The United Nations General Assembly and the World Health Organization have encouraged intersectoral collaboration in the fight against non-communicable diseases (NCDs). (1) However, few constructive opportunities for practical intersectoral collaboration in the areas of food and trade have been documented; most research conducted so far has focused instead on the barriers to collaboration and on the health risks associated with changes in trade policy. (2-4) This article describes how an initiative known as Aid for Trade, which is an established mechanism for development funding, can become an avenue for collaboration between the trade and health sectors.
Fruits and vegetables are important components of healthy diets. Their consumption in plentiful amounts reduces the risk of chronic, non-communicable diseases, particularly cardiovascular disease and cancer. (5-8) At present, the health sector is primarily involved in efforts to increase the demand for fruits and vegetables through settings-based and promotion initiatives that have proved effective. (9-11) Investment in these demand-side interventions is likely to increase in the wake of the 2011 United Nations General Assembly High-level Meeting on Non-communicable Diseases. (1) Consumption of fruits and vegetables is still far below the recommended level for effective health promotion and disease prevention in developed and developing countries. (11-13) Research has shown the need to increase the supply of fruits and vegetables to support demand-generating interventions aimed at improving people's eating habits and reducing the risk of chronic disease. (14,15) A recent report on chronic disease prevention calls on health policymakers to "better leverage agriculture to produce desirable health and nutrition outcomes". (16)
Fruit and vegetable production, trade and consumption have risen markedly in developing countries over the past 30 years, particularly in Asia. (17) However, much untapped production potential still exists in these countries, where improving the quantity, quality and distribution of fresh produce is fraught with difficulties. (11) Post-harvest losses keep many farmers from entering local and international markets, largely on account of a lack of infrastructure for product transport and processing. (18-20). In India, for example, an estimated 30-40% of the fruits and vegetables grown are lost after the harvest. (18) Tariff and non-tariff barriers imposed by high-income countries, including sanitary and phytosanitary restrictions, also reduce the capacity for export. (20)
Increasing the availability of fruits and vegetables will require upstream policy investment by the agriculture, development and trade sectors. The health sector plays a smaller role, yet it can strategically guide investment and decision-making in these sectors to improve policy coherence among them and support health goals.
Fruits and vegetables are a high-value food group; they are rich in nutrients and can be a valuable source of income for farmers. (21,22) Increasing their supply will thus have flow-on population health benefits as well as economic advantages for producers and distributors. (21,23) Investment in this area presents an opportunity to improve policy coherence and collaboration between the health and economic sectors. Foreseeable benefits include the expanded production and availability of healthy foods, a more reliable supply of products for local and export markets and economic growth for the rural sector. In this context, Aid for Trade represents an opportunity for intersectoral collaboration to increase the availability of fruits and vegetables locally and globally. Aid for Trade is one of the few sources of aid for development that have continued to increase despite the global financial crisis. However, the health sector has little or no involvement in the direction of its funds, which are substantial, at the global or national level. …