and sanitation (WASH) for FSN has been
1990). The role of health care services as part of a part of the UNICEF Conceptual Framework on
set of related services required for good nutrition Malnutrition since 1990 and has been the subject
was reinforced in the 2021 UNICEF Conceptual of substantial research and policy attention (for
Framework on Maternal and Child Nutrition instance, (Pickering et al., 2019; WHO, UNICEF and
(UNICEF, 2021). It has long been acknowledged USAID, 2015). Poor access to WASH is concentrated
that there are issues with equity in access to health in lower-income communities within lower-
income countries, exacerbating already unequal
care, including in HICs (Mooney, 1983), and that
FSN outcomes. Within these populations, the
access is constrained by financial, organizational
negative impacts of poor water and sanitation on
and social and cultural barriers (Gulliford et al.,
FSN outcomes are experienced most by infants
2002). Furthermore, access to health services
and young children, individuals with pre-existing
is unequal between countries: While the global
medical conditions and the elderly.
Healthcare Access and Quality Index improved
for most countries between 1990 and 2015, the While the focus on the impact of inadequate
divide between the best- and worst-performing infrastructure on FSN outcomes has been
countries widened over that time to a 66-point gap predominantly on WASH, there are other important
on a scale of 1 to 100 (from 28.6 to 94.6) (GBD 2015 infrastructural factors that create FSN inequalities.
Healthcare Access and Quality Collaborators, 2017). Poor housing (Jonah and May, 2020), access to
Inequalities are also seen within regions. Within affordable and reliable energy supply (Bednar
sub-Saharan Africa, for instance, countries fall both and Reames, 2020; Masters et al., 2021), and time
above and below expected levels of access to health poverty linked to urban transportation and food
care services (GBD 2015 Healthcare Access and preparation times have all been shown to shape
Quality Collaborators, 2017). food practices and FSN outcomes (Masters et al.
2023), with low-income households particularly
Inequalities by wealth in access to health care impacted by poor access to basic infrastructure to
services are seen in OECD member countries, for support FSN (Kulinkina et al., 2016).
instance (OECD, 2019); and in the United States
Within the last three years, the rising cost of energy
of America, studies show poorer households and
has exacerbated unequal FSN in many parts of the
individuals (particularly those from Hispanic and
54 ] African American communities) are less able
world. Poor households in Europe and the United
Kingdom face “heat or eat” dilemmas, leading
to afford insurance payments and, therefore, to
to reduced diet quality (Bardazzi, Bortolotti and
access health care (Dickman, Himmelstein and
Pazienza, 2021; Burlinson, Davillas and Law, 2022).
Woolhandler, 2017). Similarly, across 18 countries
In Kenya and Sri Lanka, energy costs have forced
in sub-Saharan Africa, health care use varies
shifts in cooking technologies and increased food
widely according to wealth (more so in the poorer insecurity (Perera, 2022; Shupler et al., 2021). The
countries), alongside education, employment and World Food Programme has identified access to
urbanicity (Bonfrer et al., 2014), while greater safe, sustainable and accessible cooking fuels and
gender discrimination at household and community technologies as an essential aspect of food security
level limits the use of maternal health care services and proposed pathways to improve energy access
(Adjiwanou and LeGrand, 2014). for all (Bisaga et al., 2022).

The infrastructural deficiencies experienced by

3.4.2 HOUSING, WATER, SANITATION, low-income households are also experienced by
ENERGY AND INFRASTRUCTURE food retailers operating within these geographical
locations. Poor access to water, sanitation, reliable
energy supplies and transport infrastructure shape
3 PROXIMATE DRIVERS OF FSN INEQUALITIES IN FOOD SYSTEMS AND IN OTHER RELEVANT SYSTEMS

the food practices of these businesses, which are have secondary or higher education (Development
often the primary source of food for low-income Initiatives, 2020).
residents. These infrastructural deficits impact
Access to education is highly unequal. The World
stocking practices (meaning traders need to make
Inequality Database on Education shows that
small, frequent purchases to prevent spoilage,
between 2014 and 2019, all HICs had achieved
leading to greater per-unit costs, increased food
primary school completion rates over 96 percent
safety risks and a limited range of foods sold, as
(mostly 100 percent), while only one LIC (Tajikistan)
vendors may sell more processed goods to avoid
achieved this, and a majority hovered around 50
spoilage) (Ahmed et al., 2019; Fuseini, Battersby
percent completion. Afghanistan had the largest
and Jain, 2018). As such, there is a double FSN
gender disparity in primary education, with 67
penalty experienced by individuals and households
percent of boys and 40 percent of girls completing
living with infrastructural deficiencies. Recently,
primary-level education. There are also large
there has been increased interest in equitable
divides in terms of rural–urban education in
access to infrastructure (Gilbert, Eakin and
many countries. For instance, 84 percent of urban
McPhearson, 2022) and in the role of infrastructure
adolescents completed secondary schooling in the
in health and well-being (Ramaswami, 2020).
Plurinational State of Bolivia, compared to only 50
Inequitable infrastructures and spatial planning
percent of rural adolescents. Ethnicity also shapes
undermine FSN and impact characteristics of the
school access. In Brazil, for example, 25 percent
food environment in ways that undermine access to
of Indigenous children have never been to school,
healthy diets for the most vulnerable.
compared to 16 percent of white children.

Inequalities in these other systems compound

3.4.3 EDUCATION to exacerbate the impact of inequalities in the
Equity in education has two dimensions: one
food system on FSN outcomes. As such, reducing
of fairness (gender, income and other factors
inequalities in FSN outcomes requires actions
should not be a barrier to achieving educational
within and beyond the food system.
potential) and another of inclusion (a minimum
basic standard of education should be available for
all) (OECD, 2008). Educational level, particularly
education for women, is known to be linked to
nutrition outcomes, presumably through pathways
of general ability to understand nutrition and
health information and access to skilled work
and livelihoods (Harding et al., 2018). Malnutrition [ 55
rates in children differ according to the education
levels of their mothers in many contexts: For
instance, minimum dietary diversity is achieved by
24.4 percent of children whose mothers have less
than primary education; while dietary diversity is
achieved by 35.2 percent of children whose mothers
 Chapter 4
THE SYSTEMIC DRIVERS
AND ROOT CAUSES OF FSN
INEQUALITIES

56 ]

©FAO/Thomas Nicolon
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

KEY INSIGHTS
• It is essential to view the vast inequalities in FSN outcomes not just as outcomes of inequalities in food
and related systems, but also as the result of deeper, systemic drivers.
• Many drivers that act on food systems have underlying drivers within food systems themselves. For
example, climate change and environmental decline harm food system workers and are a threat to FSN,
particularly where people and places are most vulnerable to change. However, food systems themselves
are major drivers of climate change and environmental decline. Breaking this harmful feedback has
considerable potential for reducing inequalities in FSN outcomes.
• Economic and market drivers have fundamentally changed food systems, shaping patterns of global trade
and consolidating decision-making power and ownership. These changes have altered dietary patterns
in complex ways and curtailed the agency of most food system workers. While some nutritional benefits
accrue, there are concerns about the impacts of a transition towards a Western obesogenic diet that
exacerbate FSN outcomes, starting out affecting the wealthiest in society but then gradually becoming a
problem for the most marginalized or socio-economically disadvantaged sections of society.
• Policies related to different dimensions and actors in the food systems have remained siloed, and seldom
focus on the needs of the most marginalized. In many cases, this has exacerbated pressures and created
vulnerabilities.
• Violence and conflict are the main drivers of acute and chronic hunger, undermining people’s agency and
exacerbating poor FSN outcomes for the most vulnerable. However, geopolitical interests often determine
whether the impacts of conflict on FSN outcomes are exacerbated or ameliorated, and where. Reaffirming
the right to food in all geopolitical conflicts can help reduce inequalities in FSN outcomes.
• Sociocultural drivers intersect with all categories of drivers and have generated historical inequities that
will persist, unless explicitly challenged. Policies and practices need to become equity sensitive. Existing
or emerging barriers can create and reinforce inequities.

T
he vast inequalities in FSN outcomes are economic and market drivers; 4) political and
the result of major inequalities in food institutional drivers; 5) sociocultural drivers;
systems and other systems more broadly. and 6) demographic drivers (FIGURE 1) (HLPE,
These system inequalities, or proximate drivers, 2020). Importantly, these distal drivers of FSN
[ 57
in turn are the result of deeper structural, or inequalities must be understood and addressed
distal, drivers (FIGURE 1 and FIGURE 2) that emerge as overlapping and intersecting. For example,
through time to undermine FSN. CHAPTER 4 sociocultural drivers shape and are shaped
picks up on the proximate drivers identified in by political and institutional settings (Harris
CHAPTER 3 to take a broader social and historical and Nisbett, 2021). Furthermore, complex and
perspective and examine the underlying distal intersecting interactions exist among drivers,
drivers and how and why they emerge to affect for example interactions between sociocultural
FSN. Consistent with earlier HLPE assessments drivers and technological innovations or
of food systems, these broader drivers are climate change can cause uneven impacts and
considered outside the food systems and include: vulnerabilities that exacerbate marginalization
1) biophysical and environmental drivers; 2) and inequality (O’Brien and Leichenko, 2000;
technology, innovation and infrastructure; 3) Spielman et al., 2021; Swer, 2019).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

2011), and the ability of places to make blue water

available is influenced by their economic and
governance capacity. Currently, 3 billion people
4.1 BIOPHYSICAL AND face food insecurity due to the lack of green water

ENVIRONMENTAL DRIVERS and the lack of capital and technology to make

blue water available (Falkenmark, 2013; FAO,
Food systems, particularly industrialized food 2022b; Rockström et al., 2023; Vallino, Ridolfi and
systems, are major drivers of biodiversity decline, Laio, 2020). Wastewater can alleviate some of the
environmental pollution, climate change and challenges of water scarcity, and an estimated
infectious diseases (IPCC, 2022; Rivera-Ferre et 10 percent of agricultural land is irrigated using
al., 2021). These environmental and biophysical wastewater (Jaramillo and Restrepo, 2017;
consequences of our current food systems, Winpenny et al., 2010). However, this varies
together with broader societal influences (such considerably by country; in part, by whether
as global emissions), are not distributed equally, wastewater is treated or not. Unregulated and
and intersect with people and places already
untreated wastewater, which pose safety concerns
vulnerable to FSN outcomes to further exacerbate
due to the impact of toxins on human health,
existing inequalities.
is mostly used in more populous and emerging
economies (such as China, India and Pakistan)
4.1.1 BIODIVERSITY LOSS, WATER (Jaramillo and Restrepo, 2017), where the largest
AND SOIL DEPLETION, number of food-insecure people live (Wesselbaum
et al., 2023), further exacerbating the gap between
AND POLLUTION places that are food secure and those that are
Industrial food systems carry an enormous
food insecure.
environmental cost, violate the right to a clean
environment (A/76/179), and disrupt people’s Water is generally governed within national
relationships with nature (Fakhri, 2023; Kimmerer, boundaries, yet water use in one region affects
2013). Agriculture is a major driver of deforestation availability elsewhere, and every country in the
and the third most significant sector in terms world is dependent on other countries for at least
of global greenhouse gas emissions (Crippa 50 percent of their water availability (Rockström
et al., 2021; IPCC, 2022; Pendrill et al., 2022). et al., 2023). Major food producing regions in
Deforestation and land-use change drive water Asia, Africa and South America are dependent on
depletion, through decreased availability of neighbouring countries for their supply of fresh
atmospheric water, undermining food security. water (Rockström et al., 2023). For example, Brazil
58 ] Feedbacks between deforestation and water exports 25 percent of its water to downstream
scarcity further exacerbate food security. For countries. As such, deforestation in the Brazilian
example, deforestation in the Amazon has caused Amazon affects water availability and exacerbates
4 percent drying, and for every millimetre of food insecurity in downstream countries
rainfall deficit, deforestation increases by 0.13 (Wunderling et al., 2022).
percent (Staal et al., 2020). Water depletion is a
critical threat to food security, as all agriculture Inequities in access to water also emerge within
is dependent on the availability of both naturally countries. For example, throughout the world,
occurring green water (rain water in soil ) Indigenous peoples have had their water access
and blue water (water in our surface and restricted by dominant institutions and systems
groundwater reservoirs) made available through of water governance, interrupting their spiritual
social institutions, including irrigation systems) and cultural relationships with the land and their
(Falkenmark, 2013), and agriculture consumes ability to access and secure food (Jackson, 2018).
70 percent of freshwater (Pimentel and Pimentel, In Australia’s most productive agricultural region,
2008). However, green water availability varies the Murry Darling Basin (MDB), historical exclusion
geographically, with the most populous places of Aboriginal Peoples from decision-making
being the most water scarce (Kumu & Varis, processes and from holding land and water have
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

meant that, as water access and rights are rerouted increasing rapidly ((Lam et al., 2020), and this trend
for intensive agriculture, Aboriginal communities is projected to continue through the 21st century
have lost their means of food production (including (Cheung, Reygondeau and Frölicher, 2016; Lotze et
riparian fishing and harvesting) and their al., 2019). Climate scientists have raised concerns
connection to the land. Currently, Aboriginal People about key tipping points in climate change being
in MDB make up 9.3 percent of the population, but breached (Armstrong McKay et al., 2022; Lenton et
own just 0.5 percent of its agricultural businesses al., 2019; Wunderling et al., 2021). The impacts of
and, instead, make up a larger proportion of the climate change are not distributed evenly (Bindoff
agricultural workforce (Hartwig et al., 2022). These et al., 2019; Free et al., 2019). Instead, the countries
patterns are further compounded by the fact that have contributed the most to climate change
Aboriginal Peoples in Australia are already more are both the least impacted and the most capable
vulnerable to poor FSN outcomes, with far higher of adaptation (Bruckner et al., 2022). As a global
rates of food insecurity and lower rates of life challenge, principles of justice and equity must
expectancy (Davy, 2016). feature in efforts to understand and address the
causes and consequences of climate change
In addition to biodiversity and water loss, soil (see BOX 6). Indeed, the most recent IPCC report
quality is a growing concern (FAO, 2015b). Soil highlights the need for the principle of equity to
quality can vary naturally and can be degraded be built into climate change responses (Allen
or enhanced by sociocultural norms surrounding et al., 2022), and calls for “climate reparations”
production methods, systems of governance, and were brought to global attention at the COP 26 in
intensity of use. To illustrate, degraded soils are Glasgow (Nevitt, 2021) (further discussed in
common in the fields of poor farmers in many CHAPTER 6).
locations and are a particularly prevalent problem
in sub-Saharan Africa, where people are already Because these impacts are not equally distributed,
more vulnerable to food insecurity (Tittonell and climate change also exacerbates existing
Giller, 2013; Zhang et al., 2021). Agroecosystems inequalities in FSN outcomes (IPCC, 2001),
can enhance soil quality and productivity requiring direct local action. The World Bank
by using livestock manure to move organic estimates that climate change will drive 68 million
matter, nutrients, and water (Bai and Cotrufo, to 135 million people into poverty by 2030, with the
2022; Beal et al., 2023). Conversely, historical newly poor concentrated in sub-Saharan Africa and
and contemporary processes of fencing and South Asia (World Bank, 2020). Most of the focus
on the impacts of climate change on food security
enclosure, such as those associated with private
has been directed towards production issues (such
conservancies in East Africa, that exclude people
as species distributions, yield gaps and water [ 59
and livestock, can enhance soil quality within the
scarcity). However, the impacts of climate change
conservancies (Bai and Cotrufo, 2022). However,
are felt across all components of food systems
the effect outside of the conservancies where most
(HLPE, 2022). Climate change is driving negative
people live on common lands, is to limit mobility
FSN outcomes at multiple scales, through direct
and concentrate grazing, undermining customary
impacts on food production systems, as well as
rules and systems of governance and reducing soil
impacts on the economic, environmental and social
quality and food security (Moritz et al., 2013).
systems on which people depend to meet their food
security needs. These multiple interconnections
4.1.2 CLIMATE CHANGE indicate a strong multidirectional relationship
Global food systems have been identified as between climate change, FSN and inequality,
major drivers of climate change, highlighting the operating at different spatial and temporal scales
urgency of action in this sphere (IPCC, 2019). At and interacting to have intersectional effects on
the same time, climate change is undermining the inequality in FSN outcomes.
productivity of waters, soils, food system workers
These inequalities in FSN outcomes do not operate
and the food systems themselves (Fiorella et al.,
only at regional scales. Threats and pressures
2021). Moreover, the pace of climate change is
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

to the environment often amplify existing social for food security by poor populations are more
inequalities and power imbalances within countries, vulnerable to climate change. Consequently,
particularly in communities and households particular vulnerabilities to climate change (that is,
already coping with scarcity (Chancel, Bothe and those that often fall along lines of gender, wealth,
Voituriez, 2023; Schneider et al., 2007). Islam and etc.), which increase unequal FSN outcomes,
Winkel (2017) argue that the relationship between are not just driven by people’s engagement with
climate change and poverty is characterised by a the food system, but with a set of cascading
vicious cycle, in which “initial inequality causes the impacts, where climate change intersects with
disadvantaged groups to suffer disproportionately biophysical, economic and social systems to drive
from the adverse effects of climate change, FSN inequalities (FAO, 2015c). The World Bank
resulting in greater subsequent inequality.” They has identified groups that are more vulnerable
identify three main channels “through which the to the impact of climate change. These include:
inequality-aggravating effect of climate change female-headed households, children, persons
materializes, namely (a) increase in the exposure of with disabilities, Indigenous Peoples and ethnic
the disadvantaged groups to the adverse effects of minorities, landless tenants, migrant workers,
climate change; (b) increase in their susceptibility displaced persons, sexual and gender minorities,
to damage caused by climate change; and (c) older people and other socially marginalized
decrease in their ability to cope and recover from groups. The World Bank argues that “the root
the damage suffered” (Islam and Winkel, 2017, causes of their vulnerability lie in a combination
p. 1). Such frameworks are now widely used to of their geographical locations; their financial,
understand the variable vulnerabilities of people socioeconomic, cultural and gender status; and
and places to the impacts of climate change their access to services, decision-making, and
(Cinner et al., 2013; IPCC, 2022). justice” (World Bank, 2023b). These groups also are
Components of the food systems (such as small already most likely to experience discrimination
scale fisheries and informal markets) that offer that undermines their food security, suggesting that
livelihoods to poor populations and are most used climate change will intersect with damaging social
and cultural norms to further exacerbate inequality
in FSN.

60 ]
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

BOX 6:
CLIMATE JUSTICE AS A TOOL TO ANALYSE FSN INEQUALITIES – THE CASE OF THE LOWER MEKONG
Climate justice focuses on how and why climate change impacts people differently, unevenly and disproportionately,
and in doing so extends climate change to a moral and justice issue (see (Gardiner, 2011; Sultana, 2022; Whyte, 2016)
Climate justice thus highlights the need to reduce marginalization, exploitation and oppression (which exacerbate and
are in turn exacerbated by climate change), and enhance equity and justice (Sultana, 2022). The situation of people
of the Lower Mekong region, who face challenges stemming from the impacts of climate change, deforestation and
hydropower dams, provides an example of the need for climate justice.

The Lower Mekong region is biologically diverse, economically important and home to about 65 million people. It spans
six countries in Southeast Asia. The region has undergone extensive environmental changes since the 1990s due to
agricultural expansion and intensification, deforestation, the construction of numerous dams, increased urbanization,
growing human populations and the expansion of industrial forest plantations, in addition to frequent natural disasters
from flooding and drought (Manohar et al., 2023; Spruce et al., 2020).

The Mekong River is heavily used for human transportation, fishing, drinking water and irrigation, and the livelihoods
of those who depend on the Mekong River are transitioning. Declines in fish populations and natural resources
are making life more difficult for them. Extensive hydropower development in the Mekong basin has destroyed
fisheries, reduced the productivity of local farmers and altered flow regimes that people rely on for livelihoods. With
environmental and climate changes and hydropower development, the food environment of the Mekong is becoming
less predictable in its ability to satisfy the food security needs of those who rely on it. Consistently, it is the more
marginalized groups that feel the impacts of both climate change and dam development in the region – namely,
the Indigenous and rural fishing communities. The lives of these river communities are impacted by governmental
decisions on the management of the river, migration and various environmental factors, including coastal collapse
(Barrington, Dobbs and Loden, 212). Transboundary governance is inadequate and urgent calls have been made for
transparent and timely data sharing on dam development, water levels and rainfall (MRC, 2021).

Source: Authors’ own elaboration.

[ 61
While COVID-19 was the first recent pandemic,
other recent disease outbreaks provide further
lessons on the interaction between disease,
4.1.3 ENVIRONMENT–HUMAN livelihoods, poverty and FSN. For example, delivery
HEALTH LINKAGES of health services was significantly affected by the
The industrialized food system, and its contribution outbreak of Ebola in many West African countries,
to habitat fragmentation and land-use change, is particularly facility- or community-based services
a major driver of emergent infectious diseases, associated with nutrition outcomes such as
including COVID-19 (IPBES, 2020; Rivera-Ferre malaria prevention and immunization (Mæstad and
et al., 2021). In turn, the COVID-19 pandemic Shumbullo, 2020). Similar effects were felt during
significantly affected food and nutrition outcomes the COVID-19 pandemic where, whether because
in ways that are still being charted, but ultimately of illness of health staff, government restrictions
underscored how inequalities and fragilities in or lockdowns, health services needed to prioritize
our food systems drove further increases in world the care of people with COVID-19. Routine and
hunger and food insecurity (FAO et al., 2022). important preventive services, including antenatal
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

care, childhood vaccinations and infant and

young child feeding advice, were paused in many 4.2 TECHNOLOGY,
countries, alongside some important safety nets
such as cash or food transfers, with significant
INNOVATION AND
effects on health, nutrition and food security INFRASTRUCTURE
(UNICEF, 2020). In India, for example, cash Developments in science and technology have
transfers in Bihar state were effective in mitigating boosted both agricultural yields (Binswanger, 1986;
the impact of the COVID-19 lockdown on household Freebairn, 1995; Griffin, 1979) and incomes in many
food security and diet quality, but were not able to low- and middle-income countries, particularly
prevent them altogether (Makkar et al., 2022). those which benefitted from the development of
green revolution technologies such as new high-
Inequalities in public health and the disease yielding varieties of key staple crops, new inputs
profile of populations more broadly are both such as pesticide and fertilizers, investment
impacted by and in turn impact FSN, exacerbating and innovation in irrigation technologies and
inequalities in FSN outcomes. Not only is HIV/ mechanization (Pingali, 2012). In Asia, for instance,
AIDS, for example, a driver of poverty, vulnerability as a result of the green revolution, overall output
and malnutrition, but the risks of catching HIV/ grew at an annual rate of 2.9 percent during
AIDS are higher for vulnerable populations, the 1980s and 1990s, compared with an annual
including, for example, children who are subject rate of 2.1 percent before the new varieties were
to abuse, sex workers, food system workers, and introduced in 1965 (Altieri, 2009; McMichael, 2010).
highly transient populations (MacPherson et al., The success of the green revolution in producing
2020; Seeley, Tumwekwase and Grosskurth, 2009). basic grains to meet population demands led
Furthermore, people living with HIV who are on to some improvements in yields of other crops
antiretroviral treatment can experience increased such as cassava (Patel, 2013; Thompson, 2012).
hunger, which can have significant effects on Increases in productivity, however, did not have
clinical treatment adherence (de Pee and Semba, uniform impact on all levels of society across
2010), and underweight HIV-positive children have a countries adopting green revolution technologies.
threefold higher incidence of death (Oumer, Kubsa Many studies have found that inequalities were
and Mekonnen, 2019). In terms of intersectionality, exacerbated by the green revolution, as the
it has been shown in Uganda that HIV-positive package of inputs tended to favour wealthier and
women are also more likely to have high levels larger farmers, with many small farmers falling
of aflatoxin (a natural food-borne mycotoxin) in further into debt and forced to sell land (Freebairn
their blood that non-HIV-positive women (Lauer 1995; Griffin 1979; Binswanger 1986). Building on
62 ] et al., 2020). Malaria is another infectious disease technological approach of the green revolution,
which has significant and well-known feedbacks which was predominantly led by state, cooperative
between nutritional status and disease, requiring (for instance, the World Bank), and philanthropic
cotreatment and prevention that consider both (such as the Rockefeller Foundation) institutions,
malaria and nutrition in endemic areas (Das et al., numerous highly technological and scientific
2018; Oldenburg et al., 2018). Infectious diseases research projects, driven increasingly by the
account for half of under-five deaths, lead to low private sector, have sought to improve post-harvest
appetite and to children becoming underweight and technology (CGIAR, 2010; Heinemann, Agapito-
weakened, depressing immunity and leaving those Tenfen and Carman, 2013), biotechnological
with the disease vulnerable to further infections techniques (IRR, 2013), and genetically modified
and malnutrition (Katona and Katona-Apte, 2008; organisms (Howard, 2009; Robin, 2014; Schwartz,
Perin et al., 2022). 2013).

Despite offering some farmers economic gains,

the emergence of agrobiotechnology, allowing
the manipulation of genes in living organisms
and seeds, has been highly controversial, with
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

particular concerns raised over ecological risks have tended to lack access to these technologies
and increasing social inequality (see BOX 8) (De (FAO, 2022b). The emergent generation of digital
Schutter and Vanloqueren, 2011; Friedmann, 2005; technology has the potential to generate economic
Islam, 2022). For example, in a comprehensive and environmental gains, benefitting food-system
study of the global seed industry, Howard (2009) workers. However, costs of access are high, and the
pointed out that the intensification of investments burden is only likely to be borne by large companies
in technological innovations, such as genetically or already specialized and financially successful
modified organisms, among Indigenous food sectors. Inequalities that have been historically
crops (such as maize) with the aim of increasing exacerbated by unequal access to technology are
agricultural production have shaped the seed therefore likely to be further exacerbated unless
industry wherein scientific and high-tech farming innovators and states build equitable access into
have come to dominate the global seed industry their designs.
(Howard, 2009; La Vía campesina, 2011; McMichael,
Access to developments in infrastructure, science
2010). Furthermore, the extension of patent rights,
and technology often fall along social or economic
designed to incentivize corporate investment in
lines, wherein those already vulnerable to food
agrotechnology, has enabled large corporations to
insecurity are the least able to access these
increase their market position and exert control
improvements. For instance, cultural norms can
over smaller farmers and firms (Islam 2022).
act to constrain access for certain groups, such
Notably, the seed industry is now controlled by just
as women, who often have less access than men
four companies (Béné, 2022; IPES-Food, 2017;
to clean technology and other innovative methods,
Mooney, 2018), which have control of seed patents
including digitalization. Economic barriers similarly
of high-yielding varieties of some major Indigenous
limit access. For example, remote and poorer
crops such as potatoes and maize (Howard, 2009;
regions and sectors are often the last to access
Kloppenburg, 2010; Wittman, Desmarais and
water, hygiene and sanitation infrastructural
Wiebe, 2010). The seed and food monopolies by
developments that reduce the risk of infectious
multinational corporations make it increasingly
diseases such as diarrhoeal disease (see
difficult for peasant and Indigenous peoples to grow
CHAPTER 3). Similarly, small-scale and informal actors
healthy and culturally preferred foods (Wittman,
lack access to infrastructural improvements that
Desmarais and Wiebe, 2010).
protect food from spoilage, such as cold storage,
Digital technologies have been used in making them more vulnerable to extreme events. In
agricultural automation since the 1970s. There addition, small-scale and informal actors often lack
are now a growing range of applications of these access to climate information, clean technology
technologies, including supporting the development and insurance, limiting their capacity to respond to [ 63
of precision agriculture, improved access to extreme weather.
information on markets and weather forecasting,
and supporting communication. Recent innovations
that have spread particularly rapidly in LMICs, 4.3 ECONOMIC AND
reaching some of the most rural areas, include
supporting increased access to information and MARKET DRIVERS
finance through mobile phones (Baumüller, 2017). Economic and market drivers have fundamentally
Despite closing some gaps, economic, cultural transformed global food systems. Most notable has
and educational barriers persist that either limit been the shaping and scale of international trade,
the scope of these technologies, or have made and the influence of a small number of private
them more accessible to high- and middle- actors increasingly in control of market making.
income users or countries, to more economically
active groups, to men, or to those who speak the
dominant language. For example, small-scale
4.3.1 INTERNATIONAL TRADE
International and regional trade has clearly
producers, women, youth and other groups that are
benefitted several low-, middle- , and high-
typically marginalized or in vulnerable situations
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

income nations, stimulating economic growth and The WTO undoubtably plays an important role in
improving food security and nutrition outcomes supporting global food systems, but the WTO has
(see Section 3.2.4) (Allouche, 2011; Gephart et come under increasing scrutiny, in particular as
al., 2023; Gephart and Pace, 2015; Tortajada and global food systems face cumulating and escalating
González-Gómez, 2022). However, within countries, geopolitical, environmental and economic shocks
trade has tended to increase income inequality, as (Cottrell et al., 2019). The WTO has been criticized
the labour market becomes polarized by market for not acting on the shortcomings of its rules and
integration that benefits firms that produce high- policies, inadvertently disincentivizing beneficial
quality products (Furusawa, Konishi and Tran, actions or not adapting to change quickly enough
2019; Lin and Fu, 2016). Increasing levels of income (Barlow et al., 2018; Friel et al., 2013; Hawkes et al.,
inequality, in turn, undermine diets and human 2009; Thow and Hawkes, 2009; Tienhaara, 2011),
health (Offer, Pechey and Ulijaszek, 2010), as at times, being out of step with public health goals
western obesogenic diets high in calorie-rich foods, of addressing health and nutrition inequalities
spread particularly into LMICs (Baker et al., 2020; (see, for example, (Friel et al., 2013; Hawkes et
Hawkes, 2010; Popkin, 1994). Trade has thus made al., 2009; Thow and Hawkes, 2009). Many argue
larger quantities of both healthy and unhealthy that if institutions such as the WTO are to support
foods available, but it has tended to be the richest, the right to food, reduce inequality and support
most food secure who are able to access the more efforts to address environmental and climate
diverse, healthy foods, while the poorest access change, they need reform (Fakhri, 2021). The WTO
cheaper UPF products (GloPan, 2016; Nash et al., recognizes these challenges and the need for
2022). Thus, for poor populations, the net result is reform, and has made a number of recent changes
still low-quality diets (GloPan, 2016). (Okonjo-Iweala, 2023). For example, in 2022 as food
systems bore the brunt of the converging crises
Many decisions surrounding global trade and
of COVID-19, the war in Ukraine, and decades
associated rules and policies are shaped by the
of environmental decline, members of the WTO
institutional architecture developed to guide and
signed the first agreement that puts sustainability
regulate trade. However, these processes have
at its core and seeks to protect elements of equity.
historically been influenced by those most involved
This multilateral agreement to ban all harmful
and able to shape these decisions. For example,
fishery subsidies, was signed on the back of 20
historical accounts have documented the power of
years of negotiations and the recognition that many
a small group of countries, in particular Canada,
inequalities in global trade result from uneven
64 ] the European Union, Japan and the United States
patterns of fishery and agricultural subsidies
of America, in shaping the outcome of the Uruguay
(CHAPTER 3), which overwhelmingly favour high-
round of global trade negotiations (Shaffer, 2021),
income nations and stimulate overproduction and
which in part sought to reduce the influence of
overfishing, (Arthur et al., 2019; McCauley et al.,
trade distorting subsidies, and ultimately led to the
2018; Melendez-Ortiz, Bellmann and Hepburn,
formation of the World Trade Organization (WTO).
2009; Sumaila et al., 2010). This agreement went
Despite, the intent of the Uruguay Round, countries
further in recognizing the need to protect fishers in
in the North, with the financial capacity, continued
low-income nations as they transition away from a
to subsidize food production for export, whereas
dependence on subsidies. Around the same time,
low- and middle-income nations with fewer
WTO members agreed to exempt humanitarian food
resources were not able to do the same, but had to
from export restrictions, highlighting a growing
open their markets to imports. The impact of cheap
recognition of the challenges that inequality poses
grain imports meant that although food prices
to global food systems (Okonjo-Iweala, 2023;
came down, so did the price of labour, undermining
Sumaila et al., 2010).
the livelihoods of many small scale producers
(Clapp, 2006; Gonzalez, 2002; Hawkes and Plahe,
2013; Stevens et al., 2000).
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

Speculative investment in food commodities

4.3.2 MARKET MAKING, has also been a recurring concern within food
SPECULATION AND CONCENTRATION systems, which has important equity implications
Increasingly, a new dynamic is emerging whereby
for FSN. Financial speculators often increase their
powerful retailers change the very institutional investments in agricultural commodities futures
framework of markets (Ouma, 2010, 2015). Private markets when there is uncertainty – for example,
systems of standards have emerged in the past due to market disruptions caused by war, weather
two decades (such as Tesco’s Natures Choice, events, or other forces affecting food supply –
GLOBALGAP, Marine Stewardship Council), based which often amplifies food price trends (Tadesse
on social, environmental and ethical issues, in et al., 2014; Kornher et al., 2022). This dynamic can
addition to food safety or quality, that allow for undermine food access for the poorest and most
consumer market segmentation and added value. marginalized people who typically spend a large
These systems of market-based governance reflect proportion of their income on food, thus widening
a growing concentration of influence whereby, in inequalities (Clapp and Isakson, 2018). While the
question of whether financial speculation is the
return for larger and stable transactions, consumer
main cause of food price trends is widely debated,
nations control producer nations, driving costs for
there is growing recognition that it can play a role in
producers up without an associated rise in prices:
fuelling bubbles that exacerbate food price trends
(e.g. (Clapp, 2014; Clapp and Isakson, 2018; Ghosh,
The market Heintz and Pollin, 2012; HLPE, 2011; Tadesse et al.,
concentration has led 2014; UNCTAD, 2011)).

to increased buyer As the dynamics between land and ocean use,

agriculture and development escalate, and good-
power in Europe. Some quality land becomes scarce, more productive
of the supermarkets or better-endowed land and sea become more
desirable, leading to land and ocean grabs. For
come in and dictate example, many coastal places are framed as being
their demands prime for development by foreign actors seeking
to capitalize on a blue economy that is expected to
without concessions or grow by USD 3 trillion per annum by 2030 (Bennett
negotiations. We are et al., 2021; Jouffray et al., 2020). Land or ocean
grabbing is a phenomenon emerging from both
already at the bottom of in-country and foreign investment, as domestic
[ 65
the business… We are pressure for food, biofuel and conservation
increase. These processes violate the rights of
currently sticking to local, traditional and other more marginalized
15 different production rights-holders (Cotula and Berger, 2017) and
deepen problems concerning land ownership and
standards, including lack of access to FSN. Land grabbing often involves
Tesco’s Nature’s Choice, evicting local people and communities from
their land to advance land investment purposes
EUREPGAP, Field to or rights claims to certain attributes, such as
Fork, and Fairtrade; mineral, transportation, or even carbon rights
(Karsenty, Vogel and Castell, 2014). This results
this is madness (Large in the concentration of ownership and control of
horticultural exporter vast areas in the hands of an elite few (Borras
and Franco, 2013). Land grabbing is particularly
in Kenya, quoted in prevalent in Africa, where foreign investments
(Ouma, 2010) breach customary and communal tenure
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

arrangements and reassign access and ownership (see BOX 7). Moreover, this concentration in food
to private companies, foreign governments and systems results in longer value chains that leave
investors (Batterbury and Ndi, 2018; Daniel and food system workers, who are most vulnerable to
Mittal, 2009). food insecurity, less able to adapt to the changes.
When the COVID-19 pandemic hit and global
Economic liberalization and technological
markets closed, more centralized actors were able
specialization in global food systems have created
to switch trading partners and maintain their flow
food systems capable of producing and distributing
of goods and income, whereas others lost crucial
vast quantities of food. This has resulted in
food supplies (Love et al., 2021). For example,
considerable changes to, and concentration in, the
when China closed its markets, farmed Tilapia
control of the food systems (Howard, 2016) with
exports, which had come to comprise a significant
an ever smaller number of actors controlling the
proportion of fish sold in some developing
major food system sectors (Baines and Hager,
countries, stopped. Once China was able to resume
2022; Béné, 2022; Clapp, 2021; Howard, 2009; IPES,
trade, their priority was understandably to recoup
2017; Kloppenburg, 2010; Österblom et al., 2015).
their losses, this was achieved through a switch in
Such power, and the pressure on nations and firms
sales to North America, resulting in a 50 percent
to maximize shareholder returns, weaken food
drop in exports to some developing countries,
sovereignty and agency and may increase inequity
leaving consumers vulnerable to food insecurity
in livelihoods and FSN outcomes
(Love et al., 2021).

BOX 7:
BIG FOOD” POWER AND IMPLICATIONS FOR FSN
“Big food” companies are the largest stakeholders in food manufacturing today and are characterized by
concentrated power and large market-share holdings in both national and global markets. For example, the
Coca-Cola Company and PepsiCo have held more that 50 percent of the soft drinks market share over the last
three decades (Howard, 2016; Wood et al., 2021). This unchecked concentration has permitted the companies to
earn exorbitant profits and exert undue policy influence through shaping markets, technology, innovation, policy,
and governance frameworks, to such an extent that regulations do not adequately protect against environmental,
human-health and social harms as these would affect their profit margins (Clapp, 2021).

Such power relations appear in different forms, levels and spaces within food systems, and power is exerted and
66 ] maintained through different efforts such as lobbying, network-building and agenda-setting, which directly and
indirectly influence the policy landscape (Gumbert and Fuchs, 2018; Yates et al., 2021). Large food companies
possess political power drawn from the material resources they invest in lobbying governments through campaign
financing or political sponsoring. For example, the Coca-Cola Company and PepsiCo allocate billions of dollars
annually to advertise their products and sponsor political activities (OECD, 2019). They have also gained influence
because of a level of expertise and legitimacy increasingly attributed to their representatives. Big food companies
use nutritional positioning and claims about nutritional dimensions of their products to bolster their power and
influence (Clapp and Scrinis, 2017). Their power and economic advantage enables them to influence the social and
political structures in which their activities are embedded (Clapp, 2017).

The power of big food companies over national food policies, local markets and individual food choices has recently
attracted considerable attention in global policy debates. While these companies bring about improved economic
performance through increased technology and know-how (see Section 4.2), and reduce risks of undernutrition,
they continue to drive or maintain the inequalities underlying increasing levels of hunger and malnutrition (Hossain,
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

2017; Stuckler and Nestle, 2012; Wood et al., 2021). The food systems in which these corporations operate are not
driven to deliver optimal human diets but to maximize profits. This is an underlying common factor in the increase
in malnutrition. Domestic producers who supply healthy, less-processed and locally-sourced foods to the most
vulnerable communities are not able to compete in such markets, leaving local and global food systems largely
dominated by big food companies, threatening food security and sovereignty in traditional food systems.

Evidence shows that what people eat is increasingly driven by these major food corporations across the globe. The
consumption of ultra-processed foods is growing, with sales highest in Australia, North America, Europe and Latin
America, but also growing rapidly in Asia, the Middle East and Africa (Baker et al., 2020; Stuckler and Nestle, 2012).
The concentration of market power by these companies is now linked to rising levels of overweight and obesity in
countries transitioning from low to middle income, where the companies are expanding their markets. In HICs, the
disadvantaged populations, often having low literacy levels and living in low-income housing, are more likely to be
affected by this trend due to the greater affordability of these foods relative to healthier foods (Wood et al., 2021;
Yates et al., 2021). Increasing rates of diet-related disorders are among the key health issues associated with the
excessive consumption of ultra-processed foods that are high in high fat, oil, sugar and salt (Black, 2016; Monteiro et
al., 2013). Unhealthy food marketed by these corporations is increasingly becoming the first choice as consumption
of healthy food declines, leading to malnutrition and its related consequences: increased prevalence of disease,
poverty, lower economic productivity, lower income and higher health costs. Increased monitoring could help hold
these large companies to account and slow the impact of their practices on food and nutrition insecurity.

Source: Authors’ own elaboration.

4.4 POLITICAL AND both direct and indirect, immediate and protracted,
and, as with most crises, have the greatest impact
INSTITUTIONAL DRIVERS on the most vulnerable, thus exacerbating existing
inequalities. There are currently numerous conflict
The ideas and interests of groups vying for
political influence are often at odds with the wider zones around the world, including Afghanistan,
geopolitical ideas and systems shaping food policy Ethiopia, the Sahel, Sudan, the Syrian Arab
and, in turn, FSN outcomes. The influences of these Republic, Ukraine and Yemen, and hunger and
[ 67
groups can be implicit or explicitly written into a inequality are systematic consequences of this
wide range of rules and policies related to land violence (IPES-Food, 2023a). These events lead to
ownership, access to finance, education, public the displacement of tens of thousands of people,
health, housing and welfare, as well as impacting halt food production, and disrupt supply chains.
voting and issues of representation, and driving
Food can be weaponized in armed conflict, or
action or inaction during periods of armed conflict.
food relief can be prioritized. How this plays out is
shaped by geopolitical interests and exacerbates
4.4.1 VIOLENCE AND inequalities in food security (Fakhri, 2023; UN,
ARMED CONFLICT 2021). For example, the national and international
Violence and armed conflict are principal drivers responses to the war in Ukraine were to support
of acute hunger in many parts of the world and are the flow of food, as was evidenced in the Black
expected to increase (WFP and FAO, 2022), with Sea Grain Initiative that enabled the resumption
food insecurity now recognized as both a cause of grain exports via the Black Sea (Okonjo-Iweala,
and an effect of armed conflict (Fakhri, 2023; UN, 2023). At other times, conflicts can lead to coercive
2021). The effects of armed conflict on FSN are measures being taken, in the form of blockades or
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

economic sanctions, connected with geopolitical

interests, and intended to weaken an opposing
4.4.2 POLICIES AND GOVERNANCE
Despite successive waves of reform, land policy
regime by undermining food security and ultimately
and food production remain intricately connected to
people’s human rights (Bâli, 2022; Fakhri, 2023).
the history and ideas of a place. Historical periods
For example, the UN Special Rapporteur on the
of colonialism, land enclosure, and communist
Right to Food highlights how the responses of
rule may have an ongoing influence on the policies
coalition forces to the war in Yemen have resulted
that determine what is grown and by whom and
in one of the world’s worst humanitarian disasters.
who owns and controls the land and the means of
The blockade against Yemen by coalition forces has
production (Ginzburg, 2022; Khoury et al., 2016).
been in place since 2015, blocking the supply of
The lack of meaningful land reform in many
food, fuel and water to civilians, whereas coalition
nations has resulted in a tendency for state-led
airstrikes destroyed or damaged farmland, water
fisheries and agricultural policies to overlook and
facilities, port infrastructure and medical facilities.
often undermine customary systems of tenure
In a country that imports 90 percent of everything it
and access that support FSN (Chuenpagdee and
consumes and employs 60 million in the agriculture
Jentoft, 2015; Lau et al., 2020). Instead, state-led
sector, these actions have resulted in country-wide
fishery and agricultural policies have focused on
famine and the starvation of tens of thousands of
maximizing production to meet food and economic
people. Malnutrition in Yemen is now among the
demands of populations and bring food prices
highest in the world, with 1.3 million breastfeeding
down (Leach et al., 2020; Hossain and Scott-Villiers,
mothers and 2.2 million children under 5 years
2017). These policies, together with trade policies
of age requiring treatment for acute malnutrition
(See 4.3.1), have increased quantities of food
(Fakhri, 2023).
available and reduced prices, although they have
Ever since the start of the war in Ukraine in also reduced the wages of food system workers
February 2022, the food crisis has gained more (Carolan, 2013).
prominence on both national and international
However, a long-standing focus in many countries
agendas. The invasion of Ukraine caused
on producing calories as inexpensively as
considerable disruption to supply chains and grain
possible to reduce cost to the consumer has
exports, resulting in food-price spikes, export
come at the expense of broader nutritional
restrictions, and heightened food security concerns
outcomes, particularly among groups who are
around the world (FAO, 2022c; IPES-Food, 2023a).
already vulnerable to food insecurity and NCDs
Maize hit the highest price ever recorded, wheat
(Carolan, 2013; te Lintelo and Lakshman, 2015),
reached a 14-year high (IPES-Food, 2022), while the
68 ] food price index recorded the third consecutive year
and exacerbated environmental decline (4.1.1).
Furthermore, this siloed approach to food policy
of record-high prices (UN, 2022). Price spikes, in
has meant agricultural and fishery policies are not
particular, exacerbated food insecurity among low-
food- and nutrition-sensitive, and food and nutrition
income households and LMICs, whose populations
policies are not sensitive to the needs of production
are already the least able to afford a healthy diet
systems, highlighting gaps in programming and
(Kansiime et al., 2021). Many of the countries
planning among key food system sectors (Koehn et
that have been hardest hit by these changes are
al., 2022).
already experiencing multiple food crises, which
are now compounded by rising prices and food The ongoing failure to fully recognize the right
shortages. For instance, on average, 40 percent to land and other natural resources on the part
of wheat imports to Africa come from the Russian of Indigenous and local communities threatens
Federation and Ukraine, although this figure is groups that are already vulnerable to food
much higher is some countries of East Africa and insecurity, because they depend on their land to
the Horn of Africa (90 percent in Somalia and 100 gather food resources as well as continually grow,
percent in Eritrea), a region that is also entering harvest, and produce their traditional foods. In
their fifth consecutive year of below-average rainfall response, several movements and commitments
and drought conditions. are emerging to support more equitable, inclusive
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

housing security, rural development, and social and

and integrated food systems. For example, the right
economic growth” (FAO, 2012). Because these latter
to land and other natural resources is recognized
instruments are voluntary guidelines, they require
by states as a human right of Indigenous Peoples,
uptake and implementation at national levels.
peasants and other people living in rural areas, as
However, voluntary guidelines have been shown to
established in the United Nations Declaration on
the Rights of Indigenous Peoples (UNDRIP) and lay the foundation for national regulations (IPBES,
the United Nations Declaration on the Rights of 2022). Many of these instruments, as well as
Peasants and Other People Working in debates on food systems, over the last two to three
Rural Areas (UNDROP). decades have been shaped by the food sovereignty
movement; partly emerging as a political response
The FAO Voluntary Guidelines on Small Scale to some of the ways in which Indigenous Peoples,
Fisheries (FAO, 2015d) and the CFS Voluntary peasants and smallholder famers have lost out as a
Guidelines on the Responsible Governance of result of integration into national and international
Tenure of Land, Fisheries and Forests in the agrifood systems (BOX 8).
Context of National Food Security also recognize
that “land, fisheries and forests are central for the In addition to food production policy, the political
realization of human rights, food security, poverty system also has significant effects on food and
eradication, sustainable livelihoods, social stability, nutrition inequality, given that broader government

BOX 8:
THE EMERGENCE OF FOOD SOVEREIGNTY AS A MOVEMENT
Criticism to the green revolution of the 1960s laid the foundation for the food sovereignty movement (Desmarais,
2012). La Vía Campesina, an international organization of farmers, peasants, small-scale producers and farm workers,
initiated the food sovereignty movement in 1996 to take a stance against the neoliberal model of agriculture and trade.
La Vía Campesina advocates for the right of nations and peoples to control their own food systems, food cultures
and environment, and demands a fundamental shift towards alternative agricultures such as organic farming and
agroecology (Gliessman and ferguson,2020; Village and Seligue,2007).

The food sovereignty movement gained momentum with the world food crisis of 2007–2008, characterized by a sudden
and dramatic increase in food prices, which led to food scarcity, inflation and decline of purchasing power (Wittman,
Desmarais and Wiebe, 2010). In 2007, the Nyéléni 2007 Forum for Food Sovereignty, organized by La Vía Campesina in
[ 69
Sélingué, Mali and attended by 500 delegates from over 80 countries, culminating in the adoption of the Declaration of
Nyéléni, established a common understanding of food sovereignty and issued a call to action based on these principles.
The Declaration of Nyéléni highlights the “rights of all peoples to healthy and culturally appropriate food and to
define their own food and agricultural systems” (Village and Selingue, 2007, p.1). Peasants’ rights to participate in and
define their own food production systems is an essential part of food sovereignty and is acknowledged in the United
Nations Declaration on the Rights of Peasants and Other People Working in Rural Areas (UNDROP, 2018). While food
sovereignty remains in many places a grassroots and activist-led movement, it has been institutionalized in a number
of countries. For example, food sovereignty is part of the constitution of the Plurinational State of Bolivia, Ecuador and
Mali; and France and Senegal have ministers of agriculture and food sovereignty.

Source: Authors’ own elaboration.

 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

policy can significantly shape or neglect the as food is generally considered to be a local
upstream drivers of food inequality (Friel and Ford, government mandate.
2015; Marmot et al., 2008; Nisbett et al., 2022;
WHO, 2008). This includes city planning, where Similarly, labour market regulation and incentives,
informal components of food systems have been housing and basic infrastructure provisioning,
consistently marginalized or repressed in the welfare, early-years provision (support for
pursuit of a modern ideal and orderly urbanism preschool children) and social protection, which
(Boonjubun, 2017; Hayden, 2021; Kamete, 2013). might include food provision, may also increase
At the same time, national and local governments food and nutrition inequality. For example, labour
have allowed, and at times actively pursued, the market regulation may have a direct effect on
development of supermarkets and shopping malls the agrifood sector, governing the rights of, for
as symbols of modernization, providers of formal example, migrant, child and agency workers
employment and generators of municipal revenue.
who often work in lower-paid and informal or
These decisions transform food environments in
semiformal sectors, such as fruit picking and other
the absence of food planning, often to the detriment
seasonal harvest tasks (Southern Poverty Law
of marginalized groups, who tend to buy from the
Centre, 2010) and exploitative systems of bonded
informal (and often cheaper) sector (Battersby,
2017; Wertheim-Heck, Vellema and Spaargaren, and slave labour may exist alongside or even as
2015). The food system and FSN consequences of part of formal labour markets at sea (Kittinger et
these governance decisions are rarely considered al., 2017) and on land (BOX 9).

BOX 9:
FREE YET STILL BONDED AND INVISIBLE: THE CASE OF NEPAL
The practice of bonded labour, while officially abolished in Nepal in 2002, has left repercussions for those whose
families were forced into the system. Estimates as of 2017–8 report that over 31 000 persons are forced into labour
in Nepal, 17 percent of whom are children (ILO,2019). These estimates are likely to be low, given the grave difficulty
of identifying those in bonded labour due to the hidden nature of these working arrangements. Many of the victims
are in the agricultural bonded labour system, which primarily exploits ethnic and caste minority groups, such as
the Tharu and the Dalit (Girir, 2009). Those in agricultural bonded labour are often extremely economically deprived
70 ] and indebted to their landlords to meet daily needs, which reinforces the cycle of dependence. In 2016, 29 percent
of households in a study area understood to have a concentration of ongoing bonded labour were still affected by
bonded labour and most were landless (Oosterhoff, Sharma and Burns, 2017). Bonded labourers had far lower rates
of livestock ownership, only a fraction owned land, and over half did not have access to food for 4 to 9 months of the
year. Dalits living in the Tarai (plains region) were particularly vulnerable to food insecurity (Kumar et al., 2013). Other
studies have shown that the prevalence of stunting, wasting and underweight among under-five children of former
Kamaiya families (a traditional system of bonded labour, now abolished) was higher than the national average (Khatri
et al., 2015) pointing to persistent intergenerational detrimental impacts of these systems, which persist despite
having been officially abolished.

Source: Authors’ own elaboration.

4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

4.5 SOCIOCULTURAL (Meyer-Rochow, 2009). Yet, it is during these life

stages that nutrient-rich foods are most critical
DRIVERS for long-term growth and development. Gendered
norms do not only impact women. For example,
Sociocultural drivers act directly and indirectly
to influence FSN outcomes. These drivers affect eating meat and the frequent consumption of large
social groups in different ways, particularly when quantities of “manly food”, are often considered
the dominant or institutionalized cultures mean hallmarks of masculinity, but are associated with
people of certain identities are not recognized as increased risks of obesity and diabetes, and their
equals and are prevented from participating fully production entails greater environmental pressures
(FIGURE 1). Sociocultural drivers are shaped by both (Al-Shaar et al., 2020; Godfray et al., 2018; Guasch-
contemporary (such as markers of modernity) and Ferré et al., 2019; Helgeson, 1994; Sobal, 2005).
historical (such as tradition, legacies of patriarchal Cultural norms can also affect FSN outcomes
and colonial systems) contexts, and associated indirectly, through effects on the broader social,
inequities will persist until challenged. Here we economic and food systems. National and
explore the ways in which sociocultural drivers, customary laws, social norms and traditional
as well as the failure to fully recognize the values, roles around gender, class, disability, ethnicity and
cultures, and identities of different social groups, race extend into every aspect of food systems,
affect FSN outcomes. dictating who can access and control resources
more broadly, and who faces social, economic or
political barriers, resulting in the marginalization of
4.5.1 CULTURAL NORMS certain identities (Krishna, Aravalath and Vikraman,
Food is intimately connected to people’s identities,
2019) (see CHAPTER 3). These forms of injustice and
and cultural norms shape how food is produced,
discrimination fall along lines of social identity, but
procured, prepared and eaten (Cole et al., 2020;
are also associated with the economic size of an
Huambachano, 2018, Mintz and Bois, 2002; Phillips,
actor or operation. In this way, cultural norms can
2006; Purdam, Garratt and Esmail, 2016; Counihan,
intersect with one another and with economic class
Esterik and Julier, 2018; Watson and Caldwell,
structures, further disempowering minoritized
2005). Cultural norms can directly influence food
social groups and distributing resources away from
choice and consumption and, therefore, nutritional
them, and further entrenching unequal patterns of
outcomes. This is the case, for example, where
distribution, recognition and representation (Lips,
food culture prioritizes fresh foods such as fruit,
2020). For example, gendered norms exist that
vegetables and nuts, healthy oils and optimal
dictate the roles women can hold in production
amounts of animal-source proteins (Martínez- [ 71
systems and the crops they can grow (Arndt
González et al., 2015), or traditional alternatives
and Tarp, 2000; Carr, 2008). Beyond production,
such as tofu (Qin, Wang and Luo, 2022). Taboos on
processing and trade, gendered assumptions
eating certain foods exist in virtually all societies,
are common in domestic and care work, with
have a long history, and are often associated
women being primarily responsible for childcare
with particular social groups, life stages (for
and food purchasing and preparation. These roles
instance, pregnant mothers), or special events.
and assumptions feed into and are compounded
While some are beneficial, others can lead to ill
by gendered differences in the availability of and
health, particularly when combined with gendered
access to land, credit and knowledge, affecting
assumptions or applied among vulnerable groups
the ability of women and small-scale actors to
such that they create, or exacerbate, unequal
access markets and to work in prominent roles of
distributions of nutrient-dense food (Chakona and
ownership and management in wider value chain
Shackleton, 2019). In many cultures, for instance, it
activities.
can be taboo for young children, women in general,
or pregnant or lactating women to eat certain Cultural norms can also influence political
nutrient-rich, animal-source foods, including fresh representation – influencing who has voice and
meat, fish, milk and eggs, as well as certain fruits agency in decision-making processes, which
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

in turn affects people’s ability to participate processes of recognition and representation (von
economically as equals and exacerbates existing der Porten et al., 2016).
inequalities in the distribution of assets and in
Culture is dynamic, and as social, economic and
FSN outcomes. For example, in many sectors,
political systems change, they may intersect
the roles traditionally held by women are under-
with existing social and cultural norms in ways
recognised, and policies are therefore gender blind,
that can enhance or undermine FSN outcomes.
with women not afforded political representation
Policies can exacerbate existing inequalities in
and women-dominated sectors (such as the
three key ways: placing the burden of change on
informal post-harvest sector) being the least likely
the already marginalized, supporting change for
to receive government support (Hicks et al., 2022;
the most capable, or inadvertently laying blame
Lawless et al., 2019; Njuki, Parkins and Kaler, 2016).
and creating stigma (Hicks et al., 2022; Rollins,
An example of this is the different treatment of
2023). For example, when healthy-eating policies
fishers during the COVID-19 pandemic. In several
promote fresh food that is prepared daily combine
countries, fishers (who tend to be men) were
with cultural norms that hold that women are
permitted to continue working, while informal fish
responsible for food preparation, the burden of
vendors (who tend to be women) were not afforded
change – to ensure this freshness – is placed
the same dispensation (Love et al., 2021). Yet when
on women, often in addition to existing care and
women, whether at household or national level,
work burdens. Even where policies are effective,
have greater voice and agency, food production,
they can still exacerbate inequalities by having a
nutrition, and reduction of post-harvest waste and
greater impact on improving outcomes for more
loss – which are directly related to FSN outcomes
advantaged groups who have greater agency to
– generally improve (Cole et al., 2020). Removing
benefit from corresponding interventions (Adams
barriers to voice and agency, across all groups, is
et al., 2016). Finally, when harmful social norms
critical for equitable food system transformation
remain unidentified and unchallenged, they can
(Njuki, Parkins and Kaler, 2016). However, efforts
become rationalized. For example, poorer rural
to redress these power imbalances require careful
populations are often stigmatized as “backwards”
thought to avoid a wider cultural backlash (WFP,
and denied, or not deemed worthy of, opportunities
2021).
(Nichols, 2020). Similarly, the language and
In some instances, institutionalized cultural messaging around issues and policies related to
norms that fail to recognize, and thus marginalize, public health, food and social assistance – including
particular social groups, are the result of historical food assistance, food insecurity and welfare
72 ] processes, yet still have current manifestations. support – can often result in a discourse of blame,
For example, some Indigenous Peoples consider creating stigma and shame, and making it harder
all living and non-living beings to be equal for those most in need of food assistance to access
(FAO, 2021) and consider nature — mountains, the resources they need (van der Horst, Pascucci
native crops, landscapes and wildlife – to form and Bol, 2014; Purdam, Garratt and Esmail, 2016).
an integral part of their ancestral heritage and Poorly nuanced public health interventions that
identity, fostering connection to their ancestors and stigmatize, rather than support, people living with
moral responsibilities towards future generations obesity can feed into low self-esteem and poor
(Norgaard, Reed and Horn, 2011; Whyte, 2016). mental health, as well as wider discrimination in
Some governments, including those of Canada the workplace (van der Horst, Pascucci and Bol,
and the United States of America are actively 2014; Purdam, Garratt and Esmail, 2016; World
working with Indigenous nations to foster strong, Obesity Federation, 2021). It is therefore vital
healthy, and sustainable environments, which are that policies are FSN- and equity-sensitive (see
fundamental to their livelihoods and well-being CHAPTER 6), ensuring that policies that act on the
(see, for instance, (Donatuto et al., 2020; Donatuto, food systems do not promote harmful practices,
Campbell and Gregory, 2016), in an effort to redress while on the opposite challenging inequitable
historical recognitional injustices and support social norms. Redistributive policies should clearly
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

specify, identify and tackle the underlying drivers of et al., 2020; Fröcklin et al., 2013). Women can
inequalities in FSN outcomes. experience coercive forms of gender-based violence
in trying to enter agricultural markets when their
partners seek to control finances (Castañeda
4.5.2 GENDER-BASED VIOLENCE Carney et al., 2020).
Rooted in discriminatory gender-based cultural
norms, gender-based violence (GBV) is a form of In many contexts, women are subjected to violence
control, subjugation and exploitation that reinforces and discrimination based on a number of factors.
gender inequality and protects existing privileges. For instance, Indigenous women often face
It is one of the most extreme and widespread intersecting and reinforcing forms of gender-based
manifestations of human rights violations. GBV and other violence (Wijdekop, 2017). Gendered
includes many forms of physical, sexual, economic norms also intersect with ethnicity or citizenship
and psychological violence targeted at individuals status, as in the case of women migrant farm
based on socially ascribed gender differences workers in the United States of America, who may
(Okpara and Anugwa, 2022). GBV occurs in all face several forms of exploitation, including lower
societies around the world (Castañeda Carney et pay and being subject to sexual harassment and
al., 2020), with an estimated one in three women violence (National Farm Worker Ministry, 2018;
globally expected to experience GBV in their Southern Poverty Law Centre, 2010). Furthermore,
lifetime (WHO, 2021). GBV undermines individual, many of the factors associated with migrant
household and community food security, and is, women’s farm labour, including insufficient safety
in turn, more common when families are food measures and excessive pesticide use, can pose
insecure (Gibbs et al., 2017; Hatcher et al., 2019; additional risks to women’s health and carry
Okpara and Anugwa, 2022). Perpetrators of GBV reproductive risks (Habib and Fathallah, 2012).
seek to control women by deliberately disrupting
their community ties, which in some settings
can include those that allow food value chains 4.6 DEMOGRAPHIC DRIVERS
to function. Thus, GBV destroys social ties, while Population and economic growth will together
food security requires people to work together drive demand for food and other resources
(Okpara and Anugwa, 2022). The risk of GBV in the (Beddington et al., 2012). But fears of a population
workplace is greater in informal, low paid, food explosion leading to famine and food insecurity
marketing and distribution jobs, or when women have often underlaid broader narratives on FSN in
take up jobs traditionally ascribed to men. When ways that have led to poorer populations bearing
sectors intensify and commercialize, women are the brunt of repressive policies. This was first
discussed by the eighteenth/nineteenth century
[ 73
often squeezed out or exposed to GBV attacks. This
is the case, for example, in both the dairy industry demographer and economist, Thomas Malthus.
in Kenya (Castañeda Carney et al., 2020) and the Social and historical research has documented how
fishing industry in the United Republic of Tanzania population-control measures have been applied to
(Fröcklin et al., 2013) where women, who became marginalized communities or have been used as
successful in jobs traditionally assigned to men, means to control and repress women in particular
were made to leave by the men in each industry. (Carter, 2018; Hartmann, 2016; Packard, 2016).
Yet, contemporary demographic research has
Gender-differentiated roles and entitlements can long highlighted how total fertility rates decline in
place women in vulnerable positions when they line with pro-poor income growth and women’s
carry out the daily activities necessary for food literacy and education (PRB, 2011). Education
security, such as collecting water or firewood alone has benefits for women’s empowerment
(Sommer et al., 2015). For example, women and equality and for nutritional and wider health
in vulnerable positions can experience sexual outcomes for both mothers and children (Black,
exploitation when authorities demand sexual 2016; PRB, 2011). Delayed pregnancies and birth
favours for land rights (UNDP, 2012) or for access spacing also support improved nutrition and health
to fish (Béné and Merten, 2008; Castañeda Carney
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

outcomes for mothers and children, with potential multidirectional. Based on a review of existing
intergenerational benefits (Kozuki et al., 2015). literature, de Bruin, Dengerink and van Vliet
(2021) have developed a conceptual framework
Demographic changes unfold unevenly. For
example, the proportion of the world’s population of the multidirectional relationships between
living in urban areas increased from 30 percent urbanization (framed as population growth,
in 1950 to 55 percent in 2018 and is projected rural–urban migration, urban expansion, and
to reach 68 percent by 2050 (UN, 2019). These social and economic developments), and rural
levels of urbanization are not uniform, with 82 livelihoods and food systems transformation (de
percent of the population of North America living Bruin, Dengerink and van Vliet, 2021). They argue
in urban areas, compared to just 43 percent of that urbanization drives four key elements of food
the African population. However, starting from a system transformation, namely: increase in total
lower base, Africa is the most rapidly urbanizing demand; changes in purchasing power and food
continent, with a projected threefold increase in
preferences; formalization of and more complex
urban population between 2018 and 2050 (UN,
value chains; and land-use change. These food
2019b). While often imagined as being driven by
system transformations then play a role in shaping
rural to urban migration, urbanization in LMICs is
increasingly driven by natural growth (Menashe- inequality and FSN outcomes in both rural and
Oren and Bocquier, 2021). This ongoing process urban areas. As such, it is essential to develop
of urbanization is transforming food systems and context-specific understandings of the impact of
FSN outcomes. The impacts of this process on urbanization on urban and rural development and
inequalities in FSN outcomes are complex and food systems.

74 ]
4 THE SYSTEMIC DRIVERS AND ROOT CAUSES OF FSN INEQUALITIES

Although, globally, poverty rates remain higher in Norma Kassi, speaking of her Gwich’in community,
rural areas than urban areas (UN DESA, 2021), says, “We cannot, however, simply change our diet.
urbanization and natural population growth in If we were to change suddenly and start eating
cities have resulted in an estimated 1 billion of the store-bought foods more, then disease would
world’s population living in urban slums. These increase and our rate of death would be higher,
urban populations are often more vulnerable because it would be too rapid a change, too much
to food insecurity than rural populations and of a shock to our systems” (Whyte, 2018, p. 138).
have higher rates of obesity and child stunting Indigenous Peoples currently living in settler-
(see Section 2.2.4). While the number of stunted colonial societies such as the Onondaga Nation
children worldwide fell between 1985 and 2011, in North America have higher rates of type 2
diabetes and cardiovascular diseases than their
with significant declines in rural areas, there has
white counterparts. According to a recent report,
been little change in child stunting in urban areas
65.9 percent of Onondaga County adults are either
(Ruel et al., 2017). Furthermore, while obesity is
overweight or obese, putting them at increased risk
increasing worldwide, it is more common in urban
for several chronic conditions (Onondaga County
than rural areas (Ruel et al., 2017). Thus, both
Health Department, 2021).
rural and urban areas require targeted policies,
interventions and investment, and there is a need
for ongoing work to understand the nature of
urban–rural linkages (both local and more distant).
Indigenous Peoples have long been aware of the
knock-on effect of urbanisation on FSN risks. As

[ 75
 Chapter 5
ACTIONS TO REDUCE
INEQUALITIES IN
FOOD AND OTHER
SYSTEMS TO
IMPROVE FSN

76 ]

©Quang Nguyen vinh ©Wirestock

5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

KEY INSIGHTS
• Equity-informed policy and programming must be informed by these first principles: being adaptive to
context; focusing on agency and working to undo inequitable norms; and addressing power imbalances.
• A variety of actions to reduce inequalities for FSN are possible across the food systems and related
systems.
• Within food production, major action areas to reduce inequalities for FSN include: (i) enabling more equal
access to land, forests, livestock and fisheries, (ii) applying agroecological principles across production
and broader food systems, (iii) establishing inclusive producer organizations, and (iv) investing in equity-
sensitive public agricultural and food-systems research and other rural public investments.
• Action areas related to food supply chains include: (i) adopting inclusive value chain approaches;
(ii) developing labour-protection policies, strategies and programmes for food-system workers; (iii)
considering territorial approaches in food system and regional development planning; (iv) investing in
equity-sensitive storage, food processing and distribution infrastructure; and (v) investing in improved
information systems, leveraging digital technologies.
• Action areas related to food environment and consumption include: (i) food-environment planning
and governance; (ii) incorporating behavioural insights into policymaking and programming; and (iii)
strengthening social protection.
• Action areas within enabling environment, broader context and governance include: (i) food- and
nutrition-sensitive policy and planning; (ii) addressing corporate power asymmetries in governance; (iii)
universal health care that integrates nutrition care; (iv) a holistic approach to climate and sustainability;
and (v) inclusive growth for FSN, and policy that goes beyond growth.

T
his chapter presents actions that can be Section 5.1 (adapt to context, focus on agency
taken within food systems and other FSN- and address power imbalances) that should be
relevant sectors to reduce inequalities in considered when addressing FSN inequalities to
FSN (see Section 5.2 through Section 5.5). These ensure long-lasting reduction of inequalities. These
are not exhaustive action areas. Rather, they principles can be considered alongside FIGURE 12 in
are priority areas that hold significant potential
[ 77
CHAPTER 6 (Recommendations), which expands on a
for reducing the key inequalities described roadmap for equity-sensitive policymaking.
previously. They include both incremental as
well as transformative action areas that span
the food system and the broader context. To
aid presentation, we cluster these action areas
5.1 FIRST PRINCIPLES TO
into four broad categories: food production; FOLLOW WHEN DESIGNING
food supply chains; food environment and
consumption; and enabling environment,
EQUITY-SPECIFIC ACTIONS
broader context and governance. Although for
presentational ease the action areas are placed
5.1.1 ADAPT TO CONTEXT
The HLPE-FSN has emphasized the need to
in specific categories, it is acknowledged that
acknowledge the diversity of situations across and
several areas span multiple categories and
within countries and to propose actions that are
indeed some span the entire food system.
context-specific, because food systems are situated
These actions are informed by a set of broad, in different environmental, political, sociocultural
equity-informed, first principles described in and economic contexts and face diverse challenges.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

As noted throughout this report, understanding

context is imperative to understanding the
5.1.3 ADDRESS POWER IMBALANCES
Power imbalances exist along multiple axes,
magnitude of FSN inequalities and how they affect
from corporate concentration to unequal political
different groups differently; to recognizing the key
participation, to social norms limiting certain
drivers of inequality and inequity; and ultimately, to
populations. There is a long history of participatory
creating tailored policy to promote better and more
methods that have been applied to ensure equitable
equitable outcomes. Because of context, no single
participation and to address power imbalances
policy or set of actions can be adopted wholesale
in decision-making and programming (George
without considering the local situation of inequality.
et al., 2015). Participatory learning and appraisal
In the same report, the HLPE-FSN acknowledges
approaches, for example, where rural and
that actions must combine the technical and
marginalized women focus on defining problems
political with the local; involve relevant actors at
and solutions relating to malnutrition, have been
different scales equitably; and combine local and
incremental change with broader structural change associated with better outcomes in terms of child
as appropriate to the situation. wasting (Gope et al., 2019) and dietary diversity
(Prost et al., 2022) when combined with other
interventions, such as provision of childcare
5.1.2 FOCUS ON AGENCY AND WORK creches, home-based nutrition support and video-
TO UNDO INEQUITABLE NORMS based training. Social accountability measures,
Agency is a vital concept for addressing such as social audits of food and nutrition or
inequalities and inequities. Fundamental to health services, have also shown potential in
addressing the distribution issues in the “engine improving local forms of civic participation and
of equity” is the recognition of the views, needs decision-making by marginalized groups in Odisha,
and preferences of different groups; and the India (Gordon et al., 2019). In a research context,
genuine representation or participation of participatory and action research methods can
different groups in deciding on actions most form a basis for an equitable approach to evidence-
appropriate to the particular context. These based policy formulation and community-sensitive
are crucial aspects of agency. A slogan long in action. Addressing power as part of inclusive
use in the disability movement, for example, is governance is also an important aspect of an
“nothing about us without us”. As the slogan equity-centred approach (see Section 5.5) and can
implies, communicating to or about marginalized happen in multiple contexts. Care needs to be
groups (for instance telling them about a new taken, however, to ensure that increased citizen
programme or policy), is not the same as the engagement does not allow the state to abdicate
78 ] policy directly benefiting them. Benefitting from responsibility in food system transformation.
changes is also not the same as being empowered
to participate fully in decision-making, which,
again, is not the same as transforming the
social relations which limit people’s agency in
5.2 ACTIONS TO REDUCE
the first place (Quisumbing, 2019). Addressing INEQUALITIES IN
power imbalances as fundamental as gender or
ethnic discrimination, for example, represents FOOD PRODUCTION
the most transformative equity goal. A focus
on the empowerment aspect of agency without 5.2.1 MORE EQUAL ACCESS TO FOOD-
also considering the redistribution of resources PRODUCTION RESOURCES
and power (Kabeer, 1999), will not transform the Actions to enable more equal access to production
fundamental power structures that hold people resources such as land, livestock, forests and
back from realizing their agency for FSN. In the fisheries, must be appropriate to the local context,
conceptual framework of this report, this entails have widespread support and be part of a fully
actions that simultaneously address the need for participatory process. They must go beyond
redistribution, recognition and representation. ownership to full consideration of access and
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

control, having contextual consideration for groups balance between the benefits and pitfalls inherent
that face particular disadvantage, including women, in the operation of land markets. Secure tenure
Indigenous Peoples and the poor (ILC, 2020). and well-functioning land markets, facilitated
Actions to reduce inequalities in access to food- by setting up land registries and creating legal
production resources are most effective when they clarity in property rights, can encourage transfers
are embedded in a larger set of complementary towards the most productive use of land, encourage
inequality-reducing actions, such as promoting investment in the land and help provide collateral
inclusive value chains and territorial markets for finance (Deininger, 2003), while unregulated land
(discussed in subsequent sections). markets often become instruments of exclusion
Protecting collective tenure rights to land, forests and concentration. Land transfers and reallocations
and aquatic resources that are vital to the FSN of may have to contend with the fact that just
many vulnerable communities around the world assigning legal rights may not lead to secure tenure
requires priority action (while also recognizing that and corresponding incentives to invest in that
some collective tenure systems themselves may land. The maintenance of those rights may depend
embed inequalities) (Goldstein and Udry, 2008). on political power (Goldstein and Udry, 2008).
Ongoing efforts to recognize and protect customary Institutional innovations such as setting up “land
land rights of Indigenous Peoples through mapping banks” (Aryeetey and Udry, 2010)) to improve tenure
and documentation exemplify such action (Guereña security while facilitating land sale and purchase,
and Wegerif, 2019). Meaningful mechanisms must and regulations such as limiting foreign ownership
be developed for the widespread application of free, and legally protecting renters must be considered.
prior and informed consent, as recognized under It is also important to take a holistic approach to
the UNDRIP (UN, 2007), so that the implementation action to improve equality in land access, asking
of land, forest and aquatic resource projects is fully what other actions are needed to ensure that
subject to community consent (FAO, 2016). redistribution leads to better livelihoods and better
FSN. For example, land reform actions must also
Measures to significantly improve transferability,
ensure that recipients possess appropriate skills in
accountability and local or community consent with
food production.
respect to corporate and international acquisitions
of land, forest and water resources are urgently Action to bolster women’s land rights, including
needed. Although voluntary guidelines such legal recognition and inheritance rights is critically
as the Principles for Responsible Investment important to improving gender equality both
in Agriculture and Food Systems and the CFS within and outside the household, and thereby to
guidelines on responsible governance of land improving FSN. This does not have to imply titling. [ 79
tenure exist, there are major gaps in their Programmes undertaking formal recognition
translation into practice (ILC, 2020). One approach and documentation of rights that are inclusive of
to improving transparency and accountability is
women, such as Ethiopia’s rural land certification
for countries to require submission of project and
programme (see BOX 10) and Rwanda’s land
company-level data on large-scale land and other
regularization programme (Ali, Deininger and
natural resource investments, made available
Goldstein, 2014), can have powerful impacts. At
on public datasets such as Landmatrix.org
the same time, it must be kept in mind that legal
(Flachsbarth et al., 2020).
recognition or titling alone may not imply adequate
Promoting more equal access to land is as control over assets for women in many settings
challenging as it is important. Contextually (Harris-Fry et al., 2020), and that further work on
appropriate regulations must be devised to strike a adapting social norms and attitudes will be needed.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

BOX 10:
SUCCESSFUL LAND REGISTRATION AND CERTIFICATION IN ETHIOPIA
Recognizing the importance of secure rights to land for livelihoods, equity, productivity and thereby for food security,
many countries have put in place legal frameworks to formalize land rights. However, relatively few have been
successful in practice, with commonly encountered flaws including top-down approaches, limited effort to improve
awareness of rights, and high costs of implementation. An exception was the land registration and certification
programme of Ethiopia, conducted between 1998 and 2005, which registered and then certified land rights, achieving
high coverage at low cost within a few years. Key success factors included a pragmatic focus on use rights rather
than full titles; a bottom-up, participatory approach to community-level adjudication, and the use of low-cost
community-based methods to identify field boundaries. A noteworthy feature was a focus on gender equity, with
certificates issued jointly to spouses. A stream of research has found that the programme improved security of
tenure, encouraged investment in land and improved productivity, and that household consumption expenditure
increased with the duration of holding certificates.

Sources: Bezu, S. & Holden, S. 2014. Demand for second-stage land certification in Ethiopia: Evidence from household panel data. Land Use Policy, 41: 193–205 and
Deininger, K., Ali, D.A., Holden, S. & Zevenbergen, J. 2008. Rural Land Certification in Ethiopia: Process, Initial Impact, and Implications for Other African Countries. World
Development, 36(10): 1786–1812.

Livestock present a less-challenging entry point for creation of knowledge, social values and diets, land
asset equalization, especially in terms of access and resource governance, participation, fairness
and control opportunities for women. Livestock and connectivity. The HLPE-FSN in its 2019 report
transfers to small-scale farmers are a commonly lays out the evidence that demonstrates the value
applied action to achieve greater parity in livestock of drawing on agroecology as a central part of the
assets and potential for improved consumption of structural reform of food systems necessary for
animal-source foods (Rawlins et al., 2014), as well the achievement of global goals on sustainability
as participation in value chains and market sale. and equity. The Sixth Assessment Report of the
From the perspectives gender equality and FSN, Intergovernmental Panel on Climate Change also
small-livestock programmes have shown particular notes the importance of the “use of agroecological
80 ] promise. Similarly, small-scale fishery programmes principles and practices and other approaches
(March and Failler, 2022) and tree-based solutions that work with natural processes” as an effective
(Ickowitz et al., 2022) offer sustainable pathways strategy for adapting to and reducing climate risks,
to supporting poor and marginalized groups and noting “high confidence” in the evidence base
improving their FSN. (IPCC, 2023, p. 8).

Agroecology has become one of the key approaches

5.2.2 AGROECOLOGICAL PRINCIPLES to strengthening the livelihoods of smallholders,
ACROSS PRODUCTION AND BROADER eradicating hunger, and enhancing agroecosystem
FOOD SYSTEMS resilience (Gliessman and Ferguson, 2020).
Agroecology is defined as “the application of Agroecology is often – though not exclusively
ecological concepts and principles to the design – linked to the set of wider political changes
and management of sustainable agroecosystems” advocated by proponents of food sovereignty (Wezel
(Altieri, 1995, p. 8). It reflects a science, practice et al., 2020). It is argued that, together, agroecology
and social movement that fundamentally rethinks and the wider changes offer an important set of
food systems as they currently exist. One of its actions that can be applied to tackling structural
foundational principles is social equity linked to co- socioeconomic FSN inequalities in terms of land
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

ownership, self-sufficiency and political control. decentralised and adaptive systems of governance
These two concepts also allow Indigenous (HLPE, 2019).
Peoples to exercise their rights as stewards
of the land and take part in rebuilding the
relationship between humans and non-humans 5.2.3 INCLUSIVE
in a naturally restorative framework. PRODUCER ORGANIZATIONS
Collective action via formal grouping of producers
The evidence base for agroecology’s impacts on can contribute to surmounting many of the
FSN is developing fast as approaches have been inequalities and exclusions faced by small-scale
tested and adapted in different contexts. A review producers. Various types of producer organizations
of 56 studies highlighted positive outcomes in (PO) have emerged, including cooperatives,
nearly four-fifths of the studies (Bezner Kerr et marketing groups, self-help groups, finance
al., 2021) and noted the importance of the social- associations, producer companies and various
equity dimensions within agroecological systems combinations of these.
in helping broaden the impact of these outcomes.
In terms of comparing agroecology and intensive Depending on their orientation, POs can
farming systems, trade-offs exist in terms of offer various mechanisms for improving the
environmental externalities, climate impacts and participation, inclusion and power of small-scale
land-use intensity (HLPE, 2019). There is much producers. Cooperation in production can pool
yet to be learned from further work in this area, technical knowledge and help with natural resource
particularly in terms of documenting impacts on management, including, for instance, water
FSN inequality beyond improvements in diet and management across contiguous farms. External
food security (Bezner Kerr et al., 2022). suppliers of services, such as extension services,
also realize cost advantages in delivering at group
In terms of practical changes in FSN systems, level rather than to individual producers. For
the HLPE-FSN sets out 13 agroecology example, Zambia’s Farm Input Subsidy Programme
principles (HLPE, 2019) (which further develop uses POs to deliver fertilizer subsidies to farmers
the ten principles put forward by FAO as part (Minah and Carletti, 2019). Collective marketing can
of a consultative process) (FAO, 2018a), six of lower transaction costs, especially for small-scale
which were flagged by the HLPE-FSN as equity producers (for instance, via shared transport of
specific and the rest, in keeping with this current produce to the market); increase bargaining power;
report, we denote as equity sensitive, given and increase returns and lower risk by providing
the environmental and social vulnerabilities of market information and identifying stable markets.
marginalized communities. The equity specific It can also help overcome the scale problem in [ 81
agroecology principles were: enhancing the co- supplying to modern value chains. BOX 11 describes
creation of knowledge; recognising that social the case of a highly successful PO that has enabled
values are inherent in and shape diets; considering small-scale actors to increase bargaining power in
fair livelihoods and fair treatment of intellectual a complex international value chain.
property rights as critical for all food system actors;
improving connectivity and proximity between In practice, the results of many POs have been
producers and consumers; strengthening land mixed. An increase in income from participation is
and natural resource governance for marginalised the most consistent association identified, with only
groups and building participation throughout more limited associations with food security examined
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

BOX 11:
SUCCESSFUL ORGANIZATION OF SMALL-SCALE PRODUCERS: THE COLOMBIAN NATIONAL
COFFEE FEDERATION
The Colombian National Coffee Federation (FEDCAFE) is one of the most longstanding and successful producer
organizations in the world. The federation was formed in 1927 against a backdrop where powerful foreign export
companies were paying Colombian producers a small fraction of the international price of coffee. Now the federation
has more than half a million members, most of whom are small-scale family growers. Through this collective
strength, the federation negotiates favourable contracts with the large roasting firms that dominate coffee trade.
In collaboration with the Government of Colombia, the federation operates a coffee fund that stabilizes returns to
members by adding to the fund when prices are high and using the fund to store coffee when prices are low. A key
feature of FEDCAFE is that it invests significantly in coffee research in Colombia, as well as in infrastructure and
public services in coffee-producing regions, funded via an export levy. FEDCAFE has thus managed to bring together
both elite and small-scale Colombian producers in a common cause that has furthered their joint interests.

Sources: Bentley, J.W. & Baker, P.S. 2000. The Colombian coffee growers’ federation: organised, successful smallholder farmers for 70 years. The Colombian coffee growers’
federation: organised, successful smallholder farmers for 70 years and Bosc, P.-M. 2018. Empowering through collective action. IFAD Research Series 29. International Fund
for Agricultural Development (IFAD).

or found so far (Bizikova et al., 2020). Participation 3. The composition and operating principles of
in POs can reduce inequalities by opening up the group provide different benefits. Larger and
opportunities for participants. However, the ability more heterogeneous POs may reap greater
to participate in POs may itself be subject to economies of scale and inclusivity but may be
inequalities (Bijman and Wijers, 2019; Chirwa et al., less cohesive.
2005; Shiferaw et al., 2015). A review by Bizikova et al.
(2020) finds access to land and other assets, poverty,
education and distance to market (remoteness) to be 5.2.4 EQUITY-SENSITIVE PUBLIC
important determinants of PO participation. Gender AGRICULTURAL AND FOOD-SYSTEMS
is also a barrier, and PO participation can increase RESEARCH AND OTHER RURAL
82 ] male control of resources within the household PUBLIC INVESTMENTS
(Bizikova et al., 2020). While subsides and other forms of support are
often used by governments to bolster rural
It is important that PO design pay explicit attention
incomes, raising rural farm and non-farm incomes
to inclusivity, thereby increasing representational
must be part of the long-term, sustainable solution
equity. Considerations in this regard include:
(Byerlee, de Janvry and Sadoulet, 2009). This
1. A balance must be struck between meeting is especially necessary as gaps widen between
business objectives and maximizing urban and rural incomes and FSN outcomes, and
inclusiveness (Shiferaw et al., 2015). inequalities arise within rural areas, with remote
and rainfed areas facing strong disadvantage.
2. Additional interventions may be needed to
encourage the participation of marginalized Agricultural growth is effective in reducing poverty
groups. These may include financial support (Christiaensen, Demery and Kuhl, 2011), as well
for fees, or interventions addressing the as being an important factor in reducing income
high opportunity costs of participation for inequality (Imai, Cheng and Gaiha, 2015). Rural
women – given their workloads and household public investments, including in agricultural
responsibilities (Minah and Carletti, 2019). research and rural infrastructure, are important
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

mechanisms for generating growth and improving agricultural research systems are important
rural incomes. It is important that countries not for generating the equitable rural growth that is
only invest in agriculture and rural areas, but that critical to reducing inequalities to improve FSN.
they do so by striking a balance between high- and Boosting public agricultural research is therefore
low-potential areas. Investment in high-potential an important tool for improving FSN-sensitive
areas is important to ensure food availability and equality. Research on agricultural production has
keep food prices low, while investment in low- historically been at the heart of public agricultural
potential areas (in agricultural or non-agricultural R&D. However, it is important that increased focus
activities, as locally appropriate) is particularly also be trained on research in downstream aspects,
important from an equality perspective (Fan and including value chains, distribution, processing,
Hazell, 2001). storage and markets, reflecting ongoing food
system transformations as well as innovation needs
Agricultural research has been shown to be an
arising from climate change.
important tool for fostering agricultural growth
and reducing poverty (Pray, Masters and Ayoub, There are strong regional inequalities in
2017; Thirtle, Lin and Piesse, 2003). While private agricultural research investment that must be
R&D systems inevitably focus on technologies that addressed. For instance, there are large disparities
skew towards wealthier producers and regions across countries in agricultural R&D spending.
where significant returns are generated, the global FIGURE 11 shows that while spending on agricultural
public agricultural research system and national R&D in Brazil, China, India and other middle-

FIGURE 11:
PUBLIC AGRICULTURAL RESEARCH SPENDING IN DIFFERENT COUNTRIES BY INCOME GROUP

50

40
Total spending in billion PPP dollars

[ 83
(inflation-adjusted 2011 prices)

30

20

10

0
1981 1990 2000 2010 2016

Low-income countries India

Brazil Other middle-income countries
China High-income countries

Source: Stads, G.-J., Wiebe, K.D., Nin-Pratt, A., Sulser, T.B., Benfica, R., Reda, F. & Khetarpal, R. 2022. Research for the future: Investments for efficiency,
sustainability, and equity. International Food Policy Research Institute (IFPRI).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

income countries has grown appreciably in recent

decades, spending in low-income countries is very 5.3 ACTIONS TO REDUCE
low and has largely stagnated (Stads et al., 2022). INEQUALITIES IN FOOD
In particular, R&D spending in Africa is SUPPLY CHAINS
considerably lower than in most other parts of
the world, and within Africa, spending in Central, 5.3.1 INCLUSIVE VALUE
North and West Africa is much lower than in CHAIN APPROACHES
East and Southern Africa (Suri and Udry, 2022). Inclusive value chain approaches aim to improve
Recent estimates (Sulser et al., 2021) show that the market participation, equitable distribution of
boosting agricultural R&D can play an important outcomes (such as income and food availability)
role in offsetting the impacts of climate change on and agency of all value chain actors, regardless of
hunger. While boosting productivity in historically gender, socioeconomic status and value chain role
important commodities will always be a major (UNIDO, 2011). Multistakeholder platforms (as well
component of public agricultural research, it is as innovation platforms and participatory market-
important that strong consideration be given to the chain approaches) have gained prominence,
equity-sensitivity of the research portfolio, including bringing together diverse and marginalized
investments in crops and livestock for marginal stakeholders to contribute to value chain decision-
environments and low-potential rainfed areas, and making (Barzola Iza, Dentoni and Omta, 2020;
climate-resilient technologies for smallholders. Devaux et al., 2018). Evidence from horticultural
This would involve tailoring research for local and livestock value chains in sub-Saharan Africa
contexts, for example, through participatory R&D and Latin America suggests that smallholder
methods (Etten et al., 2016). productivity, market linkages and income
opportunities can be strengthened via the creation
It is also important that agricultural research of strategic alliances in both directions (with
systems become more gender responsive. upstream input suppliers and service providers and
Meinzen-Dick et al., (2010) outline some important with downstream buyers), the provision of financial
aspects of this: i) incorporating gender equity support to assist with the purchase of productive
into strategic prioritizing, which may lead to assets (such as grants and low-interest loans),
new areas of emphasis, such as on crops or and the involvement of local actors who share new
livestock particularly important for household information and ideas (such as researchers and
FSN; ii) mainstreaming gender into all aspects practitioners ) (Devaux et al., 2009; Donovan and
84 ] of the research continuum, from priority setting Poole, 2014; van Ewijk and Ros-Tonen, 2021). This
to technology development to dissemination and process of co-learning has led to various value
evaluation; and iii) incorporating gender-equity chain innovations with positive livelihood and food
considerations into the surrounding enabling security implications (Cavatassi et al., 2011; Horton
system, including policies and institutions. et al., 2022).
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

However, there has also been critique of the role The 2010 Updated First Comprehensive Framework
of these platforms at global and local scales for Action by the High-Level task Force on the
as sites of elite capture where existing power Global Food Security Crisis and the 97th Session
asymmetries are re-entrenched rather than being of the International Labour Conference emphasize
challenged (Clapp, 2017; McKeon, 2017; Nisbett the necessity for labour and social protections that
et al., 2021). Platform facilitators should be local, recognize the right to food and the right to decent
well-connected and sensitive to power dynamics; work if food and nutrition insecurity are to be
and donors must appreciate that co-learning and alleviated (HLTF, 2010; ILO, 2008). The link between
the development of trust can take years (Horton et FSN and decent work has been reaffirmed by the
al., 2022). Furthermore, multistakeholder platforms Special Rapporteur on the Right to Food in recent
can be supported by asset-based approaches years (Fakhri, 2023).
that encourage the accumulation of social and
financial capitals – enabling smallholders to reach Evidence from India’s Mahatma Gandhi National
the investment thresholds needed to purchase Rural Employment Guarantee Act (India Ministry
productive assets and absorb the risks associated of Rural development, 2005), Brazil’s Fome Zero
with new markets (Ros-Tonen et al., 2019; Stoian strategy (FAO, 2011) and FAO’s Junior Farmer
et al., 2012). In a global context, though, small Field and Life Schools (FAO, 2023) are case studies
farmers face the risk of changing standards and that show how synergies between interventions
requirements of export markets (Ashraf, Giné and aiming at the right to adequate food and those
Karlan, 2009). aiming at the right to decent work act as powerful
drivers for long-term food security, reduced
inequalities and sustainable growth, especially for
5.3.2 LABOUR PROTECTION AND vulnerable populations (FAO, 2012; Termine and
RIGHTS THROUGHOUT THE Huambachano, 2022).
FOOD SYSTEM
The capacity of people to produce and purchase
food is rooted in employment where people rely
5.3.3 TERRITORIAL APPROACHES
on the income from their labour (FAO, 2012), yet IN FOOD SYSTEMS AND REGIONAL
the vast majority of the world’s poor suffer from DEVELOPMENT PLANNING
underemployment, unemployment, inequalities, AND POLICY
lack of access to productive resources, vulnerable Some of the major inequalities discussed in this
employment and underpaid jobs, seriously report have a strong spatial dimension, such
hindering their capacity to meet their own needs in as rural–urban differences and linkages and [ 85
dignity and to enjoy their human rights, including the challenges posed by remoteness. Yet, much
the right to adequate food (Haini et al., 2022). of agrifood, rural development and FSN policy
is designed on a sectoral basis (for instance,
In response, the need for labour protection policies, agricultural policy to drive availability, and social
strategies and programmes (such as those on protection policy to promote access), or on the
occupational safety and health, regulations on basis of administrative boundaries (Cistulli, Heikkilä
working hours and pay, maternity protection) that
and Vos, 2016). Territorial approaches instead
protect both the labour and human rights of food
recognize and leverage spatial interdependencies
system workers has gained traction over the last
and place the diversity of resources and people
decade (Rantanen, Muchiri and Lehtinen, 2020).
across territories at the heart of planning (IFAD,
2015). BOX 12 describes an example.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

BOX 12:
TERRITORIAL APPROACHES: THE CITY REGION FOOD SYSTEM IN QUITO, ECUADOR
A prominent example of a territorial approach is the City Region Food System approach. This approach considers
a city or multiple cities (which may be smaller cities or towns), their peri-urban areas and the rural catchments or
“foodsheds” they are linked to, as the unit for analysis and planning. Various flows across the region are taken into
account, such as the flow of food and labour from rural and peri-urban areas to the city, the flow of waste from the
city, and the flow of finance from cities to the rest of the region. Mapping these flows, as well as the infrastructure
(markets, roads, storage, etc.), population and socioeconomic characteristics (such as Indigenous lands) and
geographical and agricultural characteristics (such as land use and agricultural potential) enables a holistic
approach to regional planning. For example, under the auspices of FAO’s Food for the Cities Programme, the city of
Quito, Ecuador has adopted a territorial approach and codeveloped with stakeholders a vision for a more sustainable
and resilient food system and food strategy for the Quito city region. Other city region initiatives in the programme
include Toronto in Canada, Medellin in Colombia, Utrecht in the Kingdom of the Netherlands, Colombo in Sri Lanka,
and Kitwe and Lusaka in Zambia (FAO, 2018).

Sources: Blay-Palmer, A., Santini, G., Dubbeling, M., Renting, H., Taguchi, M. & Giordano, T. 2018. Validating the City Region Food System Approach: Enacting Inclusive,
Transformational City Region Food Systems. Sustainability, 10(5): 1680 and FAO. 2018. City Region Food System Toolkit: Assessing and planning sustainable city region food
systems. Food and Agriculture Organization of the United Nations.

Such territorial approaches enable the recognition and just food systems. Rather, a judicious, strategic
and incorporation into planning of several different mix that leverages the advantages of both distant
kinds of inequalities with implications for FSN. and local markets to maximize opportunity, reduce
For example, small-scale farmers in a city region inequalities and build resilience is called for (Wood
may struggle (compared to larger producers) to et al., 2023).
supply sophisticated value chains serving elite
consumption globally or in big cities. At the same
time, small and intermediate towns and cities in 5.3.4 EQUITY-SENSITIVE STORAGE,
86 ] the region may experience growth and have unmet FOOD PROCESSING
demand for nutritious food, whereas many modern AND DISTRIBUTION
value chain initiatives are primed to supply big Strategic investments by governments in storage,
city and global markets. A territorial approach in rural transport and market infrastructure have a
this example may find opportunities to develop role to play in reducing economic distances and
these smaller markets with a particular focus on costs faced by small-scale farmers and traders and
supply from small-scale farmers in the region. other value chain participants, cutting perishable
This may involve strategic investment in market food losses, and ultimately improving the availability
and transport infrastructure, cold storage and and affordability of foods across space.
processing facilities (IFAD, 2015).
Studies from Ethiopia (Rammelt and Leung,
However, this recommended action should not 2017), India (Cooper et al., 2021) and Kenya
be read as a call to abandon all distant markets (Chege, Andersson and Qaim, 2015), suggest that
for local ones. Territorial approaches are not a improved rural transport, through reliable access
panacea for all food system challenges. As far back to roads, is positively associated with smallholder
as 2006, (Born and Purcell, 2006) warned of the market inclusion. Experimental evidence from
“local trap” – the assumption that localizing food Kenya (Huss et al., 2021) and the United Republic
systems will necessarily deliver more sustainable of Tanzania (Brander, Bernauer and Huss, 2021)
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

found that households with access to improved Strategic consideration should be given to
storage facilities (such as hermetic storage territorial markets (described in the previous
bags) maintained food security during seasonal section) in infrastructure investment. For example,
shortages and COVID-19 market disruptions. Small by investing in roads connecting rural areas
scale, renewable-energy-based cold storage and to intermediate cities and towns (rather than
other food preservation technologies can play an only considering national highways leading to
important role in improving livelihoods and access capital cities) and creating or upgrading market
to perishable nutrient-dense foods for lower- infrastructure, such as cold stores in such town
income segments of the population (See BOX 13). and cities, better conditions are created for

BOX 13:
SMALL-SCALE, SOLAR-POWERED TECHNOLOGIES TO CUT FOOD LOSS AND IMPROVE OUTCOMES FOR
PRODUCERS, TRADERS AND CONSUMERS
Curtailing food loss and improving food safety, especially for nutrient-dense perishable foods such as fruits and
vegetables and animal-source foods, can make a significant contribution to FSN. This is likely to become even
more important as perishability and food-safety compromises increase with rising temperatures. However, most
technologies in the past, for instance, for cold storage, were developed to meet the needs of high-value products and
large players in the food system, and were energy intensive. Now, small-scale, solar-powered technologies are showing
potential as equitable and sustainable solutions to curtail food loss and improve FSN.

Solar freezers for fish trading in the Solomon Islands: Fishing is key to livelihoods in the Solomon Islands. Geographical
isolation of islands and markets poses a major challenge for small-scale fishers to earn income from their fish
catch. Thinking beyond traditional interventions in this sphere that focus on centralization, are large scale, and are
male-centric, an intervention was put in place by WorldFish and West Are’are Rokotanikeni Association, a local
women’s organization. The intervention entailed installing solar-powered freezers in villages. Run by women’s freezer
committees, the intervention circumvented the need for a reliable electricity supply and enabled local fishers and
traders to rent freezer space to store fish for sale.
[ 87
Solar dryers to preserve fruits and vegetables in Afghanistan: Drying techniques have long played a role in improving
access to fruits and vegetables in Afghanistan, particularly beyond harvest periods and across seasons. However,
traditional open-air drying techniques are frequently labour intensive and prone to contamination. In 2020, UNDP
worked with the Government of Afghanistan to set up simple, small-scale solar dryers that could ease drying and
reduce contamination. The project provided training to women as traditional processors of harvested produce, with the
small scale and low technological/informational barrier providing further equity-sensitivity.

Sources: Cooper, G. and Shankar, B. 2022. Do climate-resilient market systems hold the key to transforming access to nutrient-dense foods?; Feed the Future. 2019. The Cool
Women of Malaita: Solar-Powered Freezers Make Money for Rural Women in Solomon Islands | Agrilinks. Cited 25 May 2023: UNDP. 2020. Solar Dryers: Less Work More Income. In:
United Nations Development Programme (UNDP). Cited 25 May 2023; Shankar, B., Poole, N. & Bird, F.A. 2019. Agricultural inputs and nutrition in South Asia. Food Policy, 82: 28–38.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

attracting flows of nutritious foods. Finally, rural to bridge issues associated with remoteness
infrastructure investments, including for small- and the cost of scaling, enabling information to
scale affordable solutions, can boost incomes be disseminated across space at the touch of a
for the broader rural population and help reduce button (Bellemare, Bloem and Lim, 2022). Evidence
rural–urban income inequalities, with positive suggests that, downstream of the farmgate, the
implications for FSN. communication of near real-time market prices
to farmers can help them by weakening the price-
It is important to develop food-processing
setting power of intermediaries (Oura and Kouassi,
sectors in a balanced, FSN-promoting way. This
requires considering imbalances in power and 2015). Widespread and low-cost availability of price
resources between small- and large-scale firms, information across markets helps reduce regional
as well as incentivizing FSN-friendly processing. inequalities in food availability and affordability.
Strategic investments, such as low-cost loans and For example, when food prices surge in a region,
infrastructure assistance via agrifood processing rapid transmission of this information to traders
parks, are needed to encourage processing to incentivizes them to move foods into the region,
preserve and fortify foods and nutrients by MSMEs. stabilizing availability and prices for consumers.
At the same time, it is important to develop and
However, digital information systems also present
enforce stricter standards with respect to the
challenges, ranging from individual factors (such as
nutrient content of foods, particularly in relation to
digital literacy issues and distrust in technology) to
fats, salt and sugar.
systemic issues (including electricity accessibility
and mobile coverage) (Coggins et al., 2022). To
5.3.5 IMPROVED INFORMATION address these inequalities, research suggests
SYSTEMS, LEVERAGING that digital extension may be more effective when
DIGITAL TECHNOLOGIES combined with in-person approaches, including
The rapid diffusion of relatively affordable mobile local experts who are able to provide personalized
and internet technology is acknowledged to have technology sensitization (Fu and Akter, 2016),
potential in levelling the playing field for food the involvement of potential end-users in the
system actors (Aker, 2011; Deichmann, Goyal and co-development of digital platforms, and gender-
Mishra, 2016). Farmers who have access to mobile sensitive programmes that account for differences
phone-based digital extension services are more in technology access at the household level
likely to adopt new and recommended production (Dhehibi et al., 2022). Tailoring content for and
practices (Cole and Fernando, 2021; Fu and Akter, considering the specific needs of disadvantaged
88 ] 2016). Critically, digital extension services help communities and investing in digital infrastructure
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

BOX 14:
VIDEO-BASED EQUITY-SENSITIVE AGRICULTURAL EXTENSION SERVICES IN ETHIOPIA, INDIA AND KENYA
Digital Green, a global NGO, has pioneered video-based extension services in Ethiopia, India and Kenya, and
beyond. An important feature of their approach is videos produced by and for farmers, tailored to their local
needs, using local farmer role models to maximize the relevance and appeal to communities. Focusing on small-
scale farmers and farmer organizations has enabled a strong equity focus, particularly on women and the most
vulnerable populations. Since their founding in 2006, Digital Green has reached over 4.1 million farmers (70
percent of them women), working with national-level partners such as the National Rural Livelihoods Mission
and the Ministry of Agriculture in India, the Ethiopian Agricultural Transformation Institute, and the Kenyan
Agricultural and Livestock Research Organization. Independent studies have shown that their video-based
approach is significantly more cost effective than traditional extension services and increases farmer incomes.
Building upon the video-based extension approach to deliver nutrition-related content using participatory
methods has also shown potential to improve maternal and child diet quality.

Sources: Abate, G.T., Bernard, T., Makhija, S. & Spielman, D.J. 2023. Accelerating technical change through ICT: Evidence from a video-mediated extension experiment in Ethiopia.
World Development, 161: 106089; Kadiyala, S., Harris-Fry, H., Pradhan, R., Mohanty, S., Padhan, S., Rath, S., James, P. et al. 2021. Effect of nutrition-sensitive agriculture interventions
with participatory videos and women’s group meetings on maternal and child nutritional outcomes in rural Odisha, India (UPAVAN trial): a four-arm, observer-blind, cluster-
randomised controlled trial. The Lancet Planetary Health, 5(5): e263–e276.; Vasilaky, K., Toyama, K., Baul, T. & Karlan, D. 2015. Learning Digitally: Evaluating the Impact of Farmer
Training via Mediated Videos. 2015.

in remote areas and neglected geographies is also all residents and to regulate access to less-healthy
important (See BOX 14). foods. Some interventions have not addressed
power asymmetries in the food system (for
It is also important that global and national policies
instance, the incentivization of large grocery stores
be developed to improve democracy in the digital
in low-income areas), while others have been more
technology arena more broadly, paving the way to
explicit in their efforts to increase both access
providing greater data sovereignty, particularly for
and agency (for instance, by providing safe market
small, marginal or disadvantaged actors in food
space for street vendors).
systems (Hackfort, 2021).
This section highlights four areas of intervention in [ 89
food-retail-environment governance and planning.
5.4 ACTIONS TO REDUCE The first area is interventions informed by lived

INEQUALITIES IN FOOD experience to enable food-retail environments to

meet FSN needs. While there has been substantial
ENVIRONMENTS AND focus on improving supermarket access as
a means of addressing food insecurity; more
CONSUMPTION recently, efforts have been made to take a more
holistic approach to food-retail planning and
5.4.1 FOOD-RETAIL ENVIRONMENT governance through processes such as broader-
PLANNING AND GOVERNANCE based food-asset mapping in Toronto (Baker, 2018)
Food-retail environment planning and governance and extensive lived experience mapping of food
provide an opportunity to address several environments, conducted by Gehl Architects in
inequalities in FSN. In many urban areas, there various cities (see, for instance, Gehl Architects
have been a variety of interventions designed to (2021)). This is leading to more integrated
enable the food environment to provide affordable, policies and planning around the creation of food
nutritious, safe and culturally appropriate foods to environments that provide more equal access to
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

healthy diets for all. Birmingham City Council, recognizes “natural markets” as “places where
(2019), for example, passed a Healthy Food sellers and buyers have traditionally congregated”
Ordinance designed to address multiple zoning (Roever and Skinner, 2016, p.370) and prohibits
issues related to the accessibility of healthy food town vending committees from declaring these no-
and produce throughout the city – both improving vending zones, which means that vendors cannot
access to healthy foods and applying a preventive be relocated to inaccessible areas with low footfall.
planning approach to restrict retailers selling less This model is responsive to the needs of residents
healthy foods. Alternative food networks (such in terms of access and, given the co-governance
as community-supported agriculture, farmers’ approach, provides for attention to food safety, thus
markets and community gardens) have the enabling access to safe, affordable and nutritious
potential to create more equitable access to healthy food for low-income residents.
foods if and only if an explicit equity lens is applied
The final area is targeted food-retail-environment
to the design of the programming (Allen, 2010;
intervention to address the FSN of particularly
Horst, McClintock and Hoey, 2017).
vulnerable groups. For example, in 2009, the
The second area is proactive planning of food Republic of Korea passed the Special Act on Safety
environments in areas of rapid growth. Given Control of Children’s Dietary Life, which establishes
rapid urbanization in many parts of the world, green zones in which the sale of fast foods and soda
planning food environments as urban areas is banned within 200 meters of selected schools
expand is an essential act to ensure equitable (WHO, 2009). A series of similar ordinances were
access to food, particularly as new urbanites are passed in cities in the Philippines in the early 2010s.
often poor and peripherally located. In Nanjing, Public healthy-food procurement programmes
China, as the city grows and as new residential are another type of pro-equity food environment
areas are developed, city planners are obligated to interventions (FAO et al., 2022).
incorporate new markets, activated as a specific
threshold of residential units is surpassed. This
is part of a much wider suite of food-environment 5.4.2 INCORPORATING BEHAVIOURAL
planning (Zhong et al., 2021). Similarly, in Dar es INSIGHTS INTO POLICYMAKING TO
Salaam the 2016–2036 Master Plan states that REDUCE INEQUALITIES FOR FSN
each neighbourhood unit of approximately 24 000 Reducing inequalities fundamentally requires a
people and 48 hectares should have markets and people-centric approach that understands how
commercial facilities as part of the basic services and why some people are disadvantaged compared
provided. The plan also provides for: home-based to others. Frequently, the circumstances that
90 ] enterprises; vendors along/at busy transportation separate groups (such as economic status) are
routes/nodes; and commercial space for a range also associated with differential patterns of human
of emerging sectors, including food processing behaviour (for instance, rich and poor persons have
(Wegerif and Kissoly, 2022). different patterns of behaviour). Understanding and
taking into account these differences in behaviour
The third area is the development of planning and can be valuable in interventions to reduce FSN
policy tools to include informal traders within the gaps. In recent years, much research has been
food environment. The creation of an enabling conducted, particularly relating to behavioural
environment for these vendors creates a more economics, to understand how behavioural insights
inclusive food environment, boosts access to can be leveraged in interventions and policymaking,
healthy diets for the poor and potentially improves including in food systems (Just and Gabrielyan,
food safety. An example of inclusive planning for 2016; Reisch, 2021).
informal traders is India’s Protection of Livelihood
and Regulation of Street Vending Act, 2014 (Roever Some examples of ways in which behavioural
and Skinner, 2016). The act establishes town insights may be relevant to reducing inequalities for
vending committees, of which 40 percent of the FSN:
members must be street traders. The act also
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

i. Research suggests that, in some settings,

5.4.3 SOCIAL PROTECTION
poor people exhibit more “present bias” than Social protection systems can have positive impacts
the better-off, where longer-term benefits in addressing inequalities in access to food, income
are given considerably less priority than and other resources (Travasso et al., 2023). The
immediate benefits. Interventions promoting evidence base in this area, sometimes referred
healthy diets may need to consider how to to as “nutrition-sensitive social protection”, is
overcome this behavioural challenge. improving (Gentilini, 2022), and social protection
systems are now widely accepted to be a key part of
ii. Males and females in the household may have
a broader preventive or redistributive approach to
different priorities for healthy eating, and the multidimensional poverty. At the 110th Session of
priorities that prevail in the household may the International Labour Conference (ILO, 2022b),
depend on who has more power. Healthy- Member States called for universal, adequate,
eating interventions that incorporate such comprehensive and sustainable social protection
understanding (for example, targeting systems, with the ILO recommending nationally
specific household members for messaging defined sets of basic social security guarantees that
about healthy diets, or promoting more secure protection from poverty and ill-health across
collaborative dietary decision-making in the the lifecycle via a range of policy and programmes,
household), may be more likely to succeed. which include the protection of labour rights.

Some countries have set up advisory units to help Social protection relevant to FSN incorporates
mainstream behavioural insights into policymaking. various forms of social assistance (such as cash or
food transfers, and school meals), social insurance
For example, the United Kingdom’s Behavioural
(such as health or unemployment insurance) and
Insights Team has contributed to the evidence base
economic development or income-generating
on behavioural aspects in a wide range of policy
activities (such as youth-employment schemes or
areas since it was first established in 2010. In
training), reflecting different objectives that might
2014, it transformed into a not-for-profit company
be protective, preventive or promotive (Gentilini,
whose outputs have included ideas on how to use 2022; Ortiz, Kalaivani and Cummins, 2015)
behavioural science to promote sustainable diets (see TABLE 2). Developments over the past 20 years
(The Behavioural Insights Team, 2020). have also shifted the discussion towards more
transformative forms of social protection that
specifically address equity issues (Devereux and
[ 91
Sabates-Wheeler, 2004) and a focus on “graduation”
models, which usually focus a sequenced package
of support on the extreme poor (Devereux and
Sabates-Wheeler, 2015; Gentilini, 2022).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

TABLE 2:
DIFFERENT FORMS OF SOCIAL PROTECTION AND THEIR RELEVANCE TO REDUCING FSN INEQUALITIES
OBJECTIVES TYPES OF INTERVENTION RELEVANCE TO FSN
INEQUALITIES

Protective Social assistance (e.g. cash, school Cash and food transfers can
(Provide relief from social feeding and food transfers) directly avert food insecurity. They
deprivation) may be combined with education
and support for feeding practices,
dietary diversity and broader
nutritional outcomes, including
child growth.

Preventive Social insurance (e.g. health and Helps families deal with shocks
(Avert deprivation) employment insurance) that may otherwise force them into
destitution or the loss of income
sources.
Crop insurance can help smooth
seasonal or pest/disease shocks for
producers.

Promotive Income generation (e.g. microcredit, Productive assets can often be

(Enhance incomes and capabilities) productive assets employment related to food production (e.g.
training and support) livestock or poultry). Microcredit
can help the poorest overcome
financial exclusion to production
inputs (e.g. fertilizer, seeds,
irrigation, mechanization). Training
can include non-farm rural income
generation to help smallholders
diversify income.

Transformative Anti-discrimination, sensitization When combined with different

(Address social equity and campaigns, legislative and protective, preventive and promotive
inclusion) regulatory changes to protect the measures, transformative
vulnerable measures can help tackle both
immediate (lack of income/food)
and root causes.

Source: Authors’ own elaboration based on analysis in Devereux, S. & Sabates-Wheeler, R. 2004. Transformative social protection; HLPE. 2012. Food security and climate change. A
92 ] Report by the High-Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security. Rome Italy, FAO; with additional FSN analysis by authors.

Evidence on the links between social protection (cash, food, vouchers) and found that context
and FSN outcomes has been growing over the matters in terms of which may be more beneficial
past decade. Many studies have focused on the (Hoddinott et al., 2013). Some researchers have
ways in which social protection can be made raised important equity considerations around
more nutrition-sensitive, although the evidence nutrition-sensitive social protection in calling for
is still mixed and cautions against a one-size- interventions to not overly burden the poor with
fits-all approach (Barnett et al., 2022; Drimie and demands on their time, where they are already
Yosef, 2016; Groot et al., 2016; Manley et al., 2020; juggling multiple burdens. This can be the case,
Olney et al., 2022). One systematic review of 74 for example, with many interventions targeted
studies found that cash transfers improved linear primarily at mothers, particularly those already
growth of children and reduced stunting through in marginalized situations (Barnett et al., 2022;
various pathways, including increasing access to Caillavet et al., 2022; Gillespie, 2016). In these
diverse nutrient-dense foods (Manley et al., 2020). situations, harsh conditionalities (where families
Other studies have compared different modalities lose benefits if, for example, children do not
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

attend school) have been criticized as worsening, economic. But careful attention must be given to
rather than improving, the situation of vulnerable exclusion errors (eligible beneficiaries being left
communities (Cookson, 2018; Gillespie, 2016). out), particularly when crises widen to affect broad
sectors of the economy that would not normally
Social protection has featured strongly among
be affected, as crises in many countries have
policy responses to periods of global food crisis
shown (CUL, 2023). Here, the fiscal space for social
(GloPan, 2020; HLPE, 2020) such as in 2007–8 and
protection may need to be enlarged (see BOX 15),
in response to the COVID-19 pandemic. Where good
which can happen with careful analysis of existing
systemic capacity exists (WFP), social protection
expenditure, without cutting other forms of social
can offer a quick remedy to escalating food prices
spending (Ortiz, Kalaivani and Cummins, 2015).
or to broader income and livelihood losses from
shocks that might be environmental, political or

BOX 15:
SPOTLIGHT ON SOCIAL PROTECTION PROGRAMMES
Long established in OECD countries, social safety net programmes play a significant role in HICs, with allocations of
more than 12 percent of GDP on average (of which more than 5 percent is for social assistance alone) – a share of the
economy that has remained roughly constant for the past 40 years. Meanwhile, social assistance has increased in many
Latin American countries since the 1990s (notably in conditional cash transfer programmes). Social protection is also
increasing in Asia. In Africa, however, despite movement toward cash transfer programmes in sub-Saharan Africa,
the magnitude of this spending remains weak. African countries average only 1 percent of GDP in social assistance
spending. Further analysis on the proportion of spending in African countries that goes to the poorest and most
vulnerable, and among rural and agricultural households in particular, presents a more complicated picture, with
social assistance spending generally being progressive (benefitting the poorest half of the population more), although
this relationship doesn’t hold in agricultural households, where spending tends to benefit the wealthier households
more, implying further measures are needed to target the rural agricultural sector.

Source: Fisher-Post, M. & Gethin, A. 2023. Preliminary Estimates of Global Posttax Income Distributions. Technical Note. N° 2023/02. World Inequality Lab.

[ 93
5.5 ENABLING “process of bringing together common functions
within and between organizations to solve common
ENVIRONMENTS, BROADER problems, developing a commitment to shared
vision and goals and using common technologies
CONTEXT AND GOVERNANCE and resources to achieve these goals” (WHO, 1996).
It has also been proposed that policy needs to be
5.5.1 FOOD AND NUTRITION equity-sensitive, incorporating consideration of
SENSITIVE POLICY, PLANNING redistribution, recognition and representation into
AND PROGRAMMING policies (across the board, including those affecting
Many FSN outcomes are the result of inequalities FSN) (Nisbett, Harris et al 2022).
in factors beyond the food system and of the There are also increasing calls for “governance
interplay of these inequalities with food system for nutrition” (Friel et al., 2017), rather than
inequalities. There has long been recognition nutrition governance alone. Governance for
of the need for nutrition-sensitive interventions nutrition is broader than nutrition governance and
and an integrated approach to health through a is framed as the process by which the impact of
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

non-nutrition policies on nutrition is leveraged policies, planning and programming (addressing

or mitigated. Similarly, governance for nutrition the underlying drivers of FSN) (Ruel, Alderman, and
entails increased attention on food-sensitive Maternal and Child Nutrition Study Group, 2013).
planning and policy (Haysom, Battersby and Park- However, this requires transversal governance
Ross, 2020). Nutrition-sensitive interventions processes. So far, such efforts have been most
include, for example: investment in water, successful at the subnational governance scale,
sanitation and hygiene; family planning; women’s where government departments have traditionally
empowerment; and early childhood development. been less siloed than national governments. The
Food-sensitive planning and policy include, for Milan Urban Food Policy Pact website provides
instance, transport planning, precinct planning, examples of good practice that address transversal
housing building codes, and green infrastructure governance (Forster et al., 2015). Some of the
policies. Making governance more equity-sensitive challenges experienced by officials seeking to
might include various forms of decentralization drive food-sensitive actions concern overstepping
and moving power closer to the people (Baker et mandates and lack of resources. The City of Cape
al., 2018; Milsom et al., 2021; Zaidi et al., 2018b). Town has worked to address this challenge by
This may include revived forms of local decision- developing a transversal food system working
making and democracy, for instance, at the level group and conducting a mandates-mapping
of municipal food systems (Rocha and Lessa, exercise that demonstrated the ways in which food
2009). Governance for equitable food systems and nutrition overlapped with existing mandates
is not always fully in the hands of the state, as and programming (FAO, 2022d).
activism, demonstrations and even riots have been
Several processes have been outlined as ways of
important ways in which citizens have called for
making policy equity-sensitive. The WHO (2014)
more equitable food systems (Baker et al., 2018;
focuses on inequalities and suggests focusing
Hossain and Scott-Villiers, 2017; Walls and Smith,
on addressing the health outcomes of the most
2015; Zaidi et al., 2018b). Other forms of activism
disadvantaged; reducing the gap between the most
include bringing these issues into formal policy
advantaged and the most disadvantaged; seeking
spaces, such as the work of FIAN International
to flatten the gradient across the whole population;
and the CFS Civil Society and Indigenous Peoples
and ensuring that policy choices do not exacerbate
Mechanism (CSIPM) in coordinating civil society
inequalities. Others have focused more on equity,
inputs and bringing the voices of the marginalized
suggesting designing equitable policy through
into decision-making forums. Grassroots work on
careful power-sensitive participation, explicitly
food equity includes alternative food movements
including alternative voices in thinking and action
(Sage, Kropp and Antoni-Komar, 2020), access to
94 ] to sensitize policy spaces and systems that affect
the law for upholding rights claims (Dancer, 2018),
marginalized groups (Cornwall, 2003).
and advocacy through plural routes (Jurkovich,
2020), all of which can be seen as forms of activism.
A focus on equitable infrastructure provisioning and 5.5.2 ADDRESSING CORPORATE
planning (Gilbert, Eakin and McPhearson, 2022) can
also address unequal FSN outcomes.
POWER ASYMMETRIES IN
GOVERNANCE
In order to maximize FSN benefits, it is important to Special measures may be needed to counter the
link nutrition- and food-specific policies, planning power asymmetries that exist when corporate
and programming (addressing the immediate actors, particularly those who are in monopolistic
drivers of FSN) to nutrition- and food-sensitive positions nationally or oligopolistic positions globally,
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

are part of decision-making fora (Baker et al., managing these relations (via its different business
2018; Brooks, 2016; Mialon, 2020). Concerns have and civil society constituencies and interface)
been raised about the nature of multistakeholder (Duncan and Claeys, 2018; Turnhout et al., 2021), to
processes that may afford too much power to a framework convention on food systems (modelled
corporate actors in shaping food systems policy after other international conventions and tobacco-
and governance (IPES-Food, 2023b; McKeon, 2017). control measures) that would specifically exclude
There are challenges to finding effective measures private sector actors, given the danger of industry
to manage such power disparities (Fanzo et al., interference in policy on obesity (Swinburn et al.,
2020). Options that have been put forth range 2019). BOX 16 illustrates the challenge with an example
from learning from the experience of the CFS in from Mexico.

BOX 16:
SUGAR-SWEETENED BEVERAGES TAX IN MEXICO
In 2012, Mexico was one of the countries with the highest mortality and morbidity rates attributed to over consumption
of sugar (Gutiérrez et al., 2012; Pan American Health Organization, 2015; Sigh et al., 2015). To reduce the burden of non-
communicable diseases (NCD), in 2014 the government introduced a sugar-sweetened beverages (SSB) tax, subjecting
all SSBs with added sugars to a MXN 1/L excise tax (about 10 percent of SSB retail price) (Camara de Diputados LXII
Legislatura, 2013). The tax was designed and implemented amid the convergence of several factors, including: evidence
of poor results from self-regulatory measures by industry; high rates of NCDs in the country; a new government
administration seeking additional revenue sources; and civil society’s advocacy campaigns (Carriedo Lutzenkirchen,
2018). Revenue received from SSB taxation has been invested in healthy-food interventions, including consumer
awareness campaigns designed to support behavioural change and structural interventions to increase the availability
of potable water in schools and communities. The allocation of tax revenue towards such interventions has been
documented as one of the positive impacts of SSB taxation, which led to its continuation despite the opposition from big
soda corporations and other industry actors (Colchero et al., 2016; Thow et al., 2018).

Just a year after the implementation of the SSB tax, clear benefits such as reductions in the purchase of taxed
beverages and an increase in water purchases were evident. Colchero et al. (2016; 2017) found that sales of taxed
beverages were 6 percent lower compared to what was expected in the absence of the tax, and reductions continued
to accelerate, reaching a 12 percent decline by the end of 2014. Reductions were more significant among households
[ 95
of low socioeconomic status, averaging 9.1 percent, and reaching 17.4 percent decline in the same year. Average
reductions in purchases were 4 percent in rural areas and 6.3 percent in urban areas. Water purchases increased by
16.2 percent and were found to even be higher in lower-income and urban households (Colchero et al., 2016; Colchero,
Molina and Guerrero-López ,2017).

Despite its successful outcomes, Mexico’s SSB tax has suffered from political challenges, fueled mainly by persistent
lobbying from industrial corporations against the tax. In response, NGOs, academics and political lobbyists formed
a strong pro-tax coalition to counteract opposition from industrial groups (James, Lajous and Reich, 2020). Evidence
shows that continued adherence to good governance principles, support by legal measures and broad multisectoral
alliances will ensure continued gains towards reducing the NCD burden in Mexico (Carriedo Lutzenkirchen,2018).

Source: Authors’ own elaboration.

 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

Recognizing such power asymmetries also to country context. These actions include focusing
applies to decision-making in relation to land use, on maternal nutrition and the first 1 000 days of
particularly in situations such as land acquisition life of the child and scaling up the evidence-based
for agricultural investment (or other resource WHO antenatal care recommendations to prevent
extraction, including mining, which may take land malnutrition early in life (Hawkes et al., 2020).
out of agricultural or agroforestry systems). The Key equity-informed approaches in double-duty
CFS Principles for Responsible Investment in actions include:
Agriculture and Food Systems state the need to
• programmes that provide healthy eating
ensure “Effective and meaningful consultation with
advice during pregnancy counselling,
Indigenous peoples, through their representative
including behaviour-change communication;
institutions in order to obtain their free, prior
and informed consent under the United Nations • targeting populations with higher rates of
Declaration of Rights of Indigenous Peoples”(FAO, undernutrition to expand supplemental
2018, p.17) in taking such decisions (FAO, 2018c; feeding programmes for mothers using cash
Vallet et al., 2019). “Effective and meaningful” or food vouchers;
implies the right to say no to such investments
where this would not be in the long-term interest of • investing in scaling-up supportive
affected communities. environments to protect and support early life
feeding (breastfeeding and complementary
feeding practices);
5.5.3 UNIVERSAL HEALTH CARE WITH
INTEGRATION OF NUTRITION CARE • growth-monitoring programmes to monitor
In designing effective nutrition action it is critical child overweight status in contexts with
to consider the inequalities that drive the double growing child overweight;
burden of malnutrition (DBM) - the unaffordability • policies to promote and counsel on healthy
of healthy diets for some sections of the population, diets, with close monitoring and appropriate
the influence of big food companies on market targeting of fortified and supplemental foods.
proliferation with non-nutritious foods (Clapp and
Scrinis, 2017), and other socioeconomic drivers of Regardless of the policy actions taken to address
FSN inequality. Integrating nutrition into universal DBM inequalities, it is critical that policies
health coverage at all levels of care – community, undergoing development or revision articulate
primary and tertiary – provides multiple paths to clearly the nutrition-equity concerns they are trying
tackling inequalities in DBM. When considering to address and recognize their deep drivers. This
96 ] nutrition actions to be integrated in universal is especially relevant for nutrition actions focused
health coverage, there is a case for “double duty” on education and social and behaviour-change
nutrition actions, given both the universality of DBM communication. Otherwise, these types of policy
and its unequal distribution burden. Double-duty actions run the risk of being reductive and targeting
actions tackle both major burdens of malnutrition vulnerable populations by problematizing their
– undernutrition and overweight/obesity, adapting behaviours without addressing structural drivers
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

such as power imbalances, commercial interests rate of climate change is accelerating, and it is
and historical exclusion (Zorbas et al., 2021). essential that all food policy be informed by climate
sensitivity and sustainability principles, seeking
Implementing nutrition-integrated universal health
both to adapt to and mitigate climate change
care in an impactful way requires significant
impacts on the most marginalized.
investment, and LICs in particular are likely to face
challenges in raising funding at the requisite level.
Within climate change policy and advocacy, the
In recent years, the World Bank’s Global Financing
concept of climate equity is gaining traction.
Facility (GFF) has emerged as an effective way
(Manzo, 2021) develops a framework for an
to finance investment in reproductive, maternal,
equitable climate change regime based on three
newborn, child and adolescent health and nutrition.
core principles: protect the most vulnerable
The GFF enables countries to leverage donor
people from the adverse effects of global warming,
funding into larger investments in this category by
provide distributive justice across current and
offering them the scope to use in high-impact areas
future generations and ensure an inclusive and
USD 4 of bank credits for every USD 1 of donor
transparent negotiation process. Klinsky and
funding (Fernandes and Sridhar, 2017). This has
Winkler (2018) identify a set of five principles for
encouraged significant increases in investments in
assessing the equity implications of climate policy
health and nutrition in recipient countries. However,
which align well with the food-equity principles
there is scope for the GFF to be more equitable
established in Section 5.1 (Klinsky and Winkler,
and effective in its operations by improving the
2018). The decision to establish a loss and damage
representation of recipient countries and civil
financial mechanism at COP 27, in recognition
society in top-level decision-making at the global
that the financial burden of climate change rests
level and improving inclusivity in national-level
on individuals and countries least responsible
decision-making platforms (Seidelmann et al.,
for climate change and least able to adapt or
2020).
mitigate, is an important breakthrough in climate
equity (Wyns, 2023). This could play an important
5.5.4 TRANSFORMATIVE ACTION: A role in addressing some of the most iniquitous
HOLISTIC APPROACH TO CLIMATE food system outcomes driven by climate change
AND SUSTAINABILITY (Laganda, 2023; Wyns, 2023). The convergence
Unsustainable food system activities are a of equity principles across climate change and
considerable driver of climate change, with food food policy provides scope for dialogue and policy
systems being responsible for one-third of the innovation. An example of commitment to these
world’s greenhouse gas emissions (Crippa et al., principles is the Glasgow Food and Climate [ 97
2021). Recent modelling found that for every 1 Declaration launched at COP26 (IPES-Food,
°C temperature anomaly, levels of severe food 2021), which calls for joined-up action on food and
insecurity increased by 1.64 percent and moderate climate. BOX 17 provides an example of a project
and severe food insecurity increased by 2.14 focused on rural communities in Brazil’s Northeast
percent (Dasgupta and Robinson, 2022). The that operationalizes the concept of climate-equity.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

BOX 17:
CLIMATE RESILIENCE PROJECT IN RURAL COMMUNITIES OF NORTHEAST BRAZIL
A project, Sowing climate resilience in rural communities of the Northeast, recently launched (March 2020) by the
Brazilian National Development Bank, in partnership with IFAD and Green Climate Fund (GCF), aims at increasing
resilience of rural productive systems affected by climate change, thus enhancing livelihoods and resilience of rural
communities. The project will provides non-reimbursable support of BRL 1 billion for 250 000 farming families in the
semiarid Northeast, mostly families included in the National Registry of People in Situations of Vulnerability (CAD
ÚNICO).

The project will improve the production techniques of small-scale farmers, thereby increasing their productivity and
improving their capacity to face the continuous challenges of climate change in the caatinga (a shrubland and thorn
forest). Given the dry conditions of the region, the project also contemplates the acquisition of thousands of cisterns
and wastewater treatment and reuse units to provide water access. All project activities have been planned with a
focus on promoting greater opportunities for women and young people (target beneficiaries: 40 percent women and
50 percent youth), including preparing them for active leadership. The participation of traditional, Indigenous and
afro-descendant communities (Quilombolas) will also be prioritized.

Ultimately, the project is expected to implement 84 000 hectares of resilient productive systems (agroforestry
systems for family agriculture, communal production areas, and vegetable gardens in 1 000 schools). The expected
results are improvements in food security, more income for small farmers and lower carbon emissions. Overall, the
project is expected to reduce carbon emissions by 11 million tons.

It is hoped that the project will become a model of sustainable agriculture for small farmers in similar conditions
around the world who also suffer from the adverse effects of climate change. To this end, exchange activities
between farmers from similar biomes in Latin America and Africa are planned.

Source: IFAD. 2020. Brasil: Projeto Semeando Resiliência nas Comunidades Rurais do Nordeste (PCRP). Brasil, International Fund for Agricultural Development.

something long emphasized, since the introduction

98 ] 5.5.5 INCLUSIVE AND SUSTAINABLE of the Human Development Index and other
FSN GROWTH AND POLICY THAT GOES measures of wider well-being (UNDP, 2023). Some
BEYOND GROWTH commentators have noted that relying on economic
Inequality is often cast in terms of income
growth alone to eradicate extreme poverty would
disparities and poverty, because purchasing power
take too long (over 100 years to eradicate poverty
is a proximate determinant of quality of life and
at a USD 1.25-a-day poverty line, and over 200
opportunity. However, this report has demonstrated
years at a more realistic USD 5-a-day poverty line)
that there is a range of inequities that shape which
(Woodward, 2015). This requires rethinking the
populations are likely to be poor in the first place,
growth paradigm – not eschewing the need for
related to their social position relative to prevailing
economic growth, but understanding the benefits
cultural norms and the ways in which these have
and disadvantages of mainstream growth alongside
historically shaped opportunities for recognition
a growing range of alternatives, including wider
and participation. These inequities need to be
measures of well-being or economies based on
addressed in themselves. It is also vitally important
different forms of shared commons and what is
that broader economic strategy and policy be
increasingly being referred to as the “social and
reflective of principles of inclusiveness, fairness
solidarity economy” (OECD, 2023; RIPESS, 2023).
and sustainability. This will mean moving away from
economic growth as a sole paradigm of success,
5 ACTIONS TO REDUCE INEQUALITIES IN FOOD AND OTHER SYSTEMS TO IMPROVE FSN

CHAPTER 2 noted where growth is important for poverty It is also increasingly recognized that that growth
reduction, but also where high income inequality and development need to be kept within social
constrains the ability of growth to reduce poverty, and planetary boundaries (Raworth, 2018), as
and that inequality can act as a brake on growth poverty eradication this century would require a
itself. These outcomes of high inequality limit FSN. global economy 175 times the current size, with
Acknowledging the challenges of a growth-centric similarly unsustainable increases in extraction
paradigm in the face of inequality, inclusive-growth and production (Woodward, 2015). The Stockholm
approaches have gained prominence, emphasizing Resilience Centre report to the Club of Rome
broad-based growth strategies that prioritize fair (Randers et al., 2018) warned that the conventional
growth paradigm was incompatible with achieving
distribution of opportunities and benefits across
the SDGs, and that an inevitable consequence
society. The notion of inclusiveness has expanded
of pursuing conventional growth would be an
beyond economic dimensions of welfare to
intensifying trade-off between the socioeconomic
encompass well-being, voice and participation (De
and the environmental SDGs. Among the five
Mello and Dutz, 2012).
turnarounds urged in that report are accelerated
In practice, inclusive-growth approaches require productivity in food chains and active inequality
embedding inclusiveness into policy and strategic reduction (richest 10 percent take no more than 40
choices. For example, taking care to not neglect percent of income) (Randers et al., 2018).
sectors that provide more employment in the A number of aspects are important in reimagining
rush to capitalize on growth possibilities in growth to be inclusive and sustainable. The first is
high-tech sectors, so that growth does not lead redistributive taxation: It has been calculated that a
to a dual economy, increased inequality and 5 percent wealth tax on the richest 1 percent would
persistent poverty. In the context of the agrifood raise USD 1.7 trillion per year that could be spent
sector, several actions we have described in this on poverty reduction, if it were politically feasible to
report are consistent with the inclusive-growth introduce (Christensen et al., 2023). Beyond taxes,
concept, such as investing in pro-poor agricultural fairer trade rules (including reducing rich-country
R&D, with special consideration for marginal subsidies and discriminatory tariffs and addressing
environments, and ensuring that small operators technical barriers to trade that restrict the market
are able to access commercialization opportunities. access of poorer producers) would allow poorer
These approaches also require the recognition countries to earn more on their exports.
that the playing field is historically uneven, with
Some have suggested working explicitly to reverse
countries in the Global South integrated into the
land and resource enclosures through reframing [ 99
global economic system on unequal terms, often food as a commons rather than as a commodity
leading to wealth extraction and unsustainable (Vivero-Pol et al., 2019). Such approaches are
international debt (Hickel, 2018), which can compatible with rights-based approaches to food
benefit local elites but leave entire populations referenced earlier in this chapter, though the actual
impoverished and indebted to international implementation of such approaches may proceed
financial institutions. For many countries, the differently, depending on national or subnational
only way to recover from debt and its impacts on political approaches. They range from approaches
food systems is for the debt to be restructured or to agroecology and food sovereignty to forms of
cancelled (IPES-Food, 2023a). distribution of resources which help enable the
right to food, such as forms of social protection.
 Chapter 6
RECOMMENDATIONS

100 ]

©Pep Bonet/NOOR for FAO

6 RECOMMENDATIONS

T
his chapter provides recommendations to A. FSN policy and food systems policy
support a fundamental transformation of should have an explicit focus on reducing
food systems, making them more equitable inequalities, devoting particular attention
and inclusive, leading to reduced inequalities to the interaction of multiple types of
and improved FSN outcomes. Drawing upon inequality that have a cumulative impact
the previous chapters, in particular the on the same groups of people (that is,
detailed action areas in CHAPTER 5, the report intersectional inequalities), taking into
provides recommendations for different account rising power concentration in
groups involved in FSN-related policymaking, food systems.
research and action – including governments, B. In addition to continued incremental
international organizations, the private sector, action to reduce inequalities and improve
civil society and research institutions. This FSN outcomes, bold, transformative
chapter begins by presenting the principles policy that addresses the systemic
underlying the recommendations (Section 6.1). drivers of inequalities must be developed
The recommendations that follow, set forth in and acted upon.
Section 6.2, must be considered in light of these C. FSN policies and programmes should
principles to ensure that actions taken truly
[ 101
be grounded in a rights-based approach,
lead to reduced inequalities and improved FSN informed by existing human rights
outcomes for all. Section 6.3 outlines a roadmap instruments focused on the right to food
for formulating equity-sensitive policy, to enable and other interdependent rights.
actions to be contextualised for the inequities D. FSN policies and programmes aimed at
present in each country and community setting. fair distribution of resources for all must
also ensure representation of marginalized
groups and recognition of their rights. In
6.1. PRINCIPLES FOR strengthening the agency and engagement

EQUITY-SENSITIVE POLICY of marginalized groups, policies and

programmes should have an explicit focus
AND ACTION THAT REDUCE on addressing power asymmetries between

FSN INEQUALITIES stakeholders, through embedding the

principle of “nothing about us without us”
The following overarching principles (FIGURE 12)
in programme funding, design, provision,
frame practical recommendations laid out in
monitoring and evaluation.
this chapter.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

E. FSN policy and legislation should be G. Actions that address the drivers of FSN
informed by diverse knowledges, including inequalities must be grounded in national
Indigenous knowledge, and diverse forms and local context.
of data, in order to broaden the spectrum of H. All stakeholders – government,
evidence informing FSN policy and action.
international organizations, civil society
F. FSN policies and programmes should and the private sector – are responsible
consider the cumulative impact of multiple for reducing inequalities in food systems.
shocks (climate change, biodiversity loss, Each has a role to play, individually and
health crises, economic and political
collaboratively, with due consideration
crises) on the most marginalized people,
given to conflicts of interest.
recognizing the chronic stress on FSN of a
state of continuous crisis.

FIGURE 12:
PRINCIPLES FOR EQUITY- AND EQUALITY-SENSITIVE POLICY AND ACTION

D E
FSN policy and legislation
FSN policies and programmes
aimed at fair distribution of should be informed by diverse
resources must address the knowledge and forms of data.
representation of marginalized
groups and recognition of their
rights.

C FFSN policy and programming

FSN policy and programming
should be grounded in a should consider the cumulative
rights-based approach. impact of multiple shocks,
recognizing the chronic stress
that continuous crisis places on
FSN.
102 ] B G
Transformative policy that Actions that address the
addresses the systemic drivers drivers of FSN inequalities
of inequalities must be must be grounded in national
developed and acted upon. and local contexts.

A
FSN and food systems policy
should explicitly focus on
reducing inequalities, H
especially intersectional All stakeholders share the
inequalities and rising power responsibility to reduce
concentration. inequalities in food systems.

Source: Authors’ own elaboration.

6 RECOMMENDATIONS

live with dignity and agency; to have access

6.2 RECOMMENDATIONS to sufficient, nutritious, safe, healthy and
FOR EQUITY-SENSITIVE culturally appropriate food; and to participate
in sustainable food systems enabled by fair and
ACTIONS TO ADDRESS inclusive societies.

FSN INEQUALITIES The recommendations are directed to a variety

The report’s policy recommendations are built of actors and stakeholders, including states,
on the conceptual framework (FIGURE 2) and the intergovernmental organizations, the private
analysis of proximate and systemic drivers sector and civil society. Each recommendation
of FSN inequalities and the priority action indicates the key stakeholders it is addressed to.
areas discussed in previous chapters. The first
A. Tackle inequalities within food systems
cluster of recommendations includes actions
1. States, intergovernmental
to address inequalities within food systems,
organizations, the private sector and
such as facilitating equitable access to land,
civil society should work across sectors
livestock, forests and fisheries; investing in
to ensure more equitable access to
equity-sensitive extension and information
land, forests, aquatic resources and
systems, infrastructure, food processing and
other food production resources,
storage; and governing food retail while bearing
applying rights-based approaches.
an equity lens. The second cluster focuses on
inequalities in other sectors related to FSN, i. Bolster the land and resource rights
including health and education; ensuring of women, peasants, Indigenous
universal access to public services and social Peoples and other marginalized
protection; and embedding an equity focus into groups, including legal recognition
trade, investment and debt governance. The and inheritance rights; protect
third cluster focuses on actions to address communal and collective tenure
the social and political drivers of inequality, rights to resources, including
including leveraging SDG 10 (‘reduce inequality enshrining free, prior and informed
within and among countries’), mainstreaming consent, and promote sustainable
participatory approaches, building on human community-based management of
rights approaches, and taking into account the those resources.
context of climate and other crises. The fourth ii. Design regulations to improve the
and final cluster highlights the need to invest in functioning of markets for land,
and use inclusive knowledge and data systems. inputs, services, and water, while
[ 103
Among other actions, this includes the protecting the vulnerable and
recognition and inclusion of diverse ways preventing the concentration of
of knowing, the improvement of global and resources.
national data collection efforts with respect to iii. Strengthen accountability,
capturing information on major inequalities, monitoring and the requirement
and investing in public agricultural and food- for local consent with respect to
systems research, to enable better equity focus corporate/international land, forest
and understanding and monitoring of equity and and water acquisitions.
equality in FSN-relevant domains. iv. Design and implement asset-
The recommendations are mapped in TABLE 3 building and livelihood programmes,
according to their focus on the redistribution, such as land and livestock transfers,
recognition or representation aspects of equity, tailored for resource-poor,
as outlined in the conceptual framework and disadvantaged groups.
CHAPTER 1. The aim of these recommendations v. Monitor and limit concentration of
is to create an enabling environment for all to ownership (over land, transport,
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

wholesale, retail, etc.) in food local ones, are enabled to provide

systems. improved access to nutrient-
2. States, intergovernmental dense foods for all consumers at
organizations, private sector and affordable prices.
civil society should facilitate the iii. Invest in rural transport, market
organization of disadvantaged infrastructure, nutrient-preserving
stakeholders and build inclusive food processing and food storage,
institutions and partnerships to with special consideration for
improve representation. disadvantaged groups and places,
i. Build and support farmer, fisher, and supporting territorial markets.
peasant, food-producer, landless iv. Invest in filling the gaps in access
and migrant-worker organizations; to finance among micro, small
self-help groups and cooperatives; and medium enterprises (MSMEs)
as well as labour organizations along the value chain, with special
throughout food systems – consideration for groups that are
particularly including women – to traditionally disadvantaged, including
ensure better representation and small-scale producers, small-scale
agency. Explicit consideration should input providers and traders, and
be given to inclusivity in participation women, as well as those with limited
and group decision-making and the current commercial orientation.
right to freedom of association and v. Invest in information systems across
collective bargaining. food systems, leveraging digital
ii. Leverage the benefits of collective technologies – such as market-
action to improve access to inputs, price information services and
finance, information, value chain video-based extension – to help
opportunities, certification/standards overcome asymmetries in access to
and market opportunities, as well as information and to spread knowledge
decent work, safe working conditions and opportunity equitably, with
and a living income based on careful consideration for upholding data
consideration of, and with a clear privacy and data ownership.
plan to address, local contexts and vi. Invest in expanding rural, non-
power asymmetries. farm employment opportunities
104 ]
3. States, intergovernmental to ensure that income-generating
organizations, the private sector and opportunities exist outside
civil society should make equity- agriculture as alternative pathways
sensitive investments in supply chains to FSN.
and in disadvantaged areas. vii. Invest in civil society and government
i. Invest in territorial approaches staff working more closely with
in food systems and regional marginalized communities, including
development planning, including in enhancing their legal capacity to
agroecology and in local markets, uphold their right to food, decent
strengthening regional trade and work and a clean environment.
market connections to create a 4. States, intergovernmental
judicious mix of local and distant organizations, private sector and civil
market opportunities for small- society should plan and govern food
scale producers and to benefit environments including trade, retail,
local consumers. processing with an equity focus.
ii. Ensure that supply chains, especially i. Undertake proactive planning of
6 RECOMMENDATIONS

food environments in areas of rapid healthcare, immunization, nutrition

demographic growth to ensure education, sanitation and safe
equitable and affordable access to drinking water.
food, promoting access to nutrient- ii. Ensure universal access to social
rich foods, facilitating access to local protection as direct support for
fishers’ and farmers’ markets, and FSN among the most marginalized
restricting marketing and advertising groups, and to enhance access to
of unhealthy foods. productive assets for those with food
ii. Recognize the role of informal systems-dependent livelihoods.
vendors in meeting the FSN needs of iii. Maximize the fiscal space available
populations, in-cluding marginalized to improve basic public services,
groupspopulations, and develop including more comprehensive
planning and policy tools to create and progressive national and
an enabling environment to enhance international taxes on income,
their capacity to sell nutritious and profits, land, wealth and commodity
safe food. speculation, and use the proceeds to
iii. Undertake targeted interventions support the most marginalized and
in food retail environments to address the drivers of unequal FSN.
mitigate unequal FSN outcomes, iv. Contribute to ensuring access to
especially for populations at decent work for all, including in
risk of food insecurity and all food systems, as a key condition for
forms of malnutrition, such as a living wage and access to food.
children, youth and the urban poor. This would include implementing
Depending on the specific context, labour protection policies, strategies
these interventions may include: and programmes (such as those
restricting the sale of unhealthy food on occupational safety and health,
products near educational premises; regulations on working hours and
and promoting public procurement pay, maternity protection) that
programmes for nutritious foods. protect both the labour and human
iv. Implement specific measures aimed rights of food system workers.
at limiting processing and marketing 6. States and international organizations
of unhealthy food, with the aim to should embed an equity focus into [ 105
promote healthy eating. These can trade, investment and debt governance
include: introducing fiscal measures related to FSN.
such as taxes on sugar-sweetened
i. Monitor and regulate, as appropriate,
beverages and other unhealthy
corporate power asymmetries
foods, while subsidizing healthy
in food systems governance and
foods; and labelling the nutritional
decision-making, and the FSN
content and/or detrimental
implications of the expansion
effects of ultra-processed foods to
of large agribusiness and food
support FSN improvements among
corporations.
particularly vulnerable groups.
ii. Ensure, through equity-impact
B. Tackle inequalities in related systems
assessments that include the
5. States should ensure universal access representation of affected groups,
to services and resources that have a that multilateral and bilateral trade
direct impact on FSN. and investment agreements do not
i. Ensure universal access to FSN- negatively impact food environments
relevant services, including primary and diets, including a redressal
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

process available to marginalized in ensuring FSN; envisages men

groups’ representatives when taking on a greater role in FSN and
complaints arise. addresses adequate compensation
iii. Ensure greater transparency in of care workers and community
the preparation of international health workers, while avoiding
and bilateral trade and investment arrangements that exacerbate
negotiations, and develop systems to women’s “triple burden” of care.
support domestic decision-making, iii. Create interministerial platforms
coordinated between sectors on FSN, with the participation of
involved in food, the environment, agriculture, livestock, fisheries,
public health, industry and trade, forest, health, economy and finance,
to ensure that issues of equity are and trade ministries to enable the
considered and that marginalized convergence of ministerial actions
groups have a say. in FSN policy, and charge and equip
iv. Take action toward restructuring these platforms to have a strong
or cancelling the debt of countries focus on reducing inequalities.
where FSN is constrained by debt. iv. Identify and manage conflicts of
v. Continue efforts to decrease interest between more powerful and
subsidies on agricultural production less powerful groups in food systems,
in high-income and emerging including where private sector
countries, except those aiming interests and public policy goals
to enhance the nutritional or conflict; and protect research against
environmental qualities of food undue influence, bias and corruption.
production and to reduce FSN v. Strengthen inclusive spaces
inequalities, so as to level the playing for dialogue, participation and
field for LMICs. coordinated action at global, national
C. Tackle social and political drivers of and local levels that centre on
inequality building equity, including within
negotiations on climate, trade and
7. States, intergovernmental organizations,
investment agreements and related
the private sector and civil society
policy fora.
should leverage SDG 10 (‘reduced
106 ] inequalities’) to address the systemic 8. Based on a human rights approach,
drivers of unequal distribution, access states and intergovernmental
and representation, including by organizations should embed equity
mainstreaming participatory approaches principles into policy.
in policymaking and practice to amplify i. Identify policies and interventions that
marginalized voices. can support individuals and groups
i. Ensure policies target the most to break out of intergenerational food
marginalized people, explicitly state insecurity and malnutrition.
which groups they aim to impact, ii. Leverage existing human rights
strive to remove barriers and instruments such as UNDROP,
not impose burdens on the most UNDRIP, the Right to Food, the
vulnerable, and speak directly to the Voluntary Guidelines on Food Systems
2030 Agenda approach of leaving no and Nutrition and various CFS
one behind. guidance documents to strengthen
ii. Ensure that social policy pays specific equity-sensitivity of policies.
attention to women’s role, time iii. Strengthen national institutions
burdens and other existing burdens to understand and apply human
6 RECOMMENDATIONS

rights conventions to harmonize opportunities in different contexts,

policies relating to food systems, paying special attention to historically
agriculture and nutrition from an marginalized groups, women and
equity perspective. disadvantaged regions.
iv. Make redressal mechanisms ii. Improve major routine public data
available to marginalized collection and analysis efforts,
communities when cases of inequities sampling adequately along the
are identified. major axes of inequality within
9. States, intergovernmental organizations each context, to enable a full
and civil society should take into account understanding of inequality; and
the context of climate, ecological, apply a more equity-sensitive
political and economic crises in all FSN- approach to reporting data in global
related actions. reports such as SOFI and GNR.
i. Ensure adequate prioritization iii. Integrate equity-sensitivity and
of populations most affected by incorporate diverse knowledges in
climate change, conflict and other FSN research.
contemporary global crises in iv. Boost public agricultural and food
targeting policy and allocating systems research with strong
resources. consideration for equity-sensitivity
ii. Work across the humanitarian– of the research portfolio, including
development–peace nexus to research tailored to marginal
address the multiple drivers and environments and climate-resilient
manifestations of FSN inequalities in technologies for small producers.
fragile states. Mainstream gender, equity and
intersectionality considerations into
iii. Explore the option of establishing a
all aspects of research. Ensure all
fund, for example using the country-
research applies the precautionary
level funding for the follow-up to the
principle to ensure no groups are
United Nations Food Systems Summit
exposed to harm as a result of the
(UNFSS), to support transformation
research, and ensure individuals
towards more equitable food systems.
and communities retain the right to
D. Strengthen data and knowledge systems
decline participation.
to enable improved understanding and [ 107
v. Enable a richer understanding of
monitoring of equity in FSN-relevant
the root causes and systemic drivers
domains
of FSN inequalities by encouraging
i. Fill data gaps (particularly related
and funding qualitative research
to diets, micronutrient status, food
to capture the lived experiences of
composition) by systematically
actors in food systems. This includes
collecting information to identify
facilitating the understanding and
which groups have the poorest
inclusion of traditional ecological
FSN outcomes and food system
knowledge of Indigenous and local
communities in policymaking.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

TABLE 3:
HOW RECOMMENDATIONS ADDRESS THE DIMENSIONS OF RECOGNITION, REPRESENTATION
AND REDISTRIBUTION

RECOGNITION REPRESENTATION REDISTRIBUTION

A. TACKLE INEQUALITIES WITHIN FOOD SYSTEMS

1. States, intergovernmental organizations, the private sector and civil society should work across sectors to
enable more equitable access to resources, applying rights-based approaches.

i. Bolster the land and resource rights of

women, peasants, Indigenous Peoples and other
marginalized groups and protect communal and
collective tenure rights to resources.

ii. Design regulations to improve the functioning

of markets for land, inputs, services, and water,
while protecting the vulnerable and preventing the
concentration of resources.  

iii. Strengthen accountability, monitoring and the

requirement for local consent with respect to
resource acquisitions.  

iv. Design and implement asset-building and

livelihood programmes for disadvantaged groups.

v. Monitor and limit concentration of ownership in

food systems.

2. States, intergovernmental organizations, private sector and civil society should facilitate the organization of
disadvantaged stakeholders and build inclusive institutions and partnerships to improve representation.

i. Build and support inclusive producer and labour

organizations throughout food systems.

ii. Leverage the benefits of collective action to

improve access to inputs, finance, information and
market opportunities, as well as decent work, safe
working conditions and a living income, based on
careful consideration of, and with a clear plan to
address, local contexts and power asymmetries.

3. States, intergovernmental organizations and civil society should make equity-sensitive investments in
supply chains and in disadvantaged areas.
108 ]
i. Invest in territorial approaches in food systems
and regional development planning.

ii. Ensure that supply chains are enabled to provide

improved access to nutrient-dense foods for all
consumers at affordable prices.  

iii. Invest in rural transport, market infrastructure,

nutrient-preserving food processing and
food storage, with special consideration for
disadvantaged groups and places.

iv. Invest in filling the gaps in demand for financing

among MSMEs along the value chain.

v. Invest in information systems across food

systems, leveraging digital technologies to
spread knowledge and opportunity equitably, with
consideration for upholding data privacy and data
ownership.

vi. Invest in expanding rural, non-farm employment

opportunities.
6 RECOMMENDATIONS

RECOGNITION REPRESENTATION REDISTRIBUTION

vii. Invest in civil society and government
staff working more closely with marginalized
communities.

4. States, intergovernmental organizations, private sector and civil society should plan and govern food trade,
retail, processing and food environments with an equity focus.

i. Undertake proactive planning of food

environments in areas of rapid demographic
growths.

ii. Recognize the role of informal vendors

in meeting the FSN needs of marginalized
populations.

iii. Undertake targeted interventions in food retail

environments to mitigate unequal FSN outcomes.

iv. Implement specific measures aimed at limiting

processing and marketing of unhealthy food, with
the aim to promote healthy eating.

B. TACKLE INEQUALITIES IN RELATED SYSTEMS

5. States, intergovernmental organizations and civil society should ensure universal access to services and
resources that have a direct impact on FSN.

i. Ensure universal access to FSN-relevant

services, including primary healthcare,
immunization, nutrition education, sanitation and
safe drinking water.

ii. Ensure universal access to social protection to

enhance access to FSN and to enhance access to
productive assets.

iii. Maximize the fiscal space available to improve

basic public services.

iv. Contribute to ensuring access to decent

work for all, including in food systems, as a key
condition for a living wage and access to food.

6. States and international organizations should embed an equity focus into trade, investment and debt
governance related to FSN.

i. Monitor and regulate, as appropriate, corporate

power asymmetries in food systems governance
[ 109
and decision-making.

ii. Ensure that multilateral and bilateral trade

and investment agreements do not negatively
impact food environments and diets, including a
redressal process available to marginalized group
representatives when complaints arise.

iii. Ensure greater transparency in the preparation

of international and bilateral trade and investment
negotiations and develop systems to support
domestic decision-making and inclusive
participation.

iv. Take action toward restructuring or cancelling

the debt of countries where FSN is constrained by
debt.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

RECOGNITION REPRESENTATION REDISTRIBUTION

v. Continue efforts to decrease subsidies on
agricultural production in high-income and
emerging countries, except those aiming to
enhance the nutritional or environmental qualities
of food production and to reduce inequalities, so as
to level the playing field for LMICs.

C. TACKLE SOCIAL AND POLITICAL DRIVERS OF INEQUALITY

7. States, intergovernmental organizations, the private sector and civil society should leverage SDG 10,
Reduce inequalities.

i. Ensure policies target the most marginalized

people and strive to remove barriers and not
impose burdens on the most vulnerable.

ii. Ensure that social policy pays specific attention

to women's role, time burdens and other existing
burdens in ensuring FSN, as well as care workers
and community health workers and envisages men
taking on a greater role in ensuring FSN.

iii. Create interministerial platforms on FSN to

enable the convergence of ministerial actions in
FSN policy, and charge and equip the platforms to
have a strong focus on reducing inequalities.

iv. Identify and manage conflicts of interest

between more powerful and less powerful groups
in food systems.

v. Strengthen inclusive spaces for dialogue,

participation and coordinated action at global,
national and local levels that centre on building
equity.

8. Based on a human rights approach, states and intergovernmental organizations should embed equity
principles into policy.

i. Identify policies and interventions that can

support individuals and groups to break out of
intergenerational food insecurity and malnutrition.

ii. Leverage existing human rights instruments to

strengthen equity-sensitivity of policies.

110 ] iii. Strengthen national institutions to understand

and apply human rights conventions to harmonize
policies relating to food systems, agriculture and
nutrition from an equity perspective.

iv. Make redressal mechanisms available to

marginalized communities when cases of
inequities are identified.

9. States, intergovernmental organizations and civil society should take into account the context of climate,
ecological, political and economic crises in all FSN-related actions.

i. Ensure adequate prioritization of populations

most affected by climate change, conflict and other
contemporary global crises in targeting policy and
allocating resources.

ii. Work across the humanitarian–development–

peace nexus to address the multiple drivers and
manifestations of FSN inequalities in fragile states.

iii. Explore the option of establishing a fund to

support transformation towards more equitable
food systems.
6 RECOMMENDATIONS

RECOGNITION REPRESENTATION REDISTRIBUTION

D. STRENGTHEN DATA AND KNOWLEDGE SYSTEMS TO ENABLE IMPROVED UNDERSTANDING AND

MONITORING OF EQUITY IN FSN-RELEVANT DOMAINS

i. Fill data gaps (particularly related to diets,

micronutrient status, food composition) by
systematically collecting information to identify
which groups have the poorest FSN outcomes and
food system opportunities in different contexts,
paying special attention to historically marginalized
groups, women and disadvantaged regions.

ii. Improve major routine public data collection and

analysis efforts and apply a more equity-sensitive
approach to reporting data in global reports.

iii. Integrate equity-sensitivity and incorporate

diverse knowledges in FSN research.

iv. Boost public agricultural and food systems

research with strong consideration for equity-
sensitivity of the research portfolio. Mainstream
gender, equity and intersectionality considerations
into all aspects of research. Ensure participants
retain the right to decide on participation in the
research.

v. Enable a richer understanding of the root

causes and systemic drivers of FSN inequalities
by encouraging and funding qualitative research
to capture the lived experiences of actors in food
systems.
Note: the three dimensions of equity interact and are interdependent. Actions therefore relate to multiple equity dimensions; the table highlights the primary areas to aid
decision makers in ensuring actions have a broad influence.

Source: Authors’ own elaboration.

[ 111

6.3 A ROADMAP TO EQUITY- FIGURE 13 provides a roadmap to equity-sensitive

policymaking, based on the framework presented
SENSITIVE POLICY TO in CHAPTER 1, particularly on the principles of
recognition, representation and redistribution
REDUCE INEQUALITIES that form the “engine of equity”. Although it is
While actions cannot be specified for each Member recommended that this be a government-led
State and need to be deeply aligned to context, effort, not all governments may be willing or
all policies across governments must be equity- able to undertake such a detailed approach. In
sensitive, considering redistribution, recognition these contexts, assessments may be conducted
and representation (across the board, including outside of government, for example by civil
policies affecting FSN) (Nisbett et al., 2022). This society organizations, as an important advocacy
requires a specific commitment to equity, which in tool for FSN change, or by intergovernmental
turn requires a whole-of-government process. organizations directly in support of government
capacity in this area.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

FIGURE 13:
ROADMAP TO EQUITY-SENSITIVE POLICYMAKING

RECOGNITION REPRESENTATION REDISTRIBUTION

Context: data and evidence of Ensuring genuine participation of Achieve fair distribution of
who, what, where and why excluded groups, policy benefits, costs, opportunities and
well-tailored to circumstances resources, via recognition and
•What are the key FSN issues and and accountability representation
what is their scope and
magnitude? •What capacities are available to •Prioritize improvements for the
create change and how do they most affected first, then reduce
•Who is affected? Which differ by social group? the gap between the most and
population groups are worst least disadvantaged, then across
affected? How are intersectional •Whose priorities have been the entire population.
differences identified? considered to date and whose
have been ignored? How does •Consider and monitor equity
•What are the drivers of FSN, understanding differ according to trade-offs and synergies between
particularly people’s daily living cultural values and different proposed policy, fiscal and other
conditions and distribution of forms of knowledge? changes.
resources such as land?
•Which groups might need •Monitor costs as well as benefits,
•How are these shaped by additional support to participate winners and losers to ensure a
assumptions and norms (such as fully (translation, disability just transition to sustainable,
patriarchy and intersectional requirements, financial equitable FSN and that those at
discrimination)? resources, etc.)? the bottom are never left worse
•What existing laws and off.
•How will the dynamics of relative
legislation govern these areas, power be managed between •Be aware that redistributive
including international human different stakeholders? policies (such as social
rights covenants and related protection) are not automatically
provisions in domestic law? •What other forms of social sensitive to recognition and
accountability, participation and representation. Consider who is
•What is the balance of power action research might support
between producers and involved in system design,
fully supported representation analysis and MEL, and who is
consumers, rural and urban outside of policy fora, including
dwellers? excluded and why?
for MEL?
•How are conflicts of interest •What learning has taken place
managed between FSN goals through this process and how
and private sector interests, can representation and
particularly with regard to participation be continually
healthy diets? improved?

112 ]
Notes: FSN: Food security and nutrition. MEL: Monitoring, evaluation and learning.
Source: Authors’ own elaboration.
6 RECOMMENDATIONS

Inequality in FSN outcomes is evident between reason for inaction: as this report demonstrates,
individuals, groups and countries across the world: there is a shared understanding and significant
this is clear in the data presented in this report, but evidence not only on the issues but also on the
also in the experiences and observations of those ways in which both the inequalities in food systems
most affected. Inequality – leaving some people
and the fundamental inequities driving these
behind – is slowing progress on achieving global
can be addressed. Taking the recommendations
goals and national policy promises. Inequality in
above – which address recognition, representation
FSN is an injustice and an infringement of human
and redistribution to tackle inequality and inequity
rights. Such inequality in outcomes is rooted in
inequitable systems – whether social, economic or in food systems– and contextualizing them for
political – that systematically limit the opportunities the different contexts is the next step towards a
of marginalized population groups to participate transformation in food systems and ensuring food
in or benefit from food systems. But this is not a security and good nutrition for all.

[ 113
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160 ]
ANNEXES
ANNEX 1 GLOSSARY
TABLE A1. CONCEPTS AND DEFINITIONS
CONCEPT DEFINITION EXAMPLE

Inequality Observed differences in Women compared to men, globally

measurable nutritional or and regionally, are more likely
food security outcomes or to experience food insecurity,
related food-systems factors especially during times of crisis
(e.g. land ownership) between (Broussard, 2019).
socially relevant groups (e.g.
socioeconomic status, race or
ethnicity, sex).
Inequity The reasons that systematic Differences noted between men
differences in food system and women in food insecurity
opportunities or the distribution can be partially explained by
of FSN outcomes exist, driven social norms limiting economic
by systemic structural issues opportunities available to women,
and practices of unfairness, or bias towards men in policy
injustice and exclusion that lead formulation (Gammage et al.,
to inequality in food systems and, 2017).
ultimately, in FSN.
Vertical inequality Vertical inequalities reflect the Uruguay, a high-income country,
differences in the distribution has the least hunger as measured
of a factor of interest between by the Global Hunger Index of
individuals or households or <5; while Yemen, a low-income
social groups with a common country, has a Global Hunger Index
identity (gender, religion, ethnicity, of 45.1. (Concern Worldwide and
etc.). For example, distributions Welthungerhilfe, 2022).
of wealth, income or social
outcomes including FSN. Vertical
inequalities are most frequently
assessed using the Gini Index. In
some circumstances, individuals
can progress “upwards” (hence
“vertical”) in the distribution of
resources that defines a vertical
inequality (e.g. an individual has
the possibility to become wealthier,
or a small farmer can improve
their land access). Ethnographic
studies and case studies can also [ 161
depict these inequalities.
Horizontal inequality Horizontal inequalities reflect In the United States of America,
differences between different the national prevalence of adult
groups based on social, ethnic, obesity is 41.9 percent, while it is
gender or other attributes, and 49 percent among non-Hispanic
can occur along economic, social, Black adults, 45.6 percent among
political and cultural dimensions Hispanic adults, 41.4 percent
(Stewart, 2015). Some definitions among non-Hispanic White adults
of horizontal inequalities describe and 16.1 percent among non-
them as differences between Hispanic Asian adults (Bryan et al.,
socially constructed groups, 2021).
such as those based on gender,
disability, caste, religion or sexual
orientation (Balakrishnan and
Heintz, 2015).
An important question in examining
horizontal inequalities is identifying
groups that are recognized as
being discriminated against as well
as those that are not as visible and,
thus, often not accounted for in the
data (e.g. subethnic groups).
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

CONCEPT DEFINITION EXAMPLE

Horizontal inequality (continued) Globally, we find women, the Another aspect is the interaction of
disabled and minority ethnic and horizontal inequalities with conflict
religious groups, among other and other disasters. For example,
minority groups, to be in the lowest horizontal inequalities between
extreme of a distribution and ethnic groups interact with climate
thus experiencing the greatest disasters and economic and
deprivation in terms of wealth, food political marginalization, as well as
security, etc. political instability. This situation
has been seen to fuel conflict in
countries (Østby, 2013).

Intergenerational inequality Intergenerational inequality occurs Women who are undernourished

when inequality is passed on during pregnancy are at higher
from one generation to the next. risk of giving birth to children who
Economists often describe this have either low birth weight or are
in terms of wealth transmitted stunted. Their children are then
from one generation to the next, more likely to have poorer cognitive
while sociologists often describe development and economic
it in terms of lack of mobility potential and to develop NCDs later
between socioeconomic brackets. in life (Prendergast and Humphrey,
Often this reflects the extent to 2014). Conversely, interventions to
which horizontal inequality is address malnutrition in early life
perpetuated over time and can have positive effects on schooling,
reflect the persistence of systemic work and earnings (Hoddinott,
inequality for certain groups and its Rosegrant and Torero, 2012).
cumulative nature.
For many Indigenous Peoples,
preserving good kinships – with
all human beings and with non-
humans (sea, mountains, rivers,
etc.), as well as interconnectedness
to the natural environment, is
fundamental to a well-functioning
society and this understanding is
passed on from one generation to
the next. This Indigenous worldview
is akin to intergenerational
justice (Watene, 2016; Whyte,
2021) but one that is not widely
acknowledged in considering
different knowledges.
162 ]
Intersectional inequality Intersectional inequalities occur Different axes of social power,
when interrelated and mutually such as gender, economic class,
shaping categories that describe ethnicity and caste often operate
groups who are marginalized (race, simultaneously and mutually
gender, ethnic minorities) interact reinforce each other. In India,
with one another to further shape researchers examined how caste,
experiences of power asymmetries wealth and gender interacted to
and health and nutrition form stunting outcomes, finding
inequalities (Kozlowski et al., 2022). groups worse off in all three
dimensions (economic status,
caste status and gender) have
worse stunting outcomes than the
best-off groups (non-poor, non-SC/
ST boys) (Mukhopadhyay, 2015).
ANNEXES

CONCEPT DEFINITION EXAMPLE

Intersectional inequality Intersectional inequalities reflect Different forms of discrimination

(continued) a compounding of multiple against Indigenous Peoples
inequalities that interact to intersect with sexism, contributing
intensify deprivation. Intersectional to the deepening of the injustice
inequality further reflects the against Indigenous women,
cumulative nature of inequality rendering them more vulnerable
as applied to the group, rather to food insecurity and limited
than to the individual, and leads to sovereignty over access to land
an asymmetry in certain groups’ ownership and in growing,
capabilities to achieve optimal producing and preparing culturally
nutritional well-being and food relevant foods (Lemke and
security. Delormier, 2018).

INEQUITY IS AVOIDABLE AND EXISTS WHEN INJUSTICE, UNFAIRNESS AND BIAS ARE PERPETUATED.

Injustice Injustice reflects a lack of Systemic discrimination against

fairness and, in the context of Indigenous communities whose
FSN, social injustice is defined as lands and rights to land ownership
discrimination against individuals have systematically been
and groups because of social taken away from them, despite
norms and cultural values which being stewards of those lands,
consider them unequal, unwanted represents social injustice. These
or stigmatized, thus disallowing injustices are perpetuated when
them from attaining a minimum not addressed by policy or societal
level of food security or nutrition or action.
the opportunity to assure their food
security and nutritional well-being
(Nisbett et al., 2022).
Unfairness Policy and societal inaction can A smallholder woman farmer who
lead to systemic biases in systems, belongs to a low-caste group will
leading to certain groups of people experience multiple forms of bias
receiving unequal and unfair and unfairness and therefore face
treatment. This unfair treatment substantial difficulty in accessing
can have a multifold effect when resources due to her social
certain groups experience multiple position.
biases because of their intersecting
social positioning.
Bias Bias is discrimination for, or Discrimination against certain
against, a person or group, or a racial groups that, over time, has
set of ideas or beliefs, in a way excluded them from the workplace, [ 163
that is prejudicial or unfair. Bias from accumulating wealth and thus
can be implicit, in that people increasing their risk of being food
do not realize they hold these insecure from one generation to
discriminatory ideas/beliefs, the next.
or explicit where people openly
express their discriminatory
viewpoints.

DIFFERENT FORMS OF INJUSTICE AND UNFAIRNESS THAT PERPETUATE INEQUITY ARE:

Exclusion A state of disadvantage – lacking The urban poor who lack access to
access to resources as well as stable, formal housing and food.
access to and the ability for social
and political participation – that is
experienced by groups of people
who exist (or are forced to exist)
at the periphery of mainstream
society.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

CONCEPT DEFINITION EXAMPLE

Marginalization The process by which certain Racial minority groups (for

members of society are pushed example, African Americans) have
(Also called social exclusion in to the periphery owing to systematically, through repeated
some literature) their “identities, associations, policy and social action, been
experiences and environment” marginalized and excluded from
(Hall, Stevens and Meleis, 1994), access to multiple mainstream
creating barriers to their active resources and social participation
participation in the society in (e.g. voting rights, access to land,
which they reside. Implicit to the economic opportunities, healthcare
boundary creation and the pushing access).
of groups towards and beyond
these margins is the exertion of Another example of marginalization
power and dominance by certain is the exclusion of vulnerable
groups over others, reducing their populations from policy formulation
agency. regarding issues that most affect
them, as seen in climate resilience
Much nutrition research agriculture innovation policies that
concerns itself with aspects of do not take into consideration the
marginalization, such as the needs of smallholder farmers,
disempowerment of women or especially those located in low-
disparities in income. But other income countries.
axes of marginalization, such as
age, ethnicity, disability, sexual
orientation and geographic
location, receive much less
attention in nutrition or
agriculture/nutrition literature,
when examining who across
these groups have differential
FSN outcomes. Furthermore,
the interactions between these
different aspects of marginalization
are also rarely addressed. The
structural determinants of
marginalization - inequitable
access to basic services, resources
and political redressal, as well as
power relations and social norms
– are also underexplored (Harris et
al., 2019b). Economic perspectives
of marginalization focus largely on
economic structures, in particular
on the structure of markets and
their integration. The economy is
structured in such a way that some
164 ] groups of people or individuals are
segmented from it and are not able
to participate in market activities
(Kanbur, 2008).

Discrimination Differential treatment of persons Discriminatory laws and (lack

or groups of people linked of) policies prevent women from
to the possession of certain earning the same income as their
characteristics unjustly identified male counterparts.
as warranting differential
treatment. Examples of these
characteristics may be physical
(e.g. weight, sex), identity (e.g.
ethnicity, gender), and age- or
disability-related characteristics.
ANNEXES

CONCEPT DEFINITION EXAMPLE

Discrimination (continued) This differential treatment impedes

the ability of certain people to
realize their human or other rights
and can be further perpetuated
and supported by law and policy
leading to further inequality. It can
be noted, for instance, that some
people with similar economic
characteristics experience
different economic outcomes
because of their race, sex or other
non-economic characteristics
(University of Minnesota, 2016).

SYSTEMATIC DISCRIMINATION AND MARGINALIZATION IS ENABLED THROUGH SYSTEMS OF BELIEFS, PRACTICES AND
VALUES EMBEDDED IN VARIOUS SPHERES OF SOCIETY, INCLUDING ECONOMIC, SOCIAL AND POLITICAL SPHERES.
THESE SYSTEMS INCLUDE:

Patriarchy “Patriarchy centres power in Male-centric and dominated

the hands of men and is based decision-making roles within
on assumptions of gendered households as regards income
roles and heterosexual norms in expenditure on household and
micro- (family, kin) and macro- non-household items, agricultural
(community, political) settings, sex, inputs, etc.
reproduction and caring, sexuality,
access to knowledge, education,
livelihoods, freedom of movement
and expression” (Nisbett et al.,
2022). It is a system of social
structures and practices in which
men dominate, oppress and exploit
women (Walby, 1989). Patriarchal
structures have driven present day
agricultural practice and system
implementation through women’s
labour being expropriated by their
husbands. Patriarchal relations
within waged labour involve the
exclusion of women from paid work
or the segregation of women from
it. Concepts of public patriarchy
(not excluding women from spaces
but instead subordinating them) [ 165
and private patriarchy (relative
exclusion of women from arenas of
social life apart from the household
and the private sphere) (Walby,
1989) also exist.
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

CONCEPT DEFINITION EXAMPLE

Racism Racism assigns values and social Within food systems, this can be
and economic opportunities based seen in concentration of power in
on assumptions related to race, the hands of a privileged minority
ethnicity, caste, variations in skin (usually based on race) and passing
colour and assumed hereditary on the social and environmental
characteristics (Nisbett et al., “externalities” disproportionately to
2022). Structural racism includes racially stigmatized groups.
policy and practices that unfairly
disadvantage and minoritize certain
groups, for instance through
zoning and mortgage policies in
segregated neighbourhoods. Within
public health/nutrition research,
which informs policy, it has been
argued that examining purely
differences in outcomes based
on racial groupings by treating
race as a biological construct and
a determinant of malnutrition
outcomes while not considering
other social variables, offer limited
reliability and validity of findings
and perpetuates racist constructs
(Duggan et al., 2020). Such
arguments contribute to the need
to recognize the broader structural
conditions that drive racism and, as
such, drive inequalities in FSN.
Colonialism The dominance of a foreign group Traditional food systems in most
of people upon the people an area, countries in the Global South,
country or region. Dominance as well as those of Indigenous
is exerted by way of ideological, communities and societies in the
economic, territorial, linguistic, Western hemisphere, were wiped
cultural and political (unjustified) out and replaced by mechanized
subjugation of one group unto monoculture, leading to a shift
another while also exploiting the away from traditional diets to diets
subjugated group’s resources, high in sodium, fat and processed
culture, identity and so forth, foods.
for the colonizers’ benefit (Duke
Decolonizing Global Health Student The colonized are stripped of the
Working Group, 2019; Horvath, freedom to make independent
1972; Ma Rhea, 2016). economic decisions, and the
development of agriculture and
Economists describe colonialism the utilization of the country’s
166 ] as a historical phenomenon of natural resources, as well as its
territorial expansion, intimately industrial and tariff policies and
connected with the rise and growth trade relations are determined by
of the modern capitalist world the ruling country.
system. It involves processes
of control of supplies of raw
materials, mineral resources
and markets in underdeveloped
and precapitalist regions that are
subjected to the political, social,
economic, intellectual ideologies of
the colonizers.

Ableism Discrimination and exclusion of Inaccessibility of food

people with disabilities, considering environments, which includes
them inferior and not as capable as transportation and access gaps for
people without disabilities (Swenor, people with physical disabilities.
2021). This includes discrimination
at the individual, interpersonal and
structural levels against people
with disabilities or those presumed
to be disabled.
ANNEXES

CONCEPT DEFINITION EXAMPLE

Power asymmetries Power asymmetries reflect Lobbies of the ultra-processed

differentials in power between food (UPF) industry have worked
different actors in food and collectively to influence policies
social systems. These power on non-communicable diseases
asymmetries are governed by the globally and undermine WHO
interests of certain actors who guidance on UPFs and processed
exercise influence at different foods.
levels and across different sectors
of society – from multinational
trade negotiations to national
policy processes to local social
structures – rendering certain
voices louder than others and
rendering the interests of certain
groups to be more actualized.

POSITIVE FORCES TO ADDRESS INEQUALITY AND INEQUITY:

Agency Agency has been defined in previous HLPE reports as “what a person is
free to do and achieve in pursuit of whatever goals or values he or she
regards as important.” (Sen, 1985), p. 203). Empowerment is an important
aspect of agency, such that people have the ability to participate and
engage in society and contribute to shaping and bettering their own lives
and well-being (Alsop and Heinsohn, 2005).
Empowerment “One way of thinking about power is in terms of the ability to make
choices. To be disempowered means to be denied a choice, while
empowerment refers to the processes by which those who have been
denied the ability to make choices acquire such an ability. In other words,
empowerment entails change… There must be alternatives - the ability to
have chosen differently… Alternatives must not only exist; they must also
be seen to exist.” (Kabeer, 2005, p.13-14). The concept of empowerment
can be explored through three closely interrelated dimensions: agency,
resources, and achievements (Kabeer, 2005).
Source: Authors’ own elaboration.

[ 167
 REDUCING INEQUALITIES FOR FOOD SECURITY AND NUTRITION

ANNEX 2 DEFINITION OF FSN-RELATED SDG 2 INDICATORS

TABLE A2. DEFINITION OF SDG 2 INDICATORS UTILIZED IN CHAPTER 2 TO DEPICT FSN

INDICATOR DEFINITION LEVEL LEVEL OF INFERENCE

Prevalence of % of population with National Between regions and

undernourishment (PoU) inadequate dietary countries
energy intake. Based
(Also referred on country-level data Household
to as chronic on food availability, food
undernourishment and consumption and energy
hunger) needs

(Measured using data on

dietary energy supply and
food balance sheets.)

Prevalence of moderate % of country’s population Household Between and within

or severe food insecurity facing difficulties in regions and countries
accessing enough safe and
(Measured by the Food nutritious food for normal
Insecurity Experience growth and development
Scale [FIES] survey and an active and healthy
module.) life

Prevalence of moderate % of population that Household Within countries

or severe food insecurity worries about access
to enough food for their
(Measured by the household. Based on direct
Household Food interviews of individuals
Insecurity Access Scale using the HFIAS
[HFIAS] questionnaire.)

People unable to afford a % of people for whom National Between and within
healthy diet* the cost – based on least regions and countries
expensive local foods –
(Expressed as the of a healthy diet [a diet
weighted percentage that meets local dietary
168 ] [%] and the total guidelines] exceeds a
threshold proportion of
number [millions] of the
population in each region their income
and country income
group who could not
afford a healthy diet in
2020.)
(Herforth et al., 2020;
Manore, 2005)

Prevalence of anaemia % of pregnant women Individual Between and within

among women whose haemoglobin level regions and countries
is less than 110 grams
(Measured using venous per litre at sea level or 2%
or capillary blood of non-pregnant women
samples.) whose haemoglobin level
is less than 120 grams per
litre at sea level
ANNEXES

INDICATOR DEFINITION LEVEL LEVEL OF INFERENCE

Adult obesity prevalence % of adults with body mass Individual Between and within
index greater than regions and countries
(Measured using 30 kg/m2
anthropometric
measures.)

Under-5 child stunting % of children under 5 years Individual Between and within
prevalence of age with height for age regions and countries
more than 2 standard
(Measured using deviations below the
anthropometric benchmark
measures.)

Under-5 child wasting % of children under Individual Between and within

prevalence 5 years of age with weight regions and countries
for height more than
(Measured using 2 standard deviations
anthropometric below the benchmark
measures.)

Under-5 child overweight % of children under 5 with Individual Between and within
prevalence weight for height more regions and countries
than 2 standard deviations
(Measured using above the benchmark
anthropometric
measures.)

Sources: FAO. 2022. The State of Food and Agriculture 2022. Leveraging automation in agriculture for transforming agrifood systems. Rome, FAO; Herforth, A., Bai, Y., Venkat, A.,
Mahrt, K., Ebel, A. and Masters, W.A. 2020. Cost and affordability of healthy diets across and within countries: Background paper for The State of Food Security and Nutrition in
the World 2020. FAO Agricultural Development Economics Technical Study No. 9. FAO Agricultural Development Economics Technical Studies 9. Rome, Italy, FAO.

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 SÉCURITÉ ALIMENTAIRE ET NUTRITION: ÉNONCÉ D’UNE VISION GLOBALE À L’HORIZON 2030

Inequalities in food security and nutrition (FSN), between countries and regions
and within countries, communities and households, exist throughout the world,
exacerbating already alarming conditions of hunger and malnutrition.

This report provides a conceptual framework for assessing inequalities in

FSN, the inequalities within and outside food systems that underpin them, and
the systemic drivers of such inequalities. The report highlights the ethical,
socioeconomic, legal and practical imperatives for addressing these inequalities.
It emphasizes that food is a fundamental human right and that inequalities in
FSN undermine this right, as well as social and political stability. In addition, by
applying an intersectional understanding of inequalities – that is, considering the
cumulative effects of multiple interacting inequalities on marginalized peoples –
the report contributes to a more inclusive understanding and sustainable action
to reduce FSN inequalities.

The report proposes a set of measures to reduce inequalities, both within and
beyond food systems. It emphasizes the need for a transformative agenda, aiming
for structural change towards equity. By providing actionable recommendations
addressing the systemic drivers of FSN and advocating for actions in favour of
i]
equity and equality, the report contributes to global efforts towards achieving
food security and improving overall well-being, leaving no one behind.

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