In this episode of the McKinsey Global Institute’s Forward Thinking podcast, Janet Bush talks with Jessica Fanzo. Fanzo is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies at Johns Hopkins University in the United States. From 2017 to 2019, Fanzo served as the co-chair of the Global Nutrition Report and the UN High Level Panel of Experts on Food Security and Nutrition. She was the first laureate of the Carasso Foundation’s Premio Daniel Carasso prize in 2012 for her research on sustainable food and diets for long-term human health.
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Podcast transcript
Janet Bush (co-host): Michael, our guest on the podcast today has calculated that about 3.1 billion people cannot afford what can be considered a healthy diet. Does that figure shock you?
Michael Chui (co-host): It does. That really is shocking. You know, we live in a world in which inequality between countries has been falling, and yet so many people are either too poor to have a nutritious diet or just do not have access to healthy food. Add to that the impact of climate change on agriculture, and it is a huge concern.
Janet Bush: And of course the number of people who cannot eat a healthy diet is only going to rise because of disruption to wheat supplies from Ukraine and Russia and fertilizers from Belarus. War in Europe adds another very sobering layer to the challenge.
Michael Chui: Food security is such an important issue, and despite the challenges, I really want to learn more about it. Looking forward to hearing more.
Janet Bush: Welcome, Jess, to the podcast.
Jessica Fanzo: Thanks for having me, Janet. It’s good to be here.
Janet Bush: I’d like to start by asking about you. Where did you grow up, where did you study, and how did you come to specialize in food and food systems?
Jessica Fanzo: I grew up in the United States, on the East Coast. Quite close to New York City in New Jersey. Often has a bad reputation, but lovely New Jersey.
I did most of my studying at the University of Arizona in Tucson. I did an undergraduate in agriculture, and master’s and PhD in nutrition. And just serendipitously came to working more on links between food and climate after years of doing bench science and then moving much more towards international development.
I think it’s hard to ignore the work of food systems and climate and their linkages with the way the world is moving right now. So I think everyone’s sort of paying attention to these topics. But yeah, my background is a strange path to getting to where I am now.
Janet Bush: How did you come to study agriculture?
Jessica Fanzo: I really wanted to be a nutritionist. I was really interested in what we eat and why it’s important for human health. And one way to do that was by understanding how we grow food, how food is processed, food technology, and how our bodies interpret all of that when we consume food.
That was sort of a natural fit for me. But at the time, when I was doing my undergrad, which I started in 1989 and finished in ’93, nutrition, food was not really popular then. And now, you go on Instagram and food is everywhere and people brag about it and there’s lots of gourmands around the world. But at the time it was not a popular topic. It was a pretty geeky thing to work on.
Janet Bush: But you don’t come from a farming family or a foodie family.
Jessica Fanzo: No. No. Well, Italian Americans are inherently foodies in the kind of foods we love to consume. But no, no farming background. A city family.
Janet Bush: You’ve had 20 years of experience, researching, working in the field of food sustainability, health, and access. And obviously, food is a staple. It’s everywhere. Without it we don’t live. But draw out the importance of those different interlinked aspects.
Jessica Fanzo: It’s one thing to say that food is important for survival and we need it for our human health. But so much happens before food comes to the plate and before we’re able to share a meal with each other. The global food system is so big and broad.
Different kinds of food are grown around the world. It’s grown in different ways under different climatic conditions with different people. And then it moves through this whole chain of events, of being processed and packaged and stored.
The nutritional quality of those foods can really change. The safety of those foods can change. The whole texture and taste of these foods can change. While food is of course important for our everyday needs, there’s so much other stuff wrapped into food: livelihoods, culture, traditions, economics, politics. And that’s what makes food such an interesting space to work in, but one that’s so contentious and filled with so much fraught controversy and disagreement.
Janet Bush: You worked on the ground in sub-Saharan Africa, Asia, and obviously in the United States. Give us a sense of what you were doing and what you discovered.
Jessica Fanzo: Most of my work, where I started to really look outside of nutrition and look at the links between agriculture and the environment and diets, was in sub-Saharan Africa. And that was really working with smallholder farmers, many of them women, on diversifying what they grow beyond just staple crops like maize or rice. And trying to ensure that what’s grown on farms is nutritionally diverse, climate diverse, and how do we do that in a way that isn’t putting more time burden and work in the hands of women.
A lot of the work that I was doing early on in Africa, and really my 101 into agriculture, was in Africa, was really trying to understand how we can sensitize or reorient agriculture towards one that’s better for nutrition. And so a lot of my work in Africa was doing that. Mainly East Africa. Kenya, Ethiopia.
In Asia, I was doing a lot more work of looking at how rural people are leaving rural places and moving towards urban areas, and what does that mean for their livelihoods? What does that mean for their diets? How do their diets change? And what are some of the pressures that are on families that are moving away from rural areas to more urbanized places? So that was a lot of Asia. Of course Asia’s becoming very urban, and it’s a very dense, crowded continent. Really understanding how places influence diets and where people are migrating to and from.
Janet Bush: Going back to Africa, what was the main worry or piece of progress that you saw while you were there? Where did you see the way forward?
Jessica Fanzo: My first time in Africa was in the early 2000s. This is when HIV/AIDS was just wreaking havoc. And it wasn’t just HIV/AIDS. It was these triple burdens of infectious disease, of HIV, multi-drug-resistant TB, and malaria.
It was just decimating communities. Looking through that lens was trying to understand how food can be a vehicle to improve health, protect households, ensure that they’re resilient to stave off further infection and the impacts of having infectious diseases.
What was so startling to me, the first time I was in very deeply rural areas, was just the incredible poverty that these households face. We know the story now, but unfortunately the story still exists. No water, no electricity, very far from roads. Sometimes, during seasonal rains, completely cut off from those roads. And not having enough food to feed your family throughout the year.
And that is still happening and, in a lot of places, getting worse. Because of climate change, because of conflict, because of the pandemic. And so to even be having that conversation of, “Wow, I was really surprised back in the 2000s,” someone 20 years ago, before that, working in international development would have said the same thing as someone who went yesterday and said the same thing. Why do we still have this extreme poverty in the world?
To me, food was one of the opportunities to try to at least alleviate some of that poverty burden. No one should go to bed hungry; no one should only be eating rice every day. It was kind of questions around how food could be a place and a way to uplift people, get them out of those poverty traps.
Janet Bush: It’s interesting that we’ve just completed an update on globalization. But global connections. And one of our findings is that the Middle East and North Africa—not sub-Saharan Africa, but I’m sure it’s very similar—relies on imports for 60 percent of the grain they need to feed their people. And that includes wheat.
Obviously that largely comes from Ukraine and Russia, which brings us to what the World Food Programme’s executive director called “the perfect storm.” We’ve had this lack of progress, we’ve got climate change, and now we’ve got a disruption to supplies on which a continent like Africa is incredibly dependent on very few countries for the things that they need to eat. Do you share that assessment that we are now hitting the perfect storm on food?
Jessica Fanzo: I do share that, because I think if we had optimal world order and incredible multilateral cooperation and coordination, it wouldn’t be a problem to be a country that’s importing a lot of their food. But we don’t have that. And it doesn’t look like we’re going to have that in the near future, with the way COVID played out and vaccine sharing, etcetera.
I’m deeply worried for a few reasons. One is, what this shows is how fragile the global food system is. You’ve got two big breadbasket countries that are producing a handful of crops, and look what it’s done to not only food prices but food inflation. Countries that are reliant on wheat, for example, or safflower oil have been hit so hard by this. That should never have happened if we had a resilient food system and a diverse food system.
The second thing I think is really concerning about this whole conflict is that Russia and Belarus produce a lot of fertilizers. While the trading of wheat and safflower oil is a short-term crisis, the shortage of fertilizers and the prices of energy and fertilizers are going to hit multiple seasons, multiple harvests, because fertilizer is becoming incredibly expensive for farmers, so they’re either not buying it or they’re changing what they buy or what they decide to seed and what they decide to grow, or less of it. So we’re going to see an impact longer term on this whole fertilizer crisis around the world, across a lot of different crops, not just wheat and a handful of other crops.
That’s a deeper worry that I think we don’t have a really short-term solution for, because there’s not that many places in the world where we can produce nitrogen-based fertilizers and potash and other components that go into chemical fertilizers.
Janet Bush: On wheat and grains, why did we arrive at a global system which was so imbalanced? Leaving some continents so dependent on very few producers? A huge proportion of the world’s soybeans come from two countries, Brazil and the United States. Why?
We need to think about diversifying and moving away from just maize, rice, and wheat being almost 50 percent of the world’s calories consumed.
Jessica Fanzo: Such a great question. I think there’s several reasons. After World War II, we, particularly in [the] United States, and the policies of the United States, wanted to ensure that the surpluses of our grains were going somewhere. A lot of that being maize and wheat, and we were shipping it all over the world.
But there was a whole technology revolution called the green revolution, which focused on producing a handful of crops, particularly rice and wheat and some maize, in Latin America and Asia to try to stave off some of these massive famines that the world was seeing, in which we saw a significant number of people die.
And it did that. It produced varieties of these stable grains, high-yielding. They were able to be resistant to certain diseases. They were shorter; the wheat was grown shorter so it was wind-tolerant. And this revolutionized the way we could grow food in these monoculture systems. The idea back then in the agriculture global architecture was that if we produce enough calories to feed the world, that’s good enough.
Well, it was. It did feed the world. There’s enough calories to go around in aggregate now, but it’s not the right kinds of foods. There’s environmental consequences to growing these monoculture systems. There’s equity and gender issues around these crops. So it’s become problematic. But it is one that has been very hard to break that paradigm in agriculture that we need to produce a lot of calories. People want to eat bread, they want to eat rice, they want to eat corn. True. But people also want to eat animal source foods, they want to eat fruits and veg, they want to eat lots of things.
We need to think about diversifying and moving away from just maize, rice, and wheat being almost 50 percent of the world’s calories consumed. It’s really sort of crazy that we’ve put ourselves in such a precarious risk from—you know, you diversify your retirement portfolio. Why did we decide not to diversify our agriculture system?
Janet Bush: And I think that crops like wheat are still very heavily subsidized.
Jessica Fanzo: Very.
Janet Bush: So the financing has to change. The whole approach needs to change.
Jessica Fanzo: The agriculture subsidy policies, if you look at the United States, for example—very hard to reorient. Break it up, reorient it, change what’s invested in, who gets the money. Because a lot of times, big ag gets those subsidies.
But the most diverse systems in the world are the small farmers. The smallholders. How do we completely shift the whole subsidy story to something different? It’s going to take a significant transformation and changing of governance and policy in the agriculture sector.
Janet Bush: Do you think that the crisis in Ukraine and Russia, which obviously has this wheat and grain and fertilizer dimension to it—do you think that that is going to trigger a genuine drive towards diversification, which leaves us with a better food system?
Jessica Fanzo: I want to say yes, but I’m going to say no. Because we’ve seen this happen before. The 2007–2008 food price crisis, there were some governance structures put into place, but really nothing changed much. That was a shift towards biofuels.
Really nothing changed on a profound level in the food system. There’s a little bit more oversight, but overall there’s been really—stay the course. We’re seeing that in the climate change agenda, as well. There’s not big shifts, there’s not big enough behavior change. It’s a little bit of kind of the tinkering on the edges.
So we can all keep fighting and pushing for diversify, diversify, diversify, change away, move away from chemical fertilizers towards more bioproduced fertilizers. But we need to see profound changes by government and the private sector to do that. Because people’s diets will shift. People shift. As people’s income grows, not only do they diversify in what they buy, not just food, they buy other things. But their food basket diversifies. People start eating other things.
This idea that people will always want rice, maize, and wheat is just not true. We’ve seen it happen where people really want to try different things when they have more disposable income. So this idea that we’re just giving people what they want is a poor excuse.
Janet Bush: It’s interesting—in another podcast I did, with the British representative to COP, who’s now working with businesses on net zero and sustainability, she made the point that governments have not been effective on climate change. And that the impetus will come from business.
In your book, Can Fixing Dinner Fix the Planet?, you talk about the way we eat. And you’ve suggested that it’s actually individuals who may be the trigger for change. But it has to be on a large scale. Do you see hope that consumers will make the difference in terms of food and the climate?
Jessica Fanzo: I think it’s going to have to come from all levels. I think it will have to—governments have to start governing their food systems. If that means regulating or helping people, guide them to better choices and ensuring that those choices are healthy and affordable and culturally appropriate, governments have to do that, and private sector absolutely have to come to the table and make serious change.
But demand can spur government action. Demand can spur the private sector. If there’s a market for something, the private sector will definitely fill that market demand. So I think sometimes it’s difficult for people to see their place and their power and for eaters to find their place. You know, “What does it matter what my food choices are?” But collectively it can be quite powerful.
But we also need governments and food and beverage industries to help people ensure that food is affordable, ensure that healthy food is available, and that they’re not always just being exposed to ultra-processed, unhealthy foods that are cheap and convenient.
I believe that private sector has the ability, the technology to really change the game on food and ensure that there’s a lot of food products that are healthier out there. And start changing the whole portfolio away from unhealthy foods to healthy, affordable foods. And I think they can do it. They just need the will or maybe some regulation to do that.
Janet Bush: I think you’ve calculated the percentage of people who can actually afford a fully nutritious diet. But nutritious food is up to five times more expensive than a nutritionally empty diet. And that was before food prices went up this year. So what is the path towards providing more nutritious food to more people more cheaply?
But we also need governments and food and beverage industries to help people ensure that food is affordable, ensure that healthy food is available, and that they’re not always just being exposed to ultra-processed, unhealthy foods that are cheap and convenient.
Jessica Fanzo: Roughly about 3.1 billion people can’t afford what’s considered a healthy diet. Isn’t that incredible? And I think you’re right, Janet, in that that’s going to go up even more. More people, because of the food inflation.
To get to healthier diets, I think there’s really three pathways. One is ensuring that nutritious food is more available. Available being that healthy foods are being produced on farms and they’re getting to markets, supermarkets, restaurants. So just that the food is available. It’s in the supply somewhere.
There was a great study by a colleague, Daniel Mason-D’Croz at Cornell, and he calculated—he’s a modeler, and he calculated that if everyone were to consume the daily requirement of fruits and vegetables per day, which is 400 grams per capita, there’s not enough fruits and vegetables in the world supply to meet that demand.
There’s a need to just grow more diverse, nutritious foods and ensure they get to markets. That means better infrastructure, changing agriculture subsidy policies. So once that food is available, the next thing and the important thing that people are thinking about is, can they physically access it, and can they economically access the food?
Maybe it’s sitting in the supermarket, but they’re far from that market and they can’t get to it because of their own constraints, or the built environment around them doesn’t make it very easy for them. Or it’s just unaffordable. They’re not willing to pay that price.
It’s ensuring that at that level we make it easier for people to be able to access those foods physically and economically. And there’s lots of mechanisms to do that through better zoning laws, better transportation, moving markets, giving subsidies to [the] retail sector, giving cash transfers to poor households so they can purchase those products. So there’s lots of avenues to get to better access. But we need both. You need the availability and the access to be solved.
My final thing is what drives people to choose a food to purchase is really taste, price, and convenience. We have to, and this is working with the food tech companies, ensure that healthy food is tasty and convenient and at the right price point. Then people will buy it.
It’s like these alt-meats—they’re still too expensive. People purchased them at the beginning out of curiosity. Does it taste like meat or doesn’t it? People thought it tasted pretty good. But not if they’re more expensive. People won’t buy them. If it’s two times the price of hamburger meat, people won’t buy it.
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Janet Bush: Interestingly, I read the other day that China has included cultivated meat and future foods in its new five-year plan. So plant-based eggs, but other things. I mean, if China’s government is going to stand behind this, it’s huge, right?
Jessica Fanzo: That’s a game changer just based on the population alone, right? China potentially shifting away from so much pork consumption, for example. That could be game changing. I guess the question for the alt-meat companies is, can they get to scale? Can they produce these products at the scale of, potentially, China demanding these foods? That’s going to be the interesting question.
Janet Bush: But what’s interesting is that there may now be a player who really does do this at scale. So it’s either import all your alt-meat from China or make it yourself at scale.
Jessica Fanzo: Absolutely. There was a really great documentary on Hulu by David Chang, the chef. And he’s quite an innovative chef. And the documentary is all about the future of foods and the new technology around fish grown from stem cells and lab-grown meats.
He says a really funny thing, but I really resonated with it. He said, “I don’t really want to eat these kind of foods,” he’s like, “because I like eating meat, and I like real eggs, and I like fish and sushi.” He’s like, “I just don’t think we’re going to have a choice very soon.” And that’s exactly right.
We’re going to get to a point where it’s just going to be incredibly hard to raise livestock. It’s going to be a hotter-than-hell world. And raising these big beasts and the water footprint and the deforestation that goes along with that, it’s just going to get incredibly difficult for ranchers as the world gets warmer and with the more unpredictable seasons. We may not have a choice.
Janet Bush: We at MGI wrote a report on all kinds of biological innovation called The Bio Revolution. And obviously food was a large part of that. And innovation in food using technology in food was not only about feeding the world, but it was also about the climate. Do you see a lot of scope there for technology and innovation to help us solve not only the food access problem but the climate problem?
Jessica Fanzo: Absolutely. I think we’re just at the tip of the iceberg on what we can do, where we bring together, what we know about how to grow food and the ways people consume food and some of the disparities within all of that. But bringing the tech piece of solving some of these really vexing issues could really accelerate change.
I do think, though, that tech is not the only answer. It needs to go hand in hand through a justice lens, through sound policies, better governance of these technologies. Because we’ve seen, I would say, sometimes unintended consequences and maybe intended consequences of these technologies that have not always benefited the planet as well as certain populations. We need to tread carefully and really try to go forward with the best evidence that we have and learn from our past. Learn from our history of what has worked and what has not worked.
Janet Bush: It was interesting, you talked about unintended consequences and good policy. And I was looking into this debate about the precautionary principle, which is exercised by the EU, and risk assessment, which tends to be more widespread. And I read a World Bank study, and it said that the EU’s new aflatoxin standards would reduce African exports by 64 percent, but it would only reduce health risks by about 1.4 deaths per billion a year.
That just sounds crazy. But where is the balance between safety and standards and the reality that we’ve got to get food to people? It’s the same with innovation. You’ve got to be safe with innovation, but you’ve also got to let it fly.
Jessica Fanzo: I think that’s a really good example of the aflatoxin. I don’t know that study and what exactly was calculated. Aflatoxin has a range of health impacts. I’m not sure exactly on that one. But we saw that with COVID, right? We saw that the science wasn’t super clear. We really didn’t know the vaccine, the potential downstream implications. But we knew at the moment it was a disease spreading around the world, and we needed to act quickly, and we needed a vaccine to try to prevent further death and hospitalization.
That’s one of these things where you’ve learned a lot from the past of what’s worked, you learn about what happens when you don’t take action, and maybe you need to plan accordingly and use some of the historical evidence to inform decisions.
I think we’re going to see that a lot with food. When we think about GMOs or we think about these lab-grown meats or we think about some food safety regulations, we’re going to constantly be running up to areas where we don’t have a breadth of evidence to really make a 100 percent positive decision.
But we need to look at the burden and ensure that people don’t starve. And if we want to avoid just a small number of deaths, starvation is a much more profound, worse way to go. We need to proceed, but of course proceed with caution but remember our history. We never seem to look back at history and remember what we’ve learned and what we didn’t learn.
Janet Bush: Yes, it’s interesting. I read an interview with you where you commented that the response to COVID-19 was incredibly quick and bold. And then you asked why climate change, hunger, rising obesity don’t elicit bold, quick action. I guess it’s that COVID was killing people quickly, whereas these other things might kill us slowly? I guess that’s the psychology.
Jessica Fanzo: It’s not so visceral, in your face. You know, when people think about infectious diseases like Ebola, everyone’s like, “Oh my God,” you know? But the micronutrient deficiencies or dying from hunger often can be a very slow death, as well as climate change. Might not be so obvious.
But I also think COVID was one of those things where everybody was impacted. Everyone could get COVID. Whereas there’s this—misconception, I would say, that only certain people in the world die of hunger. Only certain people are impacted by climate change. “It’s not really a problem that I’m going to deal with.”
And if there’s not action taken, we’re all going to be in the same boat. It is going to get really difficult to move and grow and consume food in a very, very hot world. We’re all going to be susceptible to climate-, weather-related events that could be quite violent.
So this idea that, “it doesn’t really affect me, it’s not something I need to worry about, it’s something way down the line”—that window’s closing. It does matter.
So I think that was the difference. With COVID, it felt that everyone could get it, everyone was scared. Whereas hunger and climate still seems quite far off, or, “It’s not going to affect me, that only just happens to poor people on the other side of the world. I don’t need to worry about that.” And I think that’s a naïve perception of the world.
Janet Bush: We like ending these podcast chats with little quick-fire questions. My first one actually is rather a big one, which is: is there one action or innovation that would change the game for our global food system?
Jessica Fanzo: There’s so many great things happening. They’re not just at scale. To me the big, global thing that could happen is that food is put at the COP. At the Conference of the Parties climate change talks. It’s put into those talks and it’s on the negotiation table.
It’s been completely ignored. It’s always in side events at these COP meetings. And food is generating 30 percent of all greenhouse gases in the world. It should definitely be on the agenda.
To me, that would be a bit of a game changer, that we actually do need to take action on food to address climate change. And it usually means reorienting the food systems towards healthier foods. They usually go hand in hand. To me, the biggest game changer we could make is getting food on the agenda at COP.
Janet Bush: What makes you the most pessimistic?
Jessica Fanzo: The pace of climate change. The pace that we’re seeing change in the last decade. I am not only pessimistic, I’m deeply worried and, I would say, sad for future generations of what they may be dealing with. That’s my biggest fear and where my pessimism lies, is that climate change is everything change. Everything is changing, and everything will profoundly change for people living on the planet. And species living on the planet.
Janet Bush: The source of pessimism is so large that my next question about what makes you most optimistic may be slightly more difficult to answer.
Jessica Fanzo: I’m every day inspired by—I teach young people in the classroom every day at Johns Hopkins. And they’re probably my biggest source of optimism. They’re creative, they’re innovative, they want to make change, they are holding us to account in ways that I’ve never seen before.
I’m always incredibly optimistic when I’m around my students. Because they really are—I don’t know how they do it, but they do not give up hope. They are incredible. If the world were up to them, I would be completely optimistic about the future.
Janet Bush: Given that you come from an Italian background, and given that your life is spent analyzing and discussing food, what do you most like to eat?
Jessica Fanzo: Oh, easy. Vongole. Clams on top of pasta. It’s the best.
Janet Bush: White or red?
Jessica Fanzo: White.
Janet Bush: White. I love vongole as well.
Jessica Fanzo: Ah. So good. And bivalves, clams are so good for you and they’re so good for the environment. So oysters, clams, mussels—wonderful.
Janet Bush: And what do you dislike to eat?
Jessica Fanzo: Ham. That honey-baked, cured ham, that comes—used to come, I don’t know how it comes anymore—in those tin cans. Ugh, that’s the worst. [laughs] That’s the worst.
Janet Bush: And what’s the one piece of advice you would give to our listeners?
Jessica Fanzo: Just participate. You engage with the food system every day, multiple times a day. Whereas you don’t, hopefully, in the health system. Hopefully you’re not engaging in the health system every day unless you’re a worker in it.
But you engage in that food system every day. And that in itself holds a lot of power. The power in your purchases, the power in your decisions can make a huge difference. So get educated, pick the things that you think are important for you, whether it’s animal welfare or fair trade or healthy or sustainable. Choose foods that matter for your values and realize that your actions can be quite powerful in making change.
Janet Bush: I love that last answer. It’s up to all of us. We often feel powerless, but we can exert some control over the choices that we make. So thank you very much, Jess, for a lovely chat and a very interesting discussion.
Jessica Fanzo: Thank you so much. It was a real pleasure.
