Sugar: the next “tobacco war”?

When you first look at a teaspoon of glistening white sugar granules, you would never think that such a pleasure provider would arguably have the greatest impact on public health, the environment and a variety of other socioeconomic dimensions than any other agricultural commodity.

With its expansion into Europe and North America after the 16th century, sugar was transformed from a luxury product into an everyday use, even by the poor. However, its increased demand and over-consumption today is demonstrating some serious effects upon human health and proving detrimental to the environment.

The sugar industry is highly lucrative for a few whose concentrated power enables control over policy-making, thereby overshadowing the abuses of human rights, health and well-being as well as the erosion and degradation of land, forests, water systems and air quality.

For many countries, sugar is one of the most important sources of national income. It accounts for 70% of Cuba’s exports and 40% of exports from Belize (Fairtrade Association 2013). However, farm-workers and small-holder farmers can often fail to secure a fair return for their work and struggle to provide a decent livelihood for themselves and their families.

Traditionally, the international trade laws that govern sugar imports have made it difficult for smallholders to access the more lucrative markets of Europe and North America. These force them into competition with more powerful, wealthy countries that have greater financial resources to dedicate to sugar production and greater political power to subsidise and promote their sugar industries (Fairtrade Association 2013).

Additionally, small-scale producers have always faced competition for the land on which their livelihoods depend. It is evident, however, that changes in demand for food, energy and natural resources, alongside liberalisation of trade regimes, are making the competition over the means for production, such as land, increasingly global and progressively unequal resulting in the dispossession of land, further poverty and food insecurity, which ultimately leads to malnutrition, hunger, vulnerability to illness, chronic disease and death (O’Kane 2011, Human Rights Watch 2011).

Along with greater demand for production has come a progressively concentrated ownership of land across the world, even within developed countries such as the UK. Here, farm sizes are enlarging but both variety and the number of land owners are shrinking. In places such as India and Rwanda, farmers who once managed their own farms are now having to work as labourers for big corporations, which in many cases exploit them by providing very low wages, little occupational safety and even, in some cases, carry out physical abuse, or encourage child labour.

Such dispossession and abuses of human wellbeing lead to a host of long-lasting effects upon the livelihoods of farm workers such as injury and ill-health, which can in turn result in loss of the ability to continue work. In the case of children working the plantations, they are not only at risk of injuries, stress, exhaustion and abuse, but are also at risk of long-term respiratory disorders from inhaling smoke from cane burning to clear the fields. Contact with pesticides can cause damage to children’s skin and eyes and be detrimental to respiratory function and reproductive health over time (Fairtrade Association 2013). Such disabling health effects render workers unable to earn even the most modest living, plunging them and their families into further poverty and hunger.

Soil, seeds, water, fertiliser, pesticides and labour are all required for the production of a profitable sugar cane crop. However, industrialised sugar crops also have a detrimental impact upon biodiversity and ecosystem (O’Kane 2011, WWF 2013, Nash 1993, Repetto and Baliga 1996, WHO 1990, WHO1992, Gleick 1993).

The WWF reported that 5–6m hectares of cropland is lost annually because of soil erosion and degradation caused by heavy planting of sugar cane, known as mono-cropping. This is where the growing of a single crop occurs year after year on the same land, absent of the rotation of other crops. This affects future yields and the sustainability of sugar cultivation, threatening the livelihoods of farmers and those who work the farms. Soil erosion is another systemic cause of poverty, leading to hunger, poor diets and ultimately poor health.

Malnutrition, which includes inadequate intake of calories, protein, and numerous essential vitamins and minerals, is a major disease related to environmental degradation. It prevails in regions in which the overall food supply is inadequate, where populations lack economic resources to purchase food and where political unrest and instability interrupt food supplies. In addition, rapidly expanding human populations intensify the food-supply problems by diminishing the per capita availability of cropland (Pimentel and Pimentel 1996).

Changes in ecosystem biodiversity and invasion by exotic species caused by such changes frequently result in disease outbreaks. Several diseases identified in 1994, which emerged due to ecological damage, were coccidioidomycosis fungal infections caused by Coccidioides immitis, which effected parts of California. The number of cases increased from approximately 500 in 1990 to nearly 5,000 in 1992 (CDC 1994). With few known effective controls, this disease is expected to continue to spread in the future (CDC 1994).

With the erosion of soil also comes the threat of sediments being washed into water systems and ruining ecosystems (WWF 2013, Nash 1993, Repetto and Baliga 1996, WHO 1990, WHO1992, Gleick 1993). Modern use of stronger chemicals in increasing amounts to kill pests contaminate these sediments, which poison the waters and surrounding resources for drinking water, causing illness (WWF, no date) — 15 out of 24 of the world’s ecosystem services are being degraded or used unsustainably, according to the Millennium Ecosystem Assessment (2005).

The WHO reports that 3m people suffer acute pesticide poisoning every year, causing 220,000 deaths, a figure that doesn’t account for the impacts of chronic exposure (WHO 1992, WHO and UNEP 1990). Newly developed chemicals have also increased the varieties, potencies and quantities of chemicals that are released into the air, soil, and water. These chemicals have increased ecosystem pollution and caused serious disease problems. Worldwide, an estimated 100,000 different chemicals are used each year (Nash 1993). The US uses more than 2,700bn kg of chemicals a year, of which at least 20bn kg are considered hazardous (WRI 1994).

Even harvesting is detrimental to the environment and human health. Much of the world’s sugar cane crops need to be burned down before harvesting. Burning releases large amounts of particles and toxic gases and increases surface runoff, where it may carry suspended soil particles, dissolved inorganic nutrients and other materials into adjacent streams and lakes, reducing water quality (UoF 2009). During the burning season, smoke covers huge areas of the Amazon where it is widely grown, warming the cloud layer and reducing the updrafts that form clouds. Smoke has a lower albedo than the clouds, allowing more solar energy to enter the atmosphere and affecting the climate (UoF 2009). Crop burning has been linked to irritation of the airways (e.g. coughing or difficulty breathing), decreased lung function, aggravated asthma, development of chronic bronchitis, irregular heartbeat, heart attacks and premature death in people with heart or lung disease (UoF 2009).

As the sugar industry is in high demand and lucrative, it is welcomed in many developing countries that hope to gain access to world markets and profits. The opening of plantations and processing plants provides job opportunities and has offered positive benefits to countries such as Columbia, where the sugar mills are a major driving force of the economy, especially in employment, taxes and GDP (Fedesarrollo 2009).

However, farm workers are one of the most exploited segments of the working class (Majka and Majka 2000:163), with low wages, poor quality and segregated living conditions and limited benefits, and little protection from toxic work environments (Weiss 2007, SDC no date, Shiva 2004).

In parallel is the damage to the health of those consuming it. Diets across the globe have changed drastically with the advancement of technologies, transportation and innovation. However, with the new diet of convenience and fast food, both developed and developing countries are simultaneously experiencing increases in obesity and chronic diseases such as diabetes, cardiovascular disease and cancer associated with diets high in salt, sugar and bad fats (for example, hydrogenated oil) (Neild 2014, Aeberli et al. 2007, Malik et al. 2010, FoPH 2007, CSRI 2013, Yudkin 1986).

The average UK adult now consumes approximately 30kg of sugar a year. The WHO, however, suggests the average adult should not consume more than 10% of their daily calories from sugar (WHO 2003). Nevertheless, recent analyses indicate that children and adolescents obtain approximately 16% of their total caloric intake from added sugars (Ervin et al. 2009). Surprisingly, this sugar is not only consumed in foods that typically contain it, such as sweets and soft drinks, but is also now found in yoghurt, sports drinks, bread and processed meats.

Today, we consume 19% more sugar than in 1970 (Park 2010). Diabetes UK’s 2011/12 report stated: “Most health experts agree that the UK is facing a huge increase in the number of people with diabetes. Since 1996 the number of people diagnosed with diabetes has increased from 1.4m to 2.9m. By 2025 it is estimated that 5m people will have diabetes. Most of these cases will be Type II diabetes, because of our ageing population and rapidly rising numbers of overweight and obese people.” It may not be the consumption of sugar directly that is the cause of such chronic diseases, but it certainly has been proven to aid in the weight gain that stimulates the onset of these ailments.

The issues compounding our failing health and increased consumption of empty calories come down to price. Consumers are looking for cheaper goods, while companies are looking for greater profits. The liberalised market encourages global trade and allows for transnational corporations to exploit the developing countries’ need for opportunities to trade and profit to which they are enticed by cheap labour, relaxed regulation and access to natural resources and land. This in turn allows the rest of the world access to cheap products, but societies are certainly getting what they are paying for as these wreak havoc on their health.

In the US, the UK and Mexico obesity rates are becoming a health epidemic. Shockingly, such epidemics are not limited to wealthy consumers who can afford to gorge. Those who are unable to afford healthy foods are also affected as fresh produce and meats are in fact expensive, whereas processed foods are cheap and more readily available in impoverished areas, income inequality being a determinant of public health (Lynch et al. 2004).

The Food Ethics Council published that individuals with lower incomes consume more sugary soft drinks which heavily correlate to weight gain (Calder and Capewell 2013, Credit Suisse 2013). This growth in obesity and chronic disease is now occurring much more in developing countries undergoing a “nutrition transition”, where consumption of foods high in fats and sugars is rising, driven by urbanisation and globalisation (Hawkes 2006, Popkin 1998, O’Kane 2011). As Meltzer and Chen (2008) outline, there is a direct correlation between wages and body weight. These inequalities not only affect the health of the poor, but disadvantage them in other aspects in life such as bad body image, eating disorders, alienation, isolation, blame, lower obtainable wages or occupational status, self-esteem, and even educational attainment (Sen et al. 2008, Moran and Tenkin 2008, Kaestner et al. 2008, Enzi 1994).

Today, with the value of the free market placed above the health and wellbeing of humans, animals and the planet, the sugar industry has been able to carry on producing more for less, contributing to the suffering of many people and the loss of delicate ecosystems (Shiva 2010). Many countries, such as the UK, allow voluntary agreements to shed government responsibility and place it in the hands of the food industry, who are driven by profits rather than social responsibility. These types of interventions have not delivered the necessary outcomes (SDC, no date) and there is too much risk in governments not taking action and leaving the health of the public and planet in the hands of markets or personal choice.

In March 2004, a World Bank report concluded that sugar was the most policy-distorted of all commodities and argued how multilateral reform of sugar policy could produce global welfare gains of $4.7bn. OXFAM righty stated: “European Union (EU) sugar policies hamper global efforts to reduce poverty. Export subsidies are used to dump 5m tonnes of surplus sugar annually on world markets, destroying opportunities for exporters in developing countries. Meanwhile, producers in Africa have limited access to EU markets. The winners from the CAP sugar regime are big farmers and corporate sugar refiners such as Sudzucker and British Sugar. The losers are the poor. European consumers and taxpayers are financing a system which denies vulnerable people a chance to escape poverty and improve their lives. Reforms are needed to stop European dumping and improve market access for the poorest countries.”

Increased imports to the most protected countries — the US, EU and Japan — could create jobs for millions of workers in developing countries. Such inequality of access to markets is completely against free market ideology and has kept developing countries from making much financial headway, leaving them unable to improve infrastructure and other aids such as storage facilities to better their agricultural abilities and possibly increase the benefits to workers.

However, it is the agricultural policies prescribed by the World Bank as conditionalities of multilateral loans that have both facilitated and also driven the growing integration of such countries in the world economy. Such integration is being played out on an increasingly unequal global playing field, structured by global agricultural commodity chains and international trade, and strengthened by those very policy prescriptions. Instead of overcoming the dual economies and regulatory systems created in colonial times, people living in the region have only seen growing poverty and deepening inequality (Fortin 2005).

Recommendations to safeguard local communities in future include making a socioeconomic impact assessment a requirement of allocating land leases and regulating negotiations between communities and investors (Veldman and Lankhorst 2011). Implementing a living wage would allow workers to support their families and create opportunities for education and advancement, thus also helping to reduce child labour. Studies show that the child labour force participation rate is negatively associated with the higher level of education of the parents as well as the children. Hence promotion of literacy at the household level by states may be an important step for reducing child labour in the country (Barman 2011).

Some suggest that the answer is to boycott imports from these developing countries where the abuses are prevalent, but that could be disastrous for an even greater number of farmworkers. What is recommended is that retailers pressurise their suppliers to ensure that there are decent conditions on the farms that produce the products they buy and sell to their customers and to be transparent about this to consumers (Human Rights Watch 2011).

Additionally, health and safety committees should by necessity be on plantation sites, providing information for workers, teaching safe conduct in the workplace and providing first aid to reduce injury and harm to labourers. Such efforts would help to make a more productive, healthier and motivated workforce.

Governments also need monitor and evaluate the impact on the environment and build in costs to the agricultural sector for damage done to help mitigate the loss of biodiversity, fragile ecosystems and species.

Many environmental programmes and policies are voluntary and have been in place for decades — some with considerable success, but many others have put into question whether a strictly voluntary approach to agricultural conservation generates sufficient environmental gains as intensive industrialised farming is ruining the health of the planet.

It is difficult to limit the freedom of consumers’ choice to reduce the amount of sugar they intake, but a more equal playing field should at the very least be created whereby health warnings and marketing of alternative healthy options should be given the same exposure. With 95% of all foods advertised on children’s television being unhealthy junk foods (Powell and Longfield 2005), it’s no wonder our societies are suffering an obesity epidemic.

Food companies should also be given guidelines as to how much sugar can or cannot be used within products and more transparent and clear labelling should be legislated to inform consumers about what they are putting in their bodies (Pomeranz 2012, Calder and Capewell 2013, Neild 2014). Unfortunately the most common approach to tackling obesity and poor public health related to adverse diets is voluntary agreements with food companies. Many studies have shown these agreements do not work and the food industry continues to put profits over public health.

One of the most difficult issues to tackle, however, is the systemic inequalities within societies caused by poverty and lack of opportunity. The gap between the wealthy and the poor needs to be closed and fresh and healthy foods need to be made more accessible to the poor, instead of such foods being left a luxury. Illness and chronic diseases caused by poor diet should not be a symptom of poverty and situation. Next time you reach for that sugar-laden drink or extra spoonful in your morning coffee, think about whether you need it that badly.

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