Knowledge for better food systems

FCRN interview with Medact: Mobilising health professionals for more sustainable food systems

Medact: Medact is a London-based global health charity whose goal is to inspire and enable health professionals to act on the social, political, ecological and economic determinants of health and health inequality.  Stemming from the British medical peace movement that emerged in the 1950s and 60s, the charity was originally set up to work on war, conflict, nuclear non-proliferation and human rights.  However, recognising that climatic and environmental change threatens to reverse many of the health gains made in recent decades, Medact’s remit has broadened and now includes work on energy policy, divestment and sustainability. A new focus of its work is on food systems.

Interviewee:  Dr David McCoy – Medact Director and senior academic at the Centre for Primary Care and Public Health, Queen Mary University, London.

In this interview we talk to Medact’s director, Dr David McCoy.  David divides his time between Medact and the Centre for Primary Care and Public Health, Queen Mary University, London.  We wanted to know what drives this organisation, how they see the challenges ahead for the interlinked issues of global public health, climate and food system sustainability and what sort of engagement they would like with FCRN and the FCRN community.

What are Medact’s aims?

Medact exists to inform, inspire and mobilise the health professional community around tackling the upstream determinants of health – these are the underlying drivers of ill-health including socio economic inequality, global warming, ecological sustainability and human rights abuses.

We are a membership based organisation with a global health focus, although most of our members are based in the UK.

We carry out work across four programmes: Peace and Demilitarisation; Economic Justice; Health and Human Rights; and Climate and Ecology. This is a broad scope of work – but we do this deliberately because many of the fundamental threats to health (and underlying causes of inequity) are inter-connected. For example, economic injustice, ecological degradation and war are inter-connected, and often operate in vicious circles.  We argue that the health community should be engaged in these big issues – as health professionals, but also as members of civil society more generally.

What role do you think the health community can play in this area of food and environmental sustainability?

Food and environmental sustainability are foundations for good health. We can’t have one without the other. The health community has a mandate and responsibility to promote environmental health as a means of protecting human health. It’s as simple as that. As far as climate change is concerned, many health bodies ranging from the British Medical Association (BMJ), to the Lancet and to the World Health Organisation (WHO) now recognise global warming as one of, if not the, biggest threats to human health. See for example the BMJ editorial on Climate change and human survival, The 2015 Lancet Commission on Health and Climate Change and the work on planetary boundaries.  

We want to help create a movement within the health community that is concerned with the health of the planet.

Where does the motivation to tackle the underlying determinants come from – instead of the more short to medium term threats to global public health, such as water security, food safety, etc?

There is no tension between the underlying determinants of health and the immediate need for water and food. They are connected. We know that water security is increasing for many populations around the world, and that one factor causing this is climate change. We also know that war and conflict is one of the biggest drivers of food insecurity. But the medical community needs to do more to tackle the causes; and not just the symptoms.

How do you practically work to achieve change?

It boils down to two strategies, first of all we try to educate and inform the health community so that, for example, they are up to date on the climate science. Secondly we work to influence and change policy, using the voice and professional mandate of the health community. Two priorities at the moment are reform of energy policy and of food systems. When it comes to energy policy, we are calling for a faster transition from fossil fuel dependence towards clean energy. We have been particularly busy recently on work related to fossil fuel divestment and fracking for shale gas in the UK. In both cases we use a mix of evidence-based arguments as well as old style campaigning.  

As regards food, in addition to general awareness raising of the health impacts of climate change, we are also focusing on a few specific issues, such as the carbon footprint and quality of food served in UK hospitals. Another focus is the quantity of antibiotics used in farming – a concern that is increasingly recognised. The antibiotics issue clearly links to a third concern – the growing global consumption of meat, and the negative environmental consequences thereof.

What links between diets and health do you see a need to explore further?

Since our health is influenced by our diets, and since our diets are shaped by the food system, there is an opportunity to link disease at an individual level with a more systematic analysis of food systems.

Health care professionals are naturally concerned with individual diet and diet-related diseases. What we want to do is get the health community to consider the illnesses caused by unsustainable, inequitable and unfair food systems. This includes the contribution of food systems to climate change, but also the way the food system is structured to create unhealthy food environments for many people across the world.

How do you engage people – health professionals are incredibly busy – do they have motivation and time to get involved?

This is our biggest challenge. We are all too busy to engage politically or to campaign on the big issues. This is why Medact exists, partly to act on behalf of busy health professionals.

To what extent is teaching about the underlying determinants of health, such as climate change included in the medical studies curriculum?

They’re normally not included. What’s more, every day we’re learning new things in medicine. The expansion of new knowledge and scientific advancement means the curriculum is constantly expanding. Students simply can’t learn everything, so there is a need to rethink how we educate and train our undergraduate students so that they can learn about both the clinical aspects of medicine, as well as the wider public health dimensions.  

One example: students are taught about the importance of diet to health but they may leave university with little knowledge and understanding about how our global food system is unsustainable, damaging and unfair. This could easily be remedied.

(Where) Do you feel there is scope for collaboration with other organisations such as the FCRN?

Medact is a small but growing organisation with over 1000 members, currently with about 2.5 full time staff. In order to have impact, we must work in collaboration with others and tap into the expertise that exists in other organisations and networks. All our projects work on the principle of working synergistically and collaboratively with existing organisations and networks with shared aims and objectives.

The FCRN is one such example, producing important and high quality research and analysis. Medact can use this and then add value by communicating this to the health community.

Medact has recently been awarded a major research grant from The Esmée Fairbairn Foundation for a project entitled “Better Food, Healthy Planet: Mobilising the health community beyond healthy diets towards healthy and sustainable food systems.”  

We see the FCRN as a key partner in this work.

How do people support or join Medact?

Medact receives much of its financial support from members who pay a small subscription fee every year. The subscription fee is on a sliding scale and depends on your income level. There is no obligation as a member, but it allows you to attend and vote at our AGM.

Our definition of health professional is very broad and means that anyone who works in health can join. This includes social scientists, economists, lawyers and ambulance drivers.

A bit like with amnesty international, our impact and legitimacy is strengthened by the number of members and supporters we have, so we hope some people in the FCRN community will join by visiting our website.