There are many crucial links between health and agricultural policies. Policies that support agriculture may also interfere with market prices and, therefore, influence European consumer decisions; for example, agricultural subsidies may lower the price of tobacco, sugar, fats or alcohol and, thereby, impact on non-communicable diseases. Policies regarding agricultural practices can also have a profound impact on health; for example, permitting the overuse of pesticides and fertilizers, the misuse of antibiotics or the dangerous overcrowding of livestock.
Agricultural policies also have a global impact on health in poor countries outside Europe by both creating a subsidized market for products dumped on these countries, which may be harmful to health, and by undercutting local farm prices or imposing excessive restrictions on their exports, thereby potentially depriving local farmers of their livelihoods. Obviously, such measures can also be positive; they can promote better nutrition, support local economies both within Europe and in other countries, and prepare for and respond to a disruption to food supplies, for example, in the event of drought or flood.
WHO, in its global strategy on diet, physical activity and health, has taken the stand that “Member States need to take healthy nutrition into account in their agricultural policies” with reference to the overproduction of unhealthy commodities that contribute to obesity and non-communicable diseases. The decision to phase out European tobacco subsidies by 2010 can be seen as a victory for public health. It also paves the way for policy change in other commodity sectors, such as the ongoing reform of the fruit and vegetable sector. Despite setbacks to Common Agricultural Policy (CAP) reforms, in December 2008, the Council did adopt a regulation for the creation of a school fruit scheme, financed through the CAP. The programme, starting in 2009 and representing 90 million euros of annual EU funding, will distribute fresh fruit and vegetables across European schools in an attempt to encourage healthy eating habits and curb obesity in children aged six to ten. This money will be matched by national and private funds in those member states that choose to implement the programme.
Agricultural subsidies must be considered alongside trade tariffs and other barriers to trade. Indeed, agricultural policy has become the linchpin of international trade negotiations. In July 2008, negotiations at the WTO broke down and the Doha round was stalled due to the inability of the US, China and India to reach agreement on access to agricultural markets. The EU has relatively low tariff barriers for developing countries and, as part of the Doha trade round, has offered to eliminate all export subsidies for agricultural products. In November 2008, the long-awaited reforms to the Common Agricultural Policy also encountered problems during the meeting of the Council, when several member states rejected reforms that had been adopted by the European Commission. While reforms would not have reduced subsidies to European farmers, it would have shifted those resources from agricultural production support to rural development projects. This was also a point of contention; the final compromise maintained that an almost negligible 5 per cent of farm support would be channelled from agricultural production to rural development and environmental protection. The reform package is expected to be taken up again as a priority of the Czech presidency in May 2009.
There is a need to examine the Common Agricultural Policy of the EU within the context of a European Strategy for Global Health. This should highlight areas of public health concern within the EU and examine the impact of agricultural and trade policies on health in developing countries. The strategy should involve both politicians and consumer organizations, since they need to be able to identify how to shop ethically and healthily, and to expose current policies that act against this.
More on European Common Agriculture Policy (CAP) and Health
Support for agriculture:
Support for agriculture can prepare for and respond to agricultural crises often associated with natural disasters such as droughts, some of the most devastating agricultural crisis in Europe have stemmed from disease (among animals) or chemical contamination. But agriculture policy in the EU, as in most developed countries, has diversified beyond securing food supply and maintaining markets to include rural development and environmental protection. Ministries of Agriculture and those for the environment are now working to improve policy coherence and complimentarily.
Agricultural subsidies of approximately US$1 billion per day (780,000 million Euros) in all countries of the Organisation for Economic Cooperation and Development (OECD), including EU Member States can no longer be justified on the basis of lack of food security. In fact, food surpluses stimulated by subsidies have negative health impacts in developed as well as in developing countries and have been a major problem for the agriculture sector in developed countries since the 1970s. These subsidies transfer money to farmers, and thereby affect production decisions, incomes, international trade and the environment. In 2003 a reform of the EU Common Agricultural Policy (CAP) partially decoupled agricultural support from production levels in order to lower production incentives. However, according to an OECD report from 2004 this is not expected to lower production levels to any significant extent, except in the case of rice. In other words, attempts to reform agricultural policies often fall short of what is needed to produce significant outcomes. This was again the case in the most recent attempted reforms of the CAP under the French EU Presidency of 2008.
Impact on non-communicable diseases:
Indirect evidence strongly suggests that some elements of the CAP have negative health impacts. In the year 2000, non-communicable diseases caused 86% of deaths and 77% of the disease burden in the region, with cardiovascular disease alone causing 23 % of the total burden. The top seven factors responsible for the bulk of the European non-communicable disease burden are:
- tobacco use
- excessive intake of alcohol
- high cholesterol
- low fruit and vegetable intake
- being overweight
- having low levels of physical activity
- high blood pressure
Agricultural products have a major influence on six of these key disease risk factors. Chronic non-communicable diseases are the major cause of adult illness in all regions of the world, responsible for an estimated 35 million (or 60 %) of all world deaths in 2005. There is growing concern at the rapid worldwide increase in obesity. Clearly this worrying trend is caused to a large extent by excessive consumption of fat, sugar and alcohol, constituting more than 50% of dietary energy in a typical Western diet. In the light of this disease burden, agricultural subsidies, for example, to support sugar, fat and alcohol production run counter to public health objectives. Furthermore, measures which keep prices of fruit and vegetables high by limiting availability and use of import tariffs clearly counteract the nutrition goal of increased fruit and vegetable consumption, especially for low-income households.
Agricultural practice in Europe can also impose a burden on the environment, due to nitrogen and pesticide leakage into ground water, a further cause for health concern. The processes and mechanisms for coping with such impacts require the cooperation and coordination between agriculture and health ministries as for example, in the 1996 BSE (mad cow) outbreak which saw the disease spread world wide and the price of beef plummet. The European Agricultural Guidance and Guarantee Fund exist to help farmers and markets cope with such emergencies; however, the decision of using this fund in a veterinary health emergency is taken by DG SANCO, the European Commission’s Directorate General for Health and Consumer Affairs. Agricultural practices such as the use of antibiotics to permit animals to be managed at higher densities than would otherwise be possible, may also pose a threat to the effectiveness of such antimicrobial agents similar to the over prescription of antibiotics in humans.
The negative health impacts outside of the European region are mainly caused by trade policy as a consequence of market distortions caused by agricultural policy. While globalisation has extended access to a wide variety of foods all year round and thus contributed to public health, significant problems remain. Where as trade barriers have been abolished or greatly reduced for most industrial goods, and export subsidies have been abolished, barriers to free trade in agricultural commodities are still in place, justified on the grounds of food security or rural development. The health effects in developing countries are mainly through negative impacts on the income of farmers. One prominent example is the sugar sector. Sugar beet production is highly protected in the EU; guaranteed prices maintained by subsidies stimulate over-production at costs three times the world market price due to higher production costs. The EU sugar surplus is exported at subsidised prices (“dumping”) thereby destroying the markets and livelihoods of farmers in developing countries, who remain in poverty and in poor health even though they are capable of producing cane sugar at competitive world prices. In the sugar reform of 2006 some progress has been made in that guaranteed minimum sugar prices will be cut. This is expected to lead to a fall in production of about one-third of current levels over the next few years. Over-production of food and other agricultural products due to agricultural policies in OECD countries and the resulting distortions in international trade have been heavily criticised by developing countries, by several NGOs, EU Member States and academics. While the Directorate for Agriculture of the EU Commission is reluctant to accept that there are negative health impacts within the EU, there is a growing awareness of the damaging effect on health and poverty in developing countries of the CAP.