Learning from World Bank History: Agriculture and Food-Based Approaches for Addressing Malnutrition
Increasing the positive impact on nutrition from agriculture is now a major area of interest in the international development community. This is not the first time, however, that the topic has arisen. In 2014, the World Bank’s SecureNutrition Platform, in collaboration with the World Bank Library and Archives of Development, led a review to present a summary on how agricultural and food-based approaches have been used to address nutrition over time. The review sets the Bank within the larger political and intellectual context of the development community.
Nutrition and agriculture were both central to the genesis of the modern World Bank as we know it: an institution with a mission to reduce poverty. In 1973, President Robert McNamara called for a transformative change for the Bank to focus squarely on poverty alleviation. He identified rural development as the main vehicle for poverty reduction at that time. A nutrition unit was also created in 1973, with Alan Berg at the helm; not coincidentally the same year that rural development began, both designed to help fulfill the Bank’s new mission of poverty reduction. 
Over these last 40 years, what have been the approaches to improve nutrition through agriculture?
One of the interesting points of this review was revealing how “improving nutrition” hasn’t always meant the same thing in practice; the priorities for nutrition in the international development community have shifted over time. Although dietary recommendations have remained quite similar over the last century, the investment priority has been on one or another facet of good nutrition: for example vitamins, or proteins, or dietary energy. We have now arrived at a point where there is interest in nutrition more holistically – encompassing both undernutrition and overnutrition, including diets to meet nutritional needs. The figure above (a summary of priorities for addressing malnutrition over time) represents the main priorities for nutrition over time, with examples of the responses from both the nutrition and agriculture communities.
The current holistic view of nutrition is epitomized by the Scaling Up Nutrition (SUN) movement, wherein countries are committed to scaling up both nutrition-specific and nutrition-sensitive development. Development partners, including the World Bank, have also committed to nutrition-sensitive agriculture.
What can we learn from history about what it takes to improve nutrition through agriculture?
It is worth noting that attention has not been on this topic in earnest since the 1970s. That said, within the World Bank, attempts to link agriculture and nutrition since 1973 have not been altogether insignificant. There was no lack of guidelines, analytical work, and even staff support to advise on improving nutrition through agriculture projects. 
However, from the mid-1980s to 2010, the emphasis in nutrition has been on direct nutrition interventions, culminating in the Lancet series on maternal and child undernutrition in 2008 (updated in 2013). Agriculture investment, meanwhile, steadily declined within a distortionary policy environment during the same time period, until the food price crisis in 2008.  Neither the field of nutrition nor agriculture focused on the linkages between the two, nor has there been a favorable investment climate in agriculture or nutrition for several decades.
In addition to a lack of investment, the review noted a distinct lack of nutrition targets for success and accountability that make sense for agriculture – at least since the 70s. Arguably, in the 1970s, agriculture succeeded in responding to the main nutrition target at the time: increasing the supply of dietary energy.  It primarily achieved this through the Green Revolution and increased productivity of staple grains, which also aligned with its own goals of productivity and profitability. The target of increasing dietary energy supply is clearly not enough to solve nutrition problems, however.
Now, in 2015: What is it, exactly, that agriculture is supposed to accomplish for nutrition? If agriculture is supposed to provide more than calories and income, then what is the vision and the target?
A New Vision for Agriculture
The proposed new vision for agriculture globally is to provide sustainable, diverse, nutritious food for all  — which will not be achieved by any other sector. In the 1970s, lack of calories was the priority problem. Now, more calories are produced than ever, but we are facing a nutritious food shortage. Both undernutrition and overweight/obesity affect all regions. It is theoretically possible for everyone to eat enough, but it is impossible for everyone to eat nutritious diets. 
This vision for agriculture needs to be matched with targets that do not yet exist. Indicators of a healthy and sustainable food system are needed, so that it is clear what the target for nutrition-sensitive agriculture is.  The programmatic means may be flexible, but the ends need to be clearly defined. The historical progression on this topic shows that this is the task of the current era: to define, track and invest in targets for nutrition-sensitive agriculture.
 Robert McNamara said in an influential 1971 speech: “Reducing the ravages of serious malnutrition will itself accelerate economic development and thus contribute to the amelioration of poverty. And that there are a number of practical steps that can be taken...”
 See the review and timeline for more information about these. This review identified over 40 agriculture projects since 1973 that have explicitly included nutrition components but lessons learned are scarce because nutrition was not a main project development objective; hence effects on dietary consumption or other aspects of nutrition were not measured.
 See the review for more detail, p19-20.
 At the time, malnutrition prevalence was estimated from food shortage, and therefore, increasing food supply would tautologically bring down estimated malnutrition rates. (Even so, nutritionists remained unsettled about the lack of attention to distributional issues, and advocated for more attention to consumption.)
 Monitoring new information, such as availability and affordability of diverse, nutritious foods (not only staple crops), could also help agriculture’s bottom line by improving information about where such foods may be lacking (and thus, opportunities to meet unmet demand for diverse foods).