2017 Global Action Report by MG Publishing

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{ Yes, our world

needs your ideas and leadership.} nashville 2017 November 5-7, 2017

Nashville, Tennesse USA 2017 Summit Registration: www.globalactionplatform.org Invited guests are top senior level decision makers, leaders and innovators from the corporate, government, academic, media, investment, and NGO communities from around the world.

“The Global Action Platform represents a powerful coalition of cross-sector leaders dedicated to creating abundance through innovation in food, health, and prosperity.”

–

Dr. Fareed Zakaria, CNN

Foreign affairs program “Fareed Zakaria GPS”

and columnist for The Washington Post

www.globalactionplatform.org

The 6th Annual Global Action Summit is a program of the Global Action Platform and the CumberlandCenter, a 501c3 non profit organization Creating abundance through innovation in food, health and prosperity. © 2107 CumberlandCenter, Nashville, Tennessee, USA +1 (877) 300-5806

CHAIRMAN’S NOTE

CONSOLIDATION AND NEW DIRECTIONS This year, Global Action Platform marks a major milestone, as we conclude our first five years of programs and turn toward the next stage of our operations.

Dr. Scott T. Massey Chairman and CEO Global Action Platform

Over the past five years, we have worked with over four hundred of the world’s leading experts on food, health, and prosperity. We have convened nearly three thousand global leaders from the corporate, university, investment, NGO, and government sectors in our Summits and forums in Nashville, at the United Nations, the World Bank, and National Press Club. We have made $8M in impact investments in new enterprises and technologies that promise transformative impact on food, health, and economic growth. We have built collaborative platforms and initiatives; and we have published eight books with our excellent partners at the Diplomatic Courier, reaching millions of readers around the world. As an action research platform for innovation and collaboration, we realize that the work accomplished over the past five years with our partners is a critical knowledge base for decision makers and leaders. Hence, this year, our overriding priority has been to consolidate, synthesize, and draw lessons from the work of the last five years. The 2017 Global Action Report includes and documents the consolidation of these lessons through three “white papers” that distill the major ideas and recommendations from the world’s top experts on food, health, and economic issues who have worked with us. In consolidating this knowledge base, Global Action Platform was honored to work with North Highlands, a global consulting firm, in the development of these “white papers,” which appear as key sections of the 2017 Report. In addition to consolidating our abundance knowledge base, 2017 marks two other important milestones. In January, Global Action Platform moved into our new corporate headquarters at oneC1TY—Nashville. With this move and the opening of the first building on the twenty-acre innovation campus, we have taken a major step forward in transitioning from thought-leadership to action. As the world’s urban population heads toward 7-8B of the projected 10B total, cities and urban regions will face tremendous challenges in meeting the nutritional, health, and economic needs of their citizens. We intend to work with our partners to make oneC1TY a living laboratory for scalable, sustainable urban solutions that meet these needs. This year also marks a major turning point, as we launch the first commercial ventures in the Philippines through GPSS and the Indigenous People’s Economic Union (IPEU). The Caraga Project is a comprehensive rural development initiative for ten million acres in the Philippines. Serving as a living laboratory for scalable, sustainable rural solutions, the Caraga Project will both assist the indigenous people of the region, and create a model to help rural regions around the world benefit from global markets and integrated approaches to social, environmental, economic, and governance development. So, this year, Global Action Platform takes a major step forward, consolidating the knowledge created in our first five years of work, launching the innovation campus at oneC1TY, and pioneering comprehensive rural solutions in the Caraga region of the Philippines. The 2017 Global Action Report documents the knowledge base for food, health, and prosperity created to date, and so serves a key role in helping to shape our strategies and our programs in the years to come. We are pleased to share the knowledge synthesized in this Report and invite you to join us in the next chapter of our work to create a world of abundant food, health, and prosperity. ■

SEPTEMBER 2017

THE WORLD IN 2050

MASTHEAD

Diplomatic Courier

A Global Affairs Media Network

CEO & Publisher Ana C. Rold

Chief Author

Winona Roylance

DC Editors

Michael Kofman Paul Nash

Creative Director Christian Gilliham

DC Advisory Board Fumbi Chima Sir Ian Forbes Amb Lisa Gable Mary D. Kane Greg Lebedev Anita Mc. Bride

DC Contributors

GAR Editorial Advisors Kenneth Holyrod Scott T. Massey Sharon P. Shoemaker

GAP At Five Years Report

North Highland Global Consulting

GAR Perspectives Martin Chrisney Amr El-Husseini Emmanuel Faber Luke Gruenert Gabe Hitchcock Ilana Kamber Jeremiah Magpile Scott T. Massey Sarah Smith Bryan Thomas Juergen Voegele

Senior Photographers Michelle Guillermin Sebastian Rich

Akshan de Alwis Charles Crawford Justin Goldman Sarah S. Jones Oscar Montealegre Arun S. Nair Richard Rousseau

Director of Social Media

Global Action Platform Steering Committee

Cheryl E. Harrison Global Action Platform Kenneth Holyrod Vanderbilt University John Ingram Ingram Industries Clay Jackson BB&R Insurance Mary Kane Sister Cities International Conrad Kiechel Milken Institute Judit Arenas Licea IDLO, United Nations L. Randolph Lowry III Lipscomb University Scott T. Massey Global Action Platform Sultan Julius M.S. Mabandos V Indigenous Peoples Economic Union Stuart McWhorter Clayton Associates Ana C. Rold Medauras Global Publishing Jean-Claude Saada Cambridge Holdings, Inc. Howard-Yana Shapiro Mars Incorporated Mike Shmerling Clearbrook Holdings Corp. Thomas J. Sherrard Sherrard & Roe, PLC Sharon P. Shoemaker CIFAR/UC Davis Remy Szykier Aegis Health Security Bryan Thomas GPSS Steve Turner The Family Office Juergen Voegele The World Bank Group Nicholas Zeppos Vanderbilt University

Ted Abernathy, Jr. Economic Leadership LLC Alexander Assaouad Belmont University Justin Bakule Shared Value Initiative Jeffrey R. Balser Vanderbilt Medical Center Suparno Banerjee Hewlett Packard Cynthia H. Barbera StoryWorld Inc. Jack Bovender HCA (retired) Phil Bredesen Governor of Tennessee (2003-11) Ed Cantwell Center for Medical Interoperability John Clifton Gallup Congressman Jim Cooper U.S. House of Representatives Trevor Davies KPMG Marty and Betty Dickens Civic Leaders Ryan Doyle oneC1TY Beth Fortune Vanderbilt University Darrell S. Freeman Zycron Computer Services William H. Frist U.S. Senate Maj. Leader (1995-07) Arlene Garrison Oak Ridge Assoc. Universities Jason Gershon GPSS Jonathan Gershon GPSS Adrian Gheorghe EURIS

GLOBAL ACTION REPORT

Alexcia Chambers

Editorial Assistants Jacqueline Christ Bailey Piazza Samantha Stafford

PUBLISHING. The Global Action Report is a product of the Global Action Platform, published in collaboration with Diplomatic Courier, a Global Affairs Media Network. The Diplomatic Courier is owned by Medauras Global, an independent publishing firm based in Washington, DC. The magazine is printed six times a year and publishes a blog and online commentary weekly at www.diplomaticourier.com. EDITORIAL. The articles in this report both in print and online represent the views of their authors and do not reflect those of the editors and the publishers. The authors are responsible for the facts and interpretations. PERMISSIONS. None of the articles can be reproduced without their permission and that of the publishers. For permissions please email the editors at: info@medauras.com with your written request. LEGAL. Copyright © 2006-2017 Diplomatic Courier and Medauras Global. All rights reserved. No part of this publication can be reproduced without written consent of the publishers. All trademarks that appear in this publication are the property of the respective owners. Any and all companies featured in this publication are contacted by Medauras Global and the Diplomatic Courier to provide advertising and/or services. Every effort has been made to ensure the accuracy of information in this publication, however, Medauras Global and the Diplomatic Courier magazine make no warranties, express or implied in regards to the information, and disclaim all liability for any loss, damages, errors, or omissions. CONTACT. Mailing Address: Diplomatic Courier, 1660 L Street, NW, Suite 501, Washington, DC 20036, U.S. Fax: 202-659-5234. E-mail: editors@diplomaticourier.org. DIGITAL. Digital editions of prior Global Action Reports, Global Action Summit Programs, as well as the 2017 Global Action Report can be downloaded for free on the Diplomatic Courier App on the iStore, Google Play, and Amazon Kindle. ART/PHOTOGRAPHY/ILLUSTRATIONS. In order of appearance: page 5, photo courtesy of Scott T. Massey; page 7, photo by Joyce Boghosian; page 12-14, photos by Paul J. Hughes; page 16, photo by Patrick Tomasso; page 26, photo by Roberta Sorge; page 37, photo by Martin Reisch; page 44, photo by Miguel Mateo; page 46, UN Photo by Tobin Jones; page 47, UN Photos by Mark Garten; page 85, photo by Luca Bravo; page 86, logomark by Danone; page 87, photo courtesy of Danone; page 90, photo courtesy of Juergen Voegele; page 94, infographic courtesy of KPMG; pages 102-105, photos courtesy of Bryan Thomas and GPSS; page 107, photo by Thomas Tucker; pages 108-109, all logomarks are property of the respective companies and have been published with permission. All other images and photos by Bigstockphotos.com. WITH APPRECIATION. The Global Action Platform sincerely appreciates the following organizations and university partners. Special Advisors on Food, Health and Prosperity Strategies: The World Bank Institute for Strategy and Competitiveness, Harvard Business School, Vanderbilt Medical Center, and UC Davis. Senior Program Advisors: Aegis Health Security, California Institute for Food and Agricultural Research (CIFAR), Christ Church Cathedral, Global Alliance on Food Security Research, Jack C. Massey College of Business, Belmont University, Oak Ridge Affiliated Universities, Oxfam America, and the United Nations. The Global Action Platform wishes to acknowledge the leadership role played by Aegis Health Security in recruiting impact funds for the new Global Challenge.

A digital edition of the 2017—as well as all Global Action Reports and Global Action Summit Programs—is available to download for free on Diplomatic Courier’s App on iStore, Google Play, and Amazon.

PUBLISHER’S NOTE

THE FUTURE IS BETTER THAN YOU THINK Dare to turn on the news. It is a constant bombardment; stories of war, death, terrorism, political scandal, and financial crisis. As consumers we are 10 times more likely to view/click/read negative rather than positive news. Just like a good soap opera, data shows time and again we will follow negative news as far as it takes us. And this is what advertisers like: more eyeballs, more clicks.

Ana C. Rold CEO and Publisher Diplomatic Courier

Over ten years ago, I founded Diplomatic Courier, a Global Affairs Media Network, to tell the stories we don’t hear about very often. This is not to say we are oblivious to the major issues humanity is facing, like climate crisis, religious radicalism, and so on. We cover those stories too. Our focus on finding stories of prosperity and uncommon collaboration was to bring balance to long-form journalism. Our audience has rewarded us handsomely. In just a short and disruptive media decade, Diplomatic Courier has amassed a global readership in over 180 countries and broadcasts content live in multiple platforms, reaching over 350 million social media impressions in the last six years. In the Global Action Platform (GAP) we found our kindred spirit. Over the years, we have covered and reported on many of the well-known thought leadership gatherings out there. But in GAP we found a community of leaders seeking to effect true change. Serving as the Platform’s Senior Communications Adviser has been one of the privileges of my professional life. This year, celebrating the Platform’s five-year anniversary at the newly-built oneC1TY campus, make this edition of the report even more special. Since its founding in 2012, we have been the original and enduring rapporteurs. We have designed and produced the report you hold in your hands, capturing the ideas, challenges, and solutions that the GAP community generates each year. We then disseminate to the widest global audience possible: an audience of purpose that shares in the mission for a better world; an audience focused on the positive stories. And despite what major media outlets report, there are many positive stories. Reduction in absolute poverty. Over the last 30 years, the share of the global population living in absolute poverty has declined from 53% to under 17%. While there remains room for improvement (especially in sub-Saharan Africa and South Asia), the quality of life in every region has been steadily improving and will continue to do so. In the next 20 years, we have the ability to extinguish absolute poverty on Earth. Spending less of our income to buy food. According to the USDA, over the last 50 years the percent of our disposable income spent on food has dropped by more than 50 percent - from 14% to less than 6%. This is largely a function of better food production technology, distribution processes, and policies that have reduced the cost of food. Reduced infant mortality rates. In the last 25 years, under the age of five mortality rates have dropped by 50%. Infant mortality and neonatal mortality rates have also dropped significantly. And this is just in the last 25 years. If you look at the last 100 years, the improvements have been staggering. A better-educated world. Futurist and fellow optimist Peter Diamandis has said a better-educated world raises all tides. Along those lines, global literacy rates have increased from around 10% to close to 100% in the last 500 years. This is a function of technology democratizing access to education. Many of the solutions for a better future will come from our community at the Global Action Platform. We hope you will join too. ■

SEPTEMBER 2017

CONTENTS

SECTION

FOOD SESSION 1

27 /

SDG#2: Economic Transformation Through Food Security Session Panelists: Nicole Goldin, Senior Fellow, Center for Strategic and International Studies Hilary Haddigan, Chief of Mission Effectiveness, Heifer International Tim Pruett, CEO, iDE Moderator: Mark Fitzgerald,Global Lead Partner, UN, KPMG SESSION 2

29 /

Food Safety: Threats, Traceability, and Forensics Session Panelists: Pingfan Rao,Vice President, Chinese Institute of Food Science Technology, Director, Food Project, Future Earth Moshe Rosenberg, Professor and Specialist, Dairy Engineering and Technology, University of California Davis Alida (Linda) Stoker, Manager, Institute for Food Safety,Wageningen Moderator: David Mills, Peter J. Shields Endowed Chair in Dairy Food Science, University of California Davis SESSION 3

32 /

Oxfam Reports: Poverty, Hunger, and Income Session Panelists: Ellen Gustafson, Food System Change Advocate, Food Tank, FEED Fabio Lavelanet, CEO, FABRAR Rice, Inc. Lori Rowley, Director, Global Food Security & Aid Effectiveness, The Lugar Center Moderator: Wanneh Dixon, Senior Advisor for Aid Effectiveness Partnerships, Oxfam

GLOBAL ACTION REPORT

SESSION 4

36 /

Global Food: Interoperability for the Sustainable Agri-Food Supply Chain Session Panelists: Richard Cates, Owner & Founder, Cates Family Farm Glenda Humiston, Vice President, Agriculture & Natural Resources, University of California, Office of the President Matthew Lange, Associate Director, UC Davis Initiative for Wireless Health & Wellness James Canton, CEO & Chairman, Institute for Global Futures Moderator: Brad Holtz, Chief Strategy Officer, Center for Understanding Change SESSION 5

40 /

Food Security: No More Food to Waste Session Panelists: Charles Gause, CEO, Triad Growth Partners Kelly Johnston,Vice President, Government Affairs, Campbell Soup Co. Cheryl Mitchell, Senior Vice President, Steuben Foods Moderator: Wiebe Draijer, Chairman, Executive Board, Rabobank

SECTION

HEALTH SESSION 1

SESSION 4

SDG #3: Health and Wealth A Path to 2030

Global Health: Forging Medical Data Interoperability

45 /

56 /

Session Panelists: Charles Dalton, Senior Health Specialist, International Finance Corporation Remy Szykier, Managing Partner, Aegis Health Security Jami Taylor, Director, Global Public Health Systems Policy, J&J Donato Tramuto, CEO, Healthways Moderator: Trevor Davies,Global Head, International Development Assistance Service Institute, KPMG

Session Panelists: Neal Patel, Chief Medical Informatics Officer,Vanderbilt University Health System, Co-Medical Director, Pediatric Critical Care Service Hayley Hovious, CEO, Nashville Healthcare Council Brian Moyer, CEO, Nashville Technology Council Caroline Young, Executive Director, Nashville Health Moderator: Edward Cantwell, Executive Director, Center for Medical Interoperability

SESSION 2

SESSION 5

48 /

The Cancer Moon Shot Initiative: Scope and Prospects Session Panelists: Klaus O. Schafer, Chief Medical Officer, Client Executive, VP Business Development, CACI International Remy Szykier, Managing Partner, Aegis Health Security Trish Tweedley, Senior Director, KPMG Development & Exempt Organizations Moderator: Joxel Garcia, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center SESSION 3

52 /

60 /

Why Health Is No Oneâ&#x20AC;&#x2122;s Business: Economic Incentive Barriers to Improving Health Session Panelists: Al Garnier, Co-Founder & CEO,VTM LLC Jim Jirjis, Chief Health Information Officer of Clinical Services Group, HCA of America Robert Dittus, Associate Vice Chancellor for Public Health, Vanderbilt University Medical Center Lee Fleisher,Chair of Anesthesiology & Critical Care, University of Pennsylvania School of Medicine Moderator: Atul Grover,Executive Vice President, Association of American Medical Colleges

The Precision Medicine Initiative Session Panelists: Joshua C. Denny,Vice President for Personalized Medicine, Vanderbilt University Medical Center Dan M. Roden, Senior Vice President for Personalized Medicine, Vanderbilt University Medical Center Moderator: Kenneth Holroyd, Assistant Vice Chancellor for Research, Vanderbilt University Medical Center

SEPTEMBER 2017

CONTENTS

SECTION

PROSPERITY SESSION 1

SESSION 4

Identifying Pathways for Inclusive Growth Through SDG #1

New Models for Scaling Social Enterprise And Social Development

65 /

Session Panelists: Leslee Alexander, International Director, Tennessee Department of Economic and Community Development Tim Docking,Vice President Government Affairs, IBM Louise Kantrow, ICC Permanent Representative to the United Nations, USCIB Lona Stoll, Deputy Vice President, Department of Compact Operations, Millennium Challenge Corporation Moderator: Martin Chrisney, Director, International Development Assistance Services Institute, KPMG

SESSION 2

68 /

Riding the Tiger Session Panelists: Wilfried Aulbur, MD, Roland Berger Adarsh Kataruka, Founder, SoulAce Anurag Batra, Editor-in-Chief, Business World Moderator: Amit Kapoor, President and CEO, India Council on Competitiveness

SESSION 3

72 /

Humanistic Capital: A Convergence of Humanitarian Aid and Development Session Panelists: David Wilcox, Founder, ReachScale Amber Nystrom, Director of Social Fusion, The Women’s Technology Cluster Bryan Thomas, Managing Partner, Global Partnership for Sustainable Solutions Moderator: Iftikhar Mostafa, Senior Agriculture Economist, The World Bank Group

GLOBAL ACTION REPORT

76 /

Session Panelists: Sergio Fernandez de Cordova, Private Sector Advisory Group, United Nations, Sustainable Development Fund, UNDP Amber Nystrom, Director of Social Fusion, The Women’s Technology Cluster Stuart Williams, Founder, InPact: In Place Impact Moderator: David Wilcox, Founder, ReachScale

SESSION 5

80 /

Emerging Economic Leadership in Mega-Regions: Young American Leaders Showcase Session Panelists: Lonnell Matthews, Director, Mayor’s Office of Neighborhoods & Community Engagement Mendy Mazzo,Vice President, Skanska Tim Ozenger, CEO, Oz Arts Renata Soto, Co-Founder & Executive Director, Conexión Américas Saul Garlick, Founder and CEO, Unleesh Moderator: Linda Peek Schacht, Founding Director, Andrews Institute for Civic Leadership, Lipscomb University

SECTION

PERSPECTIVES 05 /

Chairman’s Note: Consolidation And New Directions Scott T. Massey, Founder & Chairman, Global Action Platform

07 /

Editor’s Note: The Future Is Better Than You Think Ana C. Rold, CEO & Publisher, Diplomatic Courier

92 /

Managing Change through High Quality Data: The 2017 Change Readiness Index Martin Chrisney, Director, IDAS Institute, KPMG Jeremiah Magpile, Associate, IDAS Institute, KPMG

94 /

Food Innovation: Recipes for The Next Decade Sarah Smith, Research Director, Institute for the Future’s Food Futures Lab

12 /

The New Golden Mean: Converging Trends in Impact Investment, Financial Markets, and Corporate Strategy Fareed Zakaria, Host, CNN Myron Brilliant, EVP & Head of International Affairs, U.S. Chamber of Commerce Elizabeth Littlefield, President, Overseas Private Investment Corporation David Wilton, Managing Director AIP Private Markets, Morgan Stanley

16 /

Global Action Platform at Five Years: Best Ideas for Food, Health, and Prosperity Synopsis of Expert Recommendations: 2012-2016 Produced in collaboration with North Highland Global Consulting

84 /

The Food Generation: Reconnecting Food to the People and the Planet

98 /

Personalized Therapies: A New Era in Health Luke Gruenert, Onconetics Gabe Hitchcock, Onconetics

100 /

A Global Innovation Hub in Nashville Amr El-Husseini, Founder & CEO, Lodestone Advisory Group Scott T. Massey, Founder & Chairman, Global Action Platform Ilana Kamber, Intern, Lodestone Advisory Group

102 /

Creating A Scalable, Sustainable, Shared Value Model of Rural Development Bryan Thomas, CEO & Managing Partner, Global Partnership For Sustainable Solutions (GPSS)

Emmanuel Faber, CEO & Vice-Chairman of the Board of Directors, Danone

106 / 88 /

Creating Inclusive Jobs in The Food System

How Shared Value Is Changing Capitalism’s Relationship to Society Ana C. Rold, CEO & Publisher, Diplomatic Courier

Juergen Voegele, Director, Agriculture Global Practice, The World Bank Group

SEPTEMBER 2017

COVER STORY / GLOBAL ACTION PLATFORM

“The signal feature of the world—taken as a whole—was that inequality among nations has been declining dramatically over the last 25 years.” Fareed Zakaria, Host, CNN

GLOBAL ACTION REPORT

GLOBAL ACTION PLATFORM

The New Golden Mean Converging Trends in Impact Investment, Financial Markets, and Corporate Strategy PRESENTERS: MYRON BRILLIANT, EVP & Head of International Affairs, U.S. Chamber of Commerce ELIZABETH LITTLEFIELD, President, Overseas Private Investment Corporation DAVID WILTON, Managing Director AIP Private Markets, Morgan Stanley MODERATOR: FAREED ZAKARIA, Host, CNN & Summit Host, Global Action Platform

s globalization continues to shape financial markets around the world, the issue of international trade is becoming an increasingly unstable force. In the last 25 years alone, international trade has increased at an astounding rate, with trade in 2007 alone accounting for 60% of the total global GDP; yet in more recent years, global trade has begun to see a decrease, with only 55% of the global GDP accounting for trade, and capital flow within the United States decreasing from 16% to a mere 2% in a ten-year span. Even in terms of human movement, European immigration rates have seen a decrease in five million people in the last four years, with the flow of people entering the US from Mexico similarly coming in at negative numbers over the past three years. Interestingly, while the global economic landscape may currently be in a state of flux, the social landscape may be in an even more unstable state. With the dramatic rise of countries such as China, India, Indonesia, and Brazil, inequality among nations has declined dramatically

over the past 25 years; conversely, inequality within countries continues to rise. Ultimately, these increasingly dramatic shifts reveal the need for less focus on growth and trade and more focus on redistribution in terms of both the social and economic global landscape. This raises two important questions: first, are new strategies needed to cure globalization’s current fluctuating status? And, two, how can the private sector aid in this effort? One of the biggest challenges that faces today’s global economy is the increasing lack of confidence in the private sector as a force for good. Indeed, with economic anxiety on the rise throughout the US and the world, the issue of expanding trade agendas between the US and other countries continues to remain controversial in today’s political landscape, with the US’s decreased role as a global policeman and value leader also leading to a general lack of trust in the US government and the business sector. Therefore, without the private sector’s ability to instill confidence in the general population, these problems will most likely continue in the foreseeable future.

“If we are going to be a force for good in the world, and we’re going to encourage our values, our expertise, our technology, and our innovation to spread across the world, we cannot retreat behind our barriers.” Myron Brilliant, EVP & Head of International Affairs, US Chamber of Commerce

SEPTEMBER 2017

COVER STORY / GLOBAL ACTION PLATFORM

Despite this fear over international trade, over 40 million Americans’ jobs are directly tied to international commerce— meaning that the total isolation some Americans demand could cost 12% of the population their jobs. Even more concerning, with an economic and job growth rate of 1.6 – 2%, it is not only necessary, but also imperative that the US expands trading and exports even further in order to reach a healthier and more sustainable 3 – 4% growth rate. Unfortunately, a general lack of knowledge in international issues and definitions may cause the current trend of distrust towards international relations to continue. When polled about trade agreements between the US and foreign countries, for example, a majority of American citizens agreed that these agreements were beneficial; but when asked about the same issues in economic terms—such as using the term TTIP— most polled citizens showed a general lack of knowledge about international terms, despite the fact they showed earlier indications of agreeing with such practices. Perhaps most concerning of all, when asked if they were for or against free trade relations, many people were expressly against the idea due to a misunderstanding of the term, citing they did not want to “trade for free” with foreign countries. Even if the US were to increase their involvement in international relations, the cost needed to accomplish all of the UN’s Social Development Goals would be over $100 trillion. With only $135 billion being spent on global aid by all countries annually, however, not even 1% of the total needed is being spent. It is becoming increasingly apparent that the public sector cannot handle global issues alone and will need assistance from the private sector in order to make the progress necessary to accomplishing the SDGs. While many differing opinions exist around the benefits of globalization, the world’s increasingly connected landscape has undoubtedly created a lot of social good. In the past 30 years, for example, poverty rates have decreased from 2 billion to 700 million and show no sign of stopping anytime soon. In the US specifically, issues such as indoor plumbing—which 17% of Americans did not have access to even as recently 14

GLOBAL ACTION REPORT

“We’ve unleashed the private sector, and business can’t be stopped by the government—its going to keep investing because it’s found ways to do so profitably, and the opportunities and most of the world’s customers are in these markets.” Elizabeth Littlefield, President, Overseas Private Investment Corporation

as the1960’s—have been nearly erased, with over 99% of Americans now having access to indoor plumbing. These factors ultimately demonstrate just how important globalization is to solving the world’s biggest social problems, and even more importantly how crucial it is for the private sector to be involved in the solutions. Indeed, it has become overwhelmingly apparent that the private sector is key to creating permanent social good. While a mere 20 years ago the private sector lacked the interest and investment necessary to today’s social infrastructure, this huge shift away from public funding has created a system in which private funding is now the go to method for solving social issues. In fact, many private companies are now in charge of traditionally publicly funded projects, such as building power plants, maintaining health clinics and rural schools, and implementing largescale transportation systems. Even more surprising, this shift in private sector investment has resulted in more rapid job creation, increased innovation, and more personal profit. It has also increased the speed at which social issues are being resolved. However, in order to restore confidence in business as a force for social good, there are several things the private sector

must do: first, the relationship between business and workers needs to include new training methods to prepare the workforce for future technologies as well as provide job counseling, assistance and relocation services; second, business needs to think through how best to represent America’s interests through commercial transactions around the world; and third, business needs to focus more heavily on rebuilding America’s infrastructure through investments in education and encouraging an immigration system that creates more free movement of goods and people. Ultimately, the private sector will need better analytics and data to assist investors in finding opportunities that are both profitable and deliver strong returns while simultaneously addressing challenges at the heart of global instability. But by focusing on both the economic and social landscape—such as using advocacy to push out tax and regulatory strategies in order to channel more resources into social projects, or by developing financial instruments and mechanisms required to put capital into the field efficiently in order to track social-based projects more effectively—the private sector can begin to influence society in a more positive way and reclaim the ability to truly be a force for good. ■

PRESENTS

THE WORLD IN 2050 A FORUM ABOUT OUR FUTURE

TO LEARN MORE VISIT:

WWW.COCREATE.WORLD

SECTION / GAP AT FIVE YEARS

GLOBAL ACTION PLATFORM AT FIVE YEARS

GLOBAL ACTION REPORT

GAP AT FIVE YEARS

GLOBAL ACTION PLATFORM AT FIVE YEARS Best Ideas for Food, Health, and Prosperity Synopsis of Expert Recommendations: 2012-2016 PRODUCED IN COLLABORATION WITH NORTH HIGHLAND GLOBAL CONSULTING

rom 2012-2016, Global Action Platform engaged over four hundred of the world’s leading experts and executives in food, health, and economics to define the major challenges and opportunities for advancing scalable, sustainable solutions for abundant food, health, and prosperity. Joining these experts were some 3,000 corporate, university, investor, government, and NGO leaders who participated in annual Summits and Forums where these ideas were discussed. As Global Action Platform concludes its first five years of work, launches the innovation hub at oneC1TY as a living laboratory for urban solutions, and works with GPSS and the IPEU to launch a living laboratory for rural solutions in the Philippines, we have consolidated and synthesized the ideas of the past five years into a knowledge base presented here. We see this knowledge base as a foundation for effective strategies to inform our work moving forward, and offer it as a synopsis of best practices for others who want to join with us in creating a world of abundant food, health, and prosperity.

Foundations for Creating Abundant Food

Key Ideas on Food Strategy and Systems

Over the past five years, experts across the food research and industry sectors worked with Global Action Platform to frame scalable, sustainable solutions for abundant, nutritious food for all people. As framed by these leaders, the food landscape between 2012-2016 consisted of five main areas of strategic importance:

One of the grand challenges facing the world today is how to produce enough to feed the projected ten billion people expected to inhabit our planet by 2050, while at the same time strengthening the biodiversity, climate, and environment of the earth. To feed the world’s growing population in balance with nature will require a comprehensive new food strategy and the creation of new food systems.

■ Food Strategy and Systems ■ Food Business Models ■ Food Science and Technology ■ Agri-Climate-Environment Nexus ■ Food Culture and Nutrition

Several game-changers for food were identified: business approaches to streamline distribution and financial sustainability, strategies to eliminate food waste, scientific research identifying nourishing and disease preventing foods, big data/analytics, mobile technologies for smart farming, and renewal of local food cultures and programs to improve nutrition and to engage a new generation of food entrepreneurs and farmers.

TARGETS Double available food for the world through increased production and decreased waste; ■ Increase investment in infrastructure and technology to deliver food to market without loss and improved food safety; ■ Transition to sustainable, climate-smart agriculture that transforms agriculture from the world’s most polluting sector to the world’s most sustainable force for biodiversity and environmental sustainability; ■ Develop new school programs to create the next generation of farmers and food entrepreneurs; and ■ Build trust, innovation and collaboration among farmers, businesses, governments, research institutions, NGOs and finance to overcome polarization among the sectors needed to redesign the current system.

CHALLENGES Increasing the productivity of the existing food system will not solve the challenges to abundant future food. The resilience of production systems, nutritional implications of production systems, and how to reduce waste are concerns, as well as the following: Price Volatility: Farmers face consistently low prices for their foods. Without increases to food prices, agriculture will not be sustainable for farmers. Biofuel mandates have added constraints and rigidity to the system.

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Poverty: The cycle of poverty and disease enslaves 2.3 billion people globally resulting in long-term social and economic disruptions stemming from a lack of nutrition. Climate Change: Climate change is altering the landscape for food production. The world faces as much as a four degrees Celsius warmer world which could decline food staple production by 10-15% over current levels. Governmental Regulations: The global food system is dependent on the government policies and regulations that affect trade issues, safety issues, and equity and often discriminate against the poor and most vulnerable.

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Food Waste: Globally, $750 billion worth of food is wasted each year representing one-third of the world’s food. 1.3 billion tons of food are wasted and 800 million are going hungry. After the US, China and India are some of the worst food waste culprits. Pre- and postharvest waste are critical issues. Solutions will address what happens to food upon leaving the farm, during transportation, how food is stored and displayed in retail stores, in food service, and at home are all part of the problem.

OPPORTUNITIES Women make up 43% of the agriculture labor force in developing countries but are less productive than men due to social constrains and less access to resources. By giving women the same access as men, farm yields could increase by 2030%. Updated technologies (cell phones, videos, etc.) offer ways to disseminate and extend knowledge to help farmers. The US and other nations need to work closely with governments on investments in infrastructure and agricultural innovations. Private industry can encourage people to eat healthier diets in conjunction with government incentives. The focus should be on international policies that link food production to nutrition and health outcomes and allow for the sharing of ideas and data. Science and technology have progressed to effectively use big data to study genomics and metabolic chemistry. Data will be the root to increasing the abundance of food in the developing world. Sustainable change is only possible and scalable when partners work together to coordinate and share data across disciplines.

Key Ideas on Food Business Models The world’s food is produced and distributed through the private sector. Hence to create abundant food, a paradigm shift is required in the food industry. To achieve a sustainable food and agricultural system, food companies need to bring sustainable sourcing to their business models, as well as new models for food safety, distribution, and nutrition. The challenge is figuring out what it will take for companies to adopt a sustainable resource model.

GLOBAL ACTION REPORT

At the same time, there is a constant, global drive for lower prices on food, which undermines the economic stability for producers, especially small farmers. A solution for the future will need to address the entire production and supply chain.

CHALLENGES Businesses’ priority is to maximize stakeholder value, often preventing them from investing in programs that also optimize social good. This is especially notable when ‘sustainable’ development activities are hard to substantiate. While development aid and funding are typically coordinated between national governments and organizations such as the World Bank Group, they often fail to effectively engage local stakeholders, which can lead to failure. The poorest nations are impacted the most by this lack of inclusion in new business models. The food industry’s current business model is a major barrier to information sharing and innovation. There is no unified theory of sustainability or engagement of local farmers, thus impeding the emergence of new business models that can scale innovations to achieve total food safety, security, nutrition, sustainability, and shared value economic benefit with all stakeholders in the food supply chain.

OPPORTUNITIES The Sustainable Development Goals (SDGs) offer a new framework to help businesses and governments work together to solve the problems of hunger and poverty. The SDGs are a pledge by business and government leaders to eliminate poverty, hunger and 15 other global issues by 2030. The new focus on social/environmental benefit, coupled with economic return, helps food businesses to innovation and helps recruit talented workforce, specifically millennials, who want to make a difference. Other business opportunities include: Synthetic biology to increase farming in urban areas. ■ Leveraging technology to expose farmers, distributers, and consumers to facts. ■ Utilize “big data” to inform development goals. ■ Cultivating collaboration and innovation among farmers. ■ Increasing water efficiency, safety, and quality. ■ Creating forward-looking companies.

Key Ideas on Food Science and Technology Food science and technology today faces a significant loss of faith and widespread public opposition, especially in the food technology’s relation with the food industry and global companies. As the world faces major new challenges of increasing and improving the food supply for a growing population, opposition to food science and technology—the leading source of food revolutions in the past—is at an all-time high. The food science sector will need to restore trust through better collaboration between academics and farmers, increased sensitivity to food safety and nutrition concerns of the public, and greater alignment of scientific-based solutions and food culture and values.

CHALLENGES Most experts agree that to meet increased global food demands, crop yields per acre must be maximized, while also preserving the biodiversity that contributes to the higher nutrition of foods. In meeting this goal, the food sector is also challenged by a suppression of entrepreneurship by regulatory and market-based push-back to food biotechnology. Seven to eight companies own all the seeds in the world and all biotechnology research is funded and directed by them. Transparency is required throughout the system so that the science and its products can be trusted. Food losses often occur before food can be harvested. This waste problem is one of many that may be solved by partnering with scientists and technology experts. However, collaborations between with scientists, academic institutions, and NGOs for practical solutions are often difficult. An underlying cause is demonization of food processing due to the advent of genetically modified organisms (GMOs). Additionally, collaboration among diverse cultures is difficult and compounds the challenge when attempting to solve these issues globally.

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OPPORTUNITIES Scientists agree that the following are necessary to enhance sustainability and prevent the marginalization of biotechnology: Continuing to innovate to optimize food systems through biotechnology and other means.

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Using technology to reduce food waste can reduce the required food production from 70% to 20%. ■ Recognizing the true value of food will help achieve the right pricing structure as there are many external impacts not included in the price of food. ■ Involving the public in more science-based discussions about food can build trust and move appropriate technology innovations forward. ■ Increasing understanding among food scientists of the culture and values surrounding food. ■ Engaging private investment in agricultural innovation to make long-term commitments. Listening to farmers and the public is important to effectively promoting sustainability through innovation. The World Bank is working on “Climate Smart Agriculture” to raise agricultural productivity and food nutrition, increase resilience of farmers to climate change, and look for ways to reduce carbon emissions through agriculture. ■

Key Ideas on Food Culture and Nutrition Food is not simply a commodity, nor is it simply a source of calories for the body. Food is a cultural artifact, an expression of love and companionship, an expression of culture and identity. Food is part of a complex historical and social set of meanings, memories, and values. Food is also deeply connected with nutrition and health and tied into folk medicines and traditions of healing and wellbeing. This complex interweaving of wellbeing and social tradition constitute the culture of food.

CHALLENGES Today, many people and communities are not connected with their food. Increasing numbers of people do not notice the quality of food they eat, know how it is grown, or where it comes from. Food is increasingly a commodity distributed through commerce, disconnected from history, community, and family. Increasingly food is also detached from the idea of a healthy diet or wellbeing. At the same time, human behavior and the social determinants of health are being recognized as vitally important to health. Producing more food is not enough. The food produced, manufactured, and distributed must be nutritious and promote good health. The food production industry

favors large companies which prevents the smaller, more community-focused farmers to be viable. The culinary community fuels obesity by equating the size of a meal to value (i.e. the bigger it is, the more value received). The introduction of processed foods shifted the connection of food and nutrition to consumption of more calories per meal. People also have less of a cultural or religious connection to their food.

OPPORTUNITIES A growing food culture revolution is underway in response to these challenges. Consumers are demanding increased transparency on the content of the food they purchase and consume, as well as on the sustainability and ethical practices of the sources and the food supply chain. Movements like Slow Food are reviving the traditions and pleasures of freshly prepared meals enjoyed in social settings and family. Farming is also undergoing a revolution with the growth of local, smaller-scale farms providing local food sources. Crowdfunding, and other financial tools, are helping local farmers, providing independence from the large financial institutions tied to fast food. Local communities are focusing on local food culture and their role in food production

and distribution by starting community farms and gardens. Social media allow farmers to connect directly with consumers and other farmers and chefs. The culinary community is also driving positive change. More people are eating out - asking chefs to make food choices for them. Increasingly chefs are taking more responsibility to serve locally sourced foods and healthier meals. Technology is educating chefs and consumers on different diets and cuisines around the world which can expand opportunities for healthy food and cultural experience. Because food that is best for health may also be the food that is best for the environment, shifting the message to “healthfulness” may be effective in changing consumer behavior. By understanding behavioral nutrition, we can identify why consumers make unhealthy choices even with the right information. Sustainability research and the consumer education on why it matters also provides opportunity. New global ventures in food manufacturing, processing and production are focusing on the intersection of food, health and sustainability. Implementing more sustainable approaches in food and health requires a balanced public dialogue that engages research, the public sector, and the private sector. ■ SEPTEMBER 2017

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GLOBAL ACTION PLATFORM AT FIVE YEARS Foundations for Creating Abundant Health

ealth and healthcare in developing countries and in the developed world both face significant, but very different challenges. In developing countries, access to basic healthcare is a priority, while in advanced countries, a reorganization and transformation from a system of healthcare to a system of health is underway. Physicians, healthcare executives, public health officials, medical researchers, and technology innovators working with Global Action Platform outlined three major healthcare transformations that can help create abundant health, namely reorganizing healthcare systems and population health, advancing personalization, and leveraging health data for improved health through AI and IT innovations.

Key Ideas on Health Systems and Population Historically, healthcare was centered in hospitals that were created as philanthropic institutions to house and treat the sick and located at a remove from the community. As specialization and medical services increased, healthcare clinics and offices were planned around the physicians and providers of the services, rather than the patient. As a result, the healthcare industry created a scattered, brick and mortar delivery system that had little to do with the client of those services or the creation of health. Further, the financial model for medical care evolved around payment for services rather than outcomes.

CHALLENGES Faced with tremendous healthcare expense and poor health outcomes, the great challenge today is to shift the scattered, brick and mortar healthcare system built and financed around providers to a community system of wellness organized around populations and people. Included in this challenge is the question of how to incentivize healthier behavior, engage families and individuals proactively in their own wellbeing, and how to distribute health services throughout the community. Creating shared big data projects that can help improve population health is another important challenge.

GLOBAL ACTION REPORT

OPPORTUNITIES Three keys to improving health and wellbeing are to re-organize/co-locate healthcare delivery, redesign the value proposition/incentives/finance model of healthcare; and to implement a “new medicine” focused on health, including population health strategies that change behaviors across communities and regions. Medical services can be co-located to offer integrated care to patients, and medical teams can work together in such settings to offer comprehensive, integrated care. The built environment can also be improved through public policy and private development to advance mindful, healthy living by promoting work campuses where people walk from place to place, increasing natural light in the workplace, better air and water filtration, and healthy food choices, made easy. Social media tools and community programs supported by medical practitioners can help people take more charge of their own health. Today there are increasing opportunities to promote tools to capture, send, or analyze healthcare data anywhere, anytime - focusing on ways to put more information at everyone’s fingertips. Opportunities to engage people with more health information is not purely clinical in nature. The opportunities should be holistic, value health solutions, including clinical and non-clinical methodologies driven by the public and private sectors to truly maximize the pursuit of a healthier population.

Key Ideas on Personalized Health As the healthcare landscape continues to evolve, patients are proactively managing their health while raising the expectation of the value of care received. The personalization of traditional healthcare can reduce overall costs and produce better patient outcomes. Patients are becoming more costconscious and discerning in their healthcare. Personalization is refocusing the healthcare journey, customizing treatment, and empowering the patient to take responsibility for their own health. In response to change in patient values, the system is transforming from diseasebased services to prevention and wellness.

CHALLENGES The current healthcare model was designed for reactive disease-based treatment. There is an incentive misalignment in promoting self-care. Economic incentives within the healthcare sector for providers and insurers were not designed for the evolution of value-based care. Patients have more discretionary influence into the system now and have elevated the definition of a satisfactory patient experience.

OPPORTUNITIES Converting financial incentives for providers to quality of care and outcomes in place of quantity and episodic care will ensure patients and providers are aligned

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in treatment value. As insurers begin to embrace pharmacogenomics, patients can receive customized treatment based on genetic sequence leading to more favorable outcomes and fewer adverse reactions. Patient education will be vital for the continued evolution of the new healthcare model enabling patients to become self-proponents of their health while increasing overall satisfaction with the system.

Key Ideas on Health AI and IT Innovation Efforts to achieve seamless integration among disparate medical technology systems should help to deliver better healthcare services. By compiling data rendered from different technology systems, big data can help the clinician make better delivery decisions in a timelier fashion and help the patient make more informed lifestyle/health choices. There is a disconnect between patient needs and the ability of the healthcare system to deliver timely and costeffective services. The healthcare system can make better decisions on healthcare delivery, disease diagnosis, and epidemic prevention by leveraging the power of big data and eliminate the medical system silos that exist today.

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The patient population is aging and the majority of Americans are obese or overweight. Outside the US and developed world, there is a basic lack of access to the most basic forms of healthcare, much less access to advanced technologies or benefits from big data. Healthcare technologies were initially developed from a doctorâ&#x20AC;&#x2122;s perspective â&#x20AC;&#x201C; without including the patient in the decision-making process. Most data are reactive, not predictive. Healthcare systems need to work more efficiently by achieving seamless integrations and interoperability of disparate systems. Finally, to develop a patient-driven, predictive, seamlessly integrated IT solution for healthcare, secure methods for data storage and sharing will be needed.

Innovation can be achieved by identifying ways to increase engagement between the doctor and the patient. The use of technology and personalization may be among the best opportunities to succeed at this. Harnessing big data to predict disease patterns in an area of the population or to curtail the spread of a disease are opportunities being pursued. Big data can also be used to improve clinical outcomes. Consumer products such as the Fitbit are already using big data to provide information to consumers to help them make better lifestyle decisions. In developing areas where basic healthcare is lacking mobile devices tied to hospitals and university medical centers can provide a way for remote diagnostic treatment to occur. â&#x2013;

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GLOBAL ACTION PLATFORM AT FIVE YEARS Foundations for Creating Abundant Prosperity

enowned economists, corporate executives, national and regional economic leaders, investors, and international banking executives working with Global Action Platform during its first five years identified four drivers key to creating universal prosperity and outlined concepts of shared value and social progress as the aim for future economic growth. The drivers for prosperity are: ■ Economic Regions ■ Clusters ■ Ecosystems and Competitiveness ■ Capital Investments ■ Innovation

Key Ideas on Economic Regions In 2015, the United Nations (UN) adopted the Sustainable Development Goals (SDGs), setting the eradication of poverty in all forms everywhere as the first goal. Regional economic strategy is a key to achieving this goal. Regions that leverage local assets are thriving around the world. By harnessing the skills, thought capital, financial support, and energy of local leaders, universities, employers and businesses, local economies can compete in global markets to generate prosperity. These regions have the potential to shape solutions in health, food, and prosperity at every economic level. Hence, a key to the creation of universal prosperity is the activation of regional economies that leverage the talent and assets of their local knowledge, workforce, institutions, and capital.

CHALLENGES While there is no one model for regional economic development, there are universal key issues to address, including regional strategy, cross-sector collaboration, university-business engagement, capital, and workforce skills. Among the greatest barriers to regional economic development are lack of leadership, lack of trust, unwillingness to collaborate and share, and misalignment of government jurisdictions with economic regions.

GLOBAL ACTION REPORT

Despite globally decreasing poverty levels, the current stage of globalization has created alarming wealth gaps. Part of the solution to income disparity may lie in transformative economic initiatives and projects that are regionally developed, technical and financial assistance with improved hard and soft infrastructure, assistance in addressing expertise and resource gaps, and improved policy in all levels of government.

OPPORTUNITIES Focus on high growth and regionally competitive areas of innovation and implementation of a bottom-up approach to local investment can help economically stressed communities become full participants in the global economy. Employee-owned companies bring growth and benefits to employees and communities. Cooperation circles with at least seven people from three traditions working together to promote solidarity should also be explored. Solutions should be collaborative and focus on taking care of the community. Multi-sector partnership is important for successful regional economic development. Policymakers, government, private sector and universities all have a role to play.

Key Ideas on Clusters Growth recipes of the past are failing; future growth strategies must move beyond the historic rubrics of

deregulation, monetary policy, cheap labor, and globalization. Future growth in a world driven by innovation and global competition will need to focus on strategies to create clusters. A cluster is a geographic concentration of competing and cooperating companies, suppliers, service providers and associated institutions. Regions are creating powerful local economies by leveraging the research and innovation assets of universities with business leadership and entrepreneurs. Financial capital follows human capital, which follows the innovations developed by universities. Ongoing private sector co-investments with universities enable interdisciplinary, cross-functional conversations and relationships. In the US, cluster initiatives have blossomed since original federal funding in 2010. These collaborative initiatives aim to reduce risks associated with innovation and investment. Successful cluster structures are not driven by economics alone; policy and publicsector engagement also matter. Cluster collaborations have led to legislative changes and better information sharing through increased networking events, seminars, and communications.

CHALLENGES Challenges to strong cluster development include sustaining membership interest and participation among competitors, diversifying funding for cluster projects beyond government grants,

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and maintaining collaborations among companies that differ in size. Defining metrics, the shifting attitudes and opinions of political leaders, public and private sector bureaucracies, and the rigidity of government grant categories also pose challenges for regional leaders working to create new clusters.

OPPORTUNITIES The key to cluster development is creation of a regional ecosystem built on trusted relationships among research scientists, business leaders and venture capitalists that is supported by strong civic commitment. Financially successful innovation clusters must engage teams focused on market expertise, technology innovations, and entrepreneurial and financial resources. Research universities provide critical assets that can anchor an entrepreneurial environment, where the business and academic communities join early in the process and follow a grassroots, bottom-up approach that allows people to become friends and colleagues first, share knowledge, share experience, build trust, and then co-venture and make deals. Helping clusters connect with other clusters and a well-managed, skilled talent workforce are important to successful cluster development.

Key Ideas on Ecosystems and Competitiveness Companies can improve their global competitiveness while improving their local communities and the lives of their employees by creating successful ecosystems and industry clusters. Collaborative efforts made in the right places with the right underlying activity and leadership can solve problems locally while giving companies an edge globally.

CHALLENGES The discussion of competitiveness today often focuses on concerns about inequality and joblessness. Around the world, global competition has increased corporate productivity and profits, while exposure to global competition has also led to stagnant and/or declining middle and lower incomes and lost jobs. A Harvard Business School initiative to understand how private-sector leaders think about competitiveness and to find innovative ways to improve it revealed few areas in which the US is perceived as strong and improving and that the US is losing off-shoring and location decisions at alarming rates.

OPPORTUNITIES Successful clusters can improve conditions for communities while creating globally competitive companies. Regions with strong clusters perform better in terms of wages, innovation and productivity. While many multinationals feel diminished responsibilities toward local communities and workforces, some are also learning that chasing low wages and supplier pricing around the world is costlier than expected. Creating a healthy â&#x20AC;&#x153;commons,â&#x20AC;? using shared resources allow businesses and individuals to prosper. Businesses can build and protect the commons in three ways: running their own businesses vigorously, avoid undermining the commons in the pursuit of profitability, and finding ways to grow business while building the commons and collaborating with other sectors. Keys to cluster success are underlying economic activity, open membership to foreign and large companies, strong organization managers and staff, and related industry and location. Collaboration in developing clusters ensures the right mix of people are engaged to create the next wave of innovation and prosperity. There are already many examples of successful cross-sector partnerships dedicated to revitalizing business environments, creating opportunities for the middle class, and building ecosystems for shared prosperity.

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Key Ideas on Innovation Innovation is critical to driving the economy and solving food and health problems. Research is the fountainhead of innovation and a driver of economic growth. Since World War II, more than 50 percent of America’s economic growth came from advances in science and technology. Dr. Francis Collins asserts that, “If we care about advances in health, if we care about finding answers to cancer and heart disease and diabetes, if we care about getting our economy back on track, there would be no better way than to make an effort to make (public funding for healthcare) a priority.”

CHALLENGES Decline in government research funding over the last decade has threatened America’s research, undermining its potential to build on existing talent and diminishing potential support for the next generation of scientists. The US still has the world’s leading universities, but this leadership is eroding in the face of new competition in China and elsewhere. A new competitive landscape has also caused a shift away from research led by individual organizations to a more collaborative model that draws on expanded networks and benefits by shared risk across multiple sectors.

OPPORTUNITIES The private sector is hungry for partnerships. There is growing enthusiasm for forging meaningful collaborations among the National Institutes of Health (NIH), academia, the private sector, foundations and public advocates for research. There are many successful models of multi-disciplinary, multi-institutional activities that are leading breakthroughs in scientific advancement. In this funding-poor environment, global partnerships across public and private enterprises can be created that avoid waste and duplication. Partnerships also help cross the gap between scientific discovery and real-world application. As funding and risk tolerance decline in universities, collaborative models of innovation will be critical to drive growth and global solutions. In addition to providing much needed funding, collaboration allows 24

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companies and universities to mitigate market risk while addressing food, health, and prosperity issues. An aligned regional economic development strategy model offers incentives for innovation, awards faculty leaders and strategically guides entrepreneurs. It is accessible to private sector partners who seek innovation. It serves public and consumer benefit, leading to prosperity through globally responsible metrics, guided by best practices for building sustainable systems. To accomplish a successful innovation hub, a comprehensive collaborative platform is needed that combines the most important elements of social-media-enabled and in-person engagement. The Global Action Platform has set a course to design an “Innovation Hub” model as an anchor for regional innovation and cluster development. With oneC1TY as a physical location, the goal is to create the necessary ecosystem and competitive strategy anchored in university-business collaboration.

Key Ideas on Social Progress and Shared Prosperity Social Progress is defined as “the capacity of a society to meet the basic human needs of its citizens, establish the building blocks that allow citizens and communities to enhance and sustain the quality of their lives and create conditions for all individuals to reach their full potential.” Measuring the success of social progress initiatives can be vastly different, even among countries of similar wealth. Harvard Business School’s Social Progress Imperative created the Social Progress Index (SPI) consisting solely of social environmental indicators and allowing easy comparison of the effectiveness of their efforts to improve their citizen’s lives among countries of similar wealth. Harvard also created the U.S. Competitiveness Project in 2013 to evaluate the state of the U.S. Economy, how competitiveness is defined and how research can be used to make improvements to the current economy. In addition, adoption of the Sustainable Development Goals (SDGs) by the United Nations has put global equality up for debate. For SDG1 (end poverty in all form everywhere), the

shared values initiative is a prevalent solution where companies focus on social issues, while supporting the society and environment that make their businesses possible. To move to more sustainable practices in food and health we will need to change human behavior, but first we must align on what “sustainability” truly means. Connecting at a personal and local level is important to foster shared prosperity—individuals, businesses and government—must all partner to achieve individual well-being for the community.

CHALLENGES Perhaps the greatest challenges facing the emerging focus on shared value and social progress is resistance in the traditional business sector to incorporating social progress with core business strategy. Can profit and return on investment be sustained or increased by integrating social and environmental impacts in core business activities? Developing valid and reliable metrics for shared value is also a key challenge to the approach becoming mainstream. In this early stage, finding investors who support the shared values initiative can be particularly challenging, since companies often focus on the initiative’s risks. There are also many systems and infrastructures that need to be overhauled to implement shared value in a company. To be successful, companies must integrate complex social issues into the corporation’s core business model.

OPPORTUNITIES When used appropriately, the SPI can drive data-based policy decisions and measure the effectiveness of existing policies. Partnerships for shared value initiatives are driven by investors who support the underlying cause and realize that the investment may take longer to return. Investors should recognize the growth potential of socially responsible companies. Implementation of shared social goals can be dependent on the appropriate regulatory infrastructure. Social issues and these business models must be completely integrated for success. Addressing technology barriers for small companies and cross-sector collaborations are also opportunities. Consumers and investors need to reward companies for exhibiting socially responsible behaviors. Countries must create peer pressure to drive social responsibility,

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Evolving financial conditions and a new focus on achieving financial and social gains have created a new investment environment for organizations, driving the need for innovative solutions.

and governmental policies must incentivize companies to be socially responsible. A community of social investors can promote flexibility and transparency to promote success.

Capital and Investments Changing financial conditions since the bull market of the 1980s make innovations more valuable than ever. Three reasons why companies fail are: access to capital, access to talent, and execution by the management team. Creating an ecosystem that accepts “failing fast” is imperative for successful innovation. The concept of impact investing has emerged over the last decade balancing social gains with modest financial risk. Impact investing adds complexity to organizational investment, driving companies to seek more diverse forms of investment to achieve their returns.

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Four key challenges exist for portfolio managers in attempts to beat the market:

Driven by millennials, impact investing is becoming increasingly more important to employees. Millennials embrace companies with a greater sense of purpose and social obligation to addressing issues. To appeal to this audience, organizations must learn how to fund and market social investing. One strategy is learning to work with state and federal government agencies to take advantage of available grants and funding. Local fundraising and crowd sourcing provide other opportunities for organizations to raise the necessary capital. Fortunately, the lack of competition in the social innovation markets drives industry collaboration and alliances. ■

Lack of relevant information in one place when decisions need to be made. ■ Outmoded technology used by mode investors for capital allocation. ■ Amount of capital needed for startups is going down. ■ The track record for public-sector funded venture capital is dismal. ■

Impact investing is plagued by the risk of loss. Organizations must realize that while social investments may not achieve market returns, they are still necessary. Social enterprises often lack the business acumen to develop a sound plan and can benefit from engaging business resources to assist in building these models. The scale of some social problems also makes impact investment more complex. Significant capital may be required to effectively address the social issues. Luckily, social enterprises attract investors and donors that may not require the typical rate of return (i.e. philanthropists, grants, etc.).

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FOOD

GLOBAL ACTION REPORT

SESSION 1

FOOD

Session 1: SDG#2: Economic Transformation Through Food Security SESSION PANELISTS: NICOLE GOLDIN, Senior Fellow, Center for Strategic and International Studies HILARY HADDIGAN, Chief of Mission Effectiveness, Heifer International TIM PRUETT, CEO, iDE JERRY SKEES, Emeriti Faculty, University of Kentucky MODERATOR: MARK FITZGERALD, Global Lead Partner, UN, KPMG

SITUATION With the introduction of the Sustainable Development Goals (also known as the SDGs) by the United Nations in 2015, sectors across the board are working around the clock to address problems in food, health, poverty and sustainability. Indeed, with the overall goals of the second SDG focusing on ending hunger, achieving food security, improving nutrition, and promoting sustainable agriculture, it is crucial that large-scale frameworks be put in place in order to address these issues. However, while worldwide hunger has lessened to a degree and investments in agriculture has jumped dramatically in terms of venture capital in the last three to four years, the demographics of agriculture have shifted upward to an average age of 55-60 throughout the world, a shift that no doubt signals future concerns for agriculture. In fact, the continuous growth of the agriculture industry as well as the increasingly aging population of the workers is already beginning to create problems. Despite the need for younger workers, fewer and fewer young people are going into agriculture, and many farmers already in the industry are beginning to leave due to issues with poverty. And with unreliable income and uncertainty surrounding the future of small farmers, it has become nearly impossible to retain talent in this sector. Even more alarming, the continuously expanding population will most likely reach around 9.5 billion people in 2050, creating extreme increases in demand for food and thereby a need for more farmers.

CHALLENGES Therefore, it is absolutely vital that the agricultural industry be altered to both attract and retain talent in larger volumes. Without doing so, the future of not only food but also the world looks bleak. However, agricultural industry experts are working endlessly to find solutions to this problem, and many of those experts may be close to creating longterm solutions. By focusing on investing in small farmers, preparing and insuring against natural disasters, and increasing programs to include youth in agriculture, the industry may be able to revitalize itself and provide not only for people in developed countries, but also increase food consumption in developing countries as well.

KEY QUESTIONS 1. How can agriculture attract young talent? 2. Do both small and large farmers need insurance coverage against natural disasters? 3. What can be done to assist small farmers in their pursuits? 4. How can farmers stimulate both their local economy as well as their local government? 5. How can companies and institutions bring more food to developing countries?

Although undernourishment rates have declined from 23% in 1990 to 13% in 2015, there are still 800 million chronically undernourished people throughout South Asia and Sub-Saharan Africa, with over 160 million children under the age of 5 remaining stunted by malnutrition. These numbers demonstrate that there is still an immediate need for a larger and more plentiful food system that can alleviate the nutrition needs of developing countries. However, many developing countries aren’t as motivated by subsidy incentives that developed countries use as a means of capitalist drives, nor do they have access to more advanced agricultural technologies, making malnutrition a difficult problem to solve. Similarly, due to the changes in demographics, urbanization, and youth workplace goals, it is harder than ever to attract talent in agriculture. While half of the world’s population is under the age of 30— with 1 in 4 people considered youth—there is a surplus of able-bodied unskilled workers available to join the workforce. In Africa, for example, 2/3 of the workforce engages in work related to agriculture, which comprises nearly 1/3 of the country’s GDP. However, while the average farmer in the US is 55 and South African farmers on average being 62, this worldwide youth gap will continue to widen unless proper intervention is allowed. As the youth population increases, so does the need for more food. With the increasing size of the youth growth gap, the lack of ability in the global economy to absorb and harness the potential of SEPTEMBER 2017

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young people as well as the lack of young people going into agriculture is becoming doubly as detrimental. In fact, youth are more than four times as likely to be unemployed, underemployed, or part of an informal economy. Lastly, land issues, the status issue of agriculture, difficulty gaining capital to begin agriculture expenditure, and gender inequality also effect the agricultural industry in negative ways. In fact, current studies estimate that it will take at least 170 years to close the global economic gender gap and will also take quite a few years to increase the amount of youth in agriculture. Therefore, it is imperative that frameworks be set up to deal with these issues as soon as possible.

“We have this burgeoning youth demographic around the world with tremendous potential to drive their economies forward, and yet in agriculture and the food system, we have an increasingly aging workforce and an aging demographic.” Nicole Goldin, Senior Fellow, Center for Strategic and International Studies

“Not only can they be profitable, but as farmers begin to build their own economic models on their own farms and grow, they create job opportunities on and off farm that increase job economy.” Hilary Haddigan, Chief of Mission Effectiveness, Heifer International

“Agriculture requires a virtuous cycle. You have to have the seed, the fertilizer, the water, all of the pieces have to come together and everybody in the system has to profit in order for it to grow and expand and develop.” Tim Pruett, CEO, iDE

OPPORTUNITIES With the burgeoning youth population also comes the potential for many new workers. With over one billion young people entering the workforce in the next 10 years, it is crucial that systems be put in place to funnel their talents into necessary sectors, like agriculture. Through training programs not only for farming but also for agro-processing, agricultural research, forecasting, logistics, and transportation of food, benefits such as technology, agripreneurship, and governance opportunities will be on the rise. Even more important, many of these jobs will not be rural-based, and therefore more accessible even in urban areas. Indeed, with venture capital investment in agriculture increasing dramatically along with new forms of incubation and acceleration being introduced into the system daily, the agricultural industry is poised to become a food-processing powerhouse capable of feeding the world. The inherent fact that agriculture is a necessity to survival along with the fact that agriculture is a long-term industry shows that the agricultural industry is capable of adapting to people’s needs, and is ready to do so in the next few years. Another very real—and nearly unstoppable—challenge for agriculture is natural disasters such as flooding, drought, hurricanes, tornadoes, and earthquakes. But while very little can be done to prevent these disasters, research and development firms such as Global Parametrics provide risk management, 28

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“You need to work on a global scale to provide cover for global partners that have investments on the planet for various extreme events with natural disasters.” Jerry Skees, Emeriti Faculty, University of Kentucky

financial inclusion, and even forecast insurance in an effort to safeguard farmers from unavoidable disasters. These sorts of practices can be accomplished by providing recovery lending on the backend of a disaster in order to get farms up and running as soon as possible. Similarly, rather than focusing on individual farmers as many companies have done in the past, non-profit organization Heifer International focuses on how to build market systems as a whole, as well as stimulating financial capital, impact investment, technology, increasing productivity, and even encouraging social capital between farmers through the philanthropy of early backers and continued investment in farmer success. In East Africa, for example, Heifer International developed a hub for the aggregation of milk where farmers can now send their milk to be sold in markets. Through the creation of this hub, farmers were not only able to stimulate the agricultural economy but also the banking economy and distribution economy as well through increased bank participation and the creation of a milk bike delivery system. This hub system not only helps the farmers, but the local economy as a whole. Other companies such as iDE use

the capitalist market as a means to solve global issues like poverty, food shortage, and malnutrition. Through their business, technologies such as latrine water filters, irrigation kits, and different styles of pumps are both created in developing countries and sold to developing countries in order to stimulate the market and provide solutions for health problems. With the understanding of the local economy, these technologies not only solve social issues but also expand markets, increase food, and increase the local community’s income. Lastly, incentives for both the agricultural industry as well as investors need to be set in place in order to assist youth in agricultural start-ups as well as increase productivity for current farmers. In Sub-Saharan Africa, for example, the International Food Policy Research Institute found that when asked what the biggest barrier to adopting new and more efficient water pumps was, farmers answered that the cost and amount of time needed was too high. The researchers, however, found that if they provided agricultural products such as these water pumps in popular and accessible kiosks, farmers were more incentivized to buy the pumps, which in turn increased agricultural production as a whole. ■

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Session 2: Food Safety: Threats, Traceability, and Forensics SESSION PANELISTS: PINGFAN RAO, Vice President, Chinese Institute of Food Science Technology, Director, Food Project, Future Earth MOSHE ROSENBERG, Professor and Specialist, Dairy Engineering and Technology, University of California Davis ALIDA (LINDA) STOKER, Manager, Institute for Food Safety, Wageningen UR MODERATOR: DAVID MILLS, Peter J. Shields Endowed Chair in Dairy Food Science, University of California Davis

SITUATION Although the increasing globalization of the food economy has brought about an endless stream of benefits, topics such as food security and authenticity are being threatened by worldwide food fraud. With issues such as adulteration, misrepresentation, counterfeiting, tampering, and modification being committed at all points along the food supply chain, it is difficult to pinpoint where food fraud is being committed and how to best remedy the situation on a global scale. One study revealed, for example, that an astounding 80% of a certain Italian cheese sold in the US was actually not processed in Italy at all, but in other unknown locations. With many food products—especially specialty products—being sold for hundreds of dollars per ounce, food fraud is being committed on a worldwide scale in order to cut back food costs and turn a large profit. The biggest issue that food industry faces today, therefore, is food fraud. With the complex food processing system and relative ease of infiltration, however, it is difficult to pinpoint how, when, and who is behind this food fraud process. And with food fraud being relatively unknown to consumers and even food companies, systematic, large-scale frameworks for finding and punishing those who commit food fraud have yet to come into effect. Indeed, reports show that it wasn’t until this past year that 20 of the largest food

companies decided to declare war on food fraud. It is also important for consumers to understand the risks of food fraud as well as gain a greater understanding of food and what it is made up of. In order to bring an end to food fraud, therefore, it is crucial that a legal and forensic framework be put into place in order to locate and persecute those who commit food fraud, as well as create a distribution of information for consumers to tap into.

KEY QUESTIONS 1. What is food fraud? 2. How prevalent is food fraud on a global scale? 3. What systems can be put into place to promote food safety and food defense? 4. How can consumers become more aware of food fraud and food safety? 5. What programs and training are being put in place to train students in food forensics?

CHALLENGES With 600 million people—or about 1 in 10—falling ill from contaminated food each year, food safety and food

authentication are crucial to not only guaranteeing the food you buy is what you paid for, but also guaranteeing its overall safety to consumers. However, with the globalization of the food market and the ease of large-scale distribution between borders, finding the exact origin of any foodborne illnesses, whether it is a deliberate bio-terrorist attack or an accidental bacterial infection, has become increasingly difficult. And while bacterial contamination can often be prevented through sanitary measures, the issue of bio-terrorism has become an extremely worrisome one due to its inherently harmful nature and ability to target large populations through biological and chemical changes in food. Even more prevalent than food contamination is the practice of food fraud. While there are age-old industry practices that have been put into place in order to prevent contamination, the issue of food fraud is a relatively new one that has yet to be addressed. The first issue with food fraud is the fact that it is intentional—unlike accidental contamination, food fraud is performed by those who intend to make quick money by misleading customers. This can include tampering with food products, labeling, packaging and/or misrepresenting and adulterating the product itself. One of the biggest issues of food SEPTEMBER 2017

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fraud, however, is its impact on the food economy. For example, it has been estimated that one single food fraud case within a company can amount to an astonishing 15-20% damage to annual revenue, and even more damage to the company’s image. It also has been estimated that overall loss due to food fraud is at 40-60 billion dollars a year for the entire food industry. Even more so, the conflict between necessary transparency for authentication and traceability and the IP of a given food product—such as its ingredients or the process by which it was created—has created a difficult system for food producers to be fully honest about their food. There are also many economic, social, and political drivers of food fraud. First, the globalization of the food economy and the increasing complication of the food supply change has created an environment in which food fraud can thrive; second, limited supply and high demand in areas of economic insecurity further fuel food fraud; and lastly, consumer trust in labels and a lack of enforcement against food fraud has created a system within which those who commit food fraud face little consequence for their actions. However, creating a system to identify, isolate, and reprimand food fraud corruption is no easy task. The fact that

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food like fruits and vegetables are living systems with inherent viabilities—such as biological and chemical compositions —creates an overall dynamic system whereby tracking identifiable markers becomes difficult. Therefore, developing and maintaining a system of traceability can be costly, especially for developing countries. Today, there is no standard format for the evaluation of whether or not a food is authentic, nor is there an easily accessible digital database to disperse food information on a large scale. The last problem with food fraud is the fact that the consumer is generally unaware of when it occurs. While the human body has mechanisms to alert itself against things like smoke, the symptoms for bad food—whether it is due to allergies, contamination, or over-processing—take on many vague symptoms, such as vomiting, diarrhea, indigestion, and thirst, all of which can be caused by a plethora of ailments. Overconsumption of sodium, for example, can cause extreme thirst that can be alleviated by the drinking of water. However, continuous consumption of sodium can lead to more serious problems, all of which are not inherently alerted by the body’s defense mechanisms. It is vital, therefore, that people become more educated about the effects of food and how to spot food contamination.

OPPORTUNITIES Although food authentication may be a difficult process to bring into fruition, it is an essential stepping-stone to creating a safer and more authentic food industry. In Europe, for example, the food industry has put into place mechanisms by which foods are legally bound to the authentication of their place of origin. Through this process, food producers are obligated to provide unique identification of their products. Indeed, many laboratories are beginning to focus more on issues such as DNA sequencing, microbiology, and nanotechnology in order to identify potential cases of food fraud. In terms of DNA sequencing specifically, scientists are able to quickly identify large pools of microbial data with a simple swabbing of a surface, or a small piece of food. Through this process, scientists are able not only check for contamination, but also check to make sure that necessary microbes are present. In this way, DNA sequencing can be used to map the food landscape of a factory and identify any potential harmful agents. Another potentially effective way in which food fraud can be identified is through the training of specialists in the field of food forensics. Through the studying of microbiology, pesticides,

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and micro-toxins, in addition to processes such as how the food chain works and how to make food authentication cheaper and more accessible throughout the industry, food forensic scientists are able to both identify potential instances of food fraud as well as pursue more efficient forms of food authentication. Additionally, big data systems need to be integrated into the food authentication process in order to track continuous and changing parameters food quality and makeup, as well as pinpoint any unusual changes in an effort to track any potential food fraud instances. Even more importantly, big data systems can be used to track

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consumer behavior in order to align the industry with the desire of the customers. Similarly, big data systems also enable researchers worldwide to research food security under a common set of language, definitions, and parameters. Lastly, a system used to educate consumers on what they are eating and how it affects them needs to be put into place in order to create a society of well-informed citizens who can help food scientists identify any potential fraudulent foods. For example, a recent study was performed in which students were asked to identify different teas. While at first, they were unable to tell the subtle flavors apart due to the harsh artificial flavors

they were used to in food, after a month spent reducing their intake of artificial flavoring, participants were able to easily identify the different teas. This study ultimately shows that with training and access to information, consumers can possess more refined tasting mechanisms in order to accurately identify authentic— and more importantly, safe—food. ■

“The behavior of the consumer will ultimately influence what the industry is going to produce.” Alida (Linda) Stoker, Manager, Institute for Food Safety, Wageningen UR

“When we authenticate food to make sure it’s the food that we think it is, we protect the interest of consumers, communities, economies, and even the national economy.” Moshe Rosenberg, Professor and Specialist, Dairy Engineering and Technology, University of California Davis

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Session 3: Oxfam Reports: Poverty, Hunger, and Income SESSION PANELISTS: ELLEN GUSTAFSON, Food System Change Advocate, Food Tank, FEED FABIO LAVELANET, CEO, FABRAR Rice, Inc. LORI ROWLEY, Director, Global Food Security & Aid Effectiveness, The Lugar Center MODERATOR: WANNEH DIXON, Senior Advisor for Aid Effectiveness Partnerships, Oxfam

SITUATION By 2050, it is estimated that the farm industry will need to more than double its production volume in order to feed the world population of over nine billion people—an additional two billion more people than today—a majority of which will be born in countries that are currently food insecure. With population growth set to increase by 34% in central Asia, 56% in North Africa and Asia, and an astounding 120% in Sub-Saharan Africa, it is of the utmost importance that worldwide food production not only increase substantially, but that the mechanisms by which food is distributed be reconfigured to bring easier and more universal access to food. This increase in food production will cost an estimated $265 billion dollars, an amount that no one organization can sustain by itself. Therefore, the need for collaborative, effective partnerships to empower and educate one another is necessary to the creation of effective solutions designed to assist in the upcoming population boom. However, with a developing trend toward supporting local farms and food consumption, increased private sector interest in foreign food aid, and an increasingly productive food transportation system, the possibility of a future filled with an abundance of food is entirely possible.

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KEY QUESTIONS With the livelihood of both farmers and citizens at stake, it is crucial that the public sector, private sector, NGOs and investors come together to increase the livelihood of smallholder farmers and the worldwide food industry in order to increase food production around the globe. Perhaps even more importantly, it is vital that both the private sector and various governments ensure the sustainability of long-term solutions and mechanisms within the food industry. Without the creation of sustainable longterm solutions, the sustainability of the farming industry will be uncertain, and the livelihood of an increasing population will potentially be in danger.

1. How does the private sector support local farmers? 2. How does our domestic food aid system assist foreign countries? 3. A re the government and the private sector aligned in their efforts to bring food security? 4. S hould the focus of food security be on increasing food production or increasing access to food? 5. I s sustainability important in creating solutions for food security? 6. D oes the general public know about the food crisis? What can we do to increase awareness?

“Everything is interrelated – we as processors depend on the farmers, farmers depend on us as an outlet for their rice, we depend on distributors and transporters to move the rice from the farms to the mill and to the market, and we depend on retailers to get rice to the consumers.” Fabio Lavelanet, CEO, FABRAR Rice, Inc.

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CHALLENGES One of the biggest challenges facing the farming and food economy is the fact that many people in western countries— especially the United States—are unaware of worldwide crises within the food industry. This is due to the fact that the general public is often disconnected from the mechanisms of the food supply chain and unaware of how this system works, what it is comprised of, and how this food industry has changed over the years. This disconnect has led to a general unawareness of the global food system. One study showed that when polled about how much they thought the US government spends on foreign aid, participants’ answers ranged from 10% of the total federal budget to 60% of the total federal budget. In reality, the federal budget for foreign food aid is a mere 1%, much lower than even the lowest estimate participants gave. In fact, faith-based organizations are often more likely to donate to foreign food aid than governments. In general, US food aid assistance is sent to countries experiencing a national emergency, such as a drought or conflict within the country. While this aid is necessary, very little assistance is spent on helping local growers so they can feed themselves and create long-term sustainable sources of local food. In fact, studies show that a whopping 75% of those who are considered chronically hungry are small farmers, 34

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a large percentage which bodes ill for the future of food. Indeed, it is crucial that foreign aid not only be used to help small farmers temporarily, but that this aid also be continuously used in order to assist farmers, the local economy, and companies and NGO mechanisms over the long-term. Without government funding being funneled into these mechanisms, however, long-term sustainable solutions will be difficult to achieve. Oftentimes, once US investment leaves a project dedicated to boosting local farmers, the project becomes unsustainable and the farmers re-enter a state of chronic hunger and inability to produce necessary amounts of food. This sustainability is dependent not only on the American government, but the local governments as well. With rampant corruption found throughout several

regions in developing countries, food is often unable to move freely in the market and the lack of regulatory systems brings a potential for food corruption and food fraud. Therefore, regional and local governing systems are of the utmost importance in opening these markets and ensuring food quality in order to create an environment in which the farming industry can thrive. Lastly, nearly all systems in the food value chain—whether it is processers, farmers, outlets, or transportation—needs to be stimulated in order to increase food production. This needs to be done in order to create a variety of foods that meet the nutritional needs of consumers, as well as create more ease of access to these foods for consumers around the world. Without access to safe and consumable food, any increase in food production that is made will have no effect on the global food crisis.

“Global food security and global hunger have no party status. It’s about feeding hungry people and stabilizing populations, which is why hunger is a national security issue.” Lori Rowley, Director, Global Food Security & Aid Effectiveness, The Lugar Center

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OPPORTUNITIES Despite the big challenges that face the farming industry, there are a plethora of opportunities available that could lead to sustainable, long-term solutions. Fabio Lavelanet’s company, FABRAR Rice, for example, is a rice processing company located in Liberia that functions as a social enterprise along the rice value chain in order to create value and markets for small rural market farmers. By working with 200 Liberian famer families, FABRAR is able to help produce over 150 metric tons of rice per month, a venture that greatly assists both the farmers they work with as well as the local economy. Even more importantly, it is these sort of local enterprises that are able to assist on the ground in case of local emergencies. During the Ebola crisis, for example, Lavelanet’s team partnered with the World Food Programme in order to provide rice for those affected by Ebola in Liberia. It is in this way that social enterprises such as FABRAR can not only be used to sustain farm growth, but also act as first responders in times of emergency. In terms of sustainability, many of the larger aide programs have begun to create small garden programs where the bags one receives food aid in can also be used to plant a tiny garden for continuous food production at the individual level. Similarly, non-profit organizations like 1000 days

also provide nutrition to expectant mothers and newborn babies in order to sustain livelihood for a child’s first 1000 days. On a more general level, partnerships within industries, between sectors, and with the government are beginning to form in an effort to improve the farming industry’s capacity to produce. By having a manufacturing partner with farm bureaus and commodities groups, for example, joint research can be conducted on multiple fronts and the market can become more open and diverse. Within the food industry, partnerships between those who focus on quality and those who focus more on quantity are also beginning to develop. While traditionally quantity and quality were seen as mutually exclusive, the partnership between these two thought processes is beginning to create potential solutions for food crises such as solutions for food shortage, undernutrition, and small farmer livelihood.

Lastly, renewed interest in locally grown foods has created an interesting shift in utilizing mass-market food production less and accessing smallholder farmers more in an effort to sustain local communities. This shift presents a new interesting alternative to the pressure large food manufacturers face: rather than having to feed the entire world, perhaps local areas can feed themselves. Ultimately, a balance is needed between large food companies and local smallholder farms in order to provide accessible and relatively cheap food while retaining the nutrition value of locally grown foods. Overall, farmer’s markets have seen an increase of 10% in growth in the last 15 years throughout America and the rest of the world, and this number continues to rise. While ample solutions are still necessary to ensure the sustainability of the market, the food industry is experiencing growth like never before, and may very well continue to do so until 2050 and beyond. ■

“There needs to be a balance between enough food production so that people around the world can eat well for cheap, but we also need to be humble in the fact that perhaps a system of regional local systems is a better system to ensure better nutrition for people.” Ellen Gustafson, Food System Change Advocate, Food Tank, FEED

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Session 4: Global Food: Interoperability for the Sustainable Agri-Food Supply Chain SESSION PANELISTS: RICHARD CATES, Owner & Founder, Cates Family Farm GLENDA HUMISTON, Vice President, Agriculture & Natural Resources, University of California, Office of the President MATTHEW LANGE, Associate Director, UC Davis Initiative for Wireless Health & Wellness JAMES CANTON, CEO & Chairman, Institute for Global Futures MODERATOR: BRAD HOLTZ, Chief Strategy Officer, Center for Understanding Change

SITUATION In order to produce scalable, sustainable solutions for improving supply chain operations and creating significant positive impact in terms of decreasing hunger and improving nutrition, it is important that we consider the interoperable factors that connect global agriculture to food supply chains. Through the interoperability of these systems, both industry-wide innovations as well as local systems innovations can be created in an effort to boost the sustainability of this global food supply chain and widen its reach to areas in need. The inherent nature of interoperability shows that it is vital for factors, such as university involvement, information infrastructure, food forecasting, and increases in farmer participation, to be emphasized in order to strengthen the individual systems throughout the agrifood supply chain. Without a stronger focus on the specific mechanisms of the system in addition to the context and understanding of the system as a whole, global issues such as chronic hunger and malnutrition will continue to persist. Perhaps most important of all, ontology of standardized terms surrounding food and sustainability must be created in an effort to connect different food systems around the world into a global system of ideas that share a common base of knowledge.

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KEY QUESTIONS Without standardized definitions, global partnerships will face difficulty collaborating and face even more trouble solving large-scale issues such as global hunger and malnutrition. Ultimately, a basis for the global food chain supply system will be of the utmost importance to scale solutions to the global level, and innovations at every point in the agrifood supply chain will be needed to solve the issues that will face us in the near future, throughout 2050, and beyond.

1. H ow can agriculture attract more talent? 2. H ow can we get the interoperability of the agri-food supply chain to work effectively? 3. H ow can information and data be used in the Internet of Food? 4. I s it possible to forecast the future of food supply chains? How can we achieve this? 5. W hat is sustainability and how does it apply to the agri-food supply chain? 6. H ow can educational institutions get involved in the agri-food industry?

“It’s about finding the synergies. Finding the places where we can leverage each other’s resources, where we can identify and implement those economies of scale to try to make the system work better for everybody – the consumer, the producer, the small scale, the large scale, and really go after that triple bottom line of sustainability: people, planet, and prosperity.” Glenda Humiston, Vice President, Agriculture & Natural Resources, University of California, Office of the President

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CHALLENGES While many people stress the importance of affordability and access, many others throughout the industry insist that production is the most important issue in food production. However, with this binary of issues comes a lack of ability to look at the infrastructure and support system of the industry as a whole, which is crucial to the creation of holistic approaches to agrifood problems. Indeed, with issues such as bottlenecks in the agri-food supply chain, in addition to opportunities such as agritourism and renewable energy being visible only from an overall view of the system, a holistic and comprehensive approach to the agri-food supply chain is undeniably an important one. In terms of health, for example, deaths related to food comprise five of the top seven causes of death worldwide. With medicine’s focus on curing diseases after the fact rather than preventing health issues before health problems occur, these food-related deaths continue to persist unchallenged. And while medicine’s work continues to make waves, the lack of focus on food and preventative medicine makes it difficult to find solutions for food-based health problems. Indeed, with a lack of interconnected policy making tools for sustainable food systems, lack of interconnected knowledge, and a limited understanding in the linkages between nutrition and sustainability, issues in health and 38

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sustainability are far from being solved. Even more distressing, the lack of accessible data—data that exists locked away in silos—increases the inability of different sectors in the agri-food supply chain to come together and solve problems collectively. While there are vast landscapes of data available, the lack of accessibility makes accelerated innovations difficult to promote on a massive scale. Paradoxically, however, the speed of innovation as it is now is currently surpassing human capabilities whilst also being unable to keep with the ever-increasing population size. Therefore, both innovations in the food sector and our ability to understand these innovations on a larger level are imperative to the acceleration of the capabilities of the agri-food supply chain. Lastly, James Canton, CEO of the Institute for Global Futures, insists that there is not enough money in the entirety of the world to end hunger and provide healthcare for all. He maintains that the systems we have in place today are not fully scalable due to a lack of advanced, smart technology. Therefore, the only way

to begin handling these issues is not by spending more money, but by using both the technology we have now and future technology in smarter ways. It is only through the use of advanced tools, then, that worldwide hunger can come to an end.

OPPORTUNITIES Despite the challenges the agri-food supply chain faces, there are numerous solutions being proposed on a daily basis. In terms of farming, for example, Richard Cates proposes that care for soil is the most crucial factor to sustaining a supply of food. With too intensive of farming occurring on too small of fields around the globe, however, much of the world’s soil is being depleted of its nutrients. Nevertheless, by using the soil as it was intended – such as using the former tallgrass lands in Wisconsin to grow grass for cows to graze on, as Cates farm did – the soil can be restored to its proper levels. On a more system-wide scale, the creation of consortiums such as the Central Valley AgPlus Food and Beverage Manufacturing Consortium

“We’re living in an era where all of these technologies are going to converge – let’s point them toward feeding the planet and ending hunger.” James Canton, CEO & Chairman, Institute for Global Futures

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can help industry leaders approach the agri-food system from a more holistic, comprehensive view. Indeed, by focusing on industry members such as small entrepreneurs as well as large food manufacturing entities, attention can be placed on insuring adequate infrastructure, creating access to funding for new farmers, improving R&D in new products and techniques in the supply chain, and training the workforce in every area of the agri-food supply system. For small and medium scale farmers in particular, the creation of new forms of infrastructure—as many industry experts believe should be done—is nearly impossible. Using pre-existing infrastructures, then, should be an integral aspect of the creation of solutions. With the issue of bottlenecks occurring in the distribution system of agri-food supply chains, for example, there exists a plethora of solutions to this problem without forcing the creation of a new infrastructure. First, the farmer can partner with food banks— which consists of everything needed to store food safely—to create a for-profit wing that can serve schools and other institutions in the area. Through this system, farmers not only have access to cold storage hubs, but also gain access to a system of transportation that can transport farm product onto food trucks that travel to large cities to collect donations and bring these donations back to the food bank. It is in this way that both farmers and food banks can cut costs

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while increasing production. Therefore, making use of existing infrastructures is crucial to the livelihood of farmers and other systems in the food supply chain. In terms of the structure of the agrifood system itself, a new concept being coined the Internet of Food, which combines the Internet of Things with the food value chain and provides many potential solutions in terms of information and data. This idea begins with sensors, robotics, and other such technology that is already prevalent throughout the agri-food industry, and combines these technologies with massive pools of food data in order to create a massive library of constantly updating food information, such as information about soil content, customer satisfaction and everything in between. This Internet of Food can ultimately be achieved through the creation of a common language surrounding food, such as definitions of food, issues surrounding food production, and how these issues affect people, all of which can generate an infrastructure upon which we can access data about food around the world. This system could potentially contain sophisticated search engines that will

tell you about your food—for example, how much phosphate was present in the soil as it was grown, or where to find phosphate-less soil-grown food. Through the use of tagging data elements to food data—much like Facebook—and the connection of sensors and other machinery to pools of data, the universality of food information could change the landscape of the agri-food industry. Ultimately, the future of food is entirely dependent on us. With accelerated innovations occurring around the globe, technology is driving change at unprecedented rates. Even more important, we are the ones driving these innovations, and therefore we are the ones shaping the future. Indeed, groundbreaking technologies such as nanotechnology, IT, and quantum technology are posed to change the landscape and potentially solve problems in food and health, and we are the ones ultimately creating these innovations. With the help of these new and increasingly advanced technologies, it is entirely possible that almost all issues in food security and food availability will be solved in the near future. ■

“We want to actually have the Internet of Food be a technology where we can enable farmers and food processers to align their economic incentives together with the system to improve sustainability and to improve health.” Matthew Lange, Associate Director, UC Davis Initiative for Wireless Health & Wellness

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Session 5: Food Security: No More Food to Waste SESSION PANELISTS: CHARLES GAUSE, CEO, Triad Growth Partners KELLY JOHNSTON, Vice President, Government Affairs, Campbell Soup Co. CHERYL MITCHELL, Senior Vice President, Steuben Foods MODERATOR: WIEBE DRAIJER, Chairman, Executive Board, Rabobank

SITUATION With 2.3 billion tons of food wasted yearly, the issue of food waste is becoming an increasingly alarming concern in the food industry. Indeed, this waste causes a loss of trillions of dollars not only through the loss of the food itself, but also through the water, gas emissions, and land waste that comes vicariously through this process. In fact, it is estimated that nearly 25% of water used in agriculture is lost due to its use on food that is eventually wasted, and nearly 8% of gas emissions are due to the methane emissions of wasted food. With Sustainable Development Goal 2’s goal of ending hunger, achieving food security, improving nutrition, and promoting sustainable agriculture, it is imperative that the amount of food waste that occurs at both the global level and within companies be lessened in order to boost food production in the coming years. But with very few solutions for the various causes of food waste, it is difficult to create a one-size-fits-all solution. Because of food waste’s many issues such as outdated regulatory systems, contamination, and a lack of innovative technology, perfectly good food continues to be wasted on a daily basis while chronic hunger remains a major problem. Therefore, it is imperative that solutions be made not only on a global scale, but also for each of food waste’s specific problems.

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KEY QUESTIONS However, innovations in new forms of organic food production, company culture, and contamination detection are beginning to make waves throughout the industry. Despite the vast challenges that food waste has created throughout the world, the creation of effective and problem-specific solutions is in full swing and may already be decreasing food waste around the globe.

1. How is food waste impacting the agri-food industry? 2. How does contamination contribute to food waste? 3. What is being done to optimize the nutritional value of foods? 4. How are larger companies integrating food waste management into their company structure? 5. What should or shouldn’t the government do to help?

“By transforming the grains, nuts, and seeds, what we’ve done is liberated all the nutrients involved in these grains, nuts and seeds and allowed them to recombine in such a way that maximizes the digestibility of the protein, in the case of protein turned into fiber.” Cheryl Mitchell, Senior Vice President, Steuben Foods

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OPPORTUNITIES

CHALLENGES One of the most commonly acknowledged issues of food waste is contamination. Due to the fact that waste management facilities are largely under the care of local governments, a severe lack of innovation permeates the waste management industry. Similarly, the chemical industry’s advances in innovations in food contamination detection are few and far between, with very few changes having been made in the recent past. Therefore, contamination continues to persist with very little measures put into place to deal with this large problem. Though contamination is one of the most widely known causes of food waste, the biggest culprit of food waste is actually the process of food manufacturing itself. In terms of grains, nuts and seeds, for example, nutrients such as proteins, fibers, minerals, and antioxidants are lost during processing—a method of processing which has been used for the past 100 years. In fact, the biggest issue with the manufacturing of grains, nuts and seeds comes from the refinement process most of these raw materials go through, producing material such as corn syrup, refined sugars, cornstarch, and unhealthy oils. The nutritional remains of this process are then fed to animals, thereby decreasing the total amount humans can use for consumption and contributing further to food waste. Another potential factor behind food waste is the restrictive regulatory systems 42

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the US government has placed on the production of food. With strict labeling practices, a bifurcated food safety inspection system, and confusing food code dating, both manufacturers and consumers have a difficult time assessing the freshness of food and whether or not it is safe to eat or should be thrown out. With different food dating terms used for quality and safety, this obscure system of food safety often causes consumers to throw away perfectly safe food, and also prevents food banks from being able to accept gently expired food that is still considered nutritious. Most frustrating of all, a lack of awareness of the technologies and techniques that are available to lessen food waste is present throughout the world. With very little global infrastructures dedicated to the communication of innovations and technologies in food safety present, a large gap in information and communication has formed. Therefore, it is imperative that systems be put into place in order to increase awareness of innovations that may be relevant to countries across the world, and bring the world together in order to fight food waste in more collaborative ways.

Despite the many issues food waste creates, many industries are creating innovative technologies and production methods to decrease local food waste and increase the nutritional value of foods. In the waste management industry, for example, companies such as Triad Growth Partners are focusing on the creation of new technologies specific to food waste that is low cost, quickly produced, and easily distributed. These technologies will ultimately focus on inspection and detection, and Triad Growth Partners will work to make these solutions not only local, but also world-wide. In terms of the production of grains, nuts and seeds (GNS)—and manufactured food in general—the general shift in more health-focused and organic foods is forcing the industry to adopt new manufacturing practices. In most ingredient-laden foods, for example, producers have had to change the type and amount of ingredients that are needed to make food; that is, to cut down on artificial ingredients and use more plant-based ingredients, especially in analogue products created for vegans. This has ultimately created a shift from

“We want to enable people to solve and treat their problems associated with known contamination by recapturing contaminated soil, water, and son on for food production.” Charles Gause, CEO, Triad Growth Partners

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using wheat-gluten and refined ingredients to using nutrient-rich and complex ingredients that utilize whole grains. New research suggests that one of the best ways to maximize nutrients in GNS is to convert them into milk-based products. Liquid concentrate, compared to raw materials, often contains all of the micronutrients and regular nutrients of GNS that traditional manufacturing often loses. Even more convenient, milk-based products are stable and easy to utilize by other manufacturers due to its liquid texture. Best of all, these GNS milks are often ready to consume as is, creating a food supply that can easily and readily be distributed globally. Even the technology by which seeds, nuts and grains can be transformed into milk-based products can be distributed worldwide. This process can also recombine nutrients to maximize protein levels. In high protein rice or powder, for example, these compounds can often hold up to 32% protein. New processes are also able to remove unhealthy oils and maximize macronutrients in many different foods and can be utilized in the creation of beverages, baked goods, and even meat analogues, such as the use of hemp proteins in place of traditional wheatgluten-soy proteins. Therefore, these new nutrient-enhancing systems ultimately increase food nutrition value while decreasing food waste.

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Large companies are also beginning to change their company culture to lessen issues related to food waste. In Campbell, for example, leadership has established new mission statements to decrease greenhouse gasses, cut down water use by 24-25%, increase waste recycling to 95%, and create sustainable food products. Indeed, one of Campbell’s most effective ways of dealing with large-scale peach food waste was by creating a fruit-based salsa to be sent to food banks in New Jersey. With 50 to 100 thousand pounds of fresh peaches thrown into landfills every year due to aesthetic issues, these supposedly “imperfect” peaches were causing major food waste. By turning these peaches into salsa, however, Campbell was able to create a nutritious, low-calorie food product for those who visited the South Jersey food bank. It is in this sort of way that companies can lessen food waste, boost nutritional values, and improve their community. Ultimately, a one-size-fits-all solution will not solve the global food waste issue. With different food waste issues facing different

sectors—such as school lunch food waste, regulatory mandated food waste within companies, and general contamination of any healthy food supply—one solution will not solve all of these specific problems. Therefore, solutions should be introduced at the local level to better solve the specificities of the food waste issue, with governments focusing on funding science to further improve solutions and creating communication lines between areas to spread awareness of new and innovative solutions. ■

“It strikes me as really paradoxical that we are in the wealthiest country in the United States yet in Camden New Jersey we have a major food security problem. And globally, we have a growing obesity and overweight problem.” Kelly Johnston, Vice President, Government Affairs, Campbell Soup Co.

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HEALTH

GLOBAL ACTION REPORT

SESSION 1

HEALTH

Session 1: SDG #3: Health and Wealth A Path to 2030 SESSION PANELISTS: CHARLES DALTON, Senior Health Specialist, International Finance Corporation REMY SZYKIER, Managing Partner, Aegis Health Security JAMI TAYLOR, Director, Global Public Health Systems Policy, J&J DONATO TRAMUTO, CEO, Healthways MODERATOR: TREVOR DAVIES, Global Head, International Development Assistance Service Institute, KPMG

SITUATION Despite the need for continuous and reliable investments in health, investment in the healthcare industry remains unpredictable and limited to only a few systems within this industry. While investments in such systems are vital, focus on education, integration, and technology also needs to be increased in order to improve the health and wellbeing of everyone around the globe. Indeed, with Sustainable Development Goal 3’s mission of ensuring healthy lives and promoting wellbeing for everyone at all ages, it is crucial that more holistic and integrated approaches to health be implemented both at the local and global levels in order to improve the safety of everyone. While investments in health are important to the longevity of people around the world, they are also important in terms of the economy. By investing in both large systems and individuals, a healthy workforce with improved earnings is not only possible, but also probable. The question is, then, how to build location-specific healthcare systems that can be integrated into a larger, worldwide health system. This is best done through the integration of healthcare systems across the board. However, with a tendency toward silo thinking in many healthcare fields—from strict focus on individual diseases to an even narrower

KEY QUESTIONS focus on treatment—different areas of health have difficulty coming together to discuss issues in healthcare. It is absolutely important, therefore, that these systems be more open to integration and communication in order to more effectively increase the wellbeing of the global population. With a continuously expanding global population, the innovation of the healthcare industry is not only important to the wellbeing of today’s population, but to the wellbeing of future generations as well. However, through company involvement, more engagement between the private and public sectors and integration at all levels, a newer, more universal system of healthcare is entirely possible.

1. How can we improve both access to and quality of healthcare systems? 2. Where do investments need to be made in healthcare? Where should resources be allocated? 3. How can data be used to better understand our current healthcare system and potential changes in this system? 4. How can a balance between the public and private sector be made in terms of universal healthcare? 5. How can we prepare for the upcoming population boom?

“When you bring ‘good’ into business, your ability to drive greater profitability and drive greater success can be realized.” Donato Tramuto, CEO, Healthways

“We’re on the cusp of a renaissance in R&D and how it pertains to neglected diseases and diseases of poverty, and it is this renaissance that will create a flourishing of new integrated solutions that can prevent and treat disease like never before.” Jami Taylor, Director, Global Public Health Systems Policy, J&J

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Hospital in Mogadishu - UN Photo/Tobin Jones

CHALLENGES One of the biggest challenges facing both local and national healthcare systems today is the misalignment of systems within the healthcare industry as a whole. While a country’s healthcare system will often rely on the public sector for support, the public sector does not usually have the ability to provide universal healthcare to protect the wellbeing of its citizens, nor does the private sector receive enough investment to sustain the healthcare system on its own. Additionally, the lack of trained healthcare professionals further restricts access to healthcare for a large portion of people. With many developing countries lacking in specialty doctors, issues with disease, maternal mortality, and general lack of health continue to persist. In Africa in particular, the increase from one billion people to 2.5 billion people by 2050 is estimated to create a strain on existing systems designed to fight diseases, thereby rendering these systems ineffective and ultimately allowing many diseases to spread to a wider population. In addition to a lack of investment and solutions to disease control, the healthcare industry also faces many barriers in the creation and distribution of vaccines and other pharmaceutical drugs. With a shortage of commercial opportunities, strict regulatory pathways, and a lack of investment in neglected diseases, many potential solutions created to eradicate

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OPPORTUNITIES disease have been stifled under the current system of regulations. These barriers are often fueled by a general lack of trust in pharmaceutical companies as well as the healthcare industry as a whole. Indeed, with a healthcare system geared toward curing health issues after they occur rather than preventing them initially, suspicion is often thrown toward the supposedly selfish intentions of the pharmaceutical industry. It is important, therefore, that not only pharmaceutical companies but also the global healthcare system shift away from a purely drug-centered approach and instead focus more on holistic approaches to health, such as screening for alternate causes to an issue—such as external factors like smoking and eating habits that could potentially affect heart health, for example—before prescribing drugs. Lastly, the issue of empowering and informing consumers in the healthcare industry is often forgotten about. This is an issue due to the fact that one, many consumers are often not aware of where and how to gain access to healthcare; two, any individuals who may eventually gain access to healthcare are often already host to many health issues, thereby driving up health costs; and three, the lack of effective models in disease prevention has prevented today’s healthcare system from transforming into a more wellness-centered model of health.

Despite the many barriers the healthcare industry faces, there exists many more opportunities. The Thrive to Five Program, for example, tackles the issues of both infant and pediatric mortality through the education of villagers on the dangers that many infants and toddlers face in the first five years of life. This program aims to improve the wellbeing of children first by educating mothers on the importance of regular check-ups; next, by educating villagers on the importance of vaccinations; and lastly, by providing access to villagers to a pediatric app that can be used to further gather any information pertinent to the survival of their child. Ultimately, the creation of this program has reduced pediatric mortality by half and created an education system not only for children, but adults as well. In the realm of vaccinations and medication, innovations in old vaccine models are changing the pharmaceutical industry. With a Johnson & Johnson lab’s discovery of a new anti-micro bacterial agent with the power to fight tuberculosis, for example, the 40-year-old concoction often used to fight tuberculosis has now been thrown out and a more effective vaccine has been inserted in its place. This ultimately demonstrates not only the fact that there are solutions even to century old problems, but also has begun to shift focus onto the patients’

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HEALTH

Mumbai - UN Photo/ Mark Garten

wellbeing, as well as the social determinants—such as poverty and where one lives—that often affect one’s health. In addition to specific solutions that target the issues of education and vaccinations, more general solutions are also being introduced at the larger population level. Silver Sneakers— a program created by Healthways— focuses on the health and wellbeing of both elderly individuals as well as the elderly population as a whole through the creation of fitness programs catered toward older people. By focusing on both physical and social wellbeing, Silver Sneakers is able to create a physically healthier, more socially active population of elderly individuals while also demonstrating how the needs of certain populaces differ from the general population. Indeed, it is through this focus on targeted populations that specific

Women’s hospital in India - UN Photo/ Mark Garten

socially determined health issues can be more effectively analyzed. In order to track the effectiveness of these solutions, however, data is necessary so as to efficiently evaluate and communicate the effectiveness of these solutions. Through the Clinton Global Initiative Commitment, for example, Aegis Health Security was given a chance to analyze the health of the people of Washington, DC on a larger, populationbased scale. It was in this way that they were not only able to analyze the social determinants of health throughout the city, but also to predict potential outcomes based on new solutions. Through the inclusion of a large, diverse, controlled population, Aegis Health Security was able to identify the specific causes of health inequity and disparities in health outcomes, as well as identify stakeholders in health in the private and public sectors.

Through this study, Aegis was ultimately able to identify the key factors—such as income level and even one’s zip code— that effect overall health outcomes. In the end, low-cost high-value models of health systems appear to be the most effective solution to combatting issues in today’s healthcare industry. In fact, these models often demonstrate how private sector entities in areas outside of the United States are able to provide services for a fraction of the cost that the US government and individuals are used to paying in the United States, and demonstrate how we could potentially adapt to such a system. Indeed, data has shown that it is often through a mixed system of public and private sector involvement that healthcare systems not only thrive, but also remain stable and sustainable. ■

“There’s not one system that fits all; we need to look at what is working in Rwanda, what is working in Ghana, why it is working and take those lessons and try to apply it to other countries.” Charles Dalton, Senior Health Specialist, International Finance Corporation

“Data is a big component in bringing in the private sector with the public sector and one, facilitating a dialogue; and two, sharing that data.” Remy Szykier, Managing Partner, Aegis Health Security

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Session 2: The Cancer Moon Shot Initiative: Scope and Prospects SESSION PANELISTS: KLAUS O. SCHAFER, Chief Medical Officer, Client Executive, VP Business Development, CACI International JOEY STARNES, MD/MPH Candidate, Vanderbilt University School of Medicine REMY SZYKIER, Managing Partner, Aegis Health Security TRISH TWEEDLEY, Senior Director, KPMG Development and Exempt Organizations MODERATOR: JOXEL GARCIA, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center

KEY QUESTIONS

SITUATION While the general life expectancy of the global population continues to increase, issues with new age-related diseases are also on the rise—especially cancer. In fact, recent studies estimate that one third of women alive today— and an astounding one half of men— will develop some form of cancer in their lifetime. Even more concerning, without increased focus on prevention and finding a cure, these numbers will continue to increase as general health and life expectancy continues to improve. It is of the utmost importance, therefore, that a comprehensive solution be put into place to both create a cure and perhaps even prevent future forms of cancer. The National Cancer Moonshot Initiative is one such vehicle that could potentially provide a cure to many of the cancers that plague the world today. With former vice president Joe Biden at its helm, the National Cancer Moonshot Initiative is aimed at raising awareness in order to fund new research on upand-coming cancer-related innovations. Unfortunately, this initiative will require substantial funding, and with only 200 million dollars available of the one billion needed to fund the initiative, scientists and businesses alike are scrambling to increase awareness and funding for the program.

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In addition to the issue of funding, the National Cancer Moonshot Initiative also faces challenges in terms of continuous support, stagnant silos, and a lack of education both on the side of practitioners and the general public. With current issues stagnating the health economy in addition to a lack of knowledge about the challenges that will potentially be caused by increased longevity, it is difficult to figure out where exactly focus should be placed. However, there is still hope for the success of the National Cancer Moonshot Initiative and ultimately a cure for cancer. Through more focus on prevention, integration, and communication, increases in innovation could potentially lead to cures that are distributed quickly and more efficiently on a global scale. Similarly, improvements in education and concentration in both individual and community health could potentially increase the speed with which breakthrough medicine can become available to practitioners—and more importantly, the general public. Ultimately, through the implementation of these system-wide changes, the curing and prevention of cancer is possible and a future of healthy, cancer-free lives may be just on the horizon.

1. How can we decrease silos within the health industry and increase the integration of information and data? 2. How can we create a national agenda for cancer? 3. What are the factors at both the individual and community level that impact health outcomes? 4. How can we engage other nontraditional industries—such as music and sports—to increase awareness about the National Cancer Moonshot Initiative? 5. How can we distribute new cancer innovations more quickly and efficiently?

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The Cancer Moon Shot Initiative: Scope and Prospects

“If we keep these silos, the national moonshot will fail. If we don’t make awareness about national moonshot and we don’t get funding, this is just going to be a nice initiative that only lasts three years.” Joxel Garcia, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center

“It’s really important that we realize that success is defined by what we choose to measure—in cancer we’ve typically measured five years of survival—but that doesn’t capture any of the quality of life metrics or the side effects associated with those treatments.” Joey Starnes, MD/MPH Candidate, Vanderbilt University School of Medicine

“So many of the great organizations that are really in communities— mission-driven, under-resourced—are touching the populations that we all want to reach, but they lack the business skills and the infrastructure to be able to deliver fully on their mission.” Trish Tweedley, Senior Director, KPMG Development and Exempt Organizations

CHALLENGES One of the first challenges to preventing cancer is the ability to diagnose the correct cancer in the first place. Researchers at MD Anderson, for example, have found that over 27% of patients who go to MD Anderson to be treated for cancer are initially misdiagnosed by their primary doctors, a problem that could lead to ineffective pathology and radiology treatments that could potentially harm the patient. Surprisingly, this 20-40% rate of misdiagnosis doesn’t only affect the United States, but is relatively the same all around the world. Even more concerning, it is estimated that only 2% of people who qualify for clinical trials for cancer medication are able to participate due to costs. Besides the fact that those being treated at cancer centers—such as MD Anderson, Vanderbilt, and Harvard— are not representative of the general population, the speed at which these clinical treatments are made available to the rest of the population remains painfully slow. Indeed, on average, research in cancer treatments can take 12-20 years to move from initial research to being made available the general population, with new drugs often costing upwards of two billion dollars to be developed. One of the biggest challenges, then, is how to decrease this time-consuming process to somewhere around 3-5 years while also decreasing the cost of development.

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One of the biggest causes of this slow-moving process is the plethora of data-filled silos that inhabit the health and medicine industry. With competition between companies causing a lack of shared information, useful data such as genomics, DNA, RNA, metabolic, and patient information remains inaccessible by each individual cancer center. Therefore, in order to increase innovations, it is imperative that these silos are opened to enable more easy flow of data throughout the industry. Unfortunately, it is not only the process of cancer research that is slow, but also the speed at which this information is transmitted to practitioners. Studies have shown that on average, it takes 7-9 years for physicians to include moonshot medications in their portfolio of medications due to the disorganization of the vast amount of data made available to them. If future trends follow current trend then, it would take over 40 years of work to introduce a mere six new drugs to the market. On a more general scale, the different needs of federal institutions, medical clinics, and medical innovators are often at odds. For example, with the recent creation of a device that has the ability to comprehensively detect all strains of influenza overnight, medical innovators are now able to more effectively detect and follow the different strains of influenza that their patients come into

contact with; but with the time constraints medical practitioners are forced to adhere to as well as the FDA’s desire for more simple and efficient techniques, this complicated and time-consuming device is unable to meet the needs of the current system of health and therefore has not yet passed FDA regulations. Lastly, the ability of medical innovations to reach more rural populations is hindered by many different factors, such as difficulty in transportation, lack of educational institutions for consumers, and limited funding for these programs. The Lwala Community Alliance in Kenya, for example, uses a community health worker model to provide health services to the rural populations of Kenya. With a lack of transportation between health hubs and communities, however, necessary health treatment is difficult to disperse to the general population and with a lack of educational mechanisms and health specialists in these rural communities, it is nearly impossible for patients to receive the treatment needed to ensure a healthy life. With limited funding, even within already existing programs, funding for newer, more efficient programs often drains current funding, or receives very little funding at all. It is of the utmost importance, then, that funding not only be sustained within older programs, but that this funding continues to increase as old programs transition into new ones.

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HEALTH

OPPORTUNITIES While most medical data currently remain in stagnant silos, the potential unlocking of this data presents vast opportunities both within the health sector as well as between sectors. For example, by sharing patient diagnostic information and research in genetics, cancer prevention can be increased and more effective cures may finally be created—a situation that can only be accomplished through the sharing of data. Even more assuring, this system of information sharing and collaboration can be integrated into current network systems. With the Mothers2Mothers model, for example, community women in South Africa are trained to identify and report symptoms of HIV to health centers in an effort to increase HIV awareness while decreasing its spread. Through the integration of local women into this program, then, it is possible to detect HIV quickly and efficiently without much additional cost, a system that could potentially be replicated in many different health programs. Collaboration can also be increased

through the partnership of both health companies and non-health institutions. While transportation and education remain a difficult problem for the health industry, partnerships with transportation companies and community centers has the ability to solve these problems. By partnering with transportation, for example, services for people who would have traditionally been unable to reach health clinics—whether it is due to distance, age, or health-related issues—can be provided, either through partnerships with taxi companies, public transportation, or even citizen drivers. Therefore, it is not only important, but also necessary that new partnerships be made between industries in order to provide health for those most in need. Social trends are also changing. With the US population becoming increasingly more involved in their own healthcare, pressure from the public is causing certain medications to receive a large push in their development. The popularization of a clinical muscular dystrophy treatment, for example, has caused its development to

speed up dramatically while also putting immense amounts of pressure on the FDA to release the drug as soon as trials are finished. With public pressure, therefore, it is possible that the creation of drugs— which usually takes 12-20 years to reach the general public—could potentially enter the market at a much faster rate. Finally, new and unique forms of cross-industry partnerships are creating raised awareness for medical issues like cancer. In the music industry, for example, a Moonshot concert aimed at raising awareness about the National Cancer Moonshot Initiative is in the works. It will be nationally televised in January of next year, bringing together people in the health sector, music industry, and the general public in a joint effort to fight cancer. Ultimately, through cross-sector collaborations—such as music and medicine—it is possible for not only the general public to become more aware of the National Cancer Moonshot Initiative, but also bring in the interest of global philanthropists. ■

“One thing we need to be careful of as personalized and integrated medicine becomes increasingly available in other countries is not to export the problems that we’ve created in the West.” Klaus O. Schafer, Chief Medical Officer, Client Executive, VP Business Development, CACI International

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Session 3: The Precision Medicine Initiative SESSION PANELISTS: JOSHUA C. DENNY, Vice President for Personalized Medicine, Vanderbilt University Medical Center DAN M. RODEN, Senior Vice President for Personalized Medicine, Vanderbilt University Medical Center MODERATOR: KENNETH HOLROYD, Assistant Vice Chancellor for Research, Vanderbilt University Medical Center

SITUATION With the health industry slowly beginning to shift its focus towards more personalized health, precision medicine—an approach to health, prevention, and treatment that focuses on individual variability in genes, the environment, and one’s activities to create a more personalized care—is gaining significant traction. Indeed, during Barack Obama’s State of the Union Address in 2015, the Precision Medicine Initiative and its consequent research programs were announced in an effort to further catalyze the upcoming precision medicine industry. In order to more comprehensively understand the unique genetic variations of individuals, however, it is important that large, deep, diverse pools of data be collected in an effort to better understand how genes function both on an individual and community level. The All of Us Research Program, for example, has been put into place to tackle this very problem. By enrolling over one million people in this study, All of Us aims to comprehensively study the biological, environmental, and behavioral factors of diverse populations within the United States in order to gain new insights into genetics, health, and personalized medicine.

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KEY QUESTIONS Due to its massive scope and potential for breakthrough discoveries in the realm of genetics, the All of Us Research Program is now being hailed as the second phase of the Human Genome Project. Despite the potential significance of this project, however, this program also faces many challenges. These include difficulty in locating diverse pools of patients, trouble relaying important information to healthcare providers quickly and efficiently, and difficulty creating more indepth and comprehensive analyses of all genetic variants. It is crucial, then, that not only researchers become more involved in the All of Us Research Program, but also that practitioners and the public alike join together in an effort to create a better system of personalized health for all.

1. How can we transition into a comprehensive system of precision medicine? 2. Can we deliver information on genetic variation? Does this reveal insights into patient drug response? Can we use this to improve drug outcomes in hospitals? 3. How can we use new technologies to transform both precision medicine and the healthcare industry? 4. How does zip code play a part in individual health? 5. Are electronic health records necessary to the Precision Medicine Initiative?

“If you know a drug that targets a particular gene and you find that gene is associated with particular diseases – some of which are your drug targets – those other diseases that that gene is associated with may reveal other uses for that drug.” Joshua C. Denny, Vice President for Personalized Medicine, Vanderbilt University Medical Center

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The Precision Medicine Initiative

“Electronic health records are in fact a legitimate and useful way of approaching problems of discovery in healthcare.” Dan M. Roden, Senior Vice President for Personalized Medicine, Vanderbilt University Medical Center

OPPORTUNITIES

CHALLENGES The first—and largest—issue that precision medicine is aimed at solving is the persistent problem of poor drug response in patients. For example, recent studies have revealed that while the enzyme CYP2C19 is present in all individuals, about 2.7% of the population is estimated to have variations in this enzyme that prevent certain drugs used in conjunction with artery surgery and stents from working as intended. In fact, while 8% of patients without the enzyme variation may experience adverse reactions to the drug, over 12% with the variation show adverse reactions—a finding that supports the idea that drug effectiveness is indeed highly dependent on genetics. Despite the apparent connection between CYP2C19 variations and drug effectiveness, the slight difference of 4% in outcomes leads many practitioners to question whether or not extensive testing for the gene is necessary when only 1 in 40 patients will have this variation that leads to a slightly higher risk of adverse effects. In order to lessen this time-consuming testing, therefore, it is crucial that comprehensive genetic tests with the ability to test more than one genetic marker become more commonplace so as to not dissuade health professionals from extensive genetic checkups.

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Another problem that precision medicine faces is the difficulty finding relevant patients for large-scale research programs. A research study aimed at finding extremely rare variants in the gene NPC101—a gene that is vital to the encoding of a protein that controls cholesterol and metabolism, for example—would require upwards of one million participants to accurately study this specific gene variation, which is extremely rare. While Dan Roden’s team was able to assist in a study that had 115,000 participants, the inability to gather extremely large pools of participants makes it difficult to study NPC101 and other rare genetic variations that could lead to key insights. Lastly, while genetic health is a crucial factor in precision medicine, something as simple as one’s zip code can also determine many health outcomes. Factors such as where you were born, how far away you live from a grocery store, how much air pollution you are exposed to on a daily basis and even your income level often factors into one’s health and is often just as important as genetic health. However, the lack of focus on nonbiological factors makes it difficult to understand overall health, which includes biological, social, behavioral, and environmental factors.

With the united efforts of both healthcare institutions and cross-sector collaborations, the ability to create an all-encompassing, sector-wide electronic record system of patient information is possible. Indeed, research programs under Vanderbilt’s BioVU program have already begun to create a biobank with electronic records of over 2.5 million people, nearly 250,000 of which have DNA information recorded with 100,000 of those preparing for extensive genetic testing. By coupling these DNA records with patient records, the creation of a multi-perspective patient information resource is not only possible, but also currently being utilized by researchers. These electronic patient records not only enable doctors and researchers to be in constant contact with a patient but also follow their health journey regardless of whether or not they are located near each other. With a DNA biobank, individual patients can undergo several different tests to gather particular billing codes, all of which can be combined with information on patient activities to provide researchers with comprehensive health views of patients. And with the creation of new patient-based technologies—such as patient portals and smartphone apps— patients can choose whether or not to

SESSION 3

share their medical information with doctors and researchers of their choice. The All of Us Research Program uses electronic patient records and other tools to aid the Precision Medicine Initiative and further discover key insights in the realm of genetics. With over 60 engagement studios with 600 participants, for example, patients can engage in topics and provide feedback relevant to precision medicine in a more partner-like way in order to share in an advocacy network where patients can take control of their own health. On a more general scale, the All of Us Research Program also enables participants to self-report certain measures such as diet, activities, exposures, habits, and sleep to healthcare providers that work closely with them. They can also provide geographic information in order to alert healthcare providers to certain environmental factors they may be exposed to and unaware of, and also participate in a basic physical evaluation and provide a collection of bio specimens so that researcher can continue to add information to their large pool of standard patient records. The All of Us Research Program rests on the hope that like the Framingham Heart Study—which is credited with transforming modern healthcare through the deep study of

HEALTH

5000 individuals who were followed longitudinally over time, a practice which ultimately found that smoking is harmful, exercise reduces cardiovascular risk, and that cholesterol over 300 and a blood pressure of 180 over 120 is detrimental to health, despite a potential lack of symptoms—the All of Us Research Program will also be able unlock new discoveries in the world of health and transform both the health industry and overall health. Lastly, new and innovative tests are already being used to compile genetic information in a more comprehensive way. The PREDICT Program, for example, is aimed at delivering information on gene variants that are important to drug outcomes, and using this information to improve overall drug outcomes. One such test that aids in this process is the testing of drug gene pairs, which have the ability to reveal whether a specific drug may be extremely adverse for a patient, have no effect, or work as intended. Interestingly, even testing just five drug gene pairs reveals unique responses in nearly every individual—a finding which demonstrates that even the most “normal” patients have genetic information that is unique and may provide new insights. Similarly, by using dense phenotypic records, researchers can now move

away from traditional genetic studies that only focus on one trait or disease and move toward a system where several phenotypes are explored at once. With this system, researchers can look at findings in context and better understand interactions between certain genes and ultimately discover how exposures, associations, and predictors during testing can be used to determine future outcomes in a more efficient way. ■

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Session 4: Global Health: Forging Medical Data Interoperability SESSION PANELISTS: NEAL PATEL, Chief Medical Informatics Officer, Vanderbilt University Health System, Co-Medical Director, Pediatric Critical Care Service HAYLEY HOVIOUS, CEO, Nashville Healthcare Council BRIAN MOYER, CEO, Nashville Technology Council CAROLINE YOUNG, Executive Director, Nashville Health MODERATOR: EDWARD CANTWELL, Executive Director, Center for Medical Interoperability

SITUATION One of the largest problems in the U.S. healthcare industry is the issue of data and information. With the vast majority of information lying stagnant within silos and data flow continuously being stifled, collaborations and multipartner projects are extremely difficult to generate and new innovations are few and far between. It is of the utmost importance, then, that data liquidity— which is the appropriately protected and controlled free flow of data— become more accessible in order to allow both patients and practitioners to come together and improve health. In fact, it is this very absence of data liquidity that causes healthcare costs to increase dramatically and vendors to become more empowered to promote proprietary systems, thereby creating a self-sustained system of data inequality. Even more concerning, the absence of data liquidity makes it difficult for entrepreneurs to obtain relevant information and disrupt the industry in a necessary way, and makes it impossible for efficient and large scale solutions to be put into place. Despite the many challenges healthcare data faces, there are also many opportunities present within the healthcare industry. First, there is the

GLOBAL ACTION REPORT

KEY QUESTIONS ability of transparent and accessible data to potentially unlock countless innovations; second, the creation of groups focused on convention and collaboration is enabling the healthcare sector, public sector, private sector, and governmental spheres to both understand each other and work together better; and third, technologies such as block chain, Google, and Uber are offering new and exciting innovations in health from everything such as data security to transportation. Ultimately, while the disjointed landscape of data remains the healthcare industry’s largest problem, it is possible that new innovations and technology could potentially unlock this world of data and bring companies and sectors alike together to work toward a better and more efficient healthcare system.

1. How can medical data interoperability benefit both individual health as well as public health? 2. What is data liquidity? 3. Should patient information be made easily accessible? What can be done to secure this data? 4. How secured are current health data? 5. What technologies and innovations are being implemented in order to increase medical data interoperability?

“Despite the fact that the charge of this organization is ‘how can we change things by 2030,’ we’ve been after this same Holy Grail in many different ways since the advent of modern medicine.” Neal Patel, Chief Medical Informatics Officer, Vanderbilt University Health System, Co-Medical Director, Pediatric Critical Care Service

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Global Health: Forging Medical Data Interoperability

“How disjointed and ineffective is care when there is no sharing of information among the community and you can’t get a comprehensive record of someone’s health over time.” Hayley Hovious, CEO, Nashville Healthcare Council

OPPORTUNITIES

CHALLENGES One of the biggest barriers to promoting a more interoperable health data system is the fear of inefficient security measures and cyber-attacks. Just recently, Johnson & Johnson— one of the largest and most secured companies in the world—experienced a security breach in their devices, an incident that has caused an increase in caution around data sharing. With health records considered extremely valuable on the black market, many hackers, companies, and even governments are determined to hack US health records—either in an effort to gather data on new innovations, or even for more nefarious purposes, such as hacking x-ray machines or infusion pumps within hospitals. Similarly, the issue of personal privacy is also a concern. While health records remain generally secured, information such as social media postings and shopping habits are constantly being compiled by companies and can often be used as a potential measurement of health. If a woman shops at Target for a pregnancy test, for example, Target’s data system could hypothetically be aware of her pregnancy even before her husband. And with social media collecting information on consumer postings, likes, and even what they click on, valuable

GLOBAL ACTION REPORT

personal information is constantly being collected. Even if data were to become securely accessible, the healthcare industry’s vast amount of data remains unorganized and trapped within silos. With a plethora of data such as lab results, patient health records, and research findings being locked up and inaccessible, sorting through this data and connecting it to other pertinent data would take decades. And with a lack of communication even between similar data information—such as a nationwide patient health record system—the sheer disorganization of this data would ultimately decrease any accessibility. Therefore, it is crucial that companies and institutions within the healthcare industry become more interoperable and less proprietary. Apple, for example, was first criticized for their proprietarylike structure; but after creating a more interoperable system where a vast number of users from across the world are connected by a cloud of data, new avenues for data and information analytics have become entirely possible. However, with the US culture of proprietary-focused business and a lack of standards and trust, interoperability still remains uncertain.

In order to better connect the health industry and other sectors, companies such as Nashville Health and the Nashville Technology Council are serving as a convener and collaborator between organizations, individuals, businesses, non-profits, government, and faith-based organizations as well as both the K-12 and university education system. This is done not only to educate youth on the potential pathways in technology and provide them with opportunities to experience the technology industry, but also create a dialogue around aligning resources and collaborating in more effective and transparent ways in order to bolster collaborations within the health industry. Similarly, large organizations are also working to create disruptive innovations in the health industry. Google’s research, for example, has revealed that the number one related search to the term “emergency room” is “headache.” In order to better help potentially ill individuals instead of simply feeding back related searches, therefore, Google has begun to create a more intelligent system in which content such as self-help and urgent care information will be the first search results to show up, as well as other more useful information.

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Uber is also beginning to propose potential solutions that could revolutionize the healthcare industry. With an estimated 80% of the U.S. population a mere 10 minutes away at any given time from an active Uber driver, Uber is proving to be one of the most accessible forms of transportation in the nation. With this information in mind, Uber has proposed a system of healthcare transportation that would enable Uber driver to transport patients to the nearest hospital or healthcare clinic within 15 minutes of their appointment in an effort to cut back on waiting room use. Working with physicians, therefore, Uber would be able to pick up a patient once the physician knows their examination room will be empty and thereby create a more efficient process for both the patient and the physician. Lastly, innovations such as blockchain technology allow institutions to protect information while also creating a system

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in which this information is highly distributed and easily accessible—a system that would ultimately be tremendously useful to the healthcare industry. This would allow healthcare providers to work securely with multiple companies as well as create a layered access to their own records—such as a health persona, a wellness persona, and a genomics persona—that would make certain levels of their data more accessible than others. Ultimately, public pressure on proprietary vendors is increasing, and interoperability is becoming more and more of a possibility. While many challenges may face the healthcare industry, innovations in data, technology, and communication are allowing better flow of data and creating more access to necessary information. Without free data, the healthcare system will continue as is, but with the unlocking of information a new generation of healthcare is possible. ■

“If you look at healthcare as a portfolio of millions of devices at the point of care – whether its health or wellness – its almost one of the most backwards industries in terms of the structure of the data and the following of the standards, so it’s almost impossible to go from data to information.” Edward Cantwell, Executive Director, Center for Medical Interoperability

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Session 5: Why Health Is No One’s Business: Economic Incentive Barriers to Improving Health SESSION PANELISTS: AL GARNIER, Co-Founder & CEO, VTM LLC JIM JIRJIS, Chief Health Information Officer of Clinical Services Group, HCA of America ROBERT DITTUS, Associate Vice Chancellor for Public Health, Vanderbilt University Medical Center LEE FLEISHER, Chair of Anesthesiology & Critical Care, University of Pennsylvania School of Medicine MODERATOR: ATUL GROVER, Executive Vice President, Association of American Medical Colleges

SITUATION In today’s American healthcare industry, many believe that the current healthcare system of “sick care”—a system in which people are treated by curing existing ailments rather than being treated to prevent them—has created a skewed system of payment that has generated many economic incentive barriers to improving health. But what are the factors that are causing these barriers to occur? While many industry insiders point to inefficient governmentfunded health programs, focus on late-term care, and the continuation of patient-burdened payment systems as some of the main factors that have upheld this economically unequal system of health, the complexity of the issue continues to perplex experts and solutions have yet to be found. Indeed, although Sustainable Development Goal 3’s aim is to ensure healthy lives and promote wellbeing for all at all ages, the United States continues to lag behind other countries in terms of this health goal. Within the OECD countries, for example, the United States is often ranked at the top in terms of healthcare spending per capita – yet the outcomes do not tend to reflect this investment as the US often ranks much lower in terms of actual health outcomes.

GLOBAL ACTION REPORT

KEY QUESTIONS This is due to the fact that while the U.S. may spend large amounts of money on the healthcare industry, the majority of this funding is spent on clinical care rather than social welfare—such as poverty reduction and education—that many other countries tend to focus on. Ultimately, it is this lack of focus on prevention and early intervention that continues to contribute to the issues the healthcare industry faces today. Despite these large economic incentive barriers, however, there are also solutions being created in an effort to combat the U.S.’s current healthcare system and improve health for every individual. Through shifting the payment burden off of patients, for example, or even creating a more aggregated payment system, both individuals and the healthcare industry can receive more substantial benefits. And with the help of advancing technologies, the future of an economically-driven healthcare system may soon be upon us.

1. How do current healthcare payment systems work? How does this affect both patients and healthcare providers? 2. How can we move away from an illness-focused healthcare system and move toward a system of health and wellness? 3. How can we use new technologies to break down economic incentive barriers? 4. How can we measure quality in healthcare? 5. How can we change the incentive structure of today’s healthcare industry?

“People don’t want healthcare; they want health and we’ve forced people to think they have to go through healthcare to get it. This is why we have managed to spend so much money on healthcare.” Robert Dittus, Associate Vice Chancellor for Public Health, Vanderbilt University Medical Center

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Why Health Is No One’s Business: Economic Incentive Barriers to Improving Health

“We have to move upstream and address things that are a bigger impact on our health than tobacco ever was.” Al Garnier, Co-Founder & CEO, VTM LLC

CHALLENGES While health is defined as the state of complete physical, mental, and social wellbeing, the United States often focuses more on the absence of disease or infirmity rather than overall wellness. Indeed, in addition to SDG 3’s goal of health for all, there are no less than 16 other goals and targets directly or indirectly connected to achieving health, such as reducing communicable diseases of epidemics; preventing noncommunicable diseases like obesity and diabetes; preventing substance abuse; and reducing death from road traffic accidents. Despite this focus on prevention and early stage intervention, however, the US still continues to focus on sick care rather than health care. This is due to the fact that payment systems within the United States focus more on providing care when a patient is critically ill or sick rather than preventing these ailments, which often leads to more expenses for both patients and healthcare providers. Without focus on prevention—which includes cognitive care such as education and counseling as well as public intervention—focus on the social, behavioral, and environmental determinants of health is often disregarded in favor of clinical care. This focus on sick care has ultimately created a system in which there are several barriers to proper diagnosis

GLOBAL ACTION REPORT

and treatment for patients, particularly secondary and tertiary prevention, as well as a lack of safety, equality, and incentives. Additionally, the very basis of the US healthcare system—its vocabulary—is also heavily focused on sickness, with very little health-centered vocabulary and institutions, all of which continuously contributes to this system of sick care. There are also misplaced incentives that are blocking improvements to health, such as the fact that doctors are pushed to not only focus on patient care and research, but also take care of population health care issues such as increased consumption of high fructose corn syrup. With the massive epidemic of obesity and diabetes in the Philippines, for example, studies have shown that the increasing prevalence of high fructose corn syrup within foods is heavily linked to this epidemic; yet doctors are being forced to use their resources to treat these solvable problems in patients instead of other more patient-specific issues. Without government intervention within public health, therefore, doctors are unable to perform their jobs to the fullest extent. In the US specifically, the focus on medicine—especially opioids— has created an unhealthy system of prescription drug dependence. In fact, studies have shown that the United States consumes, on average, 79,000

kilograms of opiates per year, which is nearly 50 times the amount Great Britain does. Even more concerning, with nearly 25% of advertisements on television focused on drugs, this focus on opiates and medication does not appear to be stopping anytime soon, thereby reinforcing the US’s current sick care system. Another challenge that the healthcare industry faces is that of universal quality measures, or rather the lack thereof. With over 680 measures that are endorsed by the national quality forum, the large but simplistic scope of quality measures is often confusing and inefficient, and lacks any nationwide system of standards. Procedures to measure readmission rates, for example, are based on whether or not a patient returns to the hospital within 30 days of surgery. Rather than being measured based on the amount of times they are readmitted, however, both one day of readmission and 29 days of readmission are counted the same and doesn’t adjust for many factors, such as social determinants and comorbidities. Similarly, the lack of a basic system of quality measures used throughout the United States has created a system in which different measures are applied in different healthcare clinics for the same issue, thereby creating a silo of disjointed data. This problem will not be easily

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solved, either; with hospitals having to deal with different measures to relay information to different insurers, the local community, and state Medicaid programs, the issue of creating a universal quality measuring system will not only have to be solved within the healthcare industry but other industries as well.

OPPORTUNITIES In order to better connect the health Despite the enormous economic incentive barriers that the healthcare industry faces, there are several new innovations and potential reforms that may offer what the healthcare industry needs. With new payment reforms, such as a more aggregate-centered payment system, healthcare professionals are paid for aggregate clusters of people— whether they are geographic-based clusters, insurance plans, or have certain risk factors. With this reform, people have the opportunity to redistribute how they want to spend their money and

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potentially lead to better quality within the healthcare industry. The HCA of America, for example, is creating several different kinds of value-based models in order to test new forms of payment. As the largest nongovernment-owned hospital system in the US with over 170 hospitals, 7000 employed physicians, and hundreds of clinics, these new models are being tested on a large scale, and while no single economic model has yet proven to be able to shift value dramatically, it is only a matter of time before a breakthrough occurs. Other institutions such as Vanderbilt are also working on pilot programs to study behavioral mechanisms within patients. Traditionally, many in the healthcare industry argued that the non-adherence of medication by patients was one of the biggest issues in recovery, but researchers at Vanderbilt were determined to prove this notion incorrect. By creating a system in which care coordinators are paired

with patients in order to closely follow their progress in programs focused on lowering one’s blood pressure, for example, researchers found that after a mere 12 weeks in the program, participants had lowered their blood pressure to their target goal and 8790% of patients had adhered to their prescribed medications. Even more surprising, most of the other 10% also adhered to their medication guidelines, but were simply intolerant or resistant to the medication. In the end, this combination of innovative payment methods, deeper research on patients and new technologies has the ability to create a more efficient, accessible healthcare economy and promote health and wellness for all. ■

“With meaningful use, technology and enough critical mass to your point, improving the patient’s relationship with the healthcare system, and lowering the cost through the leveraging of technology—you see results.” Jim Jirjis, Chief Health Information Officer of Clinical Services Group, HCA of America

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GLOBAL ACTION REPORT

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Session 1: Identifying Pathways for Inclusive Growth Through SDG #1 SESSION PANELISTS: LESLEE ALEXANDER, International Director, Tennessee Department of Economic and Community Development TIM DOCKING, Vice President Government Affairs, IBM LOUISE KANTROW, ICC Permanent Representative to the United Nations, USCIB LONA STOLL, Deputy Vice President, Department of Compact Operations, Millennium Challenge Corporation MODERATOR: MARTIN CHRISNEY, Director, International Development Assistance Services Institute, KPMG

SITUATION With the implementation of the Sustainable Development Goals in 2015, the 17 Sustainable Development Goals—with 167 targets and over 260 indicators—are some of the most ambitious targets of the 21st century. With SDG #1 (ending poverty in all its forms everywhere), SDG #8 (promoting sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all) and SDG #16 (promoting peaceful and inclusive societies for sustainable development, providing access to justice for all and building effective, accountable and inclusive institutions at all levels) in particular, the SDGs show that business involvement is absolutely critical at all levels of the 2030 Agenda. Indeed, the creation of the Global Business Alliance for 2030 has brought together both global and sectorial business in order to inform and elaborate on the specifics of each of the SDG’s specific goals and targets. With issues of inclusion,

KEY QUESTIONS transparency, and the shortcomings of the Millennium Development Goals, however, the private sector’s involvement in the SDGs has often been questioned, with the business sector often being implicated in some of the very problems they are attempting to solve. It is crucial, therefore, that both the public and private sectors come together to combat social issues on a global level in an effort to dispel myths about the private sector and more effectively promote the SDGs. Despite widespread belief, over 80% of poverty occurs in middle income and advanced countries. Therefore, rather than simply focusing on developing countries, it is also important to look inward and concentrate on solutions to combat the poverty in our own country. Through the partnership between small business, large corporations, NGOs and the government, both social issues in the U.S. and abroad can be solved and the world will be one step closer to achieving all seventeen Sustainable Development Goals.

“[The private sector] can target and utilize, but then your entrepreneurs are really the ones who are the most important part of your community.” Leslee Alexander, International Director, Tennessee Department of Economic and Community Development

1. How can the private sector impact the SDGs? 2. How have public private partnerships in Tennessee impacted the economic and social landscape of the state? 3. How can countries use direct foreign investment to create more sustainable infrastructures? 4. What role does data have in the SDGs? 5. How can a company’s core beliefs also assist in the completion of the SDGs?

CHALLENGES One of the biggest barriers that the original Millennium Development Goals faced was the issue of data. With no global indicator framework in place for the first five years of the project, the lack of data measurements led to unknown outcomes, little measures of success, and difficulty understanding what needed to be changed in each individual program and how best to proceed. It is crucial, therefore, that parallel indicator frameworks be put into place in order to better understand the success of projects in the Sustainable Development Goals, lest we continue to repeat the failures of the past. Indeed, during the implementation of the Millennium Development Goals, the private sector was traditionally seen as part of the problem and not the solution, and SEPTEMBER 2017

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Identifying Pathways for Inclusive Growth Through SDG #1

“When we’re thinking about tackling the inequality within countries, that’s a really important part of us thinking about the equation behind where we invest.” Lona Stoll, Deputy Vice President, Department of Compact Operations, Millennium Challenge Corporation

“Underneath the SDGs is the belief that growth is necessary, that skills are necessary, that people’s daily needs are met and that societies grow.” Tim Docking, Vice President Government Affairs, IBM

“Countries that trade with each other and invest with each other will not go to war with each other.” Louise Kantrow, ICC Permanent Representative to the United Nations, USCIB

the development community was still in the beginning stages of understanding the importance of incentivizing economic growth in order to create the conditions in which the private sector can thrive. Even with today’s billions of dollars being funneled into the development community and private sector and a better understanding of how to achieve the SDGs, this investment is not enough to encompass the trillions of dollars needed to achieve every Sustainable Development Goal. In addition to funding, the entities that are directing programs to meet each Sustainable Development Goal also need to understand the systems they’re trying to impact, bring together stakeholders, be open and transparent in order to allow people to join the project and also keep them accountable, and have the data necessary to decide where to invest and understand how investments are impacting the project. Despite the vast amounts of data available, the difficulty in organizing and understanding these data leads to many questions, such as how to create a system in which there is data-driven development and how to monitor a project and recognize when something is wrong and immediately 66

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correct the course of the project. It is paramount, therefore, that data become more organized in an effort to better understand greater amounts of data in a more efficient and accessible way. Lastly, the challenge of inclusion in both the Sustainable Development Goals and the social changes they are attempting to create makes it difficult for women and minorities to gain equal ground with the rest of the world. With a significant difference between men and women in terms of secondary education even in the most developed of countries, inclusion is difficult to achieve. But with government-involved policy changes aimed toward the creation of gender-neutral curriculum, re-training of teachers, and the understanding of other factors that prevent girls from enrolling and completing school, society and the SDGs can become more inclusive.

OPPORTUNITIES To increase business participation in the SDGs, large multinationals are mapping out how their core business practices will contribute to the Sustainable Development

Goals. KPMG, for example, is working with the UN Global Compact to provide sector-specific tools that can aid companies in the work they’re already doing to impact any relevant Sustainable Development Goals in a more significant way. Additionally, agencies such as the Millennium Challenge Corporation are oriented toward unlocking private investment and private sector growth in developing countries in order to ensure that regulatory environment changes can happen. Through compact dollars from MCC, MCC empowers countries with the ability to create the right infrastructure that can ultimately enable greater long-term investment. The creation of a technical and vocational education program, for example, not only depends on investment from the private sector but also requires the private sector to work directly with the education system in order to communicate the labor needs of the market and shape training to fit these needs. Through these kinds of public private partnerships, both the public and private sector can benefit and society itself can begin to see change. In terms of corporate volunteering, IBM’s Corporate Service Corps holds

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an annual competition internally to select the top employees to participate in four-week engagement around the world completing social and humanitarian work around the world. With 2,500 IBM employees having completed volunteer work in over 35 countries, IBMâ&#x20AC;&#x2122;s core business practices have not only impacted their consumers, but also assisted in the progress of the Sustainable Development Goals. Additionally, with four innovation centers and 14 labs around the world, IBMâ&#x20AC;&#x2122;s impact will continue to create waves in the development industry. In a more general way, the Department of Economic and Community Involvement in Tennessee is addressing SDG1 by helping citizens create resilient, thriving communities and greater job opportunities. While Tennessee was traditionally a region that relied on growing industries outside of the state, there is a growing effort to create public-private partnerships that create new industries from within. For example, the introduction of the Tennessee Valley Authority by the public sector provided both statewide energy and opportunity for residents to obtain jobs and create new businesses. Such public-private partnerships

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can help a community and transform the economic landscape of a region. Another example of a successful publicprivate partnership is the Tennessee Promise program, a program that allows all students in Tennessee to attend a two-year vocational school for free. By attending classes focused on their vocation of choice and working with mentors in the workforce, these students can enter the workforce directly from school and acquire the skills needed to enter a four-year college. The state of Tennessee also works with people recently unemployed due to a large factory leaving the state, for example, and prepares them with the skills needed to join any new companies that may move into the state. By joining together, the public and private sectors in foreign countries, programs aimed at social and economic development can potentially become more successful. In Morocco, for example, a program was created in which the government practiced results-based financing in order to fund programs that produced real, tangible results. With education and technical vocation programs in particular, programs receive funding based on the outcome of how many

participants complete the program and also gained additional performance-based funding if that person stayed in the same job for more than one year. Through these kinds of financing mechanisms, better results are possible and developing countries themselves can take over their own success. Ultimately, in emerging market economies and lesser-developed countries, domestic resource mobilization is going to have to be the primary source of development financing. Countries will have to look at their own domestic private sector as the engine for economic growth, and both the public and private sectors must be involved in their own development project. Ultimately, developing countries will need to be able to take direct foreign investment and become their own engines for growth, and private sectors both in-country and abroad will need to be involved at all levels. â&#x2013;

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Session 2: Riding the Tiger SESSION PANELISTS: WILFRIED AULBUR, MD, Roland Berger ADARSH KATARUKA, Founder, SoulAce ANURAG BATRA, Editor-in-Chief, Business World MODERATOR: AMIT KAPOOR, President and CEO, India Council on Competitiveness

CHALLENGES

SITUATION As the world becomes increasingly interconnected, both historical influences and future possibilities continue to converge in unprecedented ways. This convergence is especially strong in the case of India. With a population of 1.3 billion people and rising, India is set to become the largest and possibly most innovative country in the world by 2030. Indeed, with 35 million children born per year—which is more than the total population of Australia—India’s sheer human capital is unrivaled even in today’s world. But given the poverty, education gaps, and lagging governmental infrastructure that come along with such a massive population, India still faces many challenges. With 70% of the population—or roughly 850-900 million people—making less than $5 a day, a vast majority of India’s population lives in extreme poverty with very little economic opportunity for advancement. Even more concerning, over 400 million people in India lack any education whatsoever, barring many of them from being able to enter most job industries. Even with a college degree, an estimated 35-40 million graduates are not gainfully employed, resulting in an educated workforce that is not being utilized in meaningful ways. And with difficult patenting mechanisms and a lack of entrepreneurship-centered economic structures, progress remains slow.

GLOBAL ACTION REPORT

Fortunately, India is actively developing many potential solutions to the current problem of under-productivity. With an abundance of unique business models, a distinctive social environment and the ability to create effective scalable models, India may very well be the country that both solves economic and social issues within its own society, and also helps solve similar challenges in China and South America— all while supporting innovations that could revolutionize the world.

KEY QUESTIONS 1. What are the economic constraints that have restrained India’s entrepreneurship and social enterprises? 2. What business models are the most successful in India? 3. How can India’s economy become more efficient? 4. Is India facing a leadership crisis? 5. What innovations and opportunities are available to India? 6. How does India’s R&D sector compare to other R&D sectors from around the world?

Generally, some of the biggest challenges that face India are the many barriers experienced by entrepreneurs and innovators in India. First, there is a lack of an innovation ecosystem—including such things as importation regulations, capital and banking infrastructures, and foreign exchange rules. The lack of such a system makes innovation difficult due to a lack of uniformity across the country and governmental institutions. To receive a grant, for example, researchers first must go through a granting agency to be awarded the grant; then, they must contact the ministry of finance to release the funds—a process that ultimately slows funding, and may even prevent any grants from ever reaching the intended research institution. With strict and stifling customs regulations, importing research material is nearly impossible within India, due to archaic governmental structures and a general mistrust on the part of India’s government. If a company imports a chemical for research, for example, the government may suspect the company of criminal activity, since there is no record of the company re-selling the chemicals within India. Since current regulations provide no way for a company to identify itself as an R&D facility in customs, this problem will continue to persist. In fact, Indian law recognizes only two business types—a private company

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Riding the Tiger

“For the first time since independence, India has the means to do it right. For the first time, we now have an economy that is a top 10 economy; [according to] projections by 2030, India could be the third largest economy in the world.” Anurag Batra, Editor-in-Chief, Business World

“There are a bunch of social enterprises largely in India who want to create impact but at the same time be profitable and sustainable.” Adarsh Kataruka, Founder, SoulAce

“Economic objectives and social objectives will have to come together as we go forward in the country.” Amit Kapoor, President and CEO, India Council on Competitiveness

or NGO. Without more classifications, tax regulations and other barriers will continue to hinder the efforts of companies to conduct research and innovate. As long as the government continues to view social enterprises as a means by which companies create loopholes to take advantage of the economic system, these enterprises will continue to experience barriers within India. The lack of trust by the government is not wholly unfounded. Many industries and companies in India remain essentially family businesses, run by family members who may lack the professional leadership skills and domain expertise necessary to the creation of strong companies. Hence, corporate leadership within India remains, on the whole, weak. It is of the utmost importance that a more professional delegated leadership structure become more prevalent throughout India. This in turn will free CEOs from attending to menial HR tasks, such as employee pay raises, and allow them to focus on expanding their companies.

Without this sort of leadership, the Indian R&D sector will continue to suffer. Statistics show that in 2015, eight out of the top ten R&D companies in Asia were of Chinese origin, with only one being based in India; globally, not a single Indian R&D facility entered the top ten. Without freer regulatory and governmental structures, these R&D facilities will continue to struggle, and potentially ultimately fail. The regulatory environment is not the only constraint on R&D and social enterprises in India. The education sector in India also poses many barriers to innovation, due to low graduate retention and a lack of comprehensive basic education for the population. Despite the potential growth of the Indian economy, many MBA graduates today still leave the country to pursue job opportunities abroad. This loss of talent, coupled with the lack of general education poses a real barrier to the country’s economic growth through innovation. From 1997 to 2004, estimates reveal that the total amount of innovations

patented within India were less than that of the Massachusetts Institute of Technology in the United States. With a culture that has ultimately restrained innovation and social enterprise, the Indian economy and society are suffering. It is most important, therefore, that reforms in education, government, and social constraints be advanced to enable India to unleash its potential to scale innovation and social progress.

“India is a repository of expertise around some of the most important challenges that we face as a world.” Wilfried Aulbur, MD, Roland Berger

GLOBAL ACTION REPORT

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OPPORTUNITIES Despite the massive challenges that India faces, there are also abundant opportunities. The challenge of air pollution, for example, also offers several opportunities for entrepreneurs to create anti-pollution measures that could not only potentially assist India, but other countries as well. Ultimately, the key to creating solutions within India’s diverse landscape is to create unique solutions tailored to the country itself rather than adopting purely western approaches to these problems. More generally, one of India’s biggest strengths is its natural ability to scale. In terms of educational institutions, for example, tier 3 and tier 4 villages within India are subject to an education system where the traditional model of education in developing countries is flipped, with volunteers at the top of the organization and the lower workers paid. With this model, one woman teaches all necessary subjects to all of the children in one village, where she lives and looks after the community as well. With this model, over 30,000 schools are in operation today in tier three and tier four villages, with an estimated 50,000 more opening

up in the upcoming years. Even more surprising, this model is built on a budget of 18 million dollars per year, funded by donations from Indian expats and philanthropists. Ultimately, it is the sheer scale of these models that could be used as an outline by which more globalized scalable solutions can come into fruition. In terms of social enterprises, the Creative Million is a non-profit geared toward providing women with the jobs and funds necessary to make a difference in the creative manufacturing sector. Through this non-profit, women are able to begin generating and owning cooperatives across India in an effort to create their own value and retain it, all while increasing profits to sustain themselves and their communities. Even more encouraging, this same model can be exported to countries with strong women figures—such as Rwanda— in order to better scale women’s empowerment. Despite inefficient governmental structures, there are many informal leaders and organizations that are already revolutionizing both the social

and economic landscape of India. GK in Mumbai, for example, has created a product that has the ability to deliver protein to pregnant mothers at a quarter of the cost of any other products on the market. With this innovation, the ability to increase health in both mothers and infants, while decreasing chances of stunting, offers a potential solution to a problem that has plagued India for decades—a solution which ultimately shows that these sorts of informal leaders are perhaps better able to solve India’s social issues, while increasing market value, just like a social enterprise. Ultimately, the government will have to take steps to unlock restrictions on markets; encourage communications among the public, private, and academic sectors; and assist researchers and entrepreneurs in their search for scalable, sustainable solutions. With India’s unique culture vast population, and economic opportunities, worldsized scalable solutions may very well already be in the makings. ■

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Session 3: Humanistic Capital: A Convergence of Humanitarian Aid and Development SESSION PANELISTS: DAVID WILCOX, Founder, ReachScale AMBER NYSTROM, Director of Social Fusion, The Women’s Technology Cluster BRYAN THOMAS, Managing Partner, Global Partnership for Sustainable Solutions MODERATOR: IFTIKHAR MOSTAFA, Senior Agriculture Economist, The World Bank Group

SITUATION While development and humanitarian aid are critical forms of investment that pursue similar goals, the two types of investment also have a history of misalignment and disconnection that has resulted in many failures in humanitarian and development projects. Today, a new effort is being launched to correct the misalignments that lead to failure. In the past 18 to 24 months, the largest organizations from each of these sectors— the United Nations and the World Bank—have begun to combine investment principles from development and aid in an effort to more effectively assist crisesaffected areas and create more resilient programs all around. New programs, such as the Global Concessional Financing Facility (created to provide funds to Syrian refugees in Jordan) and the Pandemic Emergency Financing Facility (created to promote pandemic risk insurance and ensure resources get sent to pandemic-effected areas quickly) have been created strategically to combine quick emergency services with more resilient, long-term solutions. While such new programs are promising, issues such as scalability and sustainability still remain problematic, and tension between the cultures and working modalities of development and humanitarian aid persist. The question is, then, how we can integrate these two

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CHALLENGES cultures and types of investment into a more comprehensive system—and how we can sustain such endeavors. Ultimately, both refugee camps and humanitarian aid sites will require location-specific investments, both in the short and long-term. Both development and humanitarian aid have their parts to play. It is imperative, therefore, that these two industries begin to create stronger collaborations and partnerships to both assist those in immediate danger and also ensure the overall health and wellbeing of affected areas over the long run.

KEY QUESTIONS 1. How can we better integrate the humanitarian aid and development sectors in order to create more resilient solutions? 2. How can we co-create solutions in a way that brings both the humanitarian and development aid sectors together? 3. What are the issues that both the development and humanitarian aid industries currently face? 4. How can a systems approach benefit both sectors? 5. How can funding be used more effectively in these sectors?

While the overall challenge of uniting the development sector and humanitarian aid sector is crucial, the specific challenges that each sector faces also pose various barriers to the partnership between these two groups. In humanitarian aid, for example, one of the biggest challenges that many organizations face is the crisis-centered budget system. With many humanitarian aid organizations receiving 70-80% of overall donations during crises, any lack in emergency situations often results in large cuts to the budget—a disconnect which ultimately leaves very little opportunity for capacity building and pre-crisis deployment, both of which are crucial to development. It is this disconnect between annual budget and actual available money that ultimately creates barriers for organizations within humanitarian aid. Even within times of crises, the disorganization between various humanitarian aid organizations often leads to the failed sustainability of short-term projects. The Philippines’ typhoon Haiyan, for example, was one of the largest and most devastating typhoons in history. With over 10,000 reported dead, 640 schools destroyed, and countless homes and businesses obliterated, a plethora of humanitarian aid programs were called in to bring in immediate relief. The lack of organization, however, resulted in two very large failures: first, food sent to the

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Humanistic Capital: A Convergence of Humanitarian Aid and Development

“It’s absolutely essential, in my opinion, that you understand the economics of the humanitarian side—which is [the fact that] most of the money flows from crises.” David Wilcox, Founder, ReachScale

“In the middle of a catastrophe, there is chaos; but in the middle of this chaos, there is a tremendous amount of compassion.” Bryan Johnson, Managing Partner, Global Partnership for Sustainable Solutions

Filipino government by NGOs was stored in storage facilities for later use, while expired rice was sent to feed the needy people instead; and second, nearly all emergency aid resources were held onto by the government and rarely reached the affected people. Even more concerning was the rate at which organizations left the crisis site. After three months, most of the large agencies had left due to an exhausted budget and lack of aid; after eight months, almost every other agency—such as NGOs and USAID—had departed the site; and after only twelve months, there were no more organizations left in the Philippines to help citizens rebuild. Despite the aid these organizations offered to the affected areas, issues such as lack of materials to rebuild, rain exposureinduced pneumonia, and the destruction of coconut trees and fishing boats—which accounted for 70% of the area’s economy— ultimately created an environment in which problems not only persisted, but often became worse after the humanitarian aid workers pulled out. It is of the utmost importance, therefore, that a system of resilience be integrated into humanitarian aid projects in order to create more resilient homes, move people to safer areas, and pre-emptively plan against crises. This can only be done through the integration of more development-focused, long-term solutions that are necessary to the overall wellbeing of any communities affected by crises—an issue that can be

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most easily solved by collaborations with between the development and humanitarian aid sectors.

OPPORTUNITIES Ultimately, the convergence of the humanitarian aid and development sectors can only be done through the radical re-thinking of the systems framework of each sector. Through this process, sectors can re-examine their own weaknesses and identify areas where collaboration would be most beneficial, thereby better identifying with whom to partner and in what situations. One example of this type of collaboration comes from an area in the Gulf of Mexico that was experiencing dangerous depletion due to extreme over-fishing. Through reverse designing a comprehensive solution that engaged key stakeholders at all levels—such as the families who use the fisheries, the government, investors, non-profits, and all other organizations involved— a unique, co-created solution was created that benefited all stakeholders and replenished the fishing grounds. The open-minded, multi-stakeholder approach to a complex problem was key to the success of this project, demonstrating how collaboration between sectors and stakeholders is

crucial to effective and sustainable solutions. Another potential approach to better aligning humanitarian aid and development would be a systems approach connecting multiple systems working together from different fronts to solve the same problem. Because this kind of systems-design operates in a dynamic and adaptive way, both short-term and long-term problems in areas affected by crises could be addressed more sustainably though the contributions of the multiple stakeholders involved. Within such a dynamic system, financing could be designed more flexibly to best fit individual situations—thereby creating more sustainable longterm solutions. Such a broadly focused approach would ultimately require leaders who have the ability to look across industries and silos to create synergies between the multiple groups engaged in a specific system. Luckily, the idea of meta leadership was created in an effort to construct programs and workshops designed to teach participants how to look at issues from a more systemsoriented approach, and eventually bring these people into multi-sector collaborations. Through meta leadership, more dynamic and broad solutions can potentially be created, and both short and long-term goals can be met.

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In order to understand things better across the board, it is important that a database of all of the local organizations that are involved during crises be recorded, as well as a more comprehensive understanding of what capacities these areas have in order to pre-emptively plan for any future crises. Through this sort of database, both humanitarian aid and development actors could better understand an effected area even before sending aid, and therefore orchestrate how to move the various local organizations in conjunction with their own teams in order to better assist the area more quickly and effectively.

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The development sector is also beginning to create programs to increase their short-term emergency capacities. The USAID’s Crisis Modifier, for example, is a program aimed toward creating a budget for catastrophes and crises in order to increase the emergency response speed of USAID, as they are traditionally focused on more long-term development projects and not emergency response. With their wide scope, however, the Crisis Modifier system could potentially create a system of USAID first responders who could act on a crisis even before humanitarian aid arrives—a program which could, in the end, save even more lives. ■

“When you [focus on a system approach], you actually set it up so that the private sector investors and philanthropists can come in in a much more effective way because the ground has been built and that way you can have a long-term development pathway where you’re actually bringing in markets to bear, which is essential if it’s a permanent transformation.” Amber Nystrom, Director of Social Fusion, The Women’s Technology Cluster

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Session 4: New Models for Scaling Social Enterprise And Social Development SESSION PANELISTS: SERGIO FERNANDEZ DE CORDOVA, Private Sector Advisory Group, United Nations, Sustainable Development Fund, UNDP AMBER NYSTROM, Director of Social Fusion, The Women’s Technology Cluster STUART WILLIAMS, Founder, InPact: In Place Impact MODERATOR: DAVID WILCOX, Founder, ReachScale

SITUATION As economies continue to globalize, the issue of scale is becoming an increasingly relevant area of concern. Indeed, while the idea of scale was relatively unheard of even five years ago, within the past three years the topic has gained significant prominence throughout nearly every industry, especially in regard to the Sustainable Development Goals. However, with this rapid increase in prominence, many are left to wonder: why exactly has scale become one of the most important challenges we face in the modern world? And how can we use this scale to create more sustainable social enterprises and sustainable development? According to the 2013 UN Global Compact Leadership Conference, one of the biggest barriers to the creation of scalable solutions is the fact that businesses and organizations are locked in pilot paralysis and therefore are unable to develop new mechanisms to encourage scalable solutions. It is imperative, therefore, that we change our approach to social enterprises and sustainable development, such as changing how we currently resource solutions so that sustainable, scalable

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KEY QUESTIONS solutions get resourced into larger, more concentrated amounts—both in terms of talent and funding. In order to increase scalable solutions, therefore, it is crucial that impact investing and investments in sustainability continue to increase in order to better fund scale. Unless the impact investing sector continues to grow significantly, a general lack of interest in scalable solutions, and a general trend toward de-scaling, will make bringing social enterprises and sustainable development to scale extremely difficult. Ultimately, radical transformations of capital markets will be needed to reach scale and to achieve the Sustainable Development Goals. Scale, therefore, isn’t just necessary for the success of social enterprise and sustainable development; it’s a necessity for the future of virtually all social projects.

1. How can we scale social enterprises and sustainable development? 2. How do impact investing and other financial mechanisms affect our ability to scale? 3. H ow can you scale a program while keeping the environment and people’s livelihood in mind? 4. I s the world becoming increasingly de-scaled? 5. H ow can collaborations and consortia increase scalable solutions?

“You can really go in and make a difference and allow the people that we need to help to help themselves.” Stuart Williams, Founder, InPact: In Place Impact

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New Models for Scaling Social Enterprise And Social Development

“If we’re going to catapult the impact investing sector, women and millennials are among the key folks we need to focus on.” Amber Nystrom, Director of Social Fusion, The Women’s Technology Cluster

“When you start looking at scale, you have to look at how…you’ve created that ecosystem where people themselves are owning it – you’ve taught them, you’ve educated them, you’ve given them the tools and you’ve reduced their costs and improved their living.” Sergio Fernandez de Cordova, Private Sector Advisory Group, United Nations, Sustainable Development Fund, UNDP

CHALLENGES Despite the relatively recent creation of impact investment and the importance of this sector in the scalability of solutions, the impact investing industry is already beginning to face many challenges, such as a lack of structures and metrics that can better enable the scaling of industry solutions. Unfortunately, despite the dynamic and creative potential of mechanisms in the impact investing industry, the industry still has a long way to go. The challenges to scaling social enterprises often stem from a paralysis among leaders of global financial institutions to create new and more efficient solutions. With focus being put into measuring executive compensation, ensuring return to financial stakeholders, and taking care of both institutional clients and retail clients, attention on more socially centered issues such as wellbeing and the environment are often put to the side. This ultimately goes against the general idea of higher risk, higher return—an idea that, if applied, would most likely increase focus on social issues and the environment due to their inherent risk. The shortcomings of the Millennium Development Goals have also caused many to become wary of the potential weaknesses of the Sustainable Development Goals. With a lack of

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accountability and no tracking of data metrics and scalability in the MDGs, the very question of whether the MDGs were successful or not is difficult to answer. It is important, therefore, that the SDGs utilize a private sector advisory group to set up financial mechanisms, determine how governance and data metrics affect the SDGs, and gather information on the regulatory structures, banking systems, and access to capital each country has to better understand the unique needs of each country and more effectively allocate the resources needed to achieve the SDGs in each country.

OPPORTUNITIES With a change in generations on the horizon, the mobilization of women and millennials will soon be upon us. Indeed, by 2020 it is projected that one in three adults will be a millennial, a situation which will ultimately create significant changes. This change in generational power will come with a $60 trillion transfer of wealth, with 70% of this money estimated to transfer to women. Given the millennial generation’s current focus on sustainability, collaboration, long-term solutions, market mechanisms, and effective

allocations of time and resources, a future of scalable and sustainable solutions may very well be possible. One opportunity to increase the scalability of solutions is through the building of innovation ecosystems and consortia. With innovation ecosystems, people, ideas and resources can be brought together in a resilient, fluid way to work toward better solutions. A multi-sector project focused on the creation of roads and highways in Latin America, for example, was created by bringing together a consortium of people from health, prosperity, food and many other sectors in an effort not only to build better roads and highways, but also to build the roads in a healthy and environmentally-friendly way. By bringing together SDG representatives, technologies, infrastructure builders, and key stakeholders involved in health and prosperity, the project was able to demonstrate how cross-sector partnerships have the ability to create extremely effective solutions. Another such example is the In Place Impact program, which uses a circular economy design that allows all stakeholders within a community—such as students, families, businesses, and non-profits—to participate more equally in their own economy. By providing disenfranchised communities with the

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context, information, contacts and capital necessary to becoming social and environmental entrepreneurs, disenfranchised populations have the ability to create change for themselves and others while simultaneously providing In Place Impact with vital information on the effectiveness and scalability of such programs. Indeed, Stuart Williams and his team have found that despite widespread belief that those below the poverty line are often simply in search of handouts, it is often these very people who come up with the most effective social enterprise solutions. After a certain grocery food chain went out of business in the UK, for example, eleven food deserts were created where these markets once were. One local lady—who had never graduated from high school and lived below the poverty line— decided to map out the eleven locations and begin installing ship containers to be used as new grocery stores. By hiring local workers, installing solar panels on the roof for energy, and sourcing fruits and vegetables from local farmers (over a ton of which was donated to the local food bank each year) this woman could

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provide food for her community in an environmentally-friendly, sociallyresponsible manner. On a larger scale, programs are being created to eradicate poverty area by area. Sergio Fernandez de Cordova and his team, for example, created the Imperative Fund to create 250 new homes in Campeche, Mexico using a five-year plan with $5million dollars in investments with a 5% return in five years. Through this project, Cordova’s team could run metrics on how much potential earnings locals had, what the costs of living and development looked like in the area, and how best to make the land scalable and sustainable. Through programs like these, investors and social enterprises alike can help fix entire ecosystems instead of just individuals, thereby guaranteeing more sustainable and long-term solutions. The business sector in the United States itself has many opportunities to become more involved in social enterprises and sustainable development. With 18 million companies in the United States with the ability to reach over 122 million people and every community in the

U.S., the U.S. business sector has one of the most powerful reaches in the world. And with $2.1 trillion of capital available today in public companies, the sheer amount of resources and reach the business industry has could potentially alter the entire landscape of social enterprise and sustainable development. ■

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Session 5: Emerging Economic Leadership in Mega-Regions: Young American Leaders Showcase SESSION PANELISTS: LONNELL MATTHEWS, Director, Mayor’s Office of Neighborhoods & Community Engagement MENDY MAZZO, Vice President, Skanska TIM OZENGER, CEO, Oz Arts RENATA SOTO, Co-Founder & Executive Director, Conexión Américas SAUL GARLICK, Founder and CEO, Unleesh MODERATOR: LINDA PEEK SCHACHT, Founding Director, Andrews Institute for Civic Leadership, Lipscomb University

SITUATION Despite the vast amounts of wealth in today’s world, the prosperity landscape remains extremely dispersed. With millions of unemployed and unskilled workers, and growing global markets for the most skilled, the global skills gap continues to grow, thus adding to the disparities of income and wealth. It is of the utmost importance, therefore, that shared prosperity—which is the reconnecting of corporate strategy and social progress—be promoted in order to decrease the talent gap and harness the power of the private sector to scale successful solutions.

KEY QUESTIONS The Young American Leaders Program, which was created by Harvard Business School in 2014, is one such program aimed at teaching emerging civicleaders to understand the drivers of today’s global economy, the ways regions can create global innovation, and how to accelerate shared prosperity at the citylevel. In Nashville specifically, young American leaders have been tasked with the challenge of assisting the mayor of Nashville in creating 10,000 jobs for youth by next summer in order to keep them away from crime and increase their experience in the work field. In other cities around the world—everywhere from advanced cities like Nashville to towns in developing countries—similar projects are also currently underway.

“Exposure is one of the greatest tools you can give a young person that has probably been oppressed by poverty, and if we’re not going to expose them to the opportunities beyond their own community, their own block, I think we’re really missing something.” Lonnell Matthews, Director, Mayor’s Office of Neighborhoods & Community Engagement

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1. What is shared prosperity? Which programs are promoting shared prosperity? 2. How can the business sector collaborate with the public sector in an effort to fund social programs? 3. What programs are promoting immigrant development? The development of the arts? 4. How can technology impact shared prosperity? 5. What is the global skills gap? What mechanisms can be used to solve this gap?

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Emerging Economic Leadership in Mega-Regions: Young American Leaders Showcase

“Sometimes when you want to tackle a problem, you actually have to start with the relationships and the shared stories—and the shared stories that have to exist before you move to solutions.” Renata Soto, Co-Founder & Executive Director, Conexión Américas

“The best way to [solve the global skills gap] is to give people an opportunity to get in the door of work and help them scaffold up to being major contributors to every company they are a part of.” Saul Garlick, Founder and CEO, Unleesh

“The buildings that we have and infrastructure that we have is great—those are the bones of the skeleton. But I think what provides us with the heart and the soul is art and the arts.” Tim Ozenger, CEO, Oz Arts

CHALLENGES One of the biggest challenges facing shared prosperity is the global skills gap, a gap in the job economy created by the 100 million unfilled jobs remaining open due to deficiencies in workforce skills. While it is crucial that we prepare youth for the jobs market, the current education system often remains inflexible and generally does not provide enough opportunities for students to obtain competitive skills—especially soft skills. Additionally, access to information is also problematic. Although access in general has increased greatly, there is a tendency for information to become polarized by political views—which is accelerated apps based on affinity groups that only share “confirming” information aligned with individual biases. Immigration can also present challenges to shared prosperity, unless immigrants are integrated into communities and jobs. Ultimately, the immigrant population in America could be left out of economic opportunities unless programs assist them in learning English and getting the skills and certifications for employment. Perhaps even more important as a challenge, the rapid deployment of

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robotics, AI, and the Internet of Things will eliminate the need for ever more jobs—for the skilled, the unskilled, and the immigrant.

OPPORTUNITIES While the challenges of income inequality are great, many efforts are being launched to create greater shared prosperity. The Young American Leaders Program, for example, has been working with Mayor Barry in Nashville to promote the Opportunity Now Platform, a program focused on the creation of 10,000 youth-oriented jobs. By partnering with the private and nonprofit sectors as well as government, the Young American Leaders Program is able to assist young people by fostering connections in different sectors in order to promote cross sector collaborations, fundraising, and providing soft skill training to students to prepare them for the multitude of job pathways. One case study that proves this model effective is a study in which a certain electric company that manufactured wires was heavily utilized by a nearby city as their main source of jobs. By partnering with the local public school

system to create programs that educate students in the skills needed to work at the electric company—such as providing summer internships and on-the-job work experience—both students and the electric company were able to solve the local skills gap and promote shared prosperity in the community. With technology’s reach continuously increasing even in the most remote parts of the world, access to the Internet is becoming nearly universal. With smartphone apps like Unleesh, the creation of content agnostic platforms that leverage experiential learning provides people around the world with the tools needed to increase their skillset and connect with like-minded people. Indeed, with availability even in Africa, it is only a matter of time before app platforms like Unleesh begin to provide countless opportunities for remote learning and the obtainment of skills in a relatively efficient and accessible manner. More hands-on platforms like Conexión Américas strive to lessen the global skills gap by providing immigrants throughout the United States with the ability to enter society and become successful members of their communities. By directly

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assisting people in finding jobs, starting businesses, buying houses, and providing the education necessary to help them help their children succeed in school, Conexión Américas is able to provide traditionally disenfranchised groups with the ability to not only survive, but also to thrive. One such program that Conexión Américas uses to assist adults in acquiring food-related jobs is the Culinary Incubator, a program whose focus lies on supporting aspiring food entrepreneurs with obtaining a license and providing them with a commercial kitchen that is both affordable and accessible. Through the incubator, participants are able to move on to jobs in food trucks, catering companies, retail, and even creating their own restaurants, and while the incubator originally had capacity for 25 food entrepreneurs, thanks to private sector investment the program has now been extended to cater to over 50 food entrepreneurs. Indeed, Conexión Américas not only works closely with immigrant families but with the local community as well in order to create a more accessible environment for these families. By working with local elected officials and

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the private sector, Conexión Américas is able to help local people understand the factors that surround immigration, such as why people move away from Mexico, what conditions pushed them to leave and what conditions have pulled them to move to Nashville. Similarly, by working with NGOs, Conexión Américas is able to bridge the communication gap between non-Spanish speaking NGOs and the Hispanic community in an effort to provide more pathways to assistance for immigrant families. In terms of larger society-based changes, companies such as Skanska are determined to solve the larger social issues that plague societies around the world. By joining a public private partnership in the UK, for example, Skanska was able to provide funds for the building of new roads, bridges, hospitals and schools to an area that traditionally would not have access to those funds. Through partnerships such as this, the private sector can assist the public sector by putting together teams to finance, plan, build, own and operate projects for a length of time while ensuring later returns from the local community. And by hiring locally, jobs can be created for residents to create and maintain these projects.

Lastly, programs such as the Oz Arts program are dedicated to the nurturing of the artistic spirit in the human mind, and therefore aim to provide opportunities for artists to showcase their artwork in their own unique way. By brining world class contemporary artists to Nashville, Oz Arts is not only able to assist these artists in becoming more well known, but also encourage local artists to continue in their pursuit of art. And by funding both local and national artists to travel the country, the art community has shown the importance of art in the economy. ■

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The Food Generation

Reconnecting Food to the People and the Planet BY EMMANUEL FABER

ood is not a commodity. Food is not a business. Food is not a consumer good. Food is a human right. We know the global industrial food system did miracles to broaden food access and reduce hunger, but not without consequences. Our food system is currently causing considerable harm to the environment. It generates up to one-third of all human-caused greenhouse-gas emissions. Agriculture alone accounts for 70% of global water use and 75% of deforestation. It is also impacting our health. More than one in three adults were overweight in 2014, and 13% were obese. Meanwhile, one in nine people worldwide suffer from chronic undernourishment. Hunger and obesity know no geographical boundaries; North Africa, the Middle East and Latin America have almost the same percentage of overweight or obese people as Europe. And in the United States, an estimated 13 million households are “food-insecure.” Today’s system has disconnected people from their food. A recent survey found that over one-third of young adults in the United Kingdom did not know that bacon came from pigs or butter from cows. In California, more than one-half of school children interviewed did not know that onions and lettuce were plants. By treating food as a commodity, we have made it lose its meaning as health’s most essential partner. Food nourishes body and soul. It allows us to form social bonds and express our cultures and traditions. Food is a right. And people are reclaiming it. From community gardens to food sharing startups, people around the world 84

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are turning away from the current system and reinventing new ones - some going back to basics, others disrupting the world as we know it. They want to know the story behind their food—where it comes from, how it is produced, and what impact it has on their health—and they are making their decisions accordingly. Danone is determined to be part of this movement, which we refer to as the Alimentation Revolution. We want to make it a reality for as many people as possible, all across the world. Why? Because we believe in a food and water ecosystem that works in harmony with people, communities and the environment. Where our relationship with the 900 million people who chose our brands can be a force for good. Of course, we know we are not perfect, and far from it. But our intention is unequivocal and we strive to address these challenges. How? First of all, by embedding shared value into our core business model. This year, Danone announced its intention to become a B-Corp. The B-Corp movement is based on a simple

but powerful premise: by certifying companies that meet rigorous social and environmental standards, this can create a race to the top that redefines the very purpose of private enterprise, while offering consumers and stakeholders at large more transparency about companies’ business practices and products. As part of this journey, we registered DanoneWave, our newly created U.S. subsidiary as a Public Benefit Corporation, so that financial interests of shareholders are balanced with broader social and environmental considerations. With $6bn sales, I am proud to say that DanoneWave is the largest Public Benefit Corporation in the world. The second way we are transforming our company is by reinforcing its purpose. In 1972, Danone founder Antoine Riboud made a landmark speech in which he declared that “corporate responsibility doesn’t end at the factory gate or the company door.” He is the same man who said “There is only one Earth. We only live once”. His words led Danone to make a dual commitment to business success and social progress. He kick-started a

Hunger and obesity know no geographical boundaries; North Africa, the Middle East and Latin America have almost the same percentage of overweight or obese people as Europe. And in the United States, an estimated 13 million households are “food-insecure.”

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vision that lives on today: our mission, as set by Franck Riboud in 1996, is to bring health through food to as many people as possible. And we work to make these words a reality every day. We believe our ultimate goal should be the empowerment of consumers, all citizens actually, to reclaim their food sovereignty, starting with our own people as they are the best positioned to drive this revolution and be a real change force. To make this vision a reality, we started by having Danone people write a Manifesto for the Alimentation Revolution in more than 20 languages, which inspired our company signature: “One Planet, One Health”, a rallying call for our employees, consumers and partners along the food chain, to protect and nourish both. We will intensify our efforts to protect the environment and promote the health and well-being of people, as part of a larger movement, working hand-in-hand with all kinds of stakeholders. In line with the United Nations Sustainable Development Goals which are at the foundation of our strategic framework, we will be scaling up our efforts to co-drive meaningful solutions by 2030. ONE PLANET. Food starts with our planet. So, our own commitment starts with fundamentally transforming business practices so that we can play our part in the fight against climate change. We’ve already achieved carbon neutrality with our Provamel brand, with a next milestone target for Evian water by 2020. Our ambition is to become a zero-net carbon company by 2050 on what we call our full scope—the emissions we have direct control over, as well as the emissions from our entire food chain, including agriculture. Between 2008 and 2016, we succeeded in cutting the intensity of our direct carbon emissions in half. Now, we are working with suppliers, distributors and other partners to go further in our reduction efforts. And through the Livelihoods Funds, we take collective action with nine other companies to develop carbon positive projects with local partners across the world. We are also working to promote sustainable agriculture within our supply chain. In the US, our pledge to use more natural and non-GMO ingredients, and to promote sustainable agricultural practices, has direct positive impacts, including greater independence for farmers, crop biodiversity protection and animal welfare. 86

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In many countries consumers are shifting away from conventional food and retail and are exploring alternative ways. We have to reconnect with people. And reconnect people with their food. Reminding all of us that each time we eat and drink, we can vote for the world we want.

Danone is also supporting organic farming through brands like Horizon Organic and supports farmers in Europe for research projects on biodiversity techniques. Healthy food depends on quality water and so do people. That’s why we are committed to doing all we can to protect this precious resource. We build better, more responsible practices within our own water value chain. But we also go beyond our own operations, co-creating new approaches to tackle this global challenge with local communities and governments, for example to protect watersheds in high risk areas. Our goal is to reduce water consumption in our production facilities by 60% by 2020, compared to 2000. Finally, we are determined to accelerate the transition to a circular economy, starting with packaging. We are working with the Ellen MacArthur Foundation to develop circular economy roadmaps on plastics in ten priority countries. We have also joined forces with Nestlé and the USbased startup Origin Materials to develop the world’s first PET bottle made 100% from bio-based materials. With recycling and bioplastics, our perspective is that we should become a plastic-neutral company. ONE HEALTH. Food is a human right and our health’s daily partner. Which is why our focus is on fostering healthy lives, starting with our products. Through a combination

of investment, divestment, and innovation, we expanded the share of “healthy categories” in our portfolio from below 40% in 1996 to nearly 90% in 2016. Danone’s recent acquisition of WhiteWave, which specializes in plantbased products and organic produce, will further this commitment. But we also recognize we have a broader role to play in educating people about health and nutrition. We created a tool, NutriPlanet, which gives us insight into health challenges in over fifty countries and helps us determine where we can make a difference. In the United Kingdom, for instance, we launched the “Eat Like a Champ” educational program in primary schools to help combat children poor nutrition and obesity. ONE PLANET. ONE HEALTH. Inequalities are at an all-time high and our mission would miss its point without us, as a business, caring for a better social inclusiveness in the way we operate. It starts with the way we treat our employees. Danone developed over the past 20 years a tight strategic relationship with the International Union of Food Workers and signed a new chapter last year that will help strengthen job security and working conditions for all our employees and subsidiaries around the world. In the same vein, we also launched Dan’Cares to ensure our employees have access to quality healthcare wherever they live, and adopted a worldwide genderneutral parental leave policy that was applauded by United Nations Women’s HeForShe campaign. We are working to promote social inclusiveness through our three social innovation platforms. Our Danone Communities fund supports social businesses that combat malnutrition and expand access to safe water. The Danone Ecosystem Fund empowers small economic actors along Danone’s value chain, from farmers to microentrepreneurs to waste pickers, by developing innovative business models

PARTNER UPDATE / DANONE

with business, social and environmental value in more than fifty countries now. And the Livelihoods Funds raises living standards for rural communities while promoting sustainable sourcing and generating carbon credits. Despite these efforts, we know that we are a long way from fulfilling our commitment to “One Planet, One Health.” And we also know that we can’t do it alone. This is why we have embraced the principle of co-creation for many years, joining diverse stakeholders to work together and find hybrid solutions to concrete problems. Co-creation isn’t easy. But it is the only way forward. We launched our first global partnership with a development bank last June: an alliance with the InterAmerican Bank of Development to scale our sustainability and social innovation programs in Latin America in areas such as sustainable agriculture, watershed protection or inclusive recycling. We will look to create and expand similar alliances going forward.

But the most important alliance we can make is with consumers. They expect transparency; they reclaim their food sovereignty. In many countries consumers are shifting away from conventional food and retail and are exploring alternative ways. We have to reconnect with people. And reconnect people with their food. Reminding all of us that each time we eat and drink, we can vote for the world we want. We need to work with our consumers, listen and learn from them as they are driving the Alimentation Revolution, determining its future and ours. Including those who’s right to food is deprived today. “One planet. One health.” By joining forces—all together with consumers, the food industry and civil society, we can be collectively remembered as the generation that harnessed its accumulated experience, access to disruptive technology and collective intelligence to create true, lasting food sovereignty for our world. We can be the Food Generation. ■

Emmanuel Faber is CEO and Vice-Chairman of the Board of Directors of Danone, one of the leading food companies in the world. Strongly committed to promoting innovative business models that fight poverty and malnutrition, he supervised in 2005 the creation of Danone Communities, in collaboration with Muhammad Yunus. Upon the request of the French Government, in 2013 he co-wrote with Jay Naidoo a report titled “Innovating by mobilizing stakeholders: 10 proposals for a new approach to development assistance”.

SEPTEMBER 2017

PARTNER UPDATE / WORLD BANK GROUP

Creating Inclusive Jobs in The Food System

BY JUERGEN VOEGELE

etween now and 2030, about 1.6 billion people will reach working age in low and middle income countries. Together with sustaining and improving the quality of self and wage employment of the billions of people already working, creating new jobs to absorb those reaching working age will be a significant challenge. All sectors need to contribute, including the food system, particularly given its large relative size in many countries, and that it accounts for a significant share of jobs in all countries. The food system comprises more than just primary agricultural production. It includes food storage, processing, distribution, transport, associated logistics, retailing, preparation, restaurants, promotion, and other services that together include many enterprises and a relatively large share of jobs in the manufacturing and services industries in many countries. The farming (or agriculture) share of total employment still dominates in many countries, accounting for about 60 percent of total employment in SubSaharan Africa, and almost 70 percent of total employment in low-income countries globally. Inclusive of employment in the broader food system, these shares would be larger. For example, in Malawi and Tanzania, food and beverages account for more than 40 percent of total manufacturing employment. Even in some highincome countries such as New Zealand, the food and beverage share of manufacturing employment is more than 35 percent, driven primarily by 88

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exports. In the European Union, the food and beverages industry provides a larger share of employment than other manufacturing sectors, it provided more stable employment during the financial crisis, and has a higher share of women employed than overall manufacturing. Increasing the number and inclusiveness of jobs in the food system will require attention to food system growth, employment intensity, and inclusion of youth and women. Food system growth: Food demand is projected to grow by about 25 percent in developing countries over the next 15 years, with demand growing in SubSaharan African by 55 percent. With changing diets as per capita incomes increase, non-cereal food demand, and the associated jobs, is projected to grow faster than demand for cereals, and food services and manufacturing will also expand more rapidly than farming, although from a fairly low base in many countries. With urbanization, food demand growth will be more rapid in urban areas than rural areas. These trends offer new opportunities for jobs

in non-cereal, higher value, production, and in off-farm food manufacturing and services. Key action areas for promoting growth in food value chains in response to consumer demand include: raising agricultural productivity; investing in complementary infrastructure; improving the rural investment climate and trade; promoting competition, private sector participation, and entrepreneurship; and upgrading skills. Employment intensity: Employment intensity varies across different stages of the food value chain. In addition, mechanization and automation, while raising incomes per job, reduce the number of jobs per unit of output. There is ongoing debate on the extent and speed at which machines and automation will displace jobs in low- and middle-income countries during the next 15 years, and the role of policy. Polices need to ensure that they donâ&#x20AC;&#x2122;t undermine employment intensity relative to long-term trends. Key action areas include: in response to shifting demand, promote highvalue agriculture that often has higher employment intensities than cereal

In the European Union, the food and beverages industry provides a larger share of employment than other manufacturing sectors, it provided more stable employment during the financial crisis, and has a higher share of women employed than overall manufacturing.

PARTNER UPDATE / WORLD BANK GROUP

SEPTEMBER 2017

PARTNER UPDATE / WORLD BANK GROUP

production; open trade to different types of machinery imports and crowd in private sector provision of mechanized services, and avoid policies that artificially make machinery cheap relative to labor (such as credit/tax policies, and labor movement restrictions). Inclusion of women and youth: Inclusion of youth and women into food system labor markets will be paramount for equity and social stability. The population below the age of 24 accounts for the largest share of the population in almost all countries in Sub-Saharan Africa, but also in many countries in South Asia, East Asia, Latin America, and the Middle East and North Africa. Yet youth aged 15 to 24 years old are two to three times more likely than adults to be unemployed. Youth can bring energy, entrepreneurial talent, and innovative ideas that can help raise growth and incomes. However, if a large share of youth cannot find jobs and earn satisfactory incomes, they may become a source of social tension. Key actions to facilitate inclusion of women and youth include: developing their skills and facilitating job matching, improving

GLOBAL ACTION REPORT

their access to land, increasing their access to affordable finance, and improving their inclusion in policy dialogue and program design. The world has set ambitious Sustainable Development Goals. Jobs provide the incomes needed to end poverty and improve shared prosperity. Slowing global growth, concerns about automation, and inequality of incomes and opportunities are adding urgency and attention to the jobs agenda. The food system can play a critical role. Indeed, it is the largest employer in many countries, and improved incomes in the food system can have significant poverty-reducing effects. The agenda is large and will require prioritization within countries, and partnerships to implement. Ministries of agriculture need to play a more prominent role in shaping the broader public policies and investments related to food system jobs. The process requires engaging with the private sector as the key provider of jobs. Development partners need coordinated and multi-sectoral efforts around countries programs. Together we can help enhance the food systems contribution to jobs. ■

Juergen Voegele was appointed Senior Director of the World Bank’s Agriculture Global Practice on July 1, 2014. Prior to this appointment, he was the Director of the World Bank’s Agriculture and Environmental Services Department. In this role, he provided leadership on the Bank’s activities across sustainable landscapes and oceanscapes, agriculture and environmental economic policy, and risk management and markets. Since joining the World Bank in 1991, Dr. Voegele has held a number of assignments, chairing the Agriculture and Rural Development Sector Board as well as the Environment Sector Board, leading the Agriculture Unit in China and the Agriculture and Rural Development Unit of the Europe and Central Asia Region.

PARTNER UPDATE / KPMG

Managing Change through High Quality Data: The 2017 Change Readiness Index BY MARTIN CHRISNEY AND JEREMIAH MAGPILE

o country is immune to change. Whether the ‘change’ in question is a natural disaster, financial crisis, or an economic opportunity brought about by new technology, how a country’s government, private enterprise and civil society prepares for and reacts to that change has a significant impact on the welfare of its citizens and institutions. Take urbanization as an example. Today over half of the global population lives in cities, creating unprecedented demands on energy, food security, and human development. Conversely, urbanization also drives innovation, economic growth, and social inclusiveness, particularly when supported by coordinated policy and strategic investments. As the urban population doubles by 2050 mostly in developing countries, it is imperative to use all tools at our disposal to transform this change into positive social and economic impact. The pace of change is accelerating beyond cities. Two years ago, 193 countries pledged to eliminate poverty and hunger, and to fight climate change through the Sustainable Development Goals (SDGs). These 17 targets have the potential to deliver unprecedented economic and social dividends for citizens in both the developed and developing world. But how well these targets are implemented depends on a country’s ability to identify and prepare for the required change to make them a reality. Access to high-quality data is a key step for stakeholders in the public, private and civil society sectors to prioritize development initiatives and investments needed to meet 92

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the changes required by the SDGs while navigating fiscal constraints.

of target countries and providing a better understanding of risk;

ANTICIPATING CHANGE

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Since 2012 KPMG have published the Change Readiness Index, a datadriven tool designed to measure how effectively a country’s institutions— government, private sector, and people and civil society—manage and respond to this challenge. Using a combination of primary and secondary data, the CRI paints a comprehensive picture of change readiness in 136 countries which are home to 97 percent of the World’s population. A wide range of public and private organizations can benefit from the data and insights provided by the CRI to better understand country needs and tailor interventions to identified demands. For example, the CRI can be used to: ■ Improve government policy by benchmarking a country’s competitive advantages and identifying areas in need of reform;

Inform investment decisions by highlighting the strengths and weaknesses

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Identify opportunities for public and private sector partnerships by highlighting relative strengths and weaknesses in capabilities and resources; and Benchmark national strengths and weaknesses to other markets in the region and beyond, gauging performance across business issues such as technology adoption, macroeconomic framework, and business environment.

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KEY TAKEAWAYS Wealth and change readiness are related, with important variations. The 2017 CRI indicates that countries dependent on natural resources and export incomes tend to have institutional capability which lags behind expectations given their income level. Heavy reliance on natural resources is one factor associated with poor performance. Seven of the fifteen biggest ‘underperformers’ relative to their GDP per capita were oil rich nations. Nevertheless, resource rich countries (such as United Arab Emirates and Norway) can achieve high change

No country is immune to change. Whether the ‘change’ in question is a natural disaster, financial crisis, or an economic opportunity brought about by new technology, how a country’s government, private enterprise and civil society prepares for and reacts to that change has a significant impact on the welfare of its citizens and institutions.

PARTNER UPDATE / KPMG

readiness, often with an especially strong performance in government capability. Amongst those which exceed expectations relative to their income level, there are both low and high income countries. These countries have done better than their income-level peers in achieving robust governance, a strong social foundation, and a positive business environment. For example, Rwanda was one of the strongest performers relative to its GDP per capita, rising from 69th to 46th place in the CRI between 2015 and 2017, and in 2017 outperforming many countries with higher income levels. This reflects Rwanda’s continuing strong performance in the government capability pillar, where it ranked 21st, and in particular the areas of security, fiscal and budgeting, regulation and enterprise sustainability. Inclusive growth means better change readiness. Countries with higher scores for more inclusive economies tend to perform better in the Index overall. Conversely, high levels of income inequality tend to be associated with low change readiness. The top 10 countries ranked highest for inclusive growth are all in the top 50 of the Index. Policies promoting inclusive growth may provide a more robust basis for societies to adapt to changes and weather shocks, than highly unequal societies.

Alignment with the Sustainable Development Goals. CRI sub indicators can inform analysis of the SDGs in areas such as to promote inclusive and sustainable growth, employment, and decent work for all; build resilient infrastructure, industrialization and innovation; and to reduce inequality within and among countries. The CRI provides a tool for stakeholders interested in mapping country capabilities to these key SDGs.

Over the next several months, KPMG will publish analytical pieces applying the CRI to the interconnected challenges and opportunities facing 136 countries today, including those posed by the SDGs. We believe that by highlighting the strengths, weaknesses, and progress evident around the world, the CRI can illuminate the opportunities and focus the alliances, collaboration, and dialogue to tackle issues like urbanization, climate change, and natural disasters, that are already at our doorstep. ■

NEXT STEPS: PARTNERSHIPS TO ACHIEVE THE SDGS An estimated $2.5 trillion in additional financing is needed to implement the SDGs. To achieve the ambitious goals and timeline articulated by the SDGs, it is essential that countries, public and private sector institutions, and citizens access reliable data on factors that determine their ability to drive necessary change. The ability to prioritize interventions and make the case for strategic investments is key to sustaining long term impact. More importantly, effective partnerships are required across sectors—between advanced and emerging nations, and among experienced local and international agencies, innovative corporations, investors, and academic institutions—to develop necessary solutions. Leveraging actionable data such as the CRI can help inform these activities.

Martin Chrisney is the Director of KPMG’s International Development Assistance Services (IDAS) Institute where he coordinates the delivery of strategic and technical work on development topics. Martin has worked extensively with governments, multilateral development banks, bilateral agencies, non-profit organizations, and the private sector during his time with the IADB and the World Bank. Jeremiah Magpile is an Associate at the IDAS Institute where he supports the development of research and knowledge products for KPMG clients and member firms.

SEPTEMBER 2017

PARTNER UPDATE / IFTF

Food Innovation: Recipes for The Next Decade BY SARAH SMITH

ome recipes are passed down from generation to generation, becoming long-standing traditions. Others invite us to explore new regions or inspire us to reinvent our bodies. They even encourage us to reimagine the food spaces in our lives, from kitchens to marketplaces. The Food Futures Lab at Institute for the Future cultivates a community of change-makers who use food as a medium for innovation and who write the recipes for the next decade. We draw connections across their stories to forecast unexpected possibilities and we provide them tools for thinking about the kinds of futures they’re building. Using methodologies developed over nearly 50 years, we challenge assumptions and reveal new opportunities to make a resilient, equitable, and delicious future of food. We’ve identified five Ingredients for Change—capacities, tools, and platforms to reinvent food experiences—that can be combined into new recipes for innovation. Here is a taste of these ingredients, and some signals of where we already see them today, for the Global Action Review. For the full forecasts, see IFTF’s report, “Food Innovation: Recipes for the Next Decade.” Scalable Biodiversity: Toward Robust Ecosystems in the Gut, Factory, and Field Anxiety over the shrinking diversity of plant and animal crops is tempered by the realization of stunning diversity many orders of magnitude smaller, at the microbial level. Microbes have been our allies in food innovation for hundreds of 94

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thousands of years, but our understanding and command of these living ingredients is getting more granular every day. The ultimate promise of biodiversity at any scale is resilience. Embracing biodiversity as an ingredient for innovation builds a strong bridge between profitable businesses and climate resilient, healthy food systems.

The American Gut Project and the Human Food Project combine a vast collection of citizen-donated microbial samples and compare these DNAsequenced populations with samples taken from people living traditional farming or hunting-and-gathering lifestyles from Peru to Namibia.

FORECAST Dynamic Personalization The premise that one healthy diet will work for everyone is becoming increasingly suspect. Even genetically identical twins respond differently to the same foods and research is revealing the role of the gut microbiome in these variations. With the proliferation of devices and services that will give people the ability to track their own microbiomes over time or at any given moment, the next decade will see a vast expansion of support for making food choices based on personalized, dynamic information.

Cloud Intelligence: Toward Decentralized, Efficient Management of Food Systems Agriculture—and the global food system more broadly—is being reinvented with the help of low-cost, high-tech methods for connecting food, people, tools, and data together in networks across the Internet of Things. Whether enabling precision-based crop management or empowering home cooks to enlist their appliances in food preparation, cloud intelligence will create a food system that is more efficient, more productive, and more responsive to shifting social demands for food.

SIGNALS The Unified Microbiome Initiative aims to span epicenters of research on the microbiome and connect researchers across disciplines. Within a decade, researchers anticipate bridging the divide between correlative and causative insights.

FORECAST Optimized Efficiency In the next decade, our food markets, like our financial markets, will become dominated by automatic transactions, from negotiating large deals between vendors to automating home orders. As we build out the infrastructure to catalog

Microbes have been our allies in food innovation for hundreds of thousands of years, but our understanding and command of these living ingredients is getting more granular every day.

PARTNER UPDATE / IFTF

and manage discrete parts of our food web, it will begin to form interoperable, self-managing systems-of-systems. This will not only reduce inefficiencies but also help automate transactions throughout the system—transforming our approaches to everything from production to home purchasing. SIGNALS Amazon’s Dash Replenishment Service is an application programming interface (API) that manufacturers can build into any appliance or hardware to identify when supplies are low and automatically reorder from Amazon. For instance, Brita is using these APIs to detect when its water filters are expired and then trigger an automatic reorder. Spread is a Japanese food company building an indoor vertical farm with robotic systems to plant, manage, and harvest 30,000 heads of lettuce daily. Spread’s “vegetable factory” will use 98 percent recycled water and no pesticides, reliably produce food in a controlled climate, and through automation deliver locally-grown produce more cheaply. Experimental Biodesign: Toward Reinventing Food Experiences and Food Systems Culinary artists and scientists have always experimented with the tools of their disciplines to develop new foods. Louis Pasteur’s fascination with

fermentation is just one example of humans’ longstanding curiosity about the processes of cooking and preserving food. In recent years, the proliferation of research labs that combine the culinary arts with food science has expanded the scope and pace of food innovation. As synthetic biology evolves, new capacities at the intersection of culinary arts and food science are emerging.

increased foam stability for meringues and other baked goods. Programmable Pasta comes packed flat and pops into form when submerged in water. This project from MIT’s Tangible Media Group would significantly would lower shipping costs by reducing the amount of wasted space in a pasta box. It also creates fun opportunities for more interactive edible experiences.

FORECAST Multidimensional Food Experiences Bio-based experimentation is expanding to include textures, packaging, or even multisensory stimulation. Food designers are using culturing methods to produce animal proteins derived from engineered yeast and creating foods with new textures, functions like elasticity, or the ability to express properties over time. Beyond food, the fashion and materials industries are designing living materials that could enable new functionality for food packaging. These early experiments point to a future in which we’ll harness living organisms for more dynamic food experiences.

Rewritable Narrative: Toward Open Food Stories Food narratives are the stories we tell around food—recounting its history and place within culture, and embodied in its preparation, presentation, and marketing. Narrative has always been an important part of the food experience, shaping its value; and story is clearly a critical tool in selling food products. Increasingly, food purveyors are seeing the experience and narrative of food as core to their offerings—and sometimes the only way to differentiate one food product from another.

SIGNALS Clara Foods is one of several start-ups harnessing yeast to prototype cultured animal proteins. It aims to produce egg whites with a more dynamic set of properties than animal egg whites, such as a more complete protein profile or

FORECAST New Mediums In a future where everything is media— with computing power and Internet connectivity embedded in everything from human bodies to vehicles to the surfaces of our kitchens—we will be able to write and rewrite stories on any surface. People have always used food arrangement and SEPTEMBER 2017

PARTNER UPDATE / IFTF

ambience to tell stories. But with the advent of augmented reality and other communications technology, we’ll be able to change the aesthetics of food and the environment with much less effort. When manipulating the sensory environment becomes as easy as downloading an app, we’ll see many more people rewriting the narratives of food in this way. SIGNALS Marriott Hotels’ VRoom Service is a virtual reality experience allowing users to travel around the world through a headmounted display. The first destinations include an ice cream shop in Rwanda and a street market in Beijing. This kind of multisensory technology can make food narratives available to many more people. A study from Cornell University’s Department of Applied Economics reports children chose an apple with a sticker of the cartoon character Elmo on it over a cookie. This further reveals how food aesthetics can be used to nudge people toward particular choices and how new mediums for food narratives can encourage healthy choices or reinforce identities or ethics. Engaged Eaters: Toward Eater-Led Reinvention of The Food System Who is food innovation for, if not the eater? Providing food to satisfy a basic 96

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need of billions of people is the whole point of our global system of agricultural production, manufacturing, distribution, and shopping. Today, many eaters feel disconnected from how food is made, and efforts led by food companies and governments only incrementally changed ingredients or packaging. Eaters have lost trust in food companies and are once again going DIY to create a food system rooted in values of sustainability, health, sociality, and pleasure. FORECAST Participatory Production Eaters around the world are taking a more active role in producing and processing their food. This starts with kids who gain food literacy through edible education curricula, and learn to see themselves as more than just consumers. Traditional practices like small-scale farming and fermentation become easier and more precise thanks to sensors and automation technologies. As eaters produce foods they like, they’ll take new products to market, just as many of today’s successful craft beers started as home brewing projects. SIGNALS Acetaia San Giacomo, a traditional balsamic vinegar producer in Italy, worked with the local Fab Lab to

produce a kit that people can use to make vinegar at home. Blending tradition with food innovation, the kit features a 3D-printed, Arduino-powered pH sensor and aerator plus starter bacteria from the acetaia’s barrels. Leaf, an automated at-home medicinal cannabis growing system, continuously monitors the growing environment and makes adjustments to optimize plant health. With its nutrient dosing system and custom LED growlight, Leaf could provide a model for similar systems to grow produce at home. ■

Sarah Smith is a research director at Institute for the Future’s Food Futures Lab. She works with many of the world’s largest food, health, and CPG companies to challenge their assumptions and identify emerging trends and discontinuities that will transform the global marketplace and global food system. She is a frequent public speaker to audiences around the world, facilitates food innovation workshops, and equips a vast network of global food changemakers with the foresight necessary to start making better futures today. Copyright © 2017 Institute for the Future (IFTF) for Global Action Platform. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0).

PATH EX, Inc. SUMMARY Y PATH EX PATH EX has developed a proprietary technology to selectively capture bacteria and released toxins from blood for the diagnosis and treatment of systemic infections and sepsis. The broad-spectrum activity of the PATH EX technology enables rapid capture of bacteria and endotoxin from blood, regardless of bacteria type or drug resistance. This allows for subsequent bacterial collection, identification, and treatment through blood cleansing. PATH EX overcomes the inherent limitations of bacterial culture times and ineffective antibiotics. ] SEPSIS → ORGAN FAILURE → DEATH The presence of bacteria in the bloodstream can lead to sepsis. Sepsis – a life threatening organ dysfunction caused by infection – is a condition in which the risk of death is extremely high. In the US, 650,000 septic patients are admitted to the ICU annually and 250,000 die. The cost of sepsis on the healthcare system is $24B per year. For every hour that sepsis is ineffectively treated, patient risk of death increases by 7.6%. X PATH EX : BACTERIAL IDENTIFICATION AND SEPSIS THERAPY The propriety PATH EX technology uses inertial forces to selectively separate pathogens from all human blood components, enabling the analysis of pathogens at utmost sensitivity and accuracy. PATH EX collects and prepares the intact pathogens for subsequent detection in less than 1 hour, significantly decreasing the time and cost of sample preparation. The PATH EX technology is also used to reduce elevated bacteria and endotoxin levels in blood, treating the root cause of sepsis and inhibiting sepsis progression. Our platform removes infectious agents from circulating blood with >99% efficiency, allowing uninfected blood to move into the patient using a methodology comparable to hemodialysis. E PATH EX COMPETITIVE ADVANTAGE Currently, the time to prepare a blood sample for pathogen identification can take 3-5 days and our only course of treatment is antibiotics. Implementing PATH EX into the pathogen identification protocol would significantly reduce bacteria identification time and decrease costs. As a sepsis treatment option, PATH EX could reduce the average septic patient length of stay and reduce the need for antibiotics. PATH EX is a plug-and-play, disposable technology designed to work with existing hospital equipment.

SEPTEMBER 2017

PARTNER UPDATE / ONCONETICS

Personalized Therapies: A New Era in Health

BY LUKE GRUENERT AND GABE HITCHCOCK

t began in the early 20th century as a product of the industrial revolution: our world became increasingly personalized. With an abundance of resource at our fingertips, we created new technologies that made possible many of the things we take for granted today. The television created a personalized entertainment experience, allowing anyone to view full-length productions from the comfort of their home. The car personalized transportation so much so that every house has its own driveway— the modern-day equivalent to a personal train stop. More recently, visionaries like Bill Gates and Steve Jobs personalized technology and information, such that they now are staples of modern society. Personalized technologies have become the pinnacles of their respective fields not only because they are more effective, but because people want them. This creates significant opportunities for socially oriented companies to develop consumercentric, personalized technologies. The immense successes of companies like Microsoft, IBM, Apple, and Google stem directly from their incredibly powerful vision of personalizing modern technology (hence the name “PC”, or “personal computer”). As a result, we now live in a world of increasing personalization. Yet, even as science and information technology races forward, there is one industry that is yet to deliver a personalized experience: health. The disparity between medicine and technology is due to the simple fact that medicine takes time. For new drugs to be made available to the public they

GLOBAL ACTION REPORT

must first pass through rigorous quality control protocols. The development of new therapies, many of which promise lifesaving results, is stymied by the pace and expense of R&D to gain regulatory approval. Up until the latter half of the 20th Century, therapeutic agents were created serendipitously. Samples were often identified based on how different traditional therapies treated symptoms. From there, the standard model involved the isolation and subsequent extraction of the active compounds. The compounds would be analyzed for their therapeutic efficacy and select chemicals would be put into clinical trials. This was a product of the still-relevant paradigm of symptombased treatment, where the efficacy of the drug is determined by its ability to treat symptoms, not the disease itself. The promise for a new therapeutic approach came with the advent of gene therapy in the 1990s. These gene therapies, rather than treating symptoms, treated diseases at their genetic core through the manipulation of an individual’s genetic profile. Unfortunately, early gene therapies fell into disrepute after severe immunological responses led to patient death and the caseation of clinical trials. However, many current treatments being investigated by Big Pharma pose similar risks for the patient. Cancer is perhaps the best example of this as, no matter the

source of the disease, the treatment is always some variation of “kill everything.” As a result, many chemotherapies are used for multiple indications, despite the intrinsic genetic differences between cancer types. Chemotherapy is effectively blasting a patient’s system with chemicals that kill everything they touch without discriminating between healthy and diseased cells. The side effects of early gene therapy and present day chemotherapy have a common source: a lack of specificity. These therapies do not distinguish appropriately between healthy cells and diseased cells, therefore wreaking havoc upon the patient’s body during each course. In recent years, attempts have been made to address the problems with chemotherapies, namely within the fields of precision medicine and immunotherapy. It’s clear that cancer is, at its root, a genetic disorder. The problem is pinpointing the exact genetic differences between each patient and each cancer, and using that information in a therapeutically meaningful way. Precision medicine attempts to do this with big data, but falls short as it remains merely a simple optimization of existing therapies and does nothing to mitigate their side effects. In order to combat these persistent problems, immunotherapies were developed. Immunotherapies are founded on the idea that the body’s own immune

The immense successes of companies like Microsoft, IBM, Apple, and Google stem directly from their incredibly powerful vision of personalizing modern technology.

PARTNER UPDATE / ONCONETICS

system can be harnessed to therapeutic effect. By catalyzing an immune response selective to cancer cells, immunotherapy provides a greater level of specificity than does chemotherapy. However, while immunotherapy holds much promise in theory, in practice it has achieved only limited success. Out of the billions of immunogenic cells catalyzed to attack cancer cells, some invariably attack healthy tissue, resulting in unintended consequences and unforeseen side effects—many of which are as bad as chemotherapies. Fortunately, the scientific community has continued to explore and refine gene therapy-based treatments for cancer. Dr. Dieter Gruenert, a preeminent gene therapy researcher working at UCSF and a former panelist at Global Action Summit, is one such scientist. Together with his son, Luke Gruenert, Dr. Gruenert worked diligently to tackle the problems described above. Both father and son recognized the shortcomings of chemotherapy, immunotherapy and precision medicine alike. The Gruenert lab sought to create a new kind of therapy, one that addressed the genetic basis of cancer and, in so doing, created better patient outcomes and improved quality of life. After several years of research, and building upon the collective work of a multitude of researchers, the Gruenerts generated a powerful gene therapy reporter system. The new technique achieved an

The promise for a new therapeutic approach came with the advent of gene therapy in the 1990s. These gene therapies, rather than treating symptoms, treated diseases at their genetic core through the manipulation of an individual’s genetic profile. Unfortunately, early gene therapies fell into disrepute after severe immunological responses led to patient death and the caseation of clinical trials.

unprecedented degree of specificity, being capable of selectively activating in a celltype based entirely on its genetic profile. By nature, the technique is highly versatile, as it can be applied to the entire spectrum of biological cell-types. At the heart of their success was a biological tool—non-coding RNA—that remained elusive and undefined until the early 21st century. By leveraging the variable expression of these endogenous RNA, the Gruenerts devised a system for selective expression of a therapeutic protein. The simplistic yet highly customizable nature of the approach allows for therapies that can be generated quickly and seamlessly, thereby leading us into an era of truly personalized health.

Dr. Gruenert was thrilled by their accomplishments and frequently expressed his desire to push the new therapeutic paradigm forward. However, Dr. Gruenert passed away suddenly in the fall of 2016, leaving the preclinical studies of the therapy uncompleted. Today, his vision of accessible, personalized gene therapies for cancer is embodied by the work of Onconetics Pharmaceuticals, inc. Founded in Dr. Gruenert’s honor by his son, Luke, and colleagues Gabe Hitchcock and Geoff Sargent, Ph.D., Onconetics seeks to carry the work forward so that its tremendous potential can be unlocked for the benefit of cancer patients the world over. The immense therapeutic potential of Onconetics’ approach has rallied an exceptional team of scientific and healthcare professionals, from biotech CEOs to members of the National Academy of Sciences. At present, Onconetics is raising funds to fully transition from UCSF into independent lab space and finish the remaining preclinical studies. Onconetics is excited to announce its partnership with the Global Action Platform. We are thrilled to be working with GAP to drive the personalization of health and accelerate the development of this powerful tool into the clinic. Through our collective efforts, Onconetics’ will improve the lives of millions and usher in a new era of personalized medicine. ■ SEPTEMBER 2017

PARTNER UPDATE / LODESTONE ADVISORY GROUP

A Global Innovation Hub in Nashville

BY AMR EL-HUSSEINI, SCOTT T. MASSEY AND ILANA KAMBER

y generating social, economic, and environmental value, innovation serves as the impetus for a new economic model that impacts both the needs of daily life and societal issues at large. It is conducive to and necessary for sustainable growth, economic competitiveness, and job creation. The current trend in maximizing potential for innovation impact is the creation of global innovation hubs that work to foster collaboration and expand a community’s connectivity to the rest of the world. Innovation is becoming critical to a community’s economic resilience, or its ability to adapt to global trends and disruptions. In an age where technological advancements are so rapid, this necessity is even more pronounced. Nashville is one city with the potential to emerge as a global leader in innovation. Such a transformative undertaking would require increased collaboration, a broader worldview, and the cultivation of an environment conducive to entrepreneurship. Ecosystem Fundamentals A productive innovation ecosystem is dependent upon its constituents working collaboratively to identify synergies, generate original ideas, and solve global problems. The following section describes the main constituents of such an ecosystem and their responsibilities:

Education Organizations in today’s world are expected to foster an entrepreneurial culture and maintain a system that aligns incentives with required

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outcomes, such as commercialization of research. Universities should encourage such members of its community to escape their research and publishing traps and connect with industry to cultivate entrepreneurial potential. ■ Professional Services: Support services such as management consulting, investment banking, legal, accounting and tax advisory firms, and others must be local, available, and well integrated within the system. ■ Large Corporations are often highly regimented and as a result can become hyper-focused on operational efficiency and incremental improvements. In such instances, large corporations miss the key strategic imperative of focusing on planning for the future as opposed to improving the past. Large corporations are best positioned to enact policies and procedures to encourage their contractors, advisors and professional services suppliers who operate outside their region to have a local presence. ■ Government Entities have been playing an increasing role in the creation, development, and promotion of environments conducive to innovation. ■ Investors must ensure the accessibility of capital to those entrepreneurs with the best ideas and the highest potential. Because entrepreneurs prefer to be located around capital and vice versa, it is also

imperative that investors be located within an ecosystem as opposed to remotely. ■ Entrepreneurs are attracted to a functioning ecosystem that fills their needs and inspires their creativity. This ranges from access to capital and mentorship, to the rest of the support system that is conducive to innovation. These structures may initially assume the form of entrepreneurial competitions, entrepreneurship centers, accelerator programs, formal mentorship programs, or university-business-sponsored spaces. ■ Adapting to Global Trends: Current trends in innovation are dictated largely by the continued revolutionizing of technology and communication, which is breaking down land borders and making the world ever-decreasing in size. As this occurs, access to knowledge about international markets gains importance and priority. ■ Characteristics: cities are becoming the right venue in terms of size for innovative transformation. It would be difficult for an ecosystem on a smaller scale to develop a truly global outlook or to gain sufficient traction to operate on a global stage. In contrast, a country-wide ecosystem would over-complicate and create issues in terms of organization, efficiency, and impact, thus, the emergence of city-level hubs emphasizing innovation, collaboration, and global outlook.

Nashville is one city with the potential to emerge as a global leader in innovation. Such a transformative undertaking would require increased collaboration, a broader worldview, and the cultivation of an environment conducive to entrepreneurship.

PARTNER UPDATE / LODESTONE ADVISORY GROUP

What Distinguishes a Successful Hub Global Innovation Hubs come to exist deliberately, not coincidentally. While hundreds have emerged in recent years, the most successful have been built by measured, well-thought out efforts. An examination of “The Cortex Innovation Community” in St. Louis, Missouri provides a pertinent example. In 2002, the Cortex Innovation Community, formed by a coalition of top universities, a leading healthcare provider, and the Missouri Botanical Garden, recognized that their city had a significant innovation gap caused by the functioning of constituents from individual ecosystems operating in isolation from one another. The coalition sought to eliminate this gap. In its first fourteen years, Cortex was transformed from an idea into a 200-acre hub in downtown St. Louis that has generated 3,800 techrelated jobs, $500 million in investment, has become home to over 200 companies, and continues to grow today. The efforts of the Cortex Innovation Community have been successful in recreating St. Louis’s economy for several reasons: Location: St. Louis is a medium-sized city with a strategic location and a dynamic international airport that gives it access to both national and international markets. It is also home to several top universities with significant R&D and research capabilities. ■ Government Involvement: St. Louis’s government gave Cortex Innovation Community 501(c)3 designation, which allowed the tax-exempt entity to work with local and state officials to oversee the design and development of the innovation district. The St. Louis government also made remarkable efforts to brand St. Louis as a center for innovation and advocated for a national and global recognition of its city as such. ■ Global Outlook and Diversity: Through the development of inclusion initiatives and the creation of a space that embraces this diversity of knowledge, Cortex has fostered the most diverse employment environment in the region in terms of age, ethnicity, and educational attainment. ■ Deliberate and Well-Planned: Initially, the Cortex Innovation Community recognized the need to generate entrepreneurial density. It planned the development of innovation centers like ■

the Center for Emerging Technologies, TechShop, and the BioGenerator to facilitate collaboration between academia and industry and in turn to create a general culture of entrepreneurship. Global innovation hubs like The Cortex Innovation Community have been emulated in cities across the world as they prove to be effective in overcoming sustainability and disruption challenges. A Global Innovation Hub in Nashville Is a Necessity and an Opportunity Generating more than 500,000 jobs and $84 billion in revenue, Nashville healthcare companies have turned the city into the healthcare capital of the United States. With that said, if Nashville is to become a global leader in innovation, it must at the least begin by leveraging its depth in this industry while pushing to realize its innovation potential in others. Because healthcare is one of the main industries in which disruptions caused by rapid technological advancement are looming and most apparent, Nashville’s need to leverage its depth here is all the more pronounced. Given the industry’s historical focus on management, it was quite possible for a corporation to succeed with only a local agenda and a focus on building a portfolio of regional hospitals, for example. However, the increasing expansion of products and services like telemedicine, preventive medicine, robotics, and mobile diagnostic capabilities reveal the changes the industry is going through and the growing importance of Health Information Technology (“HIT”). Many innovations in this field reduce the amount of time and money spent in hospitals and doctors’ offices. With a massive number of start-ups emerging to address such changes, the global nature of the transformation in the healthcare industry forces existing players to innovate and become more global. Few of Nashville’s 300+ health-related enterprises have a significant reach beyond the US or a particular focus on innovation. However, Nashville has the potential to take active steps to remain at the forefront of American healthcare and craft the rapidly changing future of this industry. Many of the inherent characteristics that have facilitated the success of the Cortex Innovation Community in St. Louis are present in Nashville as well. Both are medium-sized cities with premier research

centers and universities, and talented, diverse workforces. One can argue that Nashville’s advantages extend even beyond these similarities. The city has proven its resilience through its ability to recreate itself from a financial services and publishing hub, into the healthcare giant it is today. Furthermore, Nashville sits at the geographic center of potentially the largest pool of talent in the continental US between Chicago and Atlanta on a north-south axis, and between Washington, DC and Denver on an east-west one. In addition to its central location, Nashville offers the strongest concentration of university assets, fastest population growth of young creatives, and the type of urban energy that puts the city in a class of its own. This natural framework that gives Nashville its potential to become a leading center for innovation. Ongoing Transformation Efforts Lodestone Advisory Group and Global Action Platform are working together to leverage a wealth of global experience and knowledge to transform Nashville into a truly global innovation hub. A successful innovation hub in Nashville would have a physical presence and would focus on the following: Fostering university-corporate partnerships that will lead to more commercialization of research. ■ Fostering collaboration among large corporations and small firms, providing small firms with access to global resources and large firms with long-term value creation opportunities. ■ Building capital markets and professional services support ecosystems locally. ■ Promoting Nashville as a truly global magnet for top talent and innovation. ■

If such efforts materialize simultaneously and under one umbrella, this transformation will have an even greater chance of success. ■

Amr El-Husseini is the founder and CEO of Lodestone Advisory Group, a boutique investment advisory and management consulting firm focusing on global innovation. Scott T. Massey is Chairman and CEO, Global Action Platform. Ilana Kamber is an intern at Lodestone Advisory Group and a student of economics and history at Yale University.

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PARTNER UPDATE / GPSS

Creating A Scalable, Sustainable, Shared Value Model of Rural Development BY BRYAN THOMAS

he grand challenges facing the world today are systemic, rooted in complex interconnections among historical, cultural, social, political, and environmental factors, as well as geographic, educational and economic conditions. To create an effective Model of Change, hence requires systems analytics and systems responses that address the complex conditions of communities and the environmental and economic issues that contribute to poverty, insurgency, hunger, sickness, and the destruction of the environment. Using a systems approach, effective strategies can be identified, interconnected, and incorporated into the framework of comprehensive development. Such comprehensive development solutions address root causes, involve the community as a fundamental strategy, and are planned and executed with a collective impact approach. A Public-Private Community Collective Impact Initiative for the Indigenous People of the Philippines This report outlines the situations and solutions, as well as the vision, mission, programs and benefits for creating a public sector collective impact platform among key government agencies to work with the Global Partnership for Sustainable Solutions / Global Action Platform and the Indigenous Peopleâ&#x20AC;&#x2122;s Economic Union to accelerate the implementation of private sector economic and social development, starting with 1.2 million acres of tribal land in the Caraga region of Mindanao.

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The uniqueness of this initiative is that it connects the worldâ&#x20AC;&#x2122;s leading companies, investors, foundations and non-profit organizations with an organized union of land owning indigenous peoples for unprecedented scalable solutions. To ensure greater security for investors and to safeguard sustainability and ecology, we have worked to also gather together vital Philippine government agencies into this initiative and formalized a Memorandum of Agreement to collaborate knowledge and resources for the comprehensive development of the Caraga Region. This is a groundbreaking element of the development plan and a first in the history of the Philippines, which can serve as a model for other countries in the future. Vision. To create a shared value economy for sustainable and comprehensive social and environmental development of the Caraga Region of the Philippines, ultimately extending to all Mindanao that is, to create a peaceful, productive, and prosperous Mindanao. Mission. The mission of Caraga Convergence Initiative is two-pronged: First, to create a public sector collective impact platform to enable core related governmental agencies to collaborate with each other in specific ways; Second, to use this public collective impact platform to work with GPSS, LLC, a global private development partnership, and the IPEU, a collective of CADTs in Caraga to implement comprehensive development strategies and projects aligned with the above vision.

PARTNER UPDATE / GPSS

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Strategy. Collective Impact is the convergence and commitment of a group of important actors from different sectors to a common agenda for solving specific social, educational, agricultural, economic, healthcare, and environmental problems at scale. Collective Impact teams require a mindset and recognition that success comes from the combination of many strategic interventions, planned in a structured timeline, and often executed simultaneously. Large-scale complex social, economic, and environmental change depends on increasing cross-sector alignment among many organizations, including government, nonprofit, and corporate sectors in essential partnership for learning, planning, and implementation of comprehensive models of development for effective change and future building. The Caraga Convergence Initiative has begun with the development of an innovative public sector collective impact platform consisting of 11 primary government agencies, with the coordination of another 11 secondary government agencies. The primary agencies that have formed the MOA with GPSS / GAP / IPEU are: Department of Environment and Natural Resources (DENR) ■ Department of Agriculture (DA) ■ Agricultural Training Institute (ATI) ■ Philippine Rural Development Project (PRDP) ■ Philippine Bureau of Fisheries and Aquaculture Resources (BIFAR) ■ Philippine Fiber Industry Development Authority (PhilFIDA) ■ Philippine Department of Trade and Industry (DTI) ■ National Counsel on Indigenous Peoples (NCIP) ■ National Economic Development Authority (NEDA) ■ National Convergence Initiative (NCI) ■ Cabinet Secretary (CABSEC) ■

In the formation of this Caraga Convergence Team, we have established five essentials for the success of this innovative integrated interagency initiative:

The uniqueness of this initiative is that it connects the world’s leading companies, investors, foundations and non-profit organizations with an organized union of land owning indigenous peoples for unprecedented scalable solutions.

will be measured and reported, with a short list of common indicators identified and used for learning and improvement. Mutually Integrated Activities. A diverse set of stakeholders, typically across sectors, coordinate a set of differentiated activities through a mutually integrated plan of action. Continuous Communication. All players engage in frequent and structured open communication to build trust, assure mutual objectives, create common motivation and collaboration, and provide consistent evaluation of progress. Consistent Support. A committed, funded staff dedicated to the initiative provides ongoing support by guiding the initiative’s vision and strategy, supporting aligned activities, establishing shared measurement practices, building public will, advancing policy, and mobilizing resources. Identification of The Present Problems In Indigenous Caraga Communities At times, the conditions and needs of a community may seem so monumental that the masses lose hope for change and are not even sure where to begin in designing and developing a model for abundant food, health, and prosperity. The situation in the indigenous areas of Caraga is staggering and the stage is set for our comprehensive development plan, that when seen to be successful here, with so much to overcome, could surely be implemented in other severely depressed areas in our community of humanity. The basic condition of the Caraga indigenous areas includes the following challenges: Widespread poverty Pervasive hunger and malnutrition ■ Near zero food self-sufficiency or food security ■ Lack of agricultural knowledge, except for upland rice and kamote (cassava) ■ Great lack of farm to market roads and infrastructure ■ Lack of schools and education for ■

Common Agenda. All participants share a vision for change that includes a common understanding of the problems and a joint approach to solving the problem through agreed-upon actions Shared Measurement. All participating organizations agree on the ways success 104 GLOBAL ACTION REPORT

■

the majority of indigenous children ■ Near zero health care for all indigenous peoples ■ Indigenous Peoples are not included in the nation’s census or statistics ■ Insurgency due to poverty, neglect and exploitation ■ 97% of primary forest has been denuded, destroying the biodiversity and natural watersheds, causing erosion and great environmental damage ■ Continual practice of illegal logging and mining ■ Lack of community water and potable water ■ Lack of electricity and energy ■ Poor relationship between local government units (LGUs) and Certificate of Ancestral Domain Title areas (CADTs) due to neglect and exploitation of the indigenous peoples. Multiple Stakeholder - Joint Venture – Cooperative Business Model Our business development model is based on multiple streams of revenue within a diversified portfolio of projects. We create strategic partnerships with a multi-stakeholder approach that involves the world’s leading socially and environmentally responsible companies, while engaging the UN, World Bank, and major government agencies for further support of these projects as joint ventures with indigenous peoples’ CADT cooperatives. Our business model and main objectives shared by the community start with these 20 elements: Gathering together leaders from key government agencies to create the Caraga Convergence Initiative MOA and gain endorsement from Philippine government leaders. Collecting data from every major government agency in the Philippines, in addition to international sources, to create a land utilization master plan for all 24 indigenous areas that comprise the 1.2 million acres. Launching a Wood Processing Plant to service the Community Based Forest Management (CBFM) with their Planted Species Trees from Caraga CADTs to:

PARTNER UPDATE / GPSS

■ Provide Fair Trade Prices for Indigenous people and free them from the unscrupulous practices of those who have ruled the timber trade. ■ Assist the DENR in stopping illegal logging in the Caraga Region. ■ Assist the DENR and Indigenous Peoples to promote reforestation. Planning and launching massive reforestation throughout the Caraga Region, in coordination with the DENR, to rebuild the forests, repair the ecological damage, and restore the biodiversity in every CADT. Registration of all indigenous peoples of Caraga as citizens of the Philippines, included in the census, with birth certificates, addresses, and voting rights.

Founding of an Agriculture – Aquaculture – Agroforestry Training Program for the Indigenous Peoples of Caraga. Establishment of demonstration farms and family food self sufficiency and agricultural training in every CADT of Caraga to empower every indigenous family to plant and sustain their food sufficiency and security garden, and thus eradicate hunger and malnutrition in every CADT. Designing integrated small scale and large-scale agricultural projects for each CADT; finding investors and corporate joint venture partners; forming the CADTs into cooperatives; and continuing to implement scalable, sustainable agricultural projects. Utilizing data from the Caraga CADT Comprehensive Development Plan will enable us to allocate specific sections of CADT land for particular crops, creating sustainable

livelihoods with disposal income for Indigenous small farmers and small businesses. Designing sustainable solutions, meeting the needs of the present, without compromising the ability of future generations to meet their own needs - finalize the Caraga CADT Comprehensive Development Plan, and integrate it into every major government agency, while GPSS and IPEU serve together with these agencies to launch it in multiple sectors with multiple stakeholders. Developing fishery and aquatic projects for CADTs where it’s ideal for their comprehensive land management plan. Partnering with Brisa International for energy, water supply, wastewater treatment, and community development. Creating financial trusts for every CADT. As revenue fills the CADT trusts, the Tribal Counsel of Elders, along with their communities, decide how to create annual CADT budgets, with accountability, to build schools, health care centers, economic projects, water and energy projects, and infrastructure for their CADTs. Seeking outside assistance from government agencies and foundations for the education, environment, health care, and other vital needs of the indigenous peoples in every CADT, while also continuing promotion of the CCI at the UN, World Bank, and Global Action Summit. Prioritizing scalability, beginning with smaller projects in every CADT, with the continual expansion for them to utilize all of their land in large scale projects

that also regenerate the biodiversity of their lands. Focusing on the entire value chain for far too long, there has been a system of exporting raw materials from the Philippines to be manufactured abroad. In The Caraga Development Model, we are focusing on the entire value chain, including post-harvest processing, manufacturing, and even renewable energy from waste. Implementing a multi-stakeholder collective impact approach involving responsible companies, investors, government agencies, NGO’s, and the indigenous communities of Caraga. Focusing on Shared Value as our management strategy, creating measurable business value by identifying and addressing social problems that intersect with the Caraga business sectors and projects. Blending of financial, social, and environmental capital to fully develop the entire Caraga Region. Centering on Abundance - Our approach must be guided by a vision of abundance, where we see abundance as the outcome of balance among human and natural systems. Hence, we aim to help the indigenous people of the Caraga Region to select projects and corporate partners able to produce a balanced approach to abundance through a sustainable, scalable, shared value development. Continuing to develop and assess the comprehensive development plans for every CADT and to empower the indigenous leaders and communities to gradually take over the responsibility for all of this. The Caraga Challenge is a once in a century opportunity, and it is a microcosm of what is needed and what can be done in every region of the world where poverty is one of the few commodities that is sustainable. ■

Bryan Thomas is a multilingual, multicultural CEO and Managing Partner of Global Partnership For Sustainable Solutions. He’s led successful start-up organizations in four countries, and provided effective organization development consulting on four continents. Bryan has spent three decades developing indigenous leaders and projects throughout the Philippines and former Soviet Union. He has BS degrees in Linguistics, Cultural Anthropology and Education, and MA in Sociology focused on Leadership & Organization Development. Bryan is also a writer and has taught and challenged over a million people in 25 countries through his public speaking.

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PARTNER UPDATE / DIPLOMATIC COURIER

How Shared Value Is Changing Capitalism’s Relationship to Society BY ANA C. ROLD

y now you have probably heard more than once the dark conclusion of a 2014 study from the Olin School of Business at Washington University: “In the next 10 years, 40% of the Fortune 500 companies will be gone.” And by now, it is hardly news that most industries are undergoing massive disruption—many will not even make it through the decade because of exponential technologies. A company’s competitors are no longer just other companies who produce similar products or services; a company is now competing with everyone. Just look at Amazon’s latest Whole Foods acquisition for a clear sign of the times. And then, there’s another parallel movement that is reinforcing the decline of the company as we’ve known it. The entire capitalist system itself is under major rejection—if populist movements everywhere in the world are any indication. Consumers think of companies as blood-sucking fiends in pursuit of profit. Corporate social responsibility (CSR), once the answer to keeping the community happy, is often perceived as inauthentic and ineffectual. Consumers are savvy and they want to purchase from brands that share their values. Enter Shared Value, initially explored in a December 2006 Harvard Business Review article by Michael E. Porter and Mark R. Kramer. The publication of the article was the beginning of a movement, which some experts saw as disruption to the old model of CSR. The gist of it was: “Companies could bring business and 106 GLOBAL ACTION REPORT

society back together if they redefined their purpose as creating ‘shared value’ —generating economic value in a way that also produces value for society by addressing its challenges. A shared value approach reconnects company success with social progress.” But we shouldn’t be too quick to discount CSR. While CSR has been around for centuries—first being mentioned in the early 1900’s and entering mainstream media in its current form later in the decade—the concepts behind CSR and shared value have often been viewed as two separate parts of a whole. The thought process between these two practices, however, is strikingly similar— while CSR is more activism-driven and shared value more focused on social change through market mechanisms, both are geared towards creating social good for employees, community, and humanity as a whole. What if, then, corporate social responsibility and shared value were not two separate parts of a whole, but two points on the same evolutionary line focused on creating a more meaningful connection between business and social good?

The Customer of the Future A report by Cone Communications shows that 91% of consumers expect companies to not only operate responsibly, but to also address social and environmental issues in today’s world—and with our current market system geared toward consumer satisfaction, consumers possess enough power to see that these changes happen. In fact, according to Cone, 84% of consumer surveyed say they seek out responsible products whenever possible, and an astounding 90% say they would boycott a company if they learned of irresponsible or deceptive business practices. Websites such as Ethical Consumer, for example, demonstrate that issues such as animal and human rights, environmental degradation, political issues and irresponsible marketing are often the main causes of large consumer boycotts, demonstrating that social and environmental issues are always at the forefront of consumer buying power and behavior. Corporate social responsibility is not just an option —it is a requirement for survival in today’s consumer-driven market.

Rather than focusing on preventing negative social and environmental impact in the products they create, through shared value, corporations can reinvent their products and its markets in a way that not only improves society and the environment, but improves their own business as well.

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Traditionally, corporate social responsibility has often been linked to more conventional forms of social responsibility such as employee volunteerism, environmentally sustainable business practices, and charities. But what if there was a way in which both corporations and their communities could mutually benefit from corporate social responsibility? Shared value takes CSR one step further by incorporating mechanisms designed to address social change directly into the core business model and production of goods and services. Rather than simply tackling social issues separately, shared value aims to change capitalism’s relationship to society in a mutually beneficial way. It is becoming increasingly apparent that the future of corporate social responsibility is in shared value. Rather than focusing on preventing negative social and environmental impact in the products they create, through shared value, corporations can reinvent their products and its markets in a way that not only improves society and the environment, but improves their own business as well. First Book is one such company focused on the social issue of 108 GLOBAL ACTION REPORT

increasing access to books, educational resources and other basic necessities for children in low-income families. Rather than focusing on a donation or charitybased model, however, First Book uses a market-driven approach to create a more sustainable and long-term solution for providing education to children in need. Other already established corporations are increasing their shared value through the reinvention of their products to help people in low-income areas. For example, Adidas has partnered with Grameen Bank to create low-cost footwear for lowincome people in Bangladesh. By creating shoes that are affordable, the people of Bangladesh can now have better protection against the environment and disease. And yet shared value is not without its criticisms. Critics have argued that if traditional market mechanisms were able to solve the social woes of society, it would have already been done. The current mechanisms behind shared value are often seen as an organizational-level attempt to change a system-level problem. A traditionally market-driven shared value approach may not be enough to solve the many social and environmental woes of our times.

In the end, while corporate social responsibility and shared value have become staple principles in today’s economic market, this pathway towards a more interconnected relationship between business and society needs to evolve beyond its current form. Without market-driven approaches to social and environmental issues, the incentive for sustainable and mutually beneficial solutions will be few and far between; but without more activism-focused volunteerism and business practices on the side of corporations, social issues will never truly be dealt with in a meaningful way. It is this progression of CSR into shared value that shows us that it is possible for business and society to partner in meaningful ways, but it is the future beyond these two ideas that will ultimately change both business and society. ■

Ana C. Rold is the Founder and CEO of Diplomatic Courier, a Global Affairs Media Network. She is also Founder of Medauras Global, Diplomatic Courier’s Publishing Firm. She teaches political science courses at Northeastern University and is the Host of The World in 2050–A Forum About Our Future.

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GLOBAL ACTION PLATFORM

Thought Leadership in Action Our Global Challenge BY SCOTT T. MASSEY

ccording to the most recent estimates, the world’s population will grow to an anticipated 9-10 billion people by 2050. At the same time, the world’s population is migrating into cities, with current estimates projecting 60% of the population living in urban areas. The intersection of these two trends will result the highest percentage of human beings living in cities in human history. To put this growth in perspective, it is estimated that to provide the necessary built environment for this new urban population will require the equivalent of building a new city for one million people from the ground up every week for the next thirty-five years. The scale and speed of this projected growth will put enormous pressure on both cities and rural areas. Leaders must work energetically to prepare for this tsunami of change. To prepare, the world needs new, scalable urban and rural models that can accommodate the projected population shifts, and to leverage the change to usher in a new era of sustainable abundance.

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GLOBAL ACTION PLATFORM Global Action Platform is an international university-business alliance based at oneC1TY to advance scalable, sustainable solutions to meet the global challenges of a world of ten billion. Our focus is on solutions for abundant food, health, and prosperity. Food and agriculture link us to the natural world; nutritious food multiplies into health; and health multiplies into prosperity. Food, health, and prosperity, in short, link and create exponential effects. The importance of these three areas is validated by the Sustainable Development Goals just announced at the United Nations, which target food, health, and prosperity as the top three global priorities. Scalable, sustainable solutions in food, health, and prosperity are essential to meet the needs of the megacities and agricultural regions of the future. THOUGHT LEADERSHIP AND INVESTMENTS To advance solutions in these areas, Global Action Platform has created a collaborative platform to mobilize the world’s foremost experts and executive leaders; target impact investments in innovation and businesses; leverage

technology for collaboration and data analytics; and communicate findings globally. This activity is organized through the core programs of Global Action Platform—Convene, Challenge, Connect, and Communicate. CONVENE—annual Summits and forums to mobilize experts and executive leaders CHALLENGE—impact investment funds to create self-sustaining, transformative solutions for food, health, and economic issues CONNECT—smart technology collaboration groups and tools combined with data analytics COMMUNICATE—global communications through reports, broadcast, and social media URBAN AND RURAL LABORATORIES Global Action Platform uses the activities above to engage the world’s top experts and leaders and then applies these ideas in urban and rural “living laboratories.” Applying the best ideas in rural and urban models creates an ongoing feedback loop to advance real world solutions.

oneC1TY

CARAGA—THE PHILIPPINES

SUMMARY

oneC1TY is a global urban model being developed in Nashville, Tennessee by Cambridge Holdings as a living laboratory for nutrition, mindful healthy living, and shared value enterprise. Global Action Platform serves as the think tank and convener for the project. Located on a twenty-acre campus with a million square feet of office, residential, and retail space, oneC1TY is designed to be more than a mixed use urban development. oneC1TY is a community, a culture, defined by a set of values. The campus in Nashville serves as the prototype for a series of oneC1TY campuses to be developed in other cities around the world, and to serve as a model for how urban centers can accelerate and expand the spread of healthy diets and lifestyles and the growth of shared prosperity to accommodate the megacities of the future.

As the nonprofit founding partner of the Global Partnership for Sustainable Solutions, Global Action Platform is also engaged in creating a comprehensive social-economic-environmental development model for large-scale rural development in the Caraga region of the Philippines. Working directly with the Indigenous People’s Economic Union (IPEU), Global Action Platform and its partners are creating strategic action plans for the development of 1.2M acres of undeveloped land in the tropics. The area is expected to expand from its initial scale to some 5-10M acres, as work gets underway. The Caraga project offers the opportunity to create an approach to rural development at scale and in a way that can be replicated and used to advance the innovative food solutions to feed the world’s growing population.

Global Action Platform works to create a world of abundance for every person. We do this by engaging the world’s top experts and leaders in the ongoing events, investments, collaborations and communications of the Global Action Platform, while applying ideas from these activities into the design and development of rural and urban models, most notably at oneC1TY-Nashville and the Caraga, Philippines. ■ CONTACT US Global Action Platform oneCITY, 8 City Boulevard Suite 402 Nashville CA 37209, USA Tel: +1 (877) 300-5806 Email: info@globalactionplatform.org Web: www.globalactionplatform.org

“Food and agriculture link us to the natural world; nutritious food multiplies into health; and health multiplies into prosperity. Food, health, and prosperity, in short, link and create exponential effects.” SEPTEMBER 2017 111

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