Dr Klaus Kraemer, MD of Nutrition Think-tank Sight and Life, on the Need for Public/Private Sector Scale vs. Global Challenges – and for Trust and Transparency Amongst Partners

In these troubling times, innovative and sustainable solutions depend not only on shared technology, but also trust and transparency across all sectors, says pioneering nutrition scientist Dr Klaus Kraemer, managing director of the Sight and Life (SAL) international think-tank in Switzerland and Adjunct Associate Professor in the Department of International Health of Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

A model of cross-sector cooperation and impact, SAL is a pioneer in nutrition innovations, based on science and working towards eradicating malnutrition in women of childbearing age and their children. It catalyses science-based solutions, works with academia, the private and public sectors and funders to advance research and build partnerships and viable social business models that have a positive impact on the nutritional status of women and children.

Susie Lunt (SL): Given SAL’s long and passionate dedication to mobilizing support, working collaboratively and breaking down silos, what are your insights on the need for civil society, businesses and donors to come together to find sustainable solutions to improve the lives of those most in need, particularly in these exceptional times?

Dr Klaus Kraemer (KK): We need to reach scale to create impact – and this requires us to understand value chains. In the case of food and nutrition, and agriculture, the chain comprises farmers (both smallholder and large), processors and food companies, plus whatever is required in a successful market, such as wholesale and retail. This all requires an enabling environment, which should primarily be the role of government, which has to create a level playing field with standards, regulations, and, importantly, enforcement, to build the capacity of and facilitate access to finance of small- and medium-sized companies. Having all this in place will be an important milestone to the availability of affordable nutritious and safe food. I see all this happening through the lens of systems thinking. Technology helps link different players in the system.

African countries need incentives to build public-health-sensitive food systems. The best approach is blended financing of loans and grants. Moreover, we need know-how and technology transfer from overseas’ investors. However, this will require a effective de-risking mechanism by the finance facilities of European countries, the World Bank or others.

We have a programme in Ghana which, as the country doesn’t have the required food lab, sends samples to Europe to make sure there are the right quantities of micronutrients in the food. We also support small- and medium-size companies with food fortification, help with regulatory aspects, and marketing of new nutritious food products.

I have a bold wish that we can really work together. This relates to the 17 Sustainable Development Goals (SDGs) set out in 2015 by the United Nations General Assembly and intended to be achieved by the year 2030 – specifically SDG 8 and 17, as well as SDGs 1, 2, and 3.

So far, SDG 8, that people should have a decent job and be provided with what is required to make an income, has been neglected. Day labourers and migrant workers, for example, have lost their jobs due to the lockdowns; they don’t get paid, and neither they nor their families can eat.  Sight and Life has responded to the COVID-19 pandemic by co-ordinating demand for food, with a supply of fortified food and supplements to a number of grassroots NGOs in India, Rwanda and South Africa and with a GoFundMe crowdfunding page to raise additional resources.

As with the 2007-8 financial crisis, in the current situation nutrition is facing a perfect storm. Also, in the COVID-19 crisis poor families forgo the consumption of relatively expensive micronutrient-rich foods such as eggs, meat, fruit and vegetables in order to fill their bellies with empty calories from starchy staples and energy-dense processed foods. This ultimately will lead to malnutrition, poor immune function and potentially the next lost generation of youth.

SL: What do humanitarian organisations and/or civil society now require from businesses and governments to unlock collaborative work going forward?

KK: The people with technical know-how can really help. There has been discussion about a social distancing app – this is something we will need in order to release the situation, so that people can again move around. Privacy is a significant issue; they should combine privacy with the need to provide information about who is close to you, and may be infected. In addition, the movements of food need to be better monitored.

My pleas would also be for governments not to hoard food and make things worse. We can plan harvests – but this requires open borders. We need migrant workers, but there is a need for technology so they can move and stay safe, and so the rest of the population can stay safe.

There is a place for people to transfer their know-how, using data from social media, big data and data mining – we need predictability. We need to use data to have better assessment of the situation, and help even more with diagnosis.

The most important development is the COVID-19 test you can do at home, with immediate read-out. That has been important for HIV/AIDS, due to the stigma, in relation to people’s willingness rather to assess themselves than send in their sample.

To an extent, the Corona virus doesn’t have the stigma that HIV/AIDS had. People are more inclined to offer samples, and to link themselves with the app, and with technology, and to disclose that they are infected.  Home would be the most important place to test – and it would be necessary to link that with smartphones.

That said, there are reports that Social stigma is deterring people—particularly sexual minorities and undocumented workers—from getting tested and revealing their COVID-19 status, as containment measures compromise privacy; according to Bloomberg, a South Korea survey found that 62% of people feared social stigma more than the virus itself.

SL: What is holding this back?

KK: This is an extraordinary time, but civil society will still have issues about working with businesses such as the defence industry, as it expects them to go back to business as usual immediately afterwards.

Companies that are trying to innovate should aim to have a lasting effect, not just in healthcare, but also in other areas of technology. They need to make a commitment, and genuinely show what they are doing, and that they want to continue after this crisis, making a contribution to society.

I have no clear answer, but the matter of trust in this kind of engagement is what is most important. For example, how can this trust be built between the arms industry and civil society? It will be a tough one.

Transparency would certainly help, and certainly any kind of innovation that is of value for the public at large, and would have a lasting effect and commitment to continue the business after the crisis.

Civil societies are those who typically hold business accountable. In nutrition, we have an access to nutrition index, providing a benchmark on how food companies are performing in addressing malnutrition in all its forms. How about an index for the transformation of the defence industry for civilian purposes?  Benchmarking is always an incentive. When it is for public benefit, then the intention is good – but stay with it!

Consumption of locally-produced food is likely to increase after the crisis. It is also to be expected that critical goods such as drug intermediates will be produced domestically. This will have a significant impact on value chains. With all the money that is pumped into the markets at these times, this will lead to inflation and will increase the costs and the price of goods and food considerably.

SL: How does this relate to the SDGs?

KK: SDGs 17 and 8 are particularly relevant. SDG 17, about partnership, is meant to bring the different stakeholders together, but I think is not being talked about so much. And SDG 8 relates to decent jobs.

What is important in this battle is that we will all fail together if we don’t work together. This is without doubt. And those who have been the most vulnerable will be the ones who will require our attention – even more than before.