Blueprint for a National US Food Strategy

This podcast was originally produced and published by the Duke Sanford World Food Policy Center on November 24, 2020. 


 

Interview Summary

So let me ask you both, can you help our listeners understand what you mean by the term National Food strategy? Emily, let’s begin with you.

Our food system – it’s incredibly fragmented in the way that it’s regulated because there’s so many different agencies that are regulating different aspects of food safety, and production and workers. So what we define as a national food strategy would be a set of food system goals and a coordinated approach that would foster consideration of these goals in law and policymaking that affects the food system. We call it a strategy because it would be setting a roadmap for the long-term goals in terms of health and food safety, food justice, environmental sustainability. Others have written saying, “We need a national food strategy or national food policy, and here’s what it should do.” The aim of our project has been very much process-based. And we need to set out a process to bring together these different agencies and coordinate them. And especially to make an opportunity for voices from outside government, those of key stakeholders and also of the general public, to participate in that process in saying what the goals should be, so that then government and the agencies regulating the food system can be responsive to that.

Laurie, I’d appreciate your input on that same question, and it’s interesting that there’s not a national food strategy. And I’m wondering if you’re getting traction for the basic concept of having such a strategy?

Yeah, that’s a great question. Emily laid out really well why we focused on a national food strategy and our emphasis on process. It’s probably easier for people to connect around the notion of process rather than substance. A lot of the calls on a national food policy were so heavily focused on substance, it allowed people to think about where there were conflicting interests and not get behind it – because it didn’t represent everyone’s interests. Our focus on process is really to think about how do you have all these various stakeholders come together so that they can develop a National Food Policy, if that’s what we want to call it, or a written document that reflects all of these varied interests? And in getting behind the process, it’s a matter of saying, “We’re committed to figuring out how do we coordinate all of these various law and policy instruments across the food system, in a way that’s going to achieve better food system outcome?”

So Laurie, let’s follow up on this a little bit. So in 2017, you Emily and others created a blueprint for a National US Food Policy, and you’ve chosen to update it now, in a document that you just released. Back in 2017, you said that the American food system, and I’m quoting here, “Is a poorly coordinated patchwork of federal, state, tribal and local laws, administered by agencies with overlapping duties that results in inefficiencies and unintended consequences.” What’s happened in the interim that made you want to update it now, and is COVID a player in this?

COVID is definitely a player in this. Not a lot has happened in terms of improving this situation, which was why we renewed our call for a national food strategy. A lot of how COVID demonstrated these inconsistencies, the lack of coordination and the really poor food system outcomes that we saw as a result of COVID. But in part it was also due to the upcoming election and an opportunity to get this in front of whichever administration was going to be in office, as a way to start thinking about how to coordinate food law and policy. What’s interesting about this as a concept is that it’s not unique to the food system. The food system is certainly where we focus but it’s not that that’s a unique situation in the United States. I mean, we often think of laws as having a discrete focus and then we have agencies that are also similarly discretely focused on the subject matter areas. Where they regulate, we don’t have a lot of mechanisms in the US to think about how to account for the possibility that those things might not only be uncoordinated, but they also might be in conflict with each other.

Emily, what are some examples of how a national food strategy could work and provide benefits to the food system?

I’m glad you asked that, because I think a lot of the work that we’ve done has been really trying to paint a picture for readers about how it would be unique to have a national food strategy in the US. But national food strategies themselves are not unique, lots of other countries have these, and that was a big piece of our research. But then we also looked at in the US, we’ve created national strategies on countless different things, and so we examine eight different ones in the US that include everything from the National Strategy for HIV and AIDS, with the National Strategy on Antibiotic Resistance, the 9/11 Commission, which was congressionally created strategy after 911, really to say, what were the lack of coordination or other weaknesses that allowed 9/11 to happen, and then how do we plan going forward?

There are lots of examples of other issues in the US where we’ve said, “This is a complicated topic with real impact on society, and we need to have a mechanism for coordinating amongst agencies to facilitate the best outcomes possible.” And I’ll just say a little bit about some of the findings, and really what we recommend. Since 2017, there have been a lot of cross agency strategies announced that impacts small specific areas of the food system. So there’s been more coordination, in particular memorandums of understanding between USDA and FDA, for example, as the two agencies really share oversight over food safety. And then there’s been, for example, a multi-agency initiative on reducing food waste, which was those two same agencies and also the EPA.

Coordination and Leadership: Our recommendations from 2017, which were really derived from six different national food strategies in other countries, and eight different national strategies on other topics in the US. And I think that the main recommendations that stand first is around coordination. So, addressing one issue might also have equity problems, or lead to more food and security issues or things like that. And I think we really need to kind of have these regulations that impact the food system being dialogue. So coordination, really having an inter-agency working group. One thing we added on to that recommendation, this time around was leadership. Knowing that there’s not really an office or agency out there now that could manage this holistically, and leadership and having an office either within the White House or somehow within the executive, that is managing the process of getting input, putting together a written plan, and then following through on it is crucial. I mean, this really wouldn’t be successful without that.

Participation: every single strategy that we found that was successful, it was because they did a really great job of realizing that voices from outside government were needed. And again, as we know in the food system, it’s so complex, so many different stakeholders are implicated, and having producers, environmental advocates, affected communities that are really struggling with food access and food insecurity, and giving all that input and then seeing where we wind up with goals.

Transparency & accountability: That is putting something in writing, saying these are our goals, and then following up with regular reporting from agencies to say how they’re moving towards those goals. And we added on this time around, this real concept of enforceability as well, giving some authority to the office that’s managing the strategy and making sure that they can follow through.

Durability. There’s lots of ways to do this, but really thinking about ways to make it flexible and update. And as an example of that the National HIV/AIDS strategy was so successful. After it was released in 2010, then an updated strategy was released in 2015, that really brought in a lot of new goals and built on the foundation of the first strategy. And I think something like that could be really beneficial here as well.

Thanks, Emily. So Laurie, are there countries that you think have done especially well at this and what have they done to make their work impressive?

One of the countries that we focused on in the original blueprint was the UK. At the time when we were doing our research, they had a really interesting Cabinet Office that was called the Strategy Unit. And the whole purpose of it was to achieve joined up policymaking in the UK, it was doing exactly what we’re suggesting would be really useful is looking across all these different agencies, looking across all the decision-making that they’re doing and then thinking, “How do we join up their efforts? How do we get them to work together in policymaking so that we’re not creating these conflicts and we’re avoiding redundancies. And at the time, the UK was in the process of developing what was called Food 2030. And that was their original food strategy paper. They initially intended to have that released over the summer, but because of COVID, they essentially broke that process into two parts, and they created part one of their strategy. And released that this summer when direct response both to COVID and also to Brexit. Their intention is to then release part two of their strategy, which is the big picture National Food strategy in the UK within the next year. So that’ll be a really interesting process to follow.

Sadly, the strategy unit in the UK fell apart, but a lot of it had to do with agencies not being used to coordinating with each other, and then facing some difficulties really getting past those obstacles and differences in agency culture and agency budgets and getting them to start thinking about coordination as something that they would do regularly.

The other country that we focused on, Canada announced their national food policy, after many, many years of grassroots efforts to push the government to create a National Food Policy. Emily just mentioned a few minutes ago that one of our recommendations was around participation. And I think Canada provides a really great example. A bunch of different types of participatory processes were fully designed to elicit comments from a broad range of stakeholders. There was a convening of different types of stakeholder groups. So it included industry, food security, advocacy organizations, and a bunch of different stakeholders that you might not normally see at the table together. And as a result of that came out with a shared set of interests, which I think is so important.

In the US, we similarly have a wide variety of stakeholders in the food system, and trying to get them to come together on a set of goals and priorities could be really difficult. And having a process that helps to facilitate those conversations, helps to get people on the same page about what the major goals and priorities are, would be so beneficial. And we have some really good models of that.

Well, now that we’re thinking about some of the obstacles, you mentioned that there are lots of stakeholders with different interests. And earlier, you both discuss the issue of the responsibility within government falling across lots of different agencies. So are there other obstacles that exists for thinking about a national strategy in the US?

Agencies have different mandates, different cultures, different budgets, getting over that hurdle, and trying to get agencies both to appreciate the value of coordination, but also just embracing that as something that’s valuable, that’s going to require a big shift in the way that agencies think about their jobs. I see that as an obstacle that’s certainly not insurmountable, but that would require some work. How to get stakeholders engaged in a way that’s really meaningful, that’s an obstacle that we need to be really thoughtful about. And how to make sure that we’re enabling people that often lack of voice in law and policymaking. And then figuring out how to get them to identify common ground to come together around a shared set of goals and priorities. And then lack of political will. And also there are certain people that benefit from the lack of coordination in the food system. Trying to get to a place where they’ve perceived benefits in a process like this, that that’s going to take some work. And allowing them to see the benefit in airing the trade offs that are inherent in food system on policymaking and allowing for greater public input, that all of that can produce outcomes that are beneficial for everyone.

You were talking about issues of territoriality in a way that parts of different agencies are handling things and they have different budgets. And so in some ways, one of the obstacles I’m imagining is that people are people, and people don’t want to give up territorial power or authority or whatever you want to call it. So that’s one issue. And I’m wondering, does a new structure needed? Should there be some new agency where this work is better consolidated or takes all the work on a specific issue like food safety and parks it in a particular agency rather than divides it? So is there some structural change that you think might be helpful?

There’s a way to do this that doesn’t require agencies to give up authority, but it’s more in alignment and some long-term decision making. And I think actually, for some agencies, it might be somewhat relieving to say, “Okay, we know that right now we can’t adequately handle certain concerns because they’re not really within our mandate, but we feel uncomfortable with the fact that when we’re regulating for food safety, that food security isn’t really part of that.” And then I would say on this question of institutional design and agency building, my take on it would be, there’s been a lot of proposals to put all of food safety into one food safety agency.

This definitely gets that some of the lack of coordination, particularly across the Food Safety and Inspection Service within USDA, which is in charge of safety for meat, poultry, and some eggs. And then the FDA, which is in charge of food safety for the rest of the food supply. So there’s been proposals in the last two administrations, both Trump and Obama, there’s been introduced in Congress on this, if the whole endeavor is just to create one agency to just handle food safety, it would be a lot of energy, maybe not worth the cost. That said, I think you kind of hinted at this, Kelly too. But just if the endeavor is to say, “We need an agency that looks at food safety, but also is equipped to balance, food safety and regulations with some of these other issues, like broader food safety, safety on farms, and in food production and food security and food assistance programs, I mean, if that’s the endeavor then, I would wholeheartedly support it, because right now, the lack of coordination on these things means that we aren’t really able to plan for the long-term.

Two other quick things, this point of political will, and circling back to an early question you asked, about the way that COVID has shown and exacerbated these challenges in the food system, I think also makes this a moment where perhaps there is political will. So many people that weren’t thinking every day about where their food was coming from, are thinking about it more now. As heartbreaking as it’s been, it also gives us a moment, hopefully, we can generate some political will around figuring out how to get out of this crisis, but also plan a little bit for the long-term.

So Laurie, what are your feelings about whether structural changes might be necessary to help address these issues?

One thing that we suggested is having a lead office or agency that would be in charge of the coordination efforts. But where would the best place be for an office or agency like that? Certainly, there would be some jockeying for position, I would assume between USDA and FDA over something like this. And I don’t know that there’s a clear or natural leader among either of those. And so maybe it is that there’s a different office that gets created that would be responsible for this that could be thinking about all these different agencies that would be involved here. And also would come from a perspective that would be somewhat less entrenched in the agency positions that they already have. But I would agree with Emily, I don’t know that you necessarily need an entirely new agency to do something like this. One of the other suggestions that we had, was to think about something like a law similar to the National Environmental Policy Act that requires agencies to be thinking about the environmental impacts of their actions, to have something like the National Food Policy Act that requires agencies to be thinking about the food system impacts of their decision making. And to have an agency that would be responsible for implementing that as a law. So that’s certainly another tool that we’ve thought about as a way to carry forward a strategy like this.

We all have a part to play in the war against food waste

This article was written by Esther Ngumbi and was originally published in Al Jazeera on November 11, 2020. 


We cannot continue to allow millions to go hungry while tonnes of perfectly good food end up in landfills every year.

On September 29, the UN Food and Agriculture Organization (FAO) and UN Environment Programme observed the first-ever International Day of Awareness of Food Loss and Waste. They urged everyone to take action to reduce food loss and waste across the entire agricultural value chain.

This is a timely message. Today, in a world where food worth more than $1 trillion is lost or wasted every year, more than 800 million people are hungry. And the COVID-19 pandemic has only made the problem worse.

According to the FAO, one-third of food produced for human consumption worldwide is annually lost or wasted along the chain that stretches from farms to processing plants, marketplaces, retailers, food-service operations, and our households. And there are many factors that contribute to food loss including limitations on crop production and other resource-saving agricultural techniques, inadequate transport and storage infrastructures, changing climate and excess purchases and portions.

Surprisingly, the proportion of food produced but not consumed within developing and developed nations are similar. However, the reasons for food waste in developed and developing countries are significantly different.

In developing countries, food waste happens during food production and is mainly due to climate-induced crop failures and inadequate infrastructures to transport food to the market and to store it once it is produced. By contrast, in the developed world, food is wasted mainly due to consumers buying or cooking more food than they need. In addition, according to a 2016 survey by the Harvard Food Law and Policy clinic, many consumers throw away perfectly good food because of confusing expiry date labels.

Despite most of the wastage taking place at the very end of the value chain, developed countries contribute significantly to global food waste. In the US, approximately 36 million tonnes of food – between 30-40 percent of the food supply – is wasted every year. In the UK, households waste 4.5 million tonnes of food each year. In Australia, nearly 7.3 million tonnes of food is wasted.

Associated with food waste are the economic costs that arise from the resources used to produce food. Farmers, for example, use 1.8 billion pounds of nitrogen fertiliser and 1.5 billion pounds of phosphorous fertiliser annually to grow wasted crops while applying more than 750 million pounds of pesticide to protect food that often ends up wasted. According to FAO, “direct economic consequences of food wastage (excluding fish and seafood) run to the tune of $750bn annually”.

All these depressing statistics can lead people to think individual actions would not make a difference. In the fight against food waste, however, everyone’s contribution matters.

So what can individuals, businesses, organisations, and corporations do to stop food waste?

In developed countries, where consumers are responsible for most of the waste, every single person can play an important role in turning the tide. Simply by not buying more food than they can eat, consumers in the developed world can help significantly reduce food waste in their countries. Buying locally produced food, which does not face the risk of being spoiled during transport, can also help. Repurposing leftover food – especially after big celebrations like Christmas, Thanksgiving, Super Bowl and Eid – can also have a huge effect.

Individual consumers can also help the fight against food waste by sharing their concerns with the restaurants they dine in or the markets and shops they buy their groceries from. If consumers start to choose establishments that take action against waste over others, more businesses will implement policies to prevent food waste.

Businesses themselves can do a lot to prevent food waste. They can encourage their customers to take leftovers home, and they can donate any excess produce to those in need. There are organisations in most developed countries helping businesses repurpose surplus food. In the US, for example, Feeding America partners with farm owners, food manufacturers and businesses to rescue food that would otherwise go to waste and send it to food banks, food pantries and meal programmes.

Fighting food waste also makes business sense. In 2017, a study evaluating financial cost and benefit data from 700 companies in 17 countries, found that for every $1 companies invested to reduce food loss and waste, they saved $14 in operating costs. The savings that can be made by avoiding food waste is also very high for private households. So advertising the financial benefits of taking action against food waste too can speed up change.

In developing countries, where most of the food goes to waste because of climate-induced failures, meanwhile, efforts geared towards helping farmers access resource-saving agricultural techniques and climate-smart practices to ensure all planted crops are harvested will go a long way. Investing in new technologies that expand the shelf life of fresh produce can also help reduce post-harvest losses. Campaigns to increase awareness about the issue can also pressure governments to invest more money in food waste reduction. And while consumers have a relatively smaller effect on food waste in the developing world, individuals can still help the fight by making sure that their household is not wasting food.

In short, there is something we all can do to ensure tonnes of food do not go to waste while millions are struggling with hunger across the world. While collective action is crucial, especially in the developed world, individual consumers and businesses can also make a big difference simply by changing their habits and practices.

We can’t eliminate hepatitis C without removing barriers to treatment

Originally written by Nick Voyles and published on Stat News on November 14, 2020


As Americans fight the Covid-19 pandemic, the epidemic caused by the hepatitis C virus also continues to rage, especially among marginalized communities. And while some barriers to accessing health care have been eliminated during Covid-19, barriers persist for treating hepatitis C.

To progress toward eliminating this disabling and deadly disease, the U.S. must eliminate Medicaid restrictions on hepatitis C treatment and educate providers about ongoing stigma that disenfranchises certain communities.

In 2016, the U.S. joined the World Health Organization and more than 190 partner countries in pledging to eliminate viral hepatitis by 2030. But as of today, the U.S. is not on track to meet that goal, despite the availability of highly effective, curative, direct-acting antiviral medication for hepatitis C. In fact, many state Medicaid programs restrict access to hepatitis C treatment by requiring patients to have severe liver disease, be treated by a specialist, and/or demonstrate sobriety, all of which create unnecessary barriers to a curative treatment.

Advocacy and litigation have resulted in some easing of Medicaid treatment restrictions since the National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation at Harvard Law School started tracking hepatitis C treatment barriers in 2017. As of August 2020, 30 states have either eliminated or reduced their severe liver disease restrictions, 20 have scaled back their prescriber restrictions, and 17 have relaxed their sobriety restrictions.

The persistent sobriety restrictions create a barrier in the fight to eliminate hepatitis C. By requiring that patients to undergo additional screening and counseling or to demonstrate a period of abstinence from drugs or alcohol for up to six months, sobriety restrictions can lead to patients being lost to follow-up or discouraging them from being treated at all.

Hepatitis C rates have been rising since 2010 as a result of increased injection drug use stemming from the opioid crisis, especially among those between the ages of 20 and 39. That’s why in April of this year, the U.S. Centers for Disease Control and Prevention updated its hepatitis C guidelines to recommend that all adults over 18 receive a one-time test for hepatitis C and that individuals who remain at risk, including people who inject drugs, are screened regularly.

Sobriety restrictions create unnecessary barriers to care. Hepatitis C treatment is just as effective among people who inject drugs, and a recent review of hepatitis C responses in Australia, Canada, and the U.S. showed that uptake of hepatitis C treatment was actually “higher among marginalized populations,” including people who inject drugs.

In addition, new research from the Center for Health Law and Policy Innovation concludes that sobriety requirements for hepatitis C treatment violate the Americans With Disabilities Act, which prohibits discriminating against persons with disabilities in public services (like Medicaid) — including people with substance use disorders.

Finally, sobriety restrictions are in direct conflict with the medical standard of care and perpetuate stigma and discrimination against underserved populations and people who inject drugs or drink alcohol.

Simply eliminating sobriety requirements for hepatitis C treatment, however, does not always increase access to care. Indiana, for example, removed sobriety restrictions for Medicaid patients in 2019, yet people who inject drugs continue facing hurdles and harmful stigma when seeking care.

In my role with the Indiana Recovery Alliance, I regularly hear from patients who are seeking hepatitis C treatment that they have been denied care for one reason or another. I learned of one person seeking treatment who could not get a referral to an infectious disease or gastrointestinal specialist unless they demonstrated 60 days of sobriety — despite no state requirement for sobriety before treatment. In another example, a referring clinician used stigmatizing and hurtful language that discouraged the patient from seeking treatment, potentially leading to worse health outcomes for the individual. These examples demonstrate that beyond removing restrictions to care, we must also work with provider and clinician communities to eliminate discrimination and fight stigma against people who use drugs or alcohol.

To improve public health, especially during a global pandemic, policymakers should evaluate and remove the discriminatory policies that limit access to hepatitis C treatment and harm reduction services by people who use drugs or alcohol. We must also educate providers about unknown biases and stigma that they may perpetuate when treating people who drink alcohol or use drugs. To effectively fight hepatitis C and progress towards elimination, everyone must be able to access the treatment they have the right to.


Nick Voyles is a member of the National Viral Hepatitis Roundtable Advisory Committee, a program manager at the Indiana Recovery Alliance, and a member of the Urban Survivors Union.

State Policies Create Barriers to Hepatitis C Elimination

Originally written by Sukanya Charuchandra and published on Hepmag on November 13, 2020.


Requiring sobriety prior to treatment and curtailing harm reduction hinder efforts to eliminate hep C.

State policies that require abstinence before initiating hepatitis C virus (HCV) treatment and laws that cut back on harm reduction services perpetuate stigma and prevent people who use alcohol or drugs from pursuing hep C screening or care, according to a new report from the National Viral Hepatitis Roundtable (NVHR) and the Center for Health Law and Policy Innovation (CHLPI) at Harvard Law School presented at The Liver Meeting Digital Experience.

“Sobriety requirements and laws that limit harm reduction services restrict access to hepatitis C treatment and deny people who use substances their right to health care,” NVHR policy manager Adrienne Simmons, PharmD, said in a press release. “These discriminatory practices not only needlessly endanger patients’ health but also undermine public health efforts to end the HCV epidemic.”

In the United States, the number of hep C cases continues to increase, largely due to sharing needles and other drug injection equipment. While direct-acting antiviral therapies can now cure most people with hep C, obstacles to its elimination remain.

Phillip Waters, a staff attorney at CHLPI, and colleagues analyzed state Medicaid criteria for HCV treatment employed between 2017 and 2020. They were specifically looking to establish whether states required drug or alcohol screening or abstinence in order to acess treatment for hep C. Using a variety of materials available to the public on Medicaid websites, they categorized states into those that had no restrictions to seeking care and those that imposed a sobriety period prior to treatment.

Some states restrict access to hep C care through regulations regarding alcohol or substance use. Medicaid programs may require that people abstain from using alcohol or drugs for a period of time before beginning hep C treatment. They may also call for screening or require those receiving therapy to remain abstinent. Some programs ask that health providers administer counseling.

Fortunately, there has been some progress toward eliminating hepatitis C treatment restrictions over the last few years.

From 2017 to 2020, the number of states requiring proof of sobriety has fallen. In 2020, 74% of Medicaid programs did not enforce a minimum period of abstinence prior to starting treatment, compared with 41% of programs in 2017. Moreover, states that continue to require sobriety checkpoints no longer specify a full year—most states have requirements of at most six months.

A majority of the 12 states that do not provide community-based prevention programs including syringe services and 13 states that criminalize HCV transmission also require sobriety in order to receive hep C treatment through Medicaid.

Since people who use alcohol or drugs are no less likely to respond to treatment than people who do not, such policies serve only to perpetuate stigma and dissuade people from getting tested or seeking treatment.

“Limiting hepatitis C treatment access through sobriety requirements not only perpetuates stigma and goes against medical standards of care but may also violate the Americans with Disabilities Act, which prohibits discrimination against persons with disabilities in public services, including people with substance use disorders who are seeking health care,” said CHLPI faculty director Robert Greenwald. “Ending these discriminatory practices is both a health justice issue and a public health issue. In order to eliminate hepatitis C in the U.S., we need to make treatment available to all who need it and remove burdensome barriers to care.”

Click here to read the study.

A spectrum of services for a spectrum of needs

Originally written by Lucas Thors and published by MV Times on November 12, 2020


Food Is Medicine Symposium highlights the importance of nutrition on a national and local scale.

“The eighth annual Food is Medicine Symposium delves into ways nutrition plays a crucial role in the healthcare system, and in the wellbeing of all communities.” — Courtesy Food Is Medicine Massachusetts

The eighth annual Food Is Medicine Symposium invites Islanders to educate themselves about the myriad ways nutrition can benefit those who are at risk or living with chronic illness.

But Food Is Medicine Massachusetts (FIMMA) is not just focused on providing medically tailored meals to those who are living with serious illnesses such as cancer, diabetes, and HIV — they are looking to address the entire spectrum of food needs to ensure people have education and access surrounding nutrition, as well as strengthening existing food service networks.

The three-part symposium will be hosted by the Harvard Center for Health Law and Policy Innovation (CHLPI) and Community Servings, a Boston-based not-for-profit that prepares and delivers scratch-made, medically tailored meals to individuals and families living with critical and chronic illnesses in Massachusetts.

According to Katie Garfield, a clinical instructor at CHLPI, the symposium has always aimed to shine a spotlight on the latest advancements in research, policy, and broader innovation in the Food Is Medicine field. 

The three-part series also offers a space for collaboration and education for organizations such as healthcare providers and community food networks that are delivering these types of nutrition interventions.

Normally, the event consists of a one-night in-person presentation, with a series of panels and presentations on-Island, but due to COVID, the symposium will be in the form of one-hour webinars that each tackle a different facet of food as medicine.

The first webinar will be focused on the initiative on a national level, including a conversation with Congressman Jim McGovern, D-MA, and with a client of Community Servings, Vanessa Georges.

Garfield said McGovern recently introduced a bill that would create a pilot program with coverage for medically tailored meals embedded in Medicare.

The second webinar will zero in on one of the central resources for Food Is Medicine interventions in Massachusetts — the Accountable Care Organization (ACO) Flexible Services Program, offered by MassHealth. 

That webinar will include comments from secretary of health and human services, Marylou Sudders, as well as a panel focused on the partner organizations and their experiences with Flexible Services. 

The third webinar is all about highlighting the role of philanthropy in driving innovation. Garfield said this will include a conversation with several service providers, discussing with them the role of food as medicine for the population they are interested in.

Although medically tailored meals have historically targeted “the sickest of the sick, those who are so ill they cannot shop or cook for themselves,” Garfield said her institution and others in FIMMA understand there is a range of individuals who could benefit from a variety of nutrition services. 

“How do we bring this spectrum of services together and think about the ways they can serve an entire community?” Garfield asked. “Some folks may just benefit from greater access to nutritious food, while others need a more specific plan for their health.”

She said the goal of FIMMA, and of the symposium, is to create a “spectrum of services for a spectrum of need.”

Additionally, education regarding nutrition and diet isn’t just essential for the general public, it is important for healthcare providers so they can be adequately equipped to screen for nutritional deficiencies and talk to patients about how what they eat impacts their health.

“Then those providers can refer patients to organizations that can help meet their needs,” Garfield said.

Jean Terranova, director of food and health policy at Community Servings, said the symposium aims to highlight the critical role of nutrition in healthcare, both as an intervention to improve health outcomes and lower healthcare costs, but also to increase general quality of life for patients.

For the past few years, Terranova said FIMMA has been working to refine how Food Is Medicine services are applied to individuals and communities — “from medically tailored meals to fruit and vegetable programs, and everything in between.”

She said the symposium will provide evidence showing the importance of these services, and the need for federal and state policies that ensure these interventions and resources are embedded in the healthcare system.

With COVID increasing demand for food services, and creating access barriers to healthy foods, Terranova said the pandemic has created a “perfect storm” for the Food Is Medicine movement. 

“The demand for all these services has never been greater,” she said.

Apart from food insecurity running rampant in the U.S. and in Massachusetts, Terranova said, COVID creates “huge operational challenges” due to health restrictions.

“If you have ever been in a production kitchen, people are really standing elbow to elbow, chopping, packaging, and so forth. All members of the [FIMMA] coalition have had to overhaul their operations so we are standing six feet apart, wearing masks and gloves,” she said. “These things add up to a lack of efficiency.”

Particularly in seasonal vacation communities like Martha’s Vineyard, where the service and hospitality industries are hurting, Terranova said the need for food resources is increasing every day. “The ripple effects are truly incredible, and I think it is going to last for a while, even if we see a vaccine and improvements in the economy,” she added.

And with health risks associated with being exposed to others, Terranova said the volunteer base, which is the lifeblood of many benevolent food organizations, has drastically diminished.

According to Terranova, the goal of FIMMA and the symposium is to strengthen networks and relationships that already exist between food resource organizations, and bridge new connections so that those in need of nutrition-based healthcare can receive the services they need. 

  • First webinar: The Future of Food Is Medicine at the Federal Level, Thursday, Nov. 12, 10 to 11 am. Register here: bit.ly/harvardfood.
  • Second webinar: Food Is Medicine in Massachusetts: Utilizing Pathways in the Massachusetts Flexible Services Program, Wednesday, Dec. 2, 1 to 2 pm. Register here: bit.ly/Harvardfood2.
  • Third webinar: The Role of Philanthropy in Driving Innovation, date and time TBD.

Agricultural Workers and the Pandemic: A Policy-Induced Crisis

Agricultural workers in the United States are facing the worst of Covid-19. Meat-packing plants and labor-intensive farms have become coronavirus hotspots, with workers at these sites experiencing extraordinarily high rates of infection. On October 21, 2020, the Food Law and Policy Clinic of Harvard Law School hosted a panel of lawyers, journalists, and organizers to examine the causes of this crisis, which has its roots in law and policy. 

Watch the recording here or below. 

Moderated by Tom Philpott, Mother Jones

Panelists include:

  • Leah Douglas, Staff Writer and Associate Editor, Food & Environmental Reporting Network
  • Micky Devitt, Legal and Policy Coordinator, Heartland Workers Center
  • Iris Figueroa, Senior Staff Attorney, Farmworker Justice
  • Edgar Franks, Political & Campaign Director, Familias Unidas por la Justicia