CONSORTIUM PER               RHIMENT
UNDER THE CG)A R     J    M9ND MTA9018)
FOR CRP 4 - Agriculture for Improved Nutrition and Health
This Consortium Performance Agreement (the "CPA") is entered into by and between:
- the Fund Council of the CGIAR Fund (the "Fund Council"), represented by the
International Bank for Reconstruction and Development (the "World Bank"), and
- the International Plant Genetic Resources Institute (operating under the name of
Bioversity International, hereafter referred to as "Bioversity"), on behalf of the
Consortium of International Agricultural Research Centers (the "Consortium")
(the Consortium together with the Fund Council are collectively referred to as the "Parties").
WHEREAS the Parties are entering into this CPA for the CGIAR Research Program (the "CRP")
entitled "Agriculture for Improved Nutrition and Health" to be financed in whole or in part by the
CGIAR Fund (MTO No. 069018) (the "CGIAR Fund");
WHEREAS on October 28, 2010, the CGIAR Fund was established;
WHEREAS donors to the CGIAR Fund (each a "Fund Donor") and the World Bank as trustee (the
"Trustee") have entered into Contribution Agreements and Contribution Arrangements for the purpose
of contributing funds to the CGIAR Fund (the "Contribution Agreements and Arrangements" or the
"Contribution Agreements or Arrangements," as the case may be);
WHEREAS on April 15, 2011 the Parties entered into a Joint Agreement setting out certain terms and
conditions governing the submission and approval of CRP proposals, the implementation and use of
funds in resulting CRPs, including, with respect to the Consortium and Centers, the treatment of
System Costs (the "Joint Agreement");
WHEREAS, the World Bank is signing this CPA solely in its capacity as signatory for the Fund
Council as the Fund Council does not have legal personality, and not in its capacity as Trustee, Fund
Office or in any other role, except as otherwise provided herein;
WHEREAS, the Consortium is a contractual joint venture set up among the 15 International
Agricultural Research Centers supported by the CGIAR under the Agreement establishing the
Consortium of International Agricultural Research Centers signed on April 29, 2010 and governed by
the rules of the Constitution annexed to that agreement;
WHEREAS, pending its formal establishment as an international organization and until it is ready to
carry out its business in its own name (the "Interim Period"), the Consortium shall draw on the legal
personality of Bioversity, a Center which has its international headquarters in Maccarese, Italy and an
office in Montpellier, France, and which is authorized to enter into agreements and contract
obligations on behalf of the Consortium under a Memorandum of Understanding between Bioversity
and the Consortium Board on behalf of the Consortium dated February 23, 2011 (the "Bioversity
MOU"); and
WHEREAS a proposal dated May 2011, as revised October 6, 2011, which was submitted by the
Consortium to the Fund Council and attached hereto as Exhibit 1 (the "CRP proposal"), was approved
by the Fund Council on July 8, 2011 and approved in revised form as of December 19, 2011, as


﻿recorded in agreed minutes of the Fund Council attached hereto as Exhibit 2 (the "Fund Council
Approval");
NOW THEREFORE, the Parties hereto agree as follows:
1. Based on the Fund Council Approval and as set forth in the CRP proposal, the amount of
funds from Window I and Window 2 of the CGIAR Fund that may be transferred to the Lead Center
as part of this CRP is US$93.631 million (or the equivalent thereof) (the Fund Council-Allocated
Component); the Total Budget for this CRP is US$191.400 million (or the equivalent thereof). The
Consortium agrees, and shall require the Lead Center for each CRP and, through such Lead Center,
any other Centers or Partners participating in such CRP to agree, that this amount and any income
earned thereon ("Investment Income") will be used only for the purposes described in the CRP
proposal and will be governed by the terms and conditions of the Joint Agreement, which is
incorporated by reference herein, and this CPA.
2.     Following the Effective Date (as defined below), the Trustee shall disburse the Window I and
Window 2 Funds (as defined in the Joint Agreement) to the Lead Center as follows in accordance with
a proper Payment Request received by the Trustee from the Consortium prior to each such
disbursement, at all times subject to the availability of funds:
(in $ million)
Year 1       Year 2      Year 3     TOTAL
Window I and Window 2            17.176       32.849      43.606     93.631
Window 3 and Bilateral           41.624       30.560      25.585     97.769
Total Budget                     58.800       63.409      69.191     191.400
For clarity, the Fund Council understood, and the Consortium concurred, that the amounts provided
for (i) the Fund Council-Allocated Component corresponded to the "CGIAR Fund" line items and
(ii) the Window 3 and Bilateral Component corresponded to the sums of the "Current Restricted
Donor Projects" and "Other Income" line items, all in Table B2, "Breakdown of costs on an overall
program basis," in the CRP proposal.
It is understood that the Trustee will transfer Window 3 Funds to Centers so designated by Fund
Donors in Contribution Agreements and Arrangements pursuant to a W3 Transfer Agreement entered
into by the Trustee and each such Center, and that a portion of such Window 3 Funds may constitute a
portion of the Window 3 and Bilateral Component, as set out in the attached CRP proposal.
3.     Following disbursement by the Trustee, (i) the Consortium shall have full fiduciary
responsibility to the Fund Donors and the Fund Council for use of Window I and 2 Funds disbursed
and the implementation of the CRP in accordance with the terms of the Contribution Agreements or
Arrangements, the governing Fund Use Agreements to which the Consortium is a party, including the
Joint Agreement, this Consortium Performance Arrangement and any relevant W3 Transfer
Agreements, and (ii) the World Bank in any capacity will have no responsibility to the Fund Donors,
the Fund Council or otherwise for the Consortium's handling of the funds from the CGIAR Fund or
the activities carried out with such funds. The Consortium shall have no responsibility to supervise or
monitor use of Window 3 Funds, and Fund Donors shall have no specific rights of recourse with
respect to Window 3 Funds under this Consortium Performance Agreement, except that in the event a
Center implementing the CRP fails to use Window 3 Funds for implementation of the SRF or in
2


﻿accordance with the Common Operational Framework, (i) the Consortium may take whatever
corrective actions it considers appropriate and within its purview; and (ii) the Trustee, in its discretion
or as instructed by Fund Council decisions, may withhold further disbursements from the CGIAR
Fund to that Center. In the event questions of interpretation regarding the use of Window 3 Funds
arise, (i) decisions about what constitutes activities for implementing the SRF shall be made by the
Consortium in consultation with the Fund Council, and (ii) decisions about compliance with the
Common Operational Framework shall be made jointly by the Consortium and the Fund Council.
Nothing in this CPA shall preclude Fund Donors from entering into side agreements with individual
Centers for use of Window 3 Funds financed by their Contributions.
4.     The Consortium agrees to exercise its fiduciary duties over the use of Window I and Window
2 Funds.
5.     The offices responsible for the Consortium, Fund Council, Fund Office and Trustee for
coordination of all relevant matters related to the implementation of this CPA, including providing or
being provided any notice, taking any action and executing any documents required or permitted
pursuant to this CPA, are, except as may be notified in writing to the other Contact:
For the Consortium (the "Consortium Contact"):
Chief Executive Officer, Consortium
c/o Agropolis International
Avenue Agropolis
F-34394 Montpellier Cedex 5
France
Tel: +33 4 67 04 7575
Email: :ons, rtlm     2111.01 Q,
For the Trustee (the "Trustee Contact"):
Director
Multilateral Trusteeship and Innovative Financing
The World Bank
1818 H Street, NW
Washington, DC 20433, U.S.A.
Tel: + 1 202 458 0019
Fax: + 1 202 614 0249
For the Fund Council (the "Fund Council Contact")
Chair of the CGIAR Fund Council
Vice President, Sustainable Development Network
The World Bank
1818 H Street, NW
Washington, DC 20433, U.S.A.
Tel: + 1 202 458 7405
Fax: + 1 202 522 7122


﻿For the Fund Office (the "Fund Office Contact"):
Executive Secretary, CGIAR Fund Council and
Head, CGIAR Fund Office
The World Bank
1818 H Street, NW
Washington, DC 20433, USA
Tel: +1 202 473 8918
Fax: +1 202 473 8110
6.     The offices responsible for each of the Fund Donors for coordination of any relevant matters
related to implementation of this CPA, including providing or being provided any notice, taking any
action or executing any documents required and permitted pursuant to this CPA, are as specified as the
"Donor Contact" in the respective Contribution Agreements or Arrangements with the Trustee. The
Fund Office agrees to notify (i) each of the then-current Fund Donors in the event the Consortium
Contact changes, and (ii) the Consortium Contact in the event any Donor Contact changes or is added
to the CGIAR Fund.
7.    The Fund Council and the Consortium will be responsible only for performing their respective
functions specifically set forth in the Joint Agreement and this CPA and will not be subject to any
other duties or responsibilities, including, without limitation, any duties or obligations that might
otherwise apply to a fiduciary or trustee under general principles of trust or fiduciary law. Nothing in
this Consortium Performance Agreement will be considered a waiver of any privileges or immunities
of the Fund Council, the Fund Donors, the World Bank, the Consortium or Bioversity under their
respective Articles of Agreement or equivalent documents and any applicable law, all of which are
expressly reserved.
8.    The Consortium consents to the disclosure of this CPA and related information in accordance
with the World Bank's policy on disclosure of information. This provision will continue in full force
and effect following completion of all CGIAR Fund disbursements and termination of the
Contribution Agreement or Arrangement.
9.     This Consortium Performance Agreement may be terminated by either the Fund Council or
the Consortium upon 180 days prior written notice. Additionally, in the event the Trustee exercises its
right of suspension and/or termination under the Contribution Agreements and Arrangements, the
Trustee shall consult with the Fund Council and the Consortium to determine the subsequent measures
to be taken with respect to the CGIAR Fund (as provided in the Contribution Agreements and
Arrangements), and the Consortium shall accordingly agree to suspend activities under or terminate,
as the case may be, this CPA. In the event of any such termination, unless the Fund Council and the
Consortium agree on another course of action, (i) any agreement entered into prior to the termination
between the Consortium and any consultants and/or other third parties will remain in effect and be
unaffected by the termination, and (ii) the Consortium  will be entitled to continue to request
disbursement of amounts from the Fund Council-Allocated Component in respect of such agreements
to the extent contemplated in the Fund Council-Allocated Component and necessary to fulfill the
Consortium's obligations thereunder as if this CPA had not been terminated. The Consortium shall
cause all other amounts from the Fund Council-Allocated Component remaining with the Lead Center
or other Centers or Partners participating in the CRP after such termination, along with Investment
Income thereon, to be returned to the Trustee for deposit into the CGIAR Fund (or returned to the
Fund Donors pro rata to their respective contributions to the CGIAR Fund if the CGIAR Fund has
been closed).
4


﻿10.   Except with respect to clauses that by their nature are meant to survive, this CPA shall
terminate upon the completion of the CRP.
I1.   This CPA may be amended only by written statement between the Fund Council and the
Consortium. In the event of conflict between this CPA and the Joint Agreement, the Joint Agreement
shall prevail.
12.   This Consortium Performance Agreement will come into operation on the date of the last duly
authorized signature provided below (the "Effective Date").
13.   Once the Consortium has been established with its own legal personality as an international
organization and is ready to conduct operations in its own name, the Consortium may request approval
from the Fund Council to transfer the rights and obligations contracted by Bioversity on behalf of the
Consortium under this CPA to such international organization. If approved by the Fund Council, then
such rights and obligations shall transfer to such international organization as of the date of such
approval or as otherwise specified by the Fund Council, and the Interim Period shall end on that date.
Until such date, Bioversity shall have the rights and obligations contracted on behalf of the
Consortium under this CPA, and shall be responsible for any liabilities incurred on behalf of the
Consortium under this CPA, notwithstanding any termination of the Bioversity MOU or any
termination under Section 9 above. As provided in the Bioversity MOU, any such liability of the
Consortium or (during the Interim Period) Bioversity shall be paid from the Funds of the Consortium,
as such term is defined therein, subject to the consent of the Fund Council, and shared jointly and
severally among all Centers concerned for any liabilities that are greater than the assets held by or on
behalf of the Consortium.
THE FUND COUNCIL,
By the International Bank for Reconstruction and Development,
Rachel Kyte//
Vice President, Sustaina e Development Network
Date
THE INTERNATIONAL PLANT GENETIC RESOURCES INSTITUTE,
on behalf of the Consortium
Emile Frison
Director General
Date    / 1O        2         z
5


﻿·x


﻿EXHIBIT 1
APPROVED CRP 4 PROPOSAL
AGRICULTURE FOR IMPROVED NUTRITION AND HEALTH
6


﻿
﻿EXHIBIT 2
MINUTES OF FUND COUNCIL MEETING ON JULY 8,2011 (excerpt):
CGIAR Fund Council
July 6-8, 2011
Washington, DC
Agenda Item 14. Decision Session for CRP Proposals
The Chair reminded the FC of the four categories of decisions that were adopted at FC4 in the
Council's decision making process. They were as follows:
CATEGORY 1: Approval
*  Light adjustments which the Fund Council expects proponents to take into consideration
CATEGORY II: Approval with conditions
*  'Must haves'
*  ISPC review of revised CRP proposal with 'Must haves' addressed
*  Virtual 'no-objection' approval of the proposal by the Fund Council
*  If there is objection, decision will be taken at a face to face Fund Council Meeting
CATEGORY III: Request re-submission of the CRP proposal
*  Substantial 'Must haves'
*  ISPC review of revised CRP proposal with 'Must haves' addressed
*  Decision taken at a face to face Fund Council Meeting
CATEGORY IV: Rejection
Discussion:
*  The FC Chair clarified that decision-making on the CRP proposals is a two-stage process,
i.e. that the decisions to be made in this session would be based primarily on the
programmatic/science content and quality of the design of the CRPs; the funding profile
discussion would be the second stage of the process and would take place following this
session.
*  In response to the question about modifications that need to be made in proposals
receiving Category II approval or Category III decision, the FC Chair clarified that they
would be drawn from the written comments previously submitted by ISPC and FC
members, and from those that were raised during the meeting.
*  On the suggestion that some proposals may be asked to come back to the Fund Council
after one year of implementation because of the nature of the requested revisions, it was
pointed out that the annual reports would be a better mechanism to monitor the changes.
A table showing a decision scenario prepared by the Fund Office based on initial feedback
from FC members on the proposals was used as a starting point for discussion. Individual FC
members indicated their views on it, and consensus was reached on a few suggested changes.
Decisions:
The Fund Council agreed on the following decisions on the 7 CRP proposals:
*  CRP3.1 - WHEAT- Global Alliance for Improving Food Security and the Livelihoods of the
Resource-Poor in the Developing World: The overall proposal (program content, total
budget and its components) was Approved with Conditions (Category II)
o Must Haves: Please see Annex 1
7


﻿* CRPl.3 - Harnessing the Developmet Potential ofAquatic Agricultural Systems for the Poor
and Vulnerable: The overall proposal (program content, total budget and its components)
was Approved with light adjustments (Category I)
*  CRP5 - Water, Land and Ecosystems: The decision was Request re-submission of the CRP
proposal (Category III) with substantial revisions.
o Must Haves: Please see Annex 2
*  CRP3.7- More Meat, Milk and Fish by and for the Poor: The overall proposal (program
content, total budget and its components) was Approved with light adjustments (Category I)
* CRP4 - Agriculture for Improved Nutrition and Health: The overall proposal (program
content, total budget and its components) was Approved with Conditions (Category II)
o Must Haves: Please see Annex 3
* CRP3.4 - Roots, Tubers and Bananas for Food Security and Income: The overall proposal
(program content, total budget and its components) was Approved with Conditions
(Category H)
o Must Haves: Please see Annex 4
* CRP2 - Policies, Institutions and Markets to Strengthen Food Security and Incomes for the
Rural Poor: The overall proposal (program content, total budget and its components) was
Approved with Conditions (Category II)
o Must Haves: Please see Annex 5
Summary of     CRP Title                            Lead Center  Total      Funds      No of
Budgets:                                                         Budget     from       Years
CRP No                                                           ($M)       W1&W2
($ M)
Category I ATproyal wit 11glit adu tM
CRP1.3         Aquatic Agricultural Systems         WorldFish    59.420     32.273     3
CRP3.7         More Meat, Milk & Fish for and by the  ILRI       119.708    35.183     3
Poor
Category II - Approval with conditions
CRP3.1         WHEAT - Global Alliance for Food     CIMMYT       260.508    40.967     3
Security and Livelihoods
CRP4           Agriculture for Improved Nutrition   IFPRI        191.400    93.631     3
and Health
CRP3.4         Roots, Tubers & Bananas for Food     CIP          207.300     135.600   3
Security and Income
CRP2           Policies, Institutions and Markets  IFPRI         265.595     139.889   3
CRP5           Water, Land and Ecosystems           IWMI         569.984    334.933    5
The European Commission expressed reservation on the decision on CRP2.
8


﻿Annex 3
CRP4 Proposal: Agriculture for Improved Nutrition and Health
A. Fund Council Decision: CATEGORY II - Approval with conditions; revised proposal to be
submitted to FC
CATEGORY II: Approval with conditions
*  'Must haves'
*   ISPC review of revised CRP proposal with 'Must haves' addressed
*   Virtual 'no-objection' approval of the revised proposal by the Fund Council
*   If there is obiection, decision taken at a face to face Fund Council Meeting
B. 'Must haves'
From ISPC2
1. The articulation of the strategy in the revised proposal should give evidence that the problems
identified are recognized by the authorities in countries with major under-nutrition problems and a
clearer specification of objectives related to the target groups affected by agricultural intensification
should be provided.
2. Many of the research activities are described at a high/generic level and some are already underway
or have been completed by partners. The revised proposal should identify the research activities with
time-bound milestones and partner roles.
3. On the basis of more detailed activities and specified outputs the revised proposal should include a
strategy for how these will be utilized to maximize the IPG benefits and the impacts on/for the specific
communities identified.
4. In some parts (components I and 3 in particular) the proposals are aspirational rather than realistic
and this should be addressed through further prioritization during the process of strategy development.
5. The proposal should make clearer use of nutrition and health-related terminology and articulate the
researchable hypotheses underlying the major areas of research to be included as well as providing a
mechanism or evidence for the quality of science underpinning each approach.
6. Further detail on linkages to other CRPs should be described, in particular making clear which work
will be funded from which CRP.
7. The ISPC encourages a strategic approach to program evolution and the avoidance of opportunistic
inclusion of some activities simply because they may draw initial funding.
From FC Members:
2 More detailed commentary is posted on the FC5 website as:
http://www.ceiarfund.orVeiarfund/sites/ceiarfund.or/files/Documents/PDF/CRP4 ispc commentary jun
e20 2001.pdf [and attached as Exhibit 3 to this CPA].
9


﻿8. Address the question why the four components proposed are the top research for development
priorities and how these four pieces fit together (or are linked with each other) to improve nutrition
and health.
9. Consider the following issues which were underlined in the Addis Abbaba workshop of CRP4:
sustainable diets, and sustainable agriculture (including sustainable agriculture intensification), and the
role of food and nutrition as ecosystems services; and the necessity to analyze the nutrient content of
the existing biodiversity of species before engaging biofortification work.
10. More attention should be given to priority assessment in component I in the proposal.
11. The issue of assessing potential trade-offs among breeding objectives like nutrient contents, yield,
yield stability etc. should be included as a priority research question in the biofortification component,
where the CGIAR has a comparative advantage and there are obvious IPG attributes associated with
the findings.
12. Clarify the comparative advantage of the CGIAR in Component 4.
13. In a balanced treatment of nutrition, appropriate attention needs to be given to dietary diversity and
therefore to the development of vegetable and fruit crops, e.g. the role of home gardens for
smallholder food security and balanced nutrition, could be given more attention in the CRP.
14. Other components clearly require further development, particularly in terms of identifying target
groups and establishing indicators of success. The section on value chain needs to recognize the
relative benefits of commercialization and home consumption. "Boundary" issues between CRP4 and
other CRPs, for instance on zoonoses on IPM / pesticide residues, also require further attention.
15. Recognize the role and potential of fish and fisheries in the CRP.
16. The policy component of the CRP needs to consider the role and impact of economic growth on
nutrition and health.
17. Clarity on the issue of whether or not the products of the Harvest Plus component involve
transgenic technology should be made in the proposal.
18. Address overlaps in the work done in biofortification between CRP 4 and CRP 3.4 which need
clarification.
19. Strengthen the discussion of partnerships throughout the proposal.
20. Strengthen the section on M & E; it is lacking in originality or specifics.,
21. The risk assessment section needs also to be improved; it should provide assessment of risks due to
proposed governance model. Sophisticated assessment of what might derail this CRP should be
provided.
22. Define a clear strategy on forming the partnerships. The CRP needs to clearly identify a group (or
groups) of partners, including the private sector, who are committed to work with the listed CGIAR
centers on this CRP.
10


﻿23. Identify quantifiable and critical outcome and impact indicators and targets, and establish a set of
agriculture-nutrition indicators that link to nutrition-health indicators.
24. Clarify how the pre-existing funding streams for Harvest Plus are accounted for in the final budget,
and what funds are available for the other research activities over the full term of the proposal.
25. From a research continuum and innovation perspective, a more balance investment is desired to
advance the agriculture nutrition and health research for development.


﻿＇、騙．，→～＇一吵＇梯～＇一「＇r~＇〝為馮否～｀〕＇、。向（、A＼→州｀“。
計一
一×＼＼、、＿___
l


﻿CIRCULATION OF REVISED CRP PROPOSAL FOR FUND COUNCIL APPROVAL
(email to Fund Council dated November 30, 2011):
12


﻿廖
&，、一＿
!,


﻿To:
Cc:
Bec:
Subject: Fw: Revised FC Meeting (FC6) Summary; CRP Matters: CRP2 and CRP4 Proposals; ToR
and Search and Selection Process for Head of lEA (Ref: 52-1130-2011)
82655 CGIAR *** DRAFT
From:       CGIAR Fund/Service/Wodd Bank
To:        fundcouncil@lists.cgiarfund.org
Cc:         c.perezdelcasbllo@cgiar.org, Pamela R. Crivelli/Person/World Bank@WorldBank,
kcassmanl @unl.edu, jlottman2@uni.edu, R.Malan@cgiar.org
Date:       11/30/201104:55 PM
Subject:    Revised FC Meeting (FC6) Summary; CRP Matters: CRP2 and CRP4 Proposals; ToR and Search
and Selection Process for Head of lEA (Ref: 52-1130-2011)
202-473-8951 CGIAR
Dear Fund Council Members,
(Note: In accordance with Section 15 of the CGIAR Fund Council's Rules of Procedure regarding
decisions without a meeting, this message is copied to all Fund Donors for their information.
ONLY Fund Council Members are requested to respond to the Decision Items)
The following items are for your information and action:
1. Sixth Fund Council Meeting (FC6) Summary: Thank you for your comments and suggestions
on the draft FC6 summary. These have been incorporated into the revised version (please see
attached).
Action Requested:
-- Approval of the meeting summary is requested on a no-objection basis. Please send your
objections, if any, to the Fund Office at <cglarfund0cgiano > by December 8, 2011.
2. CRP Matters: ISPC Commentaries on the Revised CRP2 and CRP4. Proposals. In a message
dated Oct 7, 2011 (Ref. No. 42-1007-2011), we informed you of the Consortium's submission of
the revised CRP2 proposal "Policies, Institutions and Markets," and CRP4 proposal "Agriculture
for Improved Nutrition and Health," and that they had been posted on the research portfolio
section of the CGIAR Fund web site: http://www.cgiarfund.org/cgiarfund/rese rch portfolio.
We would like to inform you that the ISPC commentaries on the two proposals are now
available. Please find them attached.
Action Requested:
-- In accordance with the process agreed at the April 2011 meeting of the Fund Council (FC4),
the revised CRP2 and CRP4 proposals are now presented for Fund Council's virtual approval on
a 'no objection' basis. Please send your objections, if any, to the Fund Office at


﻿<caiarfund0cRiar.org> by Dec 15, 2011.
3. Terms of Reference; Search and Selection Process for Head of lEA. Attached is a draft terms
of reference (ToR) for the Head of the Independent Evaluation Arrangement (IEA). It was
formulated based on recommendations from the IEA design team.
Also attached is a draft search and selection process for the Head of IEA. It was developed in
consultation with a working team at FAO which is the host institution of the IEA office.
Action Requested:
-- The draft ToR and the search and selection process for the Head of lEA are presented for
Fund Council's virtual approval on a 'no objection' basis. Please send your objections, if any, to
the Fund Office at <cgiarfund(Mcgiar.org> by Dec 15, 2011.
-- As indicated in the draft search and selection process for the Head of IEA, a Search and
Selection Committee will be created. The Fund Council is requested to send nominations for
the following:
a) 1 FC member to serve as Co-chair, and 2 FC members to serve as committee members
b) 1 evaluation expert, preferably from among senior management of the evaluation
offices in the international system, to serve as committee member
Please send your nominations to the Fund Office at <cgiarfund(OcRiar.org> by Dec 15,2011.
We have been advised by FAO that Ann Tutwiler (Deputy Director General (Knowledge)) and
Robert Moore (Director of Evaluation Office) will serve on the committee as Co-chair and
member, respectively. Nomination of a Consortium representative to serve on the committee
will be requested from the Consortium Board Chair.
FCE Summary (RevDrft-Nov29. 2011).docx
A A
ISPC Commentary on the revised proposal CRP2 (Nov 28, 2011).pdf ISPC Commentary on the revised CRP4 ANH (Nov 28. 201 1.pdf
ToR for Head of lEA (Draft-Nov 29, 201 1).docx Search and Selection Process for the Head of lEA (Drdt - Nov 29. 201 1).docx
Best wishes,
Jonathan Wadsworth
Executive Secretary
CGIAR Fund Council
CGIAR Fund Office
1818 H Street, NW, MSN G6-601
Washington, DC 20433 USA
1.202.473.8951 / www.cgiarfund.org


﻿APPROVAL OF REVISED CRP PROPOSAL AS OF DECEMBER 19, 2011
(email of Fund Council virtual approval):
13


﻿な
メへ／J
×ノ
×、ノ
ノ戸…f/／・―_


﻿To:
Cc:
Bcc:
Subject: Fw: CRP Matters: Decision on CRP2 and CRP4 Proposals: Establishment of IEA; Items for
Information (Ref: 55-1219-20  1 ' 1)
82655 CGIAR    DRAFT-
From:       CGIAR Fund/Service/Wodd Bank
To:        fundcouncil@lists.cgiarfund.org
Cc:         c.perezdelcastillo@cgiar org, Pamela R. Crivelli/Person/World Bank@WorldBank,
kcassmanl@unl.edu, jloftman2@uni.edu, R.Malan@cgiar.org
Date:       12/19/201105:25 PM
Subject:    CRP Mafters: Decision on CRP2 and CRP4 Proposals; Establishment of IEA; Items for Information
(Ref: 55-1219-2011)
202473-8951 CGIAR
Dear Fund Council Members,
1. CRP Matters: Decision on Revised CRP2 and CRP4 Proposals
In a message dated Nov 30, 2011 (Ref. No. 52-1130-2011), we presented the revised CRP2
(Policies, Institutions and Markets) and CRP4 (Agriculture for Improved Nutrition and Health)
proposals submitted by the Consortium for Fund Council's virtual approval on a 'no objection'
basis. We would like to inform you that no objection was received from any Fund Council
member during the comment period. The revised CRP2 and CRP4 proposals are therefore
considered approved. However, as indicated in the comments received, further revisions or
adjustments are expected to be addressed by the proponents during the implementation
phase of the two CRPs taking into account the ISPC commentaries.
2. Establishment of IEA
a) Terms of Reference (ToR) for the Head of IEA: No objection was received on the ToR for
the Head of IEA. The approved"version is attached.
b) Search and Selection Process for the Head of IEA: A number of comments and
suggestions were received on the search and selection process for the Head of IEA. They
have been shared with FACI for its consideration.
On the proposed Search and Selection Committee for Head of IEA, the Fund Office received a
number of nominations for co-chair and members of the committee. The Fund Office will
ascertain their willingness and availability to serve on the committee.
3. Items for Information


﻿a. Change in Schedule of the Seventh Fund Council Meeting (FC7): We would like to inform
you that the schedule of the 7th Fund Council Meeting has been changed to March 7-8,
2012 because of some logistical issues. As previously announced the venue is the Bill and
Melinda Gates Foundation headquarters in Seattle, Washington. The special lunch seminar
with BMGF Agricultural Development team to which FC members are also invited to
participate will be held on March 6, 2012.
b. Letter from Consortium Board Chair on AWARD Program: At the Consortium Board
Chair's request, I am sharing with you his letter regarding the African Women in
Agricultural Research and Development (AWARD) program. Please see attached.
Best wishes,
Jonathan Wadsworth
Executive Secretary
CGIAR Fund Council
ToR for Head of IEA.(Dec 19. 2011).pdf Letter GD-AWARD Consortium to FC pdi
CGIAR Fund Office
1818 H Street, NW, MSN P6-601
Washington, DC 20433 USA
1.202.473.8951 / www.cgiarfund.org


﻿EXHIBIT 3
ISPC COMMENTARY ON THE REVISED PROPOSAL FOR CRP4:
POLICIES, INSTITUTIONS AND MARKETS TO STRENGTHEN FOOD SECURITY AND
INCOMES FOR THE RURAL POOR
14


﻿I9
js
J
1k


��I N D E P E N D E N T   S C I E N C E   & 
P A R T N E R S H I P   C O U N C I L 
" 4 V C G I A R 
2 0   J u n e   2 0 1 1 
I S P C   C o m m e n t a r y   o n   t h e   p r o p o s a l   C R P   4 :   A g r i c u l t u r e   f o r   I m p r o v e d 
N u t r i t i o n   &   H e a l t h 
S u m m a r y 
T h e   r e s e a r c h   p r o g r a m   p r o p o s a l ,   C R P 4 ,   a s   t h e   t i t l e   i m p l i e s ,   a d d r e s s e s   t h e   s t r a t e g i c   s y s t e m   l e v e l   o b j e c t i v e 
i n   t h e   C G I A R   S t r a t e g i c   R e s e a r c h   F r a m e w o r k ;   " t o   i m p r o v e   n u t r i t i o n   a n d   h e a l t h " .   A s   t h e   o n l y   C R P   t o 
a d d r e s s   h e a l t h   a n d   n u t r i t i o n   e x p l i c i t l y ,   i t   s h o u l d   a d d   c o n s i d e r a b l e   v a l u e   t o   t h e   C R P   p o r t f o l i o ,   g i v e n 
m o u n t i n g   e v i d e n c e   t h a t   f o o d   s u p p l y   a n d   a c c e s s   t o   f o o d   a r e   n o t   e n o u g h   t o   a c h i e v e   f a v o r a b l e   n u t r i t i o n a l 
o u t c o m e s .   S e l e c t i o n   o f   t h e   f o u r   m a i n   r e s e a r c h   t h e m e s   ( V a l u e   c h a i n s   f o r   e n h a n c e d   n u t r i t i o n ; 
B i o f o r t i f i c a t i o n ;   P r e v e n t i o n   a n d   c o n t r o l   o f   a g r i c u l t u r e - a s s o c i a t e d   d i s e a s e s   ( A A D ) ;   a n d ,   I n t e g r a t e d 
A n i m a l ,   H e a l t h   a n d   N u t r i t i o n   ( A H N )   p r o g r a m s   a n d   p o l i c i e s )   p r o v i d e s   a   g e n e r a l l y   l o g i c a l   a p p r o a c h   t o   t h e 
s u b j e c t   m a t t e r   f o r   t h e   C G I A R .   I t   i n c o r p o r a t e s   a n d   b u i l d s   o n   t h e   H a r v e s t   P l u s   a n d   A g r o s a l u d   p r o g r a m s   a n d 
o t h e r   e x i s t i n g   a c t i v i t i e s ' .   I n n o v a t i v e   f e a t u r e s   o f   t h e   p r o p o s e d   r e s e a r c h   p r o g r a m s   i n c l u d e   s e a r c h i n g   f o r 
s o l u t i o n s   t o   p o o r   h e a l t h   a n d   n u t r i t i o n   b e y o n d   j u s t   p r o d u c i n g   m o r e   f o o d ,   t h r o u g h   v a l u e   c h a i n   a p p r o a c h e s 
a n d   b y   t a r g e t i n g   s p e c i f i c   d e m a n d   s i d e   o u t c o m e s   t h r o u g h   i n f l u e n c i n g   p o o r   c o n s u m e r s '   b e h a v i o r . 
T h e   p r o p o s a l   i s   g e n e r a l l y   o u t c o m e - f o c u s e d   a n d   t h e   d e s i r e d   i m p a c t s   a r e   r e l e v a n t ,   a l t h o u g h   f e w   p r o v i d e 
q u a n t i f i e d   i n f o r m a t i o n   o r   a   t i m e   f r a m e   f o r   t h e i r   a c h i e v e m e n t .   G e n d e r   i s s u e s   a r e   g i v e n   a p p r o p r i a t e 
a t t e n t i o n ,   s u p p o r t e d   b y   a   s t r o n g   j u s t i f i c a t i o n   o f   t h e i r   i m p o r t a n c e .   S i m p l i f i e d   C R P   i m p a c t   p a t h w a y s   a r e 
d e s c r i b e d   ( F i g u r e   2 )   w i t h   t h r e e   c l e a r   e n t r y   p o i n t s ;   v a l u e   c h a i n s ,   d e v e l o p m e n t   p r o g r a m   i m p l e m e n t a t i o n 
a n d   p o l i c y .   T h e   I P G   e l e m e n t s ,   h o w e v e r ,   a r e   n o t   w e l l   d e v e l o p e d ,   a n d   s o m e   o f   t h e   w o r k   a p p e a r s   v e r y   l o c a l 
i n   n a t u r e .   B u t   m u c h   o f   t h e   r e s e a r c h   c o u l d   h a v e   s t r o n g   I P G   e l e m e n t s   i f   e f f o r t s   a r e   m a d e   t o   d o   s o .   S o m e   o f 
t h e   c o m p o n e n t s   p r o v i d e   a   1 0   y e a r   p e r s p e c t i v e   b u t   t h e   p r o p o s a l   n o t e s   ( p l   1 9 ;   T a b l e   1 9 ,   p 1 2 0 )   t h a t   a   t h r e e 
y e a r   p e r i o d   i s   r e q u i r e d   t o   t u r n   t h e   c u r r e n t   a g g r e g a t i o n   o f   s u b j e c t s   i n t o   a   p r i o r i t i z e d   w o r k p l a n .   T h i s   i s 
n e e d e d   t o   b e   c o n f i d e n t   o f   t h e   p r o g r a m ' s   f u t u r e   u t i l i t y   a s ,   c u r r e n t l y ,   t h e   s c o p e   o f   t h e   a c t i v i t i e s   s k e t c h e d 
u n d e r   g e n e r a l   h e a d i n g s   w o u l d   s e e m   t o   b e   t o o   b r o a d .   T h a t   s o   m a n y   " t o o l s   a n d   a p p r o a c h e s "   a r e   t o   b e 
d e f i n e d   o r   v a l i d a t e d   a s   a   f i r s t   s t e p   i n   t h e   r e s e a r c h ,   a n d   t h a t   " c h a r a c t e r i z a t i o n "   a n d   " a s s e s s m e n t "   o f 
p r o b l e m s   s t i l l   n e e d s   t o   b e   d o n e ,   i s   a   c a u s e   f o r   c o n c e r n .   T h e   I S P C   e x p e c t e d   a   s t r o n g e r   u n d e r s t a n d i n g   o f   t h e 
p r o b l e m s   a n d   t h e   p o t e n t i a l   s o l u t i o n s   a s   t h e   f o u n d a t i o n   f o r   t h i s   p r o p o s a l .   A f t e r   m a n y   d e c a d e s   o f 
d i s c u s s i o n   a b o u t   t h e   l i n k s   b e t w e e n   a g r i c u l t u r e   a n d   n u t r i t i o n   i t   i s   d i s c o n c e r t i n g   t o   r e a d   t h a t   m u c h   o f   t h e 
r e s e a r c h   p r o p o s e d   w o u l d   b e   t o   i m p r o v e   u n d e r s t a n d i n g   r a t h e r   t h a n   g e n e r a t e   e v i d e n c e   o f   e f f e c t i v e 
s o l u t i o n s . 
O v e r a l l ,   t h e   p r o p o s e d   r e s e a r c h   s h o u l d   b e   p r i o r i t i z e d .   T h e   c u r r e n t   b a l a n c e   b e t w e e n   t h e   d i f f e r e n t 
c o m p o n e n t s   c a n   b e   q u e s t i o n e d   a n d   i n   t w o   r e s e a r c h   c o m p o n e n t s   ( I   a n d   3 )   t h e   I S P C   b e l i e v e s   t h e   P r o g r a m 
I n   m a n y   w a y s   t h e   c u r r e n t   p r o p o s a l   i s   t h e   f o r m e r   C G I A R   A g r i c u l t u r e   a n d   H e a l t h   R e s e a r c h   P l a t f o r m   w r i t   l a r g e .   I t   w o u l d   b e 
p r e f e r a b l e   i n   t h e   r e d e v e l o p m e n t   o f   t h e   C R P 4   p r o p o s a l   t o   u t i l i z e   t h e   s a m e   s h o r t   a n d   a c c u r a t e   s t a t e m e n t s   a b o u t   t h e   o b j e c t i v e s   o f 
e a c h   c o m p o n e n t   ( s e e   h t t p : / / p r o g r a m s . i f p r i . o r , / a h r p / a h r p a b o u t . a s p )   w h i c h   p r o v i d e   a   m u c h   c l e a r e r   d e s c r i p t i o n   o f   t h e   t r u e   e x t e n t   o f 
C G I A R   e x p e r i e n c e   a n d   c a p a c i t i e s   i n   t h e   s e v e r a l   f i e l d s . 


﻿seeks to do too much and hence is likely to lose its focus on delivery. In these cases, prioritization is
needed and trade-offs in pursuing alternative research choices should be provided.
Given the lack of detail, the quality of the science has to be largely assumed based on the track record of
the Centers involved. Confidence about the quality would be enhanced, however, if more reference was
made to the underlying hypotheses which will be required to develop research plans. The Program has a
wide variety of partners although, for some components, the involvement with ARIs remains to be
defined. Fuller consultation with other key agencies is promised and is a prerequisite before new
priorities can be developed or refined, particularly for the newer research components (1, 3 and 4). It will
be incumbent on the program's proponents to narrow the aspirational agenda of activities and find the
program's proper place in relation to global networks of research and development players (which the
proposal lists) with active expertise in the nutrition and health fields.
The linkages to other CRPs are listed but it is often not easy to interpret exactly in which CRP the
research will take place. This raises questions of boundaries and "co-financing", which was also a
concern with the climate change proposal.
The ISPC has commented previously, in relation to CRP 3.7 (Meat, milk and fish) that relationships
between basic technological research on livestock disease and the more immediate research needs that
may be selected through constraint analysis of the chosen livestock and fish value chains, requires better
analysis and description. In the current proposal, links are made (p71) between sub-component I (Food
Safety) of Component 3 and the value chain work in CRP 3.7, but in sub-component 2 (Zoonoses),
despite a long rationale for treating zoonotic disease in general, no explanation is proposed for the two
diseases singled out (p79). Given that cysticercosis is a food-borne disease, it is difficult to see the
overall strategy as to how synergies both within and between CRPs will be captured. The ISPC would
welcome clarification of how the different sub-components across CRPs in this area fit together.
Overall, the document provides a good description of the "why" although, despite its lengthy text, the
proposal is unclear or lacks details in several instances'on the "how". This makes it difficult to apply the
CRP evaluation criteria to judge the likelihood of delivery of high quality science and the intended
impacts. The time frame for many of the deliverables is left quite open. Thus it does not make sense
(contrary to the suggestion of the proposal, p128), to embark on a rapid deployment of CRP4 in 2011
before many of the major potential partners have been adequately consulted to refine activities and a more
structured and balanced work plan is in place.
Recommendation: Because the current proposal is not sufficiently developed, the ISPC recommends that
the CRP 4 approach be approved to allow the program's proponents to engage with partners so as to
develop a revised proposal and work plan with greater specificity. Whilst current work, including the
experimental validation of biofortification, should continue as planned, the ISPC further recommends that
approval of the remaining content and substance of the program be withheld until a more detailed
proposal is submitted. That proposal should take into account the general and more detailed advice
contained in this Commentary:
* The articulation of the strategy in the revised proposal should give evidence that the problems
identified are recognized by the authorities in countries with major under-nutrition problems and
a clearer specification of objectives related to the target groups affected by agricultural
intensification should be provided.
2


﻿*  Many of the research activities are described at a high/generic level and some are already
underway or have been completed by partners. The revised proposal should identify the research
activities with time-bound milestones and partner roles.
*  On the basis of more detailed activities and specified outputs the revised proposal should include
a strategy for how these will be utilized to maximize the IPG benefits and the impacts on/for the
specific communities identified.
*  In some parts (components I and 3 in particular) the proposals are aspirational rather than
realistic and this should be addressed through further prioritization during the process of strategy
development.
*  The proposal should make clearer use of nutrition and health-related terminology and articulate
the researchable hypotheses underlying the major areas of research to be included as well as
providing a mechanism or evidence for the quality of science underpinning each approach.
*  Further detail on linkages to other CRPs should be described, in particular making clear which
work will be funded from which CRP.
*  The ISPC encourages a strategic approach to program   evolution and the avoidance of
opportunistic inclusion of some activities simply because they may draw initial funding.
1. Strategic coherence and clarity of Program objectives
The overall objective and four research components of CRP4 directly address the System Level Outcome
(SLO) of improvement of health and nutrition. In developing this proposal, four areas emerged from a
brainstorming session of 12 CGIAR Centers. As a result, the underlying logic and potential scientific
synergies which can be achieved by achieving focus of these Centers on AHN are apparent. However, it
would be more convincing if these were 'ground-truthed' against the priorities of the 36 highest
nutritionally burdened countries (based on stunting). Before embarking on strengthening such stakeholder
interactions, however, it may be useful to better define the 'problem' of under-nutrition. Nutrition is not
one status, process or situation (nor is health). The nearly interchangeable use of terms like food security,
hunger, malnutrition, under-nutrition, ill health, and poverty throughout the proposal did not help provide
clarity. Drilling down to what aspects of nutrition and health problems would be best tackled through
investments in agriculture should be a research question in itself. The risk is that the focus on integrating
agriculture, nutrition and health over time becomes a mantra which dominates over the focus on
outcomes. As written, it is the food chain rather than simply agriculture which is the subject of study.
That said, the program seeks to address several of the main causes of malnutrition and agriculture-
associated diseases (AAD) and to identify possible avenues for improvement. The questions leading to
this identification of the research components (p 9) are the appropriate ones. However, the balance
between the individual research components, with more than fifty percent of the resources going to one
component (biofortification) invites review. A stronger justification is required for this apparent
imbalance in the allocation of resources. The proposal seems to suggest that Harvest Plus and AgroSalud
will be stand-alone elements of the new program, and the degree to which they may subsequently be
merged (with other components) into a future sub-component on biofortification is unclear. An overall
conceptual framework to provide a cohesive articulation of the Program is missing.
3


﻿The program targets two groups: (a) those with high level of malnutrition and AAD's and (b) groups
affected by agricultural intensification (see for example p ix). While the profile of the first group is well
understood, the characteristics and objectives for the second are not clear. For example, the foreword (p
ix) mentions the "poor people" in this group, whereas the text (p11) mentions all groups. Is there a clearly
proven link between intensification and greater health and nutritional risks for the poor? What is the
program's objective for this group? If it is to provide safer food, the ISPC would argue that the program
would seek to cover all groups, including planning for the inclusion of the urban poor in the future, and
not only the rural poor. Lastly, in considering targets, one of the challenges to the value chain work is that
many value chains serve both undernourished and over nourished people, so that entry points via value
chains may be a very blunt instrument.
The international public goods nature of the research is obvious in the bio-fortification component (and
should be for zoonoses when this is more clearly developed), but less clear in the other components.
Working on value chains, food safety and policies and institutions will result in local solutions. The
program has addressed the issue of generating international public goods by including the development of
methodologies and tools, but this aspect needs to be more explicitly stressed in a revised proposal.
Component I on Value chains. Overall this seems a sensible choice but the extent to which research can
push changes in value chains to meet the numerous objectives of efficiency, sustainability, and now
nutrition, should be subject to tradeoff analysis. For objective 4 (identifying the nutrition entry points for
intervention), which is clearly the most significant activity in this component, the selection criteria should
include a poverty focus to respond to the CGIAR's comparative advantage for being involved in this
work. In addition, this component will require close interaction with the private sector to be effective but
the CGIAR partners have to date little experience in developing tools for "chain agents" to assess and
enhance nutrients in foods. There is a lack of reference to policy incentives and distortions as a potentially
important determinant of nutritional outcomes of value chains, for example subsidies on specific
products.
A significant element seems to focus on changing consumer behavior, which is a very challenging area
with little clarity about likelihood of success. It is very difficult to change consumer behavior, even in rich
countries, and even with so much media attention on healthy foods and diet improvement. Research in
this area will need to go well beyond economics to embrace consumer psychology, an area in which the
CGIAR is weak. The feasibility of success in this area is rated by the ISPC as "optimistic". Evidence of
strong buy-in from stakeholders who are in a position to influence consumers would be critical here.
Component 2. Biofortification. The Harvest Plus CP appears to continue unchanged as a component of
this CRP. Some protection may well be needed to ensure that the work started in this CP is given a chance
to succeed, but it currently appears isolated. Indeed, it is considered an important feasibility experiment
which may well temper future strategies and investment in this area. AgroSalud will work with food
technologists to produce commercially prepared biofortified food resulting in urban consumers having
access to biofortified food (p54/p57). This is one of the few examples of engagement with the nutrition
and health of urban consumers in the proposal. Indeed, rapid urbanization underway in many developing
countries is associated with a major change in diets such that a growing share of food consumed by urban
poor is processed. Achieving impact on nutrition for this group may well require greater collaboration
with the food processing and manufacturing industries. This will represent new partners and, as
mentioned, may require further definition of target groups.
Component 3. Agriculture Associated Diseases. The text in this component is repetitive and hard to
follow as it seems to have a different structure and format from the other components. Research on
zoonotic and food/water-borne diseases is urgently needed but what the CGIAR should contribute is less
well articulated. The description on p79 is extremely broad. In component 3, there is reference to One
4


﻿Health as an overarching approach, but no specific actions on understanding and eventually overcoming
the constraints to its implementation. With attention of many institutions, including the major
development banks and other investors on this subject, the comparative advantage of the CGIAR in this
topic needs to be clear. For instance, specific work on the constraints and benefits of the introduction of
"One Health" would have to be a part of this program. However, it could equally well be argued that this
activity belongs in component 4.
The attention to mycotoxins (given "initial priority" status) is supported, and the ISPC notes there are a
large number of potential partners. The System-wide IPM program is mentioned as a partner for aflatoxin
research without identifying what role it might play (p68). In contrast, the System-wide IPM program is
not mentioned in tackling research questions associated with reducing pesticide use and effects on
ecosystems (p82), which is one of the major health risks from agriculture as measured by DALYs.
Otherwise too much emphasis is given in the background text to acute food safety issues (pandemics)
which are the responsibility and expertise of the OIE, FAO and WHO and their networks, when research
on other more long-standing constraints could be the focus of the proposed research for the CGIAR.
In the current proposal, one sub-component focuses on zoonoses, but there is overlap with the sub-
component on food safety. It is not clear how much effort will be directed at the selected zoonoses (Rift
Valley Fever and cysticercosis) referred to on p79, but the rationale for their selection is missing. Further
clarity is required on the zoonotic diseases to be prioritized under this proposal and the relationship
between these thrusts and underpinning strategic work on livestock disease promised under CRP 3.7.
Within component 3 there are indications that concepts from economics will be used in a behavioral
setting in disease control. This is extremely important, and a welcome emphasis wherever the research is
placed. Diseases may originate in animals, but decisions on disease control are made by humans, and
unless an effort is made to understand the incentive structures facing livestock keepers and other
stakeholders in a disease control situation, technical disease control is likely to be ineffective. That said,
the description of socio-economic data collection and impact assessment is sketchy, especially in
comparison to the other three components. For instance, Table 11 (p74) has proper descriptions of
technical disease control research activities, but just a simple bullet point noting 'health, social and other
impact assessments'.
Component 4. Cross sectoral. Focusing subcomponent 4.1 (on integrating ANH programs) could provide
early understanding (for the program) of how best to create an integrated program. However, written as a
stand-alone component, it comes across as verging on the theoretical; 'Develop methods and tools to
improve the effectiveness, efficiency, and timeliness of surveillance and monitoring systems and to
permit meaningful evaluation of complex multisectoral programs and policies (Components 1-4)' could
rightly be seen as an objective within components 1-3. More could be done at this stage to demonstrate
how the key activities of 4.1 will influence and add value to activities in the first 3 components and not
just provide an ex post service to other donor initiatives. Such evaluations should pay special attention to
prospects for scaling up. Some of the case studies may provide favorable nutritional impacts but have
little chance of success at larger scale.
2. Delivery focus and plausibility of impact
In the sense that the ultimate impact statements are appropriate, the proposal could be seen as outcome
focused. Considerations with respect to delivery are discussed throughout the proposal and the way in
which partners have been selected shows-evidence of thinking about delivering impact. There is also a
clear geographic focus. However, at this stage of development, the many assertions about the program's
potential for impact on nutritional status and health are vague and unconvincing. Generic claims that the
'health and nutrition of the poor and undernourished will be improved' are not good enough given the
5


﻿scale of funding requested. Only the Harvest Plus activities attempt to define which nutrients and
quantitative nutritional metrics, and for which target demographics, the work is intended. The proposal as
a whole may need to discuss its measures of success with some care. Will a 5% decline in iron deficiency
anemia in children under 5 suffice to determine success, or is it a 20% decline in stunting? Is health really
just a reduced exposure to, say, schistosomiasis or should it be a 50% reduced prevalence of diarrhoeal
disease (which kills far more children than schistosomiasis does)?
Target groups are not well defined or the wording is unclear. The program targets two groups (a) groups
with high level of malnutrition and AADs, and, (b) groups affected by agricultural intensification (see for.
example page ix). While the profile of the first group is well understood, the characteristics and
objectives for the second are not clear. For example, the foreword (pix) mentions the "poor people" in
this group, whereas the text (p 11) mentions all groups. What is the program's objective for this group? Is
there a clearly proven link between agricultural intensification and greater health and nutritional risks for
the poor? A closely connected choice expressed in the proposal is the focus on poor rural and peri-urban
populations. In the next 20 years, developing countries in both Africa and Asia are set to join Latin
America in having over half their populations resident in urban areas. The disconnect between production
and consumption is going to get steadily larger, nutrition of poor urban populations is going to become
ever more important, processed food is going to become more central in diets and value chains are going
to become more complex and spatially dispersed. It may make sense to prepare the groundwork for
eventual inclusion of urban groups in the proposal.
Page I notes that the "primary focus will be on improving human nutrition and health". That requires a
significant allocation of resources to demonstrate that investments in (mainly) agricultural research will
indeed result in improved nutrition and health, not just in nutritionally-enhanced foods, or in a reduction
of agriculture-based diseases. The absence of disease does not in itself equate with improved health, nor
does increased availability of more nutritious foods equate with enhanced nutritional status of consumers
(given potential anti-nutrients in the diet, nutrient losses in processing/cooking or via communicable
diseases, or lack of needed investments in nutrition and health promotion separate from investments in
agriculture). Thus the pathways are-a) not as clearly defined as suggested in the text, and b) the impacts
are likely to be more muted than claimed. Indeed, plausibility of impact can only be assessed in relation to
stated objectives but the quantification of these objectives is not well defined in the text (Harvest Plus
excepted). There is some discussion and attention to trade-offs - for example between bio-fortification
and yield (p43), but the pros and cons of other choices are not discussed in detail. For example, on food
safety, ILRI's Kenyan raw milk sale case study (p60) is mentioned, but the critical strategic issue that
stricter food safety standards increase the cost of foodstuffs, and hence affect their accessibility to the
poor, is not discussed.
That so many 'tools and approaches' are to be defined or validated as a first step in the research, and that
"characterization" and "assessment" of problems still needs to be done, is a cause for concern. The ISPC
expected a stronger understanding of the problems and the potential solutions as the foundation for this
proposal. After many decades of discussion about the links between agriculture and nutrition it is
disconcerting to read that much of the research proposed would be to improve understanding rather than
generate evidence of effective solutions. With so much vagueness around the actual hypotheses to be
tested and actual interventions to be evaluated, the impact of CRP4 cannot be easily predicted. The
program potentially includes some innovative social sciences; but to have the intended impacts the
proposal will have to achieve and integrate both social and biotechnical outputs (e.g. p79; "Surveillance
and control options based on improved understanding of disease; diagnostics that take into account
variants in circulation " etc). Simple, illustrative impact pathways are provided for the components
reflecting the actors, but lack a good description of the levers (positive or negative incentives, awareness,
lobbying mechanisms) needed to get the Program findings internalized in the chain. Overall, the research
is a mixed bag of plausible and feasible, difficult to achieve, and unclear (particularly in terms of defining
6


﻿the precise impact pathways expected). That the CRP proposes to adopt SMART indicators and methods
to determine impacts is good, and that will require a clear investment in collecting appropriate nutrition
and health variables to assess impact and partner involvement.
Finally, in terms of program plausibility, the ISPC would also draw attention to some of the statements
made, e.g. p9: "It is well recognized that poor quality diets and related micronutrient deficiencies are a
much more widespread nutritional problem than the lack of food. Solutions to improving the poor's
access to nutritious foods are therefore needed, rather than a narrow focus on producing more food." It is
incumbent on the proponents to show that impact on this issue can also be anticipated through this new
direction for research in the CGIAR.
3. Quality of science
The program has no clearly formulated hypotheses relating to the needs and constraints identified. It has
formulated an objective for each component - which is generally well done, with the exception of the
overall program objective - and a large number of research questions. The questions are relevant and are
mostly addressed in the subsequent research program. However, these questions do not allow a rigorous
validation or rejection.
The program seems, in particular in component I and 3, quite ambitious in the number of proposed
activities as shown in table 4 and 10. Leaner, more focused research activities in these components might
enhance their scientific quality.
A more explicit description of new techniques and tools used and novel outcomes expected in each
research component would have given a better understanding of the innovative character of this CRP.
Component I makes good use of case studies to develop the research issues (e.g. Box 2, providing
support for the potential to enhance and increase bioavailability of Vitamin A in staples). Research
component 1, objective 2, proposes to employ innovative techniques, whereas the rest is quite traditional;
research component 2 is innovative overall. Component 3 starts by describing research themes at the
component level, one of which aims to identify AADs with large impact on health of the poor, yet some
diseases have-already been prioritized. Quite a few stakeholders already work in the area of zoonosis,
which raises questions about the extent to which the CGIAR should be leading in this area as opposed to
conducting the research identified at the sub-component level. The participatory risk assessment and
management approaches developed (box 8) are claimed to be new, although they have been developed
some time ago (as part of the HP Avian Influenza epidemic); some of the techniques and technologies
proposed in food safety and surveillance techniques seem new. Research component 4 has some
innovative aspects in objective 4.1.1, while being rather traditional in the other sub-objectives. Sub-
component 4.1 does not exhibit the same outcome focus as other components. Instead, it appears to push a
concept, rather than considering under what circumstances the AHN sectors should be integrated. Sub-
competent 4.2, on- policies, reads better as a stand-alone component, although it also lacked explicit
mention of extensive interaction with the researchers in the other components, which are crucial for
success.
4. Quality of research and development partners and partnership management
CRP 4 presents a thorough, pragmatic approach to building and leveraging a partnership network. It
demonstrates its reliance and commitment to a robust partnership strategy by allocating 47 percent of its
budget to work with partners. The principal participating Centers-IFPRI and IRI, and the Harvest Plus
Challenge Program have particularly strong track records in building and leveraging effective
partnerships to advance their work. Although CRP 4 broadens the focus of the CGIAR's work to include
health more specifically, and notes as a potential risk, "coordination with the health sector, where the
7


﻿CGIAR has few existing partnerships" (pl21), the underlying capacity and experience of the
collaborating Centers is likely to mitigate this risk.
A high priority task for this program is development of an explicit partnership strategy. This task will be
supported by IFPRI's Partnership Coordinator. ILRI has done extensive work on its own partnership
strategy and IFPRI has institutionalized partnership management as an element of its management
structure. A clear typology of partners is articulated early in the proposal and consistently used in the
descriptions at the component level, namely: enablers (policy makers and decision makers, including
donors/investors), development implementers, value chain actors, and research partners (pl9). The
proposal demonstrates a strong grasp of the value added as well as the strategic importance of enlisting
and making use of the right mix of partners to advance the research and leverage its adoption across a
continuum of beneficiaries and actors from the household level to the policy arena. However, the private
sector is either ignored, or mentioned as a general category although they will be essential for
implementation of several outcomes. In addition, the program seems to be well linked to the regional
initiatives in Africa, but less so to other regional institutions, such as the Pan-American Health
Organization, which is not mentioned at all. The proponents recognize the challenges of managing many
partners and the identification of an individual to take overall responsibility for partnerships, which is
commended. Because of CRP 4's breadth of focus, the proposal itself enlists the participation of 10
CGIAR Centers in addition to the Harvest Plus CP, four of those (Bioversity, CIAT, IFPRI and ILRI)
with Harvest Plus will contribute $3 million or more to the proposal. Additionally, linkages to other
CRPs are listed (Appendix 6, table 1) but are often not easy to interpret. Relationships between livestock
disease activities have been mentioned. Research on fruits and nutrition is stated to take place through
CRP 6 but this component (i.e. CRP 6.1) is a very modest part of that proposal. Rather than being
reassuring, the treatment of linkages with other Centers and CPs raise questions of boundaries and "co-
financing" which remain to be worked out.
As far as a reader can assess, no formal agreements have yet been made with the partners beyond the
CGIAR Centers although many partners were involved in the IFPRI New Delhi meeting, and the core
CGIAR partners have been involved in the planning process. The arrangements and responsibilities for
M&E are proposed to be developed in the first year of program implementation. There is little
information on the adequacy of the research facilities. As these facilities would have to come for a large
part from ARIs, more explicit descriptions of which ARIs are to be involved are needed in research
component I and 4. The other research components seem to have the appropriate partners and facilities
identified.
5. Appropriateness and efficiency of Program management
IFPRI is the lead Center for CRP 4, although there is formal acknowledgment of ILRI's standing in the
program through its chairmanship of the Planning and Management Committee and a role in the
recruitment and evaluation of the Program Director. As the lead Center, IFPRI will provide financial and
management services to the CRP, provide accountability to the Consortium, and oversee the Program
Director. The proposed structure for program management and oversight includes: An Independent
Advisory Committee, a Planning and Management Committee (PMC), the Program Director, a Program
Research Team, comprising the four research leaders from each of the research components, and a
Program Management Unit (PMU), which includes a research coordinator, a program manager, and two
administrative staff. Communications and partnership management are not included in the proposed
management structure although identified as critical functions throughout the proposal. The structure
accommodates the relative importance of the two principal participating Centers, and also reflects a useful
balance between inside and outside perspectives. Where other CRPs give a cautionary level of attention
to conflict resolution mechanisms, CRP 4 seems less concerned by the prospect of conflicts among
partners or over resource allocations to research priorities. The proposal accepts a recommendation from
8


﻿the Consortium Board to assign ILRI the chairmanship of the Planning and Management Committee for
two years, and to provide ILRI with a role in the recruitment and evaluation of the Program Director.
The Program and Management Committee itself comprises both the program's research leaders, and three
representatives from participating Centers and implementing partners. It has a reasonable scope of work
and authority, meeting face-to-face twice a year or more often as needed. The Program Director is the
convener, which provides a subtle affirmation of the Program Director's relative relationship and
authority within the structure.
Program Director: The Program Director will be identified and employed by IFPRI, as the lead Center,
and report directly to the DG. As noted above, ILRI will play a role in the recruitment and evaluation of
the Program Director. The position is given clear responsibility for the overall intellectual leadership and
management of the CRP, and serves as the external representative of the program with a role in
partnership development, communications and advocacy, and resource mobilization.
The proposal implies that research leaders will be drawn from among the Centers with existing research
portfolios that align with the four research components; it is not clear who has the authority to appoint the
research leaders or to evaluate their performance. Although there is a common bias within the CRPs to
have very small management footprints, at some point it will be important to provide the Program
Director with a more explicit role in recruitment and evaluation of research leaders.
Communications and Partnership Management: The proposal makes a convincing case for the
importance of effectively identifying and developing partners, and for the central role of a coherent, well
integrated communications strategy to the success of the program (p113-114). In analyzing potential
risks, the proposal notes: "Linking research to implementation (Research Component 4) will require
extensive investment in communication, dialogue, information sharing, internal education, and advocacy.
(p122)". In both areas, the CRP proposes to identify taskforces to develop strategies for partnerships and
communications, but it fails to dedicate staff capacity at the program management level to coordinating
and overseeing these strategies. Neither function should be fulfilled on an ad hoc basis by borrowing
existing capacity from IFPRI or other Centers. The partnership strategy will be complex and involve the
engagement of new spheres of influence and different actors than have been the traditional scope of the
Centers. It would be prudent to include a management position within the Program Management Unit
that can protect the strategy, help to coordinate and align it implementation, evaluate its effectiveness and
continue the identification and cultivation of new partners as the program moves forward. Similarly, if, as
the proposal states, the program "places priority importance on establishing a strong communications
function from the beginning of the program (p.113)," it must include the capacity to manage this function
and the underlying strategy as part of the Program Management Unit-which it does not do.
In general, IFPRI as the lead Center has the level of authority that it needs to serve as an effective
fiduciary. It has not assigned itself a level of control that curtails the influence of participating Centers
and partners, or that raises serious issues about the potential for conflicts of interest. Monitoring and
evaluation functions are considered in the management realm, which may deprive them of the benefit of
challenging, disinterested assessments.
6. Clear accountability and financial soundness, and efficiency of governance
The budget presentation for the project is straightforward. The total CRP budget over three years is
projected to be $191 million. The proposal requests $17 million from the Fund in 2011, rising to $44
million in 2013. CRP management is budgeted at 2 percent of the total budget and ranges in value from
$1.3 to $1.5 over three years. There is no separate line item for communications. It is difficult to tell
from the budget narrative and the detail whether the amount assigned to management resulted from
estimating the actual costs of management or deciding that 2 percent was as much as should be spent on
9


﻿the management functions. IFPRI and other Centers are clearly incorporating some management
functions related to the management of the CRP through the Centers' existing management structures.
While this makes sense and is clearly efficient in terms of "backroom" functions like accounting, grants
management, IT support and personnel, it is not ideal to disaggregate more critical management
functions, like communications, partnership strategy and coordination, and resource mobilization, wholly
to various Centers (even the lead Center). These are critical components of the proposal's success as
outlined in the proposal itself, they are legitimate management functions, have clear costs, and should be
coordinated and managed for results by the Program Director within the CRP's management unit.
Governance and Oversight: The Independent Advisory Committee will bring together scientists, partner
representatives and a member of the current advisory committee of Harvest Plus. Its primary role is to
advise the management committee and IFPRI DG, although the management committee is required to
respond formally to its recommendations. The advisory committee is proposed to meet face-to-face once
a year. Its membership may be expanded temporarily to accommodate the program's need for specific
expertise or perspectives. Nominations will be solicited broadly from partners and participating centers,
with the Planning and Program Management Committee (a relatively well-balanced group) advancing a
slate of candidates for confirmation by the IFPRI board. The committee would be strengthened if there
was a mechanism that enabled the identification of a chair for the group, and if the appointment process
included a term limit. It should also meet more than once a year and could meet virtually if there are not
sufficient resources to support a second face-to-face meeting.
It is difficult to judge the appropriateness of the budget and budget increases when so much of the
proposal remains to be developed. Currently a very large budget is earmarked for partners/collaborators
on biofortification. While Harvest Plus and AgroSalud are well described in the proposal, it is not clear to
what extent the Harvest Plus activities will be generally merged into the program structure and what the
final balance between biofortification (currently around 50% of the total program) and the other
components will be. Thus it does not make sense to embark on a rapid deployment of CRP4 in 2011 (as
suggested on p128), before many of the major potential partners have been adequately consulted to refine
activities and a more structured and balanced work plan is in place. For this reason the ISPC has
recommended that the proposed approach for implementing CRP4 activities be approved, but that
approval of the content and substance of the program be withheld until a more detailed proposal is
submitted.
10


﻿sa
CGIAR
Research
Program 4
PrOpoSai Submit e  by
PollyReeac
if) s t t it
IFPRI
ILRI
KR
Agriculture
for lmproved
LF            Nrition&Health
xA!lNu                      tlQ# FIl Nurto   &


﻿CGIAR RESEARCH PROGRAM 4
AGRICULTURE FOR IMPROVED NUTRITION AND HEALTH
A revised proposal submitted to the CGIAR Consortium Board
by the
International Food Policy Research Institute (IFPRI)
on behalf of
Bioversity International
International Center for Tropical Agriculture (CIAT)
International Maize and Wheat Improvement Center (CIMMYT)
International Potato Center (CIP)
International Center for Agricultural Research in Dry Areas (ICARDA)
World Agroforestry Center (ICRAF)
International Crops Research Institute for the Semi-Arid Tropics (ICRISAT)
International Institute of Tropical Agriculture (IITA)
International Livestock Research Institute (ILRI)
International Water Management Institute (IWMI)
The World Fish Center
INTERNATIONAL
FOOD POLICY
RESEARCH
INSTITUTE
IFPRI*
October 2011


﻿Contents
Acronyms.........................................................vm
Foreword.........................................................
Acknowledgments...................................................xii
1. Executive Summary.................................................1
Background......................................................1
CRP4 Strategic Goal................................................1
CRP4 Strategic Framework and Research Components........................1
Research Objectives................................................2
Impact Pathways      ..................................................2
Partnerships      .....................................................3
Research Components: An Overview.....................................3
Cross-cutting Issues................................................4
Innovation ........................................................5
Management Structure..............................................5
Monitoring and Evaluation............................................5
Conclusion...................................................... 5
2. Statement of Objectives and Strategic Framework............................6
2.1 The Potential Contribution of CRP4 to the Achievement of the CGIAR's System-
Level Outcomes (SLOs)........................................... 6
2.2 CRP4 Objectives............................................... 6
2.3 CRP4's Strategic Framework....................................... 8
2.4 Target Population.............................................. 10
2.5 Geographic Focus.............................................. 10
3. Justification of the Program........................................... 12
3.1 Agriculture, Nutrition, and Health: Essential Links.........................12
3.2 A Unique Opportunity........................................... 13
4. Impact Pathways.................................................. 14
4.1 Research Strategy............................................. 14
4.2 Impact Pathways.............................................. 14
4.2.1 Value-chain Impact Pathways            ................................         ... 15
4.2.2 Development Program Impact Pathway            ......................    ........ 16
4.2.3 Policy Impact Pathway............................................ 16
4.2.4 Longer-Term and Broader Impacts           .................................. 17
5. Partnerships ..      ....................................................19
5.1 Principles and Practices......................................                 ........ 19
4.2  a  u -chan  m act  a  h ays ..........                         ............


﻿5.2 Nature and Types of Partnerships.....................          ..............20
5.3 Partnership Engagement and Development Process......................22
6. Main Activities Proposed to Generate Outputs, Outcomes, and Impacts  ............24
6.1 Component 1: Value Chains for Enhanced Nutrition.......................28
6.1 .1 Rationale, Objective, and Research Questions.......................28
6.1.2 Impact Pathway............................................35
6.1.3 Activities, Outputs, and Outcomes................................37
6.1.4 Priority Setting and Sequencing of Activities ................  .........38
6.1.5 Methods.................................................39
6.1.6 Partnerships..............................................45
6.2 Component 2: Biofortification.......................          ...............45
6.2.1 Rationale, Objectives, and Research Questions......................45
6.2.2 Impact Pathway, Outputs, and Outcomes...........................46
6.2.3 Subcomponent 2.1: HarvestPlus..................................47
6.2.4 Subcomponent 2.2: AgroSalud-Biofortified Food Basket for Latin America
and the Caribbean (www.AgroSalud.org)...........................56
6.3 Component 3: Prevention and Control of Agriculture-Associated Diseases.............61
6.3.1 Rationale.................................................61
6.3.2 Subcomponents of Component 3.................................64
6.3.3 Objective and Research Questions................................68
6.3.4 Principles.................................................72
6.3.5 Methods..................................................73
6.3.6 Subcomponent 1: improving Food Safety (initial priority)..................73
6.3.7 Subcomponent 2: Zoonotic and Emerging Diseases (initial priority) ...........83
6.3.8 Subcomponent 3: Other Health Risks in Agroecosystems           ................87
6.4 Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies..92
6.4.1 Rationale, Objectives, and Research Questions .............      ......... 92
6.4.2 Impact Pathway, Outputs, and Outcomes ofArcutrse...........................95
6.4.3 Subcomponent 4.1: Integrated Programs     ....................  .......96
6.4.4 Subcomponent 4.2: Harmonized Policies.............................104
7. Gender Research Strategy............    ................                 .......112
Component 1: Value Chains for Enhanced Nutrition and Health.................115
Component 2: Biofortification for Improved Nutrition and Health  ............ .....115
Component 3: Prevention and Control of Agriculture-Associated Diseases (iitalpririy ...........116
Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies......116
8. Innovation ......    ................................................117
8.1 New Understanding and Global Commitment       ....................  .......117
Component 2: Biofodifiation for improvedNuitioanHelh.......15


﻿8.2 New Ways of Working: New Types and Stronger Partnerships        ...............1 17
8.3 Innovative Research to Meet Emerging Challenges......................118
9. Interactions With Other CRPs........................................119
9.1 Value-chain Impact Pathway ......................              ................119
9.2 Development Program Impact Pathway..............................119
9.3 Policy Impact Pathway ..........................................120
10. Cross-cutting issues..............................................121
10.1 Capacity Strengthening ..............................         ...............121
10.2 Communications and Advocacy...................................123
10.2.1 Rationale............................................... 123
10.2.2 Start-Up Phase: Elements of the Communications Strategy     .................123
10.2.3 Development Phase: Communication Strategy for Public Awareness and
Reaching End Users....................................... 124
10.2.4 General Lessons: Communications in Cross-Sectoral Collaboration  ............. 124
11. Management Arrangement for Implementation.............................125
11.1 Governance and Management Arrangements..........................125
11.2 Program Implementation.........................................127
12. Time Frame and Milestones..........................................128
13. Opportunities and Risks...................      ............................130
13.1 Component 1: Value Chains for Enhanced Nutrition and Health  ..........    ...132
13.2 Component 2: Biofortification..........   .     ................ ............... 132
13.3 Component 3: Prevention and Control of Agriculture-Associated Diseases.............. 132
13.4 Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies..1 33
14. Monitoring and Evaluation System Proposed.............25....            ..........134
14.1 Performance Monitoring            ...................................     ..... 135
14.2 Ensuring Uptake: Translating Outputs into Outcomes    ................    ....135
14.3 Impact Assessment             ...........................................136
15. Budget ......       ......................................................139
15.1 Budgetsfor21 VlueChainsforEnh............................................. 140
15.1.1 BudgetAnalysis         .......................................... 140
15.1.2 Indirect Costs Institutional Overheadgriuure..................... s....... 140
15.2 Sources of Funding            ...................................    ........141
15.3 The Budget Cycle ...1.P........................................141
15.4 Costs by Component and Year............................              .......142
References .....       .....................................................145
5 4  ostsby  ompoentand  ear....                                  ....... 4


﻿Appendixes:
1. Glossary of Terms at the Agriculture, Nutrition, and Health Interface  ..............157
2. Countries with Child Stunting Prevalence - 20% and National Commitments to
Global Nutrition Initiatives  ................................... .....163
3. CRP4 CGIAR Performance indicators Matrix..............................165
4. Implementation and Partnership in Policy Processes: The CAADP Example .... ....175
5. Fish Value Chain for Improved Nutrition and Health: Proposed Collaboration
between CRP4 and CRP3.7        ......................................178
6.  Value Chain for Improved Nutrition through Agriculture Biodiversity............. ..........183
7. 2010 Status of Micronutrient Density in HarvestPlus Crops under Development...............188
8. Summary of Existing and Planned Activities on Prevention and Control of Agriculture
Associated Disease        .................................................189
9. From Component 3 (AAD)         ..................................... .....191
10. Examples of Integrated Agriculture, Health, and Nutrition Programs That Could Be
Included in the First Phase of Research under Component 4.1  ...............196
11. Examples of Evidence-based, Cross-Sectoral Interventions  ............... .....209
12. Potential Interactions between CRP4 and other CRPs  ................................210
13. CRP4 Capacity Strengthening Activities Table.............................218
14. CRP4 Capacity Strengthening Activities by Component  ......................220
iv


﻿TABLE OF TABLES
1.    CRP4 components and objectives   ......................................... 7
2.    CRP4 components and subcomponents...............................24
3.    CRP4 focus countries in first year of program  implementation......... .. .................26
4.    Preliminary list of value chains and countries that will be included in the CRP4
value chain for nutrition research in the first five years of the program.. .............38
5.    Activities, outputs, outcomes, and impacts of Component 1, by objective.................40
6.    Methods and indicators for Component 1  ...................... .........42
7.    Examples of partnerships for Component 1..........................45
8.    Overview of HarvestPlus activities, outputs, and outcomes  ...................51
9.    Some crop-specific HarvestPlus activities, outputs, and outcomes  ..............52
10.   Overview of AgroSalud activities, outputs, and outcomes  ............... .....58
11.   Some crop-specific AgroSalud activities, outputs, and outcomes  ...............59
12.  Initial priority research areas and relevant CGIAR experience .................66
13.   Activities, outputs, and outcomes for Subcomponent 1: Food safety-High
initial priorities (by research theme) ....................................79
14.   Examples of partnership arrangements for food safety......................82
15.   Activities, outputs, and outcomes of Subcomponent 2 (by research theme) ..............85
16.   Examples of partnerships for zoonotic and emerging diseases ................86
17.   Activities, outputs, and outcomes for Subcomponent 3 (by research theme) ............90
18.   Preliminary list of ANH programs, countries, and partners that will be
included in CRP4 in the first 5 years ....................................99
19.   Activities, outputs, and outcomes for the Integrated Programs subcomponent ............100
20.  Indicative research methods for the Integrated Programs subcomponent.... ....103
21.   Activities, outputs, and outcomes of the subcomponent on Harmonized Policy ...........108
22.   Time frame and milestones     ................................. ......129
23.   Key risks and their mitigation measures  .......................... .....1 31
24.   M&E Plan: Elements, timing, and scope .....................................138
Budget Tables
B:   Budget categories for comparison  ...........................................140
B2:   Breakdown of costs on an overall program basis .............. ................ 142
83:   Breakdown of costs for five main components for 2011  ................ .....1 43
B4:   Breakdown of costs for five main components for 2012  ............... ...... 143
85:   Breakdown of costs for five main components for 2013.. ...................144
B6:   Allocation of CRP4 Budget among participating Centers and funding sources ($000) .144
V


﻿Appendix Tables
A5.1. Opportunities and constraints in tilapia and catfish production value chain in Uganda
and the research and development actions to overcome them (extracted with
permission from the CRP3.7 proposal)  ......................... ......180
A6. 1. Activities, outputs, and outcomes  .............................. .....186
A9. 1. Detailed activity to impact plan for initial priority areas (food safety and zoonoses) ... .191
Al 0.1. Summary of case studies of programs integrating agriculture, nutrition, and health.....206
Al 3.1. CRP4 capacity-strengthening strategies, outputs, outcomes, and impacts .... ....218
TABLE OF FIGURES
1 .  CRIP4 Strategic framework..................................................................... 9
2.   CRP4 Impact pathway ........................................................................ 15
3.   Research strategy for enhancing nutrition along the value chain.......................... 33
4.   Impact pathway of Component 1 ............................................................. 36
5.   Impact pathway of Component 2 ............................................................. 47
6.   Steps in research process for biofortification ................................................ 49
7.   From research to impact: Multiple pathways in a risk management context.............. 72
8.   Research on agricultural practices and malaria risks ....................................... 91
9.   Conceptual framework of the determinants of child nutrition and health.................. 93
10.  Impact pathways of Component 4............................................................ 95
11.  CRIP4 Management structure ............................................................... 125
Appendix Figure
A4.1. CRP4 partnership and value addition illustrated using the CAADP Framework ........ 177
Vi


﻿TABLE OF BOXES
1.  CRP4's strategic goal        ..................................... .......... 6
2.   Case Study 1: Enhancing nutritional value and marketability of beans through
research and strengthening of key value-chain stakeholders in Uganda  ... ...........29
3.   Case Study 2: Increasing production, availability, and consumption of vitamin A-rich
orange-fleshed sweet potato (OFSP) in Mozambique and Uganda  ...............30
4.   Case Study 3: Traditional African green leafy vegetables find their way to
formal markets         ..................................................31
5.   Case Study 4: Improving processing and preparation of fish to preserve nutritional
quality and improve children's diets in Bangladesh  ...............................32
6.  Agriculture-Associated Diseases: What they are and why they matter ... ..............62
7.   Existing collaboration efforts.........................................73
8.   Links of aflatoxins and stunting.............. .................. ......74
9.   Methodological approaches...............      .................... .....81
10. Overview of TN, LANSA, and POSHAN policy research programs. .............. 112
11. Why focus on women to improve children's health and nutrition? .......... ..... 113
Vii


﻿ACRONYMS
AAD            agriculture-associated disease
ALVs           African leafy vegetables
ANH            agriculture nutrition health
ARDAP          Appropriate Rural Development Agriculture Program
ARI            advanced research institute
ART            antiretroviral therapy
ASARECA        Association for Strengthening Agricultural Research in Eastern and Central Africa
ATP            ability to pay
AU             African Union
AUC            African Union Commission
AU-IBAR        African Union Interafrican Bureau for Animal Resources
CAADP          Comprehensive Africa Agriculture Development Program
CBA            cost-benefit analysis
CBO            community-based organization
CEA            cost-effective analysis
CFA            Comprehensive Framework for Action
CGIAR or CG    Consultative Group on International Agricultural Research
CIAT           International Center for Tropical Agriculture
CIMMYT         International Maize and Wheat Improvement Center
CIP            International Potato Center
CIRA           Collaborations for Integrated Research and Action
CIRAD          Agricultural Research for Development
COMESA         Common Market for Eastern and Southern Africa
CoP            community of practice
CREADIS        Community Research in Environment and Development Initiatives
CRP            CGIAR Research Program
CRS            Catholic Relief Services
CSO            civil society organization
DALYs          disability-adjusted life years
DFID           United Kingdom Department for International Development
DRC            Democratic Republic of Congo
ECOWAS         Economic Community of West African States
E-HFP          Enhanced homestead food production
EID            emerging infectious disease
EMBRAPA        Brazilian Agricultural Research Cooperation
EU FP-7        European Union Framework Program 7
FANRPAN        Food Agriculture and National Resources Policy Analysis Network
FAO            Food and Agriculture Organization of the United Nations
FARA           Forum for Agricultural Research in Africa
FBD            food-borne disease
FERG           Foodborne Disease Burden Epidemiology Reference Group
FIND           Foundation for Innovative New Diagnostics
GAFSP          Global Agriculture and Food Security Programs
GAIN           Global Alliance for Improved Nutrition
GALVmed        Global Alliance for Livestock Veterinary Medicines
GBD            global burden of disease
GCARD          Global Conferences on Agricultural Research for Development
GFSI           Global Food Safety Initiative
GFU            Global Facilitation Unit for Underutilized Species
viii


﻿GXE            gene by environment
HIV/AIDS       human immunodeficiency virus/acquired immune deficiency syndrome
HKI            Helen Keller International
IA             impact assessment
IAH            Institute for Animal Health
IARC           International Association of Research of Cancer
ICARDA         International Center for Agricultural Research in Dry Areas
ICIPE          International Centre of Insect Physiology and Ecology
ICRAF          World Agroforestry Centre
ICRISAT        International Crops Research Institute for the Semi-Arid Tropics
IDRC           International Development Research Centre
IDS            Institute for Development Studies, UK
IEC            Information, Education, and Communication
IFAD           International Fund for Agricultural Development
IFPRI          International Food Policy Research Institute
IGS            Institute for Genome Sciences
IITA           International Institute of Tropical Agriculture
ILAC           Institutional Learning and Change
ILO            International Labor Organization
ILRI           International Livestock Research Institute
INSTAPA        Improved Nutrition through Staple Foods in Africa
IPG            international public good
IPM            integrated pest management
IPMA           Integrated Partnership for Malaria in Africa
IRD            Institut de Recherche pour le D6veloppement
IRRI           International Rice Research Institute
ITG            International Technology Group
IUCN           International Union for Conservation of Nature
IWMI           International Water Management Institute
KAP            knowledge, attitudes, and practices
KARI           Kenyan Agricultural Research Institute
LANSA          Leveraging Agriculture for Nutrition in South Asia
LCIRAH         Leverhulme Center for Integrated Research on Agriculture and Health
LIDC           London International Development Centre
London-RVC     London-Royal Veterinary College
LSHTM          London School of Hygiene and Tropical Medicine
LSTM           Liverpool School of Tropical Medicine
M&E            monitoring and evaluation
MDG            Millennium Development Goals
MoA            Ministry of Agriculture
MoH            Ministry of Health
MVP            Millennium Villages Project
NARES          national research and education system
NARS           National agriculture research system
NEPAD          New Partnership for Africa's Development
NGO            nongovernmental organization
NPCA           NEPAD Planning and Coordination Authority
NTFP           nontimber forest products
OFSP           orange-fleshed sweet potato
OIE            World Organization for Animal Health
OPV            open-pollinated variety
ix


﻿PACA           Partnership for Aflatoxin Control in Africa
PATH           Program for Appropriate Technology in Health
PHAST          Participatory Hygiene and Sanitation Transformation
PHFI           Public Health Foundation of India
PIA            program implementation agreement
PMC            Planning and Management Committee
PMCA           participatory market chain approach
PRA            participatory risk assessment
QCRA           quantitative comparative risk assessment
QMRA           quantitative microbial risk assessment
RAIN           Realigning Agriculture to Integrate Nutrition
REACH          Ending Child Hunger and Undernutrition
RECs           regional economic communities
ReSAKSS        Regional Strategic Analysis and Knowledge Support System
ROA            RAPID outcome assessment
RRC            Rural Resource Center
RVF            Rift Valley fever
SA             South Asia
SACIDS         Southern Africa Center for Infectious Disease
SARS           severe acute respiratory syndrome
SCN            Subcommittee on Nutrition
SLO            system-level outcome
SPMs           stated preference methods
SPS            Sanitary and Phytosanitary Measures Agreement
SROs           subregional organizations
SSA            Sub-Saharan Africa
SSAFE          supply of affordable food everywhere
STPH           Swiss Tropical and Public Health Institute
SUN            Scaling-Up Nutrition
TDR            WHO program for Research and Training in Tropical Diseases
TN             Transform Nutrition
TropIKA        Tropical Diseases Research to Foster Innovation and Knowledge Application
UG             University of Guelph
UN             United Nations
UNAIDS         Joint United Nations Program on HIV/AIDS
UNICEF         United Nations Children's Fund
USA            United States of America
USAID          United States Agency for International Development
USDA           United States Department of Agriculture
VMF            village model farm
WAHO           West African Health Organization
WB             World Bank
WFP            World Food Programme
WHO            World Health Organization
WTO            World Trade Organization
WTP            willingness to pay
WV             World Vision
WWF            World Wildlife Fund
P-ODAP          P-diaminopropionic acid
x


﻿FOREWORD
The Consultative Group on International Agricultural Research (CGIAR) has committed itself to ensuring
that agricultural research serves the needs of the poor. Two urgent needs for the poor are better nutrition
and better health. In its new vision (CGIAR SRF 2010), the CGIAR commits to reduce poverty and
hunger, improve human health and nutrition, and enhance ecosystem resilience through high-quality
international agricultural research, partnership, and leadership. This CGIAR Research Program,
Agriculture for Improved Nutrition and Health, directly and strategically supports this new vision.
Agriculture will need to develop and expand to meet the food needs of a growing population from
a finite resource base. How agriculture develops to do this can have critical consequences on the health
and nutrition of people. This program is designed to support the overall CGIAR research agenda by
improving our understanding and options for how agriculture can better accentuate the positive benefits
and mitigate the risks of agricultural development on human health and nutrition. These lessons are meant
to serve the entire CGIAR agenda, within agroecological production systems and along food value chains.
Emphasis will be placed on two populations of people. The first group is those people who are
left behind by socioeconomic development, suffer from high rates of malnutrition and agriculture
associated diseases, and rely on aid and development support. Research in the program will meet the
demands of development implementers and investors for better knowledge, technologies, and learning
approaches to improving their performance.
The second group is those poor people in dynamically intensifying and changing systems in
which research can help shape agricultural development more positively and safely. This program will
support policy- and decisionmakers and development implementers. Managing the benefits and risks of
agricultural development on human health and nutrition are central to achieving the CGIAR-stated impact
goals of poverty reduction, food security, and environmental sustainability for people in developing
countries.
This program will work at the interface of the agriculture, nutrition, and health sectors. These are
three critical pillars for development. For the ambitions of this program to be met, partnerships will be
critical. Twelve CGIAR Centers and multiple partners from agriculture, nutrition, and health communities
have actively participated in contributing to the development of this proposal through written
contributions, stakeholder and partner workshops, and oral discussions. This program proposes a much
closer partnership between the agriculture, nutrition, and health research and development communities
than seen previously. New approaches to cross-sectoral work are proposed. While new, this program will
build on past successes of CGIAR and partners working together on agriculture, nutrition, and health
programs and seeks to complement a number of new international initiatives for improving agriculture-
nutrition and agriculture-health integration and synergies.
xi


﻿ACKNOWLEDGMENTS
This proposal is the culmination of the effort of many internal and external collaborators who worked
closely together for more than one year. The process of drafting the initial concept note, which serves as
the basis for the proposal, was led by Marie Ruel (IFPRI) and John McDermott (ILRI), with important
contributions from Howdy Bouis (HarvestPlus) and focal points from 12 CGIAR Centers. The concept
note was submitted to the Consortium Board on May 9, 2010.
The project leaders allowed for comments on the concept note by posting it online for more than
10 weeks. During this time, the note benefited from the useful feedback of the Consortium Board (CB),
peer reviewers, CGIAR centers, and external partner organizations. Key internal and external
stakeholders were also interviewed in person and by phone to further incorporate their perspectives and
ideas.
The centers and partners, representing the full spectrum of the agriculture, nutrition, and health
fields, met on July 28-30, 2010, in Addis Ababa, Ethiopia. The three-day workshop was attended by more
than 60 stakeholders and represented a unique opportunity to incorporate diverse viewpoints on the
research and development goals of the CRP4 program. The meeting was supported by Lynette Aspillera
(IFPRI), Loza Mesfin (ILRI), Ginette Mignot (IFPRI), Terry Muindi (ILRI), Nicole Rosenvaigue (IFPRI),
and Sivan Yosef (IFPRI). Special thanks go to JiUrgen Hagmann, Global Team Leader for the People,
Innovation, and Change in Organisations (PICO Team, www.picoteam.or ), for his excellent facilitation,
and to his assistant, Judith Odhiambo.
The complex task of synthesizing all the components into one document was led by Marie Ruel,
John McDermott, and Howard Elliott, who coordinated a core writing team to develop the proposal. The
writing team included Jessica Fanzo and Stefano Padulosi (Bioversity), Bonnie McClafferty
(HarvestPlus), Helena Pach6n (CIAT), Maximo Torero (IFPRI), and Delia Grace (ILRI). Numerous
CGIAR colleagues and partners provided key contributions to the research proposal development, which
was submitted to the Consortium Board (CB) on September 11, 2010.
Comments from the CB and four reviewers were received on February 4, 2011. Marie Ruel and
John McDermott coordinated the revisions to the proposal, with strong support from several members of
the original writing teams. The revised proposal was shared with the key contact points from all
participating CGIAR centers, who contributed extensively to the revisions.
The revised proposal submitted on May 6, 2011, benefited from the support of Rajul Pandya-
Lorch, Klaus von Grebmer, Teunis van Rheenen, and Suresh Babu (IFPRI), continuous efforts of IFPRI's
communications team, including Gwendolyn Stansbury, Evelyn Banda, Pat Fowlkes, Julia Vivalo, and
Clare Wolfowitz (independent consultant), and the excellent assistance of the Poverty, Health and
Nutrition Division (PHND) staff Nicole Rosenvaigue and Jody Harris.
The current version of the proposal addresses the comments received from the Independent
Scientific & Partnership Council (ISPC) and the Fund Council in June 2011. Marie Ruel and John
McDermott revised the proposal with inputs from Maximo Torero, Delia Grace, Jessica Fanzo, and
Shakuntala Thilsted, with formatting, editing, and research support from Jay Willis (IFPRI), Nicole
Rosenvaigue, and Jody Harris.
The enthusiasm and responsiveness of all CGIAR partners and their continued support in revising
and strengthening this proposal is gratefully acknowledged. Leading organizations in agriculture,
nutrition, and health expressed interest in different components of the program and are committed to its
development and success. This proposal represents a starting point in an exciting process of
operationalizing a cross-sectoral research for development program on agriculture for improved nutrition
and health.
xii


﻿1. EXECUTIVE SUMMARY
Background
Hunger, malnutrition, and poor health are widespread and stubborn development challenges. Agriculture
has made remarkable advances in the past decades, but progress in improving the nutrition and health of
poor farmers and consumers in developing countries is lagging behind. A recent IFPRI 2020 Conference
in New Delhi, "Leveraging Agriculture for Improving Nutrition and Health," brought together about
1,000 stakeholders to examine how agriculture could be energized to become a more powerful tool to
tackle the persistent problems of food insecurity, malnutrition, and poor health. Building on the
momentum created by those discussions, the CGIAR Research Program on Agriculture for Nutrition and
Health (CRP4) is designed to fill the
existing gap between agricultural
development and its unfulfilled health and
nutritional benefits.
The starting point for CRP4 is that
agricultural practices, interventions, and
policies can be better adapted and
redesigned to maximize health and nutrition
benefits and to reduce health risks. This
concept reflects the new vision of the
CGIAR Strategic Results Framework
(April 2011), which has four strategic
objectives: improving human nutrition and
health, reducing rural poverty, improving
food security, and achieving sustainable
management of resources. While CRP4 will
contribute to the achievement of all four
CGIAR strategic objectives, its primary
focus will be on improving human nutrition
and health. In order to achieve this goal,
CRP4 will bring together research and
development professionals across the
agriculture, nutrition, and health (ANH)
sectors to jointly tackle key challenges and
design joint solutions.
CRP4 Strategic Goal
CRP4 is a research program that will work to accelerate progress in improving the nutrition and
health of poor people by exploiting and enhancing the synergies between agriculture, nutrition, and
health through four key research components: value chains, biofortification, control of agriculture-
associated diseases, and integrated agriculture, nutrition, and health development programs and policies.
CRP4 Strategic Framework and Research Components
Figure 1 presents the overall strategic framework of CRP4. The key development challenges that the
program will address are the stubborn problems of undernutrition and ill health that affect millions of
poor people in developing countries. CRP4 will leverage agriculture to improve the nutrition and health of
the poor through four research components that will directly address the problems of low diet quality-
the main cause of undernutrition worldwide-and of vulnerability to agriculture-associated diseases.


﻿Component I focuses on opportunities to improve nutrition along value chains to increase the poor's
access to nutritious foods. Component 2 aims to improve the availability, access, and intake of nutrient-
rich, biofortified staple foods for the poor. Component 3 addresses food safety issues along the value
chain, including the control of zoonotic diseases and the better management of agricultural systems to
reduce the risk of human diseases. Component 4 addresses the need for integration among the agriculture,
nutrition, and health sectors, at both the program and policy levels.
These four components were selected based on discussions and brainstorming with
representatives from 12 CGIAR centers and a wide range of partners who participated in the CRP4
planning meeting in July 2010. Their selection arises from the recognition and consensus that poor diet
quality and related micronutrient deficiencies are now the most pressing nutritional problem affecting the
poor. Similarly, the severe disease burden from food-borne infections and zoonotic diseases is associated
with changes in agricultural practice and policy, and therefore requires agricultural solutions. As
agriculture is the main livelihood strategy for the poor, it is they who are disproportionately affected by
these health and nutrition problems. For CRP4 to adequately tackle these challenges, the program team
carefully assessed the opportunities that exist within the current (and future) research portfolio of the
CGIAR and its partners in order to leverage agriculture to improve nutrition and health and to exploit
their potentially powerful synergies to achieve the common goal of improving the nutrition and health of
the poor.
Research Objectives
The CRP research objectives across the different components are as follows:
1. Generate knowledge and technologies to improve the nutritional quality and safety of foods
along value chains (Components 1, 2, and 3).
2. Develop, test, and release a variety of biofortified foods, as well as other nutrient-rich foods
that are affordable for the poor and accessible to them (Components 1 and 2).
3. Generate knowledge and technologies for the control of zoonotic, food-borne, water-borne,
and occupational diseases (Component 3).
4. Develop methods and tools to improve the effectiveness, efficiency, and timeliness of
surveillance and monitoring systems and to permit meaningful evaluation of complex
multisectoral programs and policies (Components 1-4).
5. Produce evidence of nutritional and health burdens and benefits and of the returns to different
interventions in different sectors (Components 1-4).
6. Assess and document changes in dietary and nutritional patterns and risks of agriculture-
associated diseases among poor people in intensifying systems, and identify and test
agricultural options to enhance nutrition and health benefits and mitigate risks of agriculture
intensification in these populations (Components I and 3).
Impact Pathways
Figure 2 presents the overall program impact pathway. CRP4 is expected to enhance the contribution of
agriculture research outputs to nutrition and health impacts through three major impact pathways and their
respective actors: (1) value chains that provide more nutritious and safer foods; (2) development
programs that successfully integrate agriculture, nutrition, and health; and (3) policy that promotes a
supportive and enabling cross-sectoral policymaking process and investment environment. Expected
outputs from CRP4 are value chains that provide more nutritious and safer foods accessible to the poor;
stronger and more effective integrated ANH programs; and better cross-sectoral policies, investments, and
regulation. CRP4 will contribute to large-scale sustainable impacts by developing strong linkages with
development implementers, including value-chain actors and ANH program implementers, and with
enablers such as international and national policymakers and governments.
2


﻿Biofortified and diverse            r
nutrient-rich foods  I
available and accessible to
the poor
Knowledge and                                                                                  r
technologies to Improve
quality and safety of foods
along value chains
developed                                                                             nutrition and
SBetter, more cost-effective                                                           health,
integrated ANH program                                                                especially
models and capacity
strengthened
* Strong evidence of role of
integrated ANH programs
in improving health and
nutrition
* Good practices in
Integrated ANH
policymaking applied
I.----------------- --------
* Cross-sectoral work
incentivized
* Capacity for joint
policymaaking strengthened
Partnerships
Effective partnerships and new partnership practices will be essential for achieving CRP4's ambitious
research outputs and development outcomes and impacts. A partnership strategy will be developed
initially, to create the best conditions for carrying out the research and making full use of the subsequent
findings. The unique complexity of CRP4, which requires working across sectors, calls for a range of
partnership types and partnership depths. CRP4 will work with four broad categories of partners: enablers
(policymakers and decisionmakers), development implementers, value-chain actors, and research
partners. We are committed to a partnership process that incorporates strategic thinking, systematic
processes with partners, innovative behaviors and resources, and implementation of best partnership
performance practices. We regard partners as the essential ingredient of a successful joint effort.
Research Components: An Overview
Component 1: Value Chains for Enhanced Nutrition-will focus on increasing the demand for nutritious
foods among poor rural and peri-urban households, and on identifying leverage points along the value
chain where innovative nutrition interventions can be incorporated to stimulate both the supply and the
demand for nutritious foods. It will build on work on value chains carried out by the CGIAR and other
partners on nutritious (usually high-value) foods. Specifically, it will
* develop innovative approaches and tools to analyze the value chain, using a "nutrition lens"
combined with a consumer focus.
3


﻿*   implement research to identify leverage points to enhance the nutritional value of select
nutrient-rich foods.
*   develop tools to assess and correct information asymmetries regarding nutrition among
different value-chain actors, including consumers.
This component's impact will result from (1) enhanced nutritional knowledge and awareness
created among value-chain actors, including consumers, and (2) the greater' selection of affordable
nutrient-rich foods available and accessible to the poor through informal and formal markets.
Component 2: Biofortification-will develop and test biofortified nutrient-dense staple crops and make
these novel crops available to the poor and undernourished. This component will have the desired impact
via an increased production and consumption of biofortified staple foods; an increased intake of iron,
zinc, and vitamin A; and a resulting reduction in the prevalence of iron, zinc, and vitamin A deficiencies.
Component 3: Prevention and Control ofAgriculture-Associated Diseases-will enhance environmental
sustainability, reduce poverty, increase food security, and contribute to the health of poor communities by
assessing, preventing, and mitigating agriculture-associated health risks, through research for improved
food and water safety; control of bacterial, viral, parasitic, or fungal diseases that can be transmitted from
animals to humans (zoonoses); and managing agroecosystems for better health. This component will find
and develop solutions and innovations to reduce the risks of agriculture-associated diseases; understand
and support appropriate institutions and incentives that will make these efforts sustainable; assess the
impact of interventions; and develop communications, advocacy, and influence strategies that will enable
the uptake and use of those interventions.
Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies-will exploit and
enhance the synergies between agriculture, nutrition, and health through operational and policy research
that permits (1) more effective integrated community-level programming, and (2) the cultivation and
strengthening of an enabling policy and institutional environment to support relevant action. This
component will harness both the synergy of integrated programming and the potential for sustained policy
commitment, to best realize the benefits of agriculture, nutrition, and health.
Cross-cutting Issues
Gender
Throughout much of the world, women are the guardians of household food security and nutrition. At the
same time, biological and cultural factors can put women and girls at particular risk of undernutrition,
micronutrient malnutrition, and poor health, especially during the reproductive period. Good agriculture,
nutrition, and health programming must therefore account for gender issues at all stages of the project
cycle, from participatory assessment and analysis through surveillance, implementation of interventions,
monitoring, and evaluation. CRP4 will focus on the following broad areas: (1) gender analysis of needs
and differential exposure to risks; (2) fostering women's participation in and benefits from agriculture,
nutrition, and health programs; (3) empowering women and increasing their access to assets;
(4) promoting equitable intrahousehold food allocation and consumption for all members; (5) ensuring
gender-friendly technology and delivery systems; and (6) building capacity.
Capacity Strengthening
Capacity strengthening is a crucial element for CRP4's longer-term and more sustainable impacts,
essential for program scale-up and sustainability. Implementing CRP4 will require adequate capacity for
translating research methods and outputs into adopted technologies and institutional and policy changes.
Just as important, it will mean developing cross-disciplinary capacity at various levels, including
government and development agencies as well as educational and research institutions. Research teams
4


﻿working on CRP4 will undertake, as a preliminary step, comprehensive assessments of capacity gaps and
needs in targeted countries and institutions, to develop an appropriate capacity-development strategy.
Innovation
Bringing together agriculture, nutrition, and health is not a new idea, but CRP4 will be innovative in a
number of areas. It will
*  foster new partnerships to ensure that agriculture, nutrition, and health are integrated and
delivered-at the community level, in large development programs, and in policymaking.
*  undertake cutting-edge research to meet emerging challenges-for instance, it will work with
partners to design mechanisms for enhancing nutrition along the agricultural value chain and
to apply new molecular biology tools informed by population biology and social research to
improve our understanding of how agricultural intensification can be more sustainably
managed.
*  invest in designing new tools and approaches to build the evidence base to usefully guide
policy and practice across sectors.
Management Structure
The governance and management arrangements for CRP4 follow the guidelines set out in the CGIAR
Strategic Results Framework. IFPRI will be the lead center, and will have overall fiduciary and
operational responsibility for the implementation of CRP4. The International Livestock Research Institute
(ILRI) will play a strong supporting role, providing the Chair of the Planning and Management
Committee (PMC) for the initial two years. The PMC will oversee the planning, management,
implementation, and monitoring and evaluation of the CRP. An Independent Advisory Committee,
composed of six members representing scientists and program development experts, will provide advice
on research program performance, research priorities and focus, and management and partnership issues.
Monitoring and Evaluation
Indicators for tracking and assessing achievements will be constructed according to the SMART
framework-specific, measurable, achievable, relevant, and time-bound-allowing for clear, results-
based management of the CRP. A monitoring and evaluation plan will be developed under each
component and subcomponent. The plans will provide a framework to track both the process of
implementation and the attainment of interim targets. They will include milestones for activities, outputs
(such as publications, datasets, training materials, and training activities), communication, dissemination,
and networking (to ensure appropriate uptake of project outcomes). Plans will also specify corrective
actions to be taken if milestones are missed.
Conclusion
The CGIAR has long played a unique role as an internationally coordinated agricultural research system
that provides international public goods. With its partners, it is well equipped to provide leadership in
developing new technologies, evidence, and applied field research for leveraging agriculture to improve
nutrition and health. The CGIAR can work closely with partners in all three sectors to develop innovative
and evidence-based solutions, strategies, and policies. Fully utilizing the CGIAR's scientific competence
and reputation in this complex interdisciplinary area and its vast collaborative network at all levels of the
impact pathway, CRP4 will achieve meaningful outcomes and tremendously benefit the health and
nutrition status of poor people, especially women and young children.
5


﻿2. STATEMENT OF OBJECTIVES AND STRATEGIC FRAMEWORK
Hunger,' malnutrition, and poor health are widespread and stubborn development challenges. Agriculture
has made remarkable advances in the past decades, but progress in improving the nutrition and health of
poor farmers and consumers in developing countries is lagging behind. The recent IFPRI 2020 conference
"Leveraging Agriculture for Improving Nutrition and Health" (New Delhi 2011) brought together about
1,000 stakeholders to think through how agriculture could be energized to become a more powerful tool
to tackle the persistent problems of food insecurity, malnutrition, and poor health. Building on the
momentum created by those discussions, the Consultative Group on International Agricultural Research
(CGIAR) Research Program on Agriculture for Nutrition and Health (CRP4) is designed to fill the
existing gap between agricultural development and its unfulfilled health and nutritional benefits.
2.1 The Potential Contribution of CRP4 to the Achievement of the CGIAR's System-Level
Outcomes (SLOs)
Agricultural practices and interventions can be better adapted to maximize health and nutrition benefits
and to reduce health risks. This concept-the starting point for CRP4-reflects the new vision of the
CGIAR Strategic Results Framework (April 2011). Improving human nutrition and health is one of the
four strategic objectives of that Framework, along with reducing rural poverty, improving food security,
and achieving sustainable management of resources. The CGIAR thus recognizes that nutrition and health
are global priorities, and that agricultural research can have a profound influence on both of these
outcomes.
Thus, while CRP4 will contribute to the achievement of all four CGIAR strategic objectives, its
primary focus will be on improving human nutrition and health. In order to achieve this goal, CRP4 is
designed to bring together research and development professionals across the agriculture, nutrition, and
health (ANH) sectors to jointly tackle key challenges and design joint solutions. The program recognizes
that increasing agricultural productivity is not sufficient in itself to improve health and nutrition, and that
the three sectors need to join forces in tackling their common development goals. The persistence of high
rates of maternal and child undernutrition, especially in Sub-Saharan Africa and South Asia, calls for new
approaches and new partnerships across the ANH sectors. Similarly, there are persistent health risks
associated with agriculture-such as water-related, food-borne, and zoonotic diseases-that also require
joint solutions to be managed between the agriculture and health sectors. The CGIAR has long played a
unique role as an internationally coordinated agricultural research system, and, with its partners, it is well
equipped to provide leadership in developing new technologies, evidence, and applied field research for
leveraging agriculture to improve nutrition and health.
2.2 CRP4 Objectives
CRP4's strategic goal is presented in Box 1. To achieve its strategic goal, the program is organized
around four components, listed in Table 1 along with their overall objectives.
'See Appendix 1 for a glossary of nutrition and health terms used in this proposal.
6


﻿Table 1. CRP4 components and objectives
Component                                       Objective
1. Value chains for enhanced nutrition and health  Leverage the value chain for select nutrient-rich foods to
increase the demand for, access to, and consumption of
affordable and nutritious foods for the poor.
2. Biofortification                             Develop and test nutrient-dense staple crops through
biofortification; make these novel crops available to the
poor and undernourished, either as individual staple
crops or as part of a food basket.
3. Prevention and ccontrol of agriculture-associated  Prevent and control agriculture-associated diseases
diseases                                    through research for improved food safety, water
quality, agricultural practices, and better control of
infectious (zoonotic and emerging) diseases.
4. Agriculture, nutrition, and health - Integrated  Exploit and enhance the synergies between agriculture,
programs and harmonized policies             nutrition, and health, through operational and policy
research that supports (1) more effective integrated
community-level programming, and (2) the cultivation
and strengthening of an enabling policy and institutional
environment to support relevant action.
The CRP research objectives across the different components are as follows:
1. Generate knowledge and technologies to improve the nutritional quality and safety of foods
along value chains (Components 1, 2, and 3).
2. Develop, test, and release a variety of biofortified foods, as well as other nutrient-rich foods
that are affordable and accessible to the poor (Components I and 2).
3. Generate knowledge and technologies for the control of zoonotic, food-borne, water-borne,
and occupational diseases (Component 3).
4. Develop methods and tools to improve the effectiveness and efficiency of surveillance and
monitoring systems and to permit meaningful evaluation of complex multisectoral programs
and policies (Components 1-4).
5. Produce evidence of nutritional and health burdens and benefits and of the returns to different
interventions in different sectors (Components 1-4).
6. Assess and document changes in dietary and nutritional patterns and risks of agriculture-
associated diseases among poor people in intensifying systems, and identify and test
agricultural options to enhance nutrition and health benefits and mitigate risks of agriculture
intensification in these populations (Components I and 3).
The four research components of CRP4 were selected based on a broad consultation process with
representatives from 12 CGIAR centers and with a wide range of partners who participated in the CRP4
planning meeting in July 2010 (see https://sites.google.com/a/cgxchange.org/mp4/home). Taking into
consideration the CGIAR's comparative advantage, the components were selected by taking into
consideration the following key questions: (1) what is the nature, scope, dimension and causes of the
nutrition and health problems that the CGIAR needs to address in order to achieve its strategic goal of
improving health and nutrition through agriculture; (2) what opportunities exist within the current (and
future) research portfolio of the CGIAR and its partners to leverage agriculture to improve nutrition and
health; and (3) how can CRP4 best use these opportunities to exploit the potentially powerful synergies
between agriculture, nutrition, and health and to achieve the common goal of improved nutrition and
health. These considerations led the team of partners to select the four broad research components listed
in Table 1.
7


﻿2.3 CRP4's Strategic Framework
Figure 1 presents the overall strategic framework of CRP4. The key development challenges that the
program is addressing are the stubborn problems of undernutrition and ill health that affect millions of
poor people globally. Root causes of poor nutrition and health include poverty, food insecurity, gender
inequity and limited access to water, sanitation, and health services. Tackling undernutrition and poor
health will thus require joint ANH solutions; each sector is essential but insufficient by itself to solve the
nutrition and health challenges faced by the poor. This CRP aims at bringing these three sectors together
in research, development programs, and policy.
It is well recognized that poor-quality diets and related micronutrient deficiencies are a much
more widespread nutritional problem than the lack of food (or calories). Although estimates from FAO
suggest that the number of hungry people (lacking calories) is close to 1 billion (FAO 2009a), WHO
estimates that anemia-which is largely caused by iron deficiency-affects 1.62 billion people worldwide
and costs US$50 billion in GDP losses each year (WHO 2008a). Vitamin A deficiency also affects 163
million children, or close to one-third of children living in developing countries (ACC/SCN 2010). Poor
diet quality and related micronutrient deficiencies are also a major cause of the staggering numbers of
stunted children in the developing world (see Appendix 2 for a list of 36 countries that account for 90
percent of the total burden of childhood stunting). The agriculture sector must provide ssolutions designed
not just to produce more food, but to improve poor people's access to nutritious foods. Similarly,
agricultural solutions are required to reduce the severe disease burden from food-borne infections and
zoonotic diseases, which are associated with changes in agricultural practice and policy. Because
agriculture is the main livelihood strategy for the poor, it is they who are disproportionately affected by
these health and nutrition problems.
Improving health and nutrition requires actions in several sectors, but CRP4 will focus on the
CGIAR's comparative advantage, which starts with agriculture. CRP4 will leverage agriculture to
improve nutrition and health of the poor through four research components that will directly address the
problems of poor diet quality and of vulnerability to agriculture-associated diseases of the poor.
Components 1-3 focus on pragmatic nutrition and health solutions to improve the poor's access to
nutritious and safe foods and to reduce agriculture-associated health risks. Component I focuses on
opportunities to improve nutrition along value chains, from production through to consumption;
Component 2 aims at improving the availability, access, and intake of nutrient-rich biofortified staple
crops for the poor; and Component 3 addresses food safety issues along the value chain, including the
control of zoonotic diseases and the better management of agricultural systems to reduce risk of human
diseases. Component 4 addresses the need for integration among the agriculture, nutrition, and health
sectors, at both the program level and the policy level (Subcomponents 4.1 and 4.2). More specifically,
the inputs generated by research on Components 1-3 will be incorporated into integrated ANH programs,
which will be tested, evaluated, and scaled up under Component 4 (Subcomponent 1 on integrated ANH
programs). Finally, evidence generated through Components 1-4.1 and through policy research
(Subcomponent 4.2) will be used to create and sustain an enabling environment, to develop institutional
capacity, and to foster synergies between agriculture, nutrition, and health at the policy level.
The lower part of Figure 1 highlights some of the development impacts that will be achieved
through CRP4's work, by integrating agriculture, nutrition, and health into value chains, development
programs, and policies. Biofortification research and value chains focused on enhancing the nutrition and
safety of foods and on stimulating the demand for such foods will lead to new options that can contribute
to increasing the availability, accessibility, and consumer awareness of the benefits of high-quality and
safe foods. Higher quality diets combined with lower risks of agriculture-associated diseases in the
population will result in healthier, better nourished, and more productive men and women farmers. Better
access to nutritious food, and better information about nutrition and food safety, will yield cross-cutting
benefits to poor consumers and producers.
8


﻿Figure 1. CRP4 Strategic framework
To achieve the program objectives, researchers in CRP4 will coordinate and initiate cutting-edge
research on catalyzing nutrition and health outcomes. Forging partnerships will be an essential element
for strengthening the connections between agriculture and health organizations and for exploiting
synergies in research, policy, and practice. Delivering impacts will require examining the context of the
broader agrifood production system and value chain and engaging critical actors through different impact
pathways.
Within the health sector, the program focuses on two main areas of impact. The first area is
promoting overall improvement in the health of women, infants, and young children through better
nutrition, by exploiting the window of opportunity for improving nutrition-the thousand days between
conception and the child's second birthday-and by targeting girls and women at all stages of the life
cycle. The second area is reducing agriculture-associated diseases through improved food safety, better
agricultural practices, and water management, as well as by controlling zoonoses (endemic and
emerging). This focus area targets people from all population groups and at all stages of the life cycle.
In addition, more specific targeting efforts will increase program impact in particular regions.
These target areas will include mainstreaming HIV/AIDS in heavy burden countries, and addressing the
rapid rises in obesity and related chronic disease risks in countries undergoing rapid economic growth and
changing agrifood systems. These additional health outcomes, although important, will not be a main
research focus in the initial phase of the program.
9


﻿2.4 Target Population
This program will target two specific populations: (1) poor, food-insecure, and malnourished populations,
and (2) populations affected by agricultural intensification. Increasing population, incomes, and
urbanization are driving increasing demand for food, which in turn has led to an intensification of
agricultural production. The expansion and intensification of agrifood systems has had enormous benefits
for farmers, market agents, private-sector business, and consumers. However, in many rapidly
intensifying systems, these benefits have been accompanied by negative environmental, nutritional, and
health effects, including food-borne and zoonotic diseases. At the same time, despite the overall trend
toward dynamic change and intensification in developing-country agrifood systems, many areas have
been left behind, and people in remote and marginal areas and conflict zones have been particularly
disadvantaged. In many cases, population has increased more rapidly than the capacity of agricultural
production and value chains, leading to chronic food and nutrition insecurity and poor health.
*  The first target group consists of poor populations who suffer from food insecurity, low diet
quality and related poor micronutrient intake, and undernutrition. These populations may be
served by social protection and development programs-and CRP4 will work on leveraging
these programs with better-integrated ANH interventions to achieve improved health and
nutrition. For those left behind, CRP4 will focus on reaching them and improving their access
to either biofortified staple crops, or new and better targeted integrated ANH programs.
*  The second target group consists of populations that are exposed to changing and intensifying
agrifood systems in various regions of the developing world. Research must answer critical
questions to assess the rapid changes in dietary patterns and lifestyles of these populations
and the associated changes in health risks. Understanding these shifts is critical for designing
appropriate policies, technologies, and institutional arrangements that will enhance nutrition
and health benefits and mitigate risks for the poor. CRP4 will take a forward-looking
perspective, given the rapid changes in many countries in its geographic focal regions.
2.5 Geographic Focus
CRP4 will focus particularly on Sub-Saharan Africa and South Asia-the two regions with the highest
burden of poverty, food insecurity, undernutrition, and poor health. The latest State of Food Insecurity in
the World report from the Food and Agriculture Organization of the United Nations (FAO) estimates that
in 2005/07, 202 million people (28 percent of the population) were undernourished in Sub-Saharan
Africa, and 333 million people (33 percent of the population) in South Asia (FAO 2010). The same two
regions are home to the vast majority of the world's undernourished children. Appendix 2 presents the 36
countries with a prevalence of child stunting greater than or equal to 20 percent; together, these countries
account for 90 percent of the global burden of childhood stunting. Several of these countries are currently
the focus of new global initiatives, which require a strong commitment to nutrition from the participating
Governments. One such initiative is the Scaling-Up Nutrition (SUN) movement
(http://www.unscn.org/en/scaling up nutrition sun/o, which was launched in 2010 to stimulate leaders to
focus more on nutrition and to adopt effective national policies to reduce undernutrition during the most
vulnerable 1,000-day period of a child's life from pregnancy to the age of two years. The High-Level
Meeting on Nutrition hosted by the United Nations (UN) secretary-general at the General Assembly in
September 2011, which provided an overview of progress one year after the launch of the movement,
showed that 20 countries (including high-burden countries such as Bangladesh, Ethiopia, Nepal, and
several countries in Sub-Saharan Africa) have joined, and several others are in the process of doing so
(see Appendix 2 for a list of SUN countries). This result reflects an unprecedented level of commitment
from developing-country government leaders.
Other initiatives such as the UN's REACH (Ending Child Hunger and Undernutrition) program
also support country efforts to reduce undernutrition. Similarly, the US government's Feed the Future
initiative is an agriculture-focused program that supports country-driven approaches to addressing the root
10


﻿causes of hunger and poverty (http://www.feedthefuture.-ov/countries.html). CRP4 will partner with
these initiatives and their networks of stakeholders in several high-burden countries. During its first year
of implementation, CRP4 team members will develop a plan for engaging with these initiatives and other
emerging regional or global initiatives in the areas of agriculture, health, and nutrition in several high-
burden countries.
CRP4 will also link with research conducted in other CRPs, including CRP3.7 value-chain work
on
*  high-value animal source foods in Ethiopia, India, Mali, Senegal, Tanzania, Uganda, and Vietnam
(Component 1);
*  community-based ANH programs implemented by nongovernmental agencies such as Helen
Keller International (HKI), Concern Worldwide, Save the Children, and Catholic Relief Services,
as well as governments and other partners, in Burkina Faso, Nepal, Zambia, and other locations
(Component 4); and
*  institutional commodity procurement for food emergencies by agencies such as the World Food
Programme (Component 3 on mycotoxins).
Targeted work will be carried out in select regions of Latin America, especially on biofortification (see
component 2.2). Within these targeted regions, specific sites for research will be selected according to the
locations of our partners' work on value chains and ANH development programming.
11


﻿3. JUSTIFICATION OF THE PROGRAM
3.1 Agriculture, Nutrition, and Health: Essential Links
The world's poor and hungry have been hard-hit in recent years. Food and financial crises have
undermined food security, bringing the number of hungry people to around I billion (FAO 2009a).
Progress in combating maternal and child undernutrition and micronutrient deficiencies has stalled in
many high-burden areas, leading to long-term, irreversible damage to the cognitive and physical abilities
of many people in developing countries-and diminishing those countries' economic productivity (World
Bank 2006). Maternal and child undernutrition contributes to more than one-third of child deaths and 10
percent of the global burden of disease (Black et al. 2008). Zoonotic diseases are causing unprecedented
concern, threatening pandemics and placing an especially heavy burden on the world's most vulnerable
people. Agriculture-related health losses are massive, accounting for up to 25 percent of all disability-
adjusted life years lost (DALYs) and 10 percent of deaths in low-income countries (Gilbert et al. 2010).
The economic toll of these health losses is also huge. For example, severe acute respiratory syndrome
(SARS), a zoonotic disease associated with food safety, cost an estimated $50 -100 billion2 (Aguirre and
Gomez 2009), and a major avian influenza pandemic could cost more than $1 trillion (Bums, van der
Mensbrugghe, and Timmer 2008). The cost of undernutrition to economic development is estimated at
$20-30 billion annually (UNICEF 2006). Without well-designed investments, programs, and policies to
address these challenges, the human and economic costs will continue to be enormous.
Agriculture plays a key role in the interrelationship between nutrition and health. It is the primary
source of human energy and essential nutrients; it is a source of income for 80 percent of the world's
poor; and it is an essential element of human life, health, and culture. On the other hand, livestock and
wild animals are the source of the great majority of human infectious and emerging diseases, and
agricultural products and practices can pose serious health risks. And while increased agricultural
development is fundamental for sustaining the nutrition and health of billions of people, it also
contributes to many challenges-such as population growth, urbanization, and climate change-that
threaten the availability of water, land, and other natural resources. Finally, millions of the world's poor
are rural people who are trapped in a combination of low-productivity agriculture, poor health, and
undernutrition (Ahmed et al. 2007).
The importance of agriculture for nutrition and health-in terms of both benefits and risks-is
recognized now as never before. The unprecedented enthusiasm and commitment of stakeholders from all
three sectors at the landmark IFPRI 2020 Conference on this topic in early 2011 strongly indicate that a
global consensus from the development community is emerging on the need to act quickly (IFPRI 2011).
Yet a lot needs to be done to design the approaches and tools needed to bring the three sectors together to
achieve their common goals. Links among the ANH communities have traditionally been weak,
jeopardizing the effectiveness and efficiency of efforts to improve health and nutrition outcomes.
Indeed, agricultural conditions and interventions may sometimes undermine health and nutrition.
Agricultural intensification, for example, has the potential to exacerbate the spread of agriculture-
associated diseases and to spur the development of new ones. The failure of agriculture to provide access
to nutritious foods and high-quality diets may aggravate the widespread problem of micronutrient
deficiencies. For example, past agricultural policies have focused on increasing production of staple
cereals, without commensurate investments in productivity increases for other food commodities, leading
to lower prices of food staples and higher prices for nutrient-rich foods such as pulses. Dietary energy
thus became more affordable to the poor (up until the recent food price rises), while dietary quality
became more expensive (Bouis, Eozenou, and Rahman 2011). The need for greater understanding of
these links will become even more critical as countries face the double burden of under- and
overnutrition, and the emergence of obesity and related chronic diseases among the poor.
2 All dollar figures are USD.
12


﻿A focus on agricultural development thus presents enormous opportunities for improving health
and nutrition. The health and nutrition of vulnerable populations can be vastly improved by managing
agricultural intensification in a sustainable way. Better food safety, water quality, and control of
occupational, zoonotic, and emerging diseases can reduce the risk of debilitating diseases. Greater access
to more nutritious and diversified diets can address maternal and child undernutrition and help tackle the
huge burden of micronutrient deficiencies. Improved nutrition and health, in turn, can reduce poverty for
the 1.4 billion people living on less than $1.25 a day (World Bank 2010). A greater focus on the role of
women in agriculture-as potential mediators of household and individual food and nutrition security-
could accelerate improvements in the nutrition and health of women and young children. The key is to act
now, as the ANH communities are beginning to recognize that they cannot meet these challenges in
isolation. Only well-coordinated efforts can offer any hope of meeting the shared goals of reducing
poverty, undernutrition, and ill health.
3.2 A Unique Opportunity
A succession of alarming recent events-global food price rises, threats of pandemics, and the spread of
animal diseases and pests across established boundaries-have threatened livelihoods, health, and
nutrition worldwide. These challenges have raised policymakers' awareness of the problem of sectoral
boundaries between disciplines and ministries, "stovepipes" that act as barriers to achieving solutions.
The need for multisectoral approaches-tools, programs, and policies-to achieve impacts at
scale is now well recognized among stakeholders in all three sectors, as signaled by a burgeoning of
multisectoral global initiatives: on nutrition and health, the Scaling Up Nutrition (SUN) movement and
the 1,000 Days Initiative; on agriculture and food security, the High Level Task Force on Food Security's
Comprehensive Framework for Action (CFA), the Committee on World Food Security, the
Comprehensive Africa Agriculture Development Program (CAADP), and the recently funded Global
Agriculture and Food Security Programs (GAFSP); on infectious diseases, the One Health Initiative; and
on food safety, several global food safety alliances, such as the World Health Organization's Foodborne
Disease Burden Epidemiology Reference Group (FERG), the Global Food Safety Initiative (GFSI), and
the Partnership for Aflatoxin Control in Africa (PACA).
Several national governments have also realized the importance of building stronger links
between agricultural growth and improved nutrition. The Indian Prime Minister, for example, has
expressed great concern regarding the persistence of high rates of undernutrition among Indian children,
in spite of significant agricultural growth over the past decade. China formed a national food security and
nutrition committee and is planning to set up a research institute on food and nutrition under the Chinese
Academy of Agricultural Science. NEPAD's African Union program launched the African Food and
Nutrition Security Day on October 31, 2010.
The IFPRI 2020 Conference provided a much-needed platform for sharing knowledge and
practice in linking agriculture, nutrition, and health. It identified a huge task ahead: filling knowledge
gaps, designing and scaling up innovative joint ANH programs, and creating an enabling environment for
joint policy based on solid partnerships and mutual accountability.
The CGIAR, with its partners, is uniquely positioned to draw on its collective experience and
research capacity in all three areas-agriculture, nutrition, and health-to start filling some of the critical
knowledge gaps and to generate and communicate evidence and learning on the linkages between
agriculture, nutrition, and health. This CRP is designed to make a difference to the lives of the rural poor
by (1) taking a systematic view of how agriculture, nutrition, and health interact globally, nationally, and
locally; (2) developing a strong body of evidence based on rigorous research to help decisionmakers
evaluate trade-offs between different investments and policy options; (3) conducting action research to
develop technologies that induce positive changes in the lives of the poor; and (4) fostering effective
approaches that bridge sectoral boundaries. Within the CGIAR, this CRP represents an opportunity for
collective action with partners at all levels of the impact pathway, from research discovery to
development outputs, for achieving meaningful outcomes for poor people.
13


﻿4. IMPACT PATHWAYS
4.1 Research Strategy
CRP4 is designed to strengthen the role of agriculture in improving human nutrition and health, through
both enhancing its positive benefits and reducing its potentially negative effects. In creating critical
linkages between agriculture, nutrition, and health, CRP4 has two overarching strategies. The first is to
influence agricultural research and development efforts to more actively pursue nutrition and health
outcomes. The second is to influence the health and nutrition communities to consider and include
agricultural solutions for improving nutrition and health outcomes. This CRP will seek to influence and
catalyze interactions among the ANH sectors in both directions.
In influencing the agricultural research community to focus on better nutrition and health
outcomes, the emphasis will be on broadening the paradigm of agricultural productivity and value-chain
research to ensure that food produced is more nutritious, safer, and accessible to the poor. For the
agriculture and nutrition communities, this work will involve developing joint solutions for the delivery
of better nutrition through production of higher-quality foods (such as biofortified, nutrient-rich staple
crops) and through nutrition-sensitive value chains.' Between the agriculture and health communities,
research will focus on joint programs for the control of agriculture-associated diseases (AAD). CRP4 will
also undertake joint research that brings the three sectors together to design efficient and effective cross-
sectoral approaches to achieve common ANH impacts. This will work through two main areas of research
partnership: to develop tools and solutions for development implementers; and to generate knowledge,
evidence, and options for policy and decisionmakers.
This research agenda will require incorporating innovative elements into the work of planning
and implementing research. New emphasis will be placed on communication and improved information
systems; integration of actions across the ANH sectors; tools and approaches for cross-sectoral policy and
decisionmaking; studying agriculture intervention options (through testing, evaluation, documentation,
and scaling-up) to provide evidence on health and nutrition outcomes; and integration of ANH programs
into the broader social protection agenda for marginalized and vulnerable populations. A major incentive
to cross-sectoral cooperation for all three sectors is the potential for far greater returns to investment and
much larger impacts, as compared to interventions in single sectors.
4.2 Impact Pathways
Figure 2 highlights the strategy leading from research outputs to development impacts. CRP4 outputs,
outcomes and contribution to the CGIAR system-level outcomes are presented in CRP4's performance
indicators matrix (Appendix 3). CRP4 will enhance the contribution of agriculture research outputs to
nutrition and health impacts through three major impact pathways: (1) value chains that provide more
nutritious and safer foods; (2) development programs that successfully integrate agriculture, nutrition, and
health; and (3) policy that promotes a supportive and enabling cross-sectoral policymaking process and
investment environment.
Nutrition-sensitive value chains are defined here as value chains that incorporate nutrition objectives and interventions to
enhance the nutrient content of foods and prevent nutrient losses along the value chain; and focus on educating the different
value-chain actors, including the consumers about the nutritional benefits of the targeted foods.
14


﻿Figure 2. CRP4 Impact pathway
nutrient-rich foods
available and accessible to
wthepoor
* Knowledge and
technologies to improve
quality and safetyof foods
along value chains                                                                   Improved
1developed
I                                                                                     nutrition and
* eeelcost-efecthealth,
Integrated AM program                                                                especially
models and capacity
strengthenedamnwoe
~*U~thned  -and young
* Strong evidence of role of                                                          children
integrated AM programs In
Improving health and
nutriton
*..Goodpractices In
integreANH
polcymaking appled
D*CrosS-sectoral work
I incentivized
* Capety forjoint
policymaaong strengthened
-------------.....
4.2.1 Value-chain Impact Pathways
CRP4 (Component 1) focuses on enhancing and protecting the nutritional content of nutritious foods
along the value chain while mitigating key food safety risks. CRP4 will add value to existing research by
bringing focused attention to the quality and safety of foods in value chains. This will include
collaborations with value-chain work conducted on highly nutritious foods such as livestock and fish
(CRP3.7), legumes (CRP3.5), and fruits and vegetables (CRP6, World Vegetable Center, and the Global
Horticulture initiative), as well as on enhancing the nutritional value and safety of staple cereals, roots,
and tubers (CRP3.1, 3.2, 3.3, 3.4, and 3.6).
Figure 2 highlights four principal ways that CRP4 research will contribute to value chains:
*   Providing food producers technical and knowledge inputs to produce more diverse and higher
nutritional value foods (Components I and 2).
*   Enhancing or protecting the nutritional value of foods along the value chain, from production
to postharvest handling and storage, through processing and distribution to consumers. This
will involve identifying entry points and methods to protect or enhance the nutritional value
of foods, and exit points where nutrient losses can be prevented (Component 1).
*   Providing information and knowledge to consumers to positively influence behavior in
seeking more nutritious and safer foods (Components 1, 2, and 3).
15


﻿* Helping regulators assess safety risks of food at different points along the value chains;
developing appropriate and effective methods for mitigating public health risks while
optimizing economic benefits to poor producers and market agents (Component 3).
There are several points of entry along the value chain where CRP4 research outputs can be used
by different value-chain actors. The value chains important to poor people are highly diverse, ranging
from small-scale, informal value chains involving only a few actors (such as farmers, traders, and
consumers) to more formal value chains involving a much larger number of value-chain actors (including
input providers, farmers, market agents, processors, distributers, transporters, retailers, and consumers).
Many of the value chains CRP4 will engage in will be local and informal markets in rural areas. Over
time, as urban demand increases, more complex value chains develop, bringing both new opportunities
and greater challenges for the poor.
There are great potential benefits to links with agribusiness in developing more efficient and
effective input and output markets, including the capacity to meet market demand for nutritional quality
and food safety standards, but such a strategy poses the risk of leaving behind small producers and poor
consumers. Two objectives of CRP4 research will be to support the ability of poor producers to
participate in these new market opportunities, and to ensure that nutritious and safe foods are available,
accessible, and affordable to poor consumers.
At the policy level, evidence from nutrition- and food safety-focused value-chains research would
inform policymakers, regulators, and public and private investors on the nutritional, health, income, and
other benefits and risks to be considered in any decisionmaking on value chains.
4.2.2 Development Program Impact Pathway
Research outputs from Components 1-3 will provide important inputs for integration into current and
future ANH programs, through evaluation activities by development partners (Subcomponent 4.1).
Enhanced monitoring, evaluation, and learning by development partners, supported by CRP4, will include
testing and adapting and scaling-up some of the research findings of other program components. This will
require CRP4 to provide inputs at critical stages in the program design, targeting, planning,
implementation, evaluation, scale-up, and assessment cycle.
Outputs from Components I and 3 are expected to contribute to other, more specific agriculture-
nutrition and agriculture-health programs implemented by development partners. For example, research in
Component 3 would contribute to the public health programs for zoonotic and emerging diseases.
Research in Components I and 2 could contribute to specific nutrition interventions by being integrated
into development programs implemented by partners such as the Ending Child Hunger and
Undernutrition (REACH) partnership, the Global Alliance for Improved Nutrition (GAIN), and other
nutrition development actors.
4.2.3 Policy Impact Pathway
Research outputs from Components 1, 2, and 3 and Subcomponent 4.1 will provide the evidence base,
knowledge, tools, and technical inputs to help decisionmakers make better investment and policy choices.
In particular, better approaches for data collection, analysis, and metrics to assess cross-sectoral outcomes
will be needed. CRP4 researchers will collaborate with universities, other advanced research institutes,
and key developing country research institutions in this area. The ability of the CRP4 partnership to
engage policymakers and national governments in evidence-based process will be critical to initial
success in the first few years of the program.
While better evidence for decisionmaking is necessary, it is far from sufficient in achieving
policy impacts. One step is that evidence needs to be communicated effectively so that it is useful to
decisionmakers. At the moment, there is strong international and national consensus on the importance of
leveraging agriculture for improving nutrition and health, which is evidenced by major international and
national initiatives such as the SUN, REACH and the WHO FERG initiative on food safety, and a variety
16


﻿of One Health initiatives for zoonoses and emerging diseases control. But this support can only be
sustained effectively if it fits with policymaking processes. The role of CRP4 will be to bring the cross-
sectoral ANH knowledge and tools into broader policy processes, in close partnership with CRP2. These
processes must closely align and support broader policy approaches. Fortunately, there is increasing scope
for doing this in Africa through the AU-NEPAD CAADP process that links broader continental and
regional policy processes to specific policies and implementation plans at the national level. Appendix 4
provides further details of how CRP4 can link to the CAADP process. For the other major CRP4 target
region of South Asia, important efforts to engage governments in policy processes will be built upon,
both at regional and national levels. IFPRI has very strong links with policymaking processes and with
economic research institutions in the region.
While the CRP4 research partnership can play a catalytic role in evidence-based policymaking,
sustaining and deepening impacts along this pathway will require a concerted effort to strengthen the
capacity in national governments for analysis, planning, program design, and evaluation of cross-sectoral
agriculture-nutrition-health. Efforts have already started to develop a coalition of research and capacity
training partners for this purpose. In India, the Public Health Foundation of India will be a critical partner
in the interface between capacity, policy, and practice for agriculture-nutrition-health interventions.
4.2.4 Longer- Term and Broader Impacts
CRP4 will only be able to contribute to large-scale sustainable impacts through strong linkages with
effective development implementers and enablers, including national governments. There are strong
indications that development implementers and enablers are now, more than ever before, committed to
scaling up ANH interventions. There also seems to be much enthusiasm, expressed at both the CRP4
partnership meeting in developing this proposal and the recent IFPRI 2020 Conference in New Delhi, that
CGIAR research is considered important to strengthen agriculture's contribution to improving nutrition
and health and providing research evidence to guide interventions, policies, and practice.
For CRP4 to be successful in contributing to these impact pathways, its research must add value
to some specific and neglected areas of evidence. The first addresses how agricultural interventions can
reach the malnourished and ill. This will require research that informs programs and policies that work for
the poor. Clearly, gender and social science research will be critical components of this. The second
addresses how interventions can enhancefood and nutrition security by increasing the poor's access to
and demand for nutritious foods. A major neglected research area that this CRP will tackle is the demand
and the practices of poor consumers with respect to nutritious and safe foods.The program will also begin
to address priority issues around the environmental sustainability of agriculture linked to better nutrition
and health. There will be two initial priorities. The first will be to improve our understanding of the
diversity of foods that can support nutritious diets; the second will be to look at the health risks linked to
rapid and uncontrolled intensification of agricultural production system and food systems.
At the IFPRI 2020 Conference, there was an overwhelming consensus that high-quality research
is missing on the impacts of multisectoral interventions and programs. Thus, a strong data and evidence
research focus is planned for the first three years of the program. Results will be critical to catalyze and
support the strong current momentum for national governments and international agencies around ANH
initiatives. CRP4 will work toward catalyzing impacts at different scales, according to the level of
partnership. At regional and international levels, impacts are potentially far-reaching. Potentially large-
scale impacts, to be further refined in initial ex-ante impact assessments, can be achieved through global
partnerships of several kinds. Some examples include
- The generation of research outputs to inform and support major international development
initiatives in nutrition. These include the previously mentioned SUN movement, planned to
operate in 36 countries and cover 2.8 billion people (356 million undernourished children);
REACH, focusing on a minimum of 10 African countries and aiming to include a large
agriculture for improved nutrition component; and a number of national government
programs.
17


﻿-  Supporting integrated ANH programming implemented by government agencies and
nongovernmental organizations (NGOs). This would build on the previous experience of
CGIAR centers working with some large international NGOs, such as Helen Keller
International and Concern Worldwide.
-  The provision of evidence and good practice for food safety linked to WHO's FERG, in
partnership with institutions in select African and Asian countries.
-  Collaboration with international zoonotic and emerging disease control initiatives, programs,
and networks (such as One Health and Ecohealth initiatives) through the World Organization
for Animal Health (OIE), FAO, and WHO.
-  Collaboration with international NGOs and intergovernmental development agencies on
complex multisectoral decisionmaking in policy, regulations, and investments.
- Leveraging major CGIAR agricultural research investments within the new CRP portfolio.
Those most likely to go to scale are (1) supporting value-chain work in other CRPs to
enhance their impacts on improving nutrition and health; and (2) providing information for
the scaling-up of biofortified staple crops in value chains and ANH programs.
The examples listed show that CRP4 will focus its efforts on generating regional and international
public goods (IPGs) consisting of knowledge, technologies, and evidence for decisionmaking and
investment. These public goods will be developed with and relevant to actors working at national and
local levels, with a focus on those goods with the widest application. This IPG strategy will also involve
working closely with international initiatives as vehicles for applying CRP4 outputs and outcomes for
both nutrition and health as widely as possible. Using the consultative planning process described for year
1 (see Sections 5 and 6), CRP4 will further co-develop specific activities leading to priority outputs and
outcomes with partners around these IPG principles and examples.
In the impact planning for CRP4, a critical element for achieving longer-term and more
sustainable impacts is through the contribution to capacity strengthening. The CGIAR, working with its
research partners, has a comparative advantage in supporting developing-country agriculture research
organizations and researchers, with long experience of working collaboratively in programs to strengthen
the capacity of both development enablers and implementers. A capacity-strengthening consortium is
being developed to include universities and research institutions from developed and developing countries
linked to CRP4.
18


﻿5. PARTNERSHIPS
5.1 Principles and Practices
Agricultural research can improve the lives of the poor only by working with-and through-
implementing partners, to help shape research strategies and to translate opportunities into impacts.
Effective partnerships and new partnership practices will therefore be essential for achieving CRP4's
ambitious research outputs and development outcomes and impacts. A partnership strategy will be
developed initially, with support from IFPRI's Partnership Coordinator, to create the best conditions for
carrying out the research and making full use of the subsequent findings. The partnership strategy will
include a roadmap, a plan of action, and a partnership monitoring and tracking system. One of the first
steps in implementing the strategy will be to do a stakeholder mapping and a landscape analysis of public
health, agriculture, and nutrition research and development actors, and to identify opportunities for
partnerships. This will be done both at the international level and at the level of the program focus
countries.
A key strategic concept in developing the partnership strategy is value addition. The lead role in
defining, designing, and implementing local policies and programs must be taken by the relevant
decisionmaking organizations and their stakeholders at all levels, including research organizations; the
role of CRP4 (and the CGIAR) is to add value to the efforts of these stakeholders. The concept of value
addition allows CRP4 to focus on its mandate as provider of international public goods, while ensuring
local relevance in implementation.
The CGIAR centers involved in this program have considerable experience in partnerships across
the types of development processes involved in CRP4 (support to policy and decisionmakers,
development implementers, and value-chain actors). In addition, all have experience in specific domains
of ANH linkages, through previous and ongoing research and research-development partnerships as well
as, collectively, through the CGLAR Agriculture and Health Research Platform. (See
http://programs.ifpri.org/ahrp/ahrp.asp for further information.)
This impressive body of experience will be critical in fulfilling the partnership requirements of
this program, which are much broader and bolder than previous endeavors. CGIAR centers have
considerable depth of knowledge of partnerships: see Horton, Prain, and Thiele (2009) for a recent review
of partnership literature, and ILRI's 2006 Partnership Strategy for partnership practices. At the partners'
meeting held in July 2010, as part of the process of developing this proposal, tremendous enthusiasm was
expressed for partnering with CRP4, as well as solid agreement on its broad framework and components.
(The proposal planning documentation is available at https://sites.goode.com/a/c xchan e.or/mp4/.)
This enthusiasm reflects the growing interest and investment in the critical linkages between agriculture,
nutrition, and health, and it is evident in many initiatives described in this proposal (including the IFPRI
2020 Conference noted earlier).
We identify four broad categories of partners: (1) enablers (policy and decisionmakers);
(2) development implementers; (3) value-chain actors (and representatives); and (4) research partners.
The unique complexity of CRP4, which requires working across sectors, calls for a range of partnership
types and depths. Partnerships will be dynamic, ranging from joint fundraising and planning to
implementation, including communication and dissemination of outputs. They will entail shared financial
and human resources. Some will be extensive and profound; others may be limited to common research
interests and the sharing of knowledge and information. Partnership relationships can also change over
time, as initial research outputs move to outcomes.
In managing partnerships, CRP4 will focus on and monitor a number of principles and practices:
*  Mutual accountability for achieving strategic goals, outcomes, and impacts
* Shared goals to create international public goods that will contribute to the achievement of
the vision of the CGIAR, with an emphasis on improving human health and nutrition
19


﻿*  Mutual respect, with open and transparent discussions between partners
*  Emphasis on identifying and meeting the needs of partners for evidence, innovation, and
other research outputs
*  Clear guidelines and practices for joint communication, publication, and sharing of credit,
based on comparative advantage and consensus
*   Priority support for developing country institutions and partners in building capacity and
skills
5.2 Nature and Types of Partnerships
CRP4 will work with four broad categories of partners: enablers, development implementers, value-chain
actors, and research partners. Each category is described below, along with examples of prospective
partners.
1. Enablers. These partners include policy- and decisionmakers as well as investors at different
levels.
o Intergovernmental organizations engaged in policy and regulations related to
nutrition and health, such as WHO, the World Food Programme (WFP), FAO, and
OIE (World Organization for Animal Health).
Intergovernmental agencies have increased their coordination in relevant areas: nutrition, through
the Subcommittee on Nutrition (SCN), the SUN movement, and the REACH initiative; food safety,
through Codex alimentarius and SPS technical standards for WTO; and zoonoses and emerging diseases,
around the One Health initiative. CGIAR centers have engaged with these organizations individually,
around major programmatic areas, as well as collectively through the Agriculture and Health Research
Platform.
o Continental, regional, and subregional organizations in the ANH sectors that
support decisionmaking related to policy, regulations, and investment.
Recent years have seen a strengthening of capacity in these organizations, with greater
harmonization of actions and political commitment, offering new opportunities for engagement. For
example, major progress can be seen in the development and implementation of CAADP, at several
levels: AU/NEPAD; regional economic communities (RECs); FARA and subregional organizations
(SROs); and national governments.
CRP4 has several mechanisms to engage with CAADP's pillars of action to strengthen policy,
decisionmaking, and capacity development. This will build on the strong and well-established role of
IFPRI with AU/NEPAD in this area, as well as on the important role played by the regional centers for
strategic analysis and knowledge support (RESAKSS) associated with three hubs (hosted by ILRI, IITA,
and the International Crops Research Institute for the Semi-Arid Tropics [ICRISAT]/the International
Water Management Institute [IWMI]). Several regional and national actors in public health will also be
engaged, such as the West African Health Organization (WAHO) and the Public Health Foundation of
India (PHFI).
o  International and regional development banks and other major bilateral investors
support the regional and national enablers: the World Bank, the African Development
Bank, the Asian Development Bank, and the Inter-American Development Bank are
significant investors in research and development in this area.
o  National governments will be partnered for cross-sectoral policymaking, strategic
planning, and capacity development, either directly or mediated through regional
processes, as appropriate.
20


﻿o Civil society organizations and various public and private organizations will be
supported with knowledge and evidence relevant to key areas of policy and
advocacy.
2. Development (or program) implementers. Several of the participating CGIAR centers in
CRP4 have extensive experience in working closely with relevant government departments
and nongovernmental organizations that will play a critical role in the impact pathway for
CRP4. The ambition is to expand, enhance, and deepen these partnerships.
o  Government ministries engaged in agriculture for improved nutrition and health
programs (such as the Ministries of Agriculture and Health in Uganda, and other
countries) who have important cross-sectoral ANH activities; and government
ministries engaged in broader development programming focused on poor and
marginal areas (such as Kenya's Ministry of Northern Development).
o   United Nations and other global initiatives that bring networks of organizations
together to achieve a common goal. Examples include the global initiatives that
promote multisectoral approaches to reduce poverty, food insecurity, undernutrition,
and poor health; and those that support country-owned processes such as the closely-
linked SUN movement, the REACH initiative, the Global Horticulture Initiative, and
the One Health initiative.
o NGOs, civil society organizations, and farmers groups engaged in agriculture and
rural development programs to improve ANH outcomes, such as Catholic Relief
Services (CRS), Helen Keller International (HKI), Concern Worldwide, Save the
Children, and World Vision (WV), at both the international and local partner level.
CRP4 will support evidence-based programming, including research.to enhance
program design, targeting, monitoring, evaluation, and scaling-up. For relatively
small marginal investments, the program can help generate and disseminate
knowledge and learning and improve impacts in a critical development domain,
potentially leveraging billions of dollars of outside investment.
3. Value-chain actors and their representatives: CRP4 will work with researchers and value-
chain actors and partners to add value to their work by focusing on the quality and safety of
foods in value chains.
o Private-sector companies and public-private initiatives working to enhance health
and nutrition through agriculture. Only a few initiatives in this area have focused on
nutrition value chains and biomedical research partners. Major entry points for
expansion will be along value chains for staple foods for both nutrition and health
outcomes, working principally around food safety, in collaboration with other CRPs.
We will expand our relationships with public-private partnerships, engaging with
GAIN in the area of agriculture and nutrition and with the Global Alliance for
Livestock Veterinary Medicines (GALVmed) on zoonoses.
o Associations and groups provide a conduit for working with producers, value-chain
intermediaries, and consumers. We will work with special interest groups (for
example, consumers' associations) as well as state and other entities bringing
together stakeholders (such as national dairy boards).
4. Research partners. CRP4 will expand beyond existing agriculture-nutrition and
agriculture-health partnerships to develop new research partnerships that work across all
three areas. CRP4 will build on existing partnerships and develop new ones with several
types of research partners:
o Advanced research institutes and academic institutions (universities) will be key
partners. Many of these are already well-established collaborators with CGIAR
21


﻿centers around nutrition and health issues, including (for agriculture and nutrition
issues) the United States Department of Agriculture (USDA), Cornell University, the
University of California at Davis, and other universities; and (for agriculture and
health issues) the Agricultural Research Development (CIRAD), the International
Centre of Insect Physiology and Ecology (icipe), and the Universities of London,
Basel (Swiss Tropical and Public Health Institute), Edinburgh, Cornell, Guelph, and
others. The new Leverhulme Center for Integrated Research on Agriculture and
Health (LCIRAH), coordinated by the London International Development Centre
(LIDC), will be a key CRP4 research partner, especially as it is currently in the
process of creating a University Network on Agriculture, Nutrition, and Health for
Development.
o  Developing-country research institutes and universities will be an important
element of the CRP research partnerships. Current partnerships in this area will be
expanded, particularly relating to zoonoses, food safety, and ecohealth, with
universities in eastern and southern Africa and South and Southeast Asia. In India,
key partners in research on agriculture and nutrition issues include the Tata Institute
of Social Sciences, the Institute of Dalit Studies, and the Sitaram Bhartia Institute of
Science and Research. Another type of partnership opportunity is offered by regional
initiatives, such as the Southern Africa Center for Infectious Disease (SACIDS)-a
virtual center, serving eastern and southern Africa.
5.3 Partnership Engagement and Development Process
During the consultative process for developing this proposal, partners provided comments online, and
many attended a partners' workshop, resulting in two important foundational accomplishments. First,
partners contributed to, and took ownership of, the research program development process, including the
design of the overall conceptual framework, priority setting, and selection and definition of the key areas
of research. Second, CGIAR centers and partners developed and shared an inventory of current interests,
activities, and capacities to be considered for inclusion in the program, as captured in the workshop
documentation (https://sites.google.com/a/cgxchange.org/mp4/). The partnership development process
resulted in strong support and agreement on the overall framework and research plan for CRP4.
While not part of the CRP4 planning, the IFPRI 2020 Conference on ANH also provided a forum
for key stakeholders working at the interface between agriculture, nutrition, and health to share
perspectives and build commitment and consensus on the way forward.
CRP4 will build on these partnerships by developing a partnership strategy for various stages of
the impact pathway, as well as a detailed implementation and monitoring plan for the overall program and
its components and subcomponents. Social network analysis tools will be used to describe and evaluate
the science and implementation networks emerging from CRP4.The program will consider and choose
from a variety of potential strategic partnership mechanisms, such as knowledge and information
platforms and communities ofpractice, and will explore how to engage existing platforms of international
organizations (such as WHO and FAO, or ReSAKSS, in which several participating centers are already
active)-and possibly expand their scope. CRP4 may also develop new platforms to support partners in
agriculture and rural development who serve as champions in developing evidence and advocacy related
to cross-sectoral ANI interventions. Critical in this will be supporting coalitions of developing-country
organizations.
We find great enthusiasm as well as extensive opportunities to enhance partnerships in this area.
We are committed to a partnership process that incorporates strategic thinking, systematic processes with
partners, new behaviors and resources, and implementation of best partnership performance practices-
the essential ingredients of a successful joint effort. The roles that CRP4 takes up with partners will be
guided by the strategic directions in this proposal and further developed into specific activities with
partners in the first years of the program. Changes in partnership roles will be guided by the CRP4 focus
22


﻿on agricultural solutions, and research on international public goods to support development, and
comparative advantage. As in any partnership arrangement, CRP4 teams will also be responsive to the
demands of clients and partners as they fit with its overall focus.
In Year 1, a major activity will be to develop a partnership strategy, which will engage a specific
plan for engaging and working with the key groups of partners identified above. This activity will include
defining overall partnership principles, research priorities, and the roles of different partners. The strategy
will then be used to proceed with joint work planning with agreed roles, responsibilities, and resource
allocations among partners.
Within the overall partnership strategy, clear guidelines will be provided for:
1. internal CGIAR partnerships and the value that CRP4 can add to value-chains research and
programs in other CRPs,
2. key partnerships in value chains, assessed with public and private value-chain actors, for both
nutritional quality and food safety,
3. partnerships on aflatoxins with continental, regional, and national programs, other CRPs,
agribusiness, and public health agencies,
4. strengthening of research-development partnerships for development programs in which
agriculture, nutrition, and health issues are critical to livelihoods,
5. research networks with developing-country researchers, supported by key developing-country
institutional research leaders, to identify and develop key metrics and evidence, and
6. partnerships with existing strategic analysis and knowledge support systems in Africa (SAKSS)
linked to AU-NEPAD and the Public Health Foundation of India (PHFI) to develop mechanisms
for using research knowledge and evidence to support policymakers and investors.
The partnership approach can be illustrated in more detail with partnerships for value chains to
enhance nutritional quality and food safety. The initial focus will be to work with programs (particularly
CRP3.7) that support value-chain development for complementary foods (in this case milk, meat, and
fish). The partnering value chain will develop the overall framework for looking at the value chain. It will
also help convene the key public and private participants and identify the role of key participants, the
capacities they need, and key research and development priorities. CRP4 will identify points along the
value chain at which nutrition or food safety can be enhanced, identify the roles of key actors in those
nutrition and health improvements, provide specific information on consumers, and support the key actors
through knowledge, tools, and evidence. An important task of CRP4 will be to define areas in which other
national and international enablers can support the value-chains actors beyond CRP4. Initial experiences
with value chains for complementary foods will be extended to fruits and vegetables and legumes and
then to biofortified foods coming from the Harvest Plus varietal development pipeline.
Appendix 4 provides an example of partnerships for policy support using the example of
CAADP. Building on current CGIAR experience with providing research evidence to support
policymaking and priority setting, CRP4 will add specific nutrition and health inputs into the overall
agriculture policy process and support links between the agriculture and public health sectors.
Combining partnerships with capacity building is central to CRP4's support for developing-
country institutions. Appendixes 13 and 14 provide further information on specifics of capacity
development that relate to proposed research outputs, outcomes, and impact areas.
23


﻿6. MAIN ACTIVITIES PROPOSED TO GENERATE OUTPUTS, OUTCOMES,
ANDIMPACTS
This section describes the four components and their subcomponents (See Table 2) of CRP4's research
program.
Table 2. CRP4 components and subcomponents
Component                                 Subcomponent
1. Value chains for enhanced nutrition and health
2. Biofortification                         1. HarvestPlus
2. Agrosalud
3. Prevention and control of agriculture-   1. Improving food safety
associated diseases                      2. Zoonotic diseases and diseases emerging from animals
3. Other health risks in agroecosystems
4. Agriculture, nutrition and health - Integrated  1. Integrated programs
programs and harmonized policies         2. Harmonized policies
A critical challenge at the proposal development stage is to define specific research activities with
milestones and partner roles. Clearly, it is impossible to achieve the level of specificity needed to start
implementation without extensive discussions with partners regarding their role, the nature of the
different partnerships needed to carry out the research, and information on funding flows, as well as a
careful joint research prioritization exercise. For this reason, CRP4 will spend a significant amount of
time designing its implementation plan in year 1, relying on extensive consultation with current and
potential partners, starting with other CRP teams. At this stage, we have identified a set of countries
where activities pertaining to the four components of CRP4 are either ongoing or will start during the first
year of implementation (see Table 3). We expect the program to expand rapidly during the first year, as
team members start engaging fully with partners and other CRPs. Below we present an overview of the
most promising partnerships and areas of research to be pursued in the short term and of the sequencing
of partnership engagement and research prioritization for the different CRP4 components. More
information is provided in the following sections, which describe each component in more detail.
For research within the value-chain impact pathway, research will initially focus on new activities
on value chains for animal source foods and on enhancing and scaling up research on orange-fleshed
sweet potatoes (OFSP) in collaboration with HarvestPlus. In both cases, the focus is on enhancing the
nutrition and health of mothers and children younger than age two. CRP4 will thus collaborate with a
subset of the target value chains in CRP3.7 (fish value chain in Uganda in the first year), nomadic dairy
value chain in Senegal (jointly with CRP2), and OFSP in Mozambique and Uganda with HarvestPlus and
its partners. During its first year of implementation, CRP4 will explore potential collaboration with other
CRP3.7 target value chains such as small ruminant meat in Ethiopia and Mali, pig meat in Uganda and
Vietnam, and milk in Tanzania and north-east India. Activities will focus on developing and applying
dietary surveys, market surveys, studies of consumer knowledge and perceptions, nutrition assessment
tools, and food safety assessments along these target value chains in years 1 and 2. In addition to these
target value chains, CRP4 will emphasize activities for the control of mycotoxins in value chains. The
role of CRP4 will be to develop an overall risk framework for mitigating aflatoxin in key value chains
(such as maize and groundnuts with CRPs 3.2 and 3.5) and to develop risk assessment methods and
mitigation options to be applied in larger initiatives such as the Program for Aflatoxin Control in Africa
(PACA). The relative roles of approaches and technologies need to be harmonized in year I with the
leaders and key scientists of CRP3.2 and 3.5.
24


﻿Beyond year 2, value-chain activities in CRP4 will expand to include other nutrient-rich foods
such as fruits and vegetables (with AVRDC), legumes (with CRP3.5), and new biofortified crops as they
become available (with HarvestPlus in Component 2). CRP4 will document the tools and approaches
developed; widely disseminate results through peer-reviewed journals, research and policy briefs, and
workshops and seminars; and train stakeholders, to ensure that these tools and approaches are used to
replicate, scale up, and motivate future investment in value chains for nutrition and food safety.
For research within the program impact pathway, nutritional assessment methods and, when
applicable, strategies for assessing and controlling agriculture-associated diseases will be applied within
the broader development program planning and implementation activities led by partners. Initial activities
in CRP4 will focus on beginning new work with CRPI.3 on aquatic systems and livelihoods in
Bangladesh and Zambia, expanding ongoing partnerships with Helen Keller International from Burkina
Faso to Nepal, and strengthening partnerships with Concern Worldwide in Zambia. In year 1, we will
actively explore opportunities to engage with other development initiatives (for example, following up on
initial discussions with REACH). Priorities for specific agriculture-associated diseases will be established
with existing food safety and zoonotic disease platforms in Africa (SACIDS, Afrique One) and Asia
(PHFI in India and a variety of programs in Southeast Asia). Through discussions with partners, we
expect to develop a clear strategy for how CRP4 can support development partners for both nutrition and
health programs by the end of year 2. In many cases, CRP4 activities will be able to take advantage of
already established or developing partnership platforms.
Research activities within the policy impact pathway will start in year I by exploring
complementarities and potential partnerships with new policy research programs in the areas of
agriculture and nutrition and knowledge management in nutrition. The two new DflD-funded projects-
Transform Nutrition (TN), a six-partner consortium led by IFPRI, and Leveraging Agriculture for
Nutrition in South Asia (LANSA), a six-partner consortium led by the Swaminathan Research Foundation
and including IFPRI as a key partner-provide an excellent opportunity for collaboration with CRP4.
Both projects aim at improving nutrition in Sub-Saharan Africa (TN) and South Asia (both projects) by
scaling up direct nutrition interventions and leveraging other sectors, especially agriculture. In India, a
similar opportunity is offered by the new IFPRI-led Partnerships and Opportunities for Strengthening and
Harmonizing Actions on Nutrition (POSHAN) supported by BMGF (see Box 10, Section 6.4.4 for a short
description of these projects).
Given the novelty of cross-sectoral policymaking, research under this component will be
developed over a longer period of time. In Africa, CRP4 will develop a clearer action plan in
collaboration with AU-NEPAD by the end of year 2 and will link to country-level implementation plans
for regional economic communities. These activities will build on the existing capacity of the Strategic
Analysis and Knowledge Support (SAKSS) programs linking the CGIAR centers and the CAADP
initiative. In South Asia, CRP4 will rely on existing agricultural policy efforts linked to the PIF. A
strong element of improved policymaking and investment decisions is the evidence base for
decisionmaking. During the first year, CRP4 will develop a strong research network of academic partners
in universities and research institutes in its target regions of Africa and Asia and in developed countries.
The goal will be to have in place a useful set of metrics, tools, and approaches to support the policy
impact pathway by the end of year 3.
25


﻿Table 3. CRP4 focus countries in first year of program implementation
Component 1            Component 2                        Component 3                     Component 4
Other risks in
Value chains    HarvestPlus    AgroSalud    Food safety   Zoonoses   agro-ecosystems  Programs    Policies
Africa
Kenya
- Enteric pathogens                                                                     x
- Emerging disease (RVF) (4 projects)                                                                X             X
- Zoonoses in western Kenya                                                                          X
- Mycotoxins (several projects)                                                         X
Uganda
- Fish value chain (with CRP3.7)             X                                          X
- OFSP value chain and dissemination
(with H+)                                  X              X                                                                    X
- Food safety in smallholder pig chain                                                  X            X
Mozambique
- OFSP value chain and dissemination
(with H+)                                  X               X                                                                   X
Zambia
- ANH programs with Concern                                                                                                      X
- Provitamin A in maize                                     X
- Possible ANH work with CRPI.3 on fish
and livelihoods                                                                                                                X
Senegal
- Nomadic dairy value chain (with CRP2)      X                                          X
Burkina Faso
- ANH programs with HKI                                                                                                          X
DRC
- Provitanin A cassava and iron beans                      X
Rwanda
- Iron beans                                                 X
Nigeria                               _
- Provitamin A cassava                                       X                                                              .
Multiple countries (Africa)
- Participatory epidemiology (2 projects)                                                          X
- Harmonization of milk hygiene
regulations in East Africa                                                            x                                                    X
(continued)
26


﻿Table 3. (continued)
Component I            Component 2                         Component 3                      Component 4
Other risks in
Value chains    HarvestPlus     AgroSalud    Food safety  Zoonoses    agro-ecosystems  Programs     Policies
Asia
Bangladesh
- Fish systems, fish ponds, programs and
livelihood (with CRPI.3)                                                                                                         X
-Zinc in rice                                                X
- Agriculture, food security, and nutrition
policies (with Feed the Future IFPRI-led
program) and DflD-funded LANSA and
Transform Nutrition TN)                                                                                                                     X
India
-Zinc in rice                                                X
- Agriculture and nutrition policy research
with LANSA and TN                                                                                                                            X
- Milk safety in Assam                                                                   X
Pakistan
- Zinc in wheat                                              X
- Agriculture and nutrition policy research
with LANSA                                                                                                                                   X
Nepal
- ANH with HKI and Save the Children                                                                                               X
- Agriculture and nutrition policy research
with TN                                                                                                                                      X
Vietnam
- Food safety in smallholder pig value
chains                                                                                 X
Multiple countries (Southeast Asia)
- Ecohealth (6 countries): Cambodia,
China, Indonesia, Laos, Thailand,
Vietnam                                                                                X            X              X
Latin America
Brazil
- High-iron and high-zinc beans and rice                                    X
Colombia
- High-iron and high-zinc beans and rice                                    X
27


﻿Additional details of activities, outputs, and outcomes are in Table 4 (Component 1), Tables 7-10
(Component 2), Tables 12, 14, and 16 (Component 3), and Tables 18 and 20 (Component 4).
To meet the overall milestones that will be further specified with partners in detailed discussions
in year 1, capacity development across the range of research activities and partnership development
activities will be critical. Research activities linked with broader organization activities, milestones for
partnerships, and key capacities to be developed are listed in Table 21.
6.1 Component 1: Value Chains for Enhanced Nutrition
6. 1. 1 Rationale, Objective, and Research Questions
Rationale
The challenge of addressing food security is not simply a matter of ensuring that all people have enough
food-or energy (calories)-to live a healthy life. A much more daunting problem is to ensure that poor
people have access to nutritious4 and high-quality diets. Typically, poor households subsist on
monotonous staple-based diets; they lack access to nutritious foods, such as fruits, vegetables, animal
source foods (fish, meat, eggs, and dairy products), or wild foods of high nutrient content. Lack of
diversity in the diet is strongly associated with inadequate intake and risks of deficiencies of essential
micronutrients (Ruel 2003; Leakey 1999; Arimond et al. 2010). The resulting deficiencies have far-
reaching health and nutrition consequences, both in the short and the long term. Economic constraints,
lack of knowledge and information, and related lack of demand for nutritious foods are critical factors
that limit poor populations' access to such foods.
Food production is just one factor in the consumption and availability of nutrients. Food is stored,
distributed, processed, retailed, prepared, and consumed in a range of ways that affect the access,
acceptability, and nutritional quality of foods for the consumer. Producing for consumption in the home
or for local markets remains important in many places; but today, the more market-oriented nature of
agricultural policies means that more farmers are net-food buyers and are thus affected by commercial
markets.
Value-chain concepts and approaches have been widely used in international development (and in
the CGIAR) with the objective of enhancing the livelihoods of food producers. Although they often
address food safety issues, value-chain analyses rarely incorporate nutritional and other health
considerations (Hawkes and Ruel 2011). The food supply chain is most often discussed from the
perspective of value-chain actors-the supply side. Little emphasis is placed on how informed consumers
can play a role in influencing the value chains, and how changes in the demand for specific foods can
influence the processes and outputs of value chains. There is also little emphasis on how actors along the
value chain can be better informed on how to enhance nutritional value and safety of foods as they move
along the value chain.
This component will build on work on value chains carried out by the CGIAR and other partners
on nutritious (usually high-value) foods.
*   It will develop new approaches and tools to analyze the value chain, using a "nutrition lens"
combined with a consumer focus.
*   It will implement research to identify leverage points to enhance the nutritional value of
select nutrient-rich foods.
4 Nutritious (or "nutrient-rich") foods are defined as foods high in essential nutrients, including animal source foods (fish, meat,
eggs, and dairy products), fruits and vegetables, biofortified staples, fortified foods, and traditional local crops sourced from
biodiverse systems (including neglected and underutilized species and wild foods). Specialized processed and/or fortified foods
for populations with special needs (acutely malnourished children, people living with HIV/AIDS, infants) are also included in
nutrient-rich (or nutritious) foods. Medicinal plants, although not classified as foods, represent an additional potential set of
commodities that may be explored in this component, in partnership with CRP6.
28


﻿* It will develop tools to assess and correct information asymmetries regarding nutrition among
different value-chain actors, including consumers.
Component I will focus on increasing the demand for nutritious foods among poor rural and peri-
urban, marginal households, and on identifying leverage points along the value chain where innovative
nutrition interventions can be incorporated to stimulate both the supply and the demand for nutritious
foods.
Boxes 2-5 present case studies that illustrate some emerging work incorporating nutrition
considerations and interventions into value chains (Hawkes and Ruel 2011). They show that value-chain
concepts and approaches offer considerable potential for enhancing efforts to improve nutrition, and they
provide a framework for identifying and implementing opportunities to leverage agriculture for improved
nutrition.
The first case study (Box 2) describes an ongoing program aimed at strengthening the bean value
chain in Uganda, to foster both nutrition and income gains among small-scale farming households. We
note that 77 percent of farmers involved in the production, harvesting, and marketing of beans in the
study area are women, and that women also play a central role in decisions regarding food preparation
and distribution as well as child feeding and care. The program thus has great potential to improve the
food security and nutrition of household members, and especially of young children.
In the second case study (Box 3), a value-chain approach was used to create a market and
stimulate the demand for-and consumption of-a new type of sweet potato: a biofort ied, vitamin A-
29


﻿rich orange-fleshedsweet potato (OFSP) in Uganda and Mozambique. This study is an excellent example
of a value chain for a newly introduced nutritious product that includes specific nutrition goals: to
increase not only production of OFSP but also its consumption, as well as the vitamin A intake and status
of poor households, with a focus on women and young children. The rigorous evaluation carried out in
both countries shows that the approach was highly successful in enhancing production, market
opportunities among small-farm producers, and consumption of OFSP, resulting in greater vitamin A
intake among particularly vulnerable groups-mothers, infants, and young children.
In the third case study (Box 4), demand and supply for traditional green leafy vegetables were
raised in tandem, by working with producers within existing local production and consumption systems.
The project aimed (1) to promote nutritious, traditional foods to increase demand; and (2) to open markets
30


﻿to respond to this demand, potentially enhancing producers' income. Women continue to be the main
actors in African leafy green vegetable production and marketing-a positive aspect that can be leveraged
to enhance the economic empowerment of women.
The last case study (Box 5) addresses some of the constraints to preserving the nutritional, safety,
and monetary value offishery products in Bangladesh. Fish value-chain analysis allowed the
identification of alternative processing techniques that can help preserve nutritional value, prevent losses
along the value chain, ensure the safety of the products, and stimulate demand. Small fish, eaten whole,
are a particularly rich source of essential micronutrients and can be used to enrich maternal and child diets
at a low cost.
31


﻿Objectives
The overall objective of this component is to leverage the value chain for select nutrient-rich (high value)
foods to increase the demand for, access to, and consumption of affordable nutritious foods among poor
rural and peri-urban marginal households, with a particular focus on benefiting vulnerable women,
infants, and young children.
The specific objectives are listed below and illustrated in Figure 3.
Specific Objectives
1. Characterize the dietary patterns of vulnerable and marginal populations and communities;
identify the available nutrient-rich foods that could be made more accessible to these
communities through value chains.
2. Understand information gaps and constraints to the consumption of nutrient-rich foods
(economic, social, and cultural).
3. Develop, test, and evaluate new tools to increase awareness, access to information, and
knowledge among consumers to stimulate demand for nutritious foods.
4. Identify nutrition entry points (where nutrients are gained) and exit points (where nutrients
are lost), at different points along the value chain; test new models to enhance or protect the
nutritional value of foods (including fortification) during postharvest handling, processing
and preserving, transportation, distribution, storage, and food preparation.
5. Evaluate the impact and cost-effectiveness of the approaches developed and tested in
objectives 3 and 4 in enhancing demand for, and access to, these targeted nutrient-rich foods
among rural and peri-urban poor populations.
Figure 3 shows a simplified value chain. On the right are shown some of its key actors; on the left
are the list of objectives and the related broad categories of activities to be undertaken under this
component. The figure shows that the starting point in this approach is the consumer rather than the
producer (as in typical value-chain work); the ultimate goal is to stimulate demand and increase access for
the poor to nutritious food, instead of the usual focus on enhancing production and producer income.
32


﻿Figure 3. Research strategy for enhancing nutrition along the value chain
Vaiue Ciain
Activities
Research Questions
Objective 1. Characterize dietary patterns and identify available nutrient-rich foods.
*  What are the dietary patterns of consumption and use, in target populations, of traditional
local foods, animal source foods, fruits and vegetables, biofortified staple foods, and
processed (including micronutrient-fortified) foods?
*  How do these patterns differ across different groups of consumers, as defined by gender,
education, household composition, income level, culture, geographic location, access to
markets, and levels of food self-sufficiency?
*  What are the changes in dietary patterns and nutritional quality of foods produced and
consumed associated with different patterns of agriculture intensification along value chains?
*  What is the nutritional value of these nutrient-rich foods (both nutrient content and functional
properties)? How is their nutritional value affected by postharvest handling, processing,
storage, and food preparation?
*  Can diversified agricultural production be scaled for commercial use while maintaining
biodiversity and ecosystems, and improving human nutrition and health? What does
agricultural biodiversity imply for peri-urban value chains, and what do trends in peri-urban
markets imply for potential success of agricultural biodiversity?
*  How adequate is the supply (quantity, quality, and seasonality) of nutrient-rich foods at
informal and formal markets?
*  What is the cost of these nutrient-rich foods in these settings? What contributions do they
make (or could they make) in the diet of the poor? Which nutrient gaps do they (or could
they) fill, especially for vulnerable women and young children?
33


﻿*  What is the potential of biodiverse systems in providing rich and varied sources of nutrients
for foods? How does this contribute to household consumption and diet quality or income
generation? (Examples of such systems include root and tuber crop diversity in the Andes,
sweet potato in Papua New Guinea, leafy green vegetables in Kenya, and minor millets in
India.)
Objective 2. Understand information gaps and constraints to consumption.
*  What are the main constraints to consumption and use, in target populations, of traditional
local foods, animal source foods, fruits and vegetables, biofortified staple foods, and
processed foods-including cultural, economic, availability, and information constraints?
What are the constraints to better use of local knowledge of biodiverse systems to improve
the nutrition of households?
*  What are the opportunities and barriers to increasing demand for and consumption of these
nutrient-rich foods among the poor? What is the role of women in decisionmaking regarding
food purchases and intrahousehold distribution?
*  What is the current level of nutritional knowledge and awareness of consumers and actors
along the value chain regarding nutrition, during phases of food processing, handling, and
preparation? What sources of information do they trust the most for information regarding
healthy diets and nutrition? How is information diffused and acquired? What is the role of
social networks in knowledge diffusion?
*  What is the willingness of poor rural and peri-urban consumers to pay for foods that are rich
in nutrients? How can their willingness to pay be increased (for example, through education,
information dissemination, and media)?
*  How do the previous four questions vary across different groups of consumers, as defined by
gender, education, household composition, income level, culture, geographic location, access
to markets, and level of food self-sufficiency?
Objective 3. Develop, test, and evaluate new tools to increase knowledge and awareness
regarding nutrition among key value-chain actors.
*  What are the most efficient and effective approaches, methods, tools, and media outlets to
disseminate information and raise public awareness about nutrient-rich foods? How can the
value chains be leveraged to inform value-chain actors, including consumers?
*  How can women participate more actively in various processes along the value chain and
play a greater role in producing high-quality nutrient-rich (and commercial) products, as well
as in shaping the demand for such foods?
*  What is the nutritional impact of commercial producers' participation in rural markets for the
poor?
Objective 4. Identify nutrition entry and exit points, and test new models to enhance nutrition
along the value chain.
*  For nutrient-rich foods, what are the potential points of entry to enrich, replace, or preserve
nutrients along the value chain?
*  What exit points along the value chain should be mitigated to avoid nutrient losses?
*  What is the added cost of making nutrient-rich foods more nutritious along the value chain?
34


﻿*  How can local value chains be used to produce specialized products for populations with
special needs (such as undernourished or pregnant mothers, persons living with HIV/AIDS,
and infants)? Strategies might include ready-to-use therapeutic foods, fortified blended foods,
biofortified crops, and improved complementary foods.
*  What nutritious products could be developed and promoted from available local foods and
underutilized crops? What scale would be appropriate and cost-effective for local production
from biodiverse systems of affordable, high-quality, specialized foods for these vulnerable
population groups?
*  How can women farmers be linked in as producers and processors of nutrient-rich foods, or
as ingredient suppliers to commercial manufacturers of specialized foods?
*  How are different entry and exit points likely to change with intensification of production and
increasing length and complexity of value chains?
Objective 5. Evaluate the impact and cost-effectiveness of the approaches developed under
Objectives 3 and 4.
*  What is the impact of the approaches developed in Objectives 3 and 4 on availability, access,
and consumption of nutrient-rich foods among the target populations? How does the impact
differ across groups of consumers, as defined by gender, education, household composition,
income level, culture, geographical location, access to markets, and level of food self-
sufficiency?
*  What is the impact on particularly vulnerable subpopulation groups, such as the poorest of the
poor and women and young children within poor households?
*  What is the cost-effectiveness of the different approaches developed?
*  What are the lessons learned for other value chains in other contexts, and at a greater scale?
*  How are the trade-offs addressed between economic gains for producers and other actors
along the value chain for nutrient-rich foods and the higher cost for consumers? Are
consumers willing to pay for additional nutritional value of foods? Which consumers? What
happens to the poorest of the poor?
Researchable Hypothesis
This component will test the main hypothesis that value chains are a feasible, effective, and cost-
effective approach to improve the supply of and demand for select nutritious foods among poor
populations and nutritionally vulnerable individuals such as women and young children. Several
excellent tools and methods exist to analyze value chains for poverty reduction or to increase small
farmers' access to markets, but none have been developed yet to test the feasibility of incorporating
nutrition goals and interventions into value-chain development. CRP4 will take up the challenge and
develop and test these tools in order to answer the key development question of whether or not
leveraging value chains is a cost-effective way of improving nutrition outcomes among the poor.
6.1.2 Impact Pathway
This component will have the desired impact if it contributes to increasing the demand for-and access
to-a larger variety of affordable nutritious foods, among vulnerable and marginalized households in
rural and peri-urban areas. This will result from (1) enhanced nutritional knowledge and awareness
created among value-chain actors, including consumers, and (2) the greater selection of affordable
nutrient-rich foods available through informal and formal markets. The pathway to achieving these
impacts will be mediated through the following three outcomes (as shown in Figure 4):
35


﻿1. Tools developed to enhance consumer knowledge, awareness, and willingness to pay for
nutritious foods are used broadly to create demand for such foods among the poor.
2. Models developed and tested to enhance nutrition along the value chain are adapted and used
for other commodities, as well as for replication and scale-up in other contexts.
3. Nutritional considerations, analysis, and interventions are increasingly incorporated in value-
chain research and development.
Figure 4. Impact pathway of Component 1
ZU
Commodities with intrinsic nutritional value that are typically out of reach for poor consumers
(and that tend to be sold for income rather than consumed by producer households) will be prioritized for
value-chain analysis and improvement. Research outputs from work on these selected food commodities
will fall into three categories:
1. detailed information on diets, consumption patterns, and access constraints for the poor to
nutritious foods
2. new tools and approaches to measure and increase consumer awareness, knowledge, and
willingness to pay for nutritious foods
3. new cost-effective models to improve the nutritional value of these foods through the value
chain
36


﻿The research in this component will be closely linked with food safety research in Component 3
to provide outputs to enhance nutritional quality and food safety along the value chain. This will require
significant engagement with three key stakeholder groups involved in value-chain work.
1. The CGIAR and other research institutions working on highly nutritious food value chains.
For example, close linkages are planned with CRP3.7 for meat, dairy, and fish along with their
partners, and with CRP2 and partners for the promotion of nutrient-rich food production.
2. Development actors involved in social protection programs or in integrated ANH programs
promoting healthy diets and increased demand for nutritious foods.
3. The private-sector food-chain actors, which are increasingly engaged in the production,
processing, distribution, and marketing of specialized foods and nutrient-rich foods.
Private-sector initiatives include programs focusing on the distribution and demand creation for
specialized foods and locally produced fortified products targeted to vulnerable groups such as pregnant
or lactating women, young children, or other individuals with special needs. A key actor will be
pharmaceutical companies involved in nutrition product development and in fortifying foods with
essential micronutrients, such as DSM, Nutriset, and others. The Global Alliance for Improved Nutrition
(GAIN), which facilitates private-sector investment in adding nutritional value to foods along the value
chain, will be an important partner and enabler for this component. Other key actors include the United
Nations (UN) REACH initiative, WFP and its development assistance programs, and governments and
nongovernmental organizations implementing social protection and targeted nutrition programs, to name
a few.
6.1.3 Activities, Outputs, and Outcomes
The proposed activities, with related outputs and outcomes are presented in Table 5, listed by objective.
These activities, outputs and outcomes are still broadly defined, but specificity will be achieved when
they are applied to the target value chains selected for research under CRP4. A tentative plan for target
value chains, countries and key partners for CRP4's work on value chains for nutrition is presented in
Table 4 by year of implementation. This plan will be revised during the first year of implementation, after
extensive discussions with a broad range of CRP4 partners are held, including with teams from other
CRPs. As noted above, CRP4's approach in value chain will be to build on the work carried out by the
CGIAR and its partners on value chains for nutrient-rich food and to incorporate nutrition in existing
work, rather than developing a new value chain research portfolio. An example of the approach that CRP4
will use to complement other CRP work on value chain is presented in Appendix 5 for tilapia and catfish
in Uganda in collaboration with CRP3.7. The example illustrates the types of activities, outputs and
outcomes that CRP4 will add to CRP3.7's work and how this joint work will add value to the work of
both CRPs and enhance their impacts on the nutrition and health of poor populations. Appendix 6
presents another example of potential research that may be undertaken in collaboration with Bioversity on
value chains for nutritious local and traditional foods and neglected and underutilized species.
37


﻿Table 4. Preliminary list of value chains and countries that will be included in the CRP4 value
chain for nutrition research in the first five years of the program
Country       Value chain              Main partner         Links with other CRP4 components
Year 1
Uganda      Fish                     CRP3.7               - Food safety
Uganda      OFSP                     HarvestPlus          - Biofortification
- Integrated ANH programs
Mozambique OFSP                      HarvestPlus          - Biofortification
- Integrated ANH programs
Senegal     Dairy (nomadic populations) CRP2              - Food safety
Year 2 (countries still to be determined; options are listed)
Mali        Small ruminant meat      CRP3.7               - Food safety
Ethiopia                                                  - Integrated ANH programs
Uganda      Pig meat                 CRP3.7               - Food safety
Vietnam                                                   - Integrated ANH programs
Tanzania    Milk                     CRP3.7               - Food safety
India                                                     - Integrated ANH programs
Year 3-5 (countries and specific commodities to be determined)
Tbd         Fruits                   CRP6                 - Integrated ANH programs
Vegetables               World Vegetable Center
Tbd         Legumes                  CRP3.5               - Integrated ANH programs
Tbd         New biofortified crops   HarvestPlus          - Biofortification
- Integrated ANH programs
Notes: Abbreviations: ANH = agriculture, nutrition and health; OFSP = orange fleshed sweet potatoes; Tbd = to be determined.
6.1.4 Priority Setting and Sequencing of Activities
The first activity in this component will be to finalize the selection of suitable value chains and contexts
to initiate research on integrating nutrition considerations and interventions into value-chain research and
development. Initial discussions with partners led to the selection of the four value chains listed in Table 4
for year 1, but additional discussions are needed to make a final selection of value chains to initiate work
in years 2 and beyond. The team will therefore organize a meeting of relevant CGIAR centers, CRPs, and
other partners who are working on value chains for nutrient-rich foods such as animal source foods,
legumes and fruit and vegetables. Examples of experts and partners for this workshop include those
working on CRP3.7 on meat, dairy, and fish and on CRP3.5 on grain legumes; experts working on
biodiversity (including staff from Bioversity and partners); staff and partners from the World
Agroforestry Centre (ICRAF) and the World Vegetable Center working on fruits and vegetables; staff
working on biofortification (Component 2 of this CRP); and development partners such as REACH,
GAIN, and private companies interested in working on value chains for enhanced nutrition. The outcome
of this initial workshop will be the confirmation of plans regarding the selected value chains for year 1;
the selection of four to five additional value chains for start-up research in years 2 and 3; and plans for
sequencing these value chains in the course of the first 3 years of the program. Follow-up workshops with
each value chain team will be conducted to draw a detailed work plan.
The criteria for value-chain selection will include a series of factors, including (but not limited to)
the potential to effectively reach the poor and improve their access to nutritious foods, the likelihood of
success in working with value-chain actors on incorporating nutrition interventions, and the goal of
working in a diversity of environments, contexts, countries, and populations, including populations
exposed to different stages of economic development, market access, and agroecological zones.
38


﻿Once value chains and contexts are selected, work will be phased in, in roughly the order in
which the activities are listed in Table 5. Research under Objectives I and 2 will be launched in Years
1-2; this will include a series of assessments using quantitative multilevel surveys, qualitative enquiry,
social network censuses, nutritional analysis of foods (where relevant), and non-survey methods to assess
consumers' acceptance and valuation of nutrient-rich foods. This rich information will be used, starting in
Year 3, to address Objectives 3-5. Tool and method development and impact evaluation (starting with
baseline in Year 3) will be implemented gradually in different contexts in Years 3-5 and will take perhaps
three-to-five years to complete, depending on the scope and rigor of the evaluation methods selected. We
therefore envision, at a minimum, a ten-year process to complete a full set of case studies and to generate
the planned research outputs and outcomes.
6.1.5 Methods
A variety of quantitative and qualitative methods will be used to address the five objectives of this
component. Table 6 provides an overview of methods and indicators that will be used for each objective.
Note that all analyses will generate gender-disaggregated data, where relevant.
39


﻿Table 5. Activities, outputs, outcomes, and impacts of Component 1, by objective
Activities                                         Outputs                                     Outcomes and Impacts
Objective 1. Characterize the dietary patterns of vulnerable and marginal populations and identify the available nutrient-rich foods that could be
made more accessible to these communities through nutrition-sensitive value chains
Years 1-2:for 5-8 value chains/contexts
* Dietary surveys and qualitative research to      * Data on food consumption patterns, use of target and  Methods, data and evidence used to design
characterize dietary patterns of target populations  other nutrient-rich foods, determinants of use, and  programs/initiatives to increase access to nutritious
* Lab analyses of nutrient content of food (including  nutrient gaps among target population         foods by the poor
lesser known, traditional and local foods) and losses  * Database on nutritional value of lesser known and
during processing (if value chain with Bioversity is  local foods (if work on biodiversity is included)  Impact: programs to increase access to nutritious
included in year 2)                             * Data on dynamics of food purchases, own-production, foods are better designed
* Market surveys on availability and cost of target  purchase and sales of nutrient-rich foods, cost, market
foods (and other nutrient-rich foods) within markets;  access among the poor
and on market access of target populations
Evidence regarding availability, access, use, processing
(Senegal (dairy) and Uganda (fish) in year 1; 4-S ooher  (and nutrient content) offoods; and identification of
commodities/contexts in year 2, including possibility of  nutrient gaps in targeted populations and individuals (in
work on biodiversity information on OFSP in        Senegal, Uganda, Mozambique, and 4-5 other
Mozambique and Uganda already available)           countries/contexts)
Methods and tools to generate this evidence tested and
well-documented
Objective 2. Understand information gaps and constraints to consumption of nutritious foods (e.g., economic, social, cultural constraints)
Years 1-2:ffor 5-8 value chains/contexts
" Qualitative and quantitative research on consumer  e Data on poor consumers' knowledge and awareness  Information used to design effective behavior change
knowledge, attitudes, awareness, preferred source of  about nutritious foods; and preferre d sources of - and  and communication (BCC) strategies to improve
information                                       channels for information on nutrition and health  demand for nutritious foods and to tailor supply of
" Non survey methods to assess consumers' acceptance,  * Tools to assess, and data on poor consumers'  attractive, culturally acceptable and convenient
valuation and willingness to pay for nutrient-rich  willingness to pay for nutritious foods and    nutritious foods for targeted populations
foods                                              preferences (types, format) of these foods
" Quantitative and qualitative research to assess food  * Data on food preparation and storage methods and  Impact. BCC strategies to stimulate demnandfor
preparation and storage methods, knowledge,        knowledge gaps identified in this area          nutritious foods among targeted poor populations are
awareness, attitudes, sources of informati on, and to                                             better designed and more effective
identify, knowledge gaps                        Improved understanding of consumers' knowledge,
(Senegal (dairy) and Uganda (fish) in year 1; 4-5 other  awareness, preferred sources of information, and
commodities/contexts in year 2; information on OFSP in  willingness to payrfor nutritiousfoods (in Senegal,
Mozambique and Uganda already available)           Uganda, Mozambique, and 4-5 other contexts)
(continued)
40


﻿Table 5. Activities, outputs, outcomes, and impacts of Component 1, by objective (continued)
Activities                                         Outputs                                    Outcomes and Impacts
Objective 3. Develop, test, and evaluate new tools to increase awareness, access to information, and knowledge among consumers to stimulate
demand for nutrient-rich foods
Implementation starting in Years 3-5; completion in Years 6-10 for 5-8 value chains/contexts
* Research in collaboration with program implementers  * Tools to increase poor consumers' awareness and  Tools and materials widely used by private sector,
to test and evaluate tools and materials to increase  promote consumption of nutritious foods developed,  NGOs, governments, and consumers to increase
consumer knowledge and awareness of, and stimulate  tested and evaluated nutrition interventions identified  consumer awareness and stimulate demand for nutritious
demand for nutritious foods                       and prioritized for research under this component  foods by the poor
* Portfolio of information, education and
(Senegal (dairy), Uganda (fish) in year 1; 4-5 other  communication materials developed and available  Impact: Poor have greater demand for -and consume
commodities contexts in year 2; information on OFSP in                                              a larger variety of nutritious foods
Mozambique and Uganda already available)
Objective 4. Identify nutrition entry points (where nutrients are gained) and exit points (where nutrients are lost) along the value chain, and test new
models to enhance or protect the nutritional value of foods during postharvest handling, processing and preserving, transportation,
distribution, preparation, and storage
Implementation starting in Years 3-5; completion in Years 6-10 for 5-8 value chains
* Value chain analysis to assess points of entry/exit  * Top performing technologies identified and tested to  * Tools and technologies developed to enhance
where nutrient content can be enhanced/protected in  enhance nutrition along the value chain for target  nutrition along the value chain are used by a variety
select value chains                               nutritious foods                                  of value chain actors
* Testing and evaluation of tools and technologies to                                               * Evidence of the feasibility of enhancing nutrition
prevent losses, increase nutrient content of nutritious  Evidence generatedfrom 5-8 value chains of the  along the value chain motivates use of methods, tools
foods along the value chain                    feasibility of leveraging value chains to improve access  and technologies by different stakeholders for new
to nutritious foods by the poor                     value chains
(Senegal (dairy), Uganda (fish); and 4-5 other                                                        Impact: Value chains provide a greater variety of
commodities/contexts)                                                                                 nutritious foods that are more accessible to the poor
Objective 5. Evaluate the impact and cost-effectiveness of the approaches developed under Objectives 3 and 4
Implementation starting in Years 3-5; completion in Years 6-10 for 5-8 value chains
* Design and carry out impact and cost-effectiveness   Evidence generated from at least 5 contexts of impact  Evidence generated regarding the impact and cost-
evaluation of approaches developed in 3 and 4     and cost-effectiveness of leveraging value chains to  effectiveness of enhancing nutrition through value
improve access to nutritious foods (supply) by the  chains in at least 5 contexts leads to greater
(Senegal (dairy), Uganda (fish) ; a selection of 3 or so  poor and to stimulate demand for such foods through  investments in value chains and BCC to improve
other commodities/contexts for impact and cost-     successful BCC (demand)                           nutrition, and use of tools and methods developed by
effectiveness evaluation)                                                                             large number of stakeholders
Impact Poor have greater access to - and consume a
lareer variety of nutritiousfoods
41


﻿Table 6. Methods and indicators for Component 1
Methods                                                             Examples of indicators
Objective 1. Characterization of dietary patterns and nutrient composition of foods
Quantitative, representative household surveys to collect basic information on  - Total expenditure; food expenditure; budget shares for different nutritious and
(1) household demographics, socioeconomic conditions, consumption/expenditure,  other foods
agricultural production, access to services and markets, and food security; (2) detailed - Household food security indicators (household hunger scale, household food
information on food consumption and acquisition; and (3) gender-disaggregated dietary  insecurity access scale, coping strategies)
intake data, using detailed 24-hour recall methods, food frequency questionnaires,  - Quantified food production (types and amounts of different foods produced;
dietary diversity assessments, and anthropometric measurements, as well as biomarkers  percent consumed, percent sold, and so forth)
(for micronutrient status) where appropriate.                               - Intake of energy, protein, fat, and select micronutrients by vulnerable individuals
(such as women and young children); nutrient gaps (at household and individual
level)
- Anthropometric measurements (weight-for-age Z-scores, height-for-age Z-scores,
weight-for-height Z-scores; stunting, wasting, underweight), focusing on women
and young children
- Biomarkers of micronutrient status, where relevant (such as serum retinol for
vitamin A, haemoglobin for anemia, serum zinc for zinc status), focusing on
women and young children
- Reported illness symptoms in past two weeks (focus on child)
Quantitative community surveys to collect information on community characteristics  - Community characteristics (number of schools, health facilities, water source,
and availability of services                                                   agriculture, and the like)
Market surveys to collect data on the availability and cost of nutrient-rich foods  - Food supply; food prices, market processes; mapping of foods available in
markets
Laboratory methods to estimate the macro- and micronutrient content of selected  - Data on calories, protein, fat, and micronutrient content of traditional foods of
traditional local foods                                                        importance in the population, which are not included in food composition tables
Agriculture, ecosystem, and biodiversity tools to characterize the food diversity of  - Species numbers, abundances, densities
agriculture landscapes and ethno-botanical characteristics of potential food sources  - Shannon diversity and evenness indices
Linear programming to (1) identify nutrient gaps and (2) select diets (based on local  - Number of uses per species and species per use category
foods available in markets) that satisfy a set of nutritional constraints
(continued)
42


﻿Table 6. Methods and indicators for Component I (continued)
Methods                                                             Examples of indicators
Objective 2. Understand information gaps and constraints to consumption of nutrient-rich foods
Quantitative: surveys in Objective I will also collect relevant data on knowledge,  - Knowledge score (based on knowledge test)
practices, and attitudes in relation to nutrition/nutritious foods; perceived constraints to  - Practices scales (for different dimensions of practices)
use of nutritious foods; preparation and storage of nutritious foods, sources, uses, and  - Lists (and quantification) of constraints identified
preferences regarding knowledge acquisition and information gathering (using social  - Lists (and quantification) of social networks, sources and providers of
network census approaches).                                                    information, and so forth
Qualitative: to be selected from a variety of potential approaches, depending on context  - In-depth information on knowledge, attitudes, and practices regarding nutritious
and specific questions addressed. Examples of approaches include focused ethnographic  food use, intake, preparation, and storage. Information on constraints to intake of
studies; focus group discussions; in-depth structured, semi-structured, and unstructured  nutritious foods (such as sociological-, cultural-, economic-, and gender-related)
interviews; observations; shadowing.                                           and on preferred sources of information relating to issues around food use.
Topics same as for quantitative surveys
Survey methods to assess consumers' acceptance and willingness to pay for nutrient-rich   Measures of expected willingness to pay as compared to existing market prices.
foods based on different levels of information. Methods include hypothetical nonmarket  This will be developed across the income distribution to control for low ability to
stated preference methods (SPMs) encompassing both contingent valuation and choice  pay (ATP).
experiments (see Alfnes et al. 2006); real nonmarket valuation methods, such as  Measurement of the nutritious attributes more valued by consumers.
Vickery and Becker-Degroote and Marschack experimental auctions (Train and Wilson   Measures of the effects of better information about the nutritional attributes of
2011; Plot and Zeiler 2005; Horowitz and McConnell 2002; Shogren et al. 2001); and  food.
real market randomized experiment methods to understand the effects of information
about nutritious attributes of food, including their effect on the WTP (Masters and
Sanogo 2002; Biroo, Roy. and Torero 2010).
Objective 3. Develop, test, and evaluate tools to increase consumer awareness, access to information, and knowledge about nutrient-rich foods
Formative research will be used to develop new education/behavior change approaches.. - Impact will be evaluated on the same indicators as above: knowledge and
Data collected under Objectives I and 2 will also be used to design education  practices test scores; changes in constraints; changes in use of information;
interventions.                                                                 changes in use of nutrient-rich food.
Rigorous evaluation methods will be used to compare and evaluate approaches; see
component 4 for description of evaluation methods, including impact, process and cost
evaluation. Qualitative data collection will be used to assess constraints to adoption and
use of recommended practices, and to interpret results of evaluation.
(continued)
43


﻿Table 6. Methods and indicators for Component 1 (continued)
Methods                                                              Examples of indicators
Objective 4: Identify nutrition entry and exit points and test new models to enhance or protect the nutritional value of foods along the value chain
Value-chain analysis: This activity will first define the value chain for analysis by  Key commodities to be targeted to improve nutrition at key entry and exit points.
identifying key commodities that could be sensitive to increases in nutritional content.   Cost-benefit analysis by commodity of potential interventions to enhance
Once the key commodities are identified, a mapping of the specific value chains will be  nutrition at specific entry points and to prevent losses at exit points along the
done with key stakeholders, and field instruments will be developed to identify key exit  value chain.
and entry points of nutritional content across the value chain. The detailed analysis of   Best practices identified in improving the nutritional content of value chains.
the value chain will include measuring its performance and evaluating the benefits and
costs associated with nutrition upgrading options. Then we will identify opportunities
and mechanisms for small farmers to benefit, based on the WTP studies of consumers;
we will pilot possible interventions and assess their impact, in terms of costs and
benefits to producers and consumers of the upgrading options implemented.
Laboratory evaluation methods will be used to quantify the losses/increases in nutrient
content along the value chain, to enable comparisons and evaluation among different
models/interventions.
Objective 5. Evaluate the effectiveness and cost-effectiveness of the approaches developed in Objectives 3-4
Rigorous evaluation methods will be used based on sound program impact theory, using  - Impact indicators: household consumption and individual intake of targeted
process evaluation and cost-effectiveness assessments (see Component 4 for details on  nutritious foods, contribution of these foods to changes in micronutrient intake
methods).                                                                       and micronutrient status, and possibly to child growth and morbidity symptoms
(depending on the micronutrient)
44


﻿6.1.6 Partnerships
In addition to CG centers and the World Vegetable Center (an international agriculture research center
focusing on vegetables), the list of potential partners for this component includes a wide variety of
stakeholders, including NARES, NGOs (such as CRS, Concern Worldwide, and Helen Keller
International), intergovernmental organizations (UN agencies and programs such as FAO, WHO, and
REACH), government institutions, foundations, and academic institutions. Beyond these partners, many
regional and locally specific partnerships and stakeholders have been identified under individual research
activity descriptions.
A strong collaboration with the private sector will be pursued under this research component for
testing sustainability of methods and tools along case study value chains. Public-private partnerships will
be fostered in collaboration with GAIN. Strategic alliances will be pursued with existing agricultural
investment projects, such as those supported by the International Fund for Agricultural Development
(IFAD) (like the Orissa Tribal Empowerment and Livelihood Program), by GAIN, and by the food and
retail industries (Table 7).
Table 7. Examples of partnerships for Component 1
Development
Enablers          implementers       Value-chain actors  Research partners   CGIAR centers
IFAD              NGOs:              - Private sector  - World Vegetable Center Bioversity
FAO               - CRS                (e.g., Land O'Lakes) - LCIRAH         CIAT
WHO               - Concern Worldwide  - GAIN          - NARES               CIMMYT
REACH             - HKI                                                      CIP
Gain                                                                        ICARDA
Government                                                                   ICRAF
institutions in                                                            ICRISAT
countries of emphasis                                                      IITA
ILRI
World Fish
6.2 Component 2: Blofortification
6.2.1 Rationale, Objectives, and Research Questions
Rationale
A primary underlying cause of malnutrition is poor diet quality, characterized by high intake of food
staples and low consumption of foods rich in vitamins and minerals, leading to widespread micronutrient
malnutrition among people who cannot afford to buy (or manage to produce) more nutritious foods. By
developing staple crop varieties whose edible portions are richer in bioavailable nutrients (through a
process called biofortification), agricultural research can provide farmers with crop varieties that can
readily improve nutrition for millions of people (Nestel et al. 2006).
CRP4 will encompass two programs designed to do just that: HarvestPlus, and AgroSalud. Since
2003, the Consultative Group on International Research (the CGIAR) has supported HarvestPlus, the
CGIAR Challenge program on biofortification. HarvestPlus has produced promising varieties of seven
nutrient-rich staple crops, poised to be released within the next three years. HarvestPlus is now
performing nutritional testing on these crops in target areas in Africa and Asia, to ensure they deliver
bioavailable nutrients. AgroSalud is undertaking biofortification work for the Latin American region. In
addition, AgroSalud proposes to explore the possible impact of the production and consumption of
several biofortified crops in the food basket that represents the typical staple crop diet in Latin America.
HarvestPlus and AgroSalud are independent programs with their own well-established goals,
visions, governance, management, and funding base. Nevertheless, the two programs work closely and
share research methods, protocols, germplasm, scientists, and communication capabilities. Published
45


﻿nutrition studies under both programs have added to the growing body of evidence that biofortification
can reduce micronutrient malnutrition in a cost-effective way. In particular, biofortified beans (developed
at CIAT) and biofortified maize (developed at the International Maize and Wheat Improvement Center
[CIMMYT]) contribute to variety development globally.
Component 2 proposes to channel investments into these two geographically distinct but related
subcomponents:
* Subcomponent 1: HarvestPlus (www.harvestplus.org)
* Subcomponent 2: Biofortified Food Basket for Latin America and the Caribbean
(www.AgroSalud.org)
Objectives
The objective of Component 2 is to develop and test nutrient-dense staple crops through biofortification
and to make these novel crops available to the poor and undernourished.
Research Questions
For biofortification to be successful, four broad questions must be addressed:
1. Can plant breeding and modem agricultural biotechnology techniques increase the nutrient
density of food staples to target levels that can potentially have a measurable and significant
impact on human nutritional status?
2. When consumed under controlled conditions, will these extra nutrients be bioavailable and
absorbed at sufficient levels to improve the nutrient status in target populations?
3. Will farmers adopt the biofortified varieties?
4. Will consumers purchase/eat the biofortified varieties?
Researchable Hypothesis
New and ongoing work in biofortification is testing the hypotheses that breeding nutrient-dense staple
crops through biofortification is feasible without affecting yield and other positive crop
characteristics, that farmers will adopt, that consumers will consume, and that the nutritional status of
targeted populations will improve. Although the proof of concept of the impact of orange-fleshed
sweet potato on vitamin A status has been demonstrated in a few countries, much remains to be done
to test these hypotheses for other target nutrients, for other crops, and in other countries. The science
behind this research is well developed, but different nutrients, crops, and environments will bring new
challenges that this CRP will address in partnership with the different commodity CRPs (CRP3 suite).
6.2.2 Impact Pathway, Outputs, and Outcomes
Figure 5 shows the impact pathway for biofortification. Outputs and outcomes revolve around (1) the
release of biofortified crop varieties, (2) their use by the farm households, and (3) subsequent distribution
through the marketing system. Details are provided for individual crops under development under each
subcomponent.
Agricultural research scientists (at CGIAR centers and National Agricultural Research Systems
[NARS]) develop high-yielding, high-nutrient lines that are tested in target countries for agronomic
performance. If they test well, the next step is for nutritionists (from both developed country and target
country institutions) to test that the varieties can improve micronutrient status under controlled conditions
through efficacy trials. Finally, dissemination of biofortified varieties is organized through partnerships
with agriculture- and health-oriented NGOs, government extension agencies, and communications
experts.
46


﻿Figure 5. Impact pathway of Component 2
6.2.3 Subcomponent 2.1: HarvestPlus
Approved in 2003, HarvestPlus was one of the first Challenge Programs supported by the CGIAR. Since
its inception it has been heralded as a successful institutional innovation, invigorating both
interdisciplinary research and cross-sectoral investment in the CGIAR. HarvestPlus is co-convened by
two of the CGIAR centers: the International Center for Tropical Agriculture (CIAT), with headquarters in
Cali, Colombia, and the International Food Policy Research Institute (IFPRI), with headquarters in
Washington, DC. As a Challenge Program, HarvestPlus is designed and managed as a time-bound,
independently-governed program of high-impact research that targets the CGIAR goals in relation to
complex issues of overwhelming global and/or regional significance, and requires partnerships among a
wide range of institutions in order to deliver its products.
Rationale, Objectives, and Research Questions
Rationale
Since 2003 HarvestPlus has built an alliance of over 200 scientists in 40 countries who breed nutrient-
dense crops and test these crops for nutritional efficacy and effectiveness. In its next phase, HarvestPlus
will focus its efforts on designing and building effective partnerships to disseminate these new nutritious
crops in nutritionally challenged regions of Africa and Asia. In this way, HarvestPlus seeks to harness the
full potential of agricultural, nutrition, and marketing sciences to develop and disseminate more nutritious
47


﻿staple foods in order to directly address the persistent problem of micronutrient malnutrition, especially
for the poor.
Objectives
The goal of HarvestPlus is to improve the health of poor people by breeding staple food crops that are
rich in micronutrients, a process referred to as "biofortification." HarvestPlus focuses on three
micronutrients that are widely recognized by the World Health Organization (WHO) as limiting in diets
of the poor: iron, zinc, and vitamin A. While spillover benefits are expected to extend beyond national
borders, seven focus country crop products make up the HarvestPlus portfolio (see Appendix 7):
*  Zinc rice for Bangladesh and India
*  Zinc wheat for India and Pakistan
*  Provitamin A maize for Zambia
*  Provitamin A cassava for Nigeria and Democratic Republic of Congo
*  Iron pearl millet for India
*   Iron-rich beans for Rwanda and DR Congo
*  Provitamin A sweet potato for Uganda and Mozambique
Research Questions
Who are the hungry, what do they eat, and will biofortification have an impact?
For biofortification to be most effective, HarvestPlus crops must be tailored to the needs and local
context of the undernourished. HarvestPlus researchers must determine who the hungry are, where they
live, and what they are consuming. They must estimate existing consumption patterns as well as potential
contributions from biofortified products to determine which crop/nutrient combination would generate the
most impact for which populations. These initial questions have been largely answered during the first
five years of the program; for these and other research findings, visit www.harvestplus.org.
Can HarvestPlus breed nutrients into staple crops without negatively effecting yield?
The ultimate end users of HarvestPlus crops are farmers as well as consumers. As rural-based
nutrition interventions, the new crops must first and foremost be attractive to farmers, with yields equal to
or greater than current varieties. Intensive plant breeding has been devoted to ensuring acceptable yield
and other positive characteristics of biofortified varieties. For each crop cycle, breeders work to
incrementally increase the level of nutrient in the edible portion of the staple crop, aiming for a level that
nutritionists have determined to have a measurable nutritional impact. HarvestPlus employs the latest
agricultural research technology-developed within the CGIAR, in international institutions and
universities around the globe, and at national agricultural research systems-to screen germplasm, breed
crops, and test and disseminate the new nutritious staple crops.
Will these crops improve nutritional status?
Improving the nutritional quality of food is a complicated endeavor. People eat food, not
nutrients; and the complexities surrounding the absorption and bioavailability of nutrients from foods still
represent, to some extent, an uncharted science. HarvestPlus nutritionists are applying the latest
understanding of nutrient inhibiting and promoting compounds that exist in foods and in humans, to
maximize the bioavailability of the micronutrients added via biofortification-and advancing the body of
knowledge in this area is one of several public goods emerging from the program. Two other critical areas
of program research are testing the efficacy of HarvestPlus crops in a controlled setting, and testing their
effectiveness in improving nutritional status in a community setting. Finally, the nutritional quality of
foods often gets compromised as food is stored and prepared. HarvestPlus nutritionists are testing the
48


﻿retention of the nutrients under local conditions and have discovered, among other things, that nutrient
retention is, in fact, a heritable characteristic. This has therefore become an additional breeding objective
for HarvestPlus plant breeders.
What are the determinants offarmer adoption of biofortfied varieties in different settings? What will be
the incentives and disincentives for consumers to purchase/eat the biofortified varieties?
There are two main strategies for introducing a new product. The push strategy is supply-driven.
It focuses on the supply of seed and relies on breeding high nutrients into agronomically superior and
high-profit varieties. The pull strategy focuses on the demand for biofortified crops or processed products.
Well-designed consumer communication and mass media campaigns will play a major role in generating
consumer demand.
Impact Pathways
The impact pathways for biofortification are described in Section 6.2.2 above. Figure 6 presents the
specific research steps involved.
Figure 6. Steps in research process for biofortification
The research process involves three phases: discovery, development, and delivery.
Discovery
Appropriate target populations for biofortification are determined through analysis of cropping patterns,
consumption trends, and prevalence of malnutrition. This intersection, in turn, determines the selection of
49


﻿focus crops and the areas where biofortified varieties should be directed (Arsenault et al. 2010; Zapata-
Caldas et al. 2009). Nutritionists work with agricultural scientists to establish nutritional breeding targets
based on several factors: the food intake of populations in need; nutrient losses during cooking, storage,
and processing; bioavailability of nutrients, related to the presence or absence of complementary
compounds; and the probability/difficulty of breeding for specific nutrients (Hotz and McClafferty 2007).
Once targets are set, the global germplasm banks of the CGIAR institutes, as well as the germplasm banks
held in trust by national partners, provide a reservoir of staple-crop germplasm to be screened for nutrient
genetic diversity (Pfeiffer and McClafferty 2007), available to be drawn on for breeding programs
(Beebe, Gonzalez, and Rengifo 2000).
Development
To date, the largest research endeavors under biofortification have focused on crop development,
including testing for nutritional bioavailability. efficacy, and effectiveness. Crop development includes all
breeding activities to produce varieties with the desired fanner and consumer characteristics-improved
nutrient content, ideal consumer quality features, and farmer-preferred agronomic performance (Pfeiffer
and McClafferty 2007). Along with breeding, nutrition studies are of paramount importance to establish
that the nutrients added through biofortification will in fact be absorbed by the human body, through
extensive and complex research into bioavailability, efficacy, and effectiveness.
Delivery
Varietal release regulations differ by country. Registering new varieties of crops requires proof (1) that
the variety is new and distinguishable, and (2) that it adds value. After registration and release comes the
least understood/most challenging aspect of biofortification: ensuring farmer and consumer acceptance of
nutrient-rich staple crops. Sustainable extension and seed production systems are the foundation of a
delivery process that will help push the products into market-but well-designed marketing and demand-
creation techniques must also be employed to generate pull by consumers. Attention to consumer
acceptance is particularly important when the additional nutrient is visible-as with provitamin A;
consumer behavior change must then be part of the delivery strategy. Finally, biofortified products must
be disseminated in an enabling public policy environment. Advocacy campaigns for biofortification can
help create space for this new nutrition intervention, in both the agriculture and public health sectors.
Activities, Outputs, and Outcomes
Table 8 presents a summary of broad activities, outputs, and outcomes for HarvestPlus. The emerging
HarvestPlus delivery program is ambitious. The first pilot launches will concentrate on delivering
provitamin A maize in Zambia, iron-rich bean in Rwanda, provitamin A-rich cassava in Nigeria, and iron-
rich pearl millet in India. During its first delivery campaign, HarvestPlus aims to reach 100,000 farmers
with these pilot crops by 2013. Lessons learned from this initial delivery exercise will be applied to
continued expansion in those areas as well as rollout of other crops in other target regions. HarvestPlus
will disseminate crops through strategic partnerships with the private sector, civil society, and
governmental organizations.
Table 9 provides some detail relating to research on specific crops and the delivery of key
biofortified varieties, through 2015. Beyond 2015, the strategy envisions three broad areas of activity: to
establish breeding for minerals and vitamins as a core activity at CGIAR centers and NARS; to scale up
delivery in additional non-target countries; and to carry out follow-up surveys to measure impact.
50


﻿Table 8. Overview of HarvestPlus activities, outputs, and outcomes
Activities                                    Outputs                                       Outcomes
Continued crop improvement, including evaluation  Improved lines of seven biofortified parents  New nutritious crops are made available to
of Genotype X Environment Interactions on    introduced into the product pathway            NARES and implementing partners in Africa and
nutrient density of edible portions                                                         Asia.
Nutrient retention and bioavailability studies  Nutritious crops that will overcome losses during  HarvestPlus crops are available that deliver
storage, processing, and cooking              nutritional benefits to the consumers.
Nutritional efficacy studies on human subjects  Published evidence that micronutrients in   HarvestPlus crops will be nutritionally efficacious
HarvestPlus crops are bioavailable and that the  and are assured to have a positive impact on
crops are efficacious in improving micronutrient  human nutritional status.
status (for targeted micronutrients) in humans
Release and delivery of HarvestPlus crops.   Biofortified crops rich in bioavailable nutrients are  Farmers and consumers have access to new
available on the market and/or available to poor  varieties of nutrient-dense maize, cassava, bean,
farmers via the public seed distribution system.  and sweet potato-and consume them regularly.
51


﻿Table 9. Some crop-specific HarvestPlus activities, outputs, and outcomes
Activities                                     Outputs                                      Outcomes
Provitamin A Sweet Potato (Uganda)
Pilot studies completed in 2010                                                          Orange sweet potato dissemination scaled-up based
on lessons learned from initial pilot studies.
Iron beans (DR Congo, Rwanda)
* CIAT-continue to develop varieties higher in  First releases expected in 2012 in Rwanda, later in  First trial packets of bean seeds distributed in 2012
iron with best agronomic properties; send  DRC; second wave, even higher in iron, available  by collaborating NGOs and government agencies.
multiple finished lines each year to Rwanda and  for dissemination
DRC for GxE testing                                                                      Government Health Ministry supports efforts to
* Rwanda and DRC NARS-test varieties for      Published evidence that high-iron beans are   disseminate high iron beans.
breeingforhig-irn lies;selct ostefficacious in improving iron status in humans
breeding for high-iron lines; select most
promising varieties for submission for varietal
release; complete efficacy trial in 2012
Iron Pearl Millet (India)
* ICRISAT-continue to develop varieties higher  First release of an OPV expected in 2012; high-iron  First packets of OPVs sold in 2012 by private seed
in iron with best agronomic properties; share  hybrids distributed as truthfully labeled by private  companies.
germplasm with private seed companies in India  companies in 2014
for development of high iron hybrids; provide
finished OPV lines for national testing    Published evidence that iron in high-iron pearl  High-iron pearl millets used in public food
* India NARS-breeding for high-iron lines,    millet is bioavailable and that high-iron pearl millet  distribution programs.
select most promising varieties for submission  is efficacious in improving iron status in humans
for varietal release; complete bioavailability and
efficacy trials in 2012
Provitamin A Maize (Zambia)
* CIMMYT and IITA-continue to develop         First releases expected in 2012 in Zambia, later  First trial packets of maize seeds distributed in
varieties higher in provitamin A with best  second waves                                 Zambia by collaborating NGOs and private seed
agronomic properties; send multiple finished                                             companies in 2012.
lines each year to Zambia for GxE testing  Published evidence that provitamin A maize is
* Zambia NARS-test varieties for adaptability to  efficacious in improving vitamin A status in  Government Health Ministry supports efforts to
growing environments, breeding for high-   humans                                         disseminate high-provitamin A maize.
provitamin A lines; select most promising
varieties for submission for varietal release;
complete efficacy trial in 2012 in Zambia
(continued)
52


﻿Table 9. Some crop-specific HarvestPlus activities, outputs, and outcomes (continued)
Activities                                     Outputs                                        Outcomes
Provitamin A Cassava (DR Congo, Nigeria)
* IITA and CIAT-continue to develop varieties      First releases expected in 2011 in Nigeria, later  First trial stems distributed by collaborating
higher in provitamin A with best agronomic      in DRC, and later second waves              NGOs in 2012 in Nigeria.
properties; send multiple finished lines each year to
Nigeria and DRC for GxE testing                 Published evidence that provitamin A cassava is  Government Health Ministry supports efforts to
* Nigeria and DRC NARS-test varieties for          efficacious in improving vitamin A status in  disseminate high-provitamin A cassava.
adaptability to growing environments, breeding for  humans
high-provitamin A lines; select most promising
varieties for submission for varietal release; complete
efficacy trial in 2013 in Kenya; collaboration with
INSTAPA
Zinc rice (Bangladesh, India)
* IRRI--continue to develop varieties higher in zinc  First releases expected in 2012 in Bangladesh,  First seeds distributed in 2013 in Bangladesh by
with best agronomic properties; send multiple   later in India, plus second waves           collaborating NGOs and government extension
finished lines each year to Bangladesh and India for                                        agencies
GxE testing
" Bangladesh and India NARS-test varieties for     Published evidence that high-zinc rice is   Government Health Ministry supports efforts to
adaptability to growing environments, breeding for  efficacious in improving zinc status in humans  disseminate high-zinc rice.
high-zinc lines; select most promising varieties for
submission for varietal release; complete efficacy
trial in 2012 in Bangladesh
Zinc wheat (India, Pakistan)
* CIMMYT-continue to develop varieties higher in   First releases expected in 2013 in India, later in  First seeds distributed in 2013 in India by
zinc with best agronomic properties; send multiple  Pakistan, plus second waves             collaborating NGOs and government extension
finished lines each year to India and Pakistan for                                          agencies
GxE testing                                     Published evidence that high-zinc wheat is
* India and Pakistan NARS-test varieties for       efficacious in improving zinc status in humans
adaptability to growing environments, breeding for
high-zinc lines; select most promising varieties for
submission for varietal release; complete efficacy
trial in 2012 in India
53


﻿Research Methods
Biofortification strategy ideally follows clear stages of discovery, development, and delivery. However,
as products advance down the impact pathway, further research findings may necessitate revisiting
previous stages to assure the highest quality nutrient-rich product. Methods used at the ten distinct stages
of the research process are as follows.
1. Identify target populations and set nutritional breeding targets
Cropping and food consumption patterns, the incidence of micronutrient malnutrition, and ex-
ante benefit-cost analysis are applied to determine where biofortified varieties should be targeted.
Breeding targets are set for specific micronutrients and crops.
2. Validate nutrition and micronutrient deficiency data
Nutritionists carry out surveys to assess the levels of food staple consumption and nutrient
intakes, by age and gender group. They also measure the effects of processing, storage, and cooking
methods for nutrient retention in biofortified crops and identify retention-friendly practices used by target
populations. They also study to what extent the nutrients bred into crops are absorbed by the body
(bioavailability) as well as the prevalence of micronutrient deficiencies. These studies guide plant
breeders in confirming or refining their breeding targets.
The analysis of retention of minerals and vitamins after storage, processing, and cooking involve
the use of the following methods:
For minerals (from most accurate to least accurate):
Inductively Coupled Plasma (ICP)
X-ray Fluorescence (XRF)
Atomic Absorption Spectrophotometer (AAS)
Near-infrared spectroscopy (NIRS)
For provitamin A (from most accurate to least accurate):
High-performance liquid chromatography (HPLC)
Thin layer chromatography (TLC)
Near-infrared spectroscopy (NIRS)
3. Screening and applied biotechnology
The global germplasm banks of the CGIAR institutes and other partners provide a reservoir of
staple crops germplasm to be screened and drawn on by HarvestPlus. Plant breeders identify the genes
that are important in the synthesis of vitamin A and translocation of minerals. They develop procedures to
implement marker-assisted selection to "flag" the desired traits for breeding higher levels of
micronutrients. Upstream transgenic research is also conducted in the case of nutrient targets that are
challenging to reach through conventional breeding.
4. Crop improvement
Crop improvement includes all breeding and product development activities to produce new
micronutrient-rich crop varieties that perform well in farmers' fields and meet farmers' expectations,
while also providing better nutrition.
5. Test genotype x environment interactions
How genotypes interact with different environments can greatly influence genotypic performance
across different crop growing scenarios. HarvestPlus researchers evaluate crops in target countries to
ensure high and stable expression of the micronutrient content in different environments where the crops
may be grown. Scientists also look at farming practices that can improve crop nutrient content by
enhancing the uptake of nutrients in the edible portion of the crop.
54


﻿6. Test nutritional efficacy
Nutrition teams develop appropriate indicators of micronutrient status; they conduct controlled
feeding trials to evaluate whether vitamins and minerals from biofortified foods are bioavailable and
whether biofortified foods improve the nutritional status of target populations. To evaluate bioavailability,
minerals and vitamins in the biofortified foods are labeled using stable isotopes and fed to subjects over a
fixed number of days. Blood is drawn and absorption of the minerals is evaluated. The evaluation of the
nutritional efficacy of biofortified crops in improving nutritional status is done using randomized
controlled trials with treatment (fed biofortified crops) and control group (fed non-biofortified crops) in a
tightly controlled environment to assess impact across individuals. The relevant biomarkers, for iron,
zinc, or vitamin A status, are used to measure efficacy and impact.
7. Identify factors driving farmer adoption and consumer acceptance
Researchers study the factors that affect whether farmers and consumers will adopt biofortified
crops or products. Crop varietal maps are developed for this purpose and to provide baseline data for
assessing impact at a later stage. This applies particularly to vitamin A-rich foods that tend to be orange in
color, and thus unfamiliar-looking to consumers.
8. Release biofortified crops in target countries
Varieties are identified for selection and submission to registration trials in countries of first
release. Following this, procedures are followed to ensure their successful formal release. Proof that the
variety is new, distinguishable, and value adding must be assembled in order to register new crop
varieties. CGIAR centers work with NARS to gather the relevant information for registration and formal
release of biofortified crops in target regions.
9. Facilitate dissemination, promotion, and consumer acceptance of crops
Delivery managers ensure that seed production, dissemination, and training and extension
systems are in place to promote these new crops. Advocates are identified who can pave the way for crops
to be accepted by consumers and adopted by farmers. Branding and other marketing strategies are created
to increase demand for biofortified crops and foods by consumers.
10. Measure impact and changes in nutritional status of target population
Baseline and follow-up surveys are conducted to measure the number of farming households that
have adopted biofortified crops, as well as any improvements in nutritional status. This will help
determine the ultimate impact of biofortified crops on public health.
Partnerships
Several CGIAR centers have been and will continue to be key in HarvestPlus crop development. In 2010
those CGIAR institutes included CIMMYT, CIAT, the International Institute of Tropical Agriculture
(IITA), IFPRI, Bioversity, CIP, IRRI, the International Center for Agricultural Research in the Dry Areas
(ICARDA), and ICRISAT. Target country NARS partners are also partners for conducting adaptive
research and gene by environment (GXE) analysis, as the crops are transferred from the CGIAR
laboratories to the field. HarvestPlus also partners with a number of public health research institutes on
the nutrition research, including, among others, Cornell University, University of California-Davis,
ETHZ Switzerland, Wageningen Agricultural University, Makerere University, Micronutrient Initiative,
and USDA. Impact analysis is conducted by external consultants as well as by CGIAR impact specialists
within the centers. Advocacy trainings employ international consultants and work with institutions in the
HarvestPlus target countries.
55


﻿6.2.4 Subcomponent 2.2: AgroSalud-Biofortified Food Basket for Latin America and the
Caribbean (www.AgroSalud.org)
AgroSalud has long experience with bringing enhanced nutritional crops to the Latin American-Caribbean
region. In the past five years, AgroSalud partners have implemented successful commercial releases
throughout the region: 21 maize cultivars with higher tryptophan and lysine levels in Bolivia, Colombia,
El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, and Panama; 8 rice cultivars with higher
iron in Bolivia, Cuba, and Panama; 5 bean cultivars with higher iron in Bolivia, Brazil, Cuba, and
Guatemala; and 8 sweet potato cultivars with more beta-carotene in Brazil, Cuba, Dominican Republic,
Haiti, and Peru (AgroSalud 2011). An additional ten nutritionally enhanced cultivars are in the pipeline,
to be released in seven countries in 2010-2011.
Rationale, Objectives, and Research Questions
Rationale
According to the World Health Organization (2004), the leading nutrition-related causes of disability in
Latin America and the Caribbean (LAC) are childhood and maternal underweight, iron-deficiency
anemia, zinc deficiency, and vitamin A deficiency. An estimated 66 million children and women in LAC
are anemic (WHO 2008a); and 8.9 million children and pregnant women are vitamin A deficient (WHO
2009). Often, individuals suffer from multiple nutritional insults simultaneously (Albalak et al. 2000).
The economic cost of these nutritional deficits in LAC in 2009 was estimated to exceed $20 billion, based
on the average GDP for LAC countries (World Bank 2009): 46 percent is attributable to underweight, 32
percent to iron deficiency, 12 percent to vitamin A deficiency, and 10 percent to zinc deficiency (Salom6n
P6rez, CIAT, personal communication). In sum, there are severe problems of food and nutrition insecurity
in Latin America and the Caribbean.
The impact of a single crop biofortified with a single nutrient has been demonstrated in three
cases: amino acid biofortified maize (Gunaratna et al. 2009); iron biofortified rice (Haas et al. 2005); and
beta-carotene biofortified sweet potato (van Jaarsveld et al. 2005; Low et al. 2007). These biofortified
crops have improved the nutritional status of people who consumed them.
LAC provides an ideal setting to test the impact of multiple crops biofortified with multiple
nutrients. First, the region suffers from multiple nutrient deficiencies and consequences, including zinc
deficiency, anemia, and stunting (IZiNCG 2004; WHO 2004). Second, the combinations of foods targeted
for biofortification make up the traditional combined diet, such as maize and beans or rice and beans
(FAO 2009b). Third, advances have already been made in breeding and releasing biofortified crops in the
region, through the AgroSalud project, as noted above.
Objectives
1. Improve food and nutrition security among the rural and urban poor in six countries (Brazil,
Colombia, Guatemala, Haiti, Honduras, and Nicaragua), through the release and
dissemination of biofortified germplasm and the promotion of newly and previously released
nutritionally enhanced cultivars in those countries. The combinations that will be promoted
are specifically related to the nutrition problems in each country and to the foods commonly
consumed: higher iron and zinc rice and beans to address iron and zinc deficiencies in Brazil;
higher iron rice and beans to address iron deficiency along with higher zinc rice, beans, and
maize, as well as high tryptophan and lysine maize to address zinc deficiency and stunting in
Colombia, Guatemala, Haiti, Honduras, and Nicaragua; and higher provitamin A cassava and
sweet potato to address vitamin A deficiency in Haiti.
2. Improve food and nutrition security among the urban poor through biofortified food products
produced and sold locally in two countries, to be selected from the following: Brazil,
Colombia, Cuba, Haiti, Nicaragua, and Panama.
56


﻿3. Strengthen ongoing breeding efforts to (1) increase yield, disease resistance, and nutritional
quality as compared to crops currently available; and (2) offer improved biofortified breeding
populations for use by NARS in their breeding programs.
4. Evaluate the agronomic, economic, and nutritional impact of biofortified crops and food
products when consumed in combination.
5. Strengthen capacity of institutions in the target countries with regard to breeding, seed
dissemination, product development, market evaluation, and impact assessment.
Research Questions
The key research question for this subcomponent is: What is the impact (agronomic, socioeconomic, and
nutritional) of farmers producing biofortified crops and consumers eating biofortified food products in
combination (for example, rice and beans together)? Integrated planning and implementation between the
impact evaluators and the specialists (in the areas of breeding, seeds, food-product development, and
market chains) will ensure that timely and relevant impact studies are completed.
Impact Pathways
The AgroSalud subcomponent follows the same impact pathways as those described in Section 6.2.2 for
biofortification.
Activities, Outputs and Outcomes
Table 10 presents a summary of broad activities for AgroSalud. Table 11 provides some detail related to
research on breeding and nutrition and the delivery of key biofortified varieties for target crops.
Research Methods
Research methods for AgroSalud are broadly similar to methods used in HarvestPlus, as elaborated in
Section 6.2.4, "Subcomponent 2.2: AgroSalud-Biofortified Food Basket for Latin America and the
Caribbean." To develop biofortified crops, conventional plant breeding methods will be employed by the
CGIAR centers, as follows: International Center for Tropical Agriculture (CIAT) for beans, cassava, and
rice; CIMMYT for maize; and the International Potato Center (CIP) for sweet potato (AgroSalud 2011).
Validation and farmer trials will be completed by NARS in each country, with technical support from the
CGIAR centers. Geographic information systems tools will be used to update on-line atlases with
nutrition, crop production, and socioeconomic status, showing potential sites for biofortification
interventions (Zapata-Caldas et al. 2009). Farmers will be trained in tested methods of nonconventional
seed production to develop quality and timely seed (AgroSalud 2011). Seed dissemination will be carried
out by partners such as NARS, NGOs, Ministries of Agriculture, and UN agencies through their food and
nutrition security programs. Food-processing specialists from the Brazilian Agricultural Research
Cooperation (EMBRAPA) and CLAYUCA will work closely with industry partners, to determine what, if
any changes, are necessary to protocols in order to substitute biofortified crops for non-biofortified crops
in product formulations. Urban distribution channels for biofortified crops and for processed foods
developed with biofortified crops will be assessed and enhanced distribution channels tested. Ex-ante and
post-hoc evaluations (agronomic, socioeconomic, and nutritional) will be completed to determine the
impact of simultaneous consumption of two or more crops biofortified with the same nutrient (for
example, beans, maize, and rice biofortified with zinc) (AgroSalud 2011). Finally, tailored
communication models will be enhanced, developed, and employed to generate demand for biofortified
crops and food products by different consumer populations.
57


﻿Table 10. Overview of AgroSalud activities, outputs, and outcomes
Activities                                       Outputs                                        Outcomes
In partnership with CRP3: develop cultivars and  Nutritionally and agronomically improved rice,  Iron-, zinc-, provitamin A- and amino acid-
complete validation and farmer evaluation trials.  beans, cassava, maize, and sweet potato cultivars  biofortified cultivars are made available to reduce
developed and tested.                           food and nutrition insecurity in LAC.
Put existing biofortification atlases online, with an  Online analysis tool available to target  Informed geographic targeting of biofortification
interactive feature.                            biofortification activities in countries.       activities.
Support partners in seed production and         Seed multiplied, disseminated, and commercially  Strengthened seed production and dissemination
dissemination and commercial release of crops.  released in countries.                          systems.
Work with stakeholders to establish food-       Commercially prepared biofortified food products  Urban consumers have access to biofortified food
processing technologies and protocols.          developed.                                       products.
Assess distribution channels in urban markets; pilot  Biofortified crops and commercially prepared  Access to and consumption of biofortified cultivars
and evaluate enhanced distribution channels.    biofortified food products distributed in urban  and food products by urban consumers.
centers.
Complete several impact studies for 2+          Quantitative evaluations of the socioeconomic and  Information generated on the benefits and costs to
combinations of different crops and food products.  nutritional impacts of 2+ combinations of    farmers and consumers of biofortification.
biofortified crops and food products.
Develop and disseminate communication modules   Diverse communication modules produced and       Demand for biofortified crops and food products
for different audiences.                        disseminated through different media.            by informed farmers, consumers, extensionists,
health professionals, and decisionmakers.
58


﻿Table 11. Some crop-specific AgroSalud activities, outputs, anld outcomes
Activities                                     Outputs                                      Outcomes
Higher-iron and -zinc beans (Brazil, Colombia, Guatemala, Haiti, Honduras, Nicaragua)
* CIAT to lead bean breeding work; country    Release of biofortified varieties: 2012 Brazil,  In 2013, food-industry partners to deliver food
NARS to conduct adaption pre-release trials  Colombia; 2013 Guatemala; 2014 Haiti, Honduras,  products with biofortified beans as an ingredient in
* By 2012, complete simulation analyses in all  Nicaragua                                    at least one country
countries to estimate dietary impact of crops.
* By 2013, complete an efficacy trial of higher-
iron beans and rice in one country.
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
Higher-iron and -zinc rice (Brazil, Colombia, Guatemala, Haiti, Honduras, Nicaragua)
* CIAT to lead rice breeding work             Release of biofortified varieties: 2013 Brazil,  In 2014, food-industry partners to deliver food
* Country NARS to conduct adaption pre-release  Colombia; 2014 Guatemala; 2015 Haiti, Honduras,  products with biofortified rice as an ingredient in at
trials                                     Nicaragua                                     least one country
* By 2012, complete simulation analyses in all
countries to estimate dietary impact of crops
* By 2014, complete an efficacy trial of higher-
zinc maize, beans, and rice in one country
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
Higher-zinc maize (Colombia, Guatemala, Haiti, Honduras, Nicaragua)
* CIMMYT to lead maize breeding work; country  Release of biofortified varieties: 2014 Guatemala,  In 2015, food-industry partners to deliver food
NARS to conduct adaption pre-release trials  Honduras, Nicaragua; 2015 Colombia, Haiti    products with biofortified maize as an ingredient in
* By 2012, complete simulation analyses in all                                              at least one country
countries to estimate dietary impact of crops
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
(continued)
59


﻿Table 11. Some crop-specific AgroSalud activities, outputs, and outcomes (continued)
Activities                                    Outputs                                      Outcomes
Higher-tryptophan and -lysine maize (Colombia, Guatemala, Haiti, Honduras, Nicaragua)
* CIMMYT to lead maize breeding work; country  Release of biofortified varieties: 2012 Guatemala,  In 2012, food-industry partners to deliver food
NARS to conduct adaption pre-release trials  Honduras, Nicaragua; 2013 Colombia, Haiti   products with biofortified maize as an ingredient in
* By 2013, complete an efficacy trial of higher-                                            at least one country
tryptophan/lysine maize and higher-zinc maize,
beans, or rice in one country
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
Provitamin A-rich cassava (Haiti)
* CIAT to lead cassava breeding work; country  Release of biofortified varieties in 2013
NARS to conduct adaption pre-release trials
* By 2012, complete simulation analyses in all
countries to estimate dietary impact of crops
* By 2014, complete an efficacy trial of higher-
provitamin A cassava and sweet potato in Haiti
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
Provitamin A-rich sweet potato (Haiti)
* CIP to lead sweet potato breeding work; country  Release of biofortified varieties in 2013
NARS to conduct adaption pre-release trials
* By 2012, complete simulation analyses in all
countries to estimate dietary impact of crops
* Government, NGOs, and private-sector partners
to multiply and disseminate seeds
60


﻿Partnerships
Three CGIAR centers will lead the highlighted activities (CIAT, CIMMYT, and CIP), alopg with
CLAYUCA (a public-private consortium operating out of CIAT) and EMBRAPA (the Brazilian NARS).
Breeding activities will be completed by CIAT for rice, beans, and cassava; by CIMMYT for maize; and
by CIP for sweet potato. Seed activities will be led by CIAT, which will also lead the market research,
geographic targeting, and impact assessment. CLAYUCA and EMBRAPA will lead the food-production
activities.
The AgroSalud project had significant success in bringing together partners from diverse sectors,
including Ministries of Agriculture (research and extension units), Ministries of Health, universities, the
private sector, local municipal governments, and NGOs, among others. At a regional level, partners
included HarvestPlus and UN agencies. The same partnership model is proposed for this subcomponent,
with subcontracts negotiated with country partners to complete specific activities, and jointly funded
activities organized with regional partners. Annual partner meetings will be held to review achievements
and plan activities for the coming year.
6.3 Component 3: Prevention and Control of Agriculture-Associated Diseases
6.3.1 Rationale
Addressing the scourge ofagriculture-associated disease (AAD): Rationale and scope.
AAD sickens and kills millions of poor people.
In poor countries, diseases associated with agriculture (Box 6) have important health impacts. Food that
nourishes can also sicken and kill. Zoonoses (diseases transmissible between animals and man) and
diseases recently emerged from animals make up 25 percent of the infectious disease burden5 in least
developed countries (Gilbert et al. 2010). Other urgent problems include fungal toxins (mycotoxins) in
staple crops and animal source foods; plant toxins; use of wastewater for agriculture; misuse of
agricultural chemicals and antibiotics; and health impacts of agricultural alteration of ecosystems (such as
irrigation practices that promote malaria).
AAD has multiple burdens that are not fully understood.
As well as adverse health impacts, the direct economic, social, and environmental costs of AAD are of
major importance, as suggested by economic assessments of individual problems. For example, beyond
their health impacts, mycotoxins lead to trade losses of up to $1.2 billion a year; and the SARS epidemic
cost $50-100 billion through economy-wide effects (Aguirre and Gomez 2009).6 Indirect effects are also
important: impaired human health lowers labor productivity and human capital accumulation (as through
schooling and training)-worsening livelihood outcomes in both the short and the long run. Disease and
malnutrition burdens are closely related: for example, research has identified nutritional risk factors for
diarrhea, the negative impacts of diarrhea on nutritional status, and the importance of dietary therapy
during and after enteric infection (Brown 2003). Diseases also interact in complex ways: for example,
aflatoxin exposure and hepatitis infection are major risk factors for liver cancer. For these reasons, the
question of how agriculture might be better managed to reduce risk is a complex one; our limited ability
to assess and attribute the multiple burdens of AAD constitutes a major impediment to rational resource
allocation (Roth et al. 2003). This presents an important opportunity for CGIAR research to contribute to
human health research and development.
5 Disease burden is measured in DALYs (Disability Adjusted Life Years), defined as years of life lost due to death and disability.
6 All dollar figures are US$.
61


﻿62


﻿AAD risks can change with agricultural intensification. While much of the burden of AADs falls
on poor and marginal populations, different risks emerge with intensification of agricultural production
(for example, viral infections associated with intensifying pig production) and longer and more complex
value chains (for example, SARS). Component 3 will focus on specific agricultural entry points for
changing AAD risk and link to the larger health community by looking at scenarios for predicting and
preventing infectious disease risks in the future
(http://www.genomicsnetwork.ac.uk/innogen/research/innogenresearchprojectsa-
z/projecttitle,2516,en.html).
Successful assessment and management of AAD requires inputs from agriculture research.
The One Health (and Ecohealth7) thinking-now prominent in the health community-recognizes
agriculture-based interventions as a key component of multidisciplinary' approaches for managing many
AAD, for several reasons. Food-borne disease requires management throughout the field-to-fork risk
pathway; controlling zoonoses, in most cases, requires eliminating disease from the animal reservoir; and
agriculture practices that put farmworkers at risk obviously require farm-level intervention. Many
important diseases, such as HIV and the influenza pandemic of 2009, emerged from animals and research
into disease emergence from agroecosystems could contribute to averting future disease threats.
Component 3 will generate evidence and develop and test the methods, tools, and approaches that
partners need to better support disease management, including prevention of diseases, where agriculture-
based actions are important. The resulting benefits are potentially large: for example, an ex ante
assessment by IWMI in Ghana found that an integrated package of risk-based measures could avert up to
90 percent of the estimated 12,000 DALYs that result from wastewater irrigation, at a cost of less than
$100 per averted DALY (including expenditures to promote and ensure uptake).
Agricultural research must include socioeconomic, gender, and ecological understanding.
From farm to fork, food is a gendered commodity: women and men have different roles in production,
processing, and retailing that expose them to different health risks and offer them different benefits
(Kimani et al. 2007). Gender roles are also an important determinant of exposure to zoonotic disease,
health-seeking behavior and ultimately health burden. Understanding the gender and social determinants
of AAD is a prerequisite to developing more appropriate solutions. Similarly, understanding economic
incentives, ecological relations, and policy determinants must inform epidemiological assessments and
interventions for AAD.
What agricultural research can contribute to improved human health.
CGIAR centers have traditionally focused on accentuating the positives rather than eliminating the
negatives of agriculture. This component offers an opportunity to direct existing research coalitions to
new problems. It can also bring the CGIAR understanding of farming systems to the health community
with potentially far-reaching benefits, as shown by a case study from Kenya. Driven by a combination of
vested interests and genuine, although ill-founded, public health concern, a regulation required all milk to
be pasteurized. CGIAR research showed that this imposed costs on milk traders and consumers-$33
million annually-without creating health benefits, as consumers boil milk before consumption (Kaitibie
et al. 2008). A coalition formed by ILRI was able to generate evidence and support advocacy for a new
approach that is pro-poor and delivers superior food safety outcomes (Leksmono et al. 2006). Similarly,
IFPRI's recent research in Kenya and in Mali has found high levels of aflatoxin contamination in maize
and groundnuts, respectively. Awareness of aflatoxins is low among small-scale producers, while testing
of produce in local markets is almost nonexistent. Further research is underway to identify cost-effective
One Health has been defined as the collaborative effort of multiple disciplines to attain optimal health for people, animals, and
our environment. Ecohealth is defined as systemic, participatory approaches to understanding and promoting health and well-
being in the context of social and ecological interactions. They have much in common and are increasingly aligned; both
emphasize multidisciplinarity and the importance of agriculture and ecosystem-based interventions (Waltner-Toews 2009).
8 Multidisciplinary is used here in the broad sense of involving several areas of research, policy, and practice.
63


﻿and locally appropriate interventions and regulatory frameworks that inform both producers and
consumers, and incentivize farmers to invest in producing crops safe for home consumption as well as
local markets.
The CGIAR has a solid track record in important areas of AAD (see Table 12). The program will
initially build on these areas of expertise (especially food safety and zoonoses), by broadening health
partnerships and increasing the relevance of research to the health community. Other important areas of
AAD will be developed in the medium to long term. One Health/Ecohealth will provide both a framework
and a bridge with the health community, crucial to the research-into-use pathway.
Research subcomponents, priority diseases, and sequencing
Development of a research agenda was guided by three principles: (1) the impact of the problem on
human health and livelihoods; (2) the relevance of agriculture research to assessing and managing the
problem; and (3) the track record, current engagement, and anticipated opportunities of CGIAR centers in
addressing the problem (as set out in Table 11). On this basis we identify two initial-priority
subcomponents, food safety and zoonoses, to be addressed immediately and with substantial investments.
We combine, as a third subcomponent, some other health risks of agroecosystems that are either emerging
areas for exploration or areas, which although important, have lower levels of CGIAR involvement
(< $250,000 per annum); work in these areas will be exploratory or at smaller scale (medium priority). As
further evidence emerges, some of these areas may become more important in the research agenda.
Within the three subcomponents, we target for initial engagement a selective list of risks to human health,
based on high potential for getting traction immediately and results within a five-year time frame.
These components have subcomponents whose priority is given in Table 12:
*  Food safety: fungal toxins (mycotoxins), biological hazards, plant toxins, chemical hazards
*  Zoonoses: neglected zoonoses; emerging diseases
*  Other health risks of agroecosystems: water-associated disease; occupational hazards; drug
and chemical resistance; ecosystem services; climate change and disease; shaping
agroecoystems for health outcomes
6.3.2 Subcomponents of Component 3
Subcomponent 1: Improving food safety (Initial priority)
Food-borne diseases (FBD) have enormous impacts on health and livelihoods and are of great concern to
consumers, producers, and policymakers. Risk analysis (assessing, managing, and communicating risk)
brings a set of common concepts and tools to addressing FBD of different origins (plant, livestock, fish)
and in different value chains, presenting an opportunity for creating synergy between centers. Science-
based measures to reduce exposure along the food chain are urgently required and must go hand-in-hand
with appropriate policies, institutions, and incentives for adoption. The WHO Reference Group, assessing
the burden and attribution of important FBD, provides an entry point for bringing CGIAR research on
prevalence, impact, and management of FBD to the arena of global governance of food safety.
Under this subcomponent, we identify three food safety health risks that can have significant
implications for health, nutrition, and livelihoods in developing countries, and that are generally agreed to
require agriculture or value-chain inputs for effective management.
1. Initial priority: Mycotoxins are fungal toxins that contaminate staple foods, feeds, and animal
source foods in most of the humid tropics; they cause acute poisoning as well as chronic
disease.
2. Initial priority: Biological hazards cause the great majority of food-borne disease and appear
to be increasing in recent years; many are zoonotic (transmissible between man and animals)
and many are also transmitted through water.
64


﻿3. Medium priority: Plant toxins are natural substances in plants that can harm health; these
include anti-nutritional factors in some legumes and cyanogenic glycosides in cassava.
Chemical hazards from pesticide residues also harm human health and affect trade in.
agricultural products.
65


﻿Table 12. Initial priority research areas and relevant CGIAR experience
Role of
Priorities   Impact            agricultural        CG track record and opportunities      Priority risks      Level of engagement
research
Mycotoxins   Medium health     Agricultural         Extensive work on pre- and postharvest  Aflatoxins in staple
impacts- not in   research key to      technologies to manage risk, including  crops and other food
GBD                mycotoxin           biocontrol (IITA, ICRISAT, CIMMYT);
Costs millions of  management          breeding for reduced toxin
dollars at national                    content/resistance to fungal infection                    Important area with
level                                  ((ITA, ICRISAT, CIMMYT); risk                             substantial ongoing
mapping and assessment; cost-
effectiveness of mitigation strategies                     rorig    i
(ICRISAT, IITA, IFPRI, ILRI); behavioral                  p
analysis to identify incentives for farmers
to adopt aflatoxin mitigation measures
(IFPRI). Opportunities to partner with
ongoing initiatives, including PACA and
EMBRAPA.
Biological   Very high health   Ag research key to  Risk assessment and management for milk  Animal source foods
hazards      impacts-major      management of food  and meat hazards along the value chain  in five value chains
contributor to     safety on farm and  (ILRI, IFPRI); assessment and         in CRP3.7
diarrheal illness in  along value chain;  management of hazards in wastewater
GBD                other research      (IWMI, IFPRI, ILRI); pro-poor riskWatwer(R5
Costs billions of  important for       management through policy and
dolas t atonl household and        organizational change (ILRI, IFPRI);
dolll              medical             certification and collective action to
management           address food safety and consumer
willingness to pay for safe food (ILRI,
IFPRI). Opportunities to link with
CRP3.7, CRP5, and WHO FERG group
Plant toxins  Health impacts less  Ag research key to  Risk-management through plant breeding  Cassava, legumes  Focused area with some
Chemical     extensive          reducing plant     (ICARDA, IITA)                                             ongoing work: medium
hazards      (chemical hazards  toxins and chemical  Pesticides and other chemical hazards in                 priority
much less          hazards on farm    food
important than
biological). Costs
not fully assessed.
(continued)
66


﻿Table 12. Initial priority research areas and relevant CGIAR experience (continued)
Role of
Priorities    Impact*            agricultural        CG track record and opportunities        Priority risks        Level of engagement
research
Neglected     High-combined      Agricultural         Risk assessment, technology development  Taenia solium       Important area with
zoonoses      GBD and costs      research key for     for classical zoonoses including Taenia                      significant ongoing
probably           management of        solium (ILRI). Opportunities to link with                    work: high initial
comparable with    disease in animal    WHO                                                          priority
malaria or HIV     reservoirs
Emerging      High potential-    Agricultural          Risk and economic assessment for avian  RVF
M     disease       HIV in GBD, costs  research role in     flu and risk management (ILRI, IFPRI)-
millions of dollars  understanding       assessment and technology development
per pandemic       emergence and         for Rift Valley Fever (RVF).
managing at source     Opportunities to link with climate
change
Water-        High-water-        Agricultural         *Systemwide program on malaria but       Scoping work        Emerging area with
associated    associated disease  research one of      overall less extensive in this area:    Vector control      some ongoing work:
~fdisease                        many research         agroecosystem-based vector control in                       medium priority
inputs into water-   lowland settings (IT A)                Pesticide toxicity
~. Occupational                     associated disease;
r    disease                          important role in '  Integrated pest management to improve    Resistance to
~  Rsisane              dug esstace nd      pesticide use (CIP, crop centers)        agrochemnicals
Resistsgnifcan ongoingtacean
2  Eosytemecosystem-related                      Assessment and management of drug
a     Eseviemn                      disease             resistance (ILRI); malaria vectors (IITA)
wchange                                               Ecosystem services for health (ILRI); health
in the context of climate change (IFPRI,
ILRI).
Notes: Bolded areas indicate priority research areas. For many AADs, the impact in terms of Global Burden of Disease (GBD) or economic losses has not been assessed; ratings reflect our current
knowledge.
67


﻿Subcomponent 2: Zoonotic diseases and diseases emerging from animals (Initial priority)
The whole world bears the burden of diseases that originate in animals (such as HIV/AIDs and swine flu).
The crucible for emergence of these diseases-and thus the opportunity for improving prevention and
early detection-is often located in agroecosystems in poor countries that are either intensifying or
degrading. Richer countries are motivated by self-interest to deal with the problems of emerging disease
and pandemics at their source, as the examples of bird flu and hemorrhagic fevers demonstrate, often
leveraging donor concern for pro-poor impacts. However, the risks and benefits from emerging disease
control may be very different for rich and poor countries, as the anti-poor effects of bird flu control in
some places has demonstrated (Roland-Holst, Epprecht, and Otte 2008). CGIAR research can help correct
this imbalance of impacts.
Alongside emerging disease is the problem of established zoonoses that are controlled elsewhere
but that persist at high levels among the poorest and most neglected populations. These neglected
zoonoses include the pig tapeworm (Taenia solium), zoonotic tuberculosis, and brucellosis. The CGLAR
has a key role in bringing to the global arena its understanding of disease impacts on the poor.
The successful control of zoonoses, whether tuberculosis in Ireland, rabies in continental Europe,
or brucellosis in Canada, has always relied on interventions at animal level. For zoonoses of livestock,
this means intervention along the farm-to-fork production pathway. The lesson from these experiences
was largely forgotten until the wake-up call of bird flu. It is now generally accepted that control of
zoonoses is best managed by multisectoral initiatives grounded in epidemiological studies, with an in-
depth understanding of the variables that influence disease emergence and transmission (Schelling et al.
2007). Effective interventions must be grounded in the local context as well as in knowledge of disease
transmission pathways; participatory methods have proved a powerful tool for engaging stakeholders and
fostering positive change.
Subcomponent 3: Other health risks in agroecosystems (Medium priority)
In addition to food-borne disease and zoonoses, agriculture in ecosystems poses a number of risks to .
human health.
Irrigation and dam construction expose millions to the vectors of malaria and other diseases. The
reduction of health risks from exposure to water-associated disease vectors has to be carefully balanced
with supporting the livelihoods of farmers. Improved and innovative agricultural and water management
practices can help reduce crop contamination, farmer exposure, vector breeding, and vector resistance.
Rural populations can be protected while reducing costs for the public health sector.
Occupational health in agriculture and among the world's poor remains an area where more
research is needed to understand the current situation and best practices, as well as variations in liability
and insurance policies. CGIAR research on integrated pest management provides an entry point.
Other issues at the intersection of human, animal, and environmental health include emerging
resistance to chemicals used in agriculture, the effect of climate on diseases associated with agriculture,
ecosystem-related health services, and shaping agriculture to attain health goals.
Other health risks of agriculture are becoming increasingly important, and new areas are
emerging where the CG has a comparative advantage based on systems understanding and biotechnology
research. Given the need for an initial focus on a few lead areas, engagement in this research area will be
initially exploratory and could expand in the medium term.
6.3.3 Objective and Research Questions
Objective
The objective of this component is to enhance environmental sustainability, reduce poverty, increase food
security, and contribute to the health of poor communities by assessing, preventing, and mitigating
agriculture-associated health risks, through research for improved food and water safety, animal-based
zoonoses control, and managing agroecosystems for better health. Much focus will be on poor and
68


﻿marginal communities, but given the rapid changes in developing countries, Component 3 will also look
at changing AAD risk and mitigation associated with intensification of agricultural production and longer
and more complex food chains. This work will fit into the broader global challenge of infectious disease
foresight studies (http://www.bis.gov.uk/foresight/our-work/projects/published-projects/infectious-
diseases/reports-and-publications).
Research Themes
The research questions address the technical issues of prioritization, innovation, technology development,
and impact assessment, as well as methodological issues, using an approach that emphasizes
understanding and evaluating novel partnerships and approaches. Questions will initially focus on the two
initial priority subcomponents (1 and 2) focusing on food safety and zoonoses, as identified in Table 11
and linked to the impact pathways in Figure 7.
*  Prioritization and systems understanding. What are the critical AAD for the poor? Which
AAD require or can benefit from international agricultural research? What is the social and
policy context for developing One Health/multidisciplinary approaches that can assess and
manage the CG-priority AAD? What is the evidence for impact? What is the specific impact
on women, the poor, and other vulnerable groups?
*  Risk and socioeconomic assessment. What are the health impacts of the diseases in the two
priority subcomponents on the poor (absolute and relative to other problems)? What is the
evidence that these AAD create other economic, livelihood, equity, and ecological burdens
(multiple burdens)? How do sociocultural factors differentially expose men and women to
risk?
*  Innovation and risk-based management. What technological, organizational, and social
innovations can improve the detection and assessment of the multiple burdens of CG-priority
AAD? How can these be developed, tested, and adapted to improve eventual uptake? What
new science-based diagnostics, technologies, breeds, biological control, animal vaccines,
methodologies, and other innovations can improve the management of CG priority AAD
(without reducing production and productivity)? How can these be developed, tested, and
pre-adapted to improve eventual uptake? How can women, often the primary managers of
family health and nutrition, have more access to innovations? What are the factors preventing
poor producers and consumers, male and female, from adopting risk mitigation and
innovations? What type of informational, behavioral, or institutional mechanisms would
promote adoption of better management strategies? 9
Researchable Hypothesis
This research component will test the key hypothesis that international agricultural research can develop
agriculture-based interventions that contribute to the prevention and control of AADs in ways that are
acceptable, cost-effective, scalable, and sustainable. There is widespread recognition that human health
depends on animal and environmental health and that management of complex health problems with an
agricultural interface (such as food safety and emerging disease) requires inputs from multiple sectors and
stakeholders. This CRP will evaluate how and what agriculture research can contribute.
Impact Pathway, Outputs, and Outcomes
We will assess the gender-disaggregated risks of AADs, particularly among the poorest producers and
consumers; find and develop, jointly with the stakeholders, solutions and innovations to reduce these
risks; understand and support appropriate institutions and incentives that will make these sustainable;
9 Throughout this component we stress that innovation includes not only new technologies but also new institutions,
configurations, partnerships, policies, mind-sets, attitudes, behaviors, and practices; and that combinations of these are usually
required to bring about pro-poor improvements in health.
69


﻿assess the impact of interventions; and develop communications, advocacy, and influence strategies that
will enable their uptake and use.
Outputs
Prioritization and systems understanding:
* Maps and rankings of AADs that identify important risks where CGIAR research can make a
difference.
*  Contribution to metrics and assessments of the multiple burdens of high-priority agriculture-
associated risks.
Risk and socioeconomic assessment:
*  New surveillance and diagnostic tools that allow for a better understanding of priority
diseases.
*  Assessments of health risks and economic, social, and ecological impacts of priority diseases,
disaggregated by gender.
Innovation and risk-based management:
*  Development of novel technologies, methods, and strategies; evaluation of these as well as
existing risk-management options in terms of disease burden reduction, cost, feasibility,
gender and equity, and policy implications.
*  Evaluations and impact assessments presented in conferences and documented in peer-
reviewed publications.
*  Widespread adoption fostered through development programs and value chains.
Cross-cutting:
*  Advocacy meetings, briefs, website, and reports disseminating research findings.
Outcomes
These research outputs will be developed in collaboration with, and to meet the demands of, the two
major categories of research users: public and civil society programs, charged with improving health and
livelihoods; and the value-chain actors, faced with increasing demands for managing disease risks (see
partnership discussion). This engagement provides a mechanism for linking research to use by including
in the design discussions those who rely on evidence and research outputs to attain their own
organizational goals. Outcomes will thus be at two levels:
1. Research outcomes-changing mind-sets and practice in development programs and value
chains, through direct engagement and joint development of research outputs
2. Development outcomes-changing mind-sets and practice among the poor dependent on
agriculture, achieved through development programs and value chains
The research outputs will contribute to the following specific outcomes:
*  Improved understanding of the gender-disaggregated risks and livelihood impacts of AADs
by farmers and key stakeholders
*  Increased understanding of the poverty, social, gender, and behavioral determinants of
adoption of risk-mitigating measures among key stakeholders
* Change in awareness, assessment, and management of the risks of AAD attributable (partially
or wholly) to CGIAR research
70


﻿*  Wide use of new technologies for better assessing, diagnosing, preventing, and managing
AAD, attributable to CGIAR research
*  New One Health/multidisciplinary partnerships that multiply and scale up the results of
CGIAR research, leading to better assessment and management of AAD
As shown in Table 12, we distinguish between two initial priority subcomponents (1 and 2),
where work is ongoing and substantive and major impacts are anticipated within 3 years, and a third
component covering emerging or important areas where the CG has less current investment.
. Figure 7 shows the impact pathway for all subcomponents. There are three main strands of
activities, summarized as prioritization, assessment, and management of risk; cross-cutting activities are
capacity-building and risk communication. Prioritization involves understanding the system context and
comparative risk assessment (risk ranking) to identify which risks to tackle first. This is linked to
assessment of risk and identification of risk factors and control points. That in turn informs the
development of cost-effective risk management methods with partners, including assessing their potential
impact and promoting uptake. Appendix 8 presents a summary of existing and planned activities on the
prevention and control of AAD.
In practice, these strands will be sequenced iteratively and not linearly. For some hazards, risk
assessment and management activities are ongoing; the question of their relative importance and
prioritization would be dealt with as part of the development of metrics, prioritization, and decision
support.
This research will be conducted in partnership with the anticipated users of research-that is,
development programs and value chains-and will respond to their needs and concerns. In turn, they will
bring to the research design an awareness of changes in knowledge, attitudes, and behavior of the poor
who are afflicted by AAD or involved in its transmission. The ultimate impact is a useful and substantial
reduction in the multiple burdens associated with AAD, a reduction that can be attributed to CGIAR
research inputs.
71


﻿Figure 7. From research to impact: Multiple pathways in a risk management context
6.3.4 Principles
The research will embody three underlying principles:
1. multidisciplinarity-involving different disciplines, policymakers, and communities
2. participation-including communities and decisionmakers in research design, implementation,
and evaluation
3. gender equity and social and economic fairness
Multiple disciplines bring multiple perspectives to understanding the epidemiology, prevention,
and management of AAD, addressing the ecological, economic, social, and political subsystems that
influence health (Lebel 2003).
Cooperation and Collaboration
Collaborative, comprehensive research strategies are a hallmark of the CGIAR approach (see Box 7). For
food safety impacts (Subcomponent 1), critical actors will vary with the stage of value-chain
development. CGIAR Centers already have experience and links with multiple actors along the food
chain and in the enabling environment-for example, national research organizations, public- and private-
sector service providers, civil societies, NGOs, and policymakers. For many poor people, informal
markets are developing, and the main actors involved are farmers' organizations and civil society. For
them, the policy context is often disabling, and engagement with policymakers will be key to achieving
shifts to more equitable and effective policy and regulation. As markets formalize, private-sector
companies become more important. For AAD relating to animals (subcomponent 2), public health and
72


﻿veterinary services are important actors. In all cases, actors will be engaged directly in each target system
or country. In other areas (Subcomponent 3), partners for engagement will be intergovernmental agencies
such as WHO, FAO, and OIE and their specific programs for food safety and disease control. The
research will include technology, policy, and institutional work needed to achieve outcomes. In addition,
cross-cutting policy and methodology research required for better cross-sectoral engagement and
decisionmaking will be implemented in Component 4.
Partners are key to our impact pathway, and we envisage a two-pronged partnership strategy
consisting of strong collaborative relations with a small number of strategic partners (two to five),
complemented by an outreach strategy of two-way communication with a broader range of relevant
partners. For some activities, strong and long-standing partnerships already exist; for others, explorations
and discussions will be held in the first six months to better understand and identify strategic and relevant
partners. Key partners already identified include WHO FERG, WHO TDR, LIDC, Swiss Tropical and
Public Health Institute (STPH), CSRS, and EMBRAPA. Mapping the partnership landscape will be an
important initial activity.
6.3.5 Methods
The keystone of this component is agriculture research, bringing innovation to improve management of
AAD and developing and testing technological, organizational, and social innovations. Epidemiology,
with its focus on health in populations, has for long been the foundation on which public health decisions
are developed, implemented, and evaluated (IOM 1988). Risk analysis is the gold-standard approach for
addressing food safety as well as diseases of trade; it contributes to the conceptual framework of the
impact pathway and will be a major research approach. Risk-based analytic approaches will need further
development to better integrate considerations of participation and equity and to be a practical application
for all levels of value-chain actors (Grace et al. 2008). Behavioral analysis will help identify information
approaches and market access incentives for farmers to adopt mitigation measures. Addressing the
complex problems of AAD from farm to fork will therefore require contributions from many disciplines,
including economics, sociology, gender studies, and ecology. Similarly, the development, testing, and
dissemination of risk assessment and management tools and strategies will require the contributions of
biology, genetics, molecular epidemiology, bioinformatics, food technology, communications, extension,
and other specialties. The interface of human health and agriculture is a meeting ground for many
disciplines and approaches, as illustrated in Box 8 and in each subcomponent.
6.3.6 Subcomponent 1: Improving Food Safety (initial priority)
Food-borne disease is one of the most important health problems in developing countries. Under this
subcomponent we address three critical areas of agriculture-associated health risks.
1. Mycotoxins are fungal toxins that contaminate staple foods, animal feeds, and animal source
foods in most of the humid tropics.
73


﻿2. Biological hazards (including micro-organisms and parasites) cause the great majority of
food-borne disease and appear to be increasing in recent years. Most arise from
contamination of foods (mainly livestock or fish source) with human pathogens or from food-
borne zoonoses.
3. Plant toxins are natural substances in plants that can harm health; these include anti-
nutritional factors in some legumes and cyanogenic glycosides in cassava. Chemical hazards
from pesticide residues can also harm human health and affect trade in agricultural products.
Rationale, Objectives, and Research Questions
Mycotoxins: Rationale
Mycotoxins are produced as secondary metabolites by several pathogenic and food spoilage fungi. They
affect almost one-quarter of global food and feed (Dohlman 2004). They are found in a wide range of
foods, including certain cereals, legumes, root crops, spices, tree nuts, and dry fruits; if animals eat
contaminated feed, they may also be present in animal source foods. The highest-risk crops are maize,
groundnuts, and cottonseed. Aflatoxins are one of the most potent natural toxins, and the most potent
carcinogens known today among mycotoxins ([ARC 1993). Other mycotoxins, including fumonisins, are
also widespread in tropical areas. Most are less well researched and their impacts less well understood
than aflatoxins.
Mycotoxin contamination affects the long-term health of humans and animals. Chronic effects
include growth retardation (Gong et al. 2004), immune suppression (Jiang et al. 2005), reproductive
problems (Shuaib et al. 2010), and cancer. Consumption of high doses can result in acute illness and
death: in 2004, more than 125 people died in Kenya. Mycotoxins also negatively affect nutritional status
by interfering with protein-energy metabolism and by affecting the synthesis of vitamins A and D as well
as zinc and selenium (Williams et al. 2004). However, more research is required to understand the
interactions between vitamin A/iron/zinc deficiency, diarrhea, and mycotoxin exposure-conditions that
frequently co-exist in children who lack access to adequate good food. Such an understanding will help in
accurately mapping and measuring the mycotoxin health burden. Another important area for
multidisciplinary research is the link between aflatoxins and stunting (Box 8).
Mycotoxin contamination also affects the agricultural economy through loss of produce, lost
access to markets, and management costs (Shane 1994). Mycotoxins are also toxic to livestock, lowering
production and productivity. Commercial food and feed sectors, large institutional buyers such as the
74


﻿World Food Programme, and national food reserve agencies therefore all require mycotoxin-safe maize,
which often means the exclusion of small farmers from this market.
Contribution of CGIAR. A number of strategies are currently being developed and evaluated to
address the problem. These include pre- and postharvest measures as well as dietary strategies:
*  Development of mycotoxin-tolerant cultivars (especially maize and groundnut) (Gardner et
al. 1987; Brown et al. 1999; Holbrook et al. 2008; Menkir et al. 2008; Waliyar et al. 2003)
*  Competitive exclusion technology for biological control (Cotty, Probst, and Jaime-Garcia
2008; Atehnkeng et al. 2008)
*  Dissemination of appropriate pre- and postharvest technologies that reduce the risk of
food/feed contamination (Hell et al. 2008; Waliyar et al. 2008a), including low-cost, effective
storage interventions
*  Various food processing practices (Fandohan, Hell, and Marasas 2008)
*  Development of simple diagnostic tools, including bio-markers, to raise an exposure alarm
and indicate severity of contamination (Waliyar et al. 2008b)
A combination of some of these cost-effective strategies can reduce mycotoxin burden in
vulnerable populations. Earlier work by IITA and partners identified local maize processing practices that
can reduce mycotoxin exposure (Cardwell and Henry 2004). Integration of public health (Strosnider et al.
2006) and agricultural strategies (Menkir et al. 2008) is a promising strategy to reduce mycotoxin
exposure in developing countries.
Priority research area. Priority will be given to aflatoxins in staple crops grown by poor farmers
in Sub-Saharan Africa for household consumption, sale, and other uses. The key research challenge is to
determine how cost-effective, pro-poor, and appropriate risk management can be scaled out for wide-
reaching impacts.
Biological hazards: Rationale
Food-borne disease is one of the most important health problems in developing countries, responsible for
4 billion annual episodes of gastrointestinal disease (UNEP 2010). As much as 70 percent of deaths
among children under five are linked to biologically contaminated food and water (Unnevehr and
Hirschorn 2000). In 2 to 3 percent of cases, severe and disabling long-term effects result, including joint
disease, kidney failure, or cardiac, retinal, or neurological disorder (Lindsay 1997). These often
permanent effects, although little noticed by policymakers, may well represent an even greater health and
economic burden than the acute disease. Parasitic food-borne zoonoses (such as cysticercosis and
echinococcosis), largely absent from rich countries, cause important losses in poor countries-in the
range of millions of DALYs and billions of dollars in medical costs, lost productivity, and losses to the
livestock sector (Maudlin, Eisler, and Welburn 2009).
In countries where detailed attribution data exists, the burden of food-borne disease is mostly due
to pathogens (Thorns 2000), most of which are zoonotic in origin (Schlundt et al. 2004). Animal source
food poses the greatest risk to human health (Adak et al. 2005; Lynch et al. 2006). In developing
countries, much less is known about every aspect: causes of diarrhea, prevalence of food-borne diseases,
high-risk foods, risk factors (including behavioral), or the cost and other impacts of illness (Kaferstein
2003).
As with other AAD, biological hazards in food can impose additional burdens on the agriculture
and livestock sector and even the ecosystem itself. The economic impact in poor countries is largely
unknown, but evidence from developed countries shows that costs can be very high. A US study
estimates the total economic impact of food-borne illness at $152 billion annually (Scharff 2010), while
work from ILRI indicates that beef-borne disease alone costs Nigeria more than $1 billion per year
(Okike, Grace, and Hussni 2010). Food safety policies and regulation can also carry a high cost, in
75


﻿excluding small-scale value-chain actors or shifting them to informal markets with higher risks and fewer
gains (Kang'ethe, Grace, and Randolph 2007).
Innovative risk-reduction approaches are needed. The use of polluted irrigation water, for
example, supports the livelihoods of between 20 and 50 million farmers and feeds up to one billion
consumers-while creating a risk of disease when crops are eaten raw. In such instances, risk reduction
and livelihood support have to be carefully balanced. Water pollutants can also impair the health of
livestock and that of the consumers of animal products, within a complex system that includes links
between water-borne and food-borne diseases.
Contribution of CGIAR. A number of approaches and strategies are being used to assess and
manage biological hazards:
*  Assessment of risk posed by biological hazards in food, combining a number of methods
ranging from participatory epidemiology to stochastic modelling (Grace et al. 2007) as well
as research into the association between gender and food safety
*  Surveys, contingent valuation, and behavioral observation to assess willingness to pay for
food safety: studies across seven countries demonstrate a 5 to 15 percent premium for safety-
assured products (Jabbar, Baker, and Fadiga 2010)
*  Training and certification of informal-sector milk traders, and evaluation of the resultant risk-
reduction and economic benefits (Kaitibie et al. 2008)
*  Nontreatment interventions to reduce the risks of farming, trading, and consuming
wastewater-irrigated vegetables
*  Understanding the benefits of informal-sector food to livelihoods, and the effects of food
safety policy both on consumer safety and on the livelihoods of those in informal food
production
Priority research area. The initial research focus will be animal source foods in seven of the
eight high-potential smallholder value chains targeted by CRP3.7 (fish and pigs in Uganda, milk in
Tanzania and India, pigs in Vietnam, sheep and goats in Ethiopia and Mali). The key research challenge
will be to improve food safety while maintaining smallholder market access.
Plant toxins and chemical hazards: Rationale
Some common food crops are associated with plant toxins and anti-nutritional factors. Cassava contains
cyanide; grass pea harbors P-ODAP (O-N-oxalyl-L-a, O-diaminopropionic acid); faba bean contains
tannin, vicine, and convicine; yams have alkaloids; and most of the food legume crops contain phytate
and raffinose family oligosaccharides. These plant toxins and anti-nutritional factors reduce the nutritive
value of food crops, and if taken in large quantity over a long period, cause serious health problems in
humans and animals, while also lowering the bioavailability of dietary minerals and micronutrients (such
as iron and zinc). Tens of thousands of people are affected by konzo and lathyrism, two toxico-nutritional
neuro-degenerative diseases that persist exclusively among the poorest and most marginalized
communities (Tshala-Katumbay and Spencer 2007). Similarly, overconsumption of grass pea in an
unbalanced diet for a period of three to four months causes lathyrism in up to 6 percent of the population
within its production zone (Spencer 1995). Favism is a medical condition caused by deficiency of the
erythrocyte-located glucose-6-phosphate dehydrogenase (G6PD) that predisposes individuals to anemia
as a result of consuming faba beans. The condition is most common in people who live around the
Mediterranean, and it generally affects men more often than women. Similarly, presence of phytic acid in
food legumes reduces the bioavailability of iron and zinc (Spear and Fehr 2007).
These crops are grown over significant areas: cassava, 18.7 m.ha.; grass pea, 1.50 m.ha.; faba
bean, 2.67 m.ha. In most areas, they are irreplaceable by other crops. Cassava and grass pea are adapted to
adverse agroclimatic conditions such as drought and waterlogging, and to the nutrient-deficient soils
76


﻿which are frequent, widespread, and persistent in South Asia (SA) and Sub-Saharan Africa (SSA) (Kumar
et al. 2010).
Chemical hazards from pesticides and from other agricultural inputs can also contaminate food,
harming human health and affecting trade in agricultural produce.
*   Contribudon of CGIAR: Over the past 25 years, in collaboration with NARS partners, CGIAR
centers have developed safer grass pea and faba bean (ICARDA) as well as cassava (ITA).
*  Centers are developing strategies that reflect particular challenges in SA and SSA, where the
production of these crops is often dominated by marginal farmers, with women comprising
much of the workforce.
*  Pesticide-related health problems continues to be part of CIP's newly created program on
complex systems.
Priority research area: The initial priority for plant toxin research will be the development and
evaluation of low-toxin or toxin-free varieties of grass pea, cassava, and faba beans; multiplication of
quality seeds, demonstration of improved agronomic practices; and training on food processing methods
for poor farmers in South Asia and Sub-Saharan Africa. Work on chemical residues in food will be
addressed through the integrated pest management research, which seeks to reduce the use of pesticides in
order to meet objectives of improving occupational health and food safety, decreasing input costs,
protecting the environment, and slowing the development of resistance.
Objectives
The objective of this component is to contribute to the assessment, prevention, and mitigation of the
multiple burdens of food-borne disease in developing countries, through demand-driven, pro-poor
research into agriculture, livestock, and agroecosystem research that builds on CGIAR's wealth of
experience and expertise.
Research Themes
Throughout the three subcomponents, the same set of research questions will support learning and
transformation, to contribute to the overall impact pathway:
*  Prioritization and systems understanding: Which hazards are of greatest concern for the poor
in developing countries (in terms of health, loss of income, and livelihoods)? What is the
relative prevalence risk? How can agriculture research and One Health/multidisciplinary
approaches add value to risk reduction? How can they address the issues of gender, equity,
participation, and ecosystem impacts? What partnerships, coalitions, and engagement are
needed to influence actors in development and those in markets to better support risk
management?
*  Risk and socioeconomic assessment: What is the epidemiology of transmission, exposure, and
vulnerability? What are the social, gender, and environmental determinants of risk and
disease impact? What are the impacts on agroecosystems? What are the risk pathways
between hazard origin and human victim? What are the risk factors and control points for
reducing each risk along the food chain from farm to fork? And how does this vary by
ecological zone or size of producer? Finally, how can interventions at farm level and along
the value chain protect consumers?
*  Innovation and risk-based management: What has been learned about these hazards, and
what are the key gaps? How is risk currently managed, and what surveillance is in place? Are
there cost-effective methods to reduce the risk (to health, income, and livelihoods) without
reducing productivity for small- and medium-scale producers? What new science-based
diagnostics, technologies, breeds, biological control, animal vaccines, methodologies, and
other innovations can improve the mitigation, surveillance, and management of risk? How
77


﻿can these innovations and technologies be developed, tested, evaluated (for both economic
and social benefits), scaled-up, and disseminated? How can policy alternatives and
implications be effectively conveyed to decisionmakers?
Impact Pathway of the Subcomponent
The overall impact pathway follows the approach diagrammed in Figure 7: major activities include
prioritization and system understanding; risk and socioeconomic assessment; and innovation and risk-
based management. At the same time, the focus on three specific health risks under this subcomponent
allows for a more targeted approach. For each health risk, research results will shape technological and
other innovations as well as information for dissemination. These innovations will be systematically
assessed, and the results will be fed back into the development of increasingly appropriate solutions in an
iterative manner. This feedback approach allows for more permanent and sustainable solutions, as well as
increased adaptive capacity for longer-term development.
The outcomes of the research will be methods, approaches, innovations, and models tested and
available to scale out to other communities. The adoption of these approaches in the targeted communities
and beyond will reduce the risks to human health from mycotoxins, biological hazards, and plant toxins,
while safeguarding or enhancing agricultural production and productivity. This will contribute to the
ultimate impacts of improved health, nutritional status, and rural livelihoods.
Improving Food Safety: Activities, Outputs, and Outcomes
Table 13 provides detail of the activities, outputs, and outcomes for this subcomponent. Refer to the key
provided to identify the specific research area for each activity, output, and outcome. Appendix 9 gives an
expanded version of this table at a higher level of detail.
78


﻿Table 13. Activities, outputs, and outcomes for Subcomponent 1: Food safety-High initial priorities (by research theme)
Activities                                                     Outputs                                          Outcomes
* Assess mycotoxin contamination in key crops across agroecological zones  * Risk maps for mycotoxins in key crops          * Risk maps for different food-bome disease used for
* Maize (Kenya) and groundnut (Nigeria) survey (IFPRI, CIMAMYT, ICRISAT)  * Risk maps for groundnut (Nigeria) and maize (Kenya)  risk targeting by government
* Maize survey across Tanzania and Kenya and dairy feed survey in high risk areas  * Risk maps for dairyfeed chain in Kenya  * Resource allocation better reflects risk and costs of
ofKenya (ILRI)                                                        * Value-chain maps for groundnut, maize, and sorghum  food-borne disease
* Assessment of the impacts over producers and
* Conduct comparative risk assessment to prioritize food-borne disease     Dependent on activities not currently funded       consuners
.     * Food-borne disease in smallholder pig system in Uganda and Vietnam (ILRI)  Metrics and assessments of multiple burdens of food-borne
disease over producers and consumers
Conduct survey of food-borne hazards along value chains                 Risk-targeting decision support tools
Assess the multiple burdens of food-borne disease
* Assess mycotoxins in soil, crops, and livestock                                                                           * Evidence from integrated health and economic
* Analyze the impact ofjajatoxm contamination on the livelihoods and health o?f  9 Evidence for policy influence             assessments influences policy and practice
people in Kenya (maize) and Mali (groundnuts) (IFPRI, CIMMYT, ICRISAT)  9 Mycotoxin detection improved                     * Prediction models used by government agencies
* Establish mycotoxin diagnostic playborm in Kenya (ILRI Improve understanding  * Estimate of rycotoxin exposure in selected human  and national and international organizations
of human health impacts of mycotoxins                                   populations                                       * New cost-effective detection tools used routinely
* Develop and test biomarker studies (IFPRI)                           - Elucidation of link between mycotoxins and          by actors along the value chain, including
* Study relation stunting and mycotoxins in Kenya (IFPRI, ILRI)           malnutrition in children                            exporters
* Monitoring blood aflatoxin loads in Malawi (ICRISAT)                                                                        Better surveillance and reporting of food-borne
disease
o
* Conduct integrated health risk and economic assessments for food-borne disease
0     * Smallholder pork in Vietnam and mycotoxins in dairy feed (7LRI)         Dependent on activities not currently funded
0     * Identify critical control points for food safety along value chains
* Poultry slaughterhouses in Vietnam and Thailand (ILRI)
Evidence to influence policy and practice
Develop and test new detection methods for food-borne hazards
Assess retention of toxins during processing
Develop and test surveillance models for food-borne hazards and diseases
(continued)
79


﻿Table 13. Activities, outputs, and outcomes for Subcomponent 1: Food safety-High initial priorities (by research theme) (continued)
Activities                                                     Outputs                                         Outcomes
* Biological control for mycotoxins: develop, test, and enable commercialization  * Biocontrol trialed in new countries     * Evidence shown to influence policy in a pro-poor
* Development and commercialization of biological control of aflatoxins in 5  * Bio-pesticide registration workshop with specificfocus  direction
African countries (ITA) and Zambia (IITA and ICRISA T)                 on the use of native beneficialsfor aflatoxin control  * Widespread adoption of improved management in
* Develop and test control innovations for mycotoxin management                                                               the target regions
* Identify cost-efj ctive control measures to reduce exposure to aflatoxins (IPPR  Dependent on activities not currently funded  * Increased income from safer agricultural produce
VCIAffYT, ICRISAT)                                                    Simple, rapid technologies for food-bore hazard detection  e New strains of atoxigenic fungae promoted and
* Postharvest technology in Malawi and Tanzania (ICRISAT)                 at field level and along value chains               commercialized
(aAlternative uses of contaminated products identified and                                                    * 1 0%/ farmers in selected areas adopt recommended
* Market-based innovations for food safety in informal markets            promoted                                            mycotoxin management
* Assess impact of training and certification of informal milk in India (ILRI)  New country- or region-specific strains for biocontrol  * Mycotoxin reduced by 70/o and exposure by 80%
* Food safety as an opportunity for value addition in Fast Africa (ILRI)
0
Evaluate, test, and disseminate low toxin strains of legumes and other
Research institutional arrangements to improve adoption and cost-effectiveness
2  Health, social, economic. and other impacts assessment
e Build capacity of NARS and graduate students                          * Policy advocacy platform                          * Shift in mind-sets toward pro-poor and risk-based
* PhID students (3) in Kenya (ILRI)                                       D     Publication of peer reviewed research articles, datasets,  food safety policy and practice
a Develop and test risk-communication strategies                          and learning materials                            * Behavioral changes of value-chain actors in high-
s Targeted dissemnivnation to decision-makers, private sector, NGOs, research                                                 risk areas
* Enhanced access for the poor to safe food
~-  comunity donodiandothon
* I Community-based capacity building
80


﻿Methods for Food Safety
Box 9 summarizes the various methodological approaches that will be drawn upon in implementing this
component.
Scientific research into new and innovative technologies and diagnostic tools builds on the
strengths of the CG and partner NARs. A further crucial component of this CRP will be the up-scaling
and adoption of these innovations by farmers and other actors along the value chain. This aspect will
require other partnerships, with public, private, and nongovernmental service and information providers,
as well as innovative research through iterative processes to adapt existing technologies so they are
socially and politically as well as technically feasible and cost-effective.
Partnerships for Food Safety
Mycotoxins
ICRISAT, CIMMYT, IITA, ILRI, and IFPRI are the main centers involved in mycotoxin research.
Established partners include advanced research institutes (ARIs), universities, EMBRAPA, and NARS.
81


﻿The component will facilitate linkages and synergies among partners to work together. The Bill and
Melinda Gates Foundation has initiated a Partnership for Aflatoxin Control in Africa (PACA), bringing
together many institutions, donors, and other stakeholders to reduce the aflatoxin burden in Africa. The
partnership includes key regional actors in Africa, including COMESA and the AU, and is being
promoted within the CAADP framework as a key issue in food security. The CG centers involved in
aflatoxin-related research are playing a key role in shaping and informing this partnership and the
priorities for research and action, together with African policymakers and research centers.
Biological hazards
ILRI, IWMI, and IFPRI are the three centers most active in this area. WHO, FAO, and OIE all have
mandates for food safety. WHO currently has a Reference Group working on attribution and burden of
FBD and are seeking collaborators (FERG) as well as a strong water, health, and sanitation program to
which IWMI is closely linked. The World Bank has done some initial, largely qualitative work with the
University of Guelph on cost of compliance to meet increased private standards. ARIs in Europe and
America are involved in ongoing projects.
Plant toxins and chemical hazards
Over the past 25 years, in collaboration with NARS partners, ICARDA and IITA have developed safer
grass pea and faba bean (ICARDA) as well as cassava (IITA). Partners are NARS in target countries and
ARIs in Belgium, the United States, Spain, and China. Among development partners, NGOS, private
sectors, and national seed agencies in South Asia and Sub-Saharan Africa will be involved for transferring
technologies. For policy and knowledge partners, WHO, FAO, and IFAD will be partnered for awareness,
risk assessment, and communication. The CGIAR Centers, in particular IITA, ICRISAT, CIP and IRRI,
have worked over many years with NARS, other International Associations of Research of Cancer
(IARCs), and the private sector on alternative technologies to harmful pesticides to reduce risks of
residues on agricultural produce and occupational hazards. To better coordinate their work, in 1996, the
CGIAR Centers have established the Systemwide Program on Integrated Pest Management.
Examples of partnership arrangements for this component are presented in Table 14.
Table 14. Examples of partnership arrangements for food safety
Development
Research theme  Enablers        implementers     Value chain    Research     CGIAR
Mycotoxins      WHO              PACA            Seed producers  EMBRAPA     ICRISAT
Codex           MoA              Food and feed  NARS         CIMMYT
alimentarius    MoH             industry       ARIs         1ITA
DFID                                                        IFPRI
Food regulators                                             ILRI
Biological hazards  WHO          WB              Food industry  NARS         ILRI
FAO             MoA              SSAFE         ARIs          IWMI
OIE             MoL                            Developing    IFPRI
Codex           MoH                            country
alimentarius                                   universities
WB
EU
Food regulators
Plant toxins    WHO              MoA             Food industry  NARS         ICARDA
FAO             MoH              Seed industry  ARIs        IITA
IFAD
Food regulators
Chemical hazards  WHO            MoA             Pesticide     NARS          IITA
FAO             MoH             industry                    ICRISAT
Codex                                                        CIP
alimentarius                                                 IRRI
Food regulators
82


﻿6.3.7 Subcomponent 2: Zoonotic and Emerging Diseases (initial priority)
Rationale, Objectives, and Research Questions
Zoonoses are an important cause of sickness and death in poor countries
Improving the health of the poor requires reducing the threat and burden of zoonoses (Perry and Grace
2009), since in least-developed countries, zoonoses (and diseases recently emerged from animals) account
for.25 percent of the Disability Adjusted Life Years (DALYs)-much greater than the combined burden
of malnutrition and food associated-toxins (WHO 2008b). Around 60 percent of all human diseases are
zoonotic (Taylor, Latham, and Woolhouse 2001). Zoonoses are responsible for most of the burden of
food-borne disease (Schlundt et al. 2004), and the majority (75 percent) of emerging diseases have
jumped species from animal hosts. Of the 35 leading communicable causes of death, 15 are either
zoonoses or have a zoonotic component (Ecker et al. 2005).
Dollars as well as DALYS: The multiple burdens of zoonotic disease
By definition, DALYs only measure the disutility to the individual of being ill. They do not capture
medical costs of illness to the individual or society (including cost of medication and provision of
healthcare infrastructure). Indirect costs include loss of production and productivity as the result of
illness, as well as costs of averting hazards (for example, mosquito nets).
Zoonoses have resulted in significant economic impacts. A study by Roth et al. (2003) shows
that, reviewing both private and public costs of human illness and costs borne by the livestock sector,
only 10 percent of the benefits of control accrued to the public sector. Diseases emerging from animals,
while probably costing less than endemic zoonoses, often have more discrete effects: the severe acute
respiratory syndrome (SARS) cost an estimated $50 billion, while a probable influenza pandemic could
cost $2 trillion (World Bank 2008).
Agriculture-based interventions are essential for the control of zoonoses
The successful control of zoonoses, whether tuberculosis in Ireland, rabies in continental Europe, or
brucellosis in Canada, has always relied on interventions at the animal level-as well as, for zoonoses of
livestock, intervention along the farm-to-fork production pathway. The lesson from these experiences was
sometimes forgotten, until bird flu came as a wake-up call. Control of zoonoses is best managed by
multisectoral initiatives grounded in epidemiological studies that identify the variables that influence
disease emergence and transmission (Schelling et al. 2007). Effective interventions need to be
contextually adapted to local conditions, on the basis of knowledge of disease transmission pathways.
Objectives
The objective is to contribute to the assessment, surveillance, control, and prevention of the multiple
burdens of zoonoses, both actual and potential, through demand-driven, pro-poor research into
agriculture, livestock, and agroecosystem research that builds on CGIAR experience and expertise.
Research questions and approaches
A. What are the priority zoonotic and emerging diseases that constrain pro-poor development?
o What is the prevalence and burden of zoonotic and emerging disease?
o What are the risk factors and control points?
o What are the options for control? What are the likely risk-risk trade-offs, costs and
benefits, and cost-effectiveness of control?
B. How to better predict, plan for, and prevent diseases emerging from agroecosystems?
83


﻿o How can surveillance, response, prevention, and preparedness systems be more
effective, integrated, and sustainable?
o Which response strategies can improve adoption of control strategies?
C. How can agriculture-based interventions contribute to control of neglected zoonoses?
o How to build and test multisectoral, integrated zoonoses control packages?
o How to develop new technologies to meet current gaps in disease control?
o How to promote uptake, adoption, and transforming knowledge into use?
Impact Pathway of Subcomponent 2
The impact pathway assumes that research will co-generate evidence, methods, and tools in collaboration
with partners, who in turn will use the research outputs to improve policies, programs, and services for
pro-poor management of zoonotic and emerging diseases. The major strands of activity follow the pattern
previously set out (Figure 7). Major activities are prioritization (burden assessment and investment
opportunities around neglected Zoonoses); assessment (pathogen detection platforms and surveillance);
management (disease control tools, methods, delivery); and capacity-strengthening and policy
engagement, as cross-cutting processes. The outcomes delivered will contribute to (1) better detection and
surveillance of diseases, (2) better prevention and control of zoonoses through integrated and
multisectoral approaches, and (3) more resilient ecosystems that reduce the risk of disease transmission
and emergence. This will contribute to the ultimate impacts of better health, nutritional status, rural
livelihoods, and ecosystem sustainability.
84


﻿Activities, Outputs, and Outcomes
Table 15. Activities, outputs, and outcomes of Subcomponent 2 (by research theme)
Activities                                             Outputs                           Outcomes
* Review and rank multiple burdens and control options for zoonoses         Identification and prioritization of  Greater awareness of health
* Mapping, examining, and anticipating future risks ofvector-borne diseases          zoonoses in systems               partners of the importance of
in eastern Africa (ILRI)                                               Contributions to methodologies for  zoonoses and need for agriculture-
.* Integrated health and socioeconomic assessment of the multiple burdens of       better assessment of the multiple  based interventions
a             zoonoses in Kenya, Ghana, Sierra Leone, Zambia, and Zimbabwe (ILRI)    burdens of zoonoses and           Funding opportunities developed to
o           * Integrated health and economic assessment for control options for Rift Valley  intervention opportunities  support intervention opportunities
-u          Fever in Kenva (ILRI)                                                 Detailed assessment of multiple
.            * Identification ofdisease in systems and bio-banking samples in Kenya and  burdens of one or two known
'             Uganda (ILRI)                                                          priority diseases (RVF)
* Work with international organizations to complement and ground truth ongoing
studies
Understand epidemiology and risk of neglected zoonoses and emerging disease  * Surveillance and control options  Tools and guidelines used by
SAssess riskjactorszfor zoonoses transmission in western Kenya (ILRI)   based on improved understanding    national and regional partners
* Understand drivers and crucibles of disease emergence                     of disease epidemiology and risk Shift in mind-sets and policies
bDevelop agent-based models to deliver quantitative estimates ofRVF   factors                            toward ecohealthone health
epidemiological dynamics (ILRI)                                       Diagnostics that take into account  approaches
Measuring and mapping drivers of emergence ofzoonotic disease in Kenya  variants in circulation available
(ILRI)
iDevelop pathogen detection platforms and diagnostic tests
*Establish a genomics platfDorm for high-throughput screening of samples
from a wide varieties of hosts and vectorsbfor the detection of known and new
pathogens in Kenya (ILRI)
Develop and test rapid testspfor cysticercosis (ILRI)
Understand the role and effectiveness of current institutions and organizations to  *Understanding of the institutional  *Institutional change in programs
monitor and control zoonosis and emerging diseases                        barriers and bridges to better     for zoonoses prevention and
* Mapping, examining, and anticipating future risks of vector-borne diseases  control of zoonoses and emerging  control
in eastern Africa (ILRI)                                              disease                          - Tools and guidelines being used by
- Capacity strengthening and evidence generation for participatory         *Evidence, tools, and methods for    national and regional partners
  epidemiologyfor better control of diseases in Africa (ILRI)        integrated zoonosis control tried by   Shift in mind-sets and policies
oo    FCo-develop and test integrated zoonosis control for one or more priority diseases  development partners      toward ecohealthonehealth
*     Integrated control of zoonoses and emerging infectious disease in 6 countries                            solutions
I           *    sinSE Asia  LRI)
* Develop policy tool box for emerging zoonoses in east, west, and southern
Africa LRP)
Key: talics /unde acnivtie r 2012-2015 with place and lead center speci ied
85


﻿Methods
An over-arching approach is One Health, a collaborative and multidisciplinary approach, that recognizes
the interdependence of human animal and ecosystem health. The research approach will integrate
*  epidemiology (risk analysis; risk factor studies; prevalence and incidence surveys; impact
assessment; diseases modeling; participatory approaches)
*  biotechnology (genomic and metagenomics; bioinformatics; development drugs, vaccines and
diagnostics; transgenic; population genetics; manipulation of microbial genomes)
*  economics (cost benefit and effectiveness analysis; value chain; behavioral economics)
*  sociology (gender and social determinants of health; health-seeking behavior; innovation
systems; uptake and adoption)
*  environment (ecosystem health; one health/ecohealth; wildlife/livestock interface; natural
resource management)
Priority research area: The initial priorities will be Rift Valley Fever as an exemplar of emerging
infectious disease and cysticercosis as an exemplar of neglected zoonoses.
Partnerships for Zoonotic and Emerging Diseases
Zoonotic diseases is a complex area, and many actors and multiple partnerships will be needed around
research, development, and policy enablement. Key research partners include CIRA, universities with
veterinary, public health, and biomedical research (STPH, IGS, London-Royal Veterinary College
[London-RVC], London School of Hygiene and Tropical Medicine [LSHTM], Oxford, Guelph, and
others), International Ecohealth Society and Alliance for Ecosystem Health; and national agricultural
research, public health, and bio-medical research institutes and universities. Development partners include
international NGOs (the International Union for Conservation of Nature [IUCN], the World Wildlife
Fund [WWF], and Oxfam); private-sector companies; public-private partnerships (FIND, GALVmed);
national NGOs; and the private sector. Knowledge and policy partners include FAO, WHO (FERG), OlE,
the United Nations Children's Fund (UNICEF), regional organizations (such as the African Union
Interafrican Bureau for Animal Resources [AU-IBAR], the Economic Community of West African States
[ECOWAS], and WAHO); PROMED10; the Joint United Nations Program on HIV/AIDS (UNAIDS);
national governments.
Table 16 presents some examples of partnerships for zoonotic and emerging diseases.
Table 16. Examples of partnerships for zoonotic and emerging diseases
Development
Enablers           implementers       Value chain      Research       CGIAR
WHO                IAH                FIND             NARS            ICRISAT
OIE                Ecohealth Alliance  GALVmed        STPH            CIMMYT
FAO                ICUN                                IGS             IITA
AU-IBAR            WWF                                 RVC             IFPRI
ECOWAS             OXFAM                               LSHTM           ILRI
Oxford
University
Guelph
University
10 PROMED is a global electronic reporting system for outbreaks of emerging infectious diseases and toxins.
86


﻿6.3.8 Subcomponent 3: Other Health Risks in Agroecosystems
Rationale, Objectives, and Research Questions
Other important issues arise at the intersection of health and agriculture that are not high initial priorities:
they are not currently a major focus of research investment (in terms of budget and personnel), and some
are emerging issues that are newly being explored. Nevertheless, CGIAR Centers have ongoing research
in these areas and have potential to expand, as further evidence and resources become available. Five such
potentially significant areas are identified:
1. Water-associated diseases
2. Occupational health
3. Resistance to pesticides, antibiotics, and other agricultural chemicals
4. Agroecosystem provision of health services
5. Links of aflatoxins and stunting
In the development of this subcomponent and subcomponent 2, we will focus on health effects of broader
agroecosystem change and the delivery of ecosystem services. We will develop collaborations with other
CRPs (particularly CRP5 and 6) and other partners interested in the health risks of agro-ecosystem
management and change.
Water-associated diseases
Contamination of irrigation water with domestic or industrial wastewater can introduce pathogens or
chemicals that may affect farmers and enter the food chain. This important problem is considered along
with Subcomponent I on Food Safety (Drechsel et al. 2010). A second major risk is water-related
diseases: malaria kills 1.1 million people annually; others include schistosomiasis and emerging diseases
such as cryptosporidiosis, giardiasis, and buruli ulcer (Erlanger et al. 2005; Keiser et al. 2005a; Steinmann
et al. 2006; WHO 2007). These diseases may be fostered by poorly designed or managed irrigation and
water storage systems (Boelee and Madsen 2006; Diuk-Wasser et al. 2006).
Occupational health
People in developing countries bear more than 80 percent of the global burden of occupational disease
and injury, and the agricultural sector is one of the most hazardous (ILO 2000). Further, according to the
International Labor Organization (ILO), the agricultural sector is one of the most hazardous to health
worldwide (see also Loureiro 2009). Occupational hazards in agriculture range from simple conditions
like heat exhaustion to complex diseases like respiratory disease, zoonotic disease, and poisoning from
agrochemicals. It is estimated that 2 to 5 million people suffer acute poisonings related to pesticides
annually, of whom 40,000 die every year; and there are 170,000 recorded fatal injuries in agriculture
annually (Cole 2006). In spite of such striking numbers, occupational health in general, and in agriculture
in particular, remains neglected in most developing countries because of competing social, economic, and
political challenges (Nuwayhid 2004).
Resistance to Pesticides, Antibiotics, and Other Agricultural Chemicals
Excessive use of pesticides can also lead to resistance in medically important insects, such as mosquitos.
Malaria in particular, can no longer be handled only through existing means, as mosquitoes have become
resistant to agricultural insecticides (Diabate et al. 2002), while the parasite itself is increasingly resistant
to antimalarial drugs. Hence the health sector has sought collaboration with professionals in the areas of
water management and plant disease control (Townson et al. 2005). There is vast experience of relevant
agricultural interventions that can help mitigate negative health impacts (Keiser et al. 2005b; McCartney
et al. 2007).
Using antibiotics (especially growth-promoters) in farmed animals has been shown to generate
resistance to antimicrobials of human importance that can spread to humans, with the potential to cause
87


﻿major harm. Resistance to other veterinary drugs, including insecticides, acaricides, and trypanocides,
also has potential to affect human health.
Agroecosystem health provision and shaping agriculture for better health outcomes
Health risks are created by many activities whose primary aim is food production and that alter natural
ecosystems. The most problematic practices involve wildlife, water management, land use, and animal
husbandry:
*  fragmentation of wildlife habitat, unsustainable harvesting of wildlife, and sale of wildlife in
wet markets
*  changes in the distribution and availability of surface waters, as through dam construction,
irrigation, and stream diversion
* agricultural land-use changes, including proliferation of both livestock and crops and greater
use of monocultures; uncontrolled urbanization and urban incursion into agricultural areas
* keeping animals in densely habited areas
* climate variability and change
* movement of people and animals, causing introduction of pathogens and pests
Objectives
The objective of this subcomponent is to assess emerging health risks related to agriculture that are
currently less prominent or less studied, and to conduct and develop research to identify their multiple
impacts and mitigate the multiple associated burdens, as appropriate.
Research Questions
The research questions include
*  How does agriculture influence the epidemiology of known and emerging diseases? What is
the risk contribution of agricultural management relative to other risk factors for the same
disease? Where are interventions most cost-effective?
*  Which disease-reducing management interventions are effective, cost-efficient (also in
reducing public health expenditure), and most suitable for labor-intensive mixed farming
systems and intensifying agricultural systems?
Impact Pathway of Subcomponent 3
Research in this subcomponent will focus on the agriculture-associated diseases for which innovative
partnerships and approaches can have the highest impact. These will build on and expand long-standing
collaborations (for example, the agricultural health platform and history of IWMI as a WHO
Collaborative Center). These powerful partnerships have an advantage over individual organizations, both
in applying innovative risk assessments and in contributing to Health Impact Assessments by developing
practical recommendations for mitigation. Likewise, the partnerships draw on social marketing
approaches to increase the adoption of risk-mitigation measures.
The research outcomes of more efficient programs, reduced exposure to water-associated disease,
and healthier environments will lead to improved health not only for farming communities but also for
rural and urban consumers affected by agriculture associated disease. Improved health in turn will
contribute to improved livelihoods and more sustainable ecosystems.
88


﻿Activities, Outputs, and Outcomes
As this subcomponent is designed as scoping work directed toward the longer term, the activities, outputs,
and outcomes shown in Table 17 are merely indicative; they will be developed over time, as the program
rolls out.
Methods
For water-associated disease and occupational health, there will be a strong emphasis on interdisciplinary
and participatory Health Impact Assessments, complementary to existing epidemiological and biological
methods. Participatory assessments are critical in developing practical recommendations for mitigation; in
addition, innovative risk assessments such as Quantitative Microbial Risk Assessment (QMRA) and
Quantitative Comparative Risk Assessment (QCRA) will be applied. Understanding drug resistance
requires broad inputs from molecular epidemiology, modeling, ecology, and economics. Understanding
agroecosystems will draw on ecosystem health and related disciplines.
89


﻿Table 17. Activities, outputs, and outcomes for Subcomponent 3 (by research theme)'
ACTIVITIES                                       OUTPUT                                       OUTCOME
* Determine relative contribution of agriculture to  * Quantified relative risk posed by agriculture  * Increased knowledge of the role of agriculture
disease burden associated with health risks of                                               factors in selected diseases
concern (compared to other environmental                                                   * Better understanding of the role of CG research
factors)                                                                                    in health issues related to agriculture
* Improve risk prioritization and management by                                              * Better targeted health strategies
national partners
* Risk analysis for better managing diseases    Methodology and results shared with          * After 3 years: Risks and benefits assessment of
Jd 2      related to agroecosystems, including promoting  implementors for development of guidelines   agricultural water management interventions
0 0 ~       appropriate levels of protection based on the   Improved sectoral productivity analysis that  evaluated under CRP5
multiple burdens of disease                   integrates health burdens with health benefits of   Risk assessments for specified health risks with
0                                                          agricultural disease management               agricultural drivers, carried out and used by
decisionmakers and implementers
* Development and scientific evaluation of      Recommendations for cost-effective             Scientifically evaluated options for increasing
o1 ~ ~      agricultural water management options that    interventions to reduce health risks           human health through better management of
interventionsat reduce heathsisk
reduce risks of agriculture-related diseases and  * Targeted uptake strategy to guide dissemination,
W      enhance health benefits of agriculture        initiated at project inception               * Better collaboration between the public health
and agricultural sectors, improved integrated
-  2disease control
a Specific activities, outcomes, and impacts related to malaria are shown in Figure 8.
90


﻿Figure 8. Research on agricultural practices and malaria risks
Research on agricultural practices and malaria risks                                Key research areas for addressing malaria risks
Fod                                             The experiences learned from ICIPE's research provide key lessons on how the
Securtry
Securityagricultural sector can help address health and vice versa. Malaria is a major
public health problem among rice farming communities and needs attention in
Acky 1. Develop1the following areas:
use technologies that remAl   AgakMukLNWillMi
innisqAotwe&   pad%dy2.Understand                                 Integrating malaria control interventions with development strategies. The
<,A                      & onageguiding principle in this study is that interventions aimed at assisting
mcommunities should be participatory, integrated, and phased according to the
2.Unsotand
Increasedtechnology to be used and local socioeconomic circumstances. A process for
Waterdeveloping long-term solutions has been initiated to ensure sustainability of
PeStkw*e WSSinterventions, including related education and training for target communities
z;;;;:&        More AWarla   5           nsckiereitacoMpMan                       and building the needed research and scientific capacity among the relevant
d lscommunities.
A&UWAd            state"Rotational cultivation of rice and soybean as an agroecosystem strategy for
atenhancing household incomes and nutrition, while reducing malaria-vector
an&$sftof lbw ossbreeding. Seasonal rotation of rice cultivation with a dryland crop could lead to
5. DeelW &opportunities for enhancing household incomes while directly contributing to
test gro-reduction of malaria risk. Soybean is a leguminous plant (also classified under
prvlnc ngic_ Setvings         appoches ft,      annual oil seed crops) that produces seed with high protein and oil content. The
ctrolmapol
& nlaI.res       legume crop enhances soil fertility.
water management strategies that will reduce the window period for vector
Outcomes and impacts                                                                    productivity while still enhancing rice production.
*   Improve farmers' health and boost productivity                                      Livestock keeping as a strategy for improved farmer income also serves as a
*   Create synergies betweeen environment, health, agriculture, and communities         sink for vector bites and malaria transmission in rice agrosystems. Livestock
"  Reuceuseof pstiidethrogh ntrducton f bologcalconrolkeeping, as a complement to rice cultivation, would improve human nutrition,
*  Reuceuseof pstiidethrogh ntrducton f bologcalconrolhealth, and household incomes, while at the same time having a direct impact on
"   Create new market niche for safe agricultural products to support farmers' income   malaria risk. The presence of livestock influences the feeding behavior of adult
*   A sustainable approach to poverty reduction in target agricultural communities      msute      n   a  motn     mlctosfrmsut           reighbtt
a Policies and decisionmakers from the ministries of agriculture. environment, and health
sensitized on this holistic approach for reducing poverty through integrated activities, in
Agriculture Productivity-Environmental Protection-Disease Control                   Source: ICIPE 2010 (provided by IITA).
Source: ITA 2010.
91


﻿Partnerships in Other Health Risks in Agroecosystems
Alongside the CGIAR, there are a number of agricultural research institutes that are crucial for success,
including icipe, CIRAD, the Institut de Recherche pour le D6veloppement (IRD), LSHTM, LSTM,
STPH, the International Technology Group (ITG), FAO, WHO, TDR, and UNICEF, as well as
universities and NARS. In addition, several networks are relevant to research, dissemination, and up-
scaling to the public health sector, as well as for capacity building. Indeed, for much of this research, the
CG may be contributing relatively small inputs drawn from their specific areas of expertise to broader-
based programs. We envisage linking to icipe, the Integrated Partnership for Malaria in Africa (IPMA),
Tropical Diseases Research to Foster Innovation & Knowledge Application (TropIKA) (WHO), Malaria
World, Access Initiative, IDRC, and others.
6.4 Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies
This Consortium Research Program (CRP4) is rooted in the belief that integration of efforts in the fields
of agriculture, nutrition, and health-from planning through implementation--can result in cost-effective
achievement of nutrition and health objectives. Component 4 is focused on maximizing delivery and
impact, by fully integrating the efforts of individual sectors and by carefully fostering supportive policy
and institutional environments.
Integrated ANH programming and harmonized policymaking are viewed here as mutually
reinforcing. On the one hand, integrated agriculture-nutrition-health program innovations can provide the
evidence to incentivize and support the development of ANH-relevant policies and institutional
arrangements. On the other hand, an "enabling" policy and institutional environment supports the
necessary development and scale-up of effective ANH programs. Component 4 comprises these two
interlinked domains: Subcomponent 4.1 focuses on programs, while Subcomponent 4.2 focuses on
policies.
6.4.1 Rationale, Objectives, and Research Questions
Rationale
Many agricultural development programs fail to include specific interventions to assure nutrition, food
safety, or health (Ruel 2001; World Bank 2007; Berti, Krasevec, and Fitzgerald 2004); often, programs
operate under the assumption that improving agriculture productivity and income will automatically
benefit nutrition and health (Diao 2007; Negin et al. 2009). Figure 9 shows that although agriculture can
improve access to food and income, it contributes to only one of the three main pillars for improving child
nutrition and health-that is, food security. The other two pillars involve providing adequate resources for
childcare and increasing access to health services and a healthy environment (UNICEF 1990). Thus,
agriculture development programs must incorporate specific interventions that address the multiple needs
of poor populations-for food, care, and health and other basic services. Among the new generation of
agriculture programs, some have explicitly integrated nutrition and health goals, but few have been
rigorously evaluated and carefully documented-especially with respect to operational issues, impact, and
cost-effectiveness (Ruel 2001; Leroy et al. 2008; World Bank 2007). Even fewer have incorporated food
safety as a component in their programs. Similarly, the community-based agriculture programs designed
to improve human nutrition and health have rarely been scaled up successfully; an exception is Helen
Keller International's homestead food production program in Bangladesh (lannotti, Cunningham, and
Ruel 2009). There is thus little empirical evidence regarding what works in an integrated ANH program,
or how and under what circumstances such programs can generate the greatest benefits for the poor
(Garrett 2008; World Bank 2007; Fanzo and Pronyk 2010).
92


﻿Figure 9. Conceptual framework of the determinants of child nutrition and health
Interventions                         Child Nutrition
i\ C, r~c C ~ Ll                   'u!r e  feouu cod S, unty
interenton
Source: Adapted from UNICEF 1990.
Note: The nutrition interventions in the green box (top left of figure) are those recommended in the Nutrition Lancet
Series (Bhutta et al. 2008).
Objectives
The overall objective of Component 4 is to exploit and enhance the synergies between agriculture,
nutrition, and health (ANH) through operational and policy research that permits (1) more effective
integrated community-level programming, and (2) the cultivation and strengthening of an enabling policy
and institutional environment to support relevant action.
Subcomponent 4.1: Integrated Programs. This subcomponent will build on existing programs
and concepts to design new approaches and models to integrate ANH, by engaging CGLAR Centers
working in collaboration with development implementers.
*  It will undertake research to understand and address the complexities of implementing such
integrated programs in environments with vastly different diets, cultures, traditions,
livelihoods, agroecosystems, vulnerabilities, exposures, and degrees of marginalization.
*  It will use state-of-the-art research methods and tools to develop, test, monitor, evaluate,
document, and scale up integrated ANH programs.
*  It will generate a critical body of evidence on these programs' nutrition and health benefits
and cost-effectiveness--evidence that is urgently needed to stimulate investment to improve
93


﻿the nutrition and health of millions of poor, marginalized, and vulnerable households and
individuals.
Subcomponent 4.2: Harmonized Policies. This subcomponent seeks to cultivate and sustain an
"enabling environment"-an essential precondition for broad and sustainable success in addressing the
underlying causes of malnutrition and agriculture-associated diseases. Such an environment requires a
political and ideological framework, as well as supporting institutional arrangements and ANH-relevant
policy frameworks and processes, that can foster decisionmaking that effectively harnesses the potential
synergies among the agriculture, nutrition, and health sectors. (Figure 9 illustrates the central supporting
function of the political and institutional framework.)
*  This subcomponent will help scientists identify the researchable challenges where integration
offers realistic benefits.
*  It will develop information, processes, and decision support tools to help policymakers
choose among feasible alternatives, based on effectiveness and efficiency considerations.
We recognize that not all ANH challenges require integrated solutions across sectors; in many
cases, sector-specific actions may be most appropriate. Careful attention will ensure that policy research
adds value to ongoing sectoral and cross-sectoral activities, while avoiding duplication of effort.
Research Questions
Examples of research questions that will be addressed by this component include the following:
*  What design and implementation features make programs most successful in achieving their
agriculture, nutrition, and health goals?
*  What are the best approaches and targeting mechanisms to ensure that women are key
participants and beneficiaries of such programs?
*  What are the best tools to rigorously evaluate complex, multisectoral ANH programs and to
generate the impact evidence needed for advocacy and to stimulate investments?
*  How can an evidence base be created and sustained to support better investments in
integrated planning across agriculture, nutrition, and health?
*  What are the best practices in engaging policy and decisionmakers for cross-sectoral
decisionmaking?
*  What capacity is needed for cross-sectoral policy research and decisionmaking, and how can
it be strengthened?
Researchable Hypothesis
This research component will test the key hypothesis that effectively integrating agriculture, health,
and nutrition in joint program and policy planning, development, and implementation leads to larger
impacts on nutrition and health outcomes than operating in silos, as is typically done. Although there
seems to be a general concensus that the time has come for the three sectors to work together, as
expressed at the IFPRI 2020 Conference in New Delhi, there is hardly any hard evidence that joint
action does indeed lead to faster and larger impacts on health, nutrition, and other development
outcomes. This CRP will test this hypothesis, specifically in relation to the integration of agriculture,
health, and nutrition at the program level, using rigorous experimental evaluation designs with
randomization and appropriate comparison groups as feasible. Research at the policy level will use
cutting-edge qualitative research methods and tools, given that experimentation is unlikely to be
feasible at that level.
94


﻿6.4.2 Impact Pathway, Outputs, and Outcomes
Of the three CRP4 impact pathways, Component 4 focuses on the last two, the pathway for programs and
the pathway for policies. Figure 10 illustrates the role of research in supporting the program and policy
domains and the broad outputs, outcomes and impacts expected. There are important synergies to be
gained in linking agriculture-nutrition-health development program implementation (on the left) and
strengthening the enabling environment (on the right).
Component 4 seeks to strengthen such links and synergies, highlighting the importance of
operational and policy research for maximizing the contribution of agriculture to nutrition and health
outcomes and impacts. Methods and tools developed to design effective ANH will be used by
decisionmakers in both governmental and nongovernmental development agencies, as will the evidence
generated on the programs' success and cost-effectiveness. Outcomes and outputs generated by the
program subcomponent (4.1) can pave the way for success in the policy subcomponent (4.2), and vice
versa. Policy frameworks and processes can be made more favorable for ANH by demonstrating the
potential benefits of effective ANH programs. In turn, the necessary program experimentation and
innovation can be supported and incentivized by enabling policy environments.
Component 4, taken as a whole, will harness both the synergy of integrated programming and the
potential for sustained policy commitment, to best realize the benefits of agriculture, nutrition, and health.
Figure 10. Impact pathways of Component 4
95


﻿6.4.3 Subcomponent 4.1: Integrated Programs
Rationale, Objectives, and Research Questions
Rationale
This subcomponent aims to maximize the nutrition and health benefits of agriculture while minimizing
the risks of agriculture-associated diseases (AADs), through applied research to improve the design,
implementation, and evaluation of community-based integrated ANH programs. It has five specific
objectives, each related to specific research questions.
Objective 1
Develop tools and indicators to design, implement, and evaluate agriculture programs that incorporate
specific nutrition and health goals and interventions at the community level.
Research Questions
*  What tools and methodologies can be developed to incorporate nutrition and health into
community-based agricultural programs?
*  What are the best tools and methods to rigorously evaluate the implementation, impact, and
cost-effectiveness of multisectoral programs such as integrated ANH programs? What
process, impact, and cost-effectiveness indicators should be used?
*  Are there simple, valid tools that can be adapted for rapid assessment, monitoring, or impact
evaluation on key indicators?
Objective 2
Rigorously evaluate the implementation, impact, and cost-effectiveness of integrated ANH programs in
diferent communities, regions, and agroecological systems, using experimental or quasi-experimental
methods for complex social programs.
Research Questions
*  Do existing or new integrated ANH programs have an impact on nutrition and health
outcomes? If so, how is this impact achieved and at what cost?
*  Under what circumstances are impacts greatest? Which types of communities, households,
and individuals benefit most? Where are the benefits greatest (in terms of region and
agroecosystem)?
*  Which packages of interventions achieve greatest benefits, and under which circumstances?
What is the value added of specific interventions (such as behavior change communication)?
What is the most effective intensity of exposure to interventions (for example, agriculture
extension), in different contexts? Overall, what level of nutrition and health impact can be
achieved through different modalities of integrated ANH programs?
Objective 3
Generate evidence and document and disseminate lessons and best practices fom research conducted
under the previous objective.
Research Questions
* How can implementation monitoring and evaluation results be used for advocacy?
96


﻿* How should the learning be synthesized to inform practice and policy, in order to accelerate
progress in improving nutrition and health globally? (Links to Subcomponent 4.2 on Policy.)
Objective 4
Explore and document mechanisms to successfully replicate, adapt, and scale up successful integrated
ANH programs, and to ensure their sustainability.
Research Questions
*  How can integrated ANH programs be adapted to different contexts and populations in
different agroecological zones, and/or scaled up to increase coverage?
*  What are the constraints and bottlenecks to replication, adaptation, and scaling-up?
*  What capacities and skills need to be developed at the community level and in government
(district, provincial, and central level), with what approaches?
*  What institutional mechanisms need to be defined and implemented to support integrated
programs at the community level?
Objective 5
Develop local capacity to design, implement, evaluate, and successfully scale up integrated ANH
programs.
This objective links to Objective 4. It seeks to work with other development partners to
accomplish two broad aims: (1) to better identify, measure, and monitor capacity constraints, weaknesses,
and needs, relevant to scaling up ANH programming; and (2) to develop approaches, tools, and methods
for strengthening essential capacities for this purpose.
Impact Pathways
The applied research carried out by CGIAR centers and its partners to support better ANH programs will
closely mirror the planning, implementing, and evaluation cycle of partnering program implementers
(governments, nongovernmental organizations, and other partners). This applied research--drawing from
outputs in other CRP4 components as well as other CRPs-will contribute to three broad types of outputs
(Figure 10):
1. Methods and tools to design, implement, and evaluate integrated ANH programs; the capacity
to use these tools and to implement cost-effective ANH programs at local, regional, national,
and international levels
2. Cost-effective program models that integrate agriculture, nutrition, and health and can be
successfully scaled-up
3. A strong body of knowledge documenting the contribution of ANH programs to improved
nutrition and health outcomes, to be used for advocacy and to guide policy and investments
The first set of outputs will be generated in Years 1-3; the second set in Years 1-5. The third set
will start emerging subsequently, after tools have been developed and applied and after the first round of
case studies have been concluded and fully documented (Year 5 and beyond).
It is expected that these outputs will be widely used by program implementers, development
practitioners, and governments to scale up ANH programs and to integrate agriculture, nutrition, and
health in national policies. The solid evidence generated by the research will stimulate greater
investments by donors and implementers in successful integrated ANH programs and policies. These
investments in turn will benefit the poor, helping to accelerate progress in improving the nutrition and
health of vulnerable populations and individuals and reducing the risk of agriculture-associated diseases.
97


﻿Activities, Outputs, and Outcomes
Research under this subcomponent will be undertaken in close collaboration with implementing partners
with whom CRP4 will work to design and carry out the action-oriented research linked to program
implementation and operations. Some of the work led by IFPRI in this area is on-going and will be
continued until it is completed in years 2012-2014. Opportunities for new case studies will be explored
during the first year of implementation of CRP4. Table 18 provides a summary of on-going research and
plans to explore new case studies and settings in the first year of implementation. Since research on ANH
programs usually involves a 4-5 year time-frame, the first five years will focus on finalizing on-going
case studies in Uganda, Mozambique, Zambia and Burkina Faso, and starting 2-3 additional ones,
possibly in Nepal, Bangladesh and Zambia (see Table 18).
Table 19 presents the activities, outputs, and outcomes for this subcomponent, with specific
objectives and broad time frames.
Priority setting, selection of case studies and sequencing of activities
Priorities will be determined jointly with several partners, including CGIAR partners and program
implementers such as local and international nongovernmental organizations, governments, and UN
agencies. As noted above, research will initially be undertaken on a subset of five to six programs in the
first phase of CRP4 development (Years 1-5). Lessons generated from this round of research will then
guide the development of a new wave of programs (in Years 5-10) that use innovative approaches to more
solidly integrate agriculture, nutrition, and health. The second phase of applied research will also have a
stronger focus on addressing agriculture-associated disease risks at the community level-an area of
increasing need, where experience on effective implementation is still limited.
The approach used for the selection of case studies will involve a rigorous process, beginning with an
open call for nominations, and a selection be based on a comprehensive set of criteria:
*  demonstrated interest and commitment to designing and implementing multisectoral ANH
programs
*   innovation in program model and willingness to face new implementation challenges
*  potential of program model to have an impact on poor and vulnerable households and individuals
*  commitment to research partnership
*  willingness to adapt implementation to the needs of research, as feasible (for example, by
implementing different packages of interventions to build comparison groups; investing time and
human resources in research partnership and in developing a joint research agenda; and showing
interest in learning and in building staff capacity).
Finally, the case studies will be selected to represent a broad set of nutrition and health issues and
programming models, as well as diversity in geographic focus and agroecological systems
98


﻿Table 18. Preliminary list of ANH programs, countries, and partners that will be included in CRP4
in the first 5 years
Country              Program                         Main partner/donor
On-going
Uganda               OFSP (reaching end users)      HarvestPlus and NGO-implementing partners (e.g.,
Mozambique                                          Helen Keller, World Vision)
Donor: Multiple
Zambia               RAIN (Realigning Agriculture to  Concern Worldwide
Integrate Nutrition)            Donor: Irish Aid
Burkina Faso         Enhanced Homestead Food        Helen Keller
Production Program              Donor: USDA
To be explored in Year I
Zambia               Fish systems, livelihoods, and  CRP1.3 and partners
Bangladesh           nutrition programs
Nepal                Strengthening ANH programs in   Save the Children, US, Helen Keller, and others
Nepal                           Donor: USAID
Notes: ANH = agriculture, nutrition, and health; OFSP = orange-fleshed sweet potatoes.
99


﻿Table 19. Activities, outputs, and outcomes for the Integrated Programs subcomponent
Activities                                            Outputs                                         Outcomes
Objective 4.1.1. Develop tools and indicators to design, implement, and evaluate agriculture programs that incorporate specific
nutrition and health goals and interventions at the community level (Years 1-3)
Develop and test essential tools for program design: formative  A set of tools and methods for informing the design  Better designed and targeted integrated ANH
research, situation analysis, nutrient gap analysis (using linear  and targeting of integrated ANH programs developed  program models, monitoring and evaluation tools
programming), inventory of resources and services (and   and available.                                    (including tools to measure quality of program
constraints to their use), program theory, and impact pathway                                              implementation, impact and cost-effectiveness)
development.                                                                                               and indicators are used by partners (NGOs,
governments, international organizations,
researchers)
Develop and test methods to document program             A set of tools, methods, and indicators to assess
implementation, quality of service delivery, and impact  implementation of ANH programs; to identify and test
pathways for complex, multisectoral ANH programs.        solutions to implementation problems; and to identify
and measure program impact pathways.
Design and test a set of tools using program theory and  State-of-the-art tools and methods developed to
experimental and quasi-experimental impact evaluation    evaluate the impact and cost-effectiveness of
approaches, to document ANH program impact and cost-     multisectoral programs such as integrated ANH
effectiveness.                                           programs.
Develop and validate a set of indicators (including gender-  A set of simple, valid indicators (disaggregated by
disaggregated indicators) to measure the impact of ANH   gender as appropriate) to measure the impact of ANH
programs on a range of outcomes (such as agricultural    programs on key ANH outcomes.
production, income, food security, diet quality and diversity,
health symptoms, nutritional status, and women's
empowerment).
Develop simple tools that can be used by program         A set of simple tools for use by program implementers  ANH program implementers use the set of simple
implementers for rapid assessments, monitoring, or simple  to conduct rapid assessments, monitoring, or simple  tools developed to assess implementation and
impact evaluation of ANH programs on key outcomes.       impact evaluation of ANH programs on key           impact of their programs on key indicators.
indicators.
Objective 4.1.2. Rigorously evaluate the implementation, impact, and cost-effectiveness of integrated ANH programs using
experimental or quasi-experimental methods for complex social programs (Years 1-5)
Use tools developed in Objective I to carry out rigorous  Research findings on impact and cost-effectiveness of  - Body of evidence on the contribution of
operational, impact, and cost-effectiveness assessments of  integrated ANH programs implemented in different  integrated ANH programs to improved outcomes
existing, strengthened, or new models of integrated ANH   agroecological zones and targeted to marginal      in different contexts
programs-implemented in a variety of agroecological zones  populations with different vulnerabilities.      - Information on cost-effectiveness of different
and targeting marginal populations with different                                                            program models in different environments
vulnerabilities.                                                                                            -Lessons learned in implementing programs in
various populations and agroecological zones
(continued)
100


﻿Table 19. Activities, outputs, and outcomes for the Integrated Programs subcomponent (continued)
Activities                                       Outputs                                         Outcomes
Objective 4.1.3. Generate evidence and document and disseminate lessons learned and best practices for designing (or strengthening)
and successfully implementing cost-effective, integrated agriculture programs that incorporate specific nutrition and health goals and
interventions at the community level (Years 5-10)
Document and synthesize evidence generated in Objective 2;  Evidence disseminated to relevant stakeholders,  Increased knowledge and commitment to sustained
publish and disseminate findings to various audiences-  showing the impact and cost-effectiveness of  investments in a new generation of integrated
academic, program implementers, and policymakers.    integrated ANH programs on agriculture, nutrition,  ANH programs.
and health outcomes.
Use evidence for advocacy among different stakeholders.
Advocacy done among relevant stakeholders.
Objective 4.1.4. Explore and document mechanisms to successfully replicate, adapt, or scale up successful programs and ensure their
sustainability (Years 5-10)
Carry out research to understand, document, and address  Information on constraints to replication, scaling-up,  Better understanding of constraints to replication,
capacity and institutional constraints to replication, scaling-  and sustainability of integrated ANH programs and on  scaling-up, and sustainability of ANH programs
up, and sustainability of integrated ANH programs.   ways to address these constraints.             and of ways to address these constraints.
Participate in government policy dialogue and global  Increased presence of policies and active ANH  National policies and global initiatives have the
initiatives to scale-up ANH programs and integrate ANH in  integrated programs.                    tools and momentum to implement integrated
policy.                                                                                             agriculture, nutrition, and health programs.
Objective 4.1.5. Develop local capacity to design, implement, evaluate, and successfully scale up integrated ANH programs
(Years 1-10)
Train program implementers in the use of simple tools  Program implementers trained in the use of tools to  Capacity developed at program level to use tools to
developed for assessments, monitoring, and simple impact  assess and scale up ANH programs.         assess and scale up ANH programs.
evaluation of ANH programs and for scaling-up.
101


﻿Research Methods
This subcomponent has two main goals: to generate the hard evidence needed regarding the health and
nutrition impacts and cost-effectiveness of integrated ANH programs; and to derive lessons learned on
how to design, implement, evaluate and scale up such programs. Research in this subcomponent will
focus on developing and using tools to strengthen program design, implementation, and evaluation, and
on documenting and disseminating the learning to facilitate replication and scale-up of successful
program models.
For these purposes, the research team will use state-of-the-art monitoring and evaluation methods,
based on program theory and on well-defined program impact pathways. The team will use mixed
methods drawing from quantitative as well as qualitative research tools, involve multidisciplinary teams,
engage local and implementation partners, and include simple tools and feedback loops to ensure that real
time information is available and used by decisionmakers at all levels.
Table 20 provides examples of methods that will be used for the program-relevant research, to be
implemented in a selected set of countries and sites (case studies). The research will also develop a set of
indicators for process, impact, and cost-effectiveness that will be used across case studies to allow valid
comparisons and possible meta-analyses of research findings. An information management and learning
system will be developed to link the different case studies and to generate learning across sites. (For more
information on site and case study selection, see Section 5 on Partnerships.)
Partnerships
CGIAR centers will work collaboratively with research partners and development implementers to carry
out the applied program-relevant research of this component. All research and capacity-strengthening
activities will be conducted jointly with partners, taking advantage of the strong international and local
networks of CGIAR centers. Bioversity, CIP, ICRAF, IFPRI, ILRI, and World Fish have already invested
in this type of research and will be actively involved in this component. Other centers may also
contribute, as they develop new program activities at the intersection of agriculture, nutrition, and health.
The set of example case studies presented in Appendix 10 shows the large number of existing
partnerships between CGIAR centers and implementing partners.
The research program will also partner with academic institutions in training and capacity
strengthening. Examples of academic institutions that have indicated their interest and commitment are
the University of Pretoria in South Africa, Columbia University (with the Millennium Villages project),
Cornell University (especially around work on- agriculture and nutrition in partnership with the Tata
Foundation), the Leverhulme Center for Integrative Research on Agriculture and Health (LCIRAH) and
the emerging University Network on Agriculture, Nutrition and Health for Development it is
coordinating, the University of California at Davis, and the Public Health Foundation of India. The
program will also partner with FAO on the development of tools and methods, and for capacity
strengthening on the ground. Partnerships with the private sector (such as Land O'Lakes) will provide
technical support for the development of tools and approaches, and facilitate engagement with networks
of farmers, cooperatives, and processors. In Africa, partnerships with the African Union and with
NEPAD/CAADP processes will be established to work on joint programs and to strengthen nutrition and
health in CAADP pillar 3.
102


﻿Table 20. Indicative research methods for the Integrated Programs subcomponent
Goal of research   Research methods
Design effective   * Formative research to define program/intervention needs
programs           * Baseline surveys to characterize population and agricultural systems
* Knowledge, attitudes, and practices surveys
* Community and market surveys
* Dietary surveys to identify food/nutrient gaps and food safety concerns
* Social network census to identify how information is acquired and disseminated
Evaluate impact    1. Evaluation designs
* Experimental designs with randomization and treatment and control (or other types of
comparison) groups, including pre-post intervention data collection, wherever feasible
* Quasi-experimental designs where experimental design is not feasible. Examples include stepped
wedge approaches (staged implementation), dose response (comparing different intensities of
interventions), matching methods (regression discontinuity, propensity score matching, or
matching individual or cluster by design)
2. Data collection
* Large surveys (cross-sectional, before/after, or longitudinal follow-up)
* Qualitative research to document how and why impact did or did not occur
* Community surveys, market surveys
Document impact    * Design an impact pathway framework, collaborating with program implementers.
pathways, quality of  * Collect data on program implementation at different steps along the program impact pathway, to
implementation        identify implementation failure and bottlenecks that may affect program quality, utilization, and
impact.
* Use operations research methods, combining methods to assess aspects such as fidelity of
implementation, quality of service delivery, uptake and coverage, and perceptions of service
providers and clients.
* Synthesize information and feed it back in timely fashion to program implementers, to enable
action to strengthen program implementation, quality of service delivery, and/or utilization.
Measure cost       * Adapt existing costing methodologies such as activity-based costing ingredients (ABC-I
approach); collect needed cost data in an ongoing manner.
Measure cost-      * Use cost and impact information to derive cost-effectiveness. Examples of effectiveness
effectiveness         indicators include: for nutrition, anthropometric measurements (underweight, stunting, and
wasting) and select micronutrient status indicators (such as vitamin A, iron, and zinc); and for
health, cases of illness prevented.
Replicate and scale * Data collected (especially on impact pathways and implementation) will be used to generate
up                    lessons learned for replication and scale-up.
* Research will also be conducted to understand and document capacity and institutional constraints
for scaling up successful programs.
Summary of CGIAR engagement with integrated ANH programs
Appendix 10 presents examples of case studies that could be good potential candidates for the applied
ANH research of this component, focusing on those in which CGIAR centers have been involved (see
Table A9.1 for a summary of the key characteristics of the studies). All the case studies are community-
based and agriculture-focused and they address at least one other sector, such as health, nutrition,
environment, animal health, markets, hygiene, or water and sanitation. All the programs have health
and/or nutrition goals, and most have a strong gender component: targeting women as program
beneficiaries, focusing on improving women's income and control over income, and/or addressing the
obstacles women face in achieving good health and nutrition for themselves and their families.
The implementers of the case studies listed in Appendix 10 were asked to identify how a
partnership with CRP4 could help fill existing and foreseen gaps in research and programming or in
documenting evidence. This information is captured in Appendix 10 and Table Al0.1. Generally,
program implementers characterized CRP4's comparative advantage as related to carrying out applied,
103


﻿program-relevant, and rigorous research to help strengthen program design, implementation, and
effectiveness in several areas: monitoring and evaluation; policy formulation and communication;
program design, implementation, and scaling up; and documentation and dissemination of lessons
learned. In addition, CRP4, through its close partnerships with several other CRPs, can bring in expertise
and innovation in agriculture, from biofortified crops to value-chain research to gender-sensitive
technologies, among others. The CGIAR is uniquely positioned to contribute to the strengthening of
integrated agriculture, nutrition, and health development programs and brings a wealth of
multidisciplinary expertise that can help scale up successful and cost-effective programs and improve the
lives of millions of poor farmers, including women.
A critical criterion for engaging with a given program will be a commitment to work on the
integration of all three sectors-agriculture, nutrition, and health-rather than only two of the sectors.
Past programs have usually focused more narrowly, on either agriculture and nutrition or agriculture and
health.
6.4.4 Subcomponent 4.2: Harmonized Policies
Rationale, Objectives, and Research Questions
Success in strengthening policy environments will depend on persuading leaders to demand a more
integrated approach in each of the three sectors. As each sector identifies areas where important
objectives can be achieved cost-effectively through cross-sectoral collaboration, these opportunities will
need to be championed in appropriate policymaking fora with evidence-based arguments.
There are three specific objectives within this subcomponent.
Objective 1. Provide a continuously updated and relevant evidence base, from an agricultural and
cross-sectoral perspective, that adds value to ongoing initiatives by supporting better investments in
integrated planning across agriculture, nutrition, and health.
Transdisciplinary research will explore what areas of information, knowledge, and evidence are
needed to support more effective decisionmaking (see Appendix 11 for examples.) An enhanced
information and knowledge base will not only support research planning and design and development
decisionmaking, but will also be an invaluable resource within CRP4 for prioritization, monitoring, and
evaluation as well as impact assessment.
Research questions
*  Given existing evidence on the effectiveness of integrated ANH collaboration at the subsectoral
level (from Subcomponent 4.1), what additional evidence is required to persuade leaders in the
three sectors to embrace integrated planning and programming?
*  What is the evidence on the impact of economic growth, and specifically agriculture-led
economic growth, on nutrition and health outcomes? How can agricultural growth strategies,
policies in areas such as food storage and trade, and public private interactions become more
nutrition- and health-sensitive?
*  How can agriculture and food policies be more strongly linked to other underlying determinants
of nutrition such as women's status, social protection programs, and sanitation to exploit
synergies and achieve greater impacts on nutrition and health? How can agricultural interventions
be designed to improve diet quality and infection rates directly?
*  How can social protection, agriculture, and women's empowerment interventions and policies be
designed to have a greater impact on diet quality, health, and nutrition?
*  How can an enabling environment be promoted and existing and enhanced political and economic
resources be used most effectively to improve nutrition and health through agriculture?
104


﻿*  What are the specific challenges in cross-sectoral development for marginal and vulnerable
peoples? How can emergency and aid programs be transformed into effective longer-term efforts
for integrated and sustainable agriculture, nutrition, and health improvements?
*  What specific emerging ANH policy and decisionmaking issues, relating to dynamically
changing agrifood systems, can be better addressed with strategic foresight and research?
*  How can nutrition and health objectives be incorporated within a multi-criteria approach to
agricultural investment planning?
*  How can ideas, data and information, analysis, and recommendations be brought together to
improve policy- and decisionmaking? How can this be done in a way that enhances the demand
for more evidence-based decisionmaking?
*  How can existing data be made more relevant for decisionmaking? At the national level,
ministries collect information at different scales and time frames, and they process it in ways that
may not be useful to other ministries. What steps can be taken to make the data serve cross-
sectoral needs and to make it available for real-time decisionmaking?
*  What capacity is currently lacking in the agriculture, nutrition, and health sectors to enable work
that is more trans-disciplinary and collaborative? How can this institutional and individual
capacity best be strengthened?
*  What models and studies can be recommended to partners looking for agricultural contributions
to resolving nutrition and health problems?
Objective 2. Assess and document good practices in engaging policymakers and decisionmakers for
cross-sectoral decisionmaking.
These good practices will take into account the hierarchy of decisionmaking, from the local to the
global. This objective will address the need to bridge the three main sectors as well as other important
sectors-for example, those dealing with gender and capacity development, as well as planning,
investment, and finance.
Research Questions
*  What global trends in agriculture, nutrition, and health frame the problems that partners face at
national and local levels? How can CRP4 bring these effectively to the table?
*  What type of governance and institutional arrangements shape actual or potential links among the
ANH sectors, and where are the opportunities and entry points for strengthening integration?
How can this be supported by capacity building?
*  How does one effectively bring an integrated message to ongoing policy and planning processes?
*  What boundary-spanning organizations or individuals can bring agriculture, nutrition, and health
together to engage policymakers and implementers? What are examples of good practices or
cross-sectoral institutional arrangements?
*  What are the particular information and analysis needs of policymakers, funding sources,
stakeholders, and the general public-and how can these needs be met?
*  Programs that cut across ministerial or agency boundaries present a number of special public
finance issues. What public finance issues need to be resolved so that cross-sectoral collaboration
is made attractive to decisionmakers in separate ministries? How are costs of integrated programs
to be allocated among participants? What role do user fees, earmarked taxes, and targeting of
beneficiaries play in the decisionmaking process?
105


﻿These and similar questions will be particularly relevant for such larger policy and
decisionmaking support efforts as the Comprehensive African Agricultural Development Program
(CAADP) (see Appendix 4). This information will also be critical to planning and implementing the
partnership, communications, and advocacy elements of this program.
Objective 3. Assess and strengthen capacity for cross-sectoral policy research and decisionmaking
This capacity development objective seeks, first, to work with partners to assess the capacity of
relevant stakeholders to carry out policy research and advisory functions, and, second, to develop and
implement resulting capacity-strengthening recommendations. Key outcomes include quantifiable targets
relating to
*  training by discipline
*  level of training recognized in human resources development plans
*  investment as share of budget and staff qualification ratios
Impact Pathways
The theory of impact underpinning this component assumes there is potential or actual demand for
research to support policy and investment decisionmaking in areas where agriculture, nutrition, and health
intersect. This demand can be satisfied by different combinations of three types of research outputs: ideas;
data and information; and evidence-based recommendations. At times of crisis, ideas reach people faster
and travel farther than data and information. Ideas are thus important to catalyze new actions, to bring
people together around an innovation, and to suggest a course of action when complete information is not
available. Subsequently, data and information may serve to reinforce decisions taken, to provide a basis
for adaptive or corrective action, or to engage partners with independent analytical capacity. Finally,
transparent analysis of credible information will provide the basis for recommendations that can inform
broader actions in an objective way. The needs of decisionmakers will therefore determine the form of
information, the sequence in which it is used, and how it is used.
Subcomponent 4.2 seeks to achieve better cross-sectoral policy and decisionmaking; well-
functioning knowledge and information systems; and improved capacity for cross-sectoral collaboration
in the three sectors. It will achieve impact along three broad avenues:
1. through the generation of knowledge, evidence of impact, and improved communication to
appropriate users
2. through the assembly of information, data, and tools to support decisionmaking
3. through an improved understanding of the institutional arrangements and processes that
promote collaboration
Intermediate users of the outputs of CRP4 will be researchers, implementers of development
programs in government and NGOs, and policymakers and decisionmakers in the cross-sectoral space
between agriculture, nutrition, and health. The other three components of CRP4 will work closely with a
range of partners on value chains, scientific research, integrated community-level programming, and
control of agriculturally associated diseases. Component 4, in its synthesis and communication role, will
help partners gain access to the knowledge generated and raise it to the policy level.
Activities, Outputs, and Outcomes
In the following discussion, we present the pathway from activities to outcome for three objectives, over
two time periods: an initial start-up period (Years 1-3); and a medium-term period (Years 4-10).
Timing and sequencing of activities
In the first three years of the CRP, this component will have a relatively small role, although this role will
be central to the evolving coherence and direction of the program. In the medium term (4-10 years), we
106


﻿assume there will be increased demand for evidence-based advice, as well as more sophisticated tools for
providing it. This component will work across the other three CRP4 components in real time to document
current best practices and to reinforce the effectiveness of their efforts through increasing sophistication
of the tools. By the tenth year, this component, together with the three others, will have refined the tools
and approaches needed for formal problem identification, for prioritizing among alternative investment
choices, and for monitoring and evaluation. By Year 10, agriculture for improved nutrition and health
investment will be based on benchmarked data; will be better leveraged on disease problems and better
targeted to the most affected; and will support more productive agricultural programs, as measured both
by income and by combined income-nutrition-and-health metrics. Table 21 shows an indicative set of
activities, outputs, outcomes, and impacts highlighting the expected time period for different activities.
Gaps in existing knowledge
An important early step will be to identify the available information and knowledge on the broader
"agriculture for health and nutrition system," as well as the information gaps that can potentially be
addressed by this program. Several networks, communities, and institutions engaged in activities to
improve health and nutrition are in fact integrated with agriculture at the local level. Some have relevant
information, and they welcome collaboration with the program because rigorous evaluation of their
information will help improve their own programs while offering analysis across a wide scale of
operation. The other four components of the program will work closely with a range of partners focusing
on key parts of the national system, i.e., value chains, scientific research, integrated programs at the
community level, and control of agriculturally associated diseases. Component 5, in its synthesis and
communication role, will help partners gain access to this knowledge and raise it to the policy level.
When it comes to national-level data on ANH expenditures, the emphasis will be on adding value
to currently available information and helping national partners link information across sectors. However,
cross-sectoral information on financing of interventions will be difficult to obtain. In addition, there are
major differences among the ANH sectors in the way interventions are financed-through user fees,
ministerial budgets, and cross-sector subsidization. They may differ as well in their primary objectives
and basis for assessment, as in the distinction between animal and human health.
Although there are many international and regional reporting systems for disease and
malnutrition, they have critical gaps in information about certain neglected areas. They also lack
information about the prioritization of efforts, benefits, and risks of specific interventions in relation to
livelihoods, agricultural productivity, and trade-offs in health and nutritional outcomes.
A final gap in knowledge lies in understanding the decisionmaking process, including the
inevitable use of incomplete data for making critical decisions in emergencies and under time constraints.
A compelling idea may catalyze initial action, and subsequent data collection may then lead to better
ways to manage the problem. In agricultural research, for example, the agricultural research intensity ratio
(as a target for investment in research) began as a notional target drawn from the industrial sector. Several
decades of measurement and analysis have resulted in detailed analytical content with clear insights for
public finance. Similarly, targets for public expenditure, such as CAADP's investment target of 10
percent of budgets, are galvanizing action and analysis. Refinement of targets and clearer understanding
of the structure of public finances will follow, as a necessary part of improved planning.
Public health leaders and epidemiologists must often make judgment calls about when and how to
intervene, weighing the costs of postponing a decision to await better information versus the costs of
possibly making a wrong decision through early intervention. For example, in the control of Rift Valley
fever-an important zoonose that occurs sporadically-decisionmakers would benefit from a phased
decisionmaking approach: breaking down the decisionmaking process into smaller steps can help
decisionmakers have more confidence in expensive mass vaccination and quarantine decisions, by
refining the uncertainties and expected costs and benefits in a sequential manner as more surveillance
information becomes available.
107


﻿Table 21. Activities, outputs, and outcomes of the subcomponent on Harmonized Policy
Activities                                           Outputs                                              Outcomes
Objective 4.2.1. Develop/enhance information tools and systems, and provide continuously updated evidence base
Create operational information system: networking  1. Community of practice (CoP) is established of     1. Inventory of data sources categorized by scale, metrics,
among sectors, information sharing, joint           agriculture-nutrition-health specialists in information  quality, and potential for merging with other data.
development.                                        systems.                                            2. Owners of data participate in CoP with view to sharing
(Years 1-3)                                       2. Data sources are mapped.                             data.
3. Systems are reviewed by partners.
Refine information for planning and monitoring;   1. Progress in agriculture for improved nutrition and  1. Funding and staffing targets are benchmarked.
increase depth of analysis.                         health system is monitored.                         2. National progress is compared with similar neighbors at
(Years 4-10)                                      2. Indicators for health and nutrition are developed.   macro level.
3. Trends in funding and quality of human resources are
tracked.    . I
Adapt or develop fit-for-purpose tools for planning,  1. Limitations of existing metrics are reviewed.  1. New tools are piloted by planners and component leaders.
monitoring, and evaluating activities.            2. New metrics are developed to relate agriculture,   2. Staff of national partners are trained in use of tools.
(Years 1-3)             .                           nutrition, and health.
Evaluate activities in integrated agriculture for  1. Metrics are adapted to benchmarks.                Use of formal tools for planning and evaluation becomes the
improved nutrition and health.                    2. Benchmarks are established for measuring component  established norm.
(Years 4-10)                                      research.
Objective 4.2.2. Assess policy processes and governance environment, and document good practices in engaging policy and
decisionmakers for cross-sectoral decisionmaking
Conceptualize the cross-sectoral "system" at the  The goals, components, resources, and management of   1. Consensus is achieved on need for integrated planning.
interface of agriculture, nutrition, and health.  the "agriculture for improved nutrition and health"   2. Decisions are made to take action.
(Years 1-3)                                       system are elaborated and promoted in policy fora.    3. Boundary-spanning mechanisms are put in place.
Assess institutional and governance arrangements and  1. CRP4 component services and outputs are recognized  1. Policy hierarchies view CRP4 as a valued source of
systems, identify and engage policymaking structures  as useful to policymaking bodies.                   knowledge and advice.
in agriculture, nutrition, and health (cf. CAADP  2. Integrated approach is understood by technical and  2. Support for pilot integrated action is obtained (on a
process).                                            advisory leaders.                                    limited domain).
(Years 1-3)                                       3. Immediate and low-cost steps to greater integration are  3. Mechanisms and resources for cross-sectoral problem
identified.                                           identification and program planning are approved by
4. Action is taken.                                     policymakers in all three sectors.
5. Directions for long-term improvement are charted.
I. Analysis of institutional impediments to cross-sector  1. Understanding of immediate and low-cost steps to
(Years 4-10)                                        work leads to solutions being identified.              greater integration lead to guidelines for long-term
2. Boundary-spanning activities and actors are identified.  improvement.
3. Policy options and investment alternatives are based on  2. Policy recommendations by national advisors become
transparent and rigorous evidence.                    cognizant of true opportunity costs of actions.
(continued)
108


﻿Table 21. Activities, outputs, and outcomes of the subcomponent on Harmonized Policy (continued)
ACTIVITIES                                         OUTPUTS                                           OUTCOMES
Objective 4.2.3. Assess and strengthen capacity for cross-sectoral policy research and decisionmaking
Jointly with partners, assess the capacity to carry out  1. Comparable cross-country data are generated to serve  Quantifiable targets for training by discipline and level of
policy research and advisory functions.           as benchmarks for monitoring.                   training are recognized in human resources development
(Years 1-3)                                     2 Training needs at national level are identified.  plan.
Implement capacity-strengthening recommendations.  Investment plans for capacity strengthening are  Quantifiable targets for investment are monitored as share
(Years 4-10)                                   implemented based on estimates in Years 1-3.       of budget, staff qualification ratios, and retention of staff.
109


﻿Research Methods
This subcomponent seeks to cultivate and strengthen enabling policy and institutional environments for
more effective integrated ANH programs and interventions. A range of established and state-of-the-art
methods will be used to analyze current policy environments, institutional arrangements, and capacity,
and to evaluate changes over the course of CRP4 as well as the impact of research on these changes.
Novel research methodologies are also likely to be developed in the course of this CRP.
An assessment of the current state of policy and institutions will provide a baseline level of
information to assess changes. Common indicators will be developed for tracking change over time, and
various methods will be used to document change. Evaluation of impact will be based solidly on
established theories of change, as recommended in the recent guidance for assessing the impact of
research, advocacy, and communication on policy and practice (Shiffman 2007; Shiffman and Smith
2007; Clark 2002). Stakeholder, network, and influence mapping (including the NetMap" method) will
assess and monitor awareness of and commitment to integrated ANH policymaking. Country case studies
will identify current good practices as well as barriers to best practice in different contexts. Tools and
principles developed for capacity assessment will be used to audit institutional capacity in policymaking
and integration (Gillespie 2001; Pelletier et al. 2011).
It is notoriously difficult to attribute specific policy impacts to specific research inputs. Where
this is not possible (and to complement any impact studies), research will assess contribution and
influence. Several methods will be used to generate learning about how evidence reaches, and influences,
different stakeholders and to document research uptake; those methods include uptake logs, citation
analysis in policy-relevant documents, RAPID Outcome Assessments (ROA), and episode studies, aiming
to understand forces, events, and decisions relevant to policy change (Jones 2011). As well as
documenting actual policy changes, research will keep track of the process of change, including
documentation of formal and informal policy processes and actors.
Partnerships
Partnerships in this policy research program will include the following:
*   Collaboration with FAO, WHO, and OIE to provide data and information on patterns of
disease occurrence and risk associated with changes in agrifood systems, to inform
surveillance and alert systems.
*   Direct engagement with national governments and policymakers at all levels in countries of
focus.
*   Partnerships with new large policy research programs involving IFPRI such as Transform
Nutrition (TN), Leveraging Agriculture for Nutrition in South Asia (LANSA), and POSHAN,
which focus on multisectoral approaches to improving nutrition at scale (see brief description
in Box 10), and with the SUN initiative in target countries. The DflD-funded LANSA is a
policy research consortium of six partner institutions led by the Swaminathan Research
Foundation and including IFPRI, LCIRAH, the Institute of Development Studies (IDS) UK,
BRAC International in Bangladesh, and the Collective for Social Science Research in
Pakistan, which will work on policy research on agriculture for improved nutrition in,
Afghanistan, Bangladesh, India, and Pakistan. The TN consortium, led by IFPRI, will also
carry out policy research to leverage agriculture and other sectors and scale up direct nutrition
" Net-Map is a participatory interview method that combines social network analysis, stakeholder mapping, and power mapping.
Net-Map helps people understand, visualize, discuss, and improve situations in which many different actors influence
outcomes. By creating Influence Network Maps, individuals and groups can clarify their own view of a situation, foster
discussion, and develop a strategic approach to their networking activities. It can also help outsiders understand and monitor
complex multi-stakeholder situations. More specifically, Net-Map helps players to determine: what actors are involved in a given
network; how they are linked; how influential they are; and what their goals are (see
http://netmap.files.wordpress.com/2008/04/netmap brochure.pdf for more information).
110


﻿interventions to accelerate progress in reducing child malnutrition. This consortium includes
IDS UK, Save the Children UK, the Public Health Foundation of India, the International
Center for Diarrheal Diseases Control in Bangladesh, and the University of Nairobi in Kenya
and will work in Bangladesh, India, Ethiopia, and Kenya.
*  Collaboration on metrics and evidence for cross-sectoral decisionmaking with universities
and research institutes, such as the University of London LICRAH program and their
emerging network of academic institutions working on agriculture, nutrition, and health.
Other partnerships will be established through linkages with new policy research consortia
such as LANSA and TN.
* Support for joint planning and program implementation of public and private human health
services, veterinary services, and agricultural services to control zoonoses and improve food
safety regulations and practices.
Many of the key skills to support policy and decisionmaking, to establish knowledge and
information systems, and to evaluate and improve institutional capacities and arrangements are well
established in the CGIAR (for example, the Consortium on Spatial Information, Priority Setting, and
Institutional Learning and Change). In this component, the CGIAR Centers involved will also build on
their individual experience in coordinating policy and decisionmaking processes. For example,
Component 4 will benefit greatly from the experience of ReSAKSS (Regional Strategic Analysis and
Knowledge Support System), a program that provides timely analysis to policymakers in Africa,
coordinated by IFPRI, with regional nodes hosted by ILRI, IWMI, and IITA. IFPRI's involvement with
the University of Minnesota, in Harvest Choice, also provides a link to rigorous research evaluation and
priority setting.
111


﻿112


﻿7. GENDER RESEARCH STRATEGY
Throughout much of the world, women are the guardians of household food security and nutrition (see
Box 11). At the same time, cultural factors can put women and girls at particular risk of undernutrition,
micronutrient malnutrition, and poor health. Good ANH programming must therefore account for gender
issues at all stages of the project cycle, from participatory assessment and analysis through surveillance,
implementation of interventions, monitoring, and evaluation.
The central gender-related questions in this program are two: How can decisionmakers reach and
involve millions of women with integrated ANH interventions that provide health and nutrition benefits
to them and their families? And how can women be protected from the potential risks associated with
agriculture, given their greater health and nutrition vulnerability, especially during the reproductive
period? Several gaps in knowledge exist with respect to these key research questions.
*  To what extent are women and girls unable to meet their nutrition and health needs over the
life cycle, and what are the most promising approaches and best practices to meet these
varying needs? How can agriculture play a bigger role in protecting women's and girls'
nutrition and health status?
*  What is women's exposure to agriculture-related disease and occupational health hazards, at
different stages of the production to consumption cycle? What interventions can be designed
to reduce this?
*  What are the best approaches to engage women in integrated ANH programs? How to ensure
that they benefit through gaining greater access to resources, and protecting their own health
and nutrition and that of their children?
*  How can behavioral change communication be used to intervene in intrahousehold food
allocation patterns that disfavor women and girls? What are the best delivery platforms for
such interventions-agricultural programs, social protection programs, reaching girls in
schools, or other approaches?
113


﻿To address these questions, CRP4 will focus on the following broad areas.
1. Gender analysis of needs and differential exposure to risks: Men, women, girls, and boys
have different nutritional needs and different risks of undernutrition and disease. Tools for risk
analysis, surveillance, and household and community nutritional assessments need to be
gendered to capture these differences. Based on the results, gendered interventions will be
integrated in each of the components.
2. Women's participation in and benefits from ANH programs: Women are key mediators of
household nutrition, and their participation in integrated ANH programs will be crucial. While
the health and nutrition sectors have often integrated gender concerns, the agriculture sector
has not been as successful, despite evidence that agriculture interventions that address gender
issues are better able to achieve nutritional objectives (Berti, Krasevec, and Fitzgerald 2004).
This is a key element of Component 4.
3. Increasing access to assets and empowering women: In most countries, women play key
roles in food and nutrition security both as agricultural laborers-sometimes sole
breadwinners-and as household caregivers. To play these key roles effectively, however,
women need access to and control over assets and other means of production. Evidence
suggests that ANH programs could enhance their outcomes by investing in increasing
women's assets and decisionmaking power. All components of CRP4 will work with CRP2,
CRP3, and CRP5 to identify and test approaches to reduce the asset gap between women and
men and to empower women to protect the food, nutrition, and health security of their family
members.
4. Intrahousehold food allocation and consumption: Intrahousehold consumption patterns of
foods-especially those considered high-value "prestige food"-often favor men in many
developing countries. These prestige foods are also usually the nutrient-rich foods that young
children and women need the most for growth and reproduction, and are the foods targeted by
CRP4. Through behavior change communication, CRP4 will increase awareness of how
production and productivity choices affect nutrition and equity issues. Through linkages with
CRP3, research will be conducted on the variable dynamics of intrahousehold food allocation,
as well as on interventions to increase the consumption of nutrient-rich foods especially by
women, children, and other vulnerable groups (such as people living with HI V/AIDS).
5. Technology development and delivery systems: Involvement of both men and women in
technology development is crucial to the uptake of such technologies. Women are very often
constrained in access to services and inputs, such as improved seeds for nutritionally enhanced
crops. Approaches such as participatory plant breeding and community seed systems and
business enterprises can improve their level of access. Women also play a critical role in
postharvest handling and processing of food, an important focus of CRP4. They will therefore
be incorporated as one of the key actors in the work on value chain for enhanced nutrition
(Component 1).
6. Capacity building and policy interventions: Women need to be involved in dialogue on
policies that affect agriculture, nutrition, and health. However, most organizations involving
local women are weak and unable to influence policy. Capacity building and organizational
development can go a long way in ensuring that these organizations play a role in influencing
relevant policies.
As well as forming an over-arching theme in CRP4, gender will also be mainstreamed into work
on each of the components of CRP research in the following ways.
114


﻿Component 1: Value Chains for Enhanced Nutrition and Health
Value chains are inherently gendered, reflecting several broad factors: the different roles that men and
women play across the spectrum of value-chain activities; the preferences of men and women for
different value chains; and different levels of engagement of men and women in specific value-chain
components and activities. This component has a strong focus on women, relating to the opportunities for
income generation for women along the value chains as well as their critical roles in the production and
marketing of nutritious foods. Some key areas of focus include:
*  Understanding and influencing (where needed) intrahousehold decisionmaking processes on
the production, marketing, and consumption of nutrient-rich foods in the context of the value
chains.
*  Identifying the roles, constraints, and opportunities of men, women, and other defined groups
as potential agents of change to improve nutrition along the value chain, especially as related
to improving women's access to better processing technologies, capacity building, or
organizational capacity.
*  Developing innovative tools, methods, and approaches (including social marketing tools) for
increasing access to information and promoting behavior change in men and women;
evaluating the effectiveness of these approaches on both genders.
*  Developing a model for strengthening women's capacity for improved decisionmaking on
production, marketing, and consumption of nutrient-rich commodities.
Component 2: Biofortification for Improved Nutrition and Health
The design and implementation of this component (and both subcomponents) were shaped to take account
of unequal access to resources and the different responsibilities of women and men in earning income and
raising families, as well as their different biological requirements for nutrients. Some specific examples
from HarvestPlus (Subcomponent 2.1) illustrate gender considerations.
*  Micronutrient requirements are higher for women than men, reflecting their different
reproduction requirements. HarvestPlus selects its target combinations of crop, nutrient, and
country to yield maximum potential savings of disability-adjusted life years (DALYs), based
on estimates of the current micronutrient status of women (and preschool children) and the
estimated nutrient adequacy of their diets.
*  Target nutrient-density levels, set for breeders to incorporate into high-yielding, high-profit
varieties, are by design based on the nutrient requirements for women of reproductive age;
bioavailability and efficacy assessments are done in this same group (as well as in preschool
children).
*  Marketing and messaging related to HarvestPlus crops and their nutritional value is designed
to convey information specifically to primary caregivers (almost always women, normally
mothers). Extension programs and messaging related to HarvestPlus crops also take into
account women's and men's contrasting perspectives and roles in farm production.
*  Assessment of HarvestPlus programs examines the specific roles of women and men in
several areas: adoption of biofortified crops, food purchases, food preparation, and
intrahousehold distribution of food.
With respect to a biofortified food basket for Latin America (Subcomponent 2.2), gender is
integrated in the following ways:
* Women are among the intended beneficiaries.
115


﻿*  At least one-third of targeted farmers will be women in projects to disseminate biofortified
seeds to farmers, in partnership with government programs and NGOs.
*  When working with the private sector to develop food products, at least one product per
country will be preferentially consumed by women (per industry's market research); this will
also necessitate involving women in product development.
*  Nutrition impact studies will focus on women (and children).
Component 3: Prevention and Control of Agriculture-Associated Diseases
Exposure to agriculture-related hazards differs by gender. For example:
*  Women doing laundry in canals may be more at risk from schistosomiasis, while young men
are at more risk from neuro-lathyrism.
*  Women are responsible for feeding households and thus play a crucial role in managing food-
borne disease. Special attention will be given to empower women to use risk-reducing
technologies.
*  Women are frequently the caretakers for sick family members and animals, resulting in
greater exposure to disease and higher burdens, but also giving them a key role in disease
management and prevention.
Gender considerations will therefore be integrated in all the components of this research. Data on
exposure and risk factors will be collected separately for various gender and age groups, with a view to
a. identifying the differential exposure of men, women, boys, and girls to risks;
b. enhancing the involvement of both men and women in the surveillance and
management of risks; and
c. developing interventions to reduce AAD targeted specifically to women or other
vulnerable groups.
Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies
As the over-arching component of the project, Component 4 will pay particular attention to the program's
gender-related impacts
*  by developing and using a set of gender-disaggregated indicators to assess the impact of
ANTH programs, and
*  by documenting and disseminating the impact of ANH programs on women's social, health,
and nutritional status.
Subcomponent 4.2 (Policy) will ensure that gender-disaggregated data are used in an integrated
way to highlight nutrition and health issues facing women and children. Within the relevant cross-sectoral
processes, ministries responsible for gender will be engaged. Finally, part of the process monitoring of
CRP4 will be mainstreaming gender within cross-sectoral planning and implementation.
116


﻿8. INNOVATION
CRP4 is an important new departure for the CGIAR. CGIAR Centers have had specific programs in
various areas of agriculture-nutrition and agriculture-health, and a number of Centers have collaborated in
an agriculture and health research platform together with external health and nutrition partners. CRP4
represents a much larger and more systematic approach by the CGIAR to engage with the human nutrition
and health communities to meet a new and explicit system-level goal of expanding agriculture's
contribution to improving nutrition and health.
Bringing together agriculture, nutrition, and health is not a new idea. In what ways will CRP4 be
innovative?
8.1 New Understanding and Global Commitment
There is a growing appreciation globally that something different needs to be done to address the massive
malnutrition and disease burdens in developing countries. It is also recognized that joint efforts of the
ANH sectors will be critical to designing solutions and achieving impacts. At the IFPRI 2020 Conference
in February 2011, "Leveraging Agriculture for Improving Nutrition and Health," this sentiment was
summarized by Prime Minister Manmohan Singh of India:
"Leveraging agriculture for improving nutrition and health ... is particularly
important in developing countries, where agriculture is also the mainstay of a
very large number ofpeople."
This strategic view is increasingly shared at operational levels as well. Implementers of
development programs understand that food-based solutions offer important opportunities to improving
nutrition, and that agricultural food safety and zoonotic disease control initiatives are an essential part of
public health efforts to reducing infectious disease burdens. CRP4 will come into operation at a time
when there is tremendous interest, understanding, and commitment to better linking agriculture, nutrition,
and health.
8.2 New Ways of Working: New Types and Stronger Partnerships
CRP4 will foster new partnerships to ensure that agriculture, nutrition, and health are integrated and
delivered-at the community level, in large development programs, and in policymaking. A major area of
this research program (Component 4) focuses on creating, and responding to, demand from program
implementers and community organizations for better evidence, knowledge, and technologies and
methods for learning and adapting. It will also respond to the demands from policymakers and investors
for better evidence on priorities, knowledge gaps, and good practices.
Within its new strategic results framework, the CGIAR has committed to making agriculture
research accountable for improving human health and nutrition-and CRP4 is its main mechanism for
achieving this strategic goal. A key design element of CRP4, enabling translation of research into
development outcomes and impacts, is its firm grounding in well-defined, practical delivery pathways:
value chains, development programs, and policymaking.
The vision of the CGIAR, in developing CRP4, allows for the development of a larger
coordinated research program that can serve as a platform for bringing together the critical mass of
multidisciplinary research expertise needed to tackle priority ANH challenges. The unique nature of the
CGIAR, as a multilateral and independent research organization, makes it a natural convenor and an
interesting partner for nutrition and health research as well as development organizations. The CGIAR
already has very positive commitments from its ANH partners to work together, expressed in partners'
meetings as well as in the IFPRI 2020 conference. These commitments will be further specified and
117


﻿operationalized in the first year of CRP4, around key research topics linked to the large development
initiatives that are highlighted in other sections of this proposal.
8.3 Innovative Research to Meet Emerging Challenges
Dramatic increases in population and urbanization are changing the relationships between agriculture and
food, especially in the developing world. In this changing social landscape, there is little understanding of
how improving knowledge and information might influence consumer behavior for better nutrition and
health options, or how this opportunity might relate to changing agricultural production and supply. This
area of international agricultural research is seriously under-invested.
The dynamic changes in agriculture in the developing world have included dramatic
intensification of agricultural practices as well as ecosystem change, resulting in big changes in disease
pathogen distribution and transmission dynamics, both in natural systems and along food chains.
CRP4 will have the ability to convene research on these and other emerging social and biological
issues. It will work with partners to design mechanisms for enhancing nutrition along the agricultural
value chain and to apply new molecular biology tools informed by population biology and social research,
to improve our understanding of how agricultural intensification can be more sustainably managed.
New Tools and Approaches to Build the Evidence Base
Research is needed to provide standardized ways of measuring, providing, and communicating evidence
that can guide good practices for joint ANH actions. Policymakers, investors, and development
implementers receive an array of information from different sectors-on return to investments, on cost-
benefit and cost-effectiveness figures, and on health and nutrition outcomes measured using various
indicators, such as DALYs, disease burden, or number of food-insecure or undernourished people. For
these different prioritization and performance indicators to usefully guide policy and practice across
sectors, shared tools, indicators, and vocabulary will be critical. While some efforts have begun on useful
cross-sectoral metrics and assessment methods, much faster progress can be made when sufficient
funding becomes available to assemble a critical mass of expertise, as through CRP4.
118


﻿9. INTERACTIONS WITH OTHER CRPS
CRP4 is the primary CGIAR program for delivering the system-level objective of improving nutrition and
health. This CRP is intended to link with and influence several other programs in the CGIAR research
portfolio to enhance the contribution of agricultural research for improving nutrition and health. There are
accordingly numerous potential interactions between CRP4 and other CRPs. Appendix 12 lists some of
the main areas of complementarity and possible joint research between CRP4 and other CRPs and
provides some indication of potential funding contributions for joint activities. The major interactions are
described below, for each of CRP4's three impact pathways. Areas for further clarification on interfaces
with other CRPs are highlighted.
9.1 Value-chain Impact Pathway
In most cases, CRP4's value-chain research will be pursued within the value-chain work in the other
CRPs such as CRP 1.3, CRP2, and the commodity CRPs under thematic area 3. CRP4 will interact with
agricultural commodity research in the key area of strategic plant breeding for improved nutrition and
health traits-for example, micronutrient-rich biofortified staple crops, and crops with reduced levels of
harmful toxins-building on the successful work of the past several years in mainstreaming nutrition and
health objectives into plant breeding programs. Under CRP4, this work will be expanded to look at
nutritional quality and food safety throughout food-value chains beyond production, through postharvest,
processing, storage, and beyond. CRP4 will rely on CRP2 for value-chain analysis, to identify
opportunities along the value chain for improving nutritional quality and food safety. CRP4 will also
work closely with the agricultural commodity CRPs in thematic area 3, to improve nutritional quality and
food safety along value chains. Nutritional quality can be enhanced either through improving the
nutritional quality of staple crops (CRP3.1/2/3/4/6) or through making accessible foods of higher
nutritional value, such as animal source foods (CRP3.7 and 1.3 [fish]), legumes (CRP3.5), and fruits
(CRP6). The latter will be the main focus of CRP4 (see discussion at the beginning of Section 6 on the
general approach to joint value-chain activities to enhance nutrition and health between CRPs). Food
safety research will require joint actions, primarily related to animal source foods (with CRP3.7) and
mycotoxins, principally in maize and groundnuts. An important task in year 1 will be to coordinate with
crop CRPs on the division of labor and comparative advantage of contributions from the different CRPs
for work along value chains. It will also be important to consider the relative roles of crop CRPs in
developing technologies and how CRP4 can support these activities to enhance their nutritional benefits
and food safety improvements.
CRP4 will contribute not only nutritional and food safety analyses, but also consumer-level
studies on diet preference, risk, and other behaviors. This increased consumer focus will be critical as
food production by and for the poor evolves from primarily subsistence and local informal markets to
more formal markets and supply to poor urban consumers.
9.2 Development Program Impact Pathway
The integrated ANH programs in Component 4 will draw on the research findings from other CRPs
relating to agricultural intervention, technologies, and innovation. In particular, there will likely be
important links between CRP4 and research undertaken in the CRPs under thematic area 1 (drylands,
humid tropics, and aquatic and coastal systems). These interactions will involve nutrition and health
inputs from CRP4 and inputs from thematic area I CRPs on agricultural biodiversity, livelihoods, fish and
aquatic systems, and agricultural program options in different agroecological and regional settings.
The elements of CRP4 linked to public health and nutrition programs will also have strong links
to other CRPs. For example, CRP4's science-based evidence and technologies can inform food safety and
veterinary public health programs, especially CRP3.7 (relating to production technologies, food-
processing techniques, diagnostics, and vaccines). Other potential health links could include links with
crop commodity CRPs on integrated pest management, with CRP5 on water-associated diseases, with
119


﻿CRP6 on indigenous technical knowledge for health, and with CRP7 on changing patterns of disease risks
associated with climate change and the effects of climate on food production opportunities and the
nutrient content of crops. Links related to other agricultural intensification issues could be further
developed under the subcomponent of health risks in agroecosystems (though they are not an initial
priority).
9.3 Policy Impact Pathway
CRP4 will have strong links with all major components of CRP2-policies, institutions, and markets.
CRP4 will use many common analytical frameworks and research methodologies as well as sharing
monitoring and evaluation methods with CRP2. Shared research approaches will extend to cross-cutting
issues such as social protection policies, risk management, and gender policies. There will also be strong
links to CRP3.7 around risk management and public health metrics and policies.
120


﻿10. CROSS-CUTTING ISSUES
10.1 Capacity Strengthening
Capacity strengthening is a crucial element for CRP4's longer-term and more sustainable impacts,
essential for program scale-up and sustainability. The CGIAR and its research partners have long
experience in supporting developing-country research organizations and researchers, through
collaboration in programs and enhancing the capacity of development implementers and enablers.
Implementing CRP4 will require adequate capacity for translating research methods and outputs
into adopted technologies and institutional and policy changes. Just as important, it will mean developing
cross-disciplinary capacity at various levels, including government and development agencies as well as
educational and research institutions. At present, the higher education systems in most CRP4 countries
lack any training in multidisciplinary expertise: programs designed for the development professional have
a single disciplinary focus with no opportunities for cross-disciplinary learning. As a result, government
professionals - with a wealth of experience in their own fields - have very limited capacity to reach out
to other disciplines, due in part to a lack of tools to address joint objectives. Similarly, researchers
working on promising innovations lack the training or the incentive to work across disciplines or sectors.
Renewed interest in the integration of agriculture and food systems with health and nutrition
outcomes presents an opportunity to develop a truly multidisciplinary capacity and outlook. Research
teams working on CRP4 will undertake, as a preliminary step, comprehensive assessments of capacity
gaps and needs in targeted countries and institutions, to develop an appropriate capacity development
strategy.  I
Capacity strengthening will be carried out at four levels: individual, group, organizational, and
policy. Given the international public goods focus of CRP4, active efforts will be taken to develop a
network with key training institutes globally that are committed to working at the intersection of
agriculture, nutrition, and health. An initial group coordinated by the Leverhulme Center for Integrated
Research on Agriculture and Health (LCIRAH) of the London International Development Centre (LIDC)
has already formed from discussions at the CRP4 partners meeting in Addis Ababa in 2010; the group of
academic institutions from both the North and the South recently created a University Network on
Agriculture, Nutrition, and Health for Development, in which CRP4 is participating. The network will be
further strengthened during the first year of implementation of CRP4.
Individual Level: Individuals involved in all program areas will be targeted for individual skill-building
with a multidisciplinary perspective. Capacity strengthening approaches will include one-on-one
collaboration, hands-on experience to learn new research and analytical methods, mentoring collaboration
with researchers, graduate student supervision, postdoctoral and visiting-scientist placements, on-the-job
training, and short courses. Approaches will be adapted as needed, based on the assessment exercise. This
interdisciplinary experience will better prepare these individuals to take on scientific and leadership roles
in advancing integrated ANH programs.
Group Level: CRP4 will encourage enhanced networking among its direct and indirect partners.
Networks of scientists, policy analysts, educators, program designers, and evaluators will develop to share
and exchange innovations and experiences. Networking will be facilitated by the use of modern
information technology, including social media, and by active efforts to encourage engagement at all
levels. For example, an educational network can bring together universities in the North and South to
exchange course content incorporating research and methods generated by CRP4.
Organizational Level: Six types of organizations will be included in capacity strengthening efforts.
1. Research organizations need capacity support particularly in the areas of research planning
and management, institutional development, resource mobilization, and scientific writing. A
networking approach will enable more isolated institutions to pool resources, including
121


﻿personnel. Systematic mentoring will be complemented by well-targeted training of senior
managers and scientists.
2. Teaching and training organizations provide the mechanism for recruitment and formation of
new scientists, technicians, practitioners, and managers. These organizations include technical
schools, universities, and training centers, as well as education networks in agriculture and
natural resources management. CRP4 will engage with a range of training organizations-
technical schools, universities, and training centers, as well as education networks in
agriculture and natural resources management-to facilitate incorporating new knowledge
generated by CRP4 into training and education curricula, and to develop relevant learning
resources. Student researchers will be involved in various components as part of thesis
research, with supervision and mentorship by the researchers.
3. Organizations designing policies and programs provide the essential bridge to widespread
adoption and scaling-up. In these organizations, capacity will be needed for (1) developing
national strategies and programs capable of implementation and funding, and (2) program
monitoring and evaluation. These organizations will also provide a forum to bring together
professionals from various disciplines, to contribute to policy and program solutions in an
integrated and multidisciplinary manner.
4. Organizations implementing intervention programs have a crucial role to play. Local
government organizations, civil society organizations (CSOs), international and local
nongovernmental organizations (NGOs), community-based organizations (CBOs), and a range
of private organizations will all be key in designing and implementing intervention programs
that emanate from CRP4. CRP4 will work with such bridging organizations to strengthen their
capacity to design, manage, use, and evaluate research outputs, through extensive
brainstorming sessions, special short courses, participatory workshops, and other special
training events.
5. CGI4R Centers themselves will gain important capacity to integrate nutrition and health
considerations into their research programs, incorporating health and nutrition goals and
interventions where appropriate. Capacity development will be mainly through joint research,
as well as advocacy based on evidence generated by this CRP. CRP4 will also support creation
of a learning platform to strengthen capacity for research across the five components of CRP4
(and across other CGIAR CRP programs doing research on nutrition and health-related
activities), by sharing knowledge and information, analytical assessment tools, methods,
participatory research strategies, specialized expertise, best practices, and feedback. The
platform will include tools including indicators for needs assessment, monitoring, and
evaluation. Based on needs assessment, the learning platform will sponsor online training
courses or e-learning materials on methods and multi-stakeholder processes.
6. Other international and regional organizations, such as UN agencies, will also benefit from
capacity development through individual and institutional partnerships, engaging in joint
research planning and analysis as well as publication of research findings and targeted
dissemination of research outputs.
Policy Level: CRP4 will support capacity creation in policy research programs at the regional and
subregional levels, with the lead CGIAR Centers providing methodological and analytical support to
universities, policy institutes, and national and international policymakers and government officials. In
Africa, for example, CRP4 will support processes such as NEPAD/CAADP, ASARECA's Policy
Analysis and Advocacy Program, and the Food Agriculture and National Resources Policy Analysis
Network (FANRPAN), drawing on IFPRI and ILRI leadership in the Regional Strategic Analysis and
Knowledge Support Systems (ReSAKSS). Similar policy analysis networks will be implemented in the
South Asia region.
122


﻿Appendix 13 presents an impact pathway for the capacity strengthening activities of CRP4, as
implemented at different levels.
Special attention will be paid in all research and capacity strengthening activities to create
opportunities for women and members of marginalized groups. Pilot sites will be selected that represent
different agroecological and socioeconomic conditions. Local and international graduate students will be
engaged in research questions designed to create models that can serve as international public goods.
Special briefings and trainings will be organized for policymakers, especially on issues related to
promoting cross-sectoral support, financing, policies, and institutional developments.
At the national level, leadership and managerial skills will be required to manage cross-sectoral
collaboration. National food security and nutrition taskforces will be engaged in a series of policy
dialogues to identify capacity gaps and to encourage incorporating the results of research into national
policies and strategies.
Appendix 14 presents a description of capacity strengthening activities for each component of
CRP4.
10.2 Communications and Advocacy
10.2.1 Rationale
The CGIAR Research Program on Agriculture for Nutrition and Health places priority importance on
establishing a strong communications function from the beginning of the program. Cross-sectoral
collaboration requires nurturing; an effective communication strategy will help (1) establish the focus of
the program for both external and internal audiences; (2) provide a unifying voice for the program; and
(3) reinforce mainstreamed messages relating to such factors as partnership behavior, gender inclusion,
and integrated planning around shared goals.
Upon approval of the program, the management team will create a task force drawing on
expertise from center and partner organizations, to develop a communications strategy for the start-up and
development phase of the CRP.
10.2.2 Start-Up Phase: Elements of the Communications Strategy
During the first years of the program, the communications goal will be to unify participants, Consortium
members, and donors around the goals of the program-improved health and nutrition through integrated
planning with agricultural research and development. The messages may be targeted in different ways to
different audiences to make them more accessible. The basic message will accomplish the following:
(1) establish a common vocabulary for expressing the program's objectives and expected impacts;
(2) demonstrate how the integrated program builds on the strengths of the lead organizations and partners
but stands on its own, as a focused program with responsibilities and the resources to fulfill them; and
(3) establish a basis of core principles for managing cross-sectoral collaboration. This third function can
include formal statements of partnership principles (see Section 10.1) and even reference materials on
desirable behaviors.
The program will also create a web portal providing an accessible and searchable archive of the
documentation, statements of principle, and decisions establishing the program. The evidence base
underlying the creation of the CRP will reinforce the value of an integrated approach. It will also provide
potential partners with the resources they need to explore new collaboration. In addition, cross-sectoral
and multi-institutional collaboration involves negotiations, and occasionally conflict resolution. The
ability to go back to first principles and to the record of initial discussions will facilitate the development
of mutual trust. Finally, the principles and practices for managing a multi-stakeholder program-drawing
on the experience of international organizations and NGOs-will be posted for continuous reference.
The program website will also be a port of entry for potential collaborators and a reference for
potential donors exploring the match between their objectives and those of the program.
123


﻿The strategy for the start-up period will identify the targets and the venues for presenting such
messages. Component 4 (Section 6.4) underlines the importance of ideas, data, and information, as
communication tools that can be used in different fora to reach different targets. Appendix 4 on
implementation partnerships describes the impact pathway for policy that uses tailored messages for the
following purposes: (1) presentations in regional and national policy fora (for example, CAADP and
subregional organizations); (2) getting agriculture on the agenda of national strategic planning exercises
in health and nutrition (and vice versa); (3) getting integrated health, nutrition, and agriculture into
National Poverty Reduction Strategies and into National Agricultural Research Fora, where they exist.
10.2.3 Development Phase: Communication Strategy for Public Awareness and Reaching End
Users
The Communications Strategy will move quickly from establishing the program to consolidating support
for its activities, recruiting new collaborators, and ensuring use of its knowledge. Public goods are freely
accessible to all, but serious efforts are required to get them into the right hands.
Targeting research outputs to particular users is a professional skill. This CRP will enhance the
productivity of its scientists and partners by having specialized communications professionals work with
scientists from project design onward to ensure the transfer of knowledge to users. Researchers will be
helped to identify target groups for research outputs and to plan the particular format of outputs to meet
their needs.
The Program Management Team will benefit from having a formal Communication and
Advocacy Strategy that balances the need for scientific rigor and credibility with the need for a stream of
public awareness materials that highlight the potential impact for advocacy purposes. The
Communications Strategy will (1) formalize policies to ensure high standards of professional quality in
CRP outputs, through peer review and editorial assistance; (2) assist researchers to maintain the value of
their intellectual property while maximizing shared use and credit by partners; and (3) identify the policy
and advocacy channels to be cultivated, in close association with researchers and partner organizations.
10.2.4 General Lessons: Communications in Cross-Sectoral Collaboration
From the beginning, the communication focus will be on the integration of agriculture, nutrition, and
health as the special characteristic of this program. Success will depend on the recognition by
decisionmakers in each sector that there are real and tangible economic gains from integration of effort.
Fiscal and budgetary arrangements can be specifically designed to make collaboration attractive to cross-
sectoral partners. A synthesis of the economic evidence showing the benefits of integrated programming,
highlighting experience from other cross-sectoral activities, will be an important element in maintaining
the collaborative commitment, and a stream of new evidence will help to reinforce it.
124


﻿11. MANAGEMENT ARRANGEMENT FOR IMPLEMENTATION
11.1 Governance and Management Arrangements
The governance and management arrangements for CRP4 follow the guidelines set out in the CGIAR
Strategic Results Framework. The Lead Center is IFPRI, which will have overall fiduciary and
operational responsibility for the implementation of CRP4. To enhance synergies across the ANH
components of the program, the Consortium Board has requested that ILRI, which currently manages
two-thirds of the health-related research in the CGIAR, play a strong support role. ILRI will provide the
Chair of the Planning and Management Committee for the first two years of CRP4; will be specifically
consulted on the recruitment and performance evaluation of the Program Director; and will lead the
implementation of Component 3 on agriculture-associated diseases.
The Board of Trustees and Director General of IFPRI are accountable for the overall execution of
CRP4 and for the effective engagement of the different partners. IFPRI will be responsible for the overall
reporting relative to its Program Implementation Agreement with the Consortium Board, and accordingly
shall require program participants to operate this CRP in accordance with the PIA and flow-down
provisions which will be reflected in contracts between IFPRI and the partner entity. Responsibilities will
then cascade to participating CGIAR Centers and partners. ILRI, in executing its responsibilities in the
implementation of Component 3, will consult closely with IFPRI and the CRP4 Director.
The overall management structure of CRP4 is outlined in Figure 11.
Figure 11. CRP4 Management structure
Consortium Board
CRP4 Lead Center (IFPRI)
Planning & Management Committee
Program Research Team
12
125


﻿The main elements of this management structure include:
Planning and Management Committee (PMC): The PMC will oversee the planning, management,
implementation, and monitoring and evaluation of the CRP. It will review and approve the program work
plans, milestones, and budgets. The PMC will discuss and approve the strategic directions of the program
and new funding initiatives, and will advise on the development, implementation, monitoring, and
evaluation of the program, including strategic linkages and partnerships. The PMC will be convened by
the Program Director, supported by the Program Management Unit (as secretariat, see description below),
and chaired by one of the Center representatives. In the first two years of the program, an ILRI
representative appointed by the ILRI Director General will serve as Chair of the PMC, as requested by the
Consortium Board. It is expected that a rotating system for chairmanship will be established by the PMC
once it is formed. PMC members will include three representatives from key CGIAR Centers and
implementing partners, and the four research component leaders. It is anticipated that the PMC will have
face-to-face meetings twice per year and more frequent meetings and decisions will be made by
consensus. As needed, the Director General of IFPRI, supported by the PMC Chair and Program Director,
will consult with the Director Generals of participating CGIAR Centers to resolve any contentious
matters.
Independent Advisory Committee: A six-person Independent Advisory Committee will be formed to
support the development of collaborative, efficient, and effective science and management. It will consist
of three scientists to cover the range of science and disciplines in the program, two representatives of
development partners (development implementers, policy/investment stakeholders), and one member of
the HarvestPlus Program Advisory Committee. This panel will be complemented by additional ad-hoc
advisors for specific or emerging issues, as needed. The Independent Advisory Committee will provide
advice to the Management Committee and the IFPRI Director General on research program performance,
research priorities and focus, and management and partnership issues. Nominations will be actively
canvassed from participating centers and partners by the Management Committee to ensure broad
acceptance. The slate of candidates will be proposed to the IFPRI Director General for confirmation by
the IFPRI Board. The Independent Advisory Committee will have one face-to-face meeting annually at
the time of one of the PMC meetings and will be consulted for advice at other times by the Program
Director. The PMC, through IFPRI and the Program Director, will be required to formally respond to the
Independent Advisory Committee recommendations.
Given the importance of partnership engagement in this CRP, it is proposed to hold a partner'and
stakeholder meeting biennially, in association with the GCARD meeting. It will be an open forum, and
sponsored participation by key partners may be budgeted into component activities.
Program Management will be led by the Program Director supported by a Program Management Unit.
The key management positions envisaged are as follows:
Program Director. CRP4 will be managed by the Program Director, who will be appointed by IFPRI in
consultation with ILRI and will report to IFPRI's Director General. The Program Director will be
responsible for ensuring the implementation and delivery of all aspects of the CRP, according to the
obligations of the Performance Implementing Agreement. Responsibilities include leadership of the CRP,
including communicating and modelling a shared vision of the CRP among participating centers and
partners; ensuring integration across agriculture, nutrition, and health; coordinating work plans, budgets,
reporting, monitoring, and evaluation; setting priorities for funding and for broader communications and
resource mobilization; representing the CRP externally and supervising the program management unit.
126


﻿Program Management Unit. This unit will consist of a small number of staff who will support the
implementing Centers and partners in the implementation of the CRP. The program management unit
positions include the following:
*  Research Coordinator - This position will focus on supporting research strategy across the
CRP and the development of high quality standardized methods and metrics for data and
evidence. The research coordinator will provide intellectual leadership in research.
*  Program Manager - This position will provide management and monitoring and evaluation
support to program research teams in implementing the CRP. This will include support on
cross-cutting issues such as gender and capacity building, development of proposals and
agreements, and monitoring and evaluation (M&E) and reporting requirements.
*  Senior Administrative Assistant - This position will offer administrative support to the
Program Director and the Management Unit staff in planning, budgeting, and reporting.
*  Research Assistant - This position will provide some basic research assistance to the Program
Director and the PMC.
Program Research Team: A small program research team will be formed, comprised of the Program
Director and the four Research Leaders from each of the research components. This team will operate
informally but will meet regularly (virtually) as well as face-to-face twice a year, in the context of the
PMC meetings. Their role will be to coordinate research and to ensure intra- and inter-CRP coherence,
focus, collaboration, and effective partnerships. The cost of these activities will be embedded in the
research components.
11.2 Program Implementation
Once this proposal is approved by the Fund Council, an Operational Plan will be developed by the PMC,
with assistance from the Program Management Unit. The components of the Operational Plan will be
agreed with the Consortium Office and will include specific elements outlined elsewhere (such as the
M&E plan). An essential component of the Operational Plan will be financial planning to support the
priority research and development areas, and how funding can be raised through the Fund Council or
other investors. Financial planning will be discussed with partners in order to stimulate joint proposal
development and appropriate sharing of resources in key priority areas.
Implementation of components and subcomponents will be the responsibility of research leaders.
Research leaders will be selected from CGIAR centers or partners that have a significant resource stake.
Funds from the Fund Council through the Consortium Board will be managed as subcontracts to the
institutions involved.
How CRP4 evolves will follow the strategic directions outlined in this proposal as well as being
responsive to partner and client demands within those directions. CRP4 will focus on bringing
agricultural solutions to agriculture, nutrition, and health challenges as a provider of research outputs and
outcomes in support of development enablers and implementers. We will make decisions about expanding
or moving into new research areas and stopping research by balancing strategic plans and responsiveness
to clients and partners. The Independent Advisory Group and other advice will be used by the Planning
and Management Committee and the Lead Center to review and challenge decisions on program
evolution.
127


﻿12. TIME FRAME AND MILESTONES
CRP4 will be fully operationalized with the signing of the Program Implementation Agreement between
the Consortium and IFPRI as the Lead Center of CRP4 (as per the CGIAR Strategy and Results
Framework).
The main initial task will be to develop a five-year operations plan with the active participation of
CRP4 centers and partners. This will include further elaboration of the impact pathways, outcomes and
impacts, partnership and human resource arrangements, and detailed plans of work and budget for
different components and subcomponents.
The overall thrust of CRP4 is relatively new for the CGIAR. It combines some ongoing research
with other well-established areas of research (such as biofortification of staple crops, nutritional
assessment of programs, and zoonoses research), as well as some smaller-scale activities that can benefit
from greater coordination and resources (such as food safety), along with some areas of innovation that
still need to be developed (such as quality and safety of foods along value chains, evidence and metrics
for priority setting, and assessment of cross-sectoral ANH interventions).
Some important milestones for the first five years are listed in Table 22. As a relatively new joint-
research area for the CGIAR and its agricultural partners, and with new collaborations being established
with partners in health and nutrition, the first three years will be require considerable efforts on
partnership development and detailed discussions with partners. Important early efforts in communication
and partnership are planned in order to build on the notable enthusiasm generated at the proposal
development stage and in related CGIAR center initiatives. This enthusiasm will need to be translated
quickly into tangible research results to guide priorities, partnerships, and investments.
How can CRP4 quickly and effectively establish clearer priorities within its partnerships and
translate these to actions with defined timelines and milestones? In the short term, we will use three
different approaches for doing this. The first is to engage in specific discussions on research priorities
with key partners, starting with teams working on other CRPs. We will discuss with CRP3.7, for instance,
the inclusion of nutrition and health activities in their seven focus value chains and select the most
suitable ones for joint work in the short term and medium term (some of these discussions have already
started). Second, within the program impact pathway, CRP4 will engage in discussions with other CRPs
such as CRPl.3 in Bangladesh and Zambia, as well as with existing program implementation partners
such as Helen Keller International in Burkina Faso and Nepal and Concern Worldwide in Zambia. The
third basic strategy will be to quickly engage key partners in developing and testing basic metrics and
evidence as well as principles and practices for joint research linked to the value chain, program, and
policy implementation pathways. This three-pronged strategy will allow us to engage more effectively
with key cross-sectoral policy platforms (AU-NEPAD and PHFI-Ag research) in Africa and India as well
as new regional policy research programs involving IFPRI and other CRP4 partners such as LANSA in
four countries of South Asia and Transform Nutrition in two countries in Africa and two in South Asia
(see Box 10).
CRP4 will also pay attention to better aligning existing research and funded projects to serve the
jointly developed priority activities and to plan and mobilize resources jointly for identified gaps.
Underlying this effort will be the need to jointly develop a shared vision of the program that takes into
account the research and development needs of the nutrition and health communities as well as those of
the CGIAR agricultural research partners.
128


﻿Table 22. Time frame and milestones
Milestone                                         Year 1    Year 2    Year 3    Year 4    Year 5
Initial institutional arrangements for CRP operations  X
among partners agreed and contracted
Management Committee established and meets        X    X    X    X    X    X    X    X    X    X
Staff appointed                                   X
Center and Partner meetings                       X    X         X         X         X         X
Science Advisory Panel established and meets           X         X         X         X         X
Detailed work-planning for components and         X    X
subcomponents
M&E plan developed                                     X
Partnership Strategy developed                         X
Communication and resource mobilization strategies  X  X
and planning for components and subcomponents
Value-chain partnerships for nutrition and food safety  X   X    X
established
Biofortification (ongoing milestones plus exploration
of new regions)
Data and evidence for prioritization and assessment of  X   X    X    X    X
nutrition and health interventions
Identification and establishment of program            X
partnership case studies
Cross-sectoral metrics development and testing         X    X    X    X    X
Priority setting and strategy refresh                                           X
129


﻿13. OPPORTUNITIES AND RISKS
The opportunities presented by this program are enormous, flowing from a groundswell of demand for
integrated ANH research-as seen by the tremendous level of participation and interest in the IFPRI 2020
Conference in New Delhi. The networks and collaborations proposed (and that, in some cases, are already
functioning) provide opportunities for enhancing dissemination and uptake of research outputs, presenting
a real opportunity to influence both debate and practice in this area. The program also provides the
opportunity to leverage additional funding and commitments from donors and stakeholders, expanding
this area of research into a potentially world-changing force.
With such -an ambitious program, there come challenges and risks. The unavoidable challenges
need to be tackled to achieve innovative impacts; the serious risks need to be mitigated or avoided, as
potentially detrimental to the work-and not all of those risks can be anticipated. Challenges flow from
the inherent difficulties in bringing different research disciplines together, exacerbated by the current
tendency to work in isolated sectors. Differences in assessment tools, guidelines, and methodologies will
certainly complicate implementation, coordination, evaluation, and interpretation of findings. Another
critical challenge is the current lack of capacity and expertise in implementing cross-sectoral work on the
ground, and this is addressed in CRP4 through a well-defined capacity-strengthening strategy.
CRPs are an important innovation of the new CGIAR, learning how to make them work and
succeed at achieving their goals will require significant investments. This challenge is multiplied when
moving beyond technology research to the types of integrative, partnership-intensive, and cross-sectoral
research proposed in CRP4. This type of research will demand new and effective governance and
management approaches. Key program risks and how they will be mitigated are outlined in Table 23.
Table 23 focuses largely on internal risks (CGIAR and CRP partnership) that will need to be
effectively managed. External risks stemming from political, social, and other contextual changes will
also need to be monitored and assessed. Partnerships will be critical in evaluating and mitigating most
external risks. The assessment, monitoring, and management of risks will be the responsibility of all
partners. Open communication about potential risks (and responses) will be encouraged but also built into
monitoring, evaluation, and management systems. Within each component of the program, specific
research opportunities and risks have been assessed (as discussed below); these will be further elaborated
in management and implementation plans.
130


﻿Table 23. Key risks and their mitigation measures
Risk                                Mitigation measures
Partnership risks
CRP teams (both within CRP4 and     Establish a clear overall framework for key research areas and agree on
with other CRPs) do not collaborate  comparative advantages, needs for individual and joint efforts and roles and
but compete in areas of research in  responsibilities of different partners. Provide mentoring and support to teams for
which joint actions are needed.     team building and management skills. Establish transparent principles and
processes for decisionmaking.
Failure to effectively engage key   Clearly articulate roles and responsibilities of national and local partners,
national and local actors           highlighting their importance along impact pathways. Give priority to capacity
development and provide funding for their contributions, where appropriate.
Failure to establish partnerships   CRP4 will generate needed evidence regarding the contributions that agriculture
between key partners across the     can make to nutrition and health outcomes. This evidence will be used for advocacy
agriculture, nutrition and health   and to identify and support champions of cross-sectoral research and development.
sectors.                            CRP4 will help strengthen the track record of key CGIAR Centers in agriculture-
nutrition and health partnerships.
Leadership risks
Lead Center, CRP4 Director and      Recruit and empower a strong Director and leadership team. Develop and support a
leadership team fail to develop,    strong Planning and Management Committee that engages key Centers and
implement and resource a compelling  partners. IFPRI provides strong support to the program and fosters collaborative
vision and program for CRP4.        behavior. Independent Advisory Committee effectively challenges and advises
IFPRI and CRP4 management team, who then can take necessary measures to
improve performance.
Lack of support by Consortium and   Provide compelling evidence and communicate importance of agriculture in
Fund Council for CRP4 agenda        nutrition and health outcomes and impacts. Support champions at all levels who can
articulate the importance of the linkages between agriculture, nutrition and health
issues.
Operational Risks
Failure to effectively coordinate and  Lead Center and Director, Planning and Management Committee and tndependent
manage CRP4 partnership.            Advisory Committee regularly monitor and evaluate management effectiveness and
adjust investments, people and procedures.
CRP4 agenda too scattered to be     Effective monitoring and evaluation process provides good information for decision
effective                           making and to identiff what is working and what is not. Independent Advisory
Committee challenges Planning and Management Committee on program focus
linked to outcome and impact performance.
Administrative Risks
Agreements between program partners  Lead Center and CRP4 management develop clear and simple agreements in
and reporting requirements are too  consultation with Consortium and Center leadership; and invest in effective and
complex and burdensome.             efficient monitoring and evaluation systems that perform and avoid duplication.
Support and administrative services are  Evaluate services provided by Lead or other key Centers for program support to
too costly and not effective,       enhance efficiency and effectiveness. Avoid duplication of services and rely on and
enhance existing capacity.
Funding Risks
Overall funding for program is      CRP4 management analyzes reasons for insufficient funding (e.g. problem with
insufficient to achieve goals,      donors: lack of interest, changing donor priorities; or problems with program (either
milestones, outputs and impacts     perceived from donor or real): poor performance, lack of relevance, poor
leadership, inefficiencies in use of funds, etc.); depending on source of problem,
specific measures are implemented to address them and to communicate with donor
to ensure that misperceptions are corrected as needed and that the relevance and
importance of the work for achieving the CGIAR goals is understood.
Allocation of funds across components .All four program components are necessary to achieve the overall goals of the
is unbalanced and prevents          program. CRP4 leadership and Planning and Management Committee will pro-
achievement of goals across the CRP.  actively engage with donors to explain the relevance and complementarity of all
Or funds to work and coordinate     four components of the program for the achievement of its goals and of the system-
research across components is       level outcomes of improving the health and nutrition of the poor through
insufficient,                       agriculture.
131


﻿13.1 Component 1: Value Chains for Enhanced Nutrition and Health
The diversity of partners assembled for this component represents a highly strategic opportunity for
interdisciplinary synergy and cross-sectoral ANH cooperation, and coordination ofjoint research
activities and partners will require careful attention. Close cooperation will be established with existing
international agricultural frameworks (such as GFAR, NEPAD, and ECOWAS/WAHO), as a way to
minimize such risks and to reinforce self-sustaining collaborative approaches.
13.2 Component 2: Biofortification
Biofortified crops are increasingly recognized as important new tools that will complement existing
nutrition interventions. Bringing a public health lens to the marketing of an agricultural commodity
presents unique opportunities for advocacy and for the diffusion of an agricultural innovation to serve
public health. Quick wins are possible in this area, in the form of readily visible results, even while
making a sustainable contribution to reducing malnutrition over large populations. Committed donors are
now investing at unprecedented levels toward food security.
This very welcome infusion of global interest merely reinforces the continuing substantial and
unwavering commitment of key donors to biofortification. Sustainable partnerships have been developed
(largely by CGIAR) across sectors and continents, with substantial research results. With the current
interest in linking agriculture to nutrition and public health, the time has arrived to build a strong platform
for developing and delivering nutritious staple crops that are relied on daily by the most nutritionally
vulnerable populations around the world.
The biofortification strategy is nevertheless not without risks and limitations. Anticipated risks
include the following:
*  Limitations on nutrient bioavailability, along with the presence of naturally existing
inhibitors, may reduce the absorption of minerals (in particular) and thus their impact on
human health.
*  Absent or weak commercial seed industries in target countries may fail to produce and
market biofortified seed and food products in sufficient amounts to ensure access by the poor
and undernourished.
*  Behavior change communications approaches may fail to educate the population regarding
the nutritional benefits of biofortified crops (especially if they are more expensive and/or
have distinguishable traits), reducing willingness to pay and incentive to consume.
*  Lack of political will, whether internal or external to the CGIAR, may mean failure to
prioritize nutrient content as a breeding objective.
0  Climatic extremes or other natural phenomena may interrupt or delay some activities or affect
the results (for example, the nutrient density of crops).
13.3 Component 3: Prevention and Control of Agriculture-Associated Diseases
New and transformational thinking is emerging in the field of health for development, as major players
increasingly recognize the need for multidisciplinary, multisectoral, integrated, and participatory
approaches. This component adopts a One Health/Ecohealth/multidisciplinary approach to address the
complex questions around food-borne, zoonotic, and other agricultural health problems. By bringing to
bear a socioeconomic and ecological understanding of the existing constraints to adopting technological
solutions, the component will identify opportunities for interventions that can realistically be evaluated,
implemented, and adapted contextually by partners. Nevertheless, while One Health multidisciplinary
approaches are conceptually attractive, they have proven difficult to operationalize, and there is a risk that
sectoral inertia may be difficult to overcome. CRP4 will develop tools to create and maintain incentives
for multisectoral approaches.
132


﻿13.4 Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies
CGIAR centers have well-established capacity and experience to work collectively with implementing
partners, providing a unique opportunity for research on implementation and delivery. Quick results are
possible by working with established programs with expertise in integrating AHN (summarized in Appendix
10). Several of these programs offer solid implementation on the ground, as well as strong capacity and
engagement of numerous partners; the CGIAR can play an important role in strengthening the design and
evaluation of such programs and in generating and documenting learning for replication, adaptation, and
scaling-up. These opportunities also feed into the policy level, generating significant learning about
approaches to improving health and nutrition outcomes through coordination with agriculture.
Linking research to implementation will require extensive investment in communication, dialogue,
information sharing, internal education, and advocacy. Developing generalizable findings across
agroecological zones will be complicated by the wide diversity of the target populations, with large
variations in food production, diets, cultures, degree of marginalization, and type and magnitude of
vulnerabilities. The main risk in this area is the possibility of insufficient funding: a failure to integrate
CRP4's findings and lessons for cross-sectoral collaboration would perpetuate the existing divisions
between program areas-leaving promising results partially developed and limited to their own subsectors.
133


﻿14. MONITORING AND EVALUATION SYSTEM PROPOSED
With support from the Program Management Unit, the CRP4 Director and the Management Team will
have the primary responsibility for designing the overall M&E framework of the CRP. They will also
coordinate and support the monitoring of progress by the research teams under each component and
subcomponent. The M&E framework will be used by all CRP4 research teams and cover the needs of all
CRP4 partners to report on program activities and outputs, track progress, and take corrective action as
needed, and to assess program influence on outcomes and impact. Monitoring and evaluation indicators
for tracking and assessing achievements will be constructed according to the SMART framework-
specific, measurable, achievable, relevant, and time-bound-allowing for clear, results-based
management of the CRP.
The overall CRP M&E system must fit within the overall Consortium M&E principles and
procedures, currently under development All M&E will be kept as simple and pragmatic as possible. Two
main objectives will underpin the M&E strategy. The first objective is to have a systematic process to
monitor performance in achieving milestones and outputs, both for the program overall and for each
participating institution and program component/subcomponent. The second objective will be to provide
indicators and lessons that can be used to support institutional and programmatic learning about what
makes research effective in achieving program outcomes and impacts. Approaches will be tailored to the
three key CRP4 impact pathways (value chains, programs, and policies). For all three pathways, the M&E
framework will be developed and implemented through close collaboration between the program
management unit and the research teams. Subcomponent 4.2 on Harmonized Policies will undertake
specific research to develop tools, methods, and indicators to assess, track, and document changes in
policy and institutional capacity for cross-sectoral ANH outcomes and impacts. These research outputs
will be incorporated and used for monitoring and evaluating CRP4.
In Year 1, a workshop of key partners and stakeholders will be convened to develop a detailed
M&E plan. This plan will be grounded in the overall impact pathway strategy and linked to the
partnership strategy, which will also be developed during the inception phase of the project. The overall
M&E plan will focus on monitoring and tracking key activities, outputs, and outcomes, as well as
partnership quality and performance in achieving outcomes and impacts. It will also focus on analyzing
how new knowledge and evidence, planned in early stages of the program, will inform subsequent
priority setting, program design, and institutional arrangements.
While the details of the M&E plan can be developed only within the overall Consortium's M&E
framework and must be linked to the development of detailed work plans with partners, some key M&E
principles and practices can be foreseen for each of the three impact pathways. Given the long road from
research for development activities to outcomes and impacts, CRP4 will pay attention to assessing impact
pathways and intermediate outputs and outcomes. Below are some key considerations that the CRP4
partnership will consider in developing its detailed M&E strategy and plans.
The advantage of the value-chain impact pathway is that a value-chain framework provides a
practical approach to identifying the key actors necessary for the value chain to perform. For CRP4,
overall value-chain performance will be monitored and evaluated largely through other partners (for
example, CRP3.7 for meat, milk, and fish), but CRP4 will have responsibility for value-chain
performance relative to nutritional quality and food safety. Understanding how to improve nutritional
quality and food safety requires understanding the behavior of consumers and other value-chain actors,
thinking through specific improvements at different steps of the value chain (breeding for more nutritious
foods, postharvest management, fortification of foods during processing and marketing by the private
sector), and assessing the capacity and performance of key actors responsible for these actions. In
collaboration with CRP2 and the commodity CRPs, CRP4 will evaluate nutrition and health within an
overall value-chain context with specific tools such as outcome mapping to assess how key actors are
changing. Also critical from the CRP4 perspective will be analysis of gender outcomes and impacts
through specific hypotheses developed. Value-chain impacts on poverty will also be a key M&E issue. In
134


﻿the year I M&E planning meetings, specific attention will be paid to the participation of and benefits for
poor people, because there is a danger that women and poor people can be disadvantaged by value-chain
development and concentration of power and decisionmaking.
For the program impact pathway, M&E principles and practices are relatively well developed for
program performance. CRP4 M&E efforts will rely on building on good M&E practices from
development implementers. In addition to this base level of M&E for programs, CRP4 will look at
pathways for change that involve the role of and benefits to women and children and indicators for
nutrition and health within the broader livelihood analysis usually employed. In year 1, CRP4 will
specifically engage with CRP1.3 and a subset of development implementers in ensuring that nutrition and
health theories of change and outcomes and impacts are explicitly included to improve current good M&E
practices. Given the importance of local capacity in programs, specific indicators of changes in
institutional capacity linked to outcomes and impacts will be included.
M&E for the policy impact pathway will be complex. CRP4 will rely largely on methods and
tools from CRP2. These joint activities are critical given that specific outcomes and impacts for nutrition
and health must be considered in the much broader context of agriculture, health, and social development
policy and investment. Specific M&E outcomes and impacts to be considered will include assessment of
institutional performance and arrangements for cross-sectoral decisionmaking. They will also include the
types of information, knowledge, and evidence needed for decisionmaking in a cross-sectoral context and
for communicating the benefits of nutrition and health improvements, particularly for the poor within
overall development and economic growth strategies. Some additional considerations that will be brought
into the detailed M&E planning and in establishing an overall CRP M&E system are found below.
14.1 Performance Monitoring
A monitoring and evaluation plan will be developed under each component and subcomponent. The plans
will provide a framework to track both the process of implementation and the attainment of interim
targets. They will include milestones for activities, outputs (such as publications, datasets, training
materials, and training activities), communication, dissemination, and networking (to ensure appropriate
uptake of project outcomes). Appendix 3 presents CRP4's preliminary performance indicators matrix, by
program component. The more detailed plan that will be designed during the first year of implementation
will include specific milestones and specify corrective actions to be taken if milestones are missed. As
well as tracking in real time CRP4 functioning to allow for flexible and adaptive management, these
milestones will provide the basis for retrospective evaluations of the use of project outputs and their
influence in subsequent years. Using the process-monitoring milestones, regular process evaluations of
program content and scope will be established for CRP4, including tracking quality of implementation
and partnership performance; these evaluations will show to what extent the program has been
implemented as planned and will identify strategic lessons for future management. Given the importance
of partnerships for the success of CRP4, social network analysis tools will be used to describe and
evaluate the science and development networks that emerge from the work of CRP4. The new CRP4
website, due to come online in time for the start of CRP operations, will provide a repository for all CRP4
outputs and allow researchers and CRP4 partners to track output milestones.
14.2 Ensuring Uptake: Translating Outputs into Outcomes
High-quality research outputs are not enough by themselves to achieve impact. They must be taken up
and used. The pathways to impact, however, are often long and complex; it is much easier to assess the
contribution of researchers to outcomes-how the intended clients of research have improved their
performance using research outputs. The outcome strategy of CRP4 will be guided by three key
objectives that define the relevance of research findings to decisionmaking: salience-findings are
relevant to the problems at hand; credibility-findings are authoritative and believable; and legitimacy-
findings are perceived as fair (Cash et al. 2002). Cash et al. also highlight the importance of boundary-
135


﻿spanning organizations that can link the providers and users of the information. While outcomes will be
beyond the control of the researchers, good program design can increase the likelihood that outputs are
translated into outcomes:
*  Increase salience by working with prospective research clients (such as governments and
NGOs) to identify the most relevant questions and problems to address.
*  Increase legitimacy by working with appropriate partners.
*  Increase awareness and credibility of the findings, and the likelihood the results will be
applied, by publicizing the project activities and research results in a variety of fora and
trusted media.
Researchers should also ensure that findings are published in a form and an outlet that is
accessible to the intended users. For example, if other researchers are the intended users, publications in a
prestigious scientific journal may be effective, but if government policymakers are the intended users,
policy briefs translated into appropriate languages are more important. CRP4 research projects will
therefore pay particular attention to publishing research results in outlets that will reach their intended
audience, either directly or through boundary-spanning organizations. While publication in high-impact
peer-reviewed journals will be prioritized, weight will also be given to other forms of publication and
outreach offering impact.
Each component of CRP4 will participate in monitoring uptake in its own area.
*  Within each component, and in consultation with the CRP4 scientific advisory committee,
key performance indicators will be identified for gauging the quality and quantity of outputs
and outcomes.
*  Components will be required to report not only on what was produced, but on measures of
uptake by different stakeholders; process approaches and indicators, such as outcome
mapping (Smutylo 2005) and participatory impact pathway assessment (Douthwaite et al.
2008), can document whether these strategies are increasing the likelihood of project
outcomes.
*  CRP4 will also use stakeholder feedback and surveys of knowledge, attitudes, and practices
(KAP) to provide indicators of outcomes and influence. Novel techniques such as NetMap
will be used to map the influence and uptake of outputs as well as stakeholder satisfaction
with deliverables.
*  Uptake logs and citation analysis in policy-relevant documents will document the influence
of research findings; episode studies will assist in understanding the forces, events, and
decisions relevant to policy changes (see Subcomponent 4.2: Harmonized Policies).
*  Qualitative analysis can be backed up by quantitative analysis of product usage statistics,
such as downloads and citations of publications, downloads and uses of databases and films
(including uses in student theses or training courses), and follow-up evaluations of training
courses or materials.
*  For a specific set of priority outcomes, a formal assessment will be conducted using a
standardized tool, such as the outcome reporting tool developed for the previous CGIAR
performance indicators.
14.3 Impact Assessment
The aims of impact assessment are (1) to enhance the success of CRP4 in achieving its stated goals, and
(2) to generate learning, by measuring the potential and actual effects of the project on the intended
beneficiaries, using tangible intermediate and final impact indicators. Both ex-ante and ex-post impact
assessment methods will be used, as shown in Table 24. Moving from outcomes to impacts requires
136


﻿triangulation among quantitative and qualitative methods to identify how research has influenced
performance along the three principle impact pathways-value chains, programs, and policies-and how
those changes have, in turn, affected the nutrition and health of target populations.
The detailed M&E plan developed in Year I will include a plan for impact assessments to be
conducted over a five-year period. In the initial three years of the program, important efforts will be
focused on collecting information and evidence to guide priority setting. Some ex-ante impact
assessments will be conducted in Year 3 based on this information, as part of a priority setting refresh.
Two to three ex-post impact evaluations will be undertaken each year beginning in Year 2. Initial ex-post
evaluations will be built on ongoing work by the CRP4 participating centers and will focus on
understanding the size, nature, and determinants of impacts. In Year 5 and beyond, ex-post impact
assessments of the program are envisioned, later to include policy and value-chain work initiated within
the CRP.
The ex-post assessment of impacts in CRP4 will be designed according to the impact pathway.
For value-chain impact pathways, value-chain analysis frameworks will be used, including a mix of
quantitative measures (such as income, quantity and nutrient content of products, level of nutrition and
food safety awareness and knowledge among key value-chain stakeholders, accessibility of nutrient-rich
and safe foods for the poor) and qualitative measures (participatory impact indicators, as well as value-
chain stakeholder coordination). For program impact pathways, ex-post studies will be planned with
implementing partners in conjunction with the program case studies selected in Subcomponent 4.1
(programs). Assessment relating to policy impact pathways will rely on the methods and tools designed
and used under Subcomponent 4.2 (Harmonized Policies). Policy changes will be documented as well as
policy processes and changes affecting key stakeholders. Three types of methods will be used.
1. Impact narratives can document cases where research has led to policy changes and impact on
the ground. These will be reported by project teams and independently verified through
interviews with key stakeholders to document the mechanisms through which research
contributed to changes.
2. Ex-post impact assessments can document the impact of a particular change in policy,
institutions, or markets on the ultimate objectives of improved nutrition and health. These
studies play an important role in documenting the value of policy-oriented research, as well as
in examining how the implementation of a policy affects the ultimate impact.
3. External reviews of the body of completed research work will assess its effect, as well as
provide lessons for other research on how to achieve impact. Within an agreed time frame,
regular external reviews of the entire CRP4 will be commissioned by the Independent
Evaluation Arrangement of the CGIAR on behalf ofthe Fund Council. These independent
evaluations will provide an external perspective on research relevance and performance, and
will serve as an important input into the periodic revision of the CRP.
137


﻿Table 24. M&E Plan: Elements, timing, and scope
2012        2013       2014       2015
Priority assessment                                  CRP                               CRP
Including some use of ex-ante impact assessment (IA) from
data and evidence in first 3 years
Performance monitoring - milestones (management and  CRP/C/SC    CRP/C/SC   CRP/C/SC   CRP/C/SC
program) at CRP level; outputs from
components/subcomponents and partner activities (self
reporting)
Annual Program Review (Science Advisory Panel)       CRP         CRP        CRP        CRP
Review would cover science focus and quality across all
components and subcomponents as well as management
issues
Outcome assessment - evaluated using a standard outcome  C/SC    C/SC       C/SC       C/SC
tool (for example, outcome reporting in previous CGIAR
performance indicator systems)
Partnership assessment - combining indicators for                CRP/C/SC              CRP/C/SC
partnership arrangements (based on outcome mapping.
(Smutylo 2005) and participatory impact pathway analysis
(Douthwaite et al. 2008) as well as partnership surveys.
Ex-post Impact assessment - a five-year plan for impact          C/SC       C/SC       C/SC
assessments will be developed in Year 1, with 2-3 ex-post
impact assessments conducted annually from Year 2.
External reviews (program and management)                                              CRP
Notes: CRP - overall CGIAR Research Program level. C/SC - focus is at the component level,
including within subcomponents where relevant.
138


﻿15. BUDGET
As described above, the impact potential for improving human nutrition and health through agricultural
interventions is enormous. CRP4 proposes a major scale-up of CGIAR efforts to this end. As a relatively
new area of CGIAR emphasis, it should be expected to grow relatively quickly once the key partnerships
and research programs are developed. Currently the major driver for funding allocations across the
program is the availability of restricted grants, which constitute 71 percent of the budget. As the program
evolves, Components 1, 3, and 4 will grow faster than Component 2 and will gradually contribute a
greater proportion of funding. The rate at which that happens will depend on the ability of the Fund
Council to provide the Consortium with resources for the overall CRP4 program and for targeted resource
mobilization for research areas identified as strategy gaps.
The indicative scale of CRP4 is reflected in the budget below, which projects $59M in activity for
2011, rising to $69M in 2013. This projection captures costs associated with collaboration among 10 CG
centers, the HarvestPlus Challenge Program, and a host of global partners. Personnel and partnership
costs represent 24 percent and 44 percent, respectively, of the total 2011 budget. A Budget is a best
estimate of the financial resources required to meet program objectives. In the original proposal, 2011
was considered to be Year 1. We acknowledge that with the passing of almost a year since the proposal
was submitted, it is more likely that the first year of the CRP will begin in January 2012 and therefore the
Year I Budget is likely to show an increase of 3% or 4%. The Financial Officers of the Lead Center and
other participating Centers are currently working together and with the Consortium to adjust budgets on a
line item basis for 2012. This approach was agreed upon at a meeting of all the CGIAR Center Finance
representatives held in Washington on September 16, 2011.
The overall program represents 6-7 percent of current CGIAR expenditures. Of this,
approximately 70 percent is for nutrition and 30 percent is for health.
One of the pillars of the CGIAR reform process is to provide greater assurance of longer-term and
sustainable funding. Donors contributing to the new Trust Fund are encouraged to contribute to Windows
I and 2 to maximize coordination and harmonization. While donors are strongly encouraged to channel
their resources through the fund, bilateral funding continues. In cases where such funding is provided, it
should be consistent with the agreed Strategy and Results Framework. The accompanying financial
projections assume that current bilateral funding will gradually be replaced by grants through the Fund.
Thus in 2011, $17M, or 29 percent of total funding, is assumed to be from the Fund. In 2013 CGIAR
Fund income is projected at $44M, or 63 percent of total funding. Component 2, Biofortification, includes
the HarvestPlus Challenge Program.
Budget figures are stated at conservative levels and do not include upside or overly optimistic
estimates. First-year budgets are based largely on financial data from each center's Medium-Term Plan
(MTP) on a full cost recovery basis and are comparable to 110 percent of actual expenditures for 2009.
This is, in fact, a modest base, given the increased interest in health and nutrition in the past two years
from stakeholders and donors as the scale of the issues is recognized. Years following the base year show
a modest cost increase of 8 percent in 2012 and 9 percent in 2013. Given the demand from stakeholders
and donors for these research topics, the budget illustrates a clear and achievable transition to a CRP
financing structure that supports a rapid deployment of CRP4 during 2011.
The accompanying tables provide a breakdown of costs on an overall program (Table 1) basis and
also by the five main components (Tables 2-4):
1. Nutrition-Sensitive Value Chains
2. Biofortification
3. Control of Agriculture-Associated Diseases
4. Programs and Policy
5. CRP Management
139


﻿15.1 Budgets for 2011
For all CRPs, 2011 is a year of transition, and at the time of submission we are in the second quarter.
Therefore, figures for 2011 include allocations made by participating Centers in their respective Board
approved Budgets for CRP4.
The proportions of funding by individual centers from CGIAR Consortium Funds and bilateral
sources varies significantly as shown in Table 5. In the case of the HarvestPlus Challenge Program almost
all of the funding is from bilateral sources and there is an allocation of $5.6M from the Consortium
Windows, which includes previous funding from the World Bank to the Challenge Program.
Only four centers have budgets in excess of $3M in 2011 for CRP4 (Bioversity $3.5M; CIAT
$4.OM; IFPRI $12.7M; and ILRI $9.7M).
15.1.1 Budget Analysis
As reflected in the table below, CRP4 partnership cost as a percentage of total operating costs is 47
percent compared to 16 percent for the CGIAR as a whole. The Biofortification component comprises 51
percent of the total CRP4 budget over the three-year period and 78 percent of total partnership cost.
HarvestPlus represents 69 percent of the Biofortification component budget, and its culture of extensive
collaboration is woven into CRP4's research activities, as evidenced by the sizable budget for
partnerships. CRP4's research agenda is highly participatory-engaging a wide mix of partners,
harnessing the expertise of CG centers, universities, local and international NGOs, and private companies.
The cost ratio of partner activity is significantly higher than personnel costs. This is indicative of the
commitment to an integrated, inclusive research solution that is aligned with the SRF objective of
strategic partnerships.
Other than office space (captured under operating expenses) to accommodate research staff,
policy research requires a relatively modest level of investment in property and equipment. Research
outputs are facilitated by information and knowledge management systems, thus computers and
information technology and services are the primary components of capital investments supporting policy
research. Table B I illustrates the low capital investments for IFPRI and CRP4 compared to the CGIAR,
which includes centers that conduct research requiring significant investment in infrastructure,
laboratories, and vehicles.
Table Bl: Budget categories for comparison
Description                                  CRP4    Biofortification CGIAR
(percent)
Personnel costs                                29          16         42
Partnership/Collaborators                      47         70          16
Operating expenses (including training & workshops)  19   11          30
Travel                                          4          3           7
Capital and other equipment for project         1          0           4
Total                                         100         100        100
15.1.2 Indirect Costs Institutional Overhead
The overall Institutional Overhead Budget of $22.9M over the three-year Budget is 13.6 percent of total
Direct Costs. This is an aggregation of the costs for each of the participating Centers calculated in
accordance with approved CGIAR Financial Guidelines. The rate includes 4 percent for pass-through
funds, the rate that has been used by CGIAR system-wide initiatives and Challenge Programs.
140


﻿15.2 Sources of Funding
For year one, assumed to be 2011, a total of $58.8M funding is budgeted of which $42M is from bilateral
sources; $25M is from bilateral sources for the Biofortification component, mainly from CIDA and the
Gates Foundation. In Years 2 and 3, assumed to be 2012 and 2013, there is an assumption that donors
supporting the Biofortification work will begin to shift their funding to the Consortium Windows 2 and 3.
The "rate of shift" is not possible to predict with any degree of accuracy. IFPRI, as designated
Lead Center for the CRP, has assembled the costs necessary to do the work, but cannot be expected to
predict with great accuracy the delineation of funding sources between Consortium Windows and
bilateral funding sources.
15.3 The Budget Cycle
Once the overall CRP has been approved, the Budget proposals for 2012 have to be further refined to
ensure that the full cost recovery principles embodied in CGIAR Financial Guideline Number 5 are
effectively made operational. As Lead Center, IFPRI has operated project-based full-cost absorption
principles for many years. The partner Centers are committed to following these principles and
identifying the appropriate cost drivers.
Detailed Budgets for 2012 will be prepared and evaluated by the Planning and Management
Committee in October 2011 to ensure that the CRP and the individual participating Centers achieve
Budget harmony for 2012.
Tables B3-B5 show the total costs by component by years 2011 to 2013, which in aggregate are
as shown below. The Biofortification line includes management costs of approximately $1.2M per year,
which would raise the total CRP Management line to $7.5M in total for three years or 4% of total costs.
$M           %
I Nutrition Sensitive Value Chains                      20        10%
2 Biofortification                                      97        51%
3 Control of Agriculture-Associated Diseases            40        21%
4 Programs and Policy                                   30         16%
Total Direct Research                                187         98%
CRP Management                                         4          2%
191       100%
141


﻿Table B2: Breakdown of costs on an overall program basis
Project Cost      000's
2011     2012     2013
Description                           Amount   Amount   Amount     Amount
group                                                            (US$)    (US$)    (US$)     (USS)
Personnel Cost                                            14,218   16,557   18,063
Travel                                                     1,944    2,146    2,365
Operating expenses                                         8,748    9,620   10,571
Training /Workshop                                        1,074    1,230     1,299   .
Partners / Collaborator / Consultancy Contracts          25,527   25,703   28,047
Capital and other equipment for project                     347      336      356
Contingency                                                 112      123      136
51,971   55,715   60,836     XIMAA
Institutional Overhead (as a %of Direct project cost)      6,829    7,694    8,355     22,879
Project Funding
2011     2012     2013    r      *
Description                           Amount   Amount   Am ou n t     dn
(US$)    (US$)    (USS)      IUSS)
Funding
CGIAR Fund                                                17,176   32,849   43,606
Current Restricted Donor Projects                        41,201    30,225   25,328
Other Income                                                423      336      257
15.4 Costs by Component and Year
The following Tables (B3-B5) provide a breakdown of costs by component for each year.
142


﻿Table B3: Breakdown of costs for five main components for 2011
Project Cost       000's                                                                      2011
Coniponont I      Cooponent   Corponent 3  Coniponent 4
co,tD-it.,N,,I.                                                                      Contiro of                     FP       T.,
g, o,i                     Dcc   t,r                                   Bo.fort,t-tr-i.~B          Pr, 9,   J      gn f  r!to
Personnel Cost                                          1,833         4,183        4,004         3,450         748
317           646          473           417          91
Train *
Partners/Collaborator/ConsultancyContracts
Capi.al and other equipnentfor project
Conngency
4   ,559     28,271        9   .997      7.985       1.158       *
Insttutiona IOwrhead (as a %of Direct project cost)      858         2,447        1,937         1,415         171     6,829
Project Funding
Funding
[CGIAR Fund                                              2,427         5,651        4,181         3,587       1,330
ICurrent Restricted Donor Projects                       2,860       24,951         7,656        5,735            -
1Other income                                              131          117            98           77            -
Table B4: Breakdown of costs for five main components for 2012
Project Cost       000's                                                                      2012
Component 1 Component 2    Conponent ,  Conrponent 4
Co't N                       -'   -                        Nutrition-                Control of                    CP
De                            c pto                      -er  t   1i o  Blofortific-tion  gcoulte-  Prog  n  and  rlana  ent  Tot
Fun din
Personnel Cost                                          2,433         4,753        4,869         3,723         778
Trvl375                                                  741           506          433           91
Operatinge)penses                                        1,230        2,795        3,535         1,916         1441
Training/IWorkshop                                        285          441           165          264           75
I    Partners / Collaborator /Cons ultancy Contracts          1,460       19,820         2,296        2,027         100
eapitalandotherequipmentforproject                        110           107           60            59            -
IniutionaOerhad (as a %ofDrect projectcost)       1,095        2,723        2,197         1,504 1
Rinding
_____CGLAR Fund                                              3,021        17,220       5,619          5,624        1,364
Fn Ing Current Restricted Donor Projects                      394         1,8             ,7           ,5
O0ther income                                              96           108           72            60-
143


﻿Table B5: Breakdown of costs for five main components for 2013
Project Cost      000's                                                                  2013
Component 1 Conm ponent 2 Component   Component 4
C-'t                     Dc    tonN,,t,it,.n-                                    C.nt,.l of                 CRP
o-                      De  cript,oon               nr,t,  ,I .  &o r-tificit-o   go  Ir   Prog, mn,  md  lnC Pn t Tots
csosocrated    Pole,y
PijcFni
Personnel Cost                                       2,695        5,478        5,137        3,943        809
Trvl424                                               858          538         455           91
Operating e  openses                                 1,337        3,326        3,723 2015               169
Training /2Workshop                                    297          476          177         272          755
N    Partners /Collaborator /Consultancy Contracts        1,590       21,831        2,406        2,-119       1 00
Capitalandoterequipmentforprject                      116     1     16          3           61          5
Contingency                                             37           40           41          193                      6
n5titut2onal8 Orhead1(a,a%of0rectproje8tcot)                  1,202        3,059        2,318       1,592         185     8354
Project Funding
Funding
JCGIAR Fund                                           4,193       23,932          7,061     6,991       1,429
CurrentRestricted Donor Projects                      3,441       11,152        7,295       3,440           -
10therlincome                                           65          101           47           44
Table 136 indicates the anticipated breakdown of funding for 2011 between the CGIAR Fund and
bilateral sources.
Table B6: Allocation of CRP4 Budget among participating Centers and funding sources ($000)
BIOVERSITY                         2,282         25                      1,1671                3,474  11,933      1,541     56%
CIAT                                           3,994                                           3,994     1,399    2,595     35%
CIP                                 433          559          88          516                  1,595     1,032     563      65%
HARVESTPLUS                                   20,493              ____                        20,493     1,500   18,993      7%
ICARDA                      _____906                              ____                           906      565      341      62%/
TCRAF                               546                                   182                    728      317,     411      44%/.
ICRISAT                             363          726         545          1821                  1,816    1,362     454      75%
TFPRI                               945        378          1,872       4,781        1,330    12,686     3,767    8,919     30%/
11TA                                528        1,084         563         481                   2,656     2,192     464      83%
ILRI                                                        7,722       1,930                  9,652     3,06     6,8       32%/
WORLDFISH                           320          80r         240          160                    800       42       758 ,    5%
144


﻿REFERENCES
Adak, G. K., S. M. Meakins, H. Yip, B. A. Lopman, and S. J. O'Brien. 2005. "Disease Risks from Foods,
England and Wales, 1996-2000." Emerging Infectious Diseases 11 (3): 365-372.
AgroSalud. 2011. "Combating Hidden Hunger in Latin America Biofortified Crops with Improved
Vitamin A, Essential Minerals, and Quality Protein: Final Report to the Canadian International
Development Agency. Cali, Colombia: International Center for Tropical Agriculture (CIAT).
Aguirre, A. A., and A. Gomez. 2009. "Essential Veterinary Education in Zoological and Wildlife
Medicine: A Global Perspective." Revue scientifique et technique 28 (2): 605-610.
Ahmed, A. U., R. Vargas Hill, L. C. Smith, D. M. Wiesmann, and T. Frankenberger. 2007. The World's
Most Deprived: Characteristics and Causes ofExtreme Poverty and Hunger. Washington, DC:
International Food Policy Research Institute.
Albalak, R., U. Ramakrishnan, A. D. Stein, F. Van der Haar, M. J. Haber, D. Schroeder, and R. Martorell.
2000. "Co-occurrence of Nutrition Problems in Honduran Children." Journal ofNutrition 130
(9): 2271-2273.
Alderman, H., L. Haddad, and C. Udry. 1996. Gender Differentials in Farm Productivity: Implications
for Household Efficiency and Agricultural Policy. Food Consumption and Nutrition Division
Discussion Paper 6. Washington, DC: International Food Policy Research Institute.
Alfnes, F., A. G. Guttormsen, G. Steine, and K. Kolstad. 2006. "Consumer's Willingness to Pay for the
Color of Salmon: A Choice Experiment with Real Economic Incentives." American Journal of
Agricultural Economics 88 (4): 1050-1061.
Arimond, M., D. Wiesmann, E. Becquey, A. Carriquiry, M. C. Daniels, M. Deitchler, N. Fanou-Fogny, et
al. 2010. "Simple Food Group Diversity Indicators Predict Micronutrient Adequacy of Women's
Diets in 5 Diverse, Resource-Poor Settings." Journal ofNutrition 140 (11): 2059S-2069S.
Arsenault, J. E., E. A. Yakes, M. B. Hossain, M. M. Islam, T. Ahmed, C. Hotz, B. Lewis, et al. 2010.
"The Current High Prevalence of Dietary Zinc Inadequacy among Children and Women in Rural
Bangladesh Could Be Substantially Ameliorated by Zinc Biofortification of Rice." Journal of
Nutrition 140 (9): 1681-1690.
Asaah, E., Z. Tchoundjeu, R. R. B. Leakey, B. Takousting, J. Njong, I. Edang. 2010. "Trees,
Agroforestry, and Multifunctional Agriculture in Cameroon." International Journal of
Agricultural Sustainability 9 (1): 110-119.
Atehnkeng, J., P. S. Ojiambo, T. Ikotun, R. A. Sikora, P. J. Cotty, and R. Bandyopadhyay. 2008.
"Evaluation of Atoxigenic Strains of Aspergillusflavus as Potential Biocontrol Agents for
Aflatoxin in Maize." Food Additives and Contaminants Part A 25 (10): 1264-1271.
Beebe, S., A. V. Gonzalez, and J. Rengifo. 2000. "Research on Trace Minerals in the Common Bean."
Food and Nutrition Bulletin 21 (4): 387-391.
Bennett, R., and J. Ijpelaar. 2005. "Updated Estimates of the Costs Associated with Thirty-Four Endemic
Livestock Diseases in Great Britain: A Note." Journal ofAgricultural Economics 56 (1): 135-
144.
Berti, P. R., J. Krasevec, and S. Fitzgerald. 2004. "A Review of the Effectiveness of Agriculture
Interventions in Improving Nutrition Outcomes." Public Health Nutrition 7 (5): 599-609.
Bharucha, Z., and J. Pretty. 2010. "The Roles and Values of Wild Foods in Agricultural Systems."
Philosophical Transactions of the Royal Society 365: 2913-2926.
145


﻿Bhutta, Z. A., T. Ahmed, R. E. Black, S. Cousens, K. Dewey, E. Giugliani, B. A Haider, et al. (for the
Maternal and Child Undernutrition Study Group). 2008. "What Works? Interventions for
Maternal and Child Undernutrition and Survival. Lancet 371 (9610): 417-440.
Birol, E., D. Roy, and M. Torero. 2010. How Safe Is My Food? Assessing the Effect of Information and
Credible Certification on Consumer Demand for Food Safety in Developing Countries.
Discussion Paper 01029. Washington, DC: International Food Policy Research Institute.
Black, R. E., L. H. Allen, Z. A. Bhutta, L. E. Caulfield, M. de Onis, M. Ezzati, Colin Mathers, et al. (for
the Maternal and Child Undernutrition Study Group). 2008. "Maternal and Child Undemutrition:
Global and Regional Exposures and Health Consequences." Lancet 371 (9608): 243-260.
Black, R. E., H. L Johnson, J. E Lawn, I. Rudan, D. G Bassani, P. Jha, H. Campbell, et al. 2010. "Global,
Regional, and National Causes of Child Mortality in 2008: A Systematic Analysis." Lancet 375
(9730): 1969-1987.
Boelee, E., and H. Madsen. 2006. Irrigation and Schistosomiasis in Africa: Ecological Aspects. Research
Report 99. Colombo, Sri Lanka: International Water Management Institute.
Bouis H. E, P. Eozenou, and A. Rahman. 2011. "Food Prices, Household Income, and Resource
Allocation: Socioeconomic Perspectives on Their Effects on Dietary Quality and Nutritional
Status." Food and Nutrition Bulletin 32 (1): S14-S23.
Brown, K. H. 2003. "Diarrhea and Malnutrition." Journal ofNutrition 133 (Supplement): 328-332.
Brown, R. L., Z. Y. Chen, T. E. Cleveland, and J. S. Russin. 1999. "Advances in the Development of
Host Resistance to Aflatoxin Contamination by Aspergillus flavus." Phytopathology (review) 89
(2): 113-117.
Bums, A., D. van der Mensbrugghe, and H. Timmer. 2008. "Evaluating the Economic Consequences of
Avian Influenza." Accessed May 6, 2011.
http://siteresources.worldbank.or,/INTTOPAVIFLU/Resources/EvaluatingAleconomics.pdf.
Cardwell, K. F., and S. H. Henry. 2004. "Risk of Exposure to and Mitigation of Effects of Aflatoxin on
Human Health: A West African Example." In Aflatoxin and Food Safety, edited by H. K. Abbas.
Boca Raton, Florida: Taylor & Francis Group.
Cash, D., W. Clark, F. Alcock, N. Dickson, N. Eckley, and J. Jager. 2002. Salience, Credibility,
Legitimacy, and Boundaries: Linking Research, Assessment, and Decision Making. Harvard
University Faculty Research Working Papers Series. Cambridge, MA, USA: John F. Kennedy
School of Government, Harvard University.
Clark, T. W. 2002. The Policy Process: A Practical Guide for Natural Resource Professionals. New
Haven, CT: Yale University Press.
Cole, D. 2006. "Occupational Health Hazards of Agriculture." In Understanding the Links between
Agriculture and Health for Food,Agriculture, and the Environment, edited by C. Hawkes and M.
T. Ruel. 2020 Vision Focus 13. Washington, DC: International Food Policy Research Institute.
Coote, C., K. Tomlins, J. Massingue, J. Okwadi, and A. Westby. 2011. Farmer, Trader, and Consumer
Decisionmaking: Toward Sustainable marketing of Orange-Fleshed Sweet Potato in Mozambique
and Uganda. Natural Resources Institute 2020 Conference Note 2. Washington, DC: International
Food Policy Research Institute.
Cotty, P. J., C. Probst, and R. Jaime-Garcia. 2008. "Etiology and Management of Aflatoxin
Contamination." In Mycotoxins: Detection Methods, Management, Public Health and
Agricultural Trade, edited by J. F. Leslie, R. Bandyopadhyay, and A. Visconti. Wallingford, UK:
CABI Publishing.
146


﻿Diabate, A., T. Baldet, F. Chandre, M. Akogbeto, T. R. Guiguemde, F. Darriet, C. Brengues, et al. 2002.
"The Role of Agricultural Use of Insecticides in Resistance to Pyrethroids in Anopheles gambiae
s.l. in Burkina Faso." American Journal of Tropical Medicine and Hygiene 67 (6): 617-622.
Diao, J. 2007. The Role ofAgriculture in Development: Implications for Sub-Saharan Africa.
Washington, DC: International Food Policy Research Institute.
Diuk-Wasser, M. A., M. B. Tour6, G. Dolo, M. Bagayoko, N. Sogoba, I. Sissoko, S. F. Traord, and C. E.
Taylor. 2006. "Effect of Rice Cultivation Patterns on Malaria Vector Abundance in Rice-
Growing Villages in Mali." American Journal of Tropical Medicine and Hygiene 76 (5): 869-
874.
Dohlman, E. 2004. Mycotoxin Regulations, Implications for International Agricultural Trade. Agriculture
Information Bulletin Number 789-6. Washington, DC: U.S. Department of Agriculture Economic
Research Service.
Douthwaite, B., S. Alvarez, G. Thiele, and R. Mackay. 2008. "Participatory Impact Pathways Analysis: A
Practical Method for Project Planning and Evaluation." boru.pbworks.com/f/PIPA-ILAC-Brief-
pre-print.doc; PIPA Wiki. The Participatory Impact Pathways Analysis Wiki.
http://impactpathways.pbwiki.com
Drechsel, P., C. A. Scott, L. Raschid-Sally, M. Redwood, and A. Bahri. 2010. Wastewater Irrigation and
Health: Assessing and Mitigating Risk in Low-Income Countries. London: Earthscan, with the
International Water Management Institute and the International Development Research Centre.
Ecker, D. J., R. Sampath, P. Willett, J. R. Wyatt, V. Samant, C. Massire, T. A. Hall, et al. 2005. "The
Microbial Rosetta Stone Database: A Compilation of Global and Emerging Infectious
Microorganisms and Bioterrorist Threat Agents." BMC Microbiology 25 (5): 19.
Erlanger, T. E., J. Keiser, M. Caldas De Castro, R. Bos, B. H. Singer, M. Tanner, and J. Utzinger. 2005.
"Effect of Water Resource Development and Management on Lymphatic filariasis, and Estimates
of Populations at Risk." American Journal of Tropical Medicine and Hygiene 73 (3): 523-533.
Fandohan, P., K. Hell, and W. F. 0. Marasas. 2008. "Food Processing to Reduce Mycotoxins in Africa."
In Mycotoxins: Detection Methods, Management, Public Health andAgricultural Trade, edited
by J. F. Leslie, R. Bandyopadhyay, and A. Visconti. Wallingford, UK: CABI Publishing.
Fanzo, J., and P. Pronyk. 2010. An Evaluation ofProgress toward the Millennium Development Goal
One-Hunger Target. Working Group on the MDGI Target. New York: UNDG.
FAO (Food and Agriculture Organization of the United Nations). 2002. "Improving National Animal-
Health Policies and Delivery Systems." In Improved Animal Health for Poverty Reduction and
Sustainable Livelihoods. Animal Production and Health Paper 153. Rome.
FAO (Food and Agriculture Organization of the United Nations). 2009a. The State ofFood Insecurity in
the World. Economic Crises-Impacts and Lessons Learned. Rome.
FAO (Food and Agriculture Organization of the United Nations). 2009b. FAOSTAT.
http://www.fao.orE/fileadmin/templates/ess/documents/food security statistics/FoodConsumptio
nFoodItems en.xls. Accessed July 2009.
FAO (Food and Agriculture Organization of the United Nations). 2010. The State ofFood Insecurity in
the World. Addressing Food Insecurity in Protracted Crises. Rome.
Gardner, C. A. C., L. L. Darrah, M. S. Zuber, and J. R. Wallin. 1987. "Genetic Control of Aflatoxin
Production in Maize." Plant Disease 71 (5): 426-429.
Garrett, J. 2008. "Improving Results for Nutrition: A Commentary on an Agenda and the Need for
Implementation Research." Journal ofNutrition 138 (3): 646-650.
147


﻿Gilbert, J., M. L. Lapar, F. Unger, and D. Grace. 2010. "The Most Important Zoonosis in the World."
Ecohealth Conference, August 18-20, London.
Gillespie, S. R. 2001. Strengthening Capacity to Improve Nutrition. Food Consumption and Nutrition
Division Discussion Paper 106. Washington, DC: International Food Policy Research Institute.
Gong, Y. Y., K. Cardwell, A. Hounsa, S. Egal, P. C. Turner, A. J. Hall, and C. P. Wild. 2002. "Dietary
Aflatoxin Exposure and Impaired Growth in Young Children from Benin and Togo: Cross-
Sectional Study." British Medical Journal 325 (1): 20-21.
Gong, Y., A. Hounsa, S. Egal, P. C. Turner, A. E. Sutcliffe, A. J. Hall, K. Cardwell, and C. P. Wild. 2004.
"Postweaning Exposure to Aflatoxin Results in Impaired Child Growth: A Longitudinal Study in
Benin, West Africa." Environmental Health Perspectives 112 (13): 1334-1338.
Gotor, E., and C. Irungu. 2010. "The Impact of Bioversity International's African Leafy Vegetables
Programme in Kenya." Impact Assessment and Project Appraisal 28 (1): 41-55.
Grace, D., A. Omore, T. Randolph, and H. 0. Mohammed. 2007. "Assuring the Safety of Animal Source
Products in Developing Countries-The Potential of Risk-Based Approaches." In Does Control
ofAnimal Infectious Risks Offer a New International Perspective?, edited by E. Camus, E.
Cardinale, C. Dalibard, D. Martinez, J. F. Renard, and F. Roger, 263-267. Proceedings of the
12th International Conference of the Association of Institutions of Tropical Veterinary Medicine,
Montpellier, France, August 20-22. Montpellier, France: CIRAD/AITVM.
Grace, D., T. Randolph, J. Olawoye, M. Dipelou, and E. Kang'ethe. 2008. "Participatory Risk
Assessment: A New Approach for Safer Food in Vulnerable African Communities." Development
in Practice 18 (4): 611-618.
Gunaratna, N. S., H. de Groote, P. Nestel, K. V. Pixley, and G. P. McCabe. 2009. "A Meta-Analysis of
Community-Based Studies on Quality Protein Maize." Food Policy 35 (3): 202-2 10.
Grure, G., A. Giuliani, and M. Smale. 2009. "Marketing Underutilized Plant Species for the Poor: A
Conceptual Framework." In A. Kontoleon, U. Pascual, and M. Smale, eds., Agrobiodiversity
Conservation and Economic Development. London and New York: Routledge.
Haas, J. D., J. L. Beard. L. E. Murray-Kolb, A. del Mundo, A. Felix, and G. Gregorio. 2005. "Iron-
Biofortified Rice Improves the Iron Stores of Non-Anemic Filipino Women" Journal of
Nutrition 135 (12): 2823-2830.
Hall, A. J., and C. P. Wild. 1994. "Epidemiology of Aflatoxin-Related Disease." In The Toxicology of
Aflatoxins: Human Health, Veterinary and Agricultural Significance, edited by D. A. Eaton and J.
D. Groopman, 233-258. San Diego: Academic Press.
Hallman, K. 2000. "Mother-Father Resources, Marriage Payments, and Girl-Boy Health in Rural
Bangladesh." Unpublished manuscript. International Food Policy Research Institute, Washington,
DC.
HarvestPlus. 2010. "Reaching and Engaging End Users (REU) with Orange Fleshed Sweet Potato (OFSP)
in East and Southern Africa." Final Report submitted to the Bill and Melinda Gates Foundation.
International Food Policy Research Institute, Washington, DC.
Hawkes, C., and M. T. Ruel. 2011. Value Chains for Nutrition. 2020 Conference Paper 4, Leveraging
agriculture for improved nutrition and health. Washington, DC: InternatiQnal Food Policy
Research Institute.
148


﻿Hell, K., P. Fandohan. R. Bandyopadhyay, K. Cardwell, S. Kiewnick, R. Sikora, and P. Cotty. 2008.
"Pre- and Postharvest Management of Aflatoxin in Maize." In Mycotoxins: Detection Methods,
Management, Public Health and Agricultural Trade, edited by J. F. Leslie, R. Bandyopadhyay,
and A. Visconti. Wallingford, UK: CABI Publishing.
Holbrook, C. C, B. Z. Guo, D. M. Wilson, and P. Timper. 2008. "The U.S. Breeding Program to Develop
Peanut with Drought Tolerance and Reduced Aflatoxin Contamination." Peanut Science 36 (1):
50-53.
Horowitz, J. K., and K. E. McConnell. 2002. "A Review of WTA/WTP Studies." Journal of
Environmental Economics and Management 44 (3): 426-47.
Horton, D., G. Prain, and G. Thiele. 2009. Perspectivies on Partnership: A Literature Review. Social
Sciences Working Paper 2009-3. Lima, Peru: International Potato Center.
Hotz, C., and B. McClafferty. 2007. "From Harvest to Health: Challenges for Developing Biofortified
Staple Foods and Determining Their Impact on Micronutrient Status." Food and Nutrition
Bulletin 28 (2, Supplement 1): S271-S279.
Hotz, C., C. Loechl, A. de Brauw, P. Eozenou, D. Gilligan, M. Moursi, B. Munhaua, P. van Jaarsveld, A.
Carriquiry, and J. V. Meenakshi. 2010. "A Large-Scale Intervention to Introduce Orange Sweet
Potato in Mozambique Reduces the Prevalence of Inadequate Vitamin A Intakes among Children
and Women." International Food Policy Research Institute, Washington, DC.
lannotti, L., K. Cunningham, and M. Ruel. 2009. "Diversifying into Healthy Diets: Homestead Food
Production in Bangladesh." In Millions Fed: Proven Successes in Agricultural Development,
edited by D. J. Spielman and R. Pandya-Lorch. Washington, DC: International Food Policy
Research Institute.
IARC (International Agency for Research on Cancer). 1993. Some Naturally Occurring Substances: Food
Items and Constituents, Heterocyclic Aromatic Amines and Mycotoxins. IARC Monographs on
the Evaluation of Carcinogenic Risk of Chemicals to Humans, vol. 56. Lyon, France.
IFPRI (International Food Policy Research Institute). 2011. 2020 Conference. New Delhi, February 10-
12. http://2020conference.ifpri.info.
ILO (International Labor Organization). 2000. Safety and Health in Agriculture. International Labor
Conference, 88th Session, Geneva, May 30-June 15.
IOM (Institute of Medicine). 1988. The Future of Public Health. Report of the Committee for the Study
of the Future of Public Health, Division of Health Care Services. Washington, DC: National
Academies Press.
IZiNCG (International Zinc Nutrition Consultative Group). 2004. "Assessment of the Risk of Zinc
Deficiency in Populations and Options for Its Control." Food and Nutrition Bulletin 25 (Supp. 2):
S91-S204.
Jabbar, M. A., D. Baker, and M. L. Fadiga, editors. 2010. Demand for Livestock Products in Developing
Countries with a Focus on Quality and Safety Attributes: Evidence from Case Studies. Research
Report 24. Nairobi, Kenya: International Livestock Research Institute.
Jiang, Y., P. E. Jolly, W. 0. Ellis, J.-S. Wang, T. D. Phillips, and J. H. Williams. 2005. "Aflatoxin BI
Albumin Adduct Levels and Cellular Immune Status in Ghanaians." International Immunology
17 (6): 807-814.
149


﻿Jolly, P., Y. Jiang, W. Ellis, R. Awuah, 0. Nnedu, T. Phillips, J. S. Wang, et al. 2006. "Determinants of
Aflatoxin Levels in Ghanaians: Sociodemographic Factors, Knowledge of Aflatoxin and Food
Handling and Consumption Practices." International Journal ofHygiene and Environmental
Health 209 (4): 345-358. Epub April 27, 2006.
Jones, H. 2011. A Guide to Monitoring and Evaluating Policy Influence. ODI Background Note. London:
Overseas Development Institute.
Jones, K. E., N. G. Patel, M. A. Levy, A. Storeygard, D. Balk, J. L. Gittleman, and P. Daszak. 2008.
"Global Trends in Emerging Infectious Diseases." Nature 451 (7181): 990-993.
Kdferstein, F. K. 2003. "Food Safety: The Fourth Pillar in the Strategy to Prevent Infant Diarrhoea."
Bulletin of the World Health Organization 81 (11): 842-843.
Kaitibie, S., A. Omore, K. Rich, B. Salasya, N. Hooton, D. Mwero, and P. Kristjanson. 2008. Influence
Pathways and Economic Impacts of Policy Change in the Kenyan Dairy Sector: The Role of
Smallholder Dairy Project. Research Report 15. Nairobi: International Livestock Research
Institute.
Kang'ethe, E., D. Grace, and T. Randolph. 2007. "Overview on Urban and Peri-Urban Agriculture:
Definition, Impacts on Human Health, Constraints and Policy Issues." East African Medical
Journal 84 (11 Suppl): S48-56.
Keiser, J., M. Caldas de Castro, M. F. Maltese, R. Bos, M. Tanner, B. H. Singer, and J. Utzinger. 2005a.
"Effect of Irrigation and Large Dams on the Burden of Malaria on a Global and Regional Scale."
American Journal of Tropical Medicine and Hygiene 72 (4): 392-406.
Keiser, J., M. F. Maltese, T. E. Erlanger, R. Bos, M. Tanner, B. H. Singer, and J. Utzinger. 2005b. "Effect
of Irrigated Rice Agriculture on Japanese Encephalitis, Including Challenges and Opportunities
for Integrated Vector Management." Acta Tropica 95 (1): 40-57.
Kimani, V. N., A. M. Ngonde, E. K. Kang'ethe, and M. W. Kiragu. 2007. "Gender, Perceptions and
Behaviour towards Health Risks Associated with Urban Dairy Farming in Dagoretti Division,
Nairobi, Kenya." East African Medical Journal 84 (11 Suppl.): S57-S64.
Kumar, S., B. Geletu, S. Ahmed, H. Nakkloul, and A. Sarker. 2010. "Genetic Improvement of Grass Pea
for Low Neurotoxin (ODAP) Content." Food and Chemical Toxicology. In press.
Leakey, R. R. B. 1999. "Potential for Novel Food Products from Agroforestry Trees." Food Chemistry 64
(1): 1-14.
Lebel, J. 2003. Health: An Ecosystem Approach (in focus). Ottawa: International Development Research
Centre.
Leksmono, C., J. Young, N. Hooton, H. Muriuki, and D. Romney. 2006. Informal Traders Lock Horns
with the Formal Milk Industry: The Role ofResearch in Pro-Poor Dairy Policy Shit in Kenya.
ODI Working Paper 266. London and Nairobi: Overseas Development Institute and International
Livestock Research Institute.
Leroy, J. L., M. Ruel, E. Verhofstadt, and D. Olney. 2008. The Micronutrient Impact ofMultisectoral
Programmes Focusing on Nutrition. Washington, DC: National Institute of Public Health (INSP)
and International Food Policy Research Institute.
Lindsay, J. A. 1997. "Chronic Sequelae of Food-Borne Disease." Emerging Infectious Diseases 3 (4):
443-452.
Liu, Y., and F. Wu. 2010. "Global Burden of Aflatoxin-Induced Hepatocellular Carcinoma: A Risk
Assessment." Environmental Health Perspectives 118 (6): 818-824.
150


﻿Loueiro, M. I. 2009. "Farmers' Health and Agricultural Productivity." Agricultural Economics 40 (4):
381-388.
Low, J. W., M. Arimond, N. Osman, B. Cunguara, F. Zano, and D. Tschirley. 2007. "A Food-Based
Approach Introducing Orange-Fleshed Sweet Potatoes Increased Vitamin A Intake and Serum
Retinol Concentrations in Young Children in Rural Mozambique." Journal ofNutrition 137 (5):
1320-1327.
Lynch, M., J. Painter, R. Woodruff, and C. Braden. 2006. "Surveillance for Food-Borne Disease
Outbreaks-United States, 1998-2002." Morbid Mortal Weekly Report Surveillance Summaries
55 (SS1O): 1-34.
Masters, W. A., and D. Sanogo. 2002. "Welfare Gains from Quality Certification of Infant Foods: Results
from a Market Experiment in Mali." American Journal ofAgricultural Economics 84 (4): 974-
989.
Maudlin, I., M. C. Eisler, and S. C. Welburn. 2009. "Neglected and Endemic Zoonoses." Philosophical
Transactions of the Royal Society ofLondon Series B (Biological Science) 364 (1530): 2777-
2787.
Mazur, R., H. K. Musoke, D. Nakimbugwe, and M. Ugen. 2011. Enhancing Nutritional Value and
Marketability ofBeans through Research and Strengthening Key Value-Chain Stakeholders in
Uganda. 2020 Conference Note 1. Washington, DC: International Food Policy Research Institute.
McCartney, M. P., E. Boelee, 0. Cofie, and C. M. Mutero. 2007. Minimizing the Negative Environmental
and Health Impacts ofAgricultural Water Resources Development in Sub-Saharan Africa.
Working Paper 117. Colombo: International Water Management Institute.
Menkir, A., R. L. Brown, R. Bandyopadhyay, Z. Chen, and T. E. Cleveland. 2008. "Breeding Maize for
Resistance to Mycotoxins at IITA." In Mycotoxins: Detection Methods, Management, Public
Health and Agricultural Trade, edited by J. F. Leslie, R. Bandyopadhyay, and A. Visconti.
Wallingford, UK: CABI Publishing.
MoFA (Ministry of Foreign Affairs of Denmark). 2010. Lessons Learned from Danida-Supported
Research for Health in Development: Eight Case Stories.
www.enrecahealth.dk/publications/enreca related publications/lessons learned.pdf/.
Negin, J., R. Remans, S. Karuti, and J. Fanzo. 2009. "Integrating a Broader Notion of Food Security and
Gender Empowerment into the African Green Revolution." Food Security 1 (3): 351-360.
Nestel, P., H. E. Bouis, J. V. Meenakshi, and W. Pfeiffer. 2006. "Biofortification of Staple Food Crops."
Journal of Nutrition 136 (4): 1064-1067.
Nuwayhid, I. A. 2004. "Occupational Health Research in Developing Countries: A Partner for Social
Justice." American Journal ofPublic Health 94 (11): 1916-1921.
Okike, A., D. Grace, and M. Hussni. 2010. "Assessment of Risks to Human Health Associated with Meat
in Nigeria." Unpublished report. Integrated Animal & Human Health Management Project.
Padulosi, S., et al. 2011. "Underutilized Species and Climate Change: Current Status and Outlook." In
Crop Adaptation to Climate Change. Wiley-Blackwell (in press).
Pelletier, D. L., E. A. Frongillo, S. Gervais, L. Hoey, P. Menon, T. Ngo, R. Stoltzfus, et al. 2011.
"Nutrition Agenda Setting, Policy Formulation, and Implementation: Lessons from The
Mainstreaming Nutrition Initiative." Health Policy and Planning 1-13.
Perry, B., and D. Grace. 2009. "The Impacts of Livestock Diseases and Their Control on Growth and
Development Processes That Are Pro-Poor." Philosophical Transactions of the Royal Society of
London B (Biological Science) 364 (1530): 2643-2655.
151


﻿Pfeiffer, W. H., and B. McClafferty. 2007. "Biofortification: Breeding Micronutrient-Dense Crops." In
Breeding Major Food Staples for the 21st Century, edited by M.S. Kang and P.M. Priyadarshan.
Oxford: Blackwell Scientific.
Plot, C. R., and K. Zeiler. 2005. "The Willingness to Pay-Willingness to Accept Gap, the 'Endowment
Effect,' Subject Misconceptions, and Experimental Procedures for Eliciting Valuations."
American Economic Review 95 (3): 530-545.
Quisumbing, A. R., ed. 2003. Household Decisions, Gender, and Development: A Synthesis ofRecent
Research. Washington, DC: International Food Policy Research Institute.
Roland-Holst, D., M. Epprecht, and J. Otte. 2008. External Shocks, Producer Risk, and Adjustment in
Smallholder Livestock Production: The Case ofHPAI in Viet Nam. FAO HPAI Research Brief
No. 4. Rome: Food and Agriculture Organization of the United Nations. .
Roos, N., A. Wahab, M. Hossain, and S. H. Thilsted. 2007. "Linking Human Nutrition and Fisheries:
Incorporating Micronutrient-Dense, Small Indigenous Fish Species in Carp Polyculture
Production in Bangladesh." Food and Nutrition Bulletin 28 (2): S280-S293.
Roth, F., J. Zinsstag, D. Orkhon, G. Chimed-Ochir, G. Hutton, 0. Cosivi, G. Carrin, and J. Otte. 2003.
"Human Health Benefits from Livestock Vaccination for Brucellosis: Case Study." Bulletin of the
World Health Organization 81 (12): 867-876.
Ruel, M. T. 2001. Can Food-Based Strategies Help Reduce Vitamin A and Iron Deficiencies? Food
Policy Review 5. Washington, DC: International Food Policy Research Institute.
Ruel, M. T. 2003. Diet Quality and Diet Changes of the Poor: A Global Research Program to Improve
Dietary Quality, Health, and Nutrition. Proposal for Global Regional Project on Diet Quality and
Diet Changes of the Poor (2003-2004). Washington, DC: International Food Policy Research
Institute.
Scharff, R. L. 2010. "Health-Related Costs from Foodborne Illness in the United States." The Produce
Safety Project at Georgetown University, Washington, DC.
<http://www.producesafetyproiect.org>.
Schelling, E., D. Grace, A. L. Willingham, and T. F. Randolph. 2007. "Which Research Approaches for
Pro-Poor Control of Zoonoses?" Food Nutrition Bulletin 28 (2): S345-S356.
Schlundt, J., H. Toyofuku, J. Jansen, and S. A. Herbst. 2004. "Emerging Food-Borne Zoonoses." Revue
Scientifique et Technique 23 (2): 513-533.
Shane, S. M. 1994. "Economic Issues Associated with Aflatoxins." In The Toxicology ofAflatoxins,
edited by D. L. Eaton and J. D. Groopman. San Diego: Academic Press, Inc.
Shea, K. M. 2003. "Antibiotic Resistance: What Is the Impact of Agricultural Uses of Antibiotics on
Children's Health?" Pediatrics 112 (1): 253-258.
Shiffman, J. 2007. "Generating Political Priority for Maternal Mortality Reduction in Five Developing
Countries." American Journal ofPublic Health 97 (5): 796-803.
Shiffman, J., and S. Smith. 2007. "Generation of Political Priority for Global Health Initiatives: A
Framework and Case Study of Maternal Mortality." The Lancet 370 (9595): 1370-1379.
Shogren, J., F. S. Cho, C. Koo, J. A. List, C. Park, P. Polo, and R. Wilhelmi. 2001. "Auction Mechanisms
and the Measurement of WTP and WTA." Resource and Energy Economics 23 (2): 97-109.
Shuaib, F. M., J. Ehiri, A. Abdullahi, J. H. Williams, and P. E. Jolly. 2010. "Reproductive Health Effects
of Aflatoxins: A Review of the Literature." Reproductive Toxicology 29 (3): 262-270.
152


﻿Smith, L. C., U. Ramakrishnan, A. Ndiaye, L. Haddad, and R. Martorell. 2002. The Importance of
Women's Status for Child Nutrition in Developing Countries. Research Report 131. Washington,
DC: International Food Policy Resarch Institute.
Smutylo, T. 2005. Outcome Mapping: A Method for Tracking Behavioural Changes in Development
Programs. ILAC Brief No. 7. Washington, DC: Institutional Learning and Change (ILAC)
Initiative, Consultative Group on International Agricultural Research (CGIAR).
http://www.idrc.ca/uploads/user-S/l 1235064481Brief-FINAL.pdf
Spear, J. D., and W. R. Fehr. 2007. "Genetic Improvement of Seedling Emergence of Soybean Lines with
Low Phytate." Crop Science 47: 1354-1360.
Spencer, P. S. 1995. "Lathyrism." In Handbook of Clinical Neurology, Intoxications of the Nervous
System, Part II, vol. 21, edited by F. A. De Wolff. Amsterdam: Elsevier.
Steinmann, P., J. Keiser, R. Bos, M. Tanner, and J. Utzinger. 2006. "Schistosomiasis and Water
Resources Development: Systematic Review, Meta-Analysis, and Estimates of People at Risk."
The Lancet Infectious Diseases 6 (7): 411-425.
Strosnider, H., E. Azziz-Baumgartner, M. Banziger, R. V. Bhat, R. Breiman, M.-N. Brune, K. DeCock, et
al. 2006. "Workgroup Report: Public Health Strategies for Reducing Aflatoxin Exposure in
Developing Countries." Environmental Health Perspectives 114 (12): 1898-903.
Taylor, L. H., S. M. Latham, and M. E. Woolhouse. 2001. "Risk Factors for Human Disease Emergence."
Philosophical Transactions of the Royal Society ofLondon, Series B, Biological Sciences 356
(1411): 983-989.
Tchoundjeu, Z., E. Asaah, P. 0. Anegbeh, A. Degrande, P. Mbile, C. Facheux, A. Tsobeng, et al. 2006.
"Putting Participatory Domestication into Practice in West and Central Africa." Forests, Trees
and Livelihoods 16 (1): 53-70.
Templeton, D., and N. Jamora. 2008. "Economic Assessment of a Change in Pesticide Regulatory Policy
in the Philippines." AARES 52nd Annual Conference, Canberra, Australia, February 5-8.
Thorns, C. J. 2000. "Bacterial Food-Borne Zoonoses." Revue Scientifique et Technique 19 (1): 226-239.
Townson, H., M. B. Nathan, M. Zaim, P. Guillet, L. Manga, R. Bos, and M. Kindhauser. 2005.
"Exploiting the Potential of Vector Control for Disease Prevention." Bulletin of the World Health
Organization 83 (12): 942-947.
Train, K., and W. W. Wilson. 2011. "Estimation on Stated-Preference Experiments Constructed from
Revealed Preference Choices." Transportation Research Part B, forthcoming.
Tshala-Katumbay, D., and P. S. Spencer. 2007. "Toxic Disorders of the Upper Motor Neuron System." In
Handbook of Clinical Neurology, Motor Neuron and Related Diseases, edited by A. Eisen and P.
Shaw. Edinburgh: Elsevier.
Ubosi, C. 0., W. B. Gross, P. B. Hamilton, M. Enrich, and P. B. Siegel. 1985. "Aflatoxin Effects in White
Leghorn Chickens Selected for Response to Sheep Erythrocyte Antigen. 2. Serological and Organ
Characteristics." Poultry Science 64 (6): 1071-1076.
UNEP (United Nations Environmental Programme). 2010. Water Quality Facts and Statistics. New York.
UNICEF (United Nations Children's Fund). 1990. Strategy for Improved Nutrition of Women and
Children in Developing Countries. A UNICEF policy review. New York.
UNSCN (United Nations Standing Committee on Nutrition). 2010. Sixth Report on the World Nutrition
Situation: Progress in Nutrition. Geneva.
153


﻿Unnevehr, L., and N. Hirschhorn. 2000. Food Safety Issues in the Developing World World Bank
Technical Paper No. 469. Washington, DC: World Bank.
Upadhyaya, H., C. Gowda, R. Pundir, V. Reddy, and S. Singh. 2006. "Development of a Core Subset of
Finger Millet Germplasm Using Geographical Origin and Data on 14 Quantitative Traits. Genetic
Resources and Crop Evolution 53 (4): 679-685.
van Jaarsveld, P. J., M. Faber, S. A. Tanumihardjo, P. Nestel, C. J. Lombard, andA. J. Spinnler Benadd.
2005. "B-Carotene-Rich Orange-Fleshed Sweet Potato Improves the Vitamin A Status of Primary
School Children Assessed with the Modified-Relative-Dose-Response Test." American Journal
of Clinical Nutrition 81 (5): 1080-1087.
Waliyar, F., P. L. Kumar, A. Traore, B. R. Ntare, B. Diarra, and 0. Kodio. 2008a. "Pre- and Postharvest
Management of Aflatoxin Contamination in Peanuts." In Mycotoxins: Detection Methods,
Management, Public Health and Agricultural Trade, edited by J. F. Leslie, R. Bandyopadhyay,
and A. Visconti. Wallingford, UK: CABI Publishing.
Waliyar, F., S. V. Reddy, K. Subramanyam, T. Y. Reddy, K. Ramadevi, P. Q. Craufurd, and T. R.
Wheeler. 2003. "Importance of Mycotoxins in Food and Feed in India." Aspects ofApplied
Biology 68: 147-154.
Waliyar, F., M. Siambi, R. Jones, S. V. Reddy, D. Chibongo, P. L. Kumar, and S. Denloye. 2008b.
"Institutionalizing Mycotoxin Testing in Africa." In Mycotoxins: Detection Methods,
Management, Public Health and Agricultural Trade, edited by J. F. Leslie, R. Bandyopadhyay,
and A. Visconti. Wallingford, UK: CABI Publishing.
Waltner-Toews, D. 2009. "Eco-Health: A Primer for Veterinarians." Canadian Veterinary Journal 50 (5):
519-521.
WHO (World Health Organization). 2004. Comparative Quantification ofHealth Risks: Global and
Regional Burden of Disease Attributable to Selected Major Risk Factors. Geneva.
WHO (World Health Organization). 2007. Buruli Ulcer Disease (Mycobacterium ulcerans infection). Fact
Sheet 1999. Geneva.
WHO (World Health Organization). 2008a. Worldwide Prevalence ofAnaemia 1993-2005: WHO Global
Database on Anaemia. Geneva.
WHO (World Health Organization). 2008b. The Global Burden ofDisease: 2004 Update. Geneva.
WHO (World Health Organization). 2009. Global Prevalence of Vitamin A Deficiency in Populations at
Risk 1995-2005: WHO Global Database on Vitamin A Deficiency. Geneva.
Williams, J. H., T. D. Phillips, P. E. Jolly, J. K. Stiles, C. M. Jolly, and D. Aggarwal. 2004. "Human
Aflatoxicosis in Developing Countries: A Review of Toxicology, Exposure, Potential Health
Consequences, and Interventions." American Journal of Clinical Nutrition 80 (5): 1106-1122.
World Bank. 2001. Engendering Development through Gender Equality in Rights, Resources, and Voice.
World Bank Policy Research Report. Management 1: Report No. 36546-MW. Washington, DC.
World Bank. 2006. Repositioning Nutrition as Central for Development. Washington, DC.
World Bank. 2007. From Agriculture to Nutrition: Pathways Synergies and Outcomes. Washington, DC.
World Bank. 2008. Evaluating the Economic Consequences of*Avian Influenza. Washington, DC.
World Bank. 2009. Peespectivas para la Economia Mundial 2008. Washington, DC.
World Bank. 2010. People, Pathogens, and Our Planet: Volume One: Toward a One Health Approach
for Controlling Zoonotic Diseases. Report Number 50833. Washington, DC.
154


﻿Zapata-Caldas, E., G. Hyman, H. Pach6n, F. A. Monserrate, and L. Vesga Varela. 2009. "Identifying
Candidate Sites for Crop Biofortification in Latin America: Case Studies in Colombia, Nicaragua,
and Bolivia." International Journal ofHealth Geographics 8 (1): 29.
155


﻿Appendixes
156


﻿APPENDIX 1. GLOSSARY OF TERMS AT THE AGRICULTURE, NUTRITION, AND
HEALTH INTERFACE
Acute malnutrition (wasting): Low weight-for-height, defined as more than 2 standard deviations below
the mean of the sex-specific reference data. Severe acute malnutrition is defined as weight-for-height
more than 3 standard deviations below the mean.
Agricultural intensification: The cultivation of land using higher levels of inputs, such as labor,
chemicals, or technologies, to obtain the maximum output.
Agriculture-associated disease: Any disease related to agricultural production or agrifood value chains
can be considered agriculture associated. Such diseases may be associated with agricultural inputs,
primary agricultural production, postharvest processing and handling along marketing chains, or even
final preparation by the consumer. The category also includes diseases influenced by ecosystem change
(for example, large dams) for food production and those associated with incursion of agroecosystems into
self-regulating systems that do not involve much human interference or manipulation (for example,
harvesting wildlife) called natural ecosystems.
Agroecosystem: (agricultural ecosystem): An agroecosystem is an ecological system modified by
people to produce plants, animals, fiber, or other agricultural products.
Anemia: The condition of having a concentration of hemoglobin in the blood below a specified cutoff
point because of a lack of iron or other factors. WHO defines anemia as a hemoglobin concentration
<1 Og/l at sea level for children under five years of age and pregnant women.
Animal source foods: Any food iten that comes from an animal source such as meat, fish, milk and
dairy products, and eggs. This category includes foods derived from fish, other aquatic animals, and
wildlife.
Bioavailability: The degree to which the amount of an ingested nutrient is absorbed and available to the
body.
Biofortification: A method of increasing the nutritional value of food crops as they are grown, either
through conventional selective breeding methods or through genetic engineering.
Biological control: The control of a pest by the introduction of a natural enemy or predator.
Biomarker: A naturally occurring molecule, gene, or characteristic by which a particular pathological or
physiological process or disease can be identified.
Body mass index (BMI): A measure of a person's weight in relation to their height, calculated by the
weight (in kilos) divided by the square of height (in meters). The desirable range is BMI 20-25; <18.5 is
considered underweight, >25 is overweight, and >30 is obese.
Burden of disease: This is the impact of a given health problem. The impact on human health may be
measured in terms of morbidity, mortality, or disability-adjusted life years (DALYs), which capture both
years lived with illness (morbidity) and death (mortality). Human and animal diseases also have direct
and indirect economic costs and impacts as well as impacts with nonmarket values (such as biodiversity
loss).
157


﻿Calories: Short for kilocalories, a unit of food energy. One calorie represents the amount of energy
required to raise the temperature of a liter of water by one degree centigrade at sea level. The common
usage of the word calorie is understood to refer to a kilocalorie and therefore actually represents 1,000
true calories of energy.
Chronic malnutrition (stunting): Low height-for-age, defined as more than 2 standard deviations below
the mean of the sex-specific reference data. Stunting is the cumulative effect of long-term deficits in food
intake, poor caring practices, and illness and is largely irreversible after two years of age.
Complementary feeding practices: A set of 10 recommended practices that mothers and/or caregivers
should implement from 6 to 24 months, the weaning period, at which point breastmilk and/or breastmilk
substitutes alone are no longer sufficient to meet the nutritional needs of growing infants.
Complementary food: Any food, whether manufactured or locally prepared, suitable as a complement to
breastmilk or to infant formula, when either becomes insufficient to satisfy the nutritional requirements of
the infant around the time of weaning.
Cost-benefit analysis: An economic assessment that sums all the costs and all the benefits associated
with an option using a common metric (usually money).
Cost-effectiveness analysis: This is the most commonly used method for performing economic analyses
in healthcare, because of the difficulty of assigning monetary values to health benefits. It sums all the
costs in a common monetary value and all the benefits in physical units.
Competitive exclusion technology: Forcing an undesirable species from a habitat by the introduction of
a more efficient species that outcompetes it and does not have the undesirable effects. It is used in
aflatoxin control and for control of gastrointestinal pathogens in livestock.
Dietary diversity: The number of unique foods or food groups consumed over a given period of time.
Dietary diversity is one of several dimensions of dietary quality. It can be measured at the individual or
the household level.
Dietary quality: There is no universal definition of dietary quality. Traditionally, however, dietary
quality has been conceptualized as a measure of nutrient adequacy. Nutrient adequacy, in turn, refers to a
diet that meets requirements for energy and all essential nutrients. More recently, the concern regarding
overnutrition and excess intake of certain nutrients and foods has led to a global shift in the definition of
dietary quality to include both concepts of nutrient deficiency and overnutrition. This shift has led to the
incorporation of concepts of diversity, proportionality (for example, balanced diets), and moderation (for
example, avoiding excess intake of certain nutrients/foods) in measures of dietary quality.
Disease control: A reduction in the incidence, prevalence, morbidity, or mortality of an infectious disease
to a locally acceptable level. This is distinguished from disease elimination (a reduction to zero of the
incidence of disease or infection in a defined geographical area) and disease eradication (permanent
reduction to zero of the worldwide incidence of infection).
Ecohealth: Systemic, participatory approaches to understanding and promoting health and well-being in
the context of social and ecological interactions. It is increasingly aligned with One Health.
Emerging disease: A disease that has been newly identified, has newly increased in incidence,
geography, or host range, or is newly evolved. Emerging infectious diseases are emerging diseases caused
by infectious agents.
158


﻿Endemic disease: The constant presence of a disease or infectious agent within a given geographic area
or population; it may also refer to the usual prevalence of a given disease within such area or population.
Energy: Expressed in joules (J), but often used interchangeably with calories.
Epidemic: The occurrence of more cases of disease than expected in a given area or among a specific
group of people or animals over a particular period of time.
Epidemiology: The study of health in populations (human, animal, or plant) and the application of this
study to control health problems (see also definition of Health).
Evidence-based: A term originally applied to clinical medical practice and extended to public health,
policy, management, and other fields. It implies the systematic search, appraisal, and use of the most
current and valid research findings for decisionmaking.
Exclusive breastfeeding (EBF): The feeding of an infant only with breastmilk from his or her mother or
a wet nurse, or expressed breast milk, and no other liquids or solids except vitamins, mineral
supplements, or medicines in drop or syrup form.
Foodborne illness/disease: Disease, usually either infectious or toxic in nature, caused by agents that
enter the body through the ingestion of food.
Food security: Food security exists when all people, at all times, have physical and economic access to
sufficient, safe, and nutritional food to meet their dietary needs and food preferences for an active and
healthy life. Food security is often disaggregated into the three pillars of food availability, food access,
and food utilization/consumption, along with stability of these over time. Food insecurity exists when
these conditions are not met.
Hazard: In food safety terminology, a hazard is anything that can cause illness or injury. Food hazards
are categorized as microbiological (for example, bacteria, parasites), chemical (for example, antibiotic
residues, toxins), or physical (for example, glass shards).
Health: Commonly used to express freedom from illness, injury, or pain, health is defined by the World
Health Organization (WHO) as "a state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity."
Hunger: A prolonged involuntary lack of food, normally due to lack of economic resources with which
to access food. There are different manifestations and consequences of hunger, which include
undernourishment, undernutrition. wasting, and in extreme cases, death.
Incidence: The number of people or animals in a given population who newly develop a disease or
health-related condition within a given period of time. (See also Prevalence).
Informal markets: Informal markets in agriculture may refer to (1) markets where many actors are not
licensed and do not pay tax (for example, street foods, backyard poultry); (2) markets where traditional
processing, products, and retail practices predominate (for example, wet markets, milk hawkers); or (3)
markets that escape effective health and safety regulation (most domestic food markets in developing
countries).
159


﻿Integrated disease control: This term may be applied to human, animal, or plant disease. It usually
implies the combination of multiple strategies to control disease. Sometimes it refers to merging of
different sectors or disciplines to control disease.
Infant and young child feeding (IYCF) practices: A set of specific recommendations regarding optimal
infant and young child feeding practices to ensure the best infant and young child growth and nutritional
status, covering best practices in breastfeeding and complementary feeding.
Iron deficiency: The most common nutritional deficiency in the world, insufficient iron in the body,
normally due to inadequate consumption of bioavailable iron. Iron deficiency, which can lead to anemia,
can also result from high blood losses or from an increase in iron requirements due to infection,
pregnancy, rapid growth, dietary habits, or any combination of these.
Iron deficiency anemia (IDA): The condition in which the body does not have enough healthy red blood
cells because of a deficiency of iron. Women and young children are the most vulnerable to IDA, which
has a range of harmful health implications.
Malnutrition: A broad term for poor nutritional status caused by deficiency or excess of calories or
nutrients (undernutrition or overnutrition).
Micronutrient(s): Vitamins and minerals needed by the body in small amounts to perform myriad
physiological functions. Although the amounts needed are small, the consequences of their absence are
severe. Iodine, vitamin A, iron, and zinc are the most important in public health terms; deficiency of these
micronutrients represents a major threat to the health and development of populations worldwide,
particularly children and pregnant women in low-income countries.
Micronutrient deficiency(ies): A consequence of the lack of access and/or consumption of
micronutrient-rich foods such as fruits, vegetables, animal products, and fortified foods. Micronutrient
deficiencies increase the risk of morbidity and mortality. More than 2 billion people in the world are
estimated to be deficient in the key vitamins and minerals iodine, vitamin A, iron, and zinc.
Mycotoxins: Naturally occurring chemicals (toxins) produced by molds that contaminate staple foods,
feeds, and animal source foods in most of the humid tropics. They cause acute poisoning as well as
contributing to chronic diseases in people and animals (including fish). There are many types of
mycotoxins: aflatoxins, ochratoxins, and fusarium toxins are considered of worldwide importance.
Neglected disease: Diseases that are prevalent among impoverished and marginalized populations in the
developing world and for which health research and interventions are inadequate to needs. There is no
standard listing, but most include sleeping sickness and cysticercosis, along with other zoonoses.
Nutrient density: A ratio derived by dividing a food's contribution to nutrient needs by its contribution
to energy (calorie) needs. When the contribution to nutrient needs exceeds the energy contribution, the
food is considered to have a favorable nutrient density.
Nutrition security: Sustained access to the basic elements of good nutrition: a balanced and adequate
diet, clean water, adequate health care and environment, and the knowledge needed to care for and ensure
a healthy and active life for all household members.
Nutritious: Nutritious (or "nutrient-rich") foods are defined in this proposal as foods high in essential
nutrients, including animal source foods (fish, meat, eggs, and dairy products), fruits and vegetables,
biofortified staples, fortified foods, and traditional local crops sourced from biodiverse systems (including
160


﻿neglected and underutilized species and wild foods). Specialized processed and/or fortified foods for
populations with special needs (acutely malnourished children, people living with HIV/AIDS, infants) are
also included in nutrient-rich (or nutritious) foods.
Obesity: A condition characterized by excess body fat, typically defined as a body mass index (BMI,
equal to weight (kg)/height (M)2) of 30 or more.
One Health: This is the collaborative effort of multiple disciplines to attain optimal health for people,
animals, and the environment.
Overnutrition: A state in which nutritional intake of either nutrients or calories exceeds nutritional need.
Overnutrition can also relate to the coexistence of excessive intake of certain nutrients (for example,
energy, certain types of fat, and carbohydrates) and deficits in some micronutrients (such as iron).
Overnutrition manifests itself as overweight (BMI>25) and obesity (BMI>30) and as vitamin or mineral
overloads. In children, overnutrition is defined-as weight for height >85t percentile (85h to 95h percentile
is overweight, and over 95h percentile is obese).
Pandemic: A disease occurring over a wide geographic area and affecting an exceptionally high
proportion of the population.
Participatory methods: Research and/or development approaches that emphasize local knowledge and
action. The application of participatory methods to epidemiology has been termed participatory
epidemiology; similar neologisms are participatory disease surveillance and participatory risk assessment.
Pathogen detection platform: A system or technology that allows the detection of disease-causing
agents.
Prevalence: The number (or proportion) of people or animals in a given population who have a disease or
health-related condition at a given point of time. (See also Incidence).
Quantitative comparative risk assessment: The process of comparing and ranking various types of risks
through providing a numerical estimate of each risk in order to identify priorities and influence resource
allocations.
Quantitative microbial risk assessment: Risk assessment that provides numerical expressions of risk
associated with a microbial hazard and indication of the attendant uncertainties.
Risk: This is defined differently in different disciplines. In epidemiology, risk is the probability of
developing an outcome in a specified period of time among subjects receiving a treatment or exposed to a
risk factor. Financial risk is the chance that an investment's return will be higher or lower than expected.
In development literature, risk is potential for loss or injury. In food safety risk analysis, risk is the
probability that a substance or situation will produce harm to human health under specified conditions and
is a combination of the likelihood of an event occurring and the magnitude of harm produced if it does.
Risk analysis: This is a structured approach for dealing with risk with three essential elements: risk
assessment (systematic evaluation of hazards and their possible effects); risk management (evaluating and
selecting responses to risk); and risk communication (exchange of information, opinions, and concerns
about risk among stakeholders).
Risk assessment: see Risk analysis.
161


﻿Risk factor: A characteristic or aspect that is statistically associated with an increased occurrence of
disease or other health-related event or condition. The association may not be causal.
Randomized controlled trial (RCT): A study in which subjects (people or animals) are allocated at
random (by chance alone) to receive one of several interventions. Well-designed and implemented RCTs
are considered the most effective way of evaluating an intervention. Developed in medical research, this
approach is increasingly applied to other fields.
Severe acute malnutrition (SAM): See Acute malnutrition (wasting).
Stunting (chronic malnutrition): See Chronic malnutrition (stunting).
Surveillance: Systematic and ongoing collection of information on disease or other health-related events
that can then be analyzed to guide disease prevention and control.
Undernourished (or undernourishment): A person whose estimated or usual food consumption,
expressed in terms of dietary energy (kcal), is below the energy requirement norm. The prevalence of
undernourishment in a specified population is sometimes used as a measure of food deprivation or
hunger.
Undernutrition: Poor nutritional status due to deficiencies in calories and/or nutrients. Manifestations of
undernutrition include abnormally low anthropometric measures such as stunting (short stature), wasting
(low weight-for-height), or underweight (low weight), clinical manifestations of undernutrition (such as
kwashiorkor or marasmus), or low levels of essential vitamins or minerals measured either through
clinical signs or biomarkers. Low or insufficient intakes of nutrients or micronutrient inadequacy of the
diet are also sometimes used to predict or define undernutrition.
Underweight: Low weight-for-age, defined as more than 2 standard deviations below the mean of the
sex-specific reference data.
Value chain: A series of activities and actors within an industry or sector, from producing a primary
product through processing to taking it to market and consumption, normally accompanied by an increase
in value as the product moves along the value chain. The value-chain framework is a tool for strategic
planning and for development.
Vitamin A deficiency (VAD): A condition resulting from low intake (or absorption) of vitamin A that
results in depletion of stores and increased susceptibility to infections. It is a leading cause of childhood
blindness and of nightblindness in adults and children.
Wasting (acute malnutrition): See Acute malnutrition (wasting).
Wet market: A term mainly used in Asia referring to a markets that sells readily perishable foods such as
meat, fish, and fruits and vegetables. It often sells live animals including poultry, fish, and wildlife.
Zoonosis: Any infectious disease that can be naturally transmitted from animals to humans, including
diseases transmitted via insect vectors. The term "reverse zoonosis" refers to transmission from humans
to animals.
Z-score: The deviation of an individual's data point from the median value of a reference population,
divided by the standard deviation of the reference.
162


﻿APPENDIX 2. COUNTRIES WITH CHILD STUNTING PREVALENCE ? 20% AND
NATIONAL COMMITMENTS TO GLOBAL NUTRITION INITIATIVES
Stunting      Stunting
Country'                                    (%)         (millions)'     SUNb         REACH'         FtFd
Africa
Angola                                     50.8         1,511
Burkina Faso                               43.1         1,060           X
Burundi                                    63.1          837
Cameroon                                   35.4          868
C6te dIvoire                               31.1          863
Democratic Rep of the Congo                44.4         4,977
Ethiopia                                   57.4         7,498           X                           X
Ghana                                      35.6         1,104           X             X             X
Kenya                                      35.8         2,054                                       X
Madagascar                                 55.5         1,724
Malawi                                     54.6         1,278           X                           X
Mali                                       42.7         1,111           X             X             X
Mozambique                                 47.0         1,547           X             X             X
Niger                                      54.2         1,545           X
Nigeria                                    43.0         9,571
South Africa                               30.9         1,616
Sudan                                      47.6         2,483
Tanzania                                   48.3         2,920           X             X             X
Uganda                                     44.8         2,675           X             X             X
Zambia                                     52.5         1,056           X                           X
Latin America / Caribbean
Guatemala                                  59.9         1,210           X                           X
Peru                                       31.3          938            X
Middle East / North Africa
Egypt                                      20.3         1,813
Iraq                                       28.3         1,223
Turkey                                     20.5         1,479
Yemen                                      59.3         2,175
South Asia
Afghanistan                                53.6         2,967
Bangladesh                                 50.5         8,787           X             X             X
India                                      51.0         61,206
Nepal                                      57.1         2,078           X             X             X
Pakistan                                   41.5         8,763
Southeast Asia
Cambodia                                   49.1          901                                        X
Indonesia                                  45.3         9,772
Myanmar                                    40.6         1,891
Philippines                                37.8         3,730
Viet Nam                                   42.4         3,375
Sources and notes:
a Black et al. 2008. These 36 countries together account for 90 percent of all stunted children in the world.
b http://www.unscn.org/en/scaling up nutrition sun/. Scaling-Up Nutrition (SUN) is a movement that supports country efforts to
reduce undernutrition, as a response to the continuing high levels of undernutrition in our world and the uneven progress towards
the Millennium Development Goal to halve poverty and hunger by the year 2015. The SUN movement stimulates leaders to
focus on nutrition and commit to effective national policies; it increases the effectiveness of existing programs by encouraging
their alignment with these policies; and it supports the participation of a wide range of stakeholders in supporting policy
implementation that leads to broad ownership and a shared responsibility for results. Since the movement was launched in
September 2010, a total of 20 Governments from across the world have committed to scaling up nutrition. These countries are:
Bangladesh, Benin Burkina Faso, Ethiopia, The Gambia, Ghana, Guatemala, LAO PDR, Malawi, Mali, Mauritania,
Mozambique, Nepal, Niger, Peru, Senegal, Tanzania, Uganda, Zambia, Zimbabwe.
' http://www.reach-partnership.org/aboutreach/whatdoesreachdeliver. REACH is a global partnership committed to meeting the
nutrition needs of the world's most vulnerable children and women through evidenced based analysis and innovative, country-led
programming to link child undernutrition, food security, health, and care in a sustainable package that builds government
institutional capacity, strengthens policy planning skills and prioritizes scarce resources. REACH is currently being implemented
in Sierra Leone, Ghana, Mali, Bangladesh, Nepal, Mozambique, Rwanda, Tanzania, Uganda, Lao PDR and Mauritania.
(continued)
163


﻿d http://www.feedthefuture.gov/countries.html . Feed the Future is a United States Government initiative that supports country
driven approaches to address the root causes of hunger and poverty, working alongside development partners to support country-
owned processes through which countries develop and implement food security investment plans that reflect their needs,
priorities, and development strategies.
Feed the Future focus countries are:
Ethiopia              Ghana                 Liberia              Keny                  Malawi
Mali                  Mozambique           Rwanda                Senegal              Tanzania
Uganda                Zambia               Banyladesh            Cambodia              Negg
Honduras              Guatemala            Nicaragua
164


﻿APPENDIX 3. CRP4 CGIAR PERFORMANCE INDICATORS MATRIX
Date: October 2011
CRP No: 4
CRP Name: Agriculture for Improved Nutrition and Health
Lead Center: lFPRI
Participating CGIAR Centers: ILRI, Bioversity, CIAT, CIMMYT, CIP, ICARDA, ICRAF, ICRISAT, IITA, IWMI, World Fish
Number of Years: 5
CRP Start Date: January 1, 2012
1. Research Outputs                                                       _TINDICATORS AND METRICS
Component 1: Value Chains for Enhanced Nutrition
Data and evidence published on food consumption patterns, availability, access, use and  Number of countries where work has started/is ongoing
processing of nutritious foods; information on dynamics of food purchases, own-production,  Number of publications (peer-reviewed journals, briefs, other communication
sales of nutrient-rich foods, market access and overall nutrient gaps (in Senegal, Uganda,  material) released and disseminated
Mozambique, and 4-5 other countries/contexts)                                   Number of datasets documented and made available online
(Measured yearly through performance monitoring)
Database on nutritional value of lesser known and local foods (if work on biodiversity is  Database produced, released, disseminated and made available on website
included)                                                                       (Measured yearly through performance monitoring)
Methods and tools to generate this type of evidence tested and well-documented  Methods and tools documented in report/publication, available on website
(Measured yearly through performance monitoring)
Data and evidence published regarding poor consumers' knowledge, awareness, and  Number of countries where work has started/is ongoing
knowledge gaps related to diverse diets and nutritious foods; preferred sources of-and  Number of publications (peer-reviewed journals, briefs, other communication
channels for-information on nutrition and health; and food preparation and storage methods  material) released and disseminated
(in Senegal, Uganda, Mozambique, and 4-5 other contexts/countries)              Number of datasets documented and made available online
(Measured yearly through performance monitoring)
Tools to assess, and data on poor consumers' willingness to pay for nutritious foods and  Number of countries where work has started/is ongoing
preferences (types, format) of these foods                                      Methods and tools documented in report/publication, available on website
Number of publications (peer-reviewed journals, briefs, other communication
material) released and disseminated
Number of datasets documented and made available online
(Measured yearly through performance monitoring)
Tools to increase poor consumers' awareness and promote consumption of nutritious foods  Number of countries where behavior change strategies to promote consumption
developed, tested, and evaluated; nutrition interventions identified and prioritized for research  of nutritious foods have been developed, tested, evaluated
under this component                                                            Number of publications (peer-reviewed journals, briefs, other communication
material) describing tools and impact findings
(Measuredyearly through performance monitoring)
(continued)
165


﻿Portfolio of information, education, and communication materials developed and available  Number of countries where materials are available
Number and types of materials available
(Measured yearly through performance monitoring)
Published evidence from 5-8 value chains of the feasibility of leveraging value chains to  Number of publications documenting experience leveraging value chains to
improve access to nutritious foods by the poor                                     improve access to nutritious foods
(Measured yearly through performance monitoring)
Top performing technologies identified and tested to enhance nutrition along the value chain  Number of countries/value chains with documented technologies to enhance
for target nutritious foods                                                        nutrition along the value chain for nutritious foods
(Measured yearly through performance monitoring)
Published evidence from at least 5 contexts of impact and cost-effectiveness of leveraging  Number of countries where impact and cost-effectiveness of value chain for
value chains to improve access to nutritious foods (supply) by the poor and to stimulate  nutrition interventions was assessed
demand for such foods through successful behavior change communications strategies  Number of publications (peer-reviewed journals, briefs, other communication
(demand)                                                                           material) released and disseminated
Number of presentations/dissemination of results given in a variety of
conference/workshop venues internationally and nationally
Number of datasets documented and made available online
(Measured yearly through performance monitoring)
Component 2: Biofortification
2.1 HarvestPlus
Improved lines of 7 biofortified parents introduced in the product pathway       Number of biofortified varieties submitted to varietal release committees by
Zinc rice for Bangladesh and India                                             NARES in indicated counties.
Zinc wheat for India and Pakistan
Provitamin A maize for Zambia
Provitamin A cassava for Nigeria and DRC
Iron pearl millet for India
Iron-rich beans for Rwanda and DRC
Provitamin A OFSP for Uganda and Mozambique
Published evidence that micronutrients in HarvestPlus crops are bioavailable and that the  Number of publications by HarvestPlus collaborators by discipline (e.g., human
crops are efficacious in improving micronutrient status (for targeted micronutrients) in  nutrition, plant science, economics) and frequency that these publications are
humans                                                                           cited by others
Biofortified crops rich in bioavailable nutrients that will overcome losses during storage,  Estimated increase in intakes of iron, zinc, and provitamin A that is derived
processing, and cooking are available on the market and/or available to poor farmers via  from:
public seed distribution systems                                                      (i)   Measured differential in iron, zinc, and provitamin A content
between currently grown (non-biofortified) varieties and the
released varieties
(ii)  Estimated retention and bioavailability of iron, zinc, and
provitamin A of released varieties
Estimated per capita consumption of biofortifed staple
2.2 AgroSalud
Proven nutritionally and agronomically improved rice, beans, cassava, maize, and sweet  Number of cultivars released
potato cultivars released                                                         (Measured yearly through performance monitoring)
(continued)
166


﻿Analysis tool to target biofortification activities in countries made available online  Tool produced and made available on website
(Measured yearly through performance monitoring)
Biofortified crops and commercially prepared biofortified food products distributed in urban  Number of vendors selling crops and food products
centers                                                                          (Measured yearly through performance monitoring)
Evidence published from quantitative evaluations of the socioeconomic and nutritional  Number of publications produced
impacts of 2+ combinations of biofortified crops and food products               (Measured yearly through performance monitoring)
Diverse communication modules produced and disseminated through different media   Number of modules produced and disseminated
(Measured yearly through performance monitoring)
Information generated on the benefits and costs to farmers and consumers of biofortification  Number of documents produced and disseminated
I (Measured yearly through performance monitoring)
Component 3: Prevention and Control of Agriculture-Associated Diseases
Prioritization of AAD and understanding of their systems context
Descriptive analysis of priority problems in systems context (e.v. value chain analysis, rsk  Number of countries where value chain mapping, risk mapping, and
maps, current control strategies for mycotoxins, key food-borne disease and zoonoses)  compilations of current control strategies for food hazards is taking place
Number of food value chains mapped
Number of commodity-specific food safety risk maps generated
Number of agro-ecosystems where zoonoses are described and priority zoonoses
identified
Conceptual framework and metrics for assessing the relative burdens (health, economics, and  Number of discussion papers on concept and potential utility of metrics for
other impacts) of AAD to guide prioritization                                      multiple disease burdens and guidelines for developing metrics available
online
Number of presentations and publications on conceptual framework of metrics
Number of partners involved in development of metrics
Assessment of the multiple burden of target AAD in specific contexts and of the relative risk  Number of target AAD for which multiple burden assessments conducted
amenable to agriculture-based interventions                                      Number of peer-reviewed publications of multiple burden assessments
Number of diseases for which agriculture-based intervention likely to be useful
based on epidemiological assessment
Risk and socioeconomic assessment of high initial priority AAD
New diagnostic, detection, and surveillance technologies and methods developed for initial  Number of diagnostic platforms in place
high priority AAD                                                                Diagnostic platform performance indicators (sample throughput and cost)
Comprehensive and integrated health risk and socioeconomic assessment for high initial  Number of detailed, integrated risk and economic assessments conducted with
priority AAD identifying critical control points and control options               recommendations for control
Number of peer-reviewed publications of integrated risk and economic
assessments
Number of policy and delivery partners involved in integrated assessment and
their level of satisfaction with the products
Number of priority AAD for which surveillance and control options based on
epidemiology and risk factor studies
I Number of new diagnostics for priority AAD developed
(continued)
167


﻿Innovation and risk management for AAD
Strategies to deliver innovations (technological, organizational and social) have been  Number of countries with mycotoxin bio-control programs in place
developed, tested and supported to better prevent and manage AAD                Number of value chains with market-based solution to food safety strategies in
High priority initial strategies: biocontrol for aflatoxins; market-based approaches to  place
managing food safety in informal domestic markets; modeling approaches to assess  Mathematical model for emerging infectious disease
emerging disease management options (RVF); control of cysticercosis in the pig value  Control strategy for cysticercosis in the smallholder value chain in Uganda
chain in Uganda
Other strategies: to be developed based on prioritization, and integrated risk and socio-
economic assessments
One Health collaborations for integrated, multi-disciplinary management of high initial  Number of countries with One Health/EcoHealth collaborations for tackling
priority zoonoses and food-borne diseases established                               AAD
Number of partners from different disciplines engaged in these partnerships
Assessment of costs and benefits of EcoHealth/One Health approaches in
management of zoonotic and emerging disease based in CGIAR projects
currently using EcoHealth projects
Health, social, and economic impact assessments of the risk management innovations  Number of rigorous evaluations of effectiveness, affordability, acceptability, and
developed                                                                         sustainability of high priority initial strategies
Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies
4.1 Integrated Programs
A set of tools, methods. and indicators (gender-disaggregated) to inform the design and  Number of methodological tools, documents/reports/publications describing the
targeting of integrated ANH programs; to assess and improve implementation; to identify and  tools, methods, and indicators developed by CRP4 for: design/targeting of
measure program impact pathways; and to evaluate impact and cost-effectiveness of   ANH; assessment of program implementation; measurement of program
multisectoral ANH programs                                                          impact and impact pathways, and cost-effectiveness
Number of such tools available on line
(Measured yearly through performance monitoring)
A set of simple tools for use by program implementers to conduct rapid assessments,  Guidelines on simple tools published and disseminated in workshops
monitoring, or simple impact evaluation of ANH programs on key indicators         (Measured yearly through performance monitoring)
A body of published evidence from rigorous evaluations in 5-6 different contexts of benefits  Number of publications (peer-reviewed journals, briefs, other communication
and cost-effectiveness ANH programs on health and nutrition (Burkina Faso, Uganda,  material) released and disseminated
Mozambique, Zambia, and 2-3 additional ones, possibly Nepal, Bangladesh, and fish systems  Number of datasets documented and made available online
in Zambia) disseminated to relevant stakeholders, and used for advocacy           Number of presentations/dissemination of results at a variety of
conference/workshop venues internationally, nationally, and locally
(Measured yearly through performance monitoring)
Rich information generated on constraints to replication, scaling-up, and sustainability of  Number of publications (peer-reviewed joumals, briefs, other communication
integrated ANH programs and on ways to address these constraints                    material) released and disseminated
Number of datasets documented and made available online
Number of presentations/dissemination of results at a variety of
conference/workshop venues internationally, nationally, and locally
(Measured yearly through performance monitoring)
(continued)
168


﻿4.2 Harmonized Policies
An annually updated and relevant evidence base from an agricultural and cross-sectoral  Number of publications summarizing cross-sectoral experience in policymaking
perspective, which adds value to ongoing initiatives by supporting better investments in  (Measured yearly through performance monitoring)
integrated planning across agriculture, nutrition, and health
A community of practice of ANH specialists in information systems established      Community of Practice created and active (measured by number and types of
interactions and initiatives)
(Measured yearly through performance monitoring)
Evidence on trends in funding and quality of human resources in ANH                Data on trends in funding, number, and quality of human resources in ANH
research
(Measured through one-time assessment)
New metrics and benchmarks to relate and measure agriculture, health, and nutrition research  Inventory of methods, tools, and indicators developed for research and
evaluation of agriculture, health, and nutrition programs and policies
(Measured through one-time assessment)
Evidence on good practices in engaging policymakers and decisionmakers for cross-sectoral,  Number of publications summarizing good practices and case studies of success
including identification of immediate and low-cost steps to greater integration (and barriers to  in cross-sectoral engagement in decisionmaking
this), and charting of directions for long-term improvement                        (Measured yearly through performance monitoring)
Capacity for cross-sectoral policy research and decisionmaking assessed, comparable cross-  Number of country data sets generated on capacity and training needs, and
country data on capacity generated, training need identified at national level, and investment  investment plans
plans for capacity strengthening identified                                        (Measured yearly through performance monitoring)
2. Research Outcomes                                                                          INDICATORS AND METRICS
Component 1: Value Chains for Enhanced Nutrition
Outcome 1.1 Data and evidence generated by CRP4 to measure food consumption patterns,  Number of countries that have implemented innovative behavior change
constraints to access to nutritious foods, consumers' knowledge, awareness and knowledge  strategies to improve demand for-and supply of-nutritious foods (among
gaps related to diverse diets and nutritious foods, preferred sources of information on nutrition  target countries and other high-burden countries), scale and coverage of such
and health, and food preparation and storage methods are used by program implementers,  initiatives in target countries
development practitioners, researchers to design effective strategies to improve demand for  (Measured through regular outcome monitoring in target countries; and
nutritious foods and tailor supply of attractive nutritious foods for targeted populations (in  through one-time assessment in other high-burden countries)
Senegal, Uganda, Mozambique, and 4-5 other contexts)
Outcome 1.2 Tools and materials developed to measure poor consumers' willingness to pay  Number of program implementers and development practitioners using the tools
for nutritious foods and preferences (types, format) of these foods are widely used by private  developed by CRP4 to measure willingness to pay for nutritious foods in  *
sector, NGOs, governments, and consumers to increase consumer awareness and stimulate  context of value chains for nutritious foods: I) in target countries; 2) in other
demand for nutritious foods by the poor                                              countries
Number of value-chain actors that request collaboration with-or assistance
from-CRP4 to use or adapt tools
(Measured through regular outcome monitoring in target countries; and
through one-time assessment in other high-burden countries)
(continued)
169


﻿Outcome 1.3 Tools and technologies developed to enhance nutrition along the value chain are  Number of value chains in target countries and in other high-burden countries
used by a variety of value-chain actors from both the public and private sector     that adopt tools and technologies developed by CRP4 to enhance nutrition
along the value chain in both public and private sector
Number of value-chain actors that request collaboration with, assistance from, or
collaboration with CRP4 to use or adapt tools
(Measured through regular outcome monitoring in target countries; and
through one-time assessment in other high-burden countries)
Outcome 1.4 Evidence of the feasibility of enhancing nutrition along the value chain  Number of value chains that adopt CRP4 tools and technologies to incorporate
motivates use of methods, tools, and technologies by different stakeholders for new value  nutrition new value chains (in target countries and other high-burden
chains                                                                              countries)
(Measured through regular outcome monitoring in target countries; and
through one-time assessment in other high-burden countries)
Outcome 1.5 Evidence generated regarding the impact and cost-effectiveness of enhancing  Significant shift in investment patterns among donors and governments in value
nutrition through value chains in at least 5 different contexts leads to greater investments in  chain for nutrition work; increases in numbers and diversity of value chains
value chains and behavior change communication to improve nutrition, and to the widespread  that incorporate nutrition goals and interventions in their work
use of the tools and methods developed by a large number of stakeholders.         (Measured through one-time global review and assessment)
Component 2: Biofortification
2.1 HarvestPlus
Outcome 2.1.1 New nutritious crops are made available to NARES and implementing partners  Number of advanced breeding lines made available to NARES from Centers and
in Africa and Asia                                                                number of releases of biofortifed crops by varietal release committees after
submission by NARES
Outcome 2.1.2 HarvestPlus crops that are assured to deliver nutritional benefits are available  Marketed volume of bioforitfied crops
and accessible to the consumers
Outcome 2.1.3 Nutrition and health communities support the dissemination and consumption  Number of nutrition and health institutions working in collaboration with
of biofortified foods                                                              HarvestPlus
Outcome 2.1.4 Delivery programs to ensure farmer adoption and consumer acceptance of  Number of seed packets distributed, level of media activities to advertise
biofortified crops are scaled up                                                   benefits of biofortifed crops
Outcome 2.1.5 Farmers and consumers have access to new varieties of nutrient-dense food  Number of farm households adopting production of biofortified crops
crops and consume them regularly                                                   Area planted to biofortified crops by adopting farm households
Increases in intakes of iron, zinc, and pro-vitamin A by adopting farm
households and consumers who buy bioforified foods in markets
Improvements in micronutrient status (as measured through blood indicators)
due to consumption of biofortified foods
Improvement in functional outcomes (e.g., work capacity and cognition) due to
improvement in micronutrient status
2.2 AgroSalud
Outcome 2.2.1 Iron-, zinc-, provitamin A- and amino acid-biofortified cultivars are made  Number of cultivars commercially released
available to consumers                                                             Number of entities (private, public) distributing seed
(Measured through regular outcome monitoring in target countries)
Outcome 2.2.2 Informed geographic targeting of biofortification activities is undertaken  Tool for geographic targeting available on line
Number of downloads of tool
(continued) (Measured through regular outcome monitoring in target countries)
(continued)
170


﻿Outcome 2.2.3 Seed production and dissemination systems are strengthened         Number of trainings offered to seed producers (farmers' groups, extensionists,
private sector)
Number of individuals trained in seed production
(Measured through regular outcome monitoring in target countries)
Outcome 2.2.4 Nutrition and health communities support the dissemination and consumption  Number of biofortification fora held with nutrition and health agencies
of biofortified foods                                                            Number of countries where biofortification is integrated into national health,
nutrition, or food security plans
(Measured through regular outcome monitoring in target countries)
Outcome 2.2.5 Delivery programs to ensure farmer adoption and consumer acceptance are  Number of delivery programs, with NGOs, government, UN agencies, and
scaled up                                                                          others in place
(Measured through regular outcome monitoring in target countries)
Proportion of farmers reporting adoption or pre-adoption of cultivars
Proportion of consumers reporting organoleptic acceptance of cultivars
(Measured through one-time assessment in target countries)
Outcome 2.2.6 Access to and consumption of biofortified cultivars and food products among  Number of urban vendors selling crops and food products
urban consumers increased                                                         (Measured through regular outcome monitoring in target countries)
Outcome 2.2.7 Demand for biofortified crops and food products by informed farmers,  Number of requests for biofortified seed, biofortified ingredients, and
consumers, extentionists, health professionals, and decisionmakers increased       biofortified food products received by partners
(Measured through regular outcome monitoring in target countries)
Component 3: Prevention and Control of Agricgltore-Associated Diseases
Outcomne 3.1: Prioritisation ofPAAD and understanding their systems context      Number of policy/decisionmakers aware of multiple disease burden assessments
Evidence generated by CRP4.3 improving the understanding by decisionmakers and     and convinced by their results increase in awareness of priority zoonoses by
implementers of the relative and absolute importance of AAD and the role of agriculture-  all stakeholders in agro-ecosystems in which zoonoses assessed
based interventions in their management                                        Number of instances of change in resource allocation by donors, researchers,
Multiple disease burden metrics and assessments developed and supported by CRP4.3 being  policy and programs that can be credibly linked to CRP4.3 dissemination and
used to inform prioritization and resource allocation for research, and health and agriculture  advocacy of disease prioritization and metrics
policies and programs                                                          Wider use of tools and guidelines assessed by number of users and satisfaction
Outcome 3.2: Integrated health risk and socioeconomic assessment conducted for key AAD  Number of policydecisionmakers aware of health integrated health risk and
Integrated health risk and socioeconomic assessment supported by CRP4.3 being used by  socioeconomic assessments and recommendations conducted by CRP4.3 and
public and private sector for strategies for the effective, equitable (including gender  convinced by their results; number of instances that these assessments lead to
equitable) and sustainable control of AAD                                        changes in risk management
New surveillance options and diagnostics developed by CRP4.3 being used          Number of surveillance options and diagnostics in use and number of people
benefiting from these
(continued)
171


﻿Outcome 3.3: Innovation and risk management for AAD                               Number of multidisciplinary integrated disease control activities that CRP4 is
Policies, programs, and private sector (both informal and formal) adapt and scale up CRP4.3  actively involved in and/or use CRP4 research; number of value chains
research outputs into integrated disease control for agriculture-associated disease with  adopting CRP4 research outputs,-number of impact assessments that show
CRP4.3 support                                                                    CRP4 technical, methodological, organizational and social innovations are
Increased capacity and skills for prevention and control of AAD at all levels (communities,  being used to better control and prevent AAD and indicating number of
programs, decisionmakers)                                                         people reached and cost/benefit
Number of researchers, students, practitioners, and others working on AAD
trained (gender disaggregated) number of people reached by community-
capacity building using methods developed by CRP4 and out-scaled by other
actors number of donors, policymakers, and other decisionmakers aware of
CRP4 research outputs and report using them in decisionmaking
Component 4: Integrated Agriculture, Nutrition, and Health Programs and Policies
4.1 Integrated Programs
Better designed and targeted integrated ANH program models, monitoring, and evaluation  Number of well-integrated ANH programs (and their approximate coverage)
tools (including tools to measure quality of program implementation, impact, and cost-  implemented in target countries and other high burden countries
effectiveness) and indicators are used by partners (NGOs, governments, international  (Mleasured through regular outcome monitoring in target countries; and
organizations, researchers)                                                       through one-time assessment in other high-burden countries)
ANH  program implementers (including governments, nongovernmental organizations, and  Number of program implementers and development actors who use CRP4 tools
other development implementers) use the set of simple tools developed to assess     to monitor and evaluate their ANH programs
implementation and impact of their programs on key indicators                      (Measured through regular outcome monitoring in target countries; and
through one-time assessment in other high-burden countries)
Evidence of impact and cost-effectiveness of ANH programs is used to stimulate investments  Change in level of investments in ANH programs in target countries and
in ANH programs                                                                     globally
(Measured through desk review and interviews with key donors, government
representatives, NGOs, and other development actors)
Increased knowledge and commitment to sustained investments in a new generation of  Same as above
integrated ANH programs
Lessons learned are used to address constraints and to successfully scale-up and replicate  Number of ANH programs that have gone to scale or have been replicated in
successful and sustainable ANH programs                                             other settings/countries
(Measured through interviews with program implementeTfrom key Ncurs and
government representatives in target and other high-burden countries)
Greater investments in national policies and global initiatives integrating agriculture, nutrition,  Number of countries that have health, nutrition, food security, poverty, or other
and health programs                                                                  policies that effectively integrate agriculture, nutrition, health
(Measured using data from monitoring ofthe Scaling Up nutrition (SUN)
movement, REACH, WHO landscape analysis, and other global initiatives with
which CRP4 has direct links)
Capacity developed at program level to use tools to assess and scale up ANH programs  Number of programs using tools developed by CRP4 to evaluate, replicate, and
scale up their ANH programs
(Measured through interviews with program implementers from key NGOs and
government representatives in target and other high-burden countries)
(continued)
172


﻿Increased presence of policies and active ANH integrated programs                 Number of countries with active ANH programs and policies
(Measured using data from monitoring of the Scaling Up Nutrition (SUN)
movement, REACH, WHO landscape analysis, and other global initiatives with
which CRP4 has direct links)
4.2 Harmonized Policies
CRP4 component services and outputs are recognized as useful to policymaking bodies;  Indicators of commitment to cross-sectional work developed and used by the
policy hierarchies view CRP4 as a valued source of knowledge and advice           SUN movement will be adapted and used to measure progress in different
Consensus is achieved on need for integrated planning; an integrated approach is understood  dimensions of cross-sectoral policymaking (CRP4 team members are directly
and implemented by technical and advisory leaders and by national-level planners  involved in Task Force F, which leads the development of these indicators);
Mechanisms and resources for cross-sectoral problem identification and program planning are  examples include indicators to measure: commitment of high level leadership,
approved by policymakers in all three sectors                                     government focal point for agriculture/nutrition/health appointed, national
agriculture and food security strategies firmly incorporate nutrition and health,
multi-stakeholder platforms established, civil society and business engagement
established, action plans developed, etc. (see Scaling Up Nutrition, Progress
report from countries and their partners in the movement to scale up nutrition;
United Nations, High Level Meeting on Nutrition, September 20, 2011)
Capacity in the use of evidence for policymaking is strengthened                 Inventory of trainings, number and types of individuals trained in cross-sectoral
policymaking, number and types of individuals involved in cross-sectoral
decision and policymaking (Measured annually)
3. Contribution to System-Level Outcomes                                                GLOBAL INDICATORS
Indicative CRP outcomes contributing to contributing to system-  Global indicator to be monitored as proxy for outcome:
level outcomes:
Nutrition outcomes:                                            Nutrition outcomes:
>   2-5 percentage point reduction in child stunting per           Nationally representative surveys such as: Demographic and Health Surveys (in
year in targeted high-burden countries (selected from          target countries); WHO global database; UNICEF Multiple Indicator Cluster
the 36 countries accounting for 90 percent of the              Surveys (MICS); SUN monitoring system; Living Standards Measurement Surveys
burden of malnutrition)                                        (LSMS) and other nationally representative surveys collecting dietary diversity and
>   25 percent reduction in prevalence of anemia and/or            nutrition outcome data
vitamin A deficiency in women and young children in
targeted high-burden countries (same as above)
(depending on specific micronutrients targeted by
CRP4 in different countries)
r   30 percent increases in dietary diversity (measured by
number of food groups consumed)
173


﻿Health outcomes:                                       Health outcomes:
>  Health outcomes: 20 percent reduction of burden of key  >  National health statistics; Global Burden of Disease
agriculture associated disease on poor people
174


﻿APPENDIX 4. IMPLEMENTATION AND PARTNERSHIP IN POLICY PROCESSES:
THE CAADP EXAMPLE
There are four types of delivery mechanism to disseminate the products of research to partner organizations,
stakeholders, and policymakers. Carrier policy processes are ongoing policy processes that provide an
opportunity for the CRP to add value to planning and implementation activities at the country and regional
levels, in terms of technical information, tools, and capacity building. As an illustration, Pillar 3 dealing with
hunger and nutrition and, in particular, the technical planning and implementation work that is being carried
out by Regional Economic Communities (RECs) and their member states, would constitute the appropriate
carrier policy processes for the CRP under the CAADP agenda. The different opportunities for value addition
at the country, regional, and continental levels are specified in the middle column of Appendix Figure A4. 1.
The first value addition opportunity in this area at the country level would consist in assisting countries to
better understand and properly articulate the issues related to agriculture for improved health and nutrition in
the formulation of long-term policy and strategy options as well as action plans under this pillar. The second
opportunity for value addition would emanate from the need for technical guidance for the design of health
and nutrition components in the current country CAADP investment plans. In both of the above cases, the
input from the CRP could be prototypes to scale up best practices for adoption, benchmarks to guide action by
stakeholders, tools and other knowledge products to facilitate implementation, and even action research to
clarify the future course of action. The value addition opportunities at the regional and continental levels are
described in the bottom two boxes of the middle column of the chart.
Anchor organizations and operational actors are at the forefront of policy planning,
implementation, and coordination at the continental, regional, and country levels. They need to be
engaged in order to influence the policy and program planning and implementation process and to learn
from that process in return to inform the research agenda setting under the CRP. Engagement with the
anchor organizations allows the CRP leadership to identify the relevant carrier policy processes and work
with the appropriate stakeholders to create the space and opportunity for value addition. In the CAADP
examples, they include the African Union Commission (AUC), the NEPAD Planning and Coordination
Authority (NPCA), the Regional Economic Communities (RECs), leading national ministries, local
governments, the national research and education systems (NARES), and the various professional and
civil society organizations (see first column).
The CRP leadership will initiate engagement with the anchor organizations very early in the
implementation phase. The preparation of the partnership strategy, road map, and action plan is a good
opportunity to initiate this engagement.
Knowledge Platforms are not only important as means to facilitate the access to and use of the
different research outputs under the CRP by stakeholders, ranging from various knowledge products,
tools, and methodologies. They are also a critical support for the monitoring, evaluation, and impact
assessment work as well as the related review and learning activities that are critical ingredients of the
process of informing policies and fine-tuning the research approach and agenda of the CRP. Illustrative
examples from the CAADP process include the Regional Strategy Analysis and Knowledge Support
Systems (ReSAKSS), established by four CG centers, IFPRI, IITA, ILRI, and IWMI in collaboration with
three RECs: the Common Market for Eastern and Southern Africa (COMESA), the Economic
Community of West African States, and the Southern African Development Community (SADC).
ReSAKSS operates three regional nodes, which are hosted by ILRI, IITA, and IWMI and coordinated by
IFPRI (www.resakss.org). The nodes support the M&E, review, benchmarking, and learning processes
under CAADP. They do that by creating knowledge products to guide implementation, tracking
implementation performance and progress toward policy goals, documenting and disseminating lessons,
and building capacities at the local level. The corresponding ReSAKSS activities at the continental and
regional levels are described in the right-hand side column of the chart.
175


﻿Given that ReSAKSS is already operating within the CG system, its facilitators include the two
leading centers of the CRP, and well implanted in the CAADP process, it would make sense to consider
using it as a knowledge platform to support the CRP's work.
176


﻿Appendix Figure A4.1. CRP4 partnership and value addition illustrated using the CAADP Framework
Key Agents          Policq    Planning and Implenentation            Capaciti Building and
Develop Country Operational Plans for        Support Country Knowledge Platforms
-Long-term Policy and strategy options       for
-Short-term scale-up opportunities           -Progress Performance and Tracking
-Progress Review and Dialogue
Country Level                                         illisrative entry point Develop health      -Evidenced-based Implementation
and nutntion components in current
country CAADP investment plans               Illustrative enry point Use the Country
SAKSS nodes being estabtished under the
CA AT)P Prores-
Facilitate Regional Action Plan to           Set up Regional knowledge Platforms for
-Guide and coordinate country actions        -Benchmarking
-Create room for cross-border collaboration  -Best Practice adoption
Regional                                                                                           -Peer Review and Dialogue
Level                                                 Illustrtive entry point: Develop health and
nutrition components in existing regional    Illustrative entry point: Adopt the
agricultural strategies and CAADP            ReSAKSS platforms set up by IFPRI. ILRIL
investment plans                             IITA, and IWMI
Continent Level       1                                Develop continental Framework to            Integrate Continental Dialogue Platforms
-Provide Political Leadership               for
-Facilitate broad geographic coverage       -Strategic partnership building
-Promote strategic partnerships             -Mainstreaming of health and nutrition in
agnicultural policy debate
IIlutrative entry point: Develop AU
agriculture, health and nutrition           Illustrative entry point Work with the
framework similar to the Land Policy        ReSAKSS on the CAADP M&E and Mutual
Framework                                   Accountability Framework
RESEARCH PARTNERSHIPS: CGIAR AND INTERNATIONAL PARTNERS
177


﻿APPENDIX 5. FISH VALUE CHAIN FOR IMPROVED NUTRITION AND HEALTH:
PROPOSED COLLABORATION BETWEEN CRP4 AND CRP3.7
The importance offish for nutrition and health and proposed CRP4-CRP3.7 research focus
In many low-income countries with water and fisheries resources, in particular among population
groups living in riparian and coastal areas, capture of both freshwater and marine fish as well as fish
production are important for livelihoods, income, and nutrition. These poor population groups
typically also suffer disproportionately from undernutrition, including micronutrient deficiencies.
Fish, in particular small fish species, are an integral part of the everyday diet, though the amount
consumed is small and intrahousehold distribution favors males. In these population groups, fish is an
irreplaceable animal source food, and its contribution to dietary diversity and to intake of several
essential micro- and macronutrients is potential invaluable, yet largely ignored.
Studies in rural Bangladesh and Cambodia show that small fish make up between 50 and 80
percent of all fish eaten during the production season. Although consumed in small quantities, these
small fish, which are consumed whole, are particularly rich in micronutrients. Their bones are an
excellent source of calcium, and in some species vitamin A accumulates in their eyes and intestines. A
study of poor, rural households in Bangladesh in 1997 revealed that small fish intake provided about
40 percent of the vitamin A and 32 percent of the calcium recommendations of an average household
in the peak fish production season. The long-chained omega-3 polyunsaturated fatty acids found in
marine and some freshwater fish also have a range of health benefits. Epidemiological studies have
shown that the prevalence of cardiovascular diseases is low in North Atlantic regions with high fish
intake, and it is well accepted that some fatty acids reduce the risks of cardiovascular failures, stroke,
and the development of dementia in adults. In young children, omega-3 fatty acids are important for
the development of membranes of the brain and the retina. The potential role of fish as a source of
essential fatty acids in the first 1,000 days has recently been highlighted in the global Scaling Up
Nutrition (SUN) Framework and Roadmap and the US government's 1,000 Days Initiative.
Many factors contribute to the favorable role of fish, in particular small fish species, in
nutrition. Where fish is abundant, it is usually well liked, people have strong cultural preferences for
it, and they perceive it as promoting nutrition, health, and well-being. Fish products-such as dried,
smoked, salted, and fermented fish, fish paste, and fish sauce-extend the duration of storage and
consumption, as well as accessibility. Small fish can be bought in small quantities from rural markets
or caught from common resources water bodies by household members. When they are used for
preparing a dish such as curry or stew, they can add flavor and taste to diets dominated by a single
staple.
Surveys in both Asia and Africa show that fish consumption is declining and that the diversity
of fish species consumed has decreased. In an effort to increase supply, governments have vigorously
promoted aquaculture, in particular in Asia, in the last 30 years. However, the technologies in use
promote monocultures of fast-growing large fish, such as carp, tilapia, and panga. The nutrient
composition of these fish is of lower quality than that of small fish because of species variation, and
nutrients, especially calcium, are lost when bones are removed before consumption.
In recent years, there has been growing awareness that the aquaculture technologies widely
promoted, especially for small-scale production, must take into consideration production,
productivity, income, and nutritional quality. In addition, more attention is being paid to the need for
better management of wetland resources to protect capture fisheries and sustain fish diversity.
CRP4 will work with CRP1.3 and CRP3.7 to increase access to and consumption of fish
among the poor in order to improve their nutrient intake, dietary quality, and nutrition and health
security. One example of a partnership that the teams decided to explore during the early stages of
implementation is joint research on the tilapia and catfish production value chain in Uganda. The table
below (Table A5.1 (extracted from CRP3.7 proposal)) provides examples of new research questions
and activities that CRP4 could add to the tilapia and catfish value chain to make it more nutrition-
sensitive and more likely to achieve its overall goals of improving diet quality and nutrition among
the poor.
178


﻿The potential health risks associated with fish consumption and proposed CRP4-CRP3.7 research
focus
Fish is a highly perishable commodity and is associated with a wide range of health hazards, including
bacteria, parasites, mycotoxins, and heavy metals. Some of these hazards are specific to fish products,
whereas others are present in other animal source foods. In countries where fish consumption is high,
it is frequently implicated in cases of food-borne illness. As for other food safety issues, risk analysis,
including risk management methods such as HACCP, is the gold standard for assuring fish safety.
However, although considerable evidence exists on the assessment and control of hazards in large,
commercial, export-oriented fish production and capture systems, there has been very limited research
in the large informal systems of most relevance to poor people involved in fish production, capture,
and processing.
Ongoing work by ILRI and partners seeks to adapt risk analysis principles and tools to the
informal markets where they have yet to be applied but have great potential for improving food safety
while safeguarding or enhancing market access for the poor (especially women). Some studies looked
at hazards in traditional fish systems in West Africa. Women have a major role in the processing of
fish and use mainly traditional and low-technology processes. Levels of hygiene are very low, and
traditional processing, such as smoking and curing, may lead to contamination with polycyclic
hydrocarbons and other substances. However, processing may also mitigate risks. In some cases
perception of risk by the public and decisionmakers does not correspond to actual risk to human
health, leading to inappropriate policy and regulation.
In conjunction with CRP1.3 and 3.7, CRP4 will conduct comparative risk assessments to
establish which hazards to human health are present in small-scale fish systems and what the relative
importance of different hazards is. For those hazards likely to have a substantial impact on human
health, risk assessment will be conducted to quantify the risk and identify the points at which it can be
best controlled. This evidence will help raise awareness among stakeholders including fish value-
chain actors, decisionmakers, and consumers. Stakeholders will be involved in the design, testing, and
rigorous evaluation of interventions to improve food safety while delivering other benefits (such as
higher yields, lower labor inputs, or better market access) that will motivate value-chain actors to
adopt risk management practices. These studies will be done as proof of concepts in the value chains
with other CRP involvement. They will be linked to development agents for wider dissemination of
the tools, methods, and technologies developed and to local decisionmakers and international
organizations (such as the WHO FERG group) important in creating an enabling environment.
179


﻿Appendix Table A5.1. Opportunities and constraints in tilapia and catfish production value chain in Uganda and the research and
development actions to overcome them (extracted with permission from the CRP3.7 proposal)
Legend: gry highlihted text presents examples of poential contribution of CRP4
Researchable issues and supporting actions        Indicative partners and their roles                         Outcomes
Improve access to  **********                                                                                                    * Farmers able to access
quality inputs                                                                                                                    quality inputs
Researchable Issues                               Research
Fertilization regimes                             * Farmers, feed producers, and farmer organizations to seek gender
*Species and production system-specific feeding    equitable methods (including contract growing) to increase
p roduction      regimes to maximize productivity and profits     production and productivity
iImpacts of production intensification on gender and  NARO and Ugandan universities and SRO partner country NARS
household power relations                         and universities to partner on developing productive and profitable
Feasibility and pro-poor and gender equitable       technologies                                              * Increased farmed fish
Low productivity,     benefits from contract growing                  * ARIs (Bergen, CIRAD, Stirling, and Wageningen) to partner on  production and
poor production                                                         reNearch. technical backs[ppng. and capacitN deelopment    conmption k the poor
practices, and                                                      *CRP+ Rweath fidi commmp#on Vpameps sip ceWawits to           especMay vsihmaable
marginal         Supporting Actions                                       ft                . P W                M            graW such as women and
* Develop record keeping, technical capacity, and
business skills among producers a
* Develop soft skills (e.g., communication, business, 
e     o    gender awareness) among CG staff
* Develop tecorn , communications, and business h"                                              or
production          skills among NAADS staff and TSPs                via.       ob vu li bDuKboW embers (womm wd young
practices        * Develop research skills among NARO and
university staff
* Develop capacity development material for use by  Supporting Actions
NAADS and TCPs                                 e Farmers and POs to help identify capacity building needs, develop
capacity building materials and participate in capacity building
programs, and to participate in technology development
*     Ministry of Agriculture to help identify and implement incentives
to adoption of productive and profitable technologies
* NAADS and TCPs to participate in development of staff
communication and gender awareness skills
* TSPs, USAID LEAD, and NGOs to partner on gendered
technolo  develo ment and dissemination to farmers
(continued)
180


﻿Researchable issues and supporting actions         Indicative partners and their roles                          Outcomes
Researchable Issues                                Research
9Impacts of harvesting and transport on postharvest  9 Farmners, hatcheries, producer organizations, and transporters to
Transportquality, nutrient cote        food safety, and price      help identif and prioritize critical steps in fish transport, devise
&* Impact of cost-effective cold chain on returns             effective and economically efficient solutions, and build capacity
Processingthroughout the value chain                                within the transport sector
e Options for postharvest processing to improve    9 NARO and Ugandan universities and SRO partner-country NARS
storage or add value, Including nutritional ad    and universities to partner on research on fish processing and cold-  Increased quantities of
Low quality and            value                                         chain development                                            affordable, nutritious and
limited value     a Idend6lloUn of en&ry points "ln the value chain  9 CRP4: CanTy out valu-charnl orudytsE to idetfy etry and cx  safe fish and fish products
mitdvale canbeekbaced"d ezit                                        Pokt where iultibul value   be
addingniarke                                                                                                                               nd increased
Ipo qai tm U                                                                                                                  intake of such products by
*premeeda; development of new proesing                       and srAfr for poor conners who do not bave reffigetabon   hpo
ImprovT    ality      tedholquis that protedt the nutritional value and  lbosoies, and respond to thms demand forfal and fuh~ produtcpoo
and seekeequitable                                                 a CRP4- Ethicxte value-chamn actors on te imaportance of protecting
and seek equitableeni                                                                   the nobtional value and safy of fish along the
value-added        Supporting Actions                                  value chain
opportunities     * Develop and deliver training on fish transport
* Seek synergies with other food , especially livestock,  Supporting Actions
in transport and cold chains                     * Ministry of Agriculture to help establish and implement priorities
* Design and implement improvements to roads and     to improve feed transport, including road and other infrastructure
other infrastructure                               improvements
* Create gender equitable employment opportunities  * Transporters, farmers, and producer organizations to help develop
and adopt better fish transport practices to improve quality, food
safety and reduce postharvest losses and prices
s  NAADS to collaborate on capacity development among fish
transporters
USAID LEAD to partner on brokering improvements in fish
transport systems
p  Technical services providers to support farmers on development of
best practices for harvesting and postharvest handling
(continued)
181


﻿Researchable issues and supporting actions          Indicative  artners and their roles                          Outcomes
Researchable Issues                                Research
* Present and likely future demand for different    e Farmers, consumers, producer organizations, NARO, and Ugandan
farmed fish products among poor consumers          universities to collaborate on fish market research
* New markets for novel products                   * NGOs to partner on market research and development
* Mechanisms to increase communication between     * ARIs (Stirling) to partner on research into marketing of
customers and producers to test the hypothesis that  aquaculture products                                        Strong demand for-and
farmers will use the information to better target  e CRP4: Raseach o impact and oweffwvenesa ofsawies           increased access to-
Poorly developed       production to market demand                        bpkm*nkd.to i     commer a            a  s        d           farmed fish products by
markets         * Use of ICT to reduce knowledge imbalances and       foumisa*6           dfispi     ^            of impact    poor and vulnerable
improve value-chain efficiency                     an chw*w id dWtfy qwft, k**c of ft-ad emteW                 consumers
 The role of POs in marketing                        raWronutrients. ard nutional staws and health of key target
AwarenL ~ising       * Drivers of competition among local, national and    goups
among poor          regional markets for farmed fish
* Impacts of increased fish supply on consumption by  Supporting Actions
vulnerable groups, including women and children       Farmers, producer organizations, and traders to collaborate on
development of marketing skills, use of ICT and collection of
Supporting Actions                                      data
*   Develop capacity to conduct market research         NAADS, TSPs, USAID LEAD, and NGOs to support farmers in
*   Develop capacity to collect human health and        adoption of ICT
nutrition data
*   Dwfttqkpac     to masure the impact abd cosx-
ef*Frescosmr of vpoud cuain fo                                                   i rition  NAO aealth
182


﻿APPENDIX 6. VALUE CHAIN FOR IMPROVED NUTRITION THROUGH
AGRICULTURE BIODIVERSITY
Background
Agricultural biodiversity pertains specifically to the biological variety exhibited among crops, animals,
and other organisms used for food and agriculture, as well as the web of relationships that bind these
forms of life at ecosystem, species, and genetic levels. It includes not only crops and livestock directly
relevant to agriculture, but also many other organisms that have indirect effects on agriculture, such as
soil fauna, weeds, pests, and predators. This agricultural biodiversity includes species with underexploited
potential for contributing to food security, health, income generation, and ecosystem services. Terms such
as underutilized, neglected, orphan, minor, promising, niche, local, and traditional are frequently used
interchangeably to describe these potentially useful species (both plant and animal), which are not
mainstream but which have at least significant local importance and considerable global potential for
improving food and nutrition security.
Creating biodiversity with high nutritional significance involves drawing on a vast array of
cultivated and wild species, which if made available and utilized effectively could contribute significantly
to the dietary diversity, livelihoods, and well-being of millions of people all over the world. Interspecies
and intraspecies variations of crops represent a considerable wealth of local biodiversity and could
contribute to improved incomes, food security, and nutrition with a better understanding of their
contributions and use. They also have significant potential for enhancing adaptation to global climate
change. Some of these species are strongly linked to the cultural heritage of their places of origin, and
many are highly adapted to marginal, complex, and difficult environments that have contributed
significantly to diversification and resilience of agroecological niches (Padulosi et al. 2011; Bharucha and
Pretty 2010).
Rationale
The role of nutrient-rich traditional foods in value chains and their accessibility in markets is a less-
explored area of research. The links between what is produced on the farm, the consumer who buys that
food, and the income received by the producer does not stop at the point of production (Hawkes and Ruel
2010). Food is stored, distributed, processed, retailed, prepared, and consumed in a range of ways that
affect the access, acceptability, and nutritional quality of foods for the consumer. Value chains are central
to consumption, diets, and nutrition, not only in terms of the supply of food, but also in terms of how
consumers influence value chains and how changes in the demand for specific local foods can influence
the processes and outputs of value chains. There has also been modest attention to how actors along the
value chain can be better informed on how to enhance the nutritional value of local foods. Food and
nutrition systems need to be rethought through new business paradigms that demonstrate the value of
biodiversity while promoting improved diet and nutrition outcomes.
Traditional foods and the species they are based on are usually produced or collected for self-
consumption and have very limited markets-mostly local ones-if any. They usually face many
marketing constraints, such as missing output markets because of high transaction costs (costly transport
and handling because of bulk or freshness, perishability, short shelf life characteristics) or suboptimal
market equilibrium (that is, although the product is sold, the price does not reveal the full value of the
product or consumer willingness to pay) due to weak market demand, inefficient supply, or a combination
of both. There may be insufficient knowledge and economic information about the product and its
benefits, including nutritional benefits, and this knowledge gap may lead to a level of demand lower than
it would have been had full information been available (Gruere et al. 2008). For example, local
populations may be ignorant of the nutritional benefit of consuming a traditional food, with the result that
demand for the food lower than it would have been had they been aware of the benefits. These conditions
contribute to a lack of market competitiveness of traditional foods and products vis-A-vis the introduced
ones associated with increased market integration. Furthermore, many of the introduced foods and
183


﻿products have benefited from public and private investments in their development and marketing, whereas
traditional ones have not. Even with nonintroduced crops, if one local crop benefits from large subsidies
compared with the others, this makes the consumption and production of the latter less financially
attractive vis-A-vis the former. For example, in India, subsidies given to rice farmers makes millet
financially less attractive to farmers and consumers alike. The removal of these subsidies should be a way
to promote millets, which are richer in calcium and iron than rice (Upadhyaya et al. 2006).
The research undertaken in this component will attempt to characterize and understand the role of
markets and value chains in improving nutrition and dietary diversification both (1) directly, through an
increase in the supply, marketing, access, and consumption/demand of nutritious foods sourced from
biodiverse systems and (2) indirectly through an increase in income for smallholder famers. Likewise,
smallholder farmers can diversify their diets and improve their nutritional status either by producing more
biodiverse sourced foods directly or by accessing more nutritious and diverse foods in markets through a
rise in their disposable incomes. There will be an emphasis on understanding what role nutritious local
and traditional foods (LTFs) and neglected and underutilized species (NUSs) play in creating demand for
food products sourced from biodiverse landscapes by rural and periurban consumers and in boosting
disposable incomes for smallholder farmers.
Research Objectives and Questions
Objective One:
To increase our understanding of how consumers can influence the demand for nutritious foods
produced by smallholder farmers, and how smallholder farmers can access nutrient-rich foods sourced
from agricultural biodiverse farming systems in informal and formal markets.
Understanding how consumer demand for nutritious foods sourced from agricultural biodiverse systems
drives production of these products among smallholder farmers in developing countries is central. It is
also important to understand the reverse-how increased production of nutritious foods sourced from
agricultural biodiverse landscapes can increase knowledge and demand for consuming these foods. This
objective will research how consumer knowledge of, demand for, and access to nutritious foods sourced
from biodiverse settings can ensure visibility and accessibility through nutrition-sensitive value chains
and other market mechanisms in diverse settings.
Research questions include the following:
*   How can markets be more diverse-friendly for consumers, and what drives consumer
preferences for nutritious LTFs sourced from biodiverse systems?
*   What is the role of women in decisionmaking regarding nutrient-rich local food purchases
and distribution within the household?
*   What are the media outlets that disseminate information, promote access, and increase
knowledge of and demand for nutritious LTFs and NUS by urban consumers?
*   What new tools increase awareness, access to information, and knowledge of nutritious LTF
products among consumers?
*   What nutritious specialized products for vulnerable populations (such as therapeutic foods
and complementary foods) could be developed, promoted, accepted, and scaled, and at what
cost, from available local foods and underutilized crops sourced from biodiverse systems?
Objective Two:
To strengthen our understanding of how agricultural biodiversity and the production of LTFs and
NUS can lead to a rise in disposable income for smallholder farmers, and what mechanisms can be
instlled to use this additional income on nutritious commodities for the household (and especially to
meet the nutritional needs of vulnerable women and young children).
184


﻿The reasons for smallholder farmers to grow and sell local and traditional foods are not clear from a
nutritional perspective, and the role of traditional foods in improving incomes and ensuring market
demand needs to be further investigated. It is also important to understand how agricultural biodiversity
can be scaled for commercial use while maintaining biodiversity and ecosystems and improving human
nutrition and health. Finally, it will be useful to understand how small farmers can be linked to periurban
and urban consumers in ways that offer mutual health, economic, social, and environmental benefits.
Marketing and promotion of biodiversity for food and nutrition has significant unrealized
potential. However, most countries and communities for which promotion and commercialization of
biodiversity for food and nutrition would be most attractive lack the capacity to assess market potential,
obtain up-to-date market information, create the necessary physical infrastructure, and develop support
strategies for their marketing.
Research questions include the following:
*  Does traditional food diversity tend to disappear with market integration, as traditional foods are
replaced with introduced foods that may be poor nutritional substitutes?
*  What are the mechanisms and incentives for smallholder famers to increase their incomes and
competitive advantages by producing nutritious LTFs sourced from agrobiodiverse systems?
*  How can value-chain benefits be best maximized for the producers of biodiverse sourced
products and consumers (that is, the most vulnerable elements of the chain)?
*  How can women farmers be linked in as producers and processors of nutrient-rich foods along the
value chain, or as ingredient suppliers to commercial manufacturers of specialized, local,
commercial products for nutritionally vulnerable populations?
*  What are the pathways for linking smallholder farmers and their nutritious products sourced from
agrobiodiverse farms to periurban and urban consumers? Specifically, what trends in periurban
markets determine the potential success of agricultural biodiversity?
*  What are the best training mechanisms related to marketing and value chains for producers?
Possible mechanisms include market evaluation, information and communication, establishment
of producer/exporter organizations, development of postharvest technologies, product
development, product presentation, trade regulations, and quality requirements of
buyers/processors.
*  How can smallholder farmers' traditional knowledge relating to the production, storage, and
marketing of nutritious products from agrobiodiverse systems be preserved and utilized?
CGIAR Centers' involvement and other necessary partners at the international, national, and
regional level
The CG centres will include Bioversity International, IFPRI, ICRISAT, CIAT, IITA, and CIFOR
The partners will include AVRDC, NARES, FAO, Convention on Biological Diversity (CBD), WHO,
Millennium Villages, Network of Farmers' and Agricultural Producers' Organizations of West Africa,
Save the Children UK, Oxfam, HKI, WAHO, and GAIN
185


﻿Appendix Table A6.1. Activities, outputs, and outcomes
Activities                                        Outputs                                             Outcomes
OBJECTIVE ONE: To increase our understanding of how consumers can influence the demand for nutritious foods produced by
smallholder farmers, and how smallholder farmers can access nutrient-rich foods sourced from agricultural biodiverse farming systems
in informal and formal markets
*Carry out analysis of the nutritional value of  - Information on consumption patterns and nutrient gaps  - Manuals and training guides established and in use for
TLFs/NUS in target areas                      for populations in biodiverse agrosystems, living in  university courses and regional workshops
* Carry out quantitative and qualitative research  rural areas and of different socioeconomic groups  Tools and certification guidelines established and shared
to (1) analyze the actual (and potential)     Evidence on the use of nutrient-rich foods (production,  with value-chain actors
contribution of TLFs/NUS to household and     postharvest handling, processing, preservation, and  . Value-chain case studies presented to private sector and
individual diet; (2) document local, national,  preparation)                                      food industry
and international consumer preferences for  - Evidence on determinants of use in households and   Value-chain integration with nutrition courses and
nutritious LTFs sourced from biodiverse       communities (knowledge, beliefs, intrahousehold     workshops made available and used
systems; (3) assess how the demand can be used  allocation of foods, sociocultural factors, and gender  * Database on the nutritional value of lesser known and
to boost production of such foods in local and  dimensions)                                       local foods developed and available as open access and
regional value chains of developing countries;  Studies completed on the development of tools and  used
(4) define the role of women in decisionmaking  certifications for nutritionally rich LTFs and NUSs  - Better understanding of households' food purchasing and
regarding nutrient-rich local food purchases and  * Projects and collaborations established with value-chain  production patterns, the role of markets, and who uses
intrahousehold distribution                   actors on increasing supply and demand for nutrient  them is used to promote healthy and diverse diets relying
* Carry out a survey to characterize media and  rich LTFs and NUSs in informal and formal markets   on local biodiversity
other outlets that disseminate information,   Data collected and analyzed on the local food
promote access and increase knowledge and     purchases, production for home consumption, and sales
demand of nutritious LTFs for urban consumers  Qualitative and quantitative data and analysis on
* Develop, test, and evaluate new communication  consumers' knowledge and awareness about nutrient-
strategies to increase awareness, access to  rich foods
information, and knowledge of nutritious LTF  - Data on the sources of information consumers rely on
products among producers, consumers and other  (e.g., formal or informal, public or private) regarding
actors along the value chain to stimulate demand  nutrition, diets, and health
for these foods
* Carry out value-chain analysis to identify what
nutritious specialized products for vulnerable
populations (e.g., therapeutic foods and
complementary foods) could be developed,
promoted, accepted, scaled up, and at what cost,
from available local foods and underutilized
crops sourced from biodiverse systems
(continued)
186


﻿Activities                                       Outputs                                             Outcomes
OBJECTIVE TWO: To strengthen our understanding of how agricultural biodiversity and the production of LTFs and NUS can lead
to a rise in disposable income for smallholder farmers, and what mechanisms can be instilled to use this additional income on nutritious
commodities for the household
" Use quantitative and qualitative research tools to  - Greater understanding of how agricultural biodiversity  * Value-chain analysis used by value-chain actors to
(1) define the mechanisms and incentives of  and the production of LTFs and NUSs can increase    identify new opportunities to enhance (or protect) the
how smallholder famers can increase their    income of smallholder farmers and women in particular  nutritional value of LTFs and NUSs along the value chain
income and competitive advantages by         Value chains for nutritious LTFs with greatest potential  Best practices identified and disseminated for improving
producing nutritious LTFs sourced from       for improving nutrition identified and prioritized for  the nutritional content of local foods along the value
agrobiodiverse systems; (2) determine how    research                                            chains
women farmers can be linked in as producers  * Best practices on production, storage, and marketing of
and processors of nutrient-rich foods along the  nutritious products from agrobiodiverse systems
value chain, or as ingredient suppliers to   identified and documented
commercial manufacturers of specialized, local,  Technologies identified for different commodities, in
commercial products for nutritionally vulnerable  areas such as domestication of neglected and
populations                                  underutilized foods
* Select value chains and carry out analysis to
identify and test ways of enhancing (or
preserving) the nutrient content of select LTFs
or NUSs along the value chain
* Collect quantitative and qualitative data on
traditional knowledge relating to the production,
storage, and marketing of nutritious products
from agrobiodiverse systems and use these data
to replicate best practices and useful traditional
knowledge among smallholder farmers, famers
associations, and national governments
* Develop and apply research tools to understand
how the preservation and sustainable
management of public biodiverse ecosystems
can provide income-generating possibilities for
local populations and how this extra income can
lead to better dietary diversity and quality
187


﻿APPENDIX 7. 2010 STATUS OF MICRONUTRIENT DENSITY IN HARVESTPLUS CROPS UNDER DEVELOPMENT
[expressed as increases in parts per million (ppm)]
Rice                    Zinc             16              8               8               3               24            2012         Bangladesh
n Bangdesh                      accelerated       I ndi a
breeding
Wheat                   Zinc             25              8              6-8           GxE trials       31-33           2013            India
2010/2011 cycle                                   Pakistan
Maize                Provitami n A       0               15             8-12       Data available       5-8           2012-13         Zambia
Hybrid                                                                               June 2010
Maize OPV            Provitamin A        0               15             4-5         Data available      4-5            2011           Zambia
June 2010          6-8            2015
Cassava              Provitamin A        0               15              14             9.5              9             2013           Nigeria
pre-breeding ClAT  total carotenoids  total carotenoids  acceeroted  DR Congo
breeding
Pearl Millet            Iron             47              30             N/A         Data available      67             2012            India
Hybrid                                                                                Feb 2011                     fast-track hybrids
Pearl Millet            Iron             47              30              50              30             77             2011            India
OPV                                                                 in progenyfines
Bean                    Iron             50              44              30              20             74            2010-11         Dr Congo
Rwanda
Orange Sweet Potato  Provitamin A        0               30           200-360           360             360           2009-10         Uganda
= approx. 110 on  dy natter basis  dry matter basis  diy matter basis  Frst variety  Mozambique
idy matter basis                                                  released 2007
188


﻿APPENDIX 8. SUMMARY OF EXISTING AND PLANNED ACTIVITIES ON PREVENTION AND CONTROL OF AGRICULTURE
ASSOCIATED DISEASE
Theme             Country/Region             Activity                                                   Partners                         Funders
Prioritisation and  Developing countries     Systematic review of zoonoses with a wildlife-livestock interface  ILRI, RVC                DFID
systems
understanding     Nigeria                    Assessing the importance of food-borne disease in the beef value  ILRI                      World Bank
chain in Nigeria
Risk and          East, South and West Africa  Quantifying weather and climate impacts on health         Liverpool University, ICTP, CSE,  EC
socioeconomic                                                                                           CSIC, ECMWF, and others
assessment        Eastern Africa             Mapping, examining and anticipating future risks of water-related  TCD, ICTP, ILRI, others  EC (under CRP7)
vector-borne diseases in eastern Africa
East, South and West Africa  Food safety in informal markets                           CSSRS, FUB, African universities  BMZ
Kenya                      Integrated Response System For Emerging Infectious Diseases in  ICIPE, KEMRI, ILRI          Google Foundation
East Africa
Kenya                      Enhancing prevention and control of Rift Valley Fever in East  ILRI, Ministry               AHRP
Africa by intersectoral assessment of control options
Kenya                      Mycotoxin diagnostics platform and application to national  ILRI/Cornell/CSIRO/Kenya/Tanza  AusAID
program maize breeding                                     nia/QAAFI
Kenya                      Underptanding aflatoxin accumulation in maize and evaluating  Cornell/U Maryland/ILRI       StART/Nelson Lab/AusAID
strategies to reduce human exposure in East Africa
Kenya                      Measuring and mitigating the risk of mycotoxins for poor milk and  ILRI, IFPRI, University of Nairobi,  MFA, Finland
maize consumers in Kenya                                   Leeds University, MTT
Kenya                      Safe Pood, Safe Dairy-assessing mycotoxin risk in dairy    University of Nairobi, ILRI      Embassy of Finland
households
Kenya Mali                 Analyze impact of aflatoxin on the livelihoods and health of-people  IFPRI, CIMMYT, ICRISAT,  Bill & Melinda Gates
in Kenya (maize) and Mali (groundnuts). Map areas at highest risk,  University of Pittsburgh, USUHS,  Foundation
identify cost-effective control measures to reduce exposure to  KARI, IER, ACDI/VOCA, and the
aflatoxins, and disseminate findings to key stakeholders and  East African Grains Council
policymakers.
Kenya                      Epidemiology of zoonoses among livestock and their keepers in  University of Edinburgh, ILRI  Wellcome Trust
East Africa
Kenya                      Zoonoses in western Kenya                                  University of Edinburgh, ILRI    BBSRC
Senegal                    Climate change and aflatoxin exposure                      Leeds University/IHTA/University  AHRP
of Thies
Risk assessment   Africa and Asia            Avian influenza control                                    IFPRI/ ILRI/ Others              DFID
and management
Kenya                      Measuring, mapping, monitoring and mitigating drivers of the  University of Edinburgh, ILRI  MRC
emergence of zoonotic and food-borne diseases: a case study
(continued)
189


﻿Theme             Country/Region             Activity                                                   Partners                        Funders
Risk management   Africa                     Participatory Epidemiology for improved disease control    ILRI, PENAPH                    Rockefeller
Africa                     Bio-pesticide registration workshop with specific focus on  USDA/IITA/IR-4                  US Department of Agriculture
aflatoxin control                                                                           (USDA)
Africa                     Early Detection Reporting Surveillance:                    ILRI, AU-IBAR                    USAID
Avian Influenza in Africa (EDRSAIA)
Kenya, Ghana, Sierra Leone,  Dynamic Drivers of Disease in Africa: Ecosystems,        STEPS, ILRI, University of       ESPA
Zimbabwe, Zambia           livestock/wildlife, health, and well-being                 Edinburgh, other partners
East and central Africa    Pro-poor dairy policy and improved milk safety for value addition  ASARECA, ILRI            EC
in the dairy chain
Burkina Faso               Biocontrol development for mycotoxin control               IITA/USDA/INERA                  Austrian Development Agency
Kenya                      Maize varietal differences in susceptibility to mycotoxins  Comell/ILRI
Kenya                      Filter paper test for milk quality and improved milk transport and  Diagnostics for all, Intellectual  Bill & Melinda Gates
holding containers                                         Ventures, ILRI                   Foundation
Kenya I Nigeria            Development and Commercialization of Biological Control of  IITA                            Bill & Melinda Gates
Aflatoxins in Nigeria and Kenya                                                             Foundation
Malawi, Tanzania           Groundnut variety improvement for yield and adaptation, human  ICRISAT/NASFAM / NARS/       McKnight Foundation/CCRP
health and nutrition; Postharvest value-chain technology   Lilongwe Central Hospital /SUA/
improvements in groundnuts in Malawi and Tanzania, and     Danish Management
innovative communication media and methods for more effective
control of aflatoxins in groundnuts
Mozambique, Zambia         Development and Commercialization of Biological Control of  IITA, Ministry of Agriculture,  USDA
Aflatoxins in Mozambique. Field activities related to local  local universities, University of
beneficial fungi biocontrol. Training of farmers, government staff,  Arizona.
and traders.
Nigeria                    Assessing the impact of avian influenza control in Nigeria  ILRI                            World Bank
Nigeria, Kenya             Efficacy trials, registration, large-scale farmers' trials, lab-scale  IITA/USDA            AATF
manufacturing, sensitization for mycotoxin biocontrol
Nigeria                    Large-scale farmers' trials, sensitization, farmer training -  IITA                         MycoRed
biocontrol for mycotoxins
Nigeria                    Low-cost manufacturing method development                  USDA/IITA                        USAID funds through IITA
Senegal                    Biocontrol R&D including demonstration trials              IITAIDPV/University of Thies     Fondation Agir pour
/USDA                           lEducation et la Santd (FAES)
South east Asia - 6 countries  Ecosystem approaches to the better Management of Zoonotic  ILRI, CMU, UGM               IDRC
emerging infectious diseases(EID) in south East Asia
India                      Generating evidence to support enhanced traditional dairying in  ILRI                       OPEC
India
Vietnam                    Reducing disease risks and improving food safety in smallholder  ILRI, HSPH, AU             ACIAR (proposal being
pig value chains in Vietnam                                                                finalized)
190


﻿APPENDIX 9. FROM COMPONENT 3 (AAD)
Appendix Table A9.1. Detailed activity to impact plan for initial priority areas (food safety and zoonoses)
Activities                                     Outputs                               Outcomes                        Impact
Mycotoxins
(1) Measurement and detection methods
* Survey along value chaiis; assess contamination in key  9 Risk maps showing magnitude of  * Prediction models used by governments,  Reduction in
crops across agroecological zones                   mycotoxin contamination in groundnut,   agencies, and national and international  aflatoxin incidence
* Initiate development of new detection methods in   maize, and other key crops               organizations                         resulting from
collaboration with ARI partners                   e Groundnut and maize value chain mapped  * New cost-effective detection tools used  effective government
* Conduct food consumption and mycotoxin exposure    with critical control points in different  routinely by actors along the value chain,  policies
surveys with health experts                         agroecological zones                    including exporters
* Analyze mycotoxins in crops, strain composition in soil,  9 Survey results showing mycotoxin exposure
and environmental variables to develop prediction  in human population
models for mycotoxins                             9 Long-term: Diagnostic relationship between
* Assess the retention of these toxins during processing;  aflatoxin levels in blood and nutritional
modify processing methods                           status of children
e Surveillance systems for adoption by
regulatory agencies
* Prediction models for occurrence of
mycotoxins                             ____________________
(2) Identify intervention opportunities and their costs; understand behavioral issues affecting their adoption
*Identify and test new atoxigenic strains of A. flavus and  9 New strains for biocontrol of A. flavus  9 New strains for biocontrol of A. flavus  *Improved rural
other new biocontrol agents for maize and groundnut  identified                             promoted                              livelihood, health,
 Develop and test novel aflatoxins control       * Appropriate pre- and postharvest alatoxin  * 10% of farmers in selected countries  and nutritional status
wTest aflatoxin mitigation technologies in farmers' fields  management packages, based on CBA and  adopt relevant technologies by 2015  of the targeted
(maize and groundnut)                               CEA, targeted to specific farming systems  e On-farm management practices (using  community as a
*Assess farmers' willingness to pay for pre- and   a Long-term: Simple, rapid technologies for  biocontrol and resistant cultivars from  result of reduced
postharvest management options                      mycotoxin detection at field level      MP3s) reduce levels in target countries  aflatoxin
" Assess cost-effectiveness (CEA) of control measures;  * Alternative uses of contaminated products  by 70%                         contamination
analyze cost and benefits (CBA) to producers of     identified and promoted               * Risk of exposure to mycotoxins reduced
technologies' adoption                            e A publicly accessible database on       by 80% in pilot sites
" Develop alternate pathways to channel contaminated  mycotoxins and relevant technological  9 New biocontrol agents adopted by
products for nonfood uses to reduce human exposure  interventions                           farmers in selected countries
" Promote processing methods to reduce retained plant
mtoxinsyco
(continued)
191


﻿Appendix Table A9.1 (continued)
Activities                                    Outputs                               Outcomes                         Impact
(3) Capacity building and information
* Train NARS on detection tools                    * Policy advocacy platform to share    i Farmers and consumers in high-risk target  Improved rural
* Develop flyers and videos in local languages to increase  information on risk associated with  regions have knowledge of mycotoxins and  livelihood, health,
awareness at different levels                      mycotoxins and their impact on         associated health risks, and methodologies /  and nutritional status
* Develop a database of levels of mycotoxin contamination  livelihoods                     technologies for minimizing contamination,  of the targeted
and relevant technological interventions          * Greater awareness of mycotoxins and  e Farmers and consumers are willing to adopt  community
associated health risks, among research  risk reduction measures.
collaborators, farmers, and consumers   Consumers are willing to pay a price
differential for products with guaranteed
low risk of mycotoxin exposure.
Biological Hazards
Activities                                         Outputs                                Outcomes                                Impact
*Contribute to assessment of the multiple burdens of FBD  e Risk-targeting decision support tools  9 More rational allocation of FBD resources  *Improved livelihood,
Develop and validate participatory approaches to                                                                                 l Metrics and assessments of multiple  reflecting broader societal concerns  health, and
prioritizing food-borne hazards                    burdens of food-bore disease         * Better detection and reporting of FBD   nutritional status of
Develop and validate rapid tests for food-borne   e Evidence and influence for more                                               o Better management of FBD  the targeted
pathogens                                          appropriate policy                                                             community
Test surveillance models and provide evidence for better        f Novel rapid tests developed, tested, and
surveillance of FBD                                shared
*Develop One Health collaborations for on-farm risk  o Novel technologies developed, tested,
reduction that address equity, participation, and  and shared
ecological aspects                                * Strategies for risk management
* Improve epidemiological understanding of transmission,  *  Surveillance system guidelines and
susceptibility, and control                        models
* Develop and test risk mitigation innovations and  *    Risk communication to multiple
strategies                                         stakeholders using multiple channels and
* Develop and test risk communication strategies     media
* Assess the impact of innovations and strategies
(continued)
192


﻿Appendix Table A9.1 (continued)
Activities                                    Outputs                             Outcomes                         Impact
Plant Toxins
(1) Measurement and detection methods
* Evaluation of low toxin lines in target region, for  * Research reports that inform stakeholders * Policymakers use information and  * Enhanced agricultural
farmers' participatory selection in SA and SSA      of the potential risk of plant toxin lines  institute regulations          production, reduced
malnutrition, and better
health
(2) Identify intervention opportunities, their costs, and understand behavioral issues effecting their adoption
* Evaluate farmers' preferred varieties through partners and * Improved varieties with low toxins * Farmers' adoption of cost-effective * Enhanced agricultural
NGOs                                                (ODAP in lathyrus, cynide in cassava,  measures to minimize exposure to plant  production, reduced
* Seed multiplication of farmers' preferred varieties in each  vicine and tannin in faba bean, phytate  toxins                  malnutrition, and better
partner country                                     and raffinose family oligosaccharides in                                   health
most legume crops)
* New trait-specific donors for traits
associated with high nutritional value
* Adoption of improved varieties and
production technologies in the target
regions
(3) Capacity building and information
* Community-based capacity building on maintaining  e Enhanced capacity of NARS in          Enhanced access for the poor to safe  Enhanced agricultural
genetic purity of adopted varieties, production of quality  conventional and molecular breeding,  food                         production, reduced
seeds, agronomic practices, and food processing methods  crop management, and seed production                                  malnutrition, better
to manage risk of plant toxins                      technologies                                                               health, gender equity, and
* Policy briefs/dialogues/advocacy to                                       strengthened NARS
promote cultivation through proper                                         capacity
infrastructure and seed support, value-
addition, and linkage with markets at
local level
* Publication of peer-reviewed research
articles, datasets, and learning materialsa
(continued)
193


﻿Appendix Table A9.1 (continued)
Activities                                     Outputs                               Outcomes                         Impact
Pesticides and residues:
(1) Measurement and detection methods
* Analyze the market structure of pesticide use in  * Research reports that inform stakeholders  * Policymakers use information and  * Improved health from
developing countries, including fraud incidence    of the potential risk of excess pesticide use  institute regulations           reduced acute and chronic
* Understand the intensities of use and common practices                                                                           exposure
across different regions
* Conduct food consumption and pesticide exposure
surveys with health experts
(2) Identify intervention opportunities and their costs; understand behavioral issues effecting their adoption
* Evaluate cost of compliance with private food safety  * Research reports to inform policies that  * Reduction of crowding out effect  Improved health from
standards for various size producers               minimize the crowding out effect of private * Farmers' adoption of cost-effective  reduced acute and chronic
* Evaluate cost-effective feasible strategies to reduce  food safety standards                measures to minimize exposure to     exposure
exposure to pesticides arising from consumption of  * Mechanisms identified to improve      pesticides
produce, use by producers, and handling and disposal  agricultural practices
* Understand consumers' willingness to pay for products * Identify cost-effective ways to maintain
with certified low risk; identify institutional    productivity with reduced exposure to
mechanisms to certify produce as safe in terms of  pesticides
pesticide use
(3) Capacity building and information
* Research and evaluation in support of harmonization of * Policy recommendation for harmonization  * Policies implemented to harmonize  * Improved health from
minor use registration of agrochemicals to increase  of minor use registration of agrochemicals  minor use of registration of     reduced acute and chronic
availability in developing countries               to increase availability in developing   agrochemicals                         exposure
* Develop cost-effective decision support tools for  countries                              * Enhance access to the poor of safe food * Improved access for the
pesticide applications such as improving integrated pest * Maintain or enhance the poor's markets                                 poor to markets with
management to reduce pesticide use (particularly of  access and improve their profitability and                                   better health practices
highly toxic pesticides) especially in peri-urban areas  food safety
adapted to resource-poor farmers
(continued)
194


﻿Appendix Table A9.1 (continued)
Activities                                   Outputs                             Outcomes                        Impact
Measure and map the multiple burdens of zoonoses and consequences
1. Review the impact (disease and economics) and control  1. A global assessment of the multiple  1. Greater awareness of health partners  1. Zoonoses control
of zoonoses                                        burdens of zoonoses and intervention  of the importance of zoonoses and  activities partly
2. Work with international organizations to complement  opportunities                     need for agriculture-based         attributable to shift in
and ground truth ongoing studies                 2. More detailed assessment of 1-2 known  interventions                   awareness funded and
priority diseases                  2. Funding opportunities developed that  delivering health and
reflect intervention opportunities  livelihood benefits to
poor people
Predict, plan for, and prevent disease emergence from agroecosystems
1. Understand drivers and crucibles of disease emergence  1. Surveillance and control options based  I.Tools and guidelines being used by  1. Improved detection and
2. Develop pathogen detection platforms             on improved understanding of disease  national and regional partners     reporting of EID reducing
2. Diagnostics that take into account  2. Shift in mind-sets and policies toward  threats to health and
variants in circulation              ecohealth solutions                 livelihoods
2. More resilient
ecosystems reducing risk
of EID
Better control of neglected zoonoses
1.Understand the role and effectiveness of current  1. Evidence, tools, and methods for  1. Tools and guidelines being used by  1. Integrated zoonoses
institutions to monitor and control for zoonosis  integrated zoonosis control tried by  national and regional partners     control delivering health
2. Develop partnerships                             development partners                2. Shift in mind-sets and policies toward  and livelihood benefits to
3. Co-develop and test integrated zoonosis control for one                               one health solutions                poor people and
or more priority diseases                                                                                                  addressing needs of poor
(including women and
other vulnerable groups)
195


﻿APPENDIX 10. EXAMPLES OF INTEGRATED AGRICULTURE, HEALTH, AND
NUTRITION PROGRAMS THAT COULD BE INCLUDED IN THE FIRST PHASE OF
RESEARCH UNDER COMPONENT 4.1
Helen Keller International and IFPRI (South Asia and West Africa)
The Enhanced Homestead Food Production (E-HFP) program, supported by Helen Keller International
(HKI), has been ongoing in a number of countries in Southeast Asia, including Bangladesh, Cambodia,
Nepal, and the Philippines. It is now being tested in select African locations. HKI has also worked closely
with the International Potato Center (CIP) in introducing orange-fleshed sweet potatoes (OFSP) in a
number of countries in Africa; OFSP is one of the products being promoted in E-HFP in that region.
Goal: The program model is expected to improve maternal and child nutrition outcomes through a
number of program impact pathways, including household-level production and consumption of high
quality foods; increasing income through the sale of food surpluses; improving knowledge, attitudes and
practices in regard to nutrition through the behavior change component; strong linkages with local health
systems to improve uptake of essential services; and empowering women through increased knowledge,
control over income, and program components that address gender equity issues.
Interventions: HKI works with local partner NGOs by first creating Village Model Farms (VMFs). Each
VMF serves approximately two groups of 20 households each; these are reached through contact groups
comprising primarily female farmers (known as "mothers groups"). These groups are provided with
valuable production inputs, including seeds, seedlings, saplings, improved animal breeds, and feed and
medicine for poultry and livestock, as well as improved cultivation techniques. Within the mothers
groups, nutrition education is integrated into the agricultural program activities, thus encouraging women
to adopt optimal dietary practices using the foods produced. The active involvement of local health staff
in the program helps to reinforce key messages promoting optimal nutritional practices and extends the
reach of the nutrition education component far beyond the members of the mothers groups.
Target population and reach: Since HKI launched the E-HFP program over two decades ago, over 5.5
million people have been directly reached (representing about 950,000 families), through work with more
than 200 NGO partners in Bangladesh, Cambodia, Nepal, and the Philippines. Many millions more have
indirectly benefited from spillover effects arising from the surplus of nutritious foods entering the local
marketplace.
Early evidence of what works: Evaluation results have shown that E-HFP has increased production of
nutritious crops and animal-based foods, improved dietary diversity, and increased income (especially
under control of women), while it has increased female empowerment in family decisionmaking. In some
countries, anemia prevalence was decreased in target children (6-59 months old) and nonpregnant
women, and night blindness was reduced in children 12-59 months old. Evaluations show that the effects
of the program survive long after HKI involvement has ended. The E-HFP model has received
international awards as a proven program for addressing hunger and malnutrition at scale. In 2009, HKI's
E-HFP program in Bangladesh was selected as one of 27 case studies out of 250 applications for Millions
Fed: Proven Successes in Agricultural Development, an initiative of the International Food Policy
Research Institute (IFPRI) funded by the Bill and Melinda Gates Foundation.
Gaps in the program: An overarching gap is the need to evaluate the model's impact on child nutrition,
particularly on growth, as well as to deepen our understanding of the various program pathways. In
addition, cost-effectiveness, including the scalability of the model, needs to be better documented.
Another gap relating to program design pertains to addressing specific deficiencies in local dietary
patterns through appropriate horticultural and small animal production strategies. We also need to explore
the feasibility of adapting the current Asia Pacific model to address the food and nutrition security needs
of the ultra-poor and the landless. Another high priority is how to adapt the model to Sub-Saharan Africa,
196


﻿where there are severe constraints relating to water availability, weak government infrastructure, and few
nongovernmental partners.
How CG can help: The CG centers can bring state-of-the-art knowledge in several areas: crop breeding
(for enhanced*nutritional value, drought and pest resistance, yield), livestock management and
improvement (with a focus on poultry and small ruminants), integrated pest management, and water
management systems. The system-wide Gender and Diversity program will provide valuable input for
overall gender analysis and development of strategies for empowering women. IFPRI will play a key role
in developing the monitoring and evaluation framework that will be necessary for mainstreaming these
programs. The CG centers' credibility with the agriculture and food policy communities will be key in
repositioning the E-HFP model, creating a strategic opportunity to harness agricultural programs to
improve nutrition and livelihoods.
"Realigning Agriculture to Integrate Nutrition" (RAIN) Concern and IFPRI (Zambia)
With the support of a grant from Irish Aid for 2010, Concern Worldwide and the International Food
Policy Research Institute (IFPRI) are working together to develop an innovative project, Realigning
Agriculture to Integrate Nutrition (RAIN). The program reconceptualizes traditional livelihoods and food
security programs, focusing on preventing stunting in children under the age of two years.
Goal: This new project will be implemented on an agricultural platform to reduce maternal and child
undernutrition. The project is to generate evidence and inform policy at national, regional, and global
levels, exploring how agricultural projects can contribute to the reduction of childhood stunting.
Interventions: The RAIN project will examine the combined potential of a targeted agricultural project
that incorporates support for home/community food production and small animal husbandry, together
with a strong nutrition and health intervention package.
Target population and reach: The project will be implemented in Mumbwa District, Central Province,
Zambia. Activities will address agricultural and nutrition practices of approximately 3,000 households
with pregnant and/or lactating women and children below the age of two years. The project will be
implemented in very close collaboration with the two key line ministries, the Ministry of Agriculture and
Cooperatives and the Ministry of Health, at both national and local levels. This is to ensure sustainability
from the beginning by involving necessary stakeholders, as well as to develop a feasible project model
that can be replicated in other areas.
Early evidence of what works: As the project is still in the design phase, there are no indications yet.
However, the design of the project takes into account evidence generated in other projects in related
areas: homestead food production, infant and young child feeding practices, women's empowerment, and
programs addressing micronutrient deficiencies using a food-based approach.
Gaps in the program: The project will be set up specifically to monitor and evaluate the impact pathway
from agriculture to nutrition. It will concentrate on activities around this pathway and the additional
health and nutrition package, especially the behavior change communication component). It will not
emphasize other pathways, such as strengthening of the health system, water, sanitation and hygiene, and
treatment of HIV (ART).
How CG can help: Technical expertise from various CG centers could greatly benefit the project,
especially IFPRI (as project partner). Also valuable will be links with ILRI, World Fish, and IITA, as well
as related institutes and programs such as HarvestPlus and the World Vegetable Center. As a route for
publication and dissemination of findings, the CG system will likely add weight, positioning the resulting
model for adoption beyond the country of implementation.
197


﻿Millennium Villages with Bioversity and IFPRI (Sub-Saharan Africa and example of humid
tropics)
The Millennium Villages Project (MVP) is a 10-year rural development project that involves the
coordinated delivery of scientifically-proven interventions in agriculture, health, infrastructure, education,
and business development. Millennium Village Project sites are drawn from hunger "hot-spots," with an
estimated underweight prevalence of at least 20 percent. Village clusters averaging approximately 40,000
people were selected to represent the major agroecological zones and fanning systems in Sub-Saharan
Africa, presenting a range of challenges relating to income generation, food security, disease ecology,
infrastructure, and health system development.
Goal: The aim of the MVP is to accelerate progress toward the Millennium Development Goals (MDG)
targets: MDG 1-to eradicate extreme poverty and hunger and eliminate undernutrition; MDG 4-to
reduce by two-thirds the under-five mortality rate; and MDG 5-to reduce by three-quarters the maternal
mortality ratio.
Interventions: The villages are demonstration and testing sites for the integrated delivery of science-
based interventions in health, education, agriculture, and infrastructure. Within the project, hunger and
undernutrition are being addressed with an integrated food- and livelihood-based model that delivers a
comprehensive package of health and development interventions.
*  Community-wide interventions support food and livelihood security: subsidized seed and
fertilizer to increase agricultural productivity; the introduction of high-value and nutritious crops;
agro-processing initiatives; and microfinance programs to stimulate small-business development.
*  A community health worker program promotes exclusive breastfeeding and locally appropriate
complementary feeding, home-based fortification, and proper food storage techniques.
*  Clinical interventions focus on persistent macro- and micronutrient deficiencies in children,
including vitamin A supplementation, treatment of severe acute malnutrition, and regular growth
monitoring.
*  For cases of moderate malnutrition, families receive InstaFlour (the United States Agency for
International Development [USAID]) or locally made nutrient-rich flour consisting of millet,
soybean, sorghum, cassava, and groundnuts.
* Basic maternal health interventions such as antenatal care and institutional delivery are supported
by efforts to promote adequate weight gain, along with iron and folic acid supplementation.
Target population and reach: Millennium Villages are located in Ethiopia, Ghana, Kenya, Malawi,
Mali, Nigeria, Rwanda, Senegal, Tanzania, and Uganda. These countries were chosen to reflect a
diversity of agroecological zones, representing the farming systems found in over 90 percent of Sub-
Saharan Africa.
Early evidence of what works: Three years after the start of this 10-year project, the risk of stunting
among children under two-years-old was reduced by 55 percent, with corresponding improvements in
household food security, childcare practices, and infectious disease control across rural sites in nine
African countries.
Gaps in the program: The use of historical controls, the uniqueness of project settings, and the
multifactorial determinants of undernutrition limit definitive causal statements and impact assessment
studies.
How CG can help: CG can bring new tools and methodologies for AHN implementation research,
strengthen evaluation to establish causality, document lessons learned and impact pathways, formulate
scaling-up strategies and comparison of impact and cost-effectiveness to other programs, and serve as an
effective partner in local and national capacity building.
198


﻿Agriculture Diversity for Nutrition, McGill University, Kenyatta University, National Museums of
Kenya, Universit6 de Abomey Calavi, and Bioversity (East, West, and Southern Africa)
Goal: This project investigates the factors underpinning the persistent rise in malnutrition in communities
in Kenya, Benin, and South Africa. The project assesses existing strategies based on targeted single or
multi-nutrient interventions-exploring how interventions based on local ecosystems and human
resources can provide sustainable solutions to hunger and malnutrition, identifying the actual and
potential contributions of local biodiversity to diets, and appraising the impact of ecosystem degradation
on nutrition and health status. The research is also attempting to identify and mobilize biodiversity
resources and biodiversity stakeholders by working with local communities as well as drawing on outside
expertise in health, agriculture, environment, and development, in order to achieve transdisciplinary
strategies for better health. These research results and outcomes may also serve as models in similar
ecosystems and environments in Africa and other developing regions.
Interventions: The interventions targeted increasing the biodiversity within the study communities' food
systems and then studying the effects of the increased agro-biodiversity and food availability on nutrition
and health outcomes of under-five children. To ensure increases in the diversity of foods in communities'
food systems, collaborating local food producers were provided with seeds of local but neglected food
crops and were trained in mixed cropping systems.
Target populations and reach: Women farmers and children under five years of age in rural agriculture
systems of Kenya, Benin, and South Africa.
Early evidence of what works: The experience from the first phase of the project affirmed the need for a
comprehensive evidence base for designing coherent interventions to conserve and utilize food
biodiversity, adapted to a wide range of situations, food systems, and ecosystems. Results to date have
made important contributions to national and regional policies, through the wider recognition of the
strong links between agro-biodiversity conservation, food, and nutrition.
Gaps in the program: Experience from the first phase also demonstrated the need for more data, and for
further empirical demonstration of the contribution of biodiversity to positive health outcomes, to justify
and guide policy changes and program implementation, and to shape specific nutritional interventions that
build on local biodiversity resources.
How CG can help: This project needs to be scaled-up and tested in other food systems, in order to
provide convincing empirical evidence of whether (and how) local food systems and biodiversity affect
child nutrition and health outcomes.
Catholic Relief Services (Asia, Africa, and Latin America)
CRS has a strong integration component in its relief and development activities across all sectors.
Goal: Within the organization's current Agriculture and Environment Strategy (2009-2014), the pillar on
Agriculture for Nutrition focuses on delivering improved nutrition and clean water.
Interventions: CRS conducts a huge number of programs in agriculture, nutrition, and health globally,
including
*  Kitchen and community gardens;
*  Education on labor-saving techniques, such as trench and keyhole gardens for the elderly and sick,
including people living with HIV;
*  "Baby-friendly farms" for breastfeeding women;
*  Silos and other food-storage buildings;
*  Junior Farmer Field Schools for orphans and vulnerable children affected by HIV and AIDS;
*  Local production and marketing of vitamin- and mineral-rich foods like sweet potatoes and beans;
199


﻿*  Education in nutrition, diet diversity, sanitation, and food-handling practices; and
*  Identification of social, physical, or cultural barriers that prevent people from using healthy
behaviors, such as washing hands before preparing food, or breastfeeding exclusively during an
infant's first six months.
In addition, CRS has put increased resources toward integrating water and sanitation interventions with
agricultural programs to improve the health of vulnerable populations. Several models are used to conduct
this work, such as the Hearth model and Participatory Hygiene and Sanitation Transformation (PHAST),
which focus on community participation and leadership.
Target populations and reach: Due to the scale of CRS global operations, CRS can offer this
partnership numerous projects of varying focus, scale, and geographic location, ranging from several
thousand to several hundred thousand households, located in Asia, Africa, and Latin America.
Early evidence of what works: M&E indicators-such as improved agriculture production, change in
crops grown, dietary diversity, reduction in stunting and underweight in children, change in behavior of
mothers and caregivers-have been used to monitor and document the successes of projects over the last
10-15 years.
Gaps in the program: The Agency would be very interested in increasing the visibility of its work to a
more general audience, through additional reports, case studies, and in-depth project evaluations.
How CG can help: CG can provide in-depth analysis of different technical approaches in the field to
evaluate what works, where, why, and how; it can also support data analysis, peer review, and report and
article production. Recent approaches and innovations from the CGIAR and universities (e.g., varieties
from HarvestPlus) might be incorporated into our work and scaled up.
Projects Working with Unique Agriculture Systems with the Integration of Nutrition and
Health
Food for Progress Project and ICRAF (North and Northwest Regions of Cameroon)
Fifteen years ago, ICRAF initiated the Food for Progress Program as a development project in the north
and northwest provinces of Cameroon to address the loss of the nutritious foods formerly gathered from
forests, and the potential importance of trees to restore soil fertility. In 2010 the project was awarded
USAID's Equator Prize.
Goal: The project aims to empower smallholder farmers to lift their households out of poverty,
malnutrition, and hunger, while at the same time creating more environmentally and socially sustainable
farming systems.
Interventions: Using participatory approaches, community tree nurseries are created to domesticate
selected indigenous fruits and nuts, which before deforestation were gathered for foods and
medicines. Rural Resource Centers (RRCs) provide training and mentoring at the village level. These
RRCs have spun off 123 satellite tree nurseries in surrounding communities, supported by NGOs, CBOs,
etc. New skills are developed at the community level through training and capacity building: restoration
of soil fertility by planting nitrogen-fixing trees and shrubs alongside food crops; tree propagation and
nursery management; tree domestication using simple, low-technology horticultural techniques; group
dynamics and community project management; marketing, business skills, and management; and the use
of microfinance.
Target population and reach: Currently the project is working with 7,095 farmers and about 50
entrepreneurs in 485 widely-dispersed communities across the region, centered around 7 RRCs located in
lowland rainforest and in the denuded Bamenda Highlands. There have been many positive and few
negative outcomes.
200


﻿Early evidence of what works: Villagers have identified 31 positive impacts, including substantial
income generation; the creation of employment and business opportunities in value-adding processing;
retention of youths in the villages; doubled or trebled crop yields; diversified and more balanced diets
(fruits and nuts, vegetables, meat, and honey); delivery of potable water piped in from hillside springs
(and other infrastructure improvements), due to community-level planning and development; reduced
workload for women (allowing more time to attend to family needs); and improved health of community
members (Tchoundjeu et al. 2006; Asaah et al. 2010).
Gaps in the program: Currently the impacts on the nutrition and health of the participating communities
are not being quantitatively assessed. Nor is there any work in progress to develop this project as a model
for "Transformed Agriculture"-focusing on the use of agriculture to promote improved health and
nutrition.
How CG can help: The application of the research agenda of CRP4 Component 3 within the project
communities should generate important information about the nutritional value of traditional and
underutilized foods, providing critical evidence of the importance of domesticating these once-plentiful
species as components of farming systems. The available time frame (1-14 years) will offer opportunities
to capture the dynamics of nutritional and health changes.
East Africa Dairy Development Project, ILRI, and Emory University (East Africa and example of
agro-pastoral system)
Goal: The project is a large-scale intervention with the objective of doubling the dairy income in poor
agro-pastoralist communities. The Bill and Melinda Gates Foundation, which funds the project, is also
interested in ensuring the project provides additional welfare benefits, specifically improved child
nutritional status.
Interventions: The project establishes dairy hubs organized around dairy farmer business groups to
provide a steady market for the farm households, together with input and service provision through
business development services.
Target populations and reach: The target populations will be 135,000 poor agro-pastoral households
with indigenous cattle in Kenya, Uganda, and Rwanda.
Early evidence of what works: In collaboration with Emory University, ILRI is conducting a qualitative
assessment of the potential pathways for dairy intensification to influence nutritional outcomes, including
assessing the potential negative effects of livestock-associated health risks. The study is expected to raise
awareness of the need and value of nutrition and health interventions to enhance nutritional outcomes.
Gaps in the program: Because the project was not originally designed to serve nutritional objectives,
there is no component assessing opportunities for enhancing nutritional benefits.
How CG can help: The qualitative assessment is likely to suggest that a clear, positive nutritional impact
would require additional measures to enhance the benefits (e.g., nutrition education) and to mitigate the
risks (e.g., control of zoonoses). This could create an opportunity for undertaking a more holistic
approach that also links to nutritional benefits through better crop diversity and quality.
KARI, PATH, and CIP (Western Kenya)
Vitamin A deficiency accounts for 6 percent of all deaths of children under five years of age and 5
percent of the total disease burden of children in this age group (as measured in disability-adjusted life
years). Orange-fleshed sweet potato (OFSP) is an important source of energy and beta-carotene, which is
converted into vitamin A in the body. Only 125 grams of most OFSP varieties supply the recommended
daily allowance of vitamin A for children and non-lactating women. Evaluations of food-based
201


﻿approaches using OFSP undertaken in Mozambique and Uganda have shown significant impacts on
vitamin A intake and status (Low et al. 2007; HarvestPlus, July 2010).
Goal: In two HIV-affected Districts in Western Kenya, CIP and partners now want to provide solid
evidence that it is possible to improve the health and nutrition of pregnant women and children up to age
2 years by integrating OFSP with health service delivery serving pregnant women.
Interventions: The intervention will include two intensity levels. The high-intensity intervention will use
community health workers in conjunction with standing health facilities. It will also include community-
based peer support through pregnant mothers' clubs. The low-intensity intervention will take place only at
prenatal programs in standing health facilities. It will provide pregnant women with nutritional
information on vitamin A-rich foods and young child feeding within existing programs, with no
agricultural component. Almost all countries have prenatal programs, many of which provide nutritional
advice to mothers. The low-intensity intervention constitutes a "minimum package" that most Sub-
Saharan African countries could adopt and expand to scale, should it prove effective.
Target populations and reach: The target is to reach 900 pregnant women and their households during
the intervention period of three-and-a-half years. Two major expected impacts are significant increases in
consumption frequency of vitamin A-rich foods; and utilization of mother-child healthcare services.
Partners include the Program for Appropriate Technology in Health (PATH); the Kenyan Agricultural
Research Institute (KARI); local government stakeholders; and two NGO partners-Community
Research in Environment and Development Initiatives (CREADIS), and Appropriate Rural Development
Agriculture Program (ARDAP).
Early evidence of what works: Although the program only started in May 2010, PATH has found
that one of the first facilities to distribute vouchers, Tamlega Dispensary, reported a 30 percent increase in
first-time visits by pregnant women in their first and second trimesters, compared to the past three
months. If this occurs in many other clinics, the voucher program may be a tool that helps antenatal care
nurses serve more women earlier in their pregnancies, giving the pregnant women information they need
to adopt healthy practices during pregnancy and, eventually, to ensure that their babies' nutrition and
healthcare is good.
Gaps in the program: A major area for investment, still needing funding, is to study the effectiveness of
linking OFSP distribution to de-worming efforts in community or school programs. Theoretically,
improving intake of vitamin A while simultaneously lowering losses due to helminthic infections should
substantially increase the effect on vitamin A status, above either intervention alone. The approach could
also be extended as part of community-based nutrition programs, in addition to the use of health facilities
as the entry point.
How CG can help: Test integration of additional crops (e.g., traditional African vegetables and fruit trees
and their respective seed systems) and/or small-stock or poultry into the approach.
WorldFish (Bangladesh and example of aquatic system)
Fish and fisheries are important for the livelihoods, food, and income of the rural population in
Bangladesh. However, increased rice production and changing agricultural patterns have resulted in a
large decline in inland fisheries. Implementation of carp pond polyculture has been very successful,
whereas little focus has been given to the commonly consumed small indigenous fish species, some of
which are rich in vitamin A and minerals (such as calcium, iron, and zinc) and are an integral part of the
rural diet. The program addresses an important element impairing the nutritional status of the rural poor:
the decline in accessibility, increase in price, and decrease in intake of small indigenous fish species, as
well as the increased intake of silver carp-the most commonly cultured fish species-which is poor in
micronutrients and not preferred for consumption (Roos et al. 2007). An integrated approach was
conducted jointly by Bangladeshi and Danish institutions, linking human nutrition and fisheries.
202


﻿Goal: The overall objective of the research and capacity-building activities is to increase the production,
accessibility, and intake of nutrient-dense small indigenous fish species, in particular mola, in order to
combat micronutrient deficiencies.
Interventions: Activities include food consumption surveys; laboratory analyses of commonly consumed
fish species; production trials of carp-mola pond polyculture; teaching, training, and dissemination of the
results.
Target populations and reach: Rural Bangladesh, in areas with inland fisheries resources in households
with small, seasonal ponds, as well as poor communities with access to wetlands.
Early evidence of what works: No decline in carp production (and thus in income) was found with the
inclusion of mola, and increased intake of mola has the potential to combat micronutrient deficiencies.
Teaching and training of graduates and field staff have led to increased awareness of the role of small
indigenous fish species for good nutrition, resulting in the promotion of carp-mola pond polyculture and
research in small indigenous fish species. The successful linking of human nutrition and fisheries to
address micronutrient deficiencies has relevance for other countries with rich fisheries resources, such as
Cambodia and countries in the Lake Victoria region of Africa.
Gaps in the program: Incorporation of behavior health communication with respect to nutrition and
health education; strengthening of marketing and processing to increase utilization of nutrient-dense fish;
and linkages to other rural development sectors, including health and education.
How CG can help: Influencing policy at the national level, building up a regional program with other
Asian countries, dissemination at global, regional, and national levels, assisting in getting funding for
research and field activities.
Human and Animal Health Research Unit at the Swiss Tropical and Public Health Institute (One
Health Model)
Goal: The human and animal health unit aims to contribute to health of humans and animals by
identifying and applying synergistic potential of closer cooperation between human and veterinary
medicine, known as "one health."
Target groups and the coverage area: The focus is primarily on the health of mobile populations and
their animals, and, second, on the control of zoonoses in developing countries. Many of these activities
are in the framework of larger international networks such as the European Union Framework Program 7
(EU FP-7), connecting research institutions in the north and south. Target groups are livestock keeping
communities and consumers of livestock products in developing and transition countries: East Africa
(Kenya, Ethiopia); West Africa (Chad, Mali, C6te d'Ivoire, Mauritania); and Central Asia (Kyrgyzstan
and Mongolia).
Interventions: Mixed research teams, from the health and agricultural sectors, research topics ranging
from molecular epidemiology to trans-sectoral economic assessment. Nutritional studies in pastoral
communities of Chad (e.g., significant association between vitamin A/B-carotene content in milk
consumed and serum retinol; higher proportion of malnutrition among mobile pastoralist women than
sedentary women of the same region).
Early evidence of what works:
*   Simultaneous assessment of zoonoses in the three sectors-health, livestock, and wildlife-
generates more information on their epidemiology.
*  Trans-sectoral economic assessment of costs of zoonoses provides the basis for valuing the
financial contributions of each sector (public and private) involved in prevention and control of
zoonoses.
203


﻿*  Assessment of response capacity in key sectors involved in prevention and control of epidemic
zoonoses guides the planning ofjoint surveillance and contingency plans.
*  Costs of human and animal health delivery services can be shared between sectors using the same
infrastructure (e.g., vehicles and cool chain), particularly in remote rural areas.
Gaps in the program: Policy formulation is needed for national zoonoses control programs. In Chad, the
government has initiated a policy formulation workshop involving a range of sectors, led by the Ministry
of Finances.
How CG can help: Providing more evidence on the role of livestock in nutrition, health, and
sustainability in arid and semi-arid regions.
Support to Household Food Security and Nutrition, FAO, and the Ministry of Agriculture
(Afghanistan)
Goal: The project aims to contribute to improve household food security, nutrition, and the livelihoods
situation in Afghanistan by addressing root causes of malnutrition such as fragile institutional capacities
in coordination and implementation, limited knowledge on nutrition and improper feeding practices,
limited access to food, especially during the winter seasons. The participation of women in agricultural
development is addressed as a cross-cutting issue contributing to the goals.
Interventions: The project supports the integration of food security and nutrition in national policies and
strategies by contributing to the intra- and interministerial and interagency dialogue and by developing the
required capacities (i.e., Ministry of Agriculture, Ministry of Public Health, Ministry of Education,
national NGOs, as well as development guidelines, etc.). To strengthen the integration of nutrition in the
agriculture, education, and health sector as well as the direct implementation of community-based food
security, nutrition and livelihoods are the priorities of direct implementation (i.e., support to literacy
classes and community groups; training of teachers, and health and agriculture extension workers;
establishing and training of women groups).
Target populations and reach: Besides support at the national level, the project directly implements
activities in three provinces, working with target groups mainly through local government structures or in
collaboration with national and local NGOs and community networks, such as women's committees and
women's groups.
Early evidence of what works: Highlights are the successful contribution to the integration of food
security and nutrition into the Afghan National Development Strategy, the National Nutrition Policy and
Strategy, and the Infant and Young Child Policy, curriculum development or the contribution to MAIL
monitoring system. National guidelines have been developed and largely disseminated (i.e., Afghan
Family Nutrition Guideline, Complementary Feeding Guideline, Food Processing Guideline, etc.). The
project supported the establishment of the MAIL's Home Economic Department as well as their
subnational network reaching out to 18 provinces. In 2009, for example, the established network was able
to reach out to 72,000 individuals providing nutrition education. Linkages to donors were established (i.e.,
Spanish and Government). In 2010, the department was able to receive additional donors as well as
internal funding to extend those food security and nutrition activities. The project also supports 5 to 8
pilot projects annually, working with most vulnerable households in linking food production, food
processing, and better family nutrition.
Gaps in the program: The focus of the project was given to the development of capacities, piloting, and
implementing food and nutrition activities under MAIL. In order to embed the lessons learnt, a more
systematic scale-up and a continued monitoring and evaluation system would be required. Furthermore,
additional limited technical capacities are hindering large-scale and sustained impacts if the actual project
support phases out.
204


﻿How CG can help: Sharing lessons with other projects would help to design effective interventions to
improve community nutrition through the agricultural sector. A systematic review of the different
interventions applied to tackle household food insecurity and malnutrition, followed by a promotion and
advocacy for successful food-based approaches, are required to increase recognition and to
institutionalize the measures. This is important to ensure that achievements are sustained.
205


﻿Appendix Table AlO.1. Summary of case studies of programs integrating agriculture, nutrition, and health
Implementer/geographic Type of program and intervention              Goal                         Where CRP4 can help
coverage/CG               package    -
collaborator
Helen Keller International  Enhanced Homestead Food Production         Improve women's and        * Evaluating impact, impact pathways, and cost-effectiveness
(EHFP):                                      children's nutrition through   Assessing whether model can be scaled up or replicated in
South Asia and West Africa  * Village model farms with food crops, poultry,  food production,      other settings (e.g., targeting ultra poor; adapting to Sub-
(950,000and livestock                                                  consumption of high quality  Saharan Africa)
Bangladesh, amili i      Agriculture training and inputs            foods, income (through sale   Assessing how to address local dietary deficiencies
Nepal,adehlamoia,        * Nutrition education and behavior change (focus  of products), better   Strengthening gender analysis
on child feeding practices and other essential  knowledge, attitudes,   Bringing state-of-the-art knowledge of crop breeding,
IFPRI                       nutrition actions)                         practices, and empowering   livestock, water and pest management, and M&E
- Involvement of local health staff and primary  women.
healthcare input
* Target women, address gender equity.
Concern Worldwide         Realigning Agriculture to Integrate Nutrition    Improve maternal and child  Note: project is still in design
(RAIN):                                      nutrition                  * Providing technical expertise in design, implementation,
Zambia                    *Agriculture project (home and community food  Generate evidence and      monitoring, and evaluation (e.g., involving ILRI, World
300hueod(aone)       production; small animal husbandry)       inform policy on how         Fish, IITA, HarvestPlus, the World Vegetable Center)
Nutrition and health intervention package   agriculture projects can   Strengthening impact evaluation using program theory and
I   Integration ofwomen's empowerment into*food-  contribute to reduce child  impact pathway methodologies
based approach                              stunting                   Documenting lessons learned; publishing and
disseminatin results
Millennium Villages       Millennium Villages Project:                *Accelerate progress toward  * Bringing new tools and methodologies for ANH
" Villages as demonstration sites for integrated  MDG targets: MDG 1 -To  implementation research
West, East, and Southern    delivery of agriculture, nutrition, health  eradicate poverty and     * Strengthening evaluation
Africa                      infrastructure                             undernutrition; MDG4 and    Documenting lessons learned and impact pathways
SIntegrated food- and livelihood-based model  5-To improve child and    Formulating scaling-up strategies
Bioversity and IFPRI        that delivers comprehensive package of health  maternal health        *     Comparison of cost-effectiveness and impact in relation to
and development interventions                                           other programs
* As partner in local and national capacity building
McGill University, Kenyatta. Agriculture Diversity for Nutrition:      Identify contribution of local    Establishing an evidence base on the contribution of
University, National      - Seed distribution for increased biodiversity in  biodiversity to diets  agrobiodiversity to improving child undernutrition and
Museums of Kenya,          local food systems                         AMobilize local biodiversity  human health
Universitd de Abomey                                                                              * Training local producers in mixed cropping  resources    Applying model to other ecosystems and environments
Calavi                      systems                                                                        s      -Draw on health, agriculture,
Kenya, Benin, and South   * Target women and children under 5          and environment sectors to
Africa/Bioversity                                                      achieve trans-disciplinary
*_ Nutrition_andhealthinterventionpackagestrategies forbetter health
(continued)
206


﻿Implementer/geograpi
Implmentr/gograhicType of program and intervention
coverage/CG         ph    c   k e                                   Goal                        Where CRP4 can help
collaborator
Catholic Relief Services  Agriculture for Nutrition interventions     * Ensure that agriculture   * Carrying out in-depth analysis of technical approaches;
including:                                    programs improve access to  evaluating what works, where, and why
Asia, Africa, and Latin   * Kitchen and community gardens, Junior Farmer  good nutrition and clean  - Evaluating how innovations from CGIAR and universities
America                     Field schools for youth affected by HIV/AIDS,  water                    can be incorporated and scaled-up
and baby-friendly farms                                               * Supporting data analysis, documentation of experience, and
IFPRI and Bioversity      * Local production and marketing of nutrient-rich                         publication of lessons learned
crops
* Education on labor-saving techniques (for
people living with HIV), nutrition, and food
safety
* Integrated water, sanitation, and agricultural
programs
ICRAF and partners        Food for Progress:                            Empower smallholder       * Assessing impacts of better livelihoods and diversified
* Domestication of indigenous fruits and nuts  farmers through            diets on nutrition and health
Cameroon                  -Capacity building and training on community  environmentally and socially  * Developing project as model for using agriculture to
7,9  arestree nursery management, via rural resource            sustainable farming systems,  promote improved health and nutrition
7,09 fatreers            centers                                    to improve health and reduce  * Generating evidence to support the domestication of
5 entre-gncs                                                        poverty and hunger         traditional species
Using time series data to document impact on nutrition and
ICRAF ahealth
Emory University          East Africa Dairy Development:                Increase dairy income and   Assessing nutritional impact
Keya Uada adRwanda * Dairy hubs organized around dairy farmer      improve child nutrition in  * Identifying holistic approaches that increase nutritional
Snbusiness groups, to provide steady market input  agro-pastoralist communities  benefits and control risks of zoonotic diseases
5and business development services
ILRI
Program for Appropriate   Orange-Fleshed Sweet Potato program in       Improve nutrition of pregnant -Assessing the effectiveness of linking biofortification with
Technology in Health      HIV-affected areas:                           women and children under 2  health services such as de-worming
(PATH); Kenyan            -Community education on nutrition and prenatal  by integrating OFSP and  * Testing integration of traditional vegetables, fruit trees, and
Agricultural Research       care                                        health service delivery in  small animals
Institute (KARI)          * Peer support through pregnant women's clubs  HI V-affected areas
- Mother-child healthcare services through use of
Western Kenya               health workers and existing facilities
9* Assessg Promotion of biofortified orangbe-fleshed sweet
their householdspoao(FP
d Targets pregnant women and children up to 2
CIP                        years
(continued)
207


﻿Implementer/geographic Type of program and intervention             Goal                       Where CRP4 can help
collaborator             package
Bangladeshi and Danish   Carp-mola polyculture research:            * Increase production,     - Assisting with behavior change communication and health
institutes; FAO          * Food consumption surveys and analysis of  accessibility, and intake of  education
nutrient content of fish species           small, nutrient-dense    * Strengthening marketing and processing of fish species
Bangladesh               * Production trials of carp-mola pond polyculture  indigenous fish species for  * Establishing links to other development sectors
* Training and dissemination of results     better nutrition and health  * Influencing national policy
WorldFish                                                                                      * Building regional program
Swiss Tropical and Public  Ecohealth Model:                         * Identify and apply synergies  * Assist with policy formulation for national zoonoses
Health Institute/        * Mixed health and agricultural teams conducting  between human and     control programs
Kenya, Ethiopia, Chad, Mali,  nutritional, epidemiological, environmental, and  veterinary medicine to  * Generate evidence on the role of livestock in nutrition,
C6te d'Ivoire, Mauritania,  economic assessments in pastoral communities  improve the health of humans  health, and sustainability in arid and semi-arid regions
Kyrgyzstan, and Mongolia   using an "eco health " approach           and animals
ILRI                                                                * Control zoonoses
FAO, Ministry of         Support to Household Food Security and     * Improve household food   * Analysis of how to scale up and continue M&E efforts
Agriculture              Nutrition in Afghanistan:                   security, nutrition, and  * Expanding technical capacities
* Support national policies and strategies that  livelihoods by addressing the * Systematic review of different interventions and lessons
Afghanistan                promote integrated food security and nutrition  root causes of malnutrition  learned
* Capacity building within and across ministries                      * Promotion and advocacy for successful food-based
IFPRI                      and agencies                                                          approaches
.o   t .* Direct implementation activities, including
Bioversity                 teacher and extension worker education, and
I training of women's groups
208


﻿APPENDIX 11. EXAMPLES OF EVIDENCE-BASED, CROSS-SECTORAL
INTERVENTIONS
Three examples illustrate how past innovations can be built upon for much broader impact across
agricultural-health-nutrition boundaries: (1) brucellosis control in Mongolia (Roth et al. 2003),
(2) smallholder dairy in Kenya (Kaitibie et al. 2008), and (3) pesticide regulatory policy in the Philippines
(Templeton and Jamora 2008).
In the case of brucellosis control in Mongolia, research was carried out to estimate the economic
benefits and cost-effectiveness of improving human health in Mongolia through the control of brucellosis
(a disease that can pass between livestock and humans) by mass vaccination of livestock. Researchers
calculated the monetary benefits to the agricultural sector, the public health sector, and private
households. This case shows how incomplete data from separate sectors could be used in models to
highlight some of the most difficult questions for policymakers and their implications. What is the most
effective way of controlling a human health problem originating in the agricultural sector? The
identification and control of zoonotic diseases increasingly depends on surveillance and action in the
agricultural sector. Second, what are the fiscal incentives that need to be put in place for effective control
of diseases? Compensation of farmers for culled stock and free vaccination may be necessary for
compliance. Finally, within government there must be protocols for the Ministries of Agriculture and
Health to allocate the necessary funds according to some principle of cost-effectiveness and ultimate
beneficiaries from the action. Collaboration is more difficult when it involves real claims on Ministerial
budgets.
In the case of smallholder dairy in Kenya, health regulations requiring pasteurization of milk
entering commercial circuits were reversed in the light of research into public health risks and a
socioeconomic poverty impact assessment by ILRI and partners. This research is relevant to many
locations in East Africa and South Asia.
In the case of the change in pesticide regulatory policy in the Philippines, IRRI and its partners
documented growing health concerns in the 1980s, particularly the harmful effects of pesticide use,
through detailed analysis of private health costs and environmental effects of rice farming in the
Philippines. This research led the Philippine government to instigate a suite of pesticide regulatory
policies and implementing guidelines and launch integrated pest management (IPM) as a national
program. There are a number of important lessons from this work: (1) the impact of policy research is
difficult to estimate; (2) there is seldom only one study that deals with an important issue (and the case of
pesticide in the Philippines goes back 20 years and IRRI studied it several times); and (3) there are always
multiple drivers of decisions. These are all good points for policy analysts to keep in mind.
All three examples illustrate the importance of bringing together knowledge and evidence,
decisionmaking processes, partnerships, communication and advocacy, and other elements in support of
integrated decisionmaking across the agriculture, nutrition, and health sectors.
209


﻿APPENDIX 12. POTENTIAL INTERACTIONS BETWEEN CRP4 AND OTHER CRPS
Legend: Shaded rows indicate CRPs that CRP4 will collaborate with most closely
Common interests                                                                                              Mechanisms for
and goalsInputs of other CRPs to CRP4                             CRP4 inputs to other CRPsclaoato/udn
and goals                                                                                                     collaboration/funding
CRP 1,1  Improve nutritional   Assess the availability of agrobiodiversity products and  Component 1:                  Direct links through addressing the
security and           their importance for nutrition and health      Research on value chain for nutrition of  same target groups and issues
agroecosyster        Research nutrition impacts of diversification of  agrobiodiversity products              related to the importance of
resilience in dry      livelihood; research synergies among crops, including Component 3:                     agrobiodiversity for dietary
farming systems        those of high nutritional value                Food safety and neglected zoonoses as   diversity and nutrition outcomes,
constraints to both human health and animal  and food safety and neglected
production/productivity                 zoonoses
CRP4 will fund nutrition
assessments, work on incorporating
nutrition into value chains for
agrobiodiversity products (value-
chain work itself will be funded by
CRPL 1), and work on food safety
and zoonoses risk assessment and
control measures.
CRP1.2   Improve nutrition of  Address nutritional risks through market- and food-  CoLponent 3:                        Potential areas of collaboration:
the poor in humid      based approaches                               Research on the ability of systems to deliver  Joint contributions to better
farming systems      Reduce health risks from pesticide use and       food quality and safety without trading off  performing systems in terms of
Address issues of      intensification                                other attributes                        food production, emphasizing
pesticide use        Feedback humid-system research needs to CRP4     Food safety risks and emerging disease as  quality, safety, and environmental
constraints to rapidly emerging value chains; sustainability
Pesticides as occupational hazards and food
safety risks                            Exact nature ofpartnership and
funding responsibilities will be
determined in first year of
I implementation
(continued)
210


﻿Common interests                                                                                            Mechanisms for
and goals                                                                                                  collaboration/funding
CRPI.3   Improve nutrition    Provide field locations for research into nutrition, food  CoWWnents 1 and 3:          Joint research on value chains for
through promotion of  safety, and occupational health in aquatic ecosystems  Research on fish value chains for nutrition  nutrition and food safety and on
fish production and  Research on wider services and support needed to build  and food safety               integrated agriculture, nutrition and
intake and healthy   healthier communities in remote and poor aquatic  Comonent 4:                         health programs including fish
aquatic ecosystems   agricultural systems                           Research on community-based homestead  products
Focus on gender,     Research on gender                              food production systems including fish ponds
women's participation,                                               as a major source of animal source foods rich Fundingfor the incorporation of
empowerment, and                                                     in essential nutrients and their impact on the  nutrition intofish value chains
nutrition and health of                                             nutrition of women and young children and  would comefrom CRP4, whereas
mothers and young                                                    on women's status (as part of research on  CRP1.3 wouldprovidefield sites
children                                                            integrated ANH programnming)           and specificfish value chains of
interest. CRP4 wouldprovide
fundingfor research on integrated
ANH programming that includes
fish products. dRPL.3 wouldfund
the incorporation of innovation in
technologies related tofish
production. Both CRPs wouldfund
research on gender.
(continued)
211


﻿Common interests        Inputs of other CRPs to CRP4                    CRP4 inputs to other CRPs             Mechanisms for
and goals                                                                                                     collaboration/funding
CRP2     Ensure food and       Assess impacts of a wide range of policies on poverty,  Components 1&2:                 Coordinate food safety research and
nutrition security and  nutrition, and health and ways to strengthen  Identify opportunities along the value chain  delivery of biofortified products
focus on policies to   policymaking to achieve greater impacts         to enhance nutritional value of biofortified  and other nutritious foods to poor
achieve these impacts  Focus on gender analysis and impacts, and methods to  crops and other nutritious foods   populations through value-chain
assess changes in gender-disaggregated outcomes  Component 3:                            research
Identify institutional arrangements that contribute to  Generate evidence on how policy and market Work jointly, and generate research
children's nutrition and health (social protection and  structure can affect agriculture-associated  results, methods, and tools to
market mechanisms); analyse gendered consumption  diseases (AAD)                         analyze policy impacts on
patterns, domestic roles, and nutrient intakes  Develop metrics for the multiple burdens of  nutntion and health outcomes
Research access to resources, inputs and knowledge  food-borne disease and zoonotics; provide  Collaborate on research on social
around agriculture-health-nutrition linkages; explore  evidence for targeted and informed policy  protection policies, risk
livelihood diversification and improvement of health  advocacy, institutional capacity building,  management, gender policies, and
and nutrition                                    and awareness-raising around AAD        knowledge management
Improve efficiency of value chains to enhance    Component 4:
nutritional security for neglected populations  Transfer learning from research on integrated CRP4 will fund the incorporation of
ANH programming and policy to other     nutrition, food safety, and
types of programs such as social        biofortified crops (or.,
protection, risk management, and gender  biofortification results) in the
programs and policies                   work of CRP2 on value chains
and policies; CRP2 will provide
field sites for research on value
chains and on social protection
and gender programs, whereas
CRP4 will fund nutrition and
health inputs and contribution to
impact analyses of nutrition and
health outcomes.
(continued)
212


﻿Common interests       Inputs of other CRPs to CRP4                   CRP4 inputs to other CRPs             Mechanisms for
and goals                                                                                                  collaboration/funding
CRP3.1I   Ensure that wheat   Technology generation of nutritionally improved wheat; Components land 3:              Joint work on wheat
meets users' quality  exploring new traits of nutritional significance  Value-chain research to enhance/preserve the biofortification, value chains for
and nutrition needs  High throughput, low-cost phenotypic screening for  nutritional value and ensure safety of  biofortified wheat, and including
nutritionally important processing-quality traits and  biofortified crop             biofortified wheat into ANH
associated marker genes                       Component 2:                           programming.
Breeding for protein quality and quantity and   Technical and institutional aspects, including
micronutrients; ensuring that wheat nutritional quality  policy, dissemination, and adoption of  CRP4 willfund all work related to
improvements fit with needs of processing industry  biofortified wheat, and research on  enhancingpreserving the
targeting, advocacy, and promotion of  nutritional value and safety of
biofortified wheat and on evaluation of  bioforted wheat along the value
nutritional impact                   chain and the research on adoption,
Components 2 and 4:                    dissemination, andpromotion of
Where relevant, research on the       intake of bioforied wheat in the
incorporation of biofortified wheat in  context ofANH programming.
integrated ANH programming, including  CRP3.1 willfund all plant-breeding
approaches to empower women with     efrts and will provide sites and
knowledge regarding nutrition and health  fundingfor value-chain research,
and the role of biofortified wheat,  which CRP4 will complement to
promotion of consumption of biofortified  add nutrition objectives.
wheat by women, children, and other
vulnerable groups, and evaluation of
nutritional impacts
CRP3.2   Nutritious maize     Develop biofortified maize (macro- and micronutrients), Same as above (CRP 1. 1), but for biofortified Same as above (CRP 1.1), but for
nutritionally enhanced germplasm, breeding      maize                                biofortified maize, and with
approaches, and functional markers            Component 3:                           additional research on mycotoxin
Nutrition research to assess factors influencing  Overall risk framework for mycotoxin  risk mitigation and impact
bioavailability                                 mitigations in food and feed         assessment.
Assess impact of maize interventions on child nutrition; Evidence of impact across different value
insights from gender and value-chain analysis that  chains and policy support        Coordination and funding
may influence impact pathway of nutritionally                                        arrangementsfor mycotoxin
enhanced maize                                                                       research will be discussed in year I
Mycotoxins           Quantification of maizec-associated mycotoxin risks,
interventions to reduce risk (breeding, bio-control,
screening tests), and capacity building and tools for
________               ~~~~partners___________________________________
(continued)
213


﻿Common interests                                                                                              Mechanisms for
and goalsInputs of other CRPs to CRP4                             CRP4 inputs to other CRPscoaortnfndn
and goals                                                                                                     collaboration/funding
CRP3.3   Improve nutrition and  Nutritional enhancement of rice; research into genes and  Same as above (CRPl.1), but for  To be determined
health through rice    allelic diversity conferring enhanced nutrition  biofortified rice
research             Estimate impact of improved rice on health.and
nutrition through DALY assessments
CRP3.4   Enhance the role of   Breeding for improved nutrition; nutritional studies to  Same as above (CRPl.1), but for roots,  Same as above (CRP1. 1), but for
roots, tubers, and   understand bioavailability and retention of minerals  tubers, and bananas              roots, tubers and bananas, and with
bananas in reducing  and vitamins during storage, cooking, and processing                                   additional research on low-toxin
risk of malnutrition  Food safety issues and product quality        Component 3:                            cassava
Food safety issues                                                    Evaluate low-toxin cassava, improved
agronomic practices, and food-processing  Coordination andfunding
methods                                 arrangements for food safety and
plant toxins will be discussed in
year 1
CRP3.5    Grain legumes for    Program Thrust 2 (Legumes for nutrition and health):  Components 1,2. and 4:            Same as above (CRP1.1) but for
health and nutrition   mechanistic studies on effects of legume consumption Same as above (CRP1. 1) but for different  beans and biofortified beans, and
on health; preparation methods to increase     varieties of beans and for biofortified beans  with additional research on
Mycotoxins             bioavailability and attractiveness of legumes;  Component 3:                           mycotoxin risk management and
nutritional and biochemical profiles           Evaluation of low-toxin grass-pea and faba  integrated pest management.
Plant toxins         Improving agronomic practice to eliminate food hazards  beans, and improved agronomic practices
such as aflatoxins                               and food-processing methods           Coordination andfunding
Development of nutritionally enhanced varieties;  Integrated pest management to allow    arrangementsfor mycotoxins and
improved seed systems for nutritionally enhanced  reduction of pesticide use           plant toxins will be discussed in
crops; promotional messages that stress nutrition  Developing and evaluating cost-effective,  year 1
pro-poor, and appropriate risk management
for iycotoxins that can be scaled out  Integratedpest management to
reduce pesticide use will be
developed in years 1-3 as part ofa
diferent approach to
reducti        cagroecosyste                       health
(continued)
214


﻿Common interests       Inputs of other CRPs to CRP4                   CRP4 inputs to other CRPs            Mechanisms for
and goals                                                                                                  collaboration/funding
CRP3.6   Enhance nutritional  Program Thrust 3 (healthy cereals for improved  Component 3:                           Same as above (CRP3. 1), but for
benefits of dryland   nutrition and well-being): accelerate and modernize  Research on pesticides as occupational  dryland cereals
cereals               development of resilient dryland cereals of improved  hazards and food safety risks
quality, through biotechnology, marker technology,  Developing and evaluating cost-effective,
Mycotoxin control     and participatory research. Provide evidence,   pro-poor, and appropriate risk management Coordination and funding
aggressive advocacy on health and nutrition benefits  for mycotoxins that can be scaled out for  arrangements for mycotoxins to be
Pesticides            of dryland cereals                              wide-reaching impacts                discussed in year 1
Research into health benefits of dryland cereals (and
livestock products from animals fed on dryland                                       Integrated pest management to
cereals); develop traditional and alternative diverse                                reduce pesticide use to be
food products high in nutrition                                                      developed in years 1-3 as part of a
Tools and capacity to monitor mycotoxins                                               different approach to
contamination, research into health effects of                                       agroecosystemr health!
Reserch_n_pesicids_asoccuptionl                                                      drpesticidesylandcereals
(continued)
215


﻿Common interests                                                                                           Mechanisms for
and 20515Inputs of other CRPs to CRP4                           CRP4 inputs to other CRPs             oabrtnfud2
and goals                                                                                                  collaboration/funding
CRP3.7   Produce more meat,   Provide comprehensive framework in focal countries  Given the importance of animal source foods Collaboration on value chains
milk, and fish to    and sites to channel research on health and nutrition for for nutrition and health, CRP3.7 will be a key  targeted by CRP3.7 to enhance
increase income, food  communities dependent on livestock and to leverage  partner of CRP4, CRP4 will work on  nutrition and food safety along
security, health, and  agriculture to improve nutrition and health.  extending the production focus of CRP3.7  the value chain and increase the
nutrition of poor                                                   (for meat, dairy products, and fish) to  poor's access to safe and
populations                                                         ensuring consumption, and the translation of  nutritious foods
increased production into greater dietary  Joint participatory diagnoses to
diversity and improved nutrition and health  develop integrated agriculture,
among poor populations, with a focus on  health, and nutrition projects that
nutritionally vulnerable women and young  link CRP3.7 and CRP4; and joint
children.                                research on incorporating
production and consumption of
Components I and 3:                      animal-source foods in ANH
Value-chain research to enhance/preserve the  programs to improve nutrition
nutritional value and ensure safety of  and health
animal source foods; use-value chain
research not only to stimulate production, CRP4 will fund the research on
but to increase demand among the poor  nutrition and health that extends
Component 4-                             the work of CRP3.7 and
Given the high nutrient density and      documents its impact on nutriton
bioavailability of micronutrients in animal-  and health outcomes. CRP3.7 will
source foods, these products are important  provide field sites and value
in homestead food production systems if  chains for CRP4 to work on.
nutrition impacts are to be achieved.
Research will be carned out on
incorporating suitable and adapted efficient
breeds of animals in integrated ANH
programming, including approaches to
empower women with knowledge
regarding nutrition and health and the role
of animal source foods, promotion of
consumption of these foods by women,
children, and other vulnerable groups, and
evaluation of nutritional impacts
(continued)
216


﻿Common interests                                                                                            Mechanisms for
and goals                                                                                                  collaboration/funding
CRP5     Improve livelihoods  Research into new socially (and economically)   Component 3:                           Coordinate water management
through research on  attractive, larger-scale approaches to water    Inform CRP5 by adding health            options to reduce AAD
water scarcity, land  management, designed to optimize water productivity  considerations as a faction in agricultural  Address health risks in research
degradations, and    while minimizing health risk and environmental damage water management interventions    projects hosted by CRP5 on water
ecosystem                                                                                                    management interventions
sustainability
Coordination and funding
arrangements will be discussed in
_______________year_I
CRP6     Enhancing            Policy and market research for NTFPs and fruit trees  Component 1:                     Work together in developing
contributions of forests,  for nutritional and medicinal value; conservation of  Assessment of nutritional value and food  capacity for nutrition and health
agroforests, and trees to  wild relatives of important food and medicinal  safety risks of NTFPs and fruit trees in the  research around forests and fruit
communities and        resources                                       context of value-chain research; work on  trees
smallholders and to the Research on forest and health issues at landscape scale,  enhancing/preserving nutritional value of  Work on participatory
environment            linked to the emergence of new diseases        fruits and stimulating demand among poor  domestication of indigenous,
Research on medicinal plants in a variety of contexts  populations                      underutilized fruit trees species in
Component 3:                            different agroecological zones
Research on health service effects of forest  and on the development and
agroecosystems; research on disease   improvement of value chains for
emergence linked to use of forest     their traditionally used, nutrient-
agroecosystems; research on medicinal  rich products
plants as relevant
CRP4 wilfund nutrition and health
research that is added to CRP6's
work based on mutual agreement.
CRP7     Pro-poor adaptation to  Climate change and environment are critical  Component 2:                          Collaborate on evaluation of health
and mitigation of      considerations for vulnerable and marginalized  Effect of climate change on micronutrient  implications of adaptation options
climate change         populations; these are also most vulnerable to threats  quality, types of plants grown, and  Collaborate on assessing the
to food and nutrition security and to AAD       genotype of staple crops grown (and   impacts of climate change on
CRP7 will produce downscaled climate and          effects on micronutrients)            consumer choices regarding
development scenarios for targeted regions    Component 3:                            nutritious foods, including
Analysis of adaptation options that may feed back to  CRP4 will produce scenarios of    changes in availability and
nutrition and human health, through shifts in the food  intensification and disease futures that will  access, in environments with
system arising from diversification             inform CRPTs work                     different levels of susceptibility
CRP7 will bring CRP4 outputs into the climate                                           to climate change shocks
community
Coordination andfunding
arrangements will be discussed in
intensifiation_anddisease_fturestha w year
217


﻿APPENDIX 13
Appendix Table A13.1. CRP4 capacity-strengthening strategies, outputs, outcomes, and impacts
Outputs                          Outcomes                            Impact
Capacity-strengthening strategies                   (direct result of CRP4 efforts)       (change in behavior)                (long-term effects)
Capacity assessment                         * Identification of capacity needs,  * Well-defined CRP4 capacity-  * Enhanced capacity for better integration
existing capacity, and capacity gaps  strengthening needs           of agriculture nutrition and health
to achieve CRP4 goals                                               objectives in development
* Capacity-strengthening strategy  * Well-developed monitoring       interventions
developed for individual components  indicators for tracking the
and CRP4                           activities and outputs of capacity-
strengthening efforts
2. Individual capacity strengthening            * Increased number of skilled      * Higher quality research on CRP4  * Improved technologies, policies, and
researchers, scientists, analysts, and  issues                      program interventions contribute to
policymakers who can generate and  * More relevant problems identified  sustainable agricultural system
use knowledge for CRP4 objectives  and addressed by national      * Increased research outputs/publications
scientists                       by national research partners
* Capable research collaborators with  * Better and equitable research  * Stronger national research
up-to-date knowledge on tools and  partnership with national research  systems/institutions
methods applied in CRP4 research   and extension systems (NARES)
3. Institutional capacity strengthening          * Well-targeted collaborative      * Strengthened research         * More relevant priorities set for
partnership with national          organizations strategic in problem-  institutions; improved ability to attract
organizations                      solving                          funding
* Focused capacity strengthening of  * Better engaged national      - Better managed national systems of
policymakers, program managers,    policymaking systems for CRP4    agriculture research and institution
and research managers              goals
* Improved institutional capacity to  * Increased publishing/outputs by
design and implement research and  national systems
program interventions            * Effective use of research results for
* Improved organization ability to   designing better-integrated
design, implement, monitor,        program interventions
evaluate, and assess the impact of
integrated programt interventions
(continued)
218


﻿Outputs                          Outcomes                            Impact
Capacity-strengthening strategies                    (direct result of CRP4 efforts)       (change in behavior)               (long-term effects)
4. Supporting teaching and training organizations  CRP4 research results and methods  * Educational and training     - Students and researchers familiar with
developed as learning resources;   organizations incorporate learning  results and research methods from
country-level case studies developed  content and case studies from  CRP4
as source book for use in training  CRP4 research in curricula    - Joint research products owned and used
and learning programs            * Joint output through exchange   internally in the country for designing
* Enhanced interaction within target  visits that enhance the quality of  program interventions and
countries among the research,      research in targeted countries   policymaking
education, and policymaking
institutions; exchange of
collaborating researchers and
students
5. Support to learning networks                  * Well-functioning formial/informal      Improved knowledge-sharing  Informed members of the learning
learning networks that use CRP4    among the network members on     networks use the knowledge gained for
methods and results                issues related to CRP4           future research programs
* Increased ownership and           CRP4 knowledge access and use by a
sustainable use of CRP4 results  wide range of institutions in North and
and methods for research and     South
educational programs
6. Improving policy environment through capacity  Strengthened capacity of          - Regional and subregional policy  * Improved policy environment that
strengthening                                  policymnakers and strategy         organizations adopt results from  enables integration of agriculture,
developers at regional and         CRP4 research as part of policy  nutrition, and health policies and
subregional policy organizations for  and strategy development      programs
making informed policies using   Use of CRP4 technologies,        Improved policies and strategies at the
CRP4 results                       research, and methods of analysis  national level that recognize and use
* Improved understanding of the policy  at various stages of policy process  results of CRP4
process and actors at the national  in targeted countries
level for increasing the use of CRP4
research results
219


﻿APPENDIX 14. CRP4 CAPACITY STRENGTHENING ACTIVITIES BY COMPONENT
Component 1 - Nutrition-Sensitive Value Chains
Capacity development will be critical for the complex multidisciplinary and multisectoral research under
this component. Full participation of regional partners will ensure individual and institutional capacity
strengthening. This will also ensure that methodological frameworks for data gathering and analysis are
harmonized, that the tools and methods developed are used widely, and that the concepts of nutrition-
sensitive value chains are adopted and disseminated. Researchers will be trained in several specific areas:
dietary assessment, including consumption and use of traditional crops; impact assessment regarding the
contribution of traditional crops and the potential contribution 'of specific interventions; and intervention
design to increase demand for nutrient-rich foods.
Institutional capacity support of value-chain stakeholders at all levels (and particularly women)
will be critical to sustainability, including farmers' organizations, NGOs, public-sector marketing
agencies, representatives of the processing industries, women entrepreneurs, and consumer associations.
A major emphasis will be on educating these value-chain stakeholders to use a nutrition lens and to
identify opportunities to enhance the nutritional value of foods at different steps of the value chain.
Capacity development will also include training to enhance their skills as advocates in promoting
nutrition-sensitive value chains (similar to the Bioversity-M.S. Swaminathan Research Foundation
training courses for women entrepreneurs). This component will also engage with relevant universities
and training organizations, supporting them to incorporate new knowledge generated by the research into
their training and education curricula.
Component 2 - Biofortification
Lessons learned from existing biofortification programs point to three specific agricultural research and
delivery areas that particularly require strengthening.
1. Capacity building to enable National Agricultural Research and Extension Systems to develop,
evaluate, and disseminate biofortified crops. Crop evaluation, in particular, requires
infrastructure for high throughput and precision phenotyping for quality traits, as well as
technical backstopping for optimizing phenotyping assays. Short-term training will be
provided on an ad hoc basis for adaptive research or GXE analysis, as an area that pertains
directly to product development within this time-bound program. Training may include
supporting the secondment of CGIAR scientists to target countries to oversee biofortified crop
development activities, providing valuable one-on-one training to NARES partners.
2. Strengthening seed systems for seed multiplication and dissemination, to ensure that
commercial release of crops is supported with abundant quality seed for farmers. Actors along
the seed system value chain will be identified, and individuals and institutions responsible for
seed policy will be targeted for capacity strengthening.
3. Because biofortification is such a new science, there is limited capacity for nutritional analysis
of staple crops by NARES in target regions. All target countries of this component will need a
regular program of laboratory assessments.
Component 3 - Control of Agriculture Associated Diseases
Capacity-strengthening activities of this component will focus on three main related areas: (1) capacity to
generate trans-disciplinary knowledge and innovative strategies; (2) capacity to disseminate, adopt, and
sustain knowledge; and (3) capacity to build partnerships and innovation networks. The overall strategy
will be to leverage on existing national and regional capacities rather than building new ones, by
encouraging south-south collaborations. Specific strategies for capacity strengthening will include:
capacity needs assessment with development partners; building on existing innovation platforms;
220


﻿capacity-building targets for development partners; and graduate and postgraduate training. This
component will work with other expert boundary partners, including the advanced research institutes in
both developed and developing countries as well as national and international NGOs. Participation of
women will be actively encouraged, with specialized training provided at individual and institutional
levels. In addition, young researchers and technicians will be encouraged to enroll in degree programs,
with the component providing a platform for collaborative research.
Component 4 - Integrated Agriculture, Nutrition, and Health (ANH) Programs
Component 4 will focus on building individual-, group-, institutional-, and policy-level capacities through
research collaboration.
Specific capacity development activity at the individual level includes strengthening the skills of
the policy researchers and analysts for designing and implementing studies to evaluate the impact of
program interventions in agriculture, nutrition, and health. At the group level, it will build and support
learning networks among research and policy organizations. Learning networks will take advantage of
complementarities among organizations, encourage shared learning and capacity development, and focus
attention on integrated agriculture, nutrition, and health program interventions.
At the institutional level, capacity will be strengthened to engage in the research process and to
extend or use research results, working with organizations such as government ministries, civil society
organizations (CSOs), international and local nongovernmental organizations (NGOs), and private
organizations. Program managers and policy decisionmakers will be targeted to mainstream the integrated
approach into program design and implementation. This component will also engage in organizational
capacity strengthening to design, manage, use, and evaluate research outputs, to develop community-
based programs integrating ANH interventions. In addition, field research sites will serve as platforms for
academic institutions in the north and south to interact and collaborate on program-relevant applied
research and to acquire invaluable field and research experience. This component will also engage with
relevant universities and training organizations, supporting them to incorporate new knowledge generated
by CRP4 into training and education curricula and other learning resources.
At the policy level, CRP4 will also link with regional organizations for capacity strengthening,
providing inputs in support of existing policy platforms that integrate agriculture for improved nutrition
and health. Initially, two key partners will provide entry points for cross-sectoral engagement, in the
target regions of Sub-Saharan Africa and South Asia.
* In Africa, AU/NEPAD (through its CAADP process) is a central animator in agricultural
interventions, with capacity to link these to broader cross-sectoral engagement through
regional economic communities and national government plans. The key target audience for
this exercise would be policy decisionmakers at the regional and subregional levels. At the
AU/NEPAD level, thematic sessions on integrating agriculture, nutrition, and health will be
conducted for program leaders and policy decisionmakers. Similar thematic presentations will
be made to strengthening the knowledge base of the policymakers in subregional
organizations, such as COMESA in eastern and southern Africa and ECOWAS in Western
and Central Africa.
*  In the much larger South Asia region, planning ministries and national food security task
forces in individual target countries will be strengthened for mainstreaming integration of
ANH objectives in national policies and strategies. Regional and national forums and
networks will be strengthened for policy dialogues and communications. For example, the
Public Health Foundation of India provides a forum for looking at innovative public health
solutions, including agricultural ones, to improve nutritional and health performance.
At the national level, leadership and managerial skills are needed to manage cross-sectoral
collaboration. In order to bring together the sectoral policymakers from agriculture, nutrition, and health,
221


﻿there is a need to understand and strengthen the policy process. Results and methods generated from this
component will be used to develop cross-sectoral capacity throughout the policy process, targeting the
national food security and nutrition taskforces to engage in a series of policy dialogues, to identify
capacity gaps and to strengthen their capacity for incorporating the results of research into national
policies and strategies.
222