Q&A Session with Dr David Nabarro, Special Envoy of WHO Director General on COVID-19, Co-Director of Institute of Global Health Innovation and Strategic Director of 4SD – Skills, Systems & Synergies for Sustainable Development

In the achievement of global nutrition security, how is COVID-19 affecting this process?

The continuing spread of the virus in different societies threatens the lives and well-being of many millions of people throughout the world.  Efforts to contain the virus impact on the livelihoods of millions more who are required to restrict their movements.  This leads to major livelihood challenges especially for those on low incomes or in the informal economy because their ability to earn incomes is reduced and the result of restrictions imposed earlier this year has been a rapid increase in the numbers of people in our world with income poverty.  Hundreds of millions of people have lost income and are struggling to make ends meet.  Because the purchasing power of poor people has reduced, their ability to purchase nutritious food for themselves and their families has been restricted.  Men, women and children are missing out on nutrition as a result of COVID-19.  This has had implications for children, reducing their ability to grow well and avoid malnutrition especially in the early years of life.

Local authorities and national governments appreciate the need to ensure that cash and nutritious food are available to poorer people, where they live.  Many governments have expanded the income support provided for poorer people and increased children’s access to nutritious food during this period.  The need to increase access to income support has put pressure on local and national budgets.  It has led countries to seek additional support from international sources including the International Monetary Fund, the World Bank and development partners.

This experience suggests that strategies to contain COVID-19 must prioritize the nutrition of children in every nation to avoid a massive increase in the numbers of children facing immediate risks and long-term harm as a result of poor nutrition in early childhood.  Those who are malnourished are 5 times more likely to die from diarrhoea and other diseases, perform less well in school when adolescent, and more likely to be poor, and susceptible to non-communicable diseases (including type 2 diabetes), when adult.

As COVID continues to threaten communities everywhere, leaders are being called on to react to people’s needs with resolute and rapid responses.  They are asked to anticipate the longer-term nutritional, educational and health consequences of the current situation – for children and women everywhere – in ways that are fully accountable to them.   No-one should be left behind!

What are the appropriate policy responses in relation to the links between COVID19 and food systems?

Food systems will be particularly affected by COVID in the coming years and will need support to reduce the impact.  Here are some key elements of policy responses:

Focus on the poor:  A 10% GDP contraction means an extra 180 million people could be plunged into poverty—85% of them living in Africa south of the Sahara and South Asia.  As many as 150 million will be hungry.  Governments need to do all they can to ensure food and income support for the vulnerable.

Prevent hunger:  Deliver school feeding outside of school.  Distribute food without congregation at delivery points.  Set up cash transfers for those below the poverty line.  Provide relief to those who have lost their income.  Prioritize the needs of those in essential roles (including in health and food systems).  Focus on sufficient nutritious food for all and prioritize women and children.

Promote nutrition: Focus on pregnant women and children under five, promote breastfeeding, provide vitamin and mineral supplements, sustain mother and child health care, treat malnutrition and diarrhoea, leave no-one behind.

Support farmers and food system workers:  Reach smallholder farmers, help them access essential inputs (e.g. seeds and fertilizers), offer bridging credit and working capital, ensure food system workers are protected, paid and can access food, link bigger food businesses to smaller ones to offer support, improve famer and small food business access to intervention funds.

Invest in civil society: Call on civil society to ensure those most in need receive vital assistance, ensure they can access finance from national governments and the international community.

Prioritize food supply:  Check prices and availability of staple and non-staple foods; monitor perishables like vegetables, fruits, pulses, dairy, eggs, fish and meat (these nutrient-rich foods are scarce due to reduced demand and an inability to move them around); ensure food can get from farm to market and that storage facilities are maintained to avoid food loss; get emergency finance to small and medium enterprises to prevent them from collapse (they are the backbone of food systems everywhere).

With a view to transforming the Food Systems towards global sustainability, including respecting the planet, achieving social security and reaching decent levels of economic viability for all, how can we overcome the challenges of COVID-19 to achieve this overall objective?

As communities, territories and nations explore how to adapt their food systems to the full spectrum of the Sustainable Development Goals, they focus on the decisions that will contribute to sustainable food systems.  The vision for the future is one where all involved in food systems have resilient livelihoods that are compatible with the changing climate.  There are many components to resilience: they are likely to include short supply chains that link food producers directly to consumers while offering affordable access to safe, nutritious and healthy foods.  This will require both creativity and audacity, drawing on indigenous knowledge and the experience of practitioners, ensuring that innovations bring tangible benefits to those who have the greatest needs.

Governments are strengthening their systems for support to food systems stakeholders whose livelihoods are threatened.  Farmer organizations, labour unions and local civil society groups play vital roles in supporting those most in need through integrated local responses.  Many governments face constant difficulties with mobilizing the funds needed to scale up support in line with need.

There are dense interconnections between safeguarding people’s health and sustaining functioning food systems.  Defences against the COVID-19 virus require that populations are engaged, that scientific evidence is heeded and that public health systems work effectively in all local communities.  As all communities come to terms with the threats posed by the virus, systems that ensure people’s access to food and nutrition must be resilient enough to respond to changing needs, especially when their income drops because movements are limited in the effort to contain the virus.  Action taken now has important implications for the longer-term viability of farmer livelihoods, people’s food security and food systems everywhere.

Farmers and rural populations are facing the climate change challenge, which they have been mitigating and adapting to for years. How to encourage climate action? 

Climate action depends on concerted efforts by national governments: governments will take action nationally and make international commitments to do so if they have substantial support from their electorates.  This means that for humanity to find pathways through the current global challenges, there is an absolute need to build a strong coalition of domestic support for climate action.  That means nurturing local solidarity with coordinated, networked action.

According to your views, what would be the role of multi-stakeholder partnerships at local, national and international levels to cope with the new normal created by COVID-19?

The reality is that the virus is a common foe: it is here to stay, and we all have roles to play in keeping it at bay.

We need every national leader working together on it and treating it with the attention it deserves. At a local level, this means, integrating local authorities, health services, residential care, businesses, religious groups, community organizations and local leaders so that they are ready to respond together as spikes in case numbers start to appear.

At a national level, this means ensuring that national authorities support the efforts of these integrated local groups.

Internationally this means strong cooperation and unified action by nations is essential – on everything from travel protocols to the development of new testing, treatment and preventive options like vaccines.  The WHO, which is a product of the cooperation between nations, is a vital source of guidance and support.

The COVID-19 crisis is not just a public health crisis; it’s also an economic, social and political crisis. It is a “complex systems” problem that requires changes in behaviours and incentives and the relationships between different groups and organizations. Effective responses, therefore, need to build on collaboration across different sectors, industries and professionals and between international, national and local levels — an ambition that has often proved difficult to put into practice.

Collective action in this regard might be in the form of coordination (e.g. among businesses), partnerships among different interest groups (e.g. businesses and communities), or dialogue across a range of stakeholders. Adaptive leadership has a crucial role to play in helping to identify the shared alignment of objectives and scope for collective action across different silos and levels of the response. Such interactions enrich the debate, are inclusive, and improve ownership of decisions.

We live in a complex, interconnected global system. #SystemsThinking offers a way of seeing a reality that recognises the interrelatedness of things. This is crucial to deliver on the ambitious 2030 Agenda.

Is there any encouraging message that you would like to share with the farmers of the world that are taking care of global food security, planet, prosperity and also facing the burden of the COVID 19 pandemic?

The 2030 Agenda and the future of our planet and its people depend on well-functioning food Systems everywhere. And Food systems are about people and the planet.

Now, more than ever is a time for sharing experiences and learning from one another, and we learn it as we’re going on. Farmers are the bedrock of society and will need support – crucial to nutritional and food security for all.



Dr David Nabarro is the Co-Director of the Institute of Global Health Innovation at Imperial College London and supports systems leadership for sustainable development through his Switzerland based social enterprise 4SD. From January 2020, David has worked as Special Envoy of WHO Director General on COVID-19.
David secured his medical qualification in 1974, spent five years working as a community-based physician (mainly in South Asia) and since then has had assignments in over 50 countries. He has worked in communities and hospitals, governments, civil society, universities, and United Nations programs. David was head of Health and Population and director for Human Development in the UK Government Department for International Development in the 1990s. From 1999 to 2017 he held leadership roles in the UN system: he worked on disease outbreaks and health issues, food insecurity and nutrition, climate change and sustainable development. In October 2018, David received the World Food Prize together with Lawrence Haddad for their leadership in raising the profile and building coalitions for action for better nutrition across the Sustainable Development Goals.