� 1Nisbett N, et al. BMJ Global Health 2021;6:e006569. doi:10.1136/bmjgh-2021-006569 Equity and expertise in the UN Food Systems Summit Nicholas Nisbett  ‍ ‍ ,1 Sharon Friel  ‍ ‍ ,2 Richmond Aryeetey  ‍ ‍ ,3 Fabio da Silva Gomes,4 Jody Harris  ‍ ‍ ,1,5 Kathryn Backholer  ‍ ‍ ,6 Phillip Baker  ‍ ‍ ,7 Valarie Blue Bird Jernigan  ‍ ‍ ,8 Sirinya Phulkerd  ‍ ‍ 9 Commentary To cite: Nisbett N, Friel S, Aryeetey R, et al. Equity and expertise in the UN Food Systems Summit. BMJ Global Health 2021;6:e006569. doi:10.1136/ bmjgh-2021-006569 Received 9 June 2021 Accepted 11 June 2021 For numbered affiliations see end of article. Correspondence to Dr Nicholas Nisbett; ​N.​Nisbett@​ids.​ac.​uk © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. The UN Food Systems Summit is expected to launch bold new actions, solutions and strat- egies to deliver progress on all 17 sustainable development goals (SDGs), each of which requires a transformation in the way the world produces, consumes and thinks about food. However, the summit preparations have started controversially, with claims of corporate capture by prominent civil society groups,1 who, alongside the current and two former UN Special Rapporteurs on the Right to Food,2 have also noted insufficient atten- tion paid to human rights and to rebalancing power in the food system itself. The issue of corporate capture is an important one for the summit. Early decisions to implement a clear set of rules on corporate participation and transparency were missed and need rectifying urgently for the summit to continue with any legitimacy, as the UN Special Rapporteurs and the scientists of a new boycott3 have pointed out. The summit has embraced the (contested,4 some would argue failed)5 principle of ‘multistakeholder inclusivity’ as essential for the summit to be a ‘safe space’ for all actors, but with little regards to how power asymmetries between stakeholders within the summit itself must be acknowledged, addressed and accounted for transparently; not a helpful precedent for a global architecture to address those same power asymmetries. Closely linked to these issues have been the role of right-based and equity-based approaches within the summit; and how far the summit’s ‘forum’ shifts away from the UN Committee on Food Security, where these issues have a strong mandate, risks diluting hard won battles for a fairer, more just and right-based food system.5 The summit hopes to contribute to the promise global leaders signed at the SDG summit to ‘leave no one behind’. Equity is, there- fore, at the heart of the summit. However, without advancing both a stronger norma- tive and multidisciplinary understanding of equity, the summit process risks missing a once in a generation chance to refocus understanding and action on food system inequity. Attention ought to be drawn not only to the current inequitable experiences and outcomes facing people within food systems but also to the reasons why such inequities in outcomes persevere (eg, non- white households were two times as likely to face food insecurity during the COVID-19 pandemic compared with white British households; and those with disability or health problems, three times more likely).6 We wonder what egregious failings of polit- ical systems are being glossed over in ‘leave no one behind’ if such virtuous aspiration leads to a failure to ask questions of why so many people, for so long, have been ‘held back’. The problem is partly with the concept of equity itself: incontrovertibly, a good thing Summary box ►► The UN Food Systems Summit is bold but contro- versial, with important implications for global food systems and public health. ►► Alongside claims of corporate capture, many have noted insufficient attention paid to human rights and to rebalancing power in the food system. ►► These issues speak to wider issues of participation and equity in the summit itself. Narrow definitions of equity only consider income inequities in outcomes and coverage. Broader definitions consider why such inequities persevere and are interlinked via process- es that can be historical and intergenerational. ►► The summit’s science group is slanted in disciplinary expertise: it lacks sufficient expertise in equity, health, noncommunicable diseases or representa- tives with expertise in indigenous knowledge. ►► It is not too late to rectify this in the summit struc- tures, as we approach the September summit meeting. on July 6, 2021 by guest. P rotected by copyright. http://gh.bm j.com / B M J G lob H ealth: first published as 10.1136/bm jgh-2021-006569 on 5 July 2021. D ow nloaded from http://gh.bmj.com/ http://crossmark.crossref.org/dialog/?doi=10.1136/bmjgh-2021-006569&domain=pdf&date_stamp=2021-07-05 http://orcid.org/0000-0002-9558-2263 http://orcid.org/0000-0002-8345-5435 http://orcid.org/0000-0003-4667-592X http://orcid.org/0000-0002-3369-1253 http://orcid.org/0000-0002-3323-575X http://orcid.org/0000-0002-0802-2349 http://orcid.org/0000-0002-3965-8518 http://orcid.org/0000-0001-9373-3120 http://gh.bmj.com/ 2 Nisbett N, et al. BMJ Global Health 2021;6:e006569. doi:10.1136/bmjgh-2021-006569 BMJ Global Health to pursue, but variously defined. For example, among experts on chronic undernutrition, equity is often concep- tualised as diverging coverage of health interventions or outcomes differing by socioeconomic groups.7 Among experts on health equity and diet-related noncommu- nicable diseases, however, equity often also refers more to the structural, social and commercial determinants of health and the concentration of power among private sector interests.8 Summit participants are tasked with proposing and prioritising a set of ‘game changing solutions’ for member states to adopt. To some equity experts, such solutions might mean providing significantly scaled up child and maternal health services, particularly targeted at marginalised communities; or similar access to systems of social protection or food assistance. Equity to others might also mean finding ways to tackle historical injus- tices that still shape people’s lives. For example, dispos- sessing communities, particularly indigenous peoples, from ancestral lands—and the culinary and agroecolog- ical skills and knowledge that adhere to those territo- ries—has been devastating to local food systems. Public health then comes to mean something quite different: regaining sovereignty and control over land and food as part of wider self-determination; working to preserve or return to traditional and healthy foods and associated culinary practices against a tidal wave of ultraprocessed, nontraditional and unhealthy products.9 Separate (but in our view, still complementary) under- standings of equity also reflect the siloed and hierar- chical knowledge systems that still frame the UN system and similar international architectures. Tackling growing uncertainties that range from pandemics, to climate change, to intractable historical food-based problems ‘require a fundamental rethinking of how expertise of multiple sorts and new forms of professionalism are convened and combined’.10 11 The scientific committee of the UNFSS is dominated by agricultural economists and natural scientists: great scholars, but a missed oppor- tunity to encounter knowledge not only from experts in health equity or gender and rights but also from indige- nous and other traditional people (not those speaking for them), food workers and others with lived experi- ence of malnutrition and diet-related diseases. We do see these voices represented elsewhere in the summit (sometimes marginally), but the summit’s approach to filling its scientific committee feels outdated for a summit concerned with food systems, when most systems experts already recognise the need for this diversity of knowledge and experience. The structure of the summit itself also adds another layer of inequity and imbalance of power. There are many ways to get involved in the summit, and in principle this is positive. But Member States or civil society organ- isation with limited resources will not be able to become a Food Systems Hero, help to raise awareness of food systems on social media, host or join a Dialogue and also participate and follow all five Action Tracks. Those with greater resources, and their propositions, will then reign. For this reason, the myriad of participation mechanisms is not as important as how this will be weighed into deci- sions; to return to the initial concerns with the summit, how will the power of those actors opposing healthier, more sustainable and more equitable food systems be constrained? As we write in June, ahead of a September Summit, time is not late to take action in rebalancing powers and enabling a greater diversity of knowledge, not simply among a multiplicity of voices in multiple public forums, but explicitly engaged at the summit’s top table of exper- tise and summit leadership. It is also not late to adopt mechanisms that limit the engagement of those actors whose primary interests have driven our food systems to become unhealthy, unsustainable and inequitable, so the voices of the people can be clearly heard. Doing so would help meet the need for putting equity-focused action at the heart of the summit in a way that accords with the existing UN legal framework on rights and the SDGs; and with the multiple traditions of equity, we argue, need to be embraced for the summit to be a success on its own terms. Author affiliations 1Health and Nutrition Research Cluster, Institute of Development Studies at the University of Sussex, Brighton, UK 2Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australian Capital Territory, Australia 3School of Public Health, University of Ghana, Accra, Ghana 4Pan American Health Organization, Washington, District of Columbia, USA 5Healthy Diets Flagship, World Vegetable Centre, Bangkok, Thailand 6Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia 7Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia 8Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, Oklahoma, USA 9Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand Twitter Phillip Baker @philbakernz Contributors  All authors contributed to this commentary. Funding  The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Competing interests  Nicholas Nisbett is a member of the UNFSS Action Track 4 Leadership Group. Dr. Nisbett declares previous funding from the Bill and Melinda Gates Foundation, India; the International Food Policy Research Institute and UK Research and Innovation. Dr Backholer declares previous funding from the National Heart Foundation of Australia. The views expressed here are that of the authors alone. Patient consent for publication  Not required. Provenance and peer review  Not commissioned; internally peer reviewed. Data availability statement  All data relevant to the study are included in the article. Open access  This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://​creativecommons.​org/​ licenses/​by-​nc/​4.​0/. on July 6, 2021 by guest. P rotected by copyright. http://gh.bm j.com / B M J G lob H ealth: first published as 10.1136/bm jgh-2021-006569 on 5 July 2021. D ow nloaded from https://twitter.com/philbakernz http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/ http://gh.bmj.com/ Nisbett N, et al. BMJ Global Health 2021;6:e006569. doi:10.1136/bmjgh-2021-006569 3 BMJ Global Health ORCID iDs Nicholas Nisbett http://​orcid.​org/​0000-​0002-​9558-​2263 Sharon Friel http://​orcid.​org/​0000-​0002-​8345-​5435 Richmond Aryeetey http://​orcid.​org/​0000-​0003-​4667-​592X Jody Harris http://​orcid.​org/​0000-​0002-​3369-​1253 Kathryn Backholer http://​orcid.​org/​0000-​0002-​3323-​575X Phillip Baker http://​orcid.​org/​0000-​0002-​0802-​2349 Valarie Blue Bird Jernigan http://​orcid.​org/​0000-​0002-​3965-​8518 Sirinya Phulkerd http://​orcid.​org/​0000-​0001-​9373-​3120 REFERENCES 1 Main concerns of CSM Letter on Food System Summit remain without adequate response. Note of the CSM liaison group after meeting with CFS chair and special Envoy for UN food system Summit (UNFSS). Civil Society and Indigenous peoples' mechanism for relations with the un Committee on world food security. 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