This ISGP podcast summarizes the debate of the policy position paper "Planning for the Next Pandemic," written by Dr. George W. Korch, Jr., Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services.  Dr. Korch's policy recommendations were debated at the ISGP Academic Partnership conference Emerging and Persistent Infectious Diseases: Focus on Pandemics,  convened with Ursinus College, Collegeville, PA, on April 11-12, 2014.

This podcast is part of the ISGP podcast series The Forum.

Native North American populations are suffering from unprecedented rates of long-term chronic disease and poor mental health, largely associated with lifestyle changes and a transition from land-based to processed foods.

For example, Native Americans in the U.S. are 420% more likely to die from diabetes than the general population and obesity is now one of the most serious public health problems facing American Indigenous children, hovering at a rate of 25%.

These problems are almost entirely caused by bad diets - moving from from traditional foods to commodity foods in a relatively short period of time - and lack of exercise.

This rapid nutritional spiral is not a fait accompli, however. Some of the most toxic effects of the Western diet could be so quickly reversed … at least to some extent, that the nutritional transition can be rewound, undoing some of its damage.

These problems and potential policy solutions were discussed the debate of Dr. Colin Samson' policy position paper, “Reversing the Nutrition Transition among Native North Americans,” Equitable, Sustainable, and Healthy Food Environments, convened by the ISGP in partnership with Simon Fraser University in Vancouver in the spring of 2016. Dr. Samson is a Professor at the Department of Sociology at the University of Essex.

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Overcoming food security challenges will involve addressing distribution, nutrition, environmental, and social concerns. It's not just about producing enough calories. How can new technologies, including robots and data analytics, be of assistance?

Dr. Evan Fraser, the Canada Research Chair in Global Food Security, Professor of Geography at the University of Guelph, and Director of the Arrel Food Institute, tries to answer the major problem of how we can feed the world’s growing population without undermining the ecosystems on which we depend for life. Many experts say the root of this problem is a need to produce 70% more food by 2050 because of the population growth.

His paper, “The Next Agricultural Revolution?" was debated at an ISGP conference titled Equitable, Sustainable, and Healthy Food Environments, which was convened in partnership with Simon Fraser University in Vancouver in 2016.

The key to achieving food security in the future is finding a balance between agricultural expansion, food production, food distribution, and protection of our natural resources. Machine learning, cloud computing, and the ability to collect vast amounts of real-time data from farms will allow farmers to tailor inputs and management far more precisely and with much greater efficiency.

The dairy industry is at the frontier of this big data transition. The “robotic milker” takes the place of human labor in many modern dairy barns. There also are tractors that are run by computers and can "learn."

The podcast hosts discuss the possible issues of robotic farming alongside its possible benefits. As they point out, there are no easy answers: Such technologies cannot be considered a panacea and in many areas they could be extremely disruptive.

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The term "double burden" refers to populations that are both overweight and undernourished, a phenomenon that is increasing in frequency and often associated with poverty.

In the past 50-plus years, the main food-related issue policy makers have been hyper-focused on has been a lack of sufficient food, which is justified, since almost 800 million people in the world are classified as hungry. In fact, 1 in every 6 kids in the United States faces hunger. However, we’re not just talking energy, or calories, consumed here, but also the levels of essential micronutrients, such as vitamins, iron, iodine, and zinc. In developing countries, billions of people are affected by iron deficiency, and half of pregnant women and 40% of preschool-aged children are anemic. Immune deficiencies caused by a lack of zinc, iron, and vitamin A rank among the top 10 leading causes of death through disease in the developing world.

At the same time all these deficiencies are occurring, the number of overweight and obese people worldwide has increased significantly, now estimated to be over 2 billion people. This means that for the first time in human history, the number of overweight and obese people globally Is roughly equal to the number of undernourished people.

The increases in obesity are due to increasing availability of cheap, energy-dense foods, on top of a lack of physical activity that tends to accompany economic growth and affluence. It’s absolutely critical that while combating undernutrition, policy makers consider the potential unintended consequences of overnutrition and set in place policies to avoid its development.

These issues and some of the solutions were presented by Dr. Mindy Kurzer, a professor in the department of food science and nutrition, as well as the director of the Healthy Foods, Healthy Lives Institute at the University of Minnesota. Her paper, Improving Nutrition through Food Quality, Access, Affordability, and Waste Reduction, was discussed at the ISGP conference, Equitable, Sustainable, and Healthy Food Environments, that was convened in partnership with Simon Fraser University in 2016.

In this podcast, co-hosts outline food policies that could help address the double burden, such as calorie-labeling on menus and subsidizing healthy foods in the marketplace. For more podcasts on this topic and others, visit ISGP’s The Forum and please consider sharing this episode with others.

Although the thought may make you squeamish, a zero-tolerance policy toward food safety risk is nonscientific, impractical, and itself risky.

Dr. Don Stoeckel, who wrote in 2014 a paper titled “Zero Tolerance is a Bad Strategy to Protect Food Safety,” argues that when making regulations (particularly involving food), government agencies are often unwilling to accept any negative outcomes, like illness, as acceptable possibilities for citizens and consumers. However, zero-tolerance risk frameworks for food contamination, or safety regulations in general, are not normally scientifically based... nor are they even practically achievable.

What is acceptable risk in the food system? How do you avoid scaring consumers in the process and begin incorporating the concept of chronic disease risk into the definition of "food safety?"

A major scientific opportunity would be the development of low-cost technologies that can be applied in the field to quickly measure whether or not a variety of microbe types are present; these tools would obviously have to be highly accurate and highly sensitive. Technologies for microbial contamination ideally would need to detect up to 10 different organisms. A low cost for such testing is paramount, because the food industry is highly sensitive to cost increases.

These and other topics are examined by the hosts int he discussion of Dr. Stoeckel's paper and the subsequent debate at the Institute on Science for Global policy's conference convened in partnership with Cornell University in 2014 in Ithaca, New York.

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Sustainable agriculture and locally sourced foods may be trendy, but they still lack prevalence in the food system. This week, the co-hosts discuss ways to increase consumer demand for and profitability of sustainably produced foods.

Sustainable agriculture refers to the concept of choosing agricultural practices that have lower environmental impacts than other, more conventional practices. Sustainability is achieved when natural systems are considered and even protected, so a sustainable agricultural system would put emphasis on managing soil and water resources, protecting biodiversity, and minimizing pollution. However, the idea has been complicated because we lack a universally accepted definition of what constitutes a sustainable system.

Sustainable and/or local food producers generally aren’t making enough profits to substantially expand their sustainable and/or local production practices. Basically, if a farmer is not paying the bills with sustainably managed corn field, that farmer is not going to be able to expand into sustainable tomato, lettuce, or carrot production anytime soon. Without understanding the barriers to profitability that sustainable and local agriculture is currently experiencing, the entire concept of sustainable and local food will remain at the demonstration-scale.

But that doesn't mean abandoning the idea — these products will do better if they can find an appropriate niche to fill. One might consider whether sustainable production will be a “better fit” for commodity crops or specialty products...consider corn versus habanero peppers, or soy versus avocados.

These arguments and ideas were part of a discussion by a paper, Profitability: The Key to Sustainable Agriculture, written by Mr. Henry Talmage, the Director of the Connecticut Farm Bureau Association, and presented at an ISGP conference, Socioeconomic Contexts of Sustainable Agriculture. This ISGP conference was convened with the help of students at Western Connecticut State University (WCSU) October 14-15, 2016 at the WCSU campus in Danbury, CT.

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How do we know that excess atmospheric carbon dioxide is the primary driver of climate change?

All the predictions say the same thing: temperatures are increasing in a manner that’s correlated with atmospheric CO2 levels. The only uncertainty that exists is the magnitude of that increase. In other words, if climate change really was some conspiracy on the part of one government or another, the data simply wouldn’t agree across the board.

To offer a bit of perspective: 56 million years ago, a historical event known as the Paleocene-Eocene Thermal Maximum occurred. This was basically the time when the earth’s climate was about 8 degrees Celsius warmer than it is today. During this time, nature released way more CO2 into the atmosphere than humans are even doing today, probably at the hands of a massive volcano-related event. That event actually induced warming at a slower rate than humans are causing today, and the end result was pretty incredible. Notable outcomes included the dwarfing of large warm-blooded animals, mass migrations, ecosystem disruptions, and extinctions — both at the local and global scale.

Shifting away from a fossil fuel-based economy over the coming years is expected to have both environmental and economic benefits. Many of the debaters agreed that sustainable, renewable energy sources are the future, both because of emissions reduction targets and because fossil fuels are finite. Policy-wise that means research projects with implications for clean energy will need full support — both ideological and financial.

These issues and others were part of a discussion of a paper written by Dr. Richard Alley, a professor at Penn State University, member of the National Academy of Sciences, and foreign member of the Royal Society. The paper, “Large and Long-Lasting Human-Caused Climate Change,” was discussed at the ISGP conference series called Climate Impact on National Security convened in partnership with the U.S. Army War College in 2016.

The policy that needs to be adopted here, according to Dr. Alley, is, quote, “a rational carbon tax.” A carbon tax is basically one that tries to put a price on carbon emissions. It tries to take into account all of those outcomes and damages that we associate with CO2 emissions. It’s hoped, of course, that such a tax could result in decreased fossil fuel consumption and thus, lower emissions.

Precedent exists for these sorts of carbon taxes, and as more and more are instituted the world's inhabitants will see how effective they are at lowering fossil fuel consumption and helping decrease emissions.

For more podcasts on this topic and others, visit ISGP’s The Forum and please consider sharing this episode with others.

Are your responses to disease risk more analytical or emotional in nature? How can disease risk be better communicated to the individuals in order to elicit appropriate public health responses?

It’s abundantly clear that risk — whether concerning food safety, climate impacts, or infectious disease — is inherently hard to understand and communicate. Emotional thinking, which tends to place a lot of emphasis on personal or one-off experiences. Misunderstandings about risk can easily cause overreaction. However, when individuals assess risk through rational analysis multiple dimensions of risk are taken into account, including the severity of the consequences and the likelihood of the event.

People’s understanding of risk, though, can be inherently flawed. Slight shifts in communication tactic can result in wildly different interpretations, even when the content of what’s being communication remains the same.Consider a rare, harmful event that is expected to occur with extremely low probability. If that risk is communicated as occurring in let’s say 1% of exposed individuals, people will tend to perceive it as much less risky than if they were told it was going to occur in 1 out of every 100 exposed persons.

For effective risk messaging to be formulated, there is a need for cultural and societal issues to be understood and not simply dismissed as irrelevant...which can, unfortunately, happen easily when they don’t align with technical assessments of risk.

However, the acceptance of misinformation, made ever more common with the popularity of social media creates confusion and even unrealistic fear regarding the spread of diseases.

The development of clear, evidence-based messages for the public presents great opportunities to reduce the social and economic costs of disease, which can be massive.

All of these ideas were part of the debate of Dr. Paul Slovic’s policy position paper titled “Communication Challenges in Managing Social and Economic Impacts of Emerging Infectious Diseases.” The paper was debated at an ISGP conference, convened at George Mason University, titled Emerging and Persistent Infectious Diseases: Focus on the Societal and Economic Context. Dr. Slovic is a professor of psychology and president of decision research at University of Oregon

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How do you feel about GM technologies improving nutritional content and yield for both human and animal consumption?

Livestock make up an extremely important commodity around the world, serving as a source of labor, food, and wealth. It’s actually estimated that 1 billion people depend on livestock in some way, shape, or form for their livelihoods. Demand for livestock-related products - things like milk, cheese, eggs, and meat - is increasing at an extremely rapid rate. This is due to factors such as population growth, rising incomes, urbanization, changes in dietary preference.

However, we have an embarrassingly small amount of data on the amount of water needed to sustain livestock production, thus making it difficult to figure out how to achieve more efficient water use habits.

A lot of the crops and livestock are produced on small-scale systems that integrate animals and crops, so optimal water solutions for North America and Europe will definitely be different than those for, let’s say, Asia and Africa. One idea that was discussed was crop residues that can be grazed over by animals or harvested. By genetically modifying the crops used for human consumption, we can induce significant improvements in yield, nutrition, and digestibility...All of which gets passed down as better crop residues for the animals as well.

Despite this potential, crop residues are often overlooked largely because of the lack of communication between livestock and crop scientists. The debaters argued that better communication regarding research and growth of mixed-use crops for humans and animals is required to realize all of these goals. This could be especially beneficial in less-affluent countries.

Building livestock agriculture as a more sustainable part of the food chain is going to require technological advancements at the production end and behavioral changes from consumers. Many debaters agreed that we need to begin measuring actual yield based on region and production system, as opposed to just measuring everything off North American standards. This will help scientists understand realistic yield potential and improve yield gaps. Additionally, metrics such as water usage need to be measured in mixed conditions, as this is closer to the reality of farmers working in less-affluent countries where small-scale systems of crops and livestock tend to be closely integrated.

All of these ideas were part of a discussion of a policy position paper, “Improving Livestock Water Productivity,” at the 2013 ISGP conference Food Safety, Security, and Defense: Focus on Food and Water that was held in Lincoln, Nebraska. The paper was written by Dr. Iain Wright, who is a program leader at Animal Science for Sustainable Productivity, which is part of the International Livestock Research Institute in Addis Ababa, Ethiopia.

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Antibiotic resistance is a serious and growing public health concern. Infections caused by methicillin resistant Staphylococcus aureus (a.k.a. MRSA) and those associated with multidrug-resistant gram-negative bacteria are increasingly limiting the utility of antibiotics in fighting many, many infections. The rapid emergence of resistance reveals a need for monitoring the spread of antibiotic resistance genes and DNA sequencing is the most rigorous means of tracking the spread of these genes. With thousands of unique resistance genes known, only DNA sequencing can provide the level of detailed genetic information required to reach a precise conclusion about a given resistance mechanism.

However, the U.S. Centers for Disease Control and Prevention (CDC) has questioned the need for expansion of sequencing if simpler diagnostics could be effective. The amount of data that comes from DNA sequencing is exceptional, but may be excessive.

As DNA sequencing technologies continue to improve, sequencing could become a routine diagnostic tool used to identify bacterial species as well as possible antibiotic resistance mechanisms. This will lead to an opportunity to use DNA sequence information to guide treatment. Information-based, targeted therapies could then decrease inappropriate antibiotic use ... and thus decrease the spread of antibiotic resistance.

International DNA sequencing would create an enormous global data base and questions arise about egalitarianism. Although computational challenges will likely be addressed by the continued and often exponential expansion of computing power, establishing a infrastructure able to manage the amount and complexity of data is an imminent need.

In the end, debaters generally agreed that reducing antimicrobial resistance will likely require a two-part strategy: first, by addressing overall use of antibiotics, and then, by coordinating an international surveillance system that integrates and adds data for global use.

These ideas and others were presented by a policy position paper, Mitigating Antibiotic Resistance with DNA Sequence Information, that was debated at the Institute on Science for Global Policy’s (ISGP) conference on Emerging and Persistent Infectious Disease: Focus on Antimicrobial Resistance. The program was convened by the ISGP in partnership with Baylor College of Medicine in Houston, Texas, and the paper was written by Dr. Timothy Palzkill, Professor and Chair of the Department of Pharmacology at Baylor.

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