By Marc Van Ameringen, Executive Director, The Global Alliance for Improved Nutrition (GAIN)

We need a new approach to urban food and nutrition systems, and we need it fast. Two thirds of the world’s population will live in cities by the year 2050. Over 90 percent of this urban growth will take place in low- and middle-income countries.  Most of these countries are already facing the double burden of malnutrition, meaning many go to bed hungry or are unable to access vital proteins, vitamins, and minerals, yet at the same time, these countries are confronted with an emerging obesity epidemic, largely driven by changing diets and lifestyles accompanying urbanization.

The speed and scale of projected urbanization is unprecedented and could cause slum populations to rise to 2 billion people. Many emerging city dwellers still suffer from undernutrition, particularly those living in slums. However, obesity is rapidly growing; already 1.9 billion people are overweight or obese globally. The rapid rise in obesity adds a whole new layer of complexity to the malnutrition situation. Today, in many emerging countries, the double burden of malnutrition is often evident in the same household. In South Asian cities 39 percent of children are stunted while 28 percent of people are obese, versus 10 percent in rural areas. 

Obesity, previously thought of as a high-income problem, is increasingly shifting to afflict more low-income households than rich ones. Furthermore, children who suffer from stunting are at an increased risk of becoming obese later in life. The poor are becoming more obese largely due to the fact that they are shifting from traditional diets to cheap, highly processed foods that tend to be high in fat, sugar, and salt. This process has been enabled by the rise of food purchasing as opposed to food production, driven by urbanization, industrialization, globalization, and trade. In East and Southern Africa a third of food purchased can be classified as highly-processed food.

Both the public and private sector will have to address the need for industrial food companies to provide more healthy choices, rather than dumping unhealthy imports.

Governments can help incentivize the local production of healthier food options and limit unhealthy imports; however, we need a new paradigm within the urban food system that is more nutritiously conscious, and this will require the full collaboration of the private sector. Some analysts have indicated that changing consumer behavior driven by urbanites in countries such as the United States is already starting to force big conglomerations to change their practices. For example, General Mills has stopped the use of artificial flavors and colors in its cereals. Furthermore, these analysts predict that a seismic shift in practices must occur for these corporations to stay relevant.

However, we must ensure that good policies and changing behaviors that mitigate a problem in one region of the world do not drive one in another. For example, exemplary government actions in the United States have helped to substantially drive down smoking rates, but as a result, many tobacco conglomerates lost money and ended up shifting their focus to emerging markets such as Indonesia, where laws are less stringent, and they were able to even target children.

Although there has been a rapid expansion of supermarkets in Africa and Asia in the past decades, the urban poor still source a large portion of their food from informal markets. It is clear that these informal markets are not likely to disappear anytime soon, and they provide a significant sector of employment for the urban poor. Governments will have to work with both formal and informal markets to improve local food systems. Improving food safety will be of the utmost importance in this equation.

We need to figure out how to get more of the right foods to cities. Public policy will be an essential tool not just for limiting bad consumption habits through sugar taxes—which have been shown to be effective in countries like Mexico—but also for incentivizing more production of the right foods in the first place. We also must look to new partnerships between public, private, and civil society sectors to create demand for healthy and nutritious foods. To capitalize on these opportunities we need new platforms where policymakers as well as key stakeholders can share best practices regarding urban food systems.

The world saw the spread of HIV coming to southern Africa almost a decade in advance, but nothing was done until it was too late. Rising urban populations put more pressure on an already burdened food system and obesity is rising in every country in the world. Africa and Asia are urbanizing to a high degree in a short span of years—urbanization that took North America and Europe several decades. If we don’t act now when it comes to improving urban food and nutrition systems, we will face a crisis that will have an enormous impact on all parts of society.