2013 Global Action Report: Food, Health, and Prosperity

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Diplomaticcourier

A Global Affairs Magazine

Special edition

2013 Global action RepoRtFood, Health, and Prosperity

Cross-sector task forces are convening and collaborating to create the Global Action Platform in 2013.

2013

The Global Food and Health Innovation Challenge was announced on March 26, 2013 with a starting $1 million award for trans-formative solutions. (From L to R): Dr. Scott Massey, Chairman, joins Mark Cackler of the World Bank, Mike Shermling, CEO, Choice Foods Group and Sam Lingo, COO, Entrepreneur Center.

Mars Incorporated, Chief Science Officer, Harold Schmitz lead a discussion on a collaborative approach to sustainable foodand the role of private sector business.

Announcing the 2nd Annual Global Summit:

GLOBAL ACTION PLATFORMCumberlandCenter

Global South Summit– NashvilleGlobal South Summit– NashvilleGLOBAL ACTION PLATFORM

Keynote Speakers:

Global South Summit - NashvilleNovember 11 & 12, 2013

Peter Diamandis is an engineer and Intel entrepreneur, founder and chair-man of the X PRIZE Foundation. He is also the co-founder and chairman of Singularity University and the co-author of the New York Times bestseller book, Abundance.

ConnectChallengeCommunicate

Convene

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Peter DiamandisFareed Zakaria

Fareed Zakaria is a columnist and editor of Newsweek International. In 2010 he became editor-at-large of Time. He is the host of CNN’s Fareed Zakaria GPS. He is also a frequent commentator and author about issues related to international relations, trade, and American foreign policy.

Food, Health and Prosperity

Jeanne McCaherty, Vice-President and Regional Director, Cargill

Michael Norris, Chief Operating Officer, Sodexo North America

Fumbi Chima, WalMart Executive Leader, Women’s Resource Council Heidi Kleinbach-Sauter,

Senior Vice PresidentPepsiCo Global Foods

2 | WWW.globalactionplatFoRM.oRg

Leaders and innovators from Accenture, Chic Group Global - China, University of Florida and Sysco are exploring challenges of the food supply chain.

Nashville welcomes global leaders, experts and entrepreneurs in food and health to attend its Global Summit in November.

Global South Summit– NashvilleGLOBAL ACTION PLATFORM

2012Keynote speaker, Thomas Friedman, New York Times Pulitzer Prize-win-ning journalist spoke to audiences of 600 about the pressing need for innovation at the Global Summit, November 2012.

Plenary Speaker, Dr. Francis Collins, Director of the National Institutes for Health, addresses an audience of over 400 leaders and Summit Fellows in Nashville, setting a new course for the future of health.

Leaders from UCSD Connect, Vanderbilt, Johns Hopkins, Maryland Industrial Partnerships and UC Davis explored topics on building life sciences clusters for innovation.

In November 2012, four hundred leaders from five continents convened in Nashville for the launch of the Global South Summit.

Today, these leaders and our partners are working actively on issues critical to our world’s future: food, health, and prosperit y. In the Global Action Report that follows, we are pleased to share their ideas and recommended actions.

The vision inspiring our work is abundance through innovation. Our goal is expanding opportunit y for all, so what is emerging is an entirely new platform for enhancing local, regional, and global economies through uncommon collaborations and investments that reward scalable and sustainable solutions.

As we look to 2050 and an anticipated population of nine billion, creating smart strategies is of paramount importance. The next three to five years are critical. Many effective approaches have already been identified. Our growing cross-sector network of international partners from universities, business, government, foundations, media and committed individuals are working together to share solutions and advance new ideas.

We stand at the threshold of new opportunit y and invite you to join us.

Dr. Scott T. MasseyChairman and CEO


2013


Diplomaticcourier

A Global Affairs MagazineSpecial edition Global South Summit– Nashville

GLOBAL ACTION PLATFORM

2013 Global action RepoRtFood, Health, and prosperity

Global South Summit– NashvilleGLOBAL ACTION PLATFORMGLOBAL ACTION PLATFORM

CumberlandCenterGlobal South Summit– Nashville


Food, HealtH and ProsPerity



Dr. Massey leads the CumberlandCenter, a university business alliance to transform innovation into prosperity. He serves as Founding Chairman of the Global South Summit, an annual global event focused on creating abun-dance through innovation in food, health, and prosperity.

eDitor-in-chief | Ana C. Roldexecutive eDitor, Gap | Cynthia H. Barbera

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puBlishinG. The Global Action Report is a product of the Global Action Platform and the CumberlandCenter, published in concert with Diplomatic Courier magazine, a product of Medauras Global LLC. The Diplomatic Courier is printed six times a year and publishes a blog and online com-mentary 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 re-sponsible for the facts and interpretations. permissions. Authors and the Cumberland Center re-tain all copyrights to their articles. None of the articles can be reproduced without their permission and that of the publish-ers. For permissions please email the editors at: [email protected] with your request.issn. The Library of Congress has assigned: ISSN 2161-7260 (Print); ISSN 2161-7287 (Online).leGal. Copyright © 2006-2013 CumberlandCenter and Global South Summit. 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 Cumberland-Center and the Global South Summit to provide advertising and/or services. Every effort has been made to ensure the accuracy of information in this publication, however, the pub-lishers and editors make no warranties, express or implied in regards to the information, and disclaim all liability for any loss, damages, errors, or ommissions. contact. For all editorial and/or publishing inquiries please contact: The Diplomatic Courier, 1660 L Street, NW, Suite 501, Washington, DC 20036, U.S. Fax: 202-659-5234. E-mail: [email protected] and [email protected]. DiGital eDition. To access this report in digital edition format, on your iPad, iPhone, or Android device, please visit www.diplomaticourier.com and enter this free token for pass-word: 13361-1521-61147.

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Leaders and innovators from Accenture, Chic Group Global - China, University of Florida and Sysco are exploring challenges of the food supply chain.

Nashville welcomes global leaders, experts and entrepreneurs in food and health to attend its Global Summit in November.

Global South Summit– NashvilleGLOBAL ACTION PLATFORM

2012Keynote speaker, Thomas Friedman, New York Times Pulitzer Prize-win-ning journalist spoke to audiences of 600 about the pressing need for innovation at the Global Summit, November 2012.

Plenary Speaker, Dr. Francis Collins, Director of the National Institutes for Health, addresses an audience of over 400 leaders and Summit Fellows in Nashville, setting a new course for the future of health.

Leaders from UCSD Connect, Vanderbilt, Johns Hopkins, Maryland Industrial Partnerships and UC Davis explored topics on building life sciences clusters for innovation.

In November 2012, four hundred leaders from five continents convened in Nashville for the launch of the Global South Summit.

Today, these leaders and our partners are working actively on issues critical to our world’s future: food, health, and prosperit y. In the Global Action Report that follows, we are pleased to share their ideas and recommended actions.

The vision inspiring our work is abundance through innovation. Our goal is expanding opportunit y for all, so what is emerging is an entirely new platform for enhancing local, regional, and global economies through uncommon collaborations and investments that reward scalable and sustainable solutions.

As we look to 2050 and an anticipated population of nine billion, creating smart strategies is of paramount importance. The next three to five years are critical. Many effective approaches have already been identified. Our growing cross-sector network of international partners from universities, business, government, foundations, media and committed individuals are working together to share solutions and advance new ideas.

We stand at the threshold of new opportunit y and invite you to join us.

Dr. Scott T. MasseyChairman and CEO


2013


Diplomaticcourier

A Global Affairs MagazineSpecial edition Global South Summit– Nashville

GLOBAL ACTION PLATFORM

2013 Global action RepoRtFood, Health, and prosperity

Global South Summit– NashvilleGLOBAL ACTION PLATFORMGLOBAL ACTION PLATFORM

CumberlandCenterGlobal South Summit– Nashville


Food, HealtH and ProsPerity



Dr. Massey leads the CumberlandCenter, a university business alliance to transform innovation into prosperity. He serves as Founding Chairman of the Global South Summit, an annual global event focused on creating abun-dance through innovation in food, health, and prosperity.



2013






Keynote Speakers:




Convene

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honorarY chairs

Jack o. BovenDer, Jr. | Retired Chairman and CEO, Hospital Corporation for America arlene Garrison | VP, University Partnerships, Oak Ridge Associated Universities

phil BreDesen | Former Tennessee Governor steve BrophY | VP, Government Affairs, Dollar General Corporation ernesto Brovelli | President, Sustainable Agriculture Initiative; Senior Manager, Sustainable Agriculture, The Coca-Cola Company conGressman Jim cooper rYan DoYle | President, oneC1TY harvill eaton | President, Cumberland UniversitykittY moon emerY | President and CEO, KittyMoon Enterprises; Senior Strategist, CumberlandCenter Beth fortune | Vice Chancellor for Public Affairs, Vanderbilt University Darrell s. freeman | Chairman, Zycron, Inc. Jim frierson | President, Compass Innovation senator Bill frist | Former Majority Leader, U.S. Senate Jose Gonzalez | Co-Founder, Conexión Americas; Instructor of Management & Entrepreneurship, Belmont Universitykeith GreGG | Chairman and CEO, JRG Ventures; Entrepreneur-in-Residence for Health Technology, Nashville Entrepreneur Center cYnthia h. BarBera | Executive Editor, Global South Summit; Founder, e-Global Reader LLC cherYl harrison | President, Harrison Design Group; UC Davis Trustee Emeritus & Advisor, UC Davis College of Agriculture & Environmental Sciencesralph hexter | Provost, University of California, Davis carol huDler | President and Publisher, The Tennessean John inGram | Chairman, Ingram Industries Inc.; Chairman and CEO Ingram Content Group claY Jackson | SVP, Regional Agency Manager, BB&T, Tennessee conraD kiechel | Director of Communications, Milken Institute rev. timothY kimBrouGh | Dean and Rector, Christ Church Cathedral l. ranDolph lowrY | President, Lipscomb University scott t. masseY | Chaiman and CEO, CumberlandCenter; Chairman, Global South Summitalex mccalla | World Bank (retired); Professor Emeritus Agricultural and Resource Economics, UC Davis paul mcelearneY | Membership Development, Clinton Global Initiative april mcmillan | Manager, Secure Biosystems Integration, Oak Ridge National Laboratory claYton mcwhorter | Founder, Clayton Associates John morGan | Chancellor, Tennessee Board of Regents trent nichols | CMO, Secure Biosystems Integration, Oak Ridge National Laboratory BraD perkins | SVP, Strategy and Innovation, Vanguard Health mike shmerlinG | Chairman and CEO, Choice Food Group; Managing Partner, XMi High Growth Development FundhowarD shapiro | Chief Agronomist, Mars Incorporated thomas J. sherrarD | Founding Partner and Member, Sherrard & Roe, PLC DeBorah wince smith | President and CEO, Council on Competitiveness remY szYkier | Co-Founder, Aegis Health Security steve turner | Principal, Market Street Enterprises JuerGen voeGele | Director, Agriculture and Rural Development Department, Sustainable Development Network, The World Bank

founDinG leaDership anD Governance



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CONTENTSintroDuctionBuilding a Global Action Platform for Food, Health and Prosperityby Scott t. MaSSeyChairman and CEO, CumberlandCenterchairman, Global South Summit

section i: aBunDant fooD

the future of fooDeditoRial by JueRGen VoeGeleDirector, Agriculture and Rural DevelopmentSustainable Development Network, the World Bank

feeDinG the planet:where Do we stand today?Mark Cackler, Sector Manager, Agriculture and Environmental ServicesThe World Bank GroupRole of Business: Harold Schmitz, Mars Inc.Role of Government: Bill Lacy, UC DavisRole of Foundations and NGOs: Prabhu Pingali, Bill and Melinda Gates FoundationRole of Research: April McMillan, Oak Ridge National LaboratoryRole of Finance: William Rosenzweig, Physic Ventures

GrowinG aBunDant fooD:Global trends in food securityFrederick Vossenaar, Ministry of Economic Affairs, Agriculture & Innovation, Royal NetherlandsKent Bradford, Seed Biotechnology Center, UC DavisMichael (Mike) Dimock, Roots of ChangeSylvia Ganier, Green Door Gourmet

from harvest to taBle:preservation, logistics and DistributionRob Howell, Sysco SystemsJeffrey K. Brecht, University of FloridaRich Kottmeyer, AccentureEdward Zhu, CHIC Group Global

at the taBle: nutrition anD healthRoy Elam, Vanderbilt Center for Integrative HealthGreg Drescher, Culinary Institute of AmericaDavid Schmidt, International Food Information Council (IFIC)

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section ii: aBunDant health

the future of healtheditoRial by SenatoR WilliaM H. FRiSt, M.d.

transforminG healthcare: how collaboration and it create Game-changing innovationKeith Gregg, Chairman and CEO, JRG VenturesJames Lakes, Director US Health and Life Sciences, MicrosoftDouglas Wenners, SVP, Provider Engagement and Contracting,Wellpoint-AnthemJordan Shlain, Commissioner, San Francisco Health Service Systems;Founder, HealthLoop, & practicing physician at Private Medical Services

the new meDicineRoy Elam, Medical Director, Vanderbilt Center for Integrative HealthSteven Burd, President and CEO, Safeway, Inc.Brent Parton, Program Director, Shout AmericaWayne Riley, President, Meharry Medical College

the future of hospitals anD hospital manaGementJordan Asher, CMO and CIO, Mission Point Health PartnersMartin Rash,Chairman and CEO, RegionalCare Hospital PartnersTrent Nichols, Senior Research Staff, Chief Medical Officer,Secure Biosystems Integration, Oak Ridge National LaboratoryLandon Gibbs, Director of Healthcare Initiatives of Clayton & Associates

personalizeD meDicine: treatinG the uniqueJeff Balser, Vice Chancellor, Vanderbilt Medical CenterRaymond DuBois, Jr., Provost and Executive Vice President,The University of Texas MD Anderson Cancer CenterDan M. Roden, Assistant Vice Chancellor for Personalized Medicine,Vanderbilt University School of Medicine

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section iii:aBunDant prosperitY Building Global innovation hubs for food and health

the future of prosperitYeditoRial by cHRiStian KetelSDirector, The Competitiveness Institute (TCI)Institute for Strategy and Competitiveness, Harvard Business School

the future of american researchFrancis Collins, Director, National Institutes of HealthTed Abernathy Jr., President and CEO, Southern Growth Policies BoardArlene Garrison, Vice President of University Partnerships, Oak Ridge Associated UniversitiesNickolas S. Zeppos, Chancellor, Vanderbilt University

international perspectives on health, fooD anD sustainaBilitYDavid Schmidt, President and CEO, International Food Information Council (IFIC)Anne-Christine Langselius, Founder of Nuwa, CEO, My Global Enterprise Solutions

BuilDinG life science clusters of innovationMary Walshok, Vice Chancellor, UCSDConnectAlan Bentley, Associate Vice Chancellor, OTTC, Vanderbilt UniversityThomas Cebula, John Hopkins, CTO CosmosID; Former FDA Director, Office of Research and Food SafetyMartha Connolly, Director, Maryland Industrial PartnershipsSteven Currall, Dean, UC Davis Graduate School of Management

DesiGninG a research innovation moDeleditoRial by cHeRyl e. HaRRiSonPresident, Harrison Design Group; UC Davis Trustee Emeritusand Advisor, College of Agriculture and Environmental Sciences,Founding Leadership Committee, Global Action Platform

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CONTENTS48


section iv: perspectives

a vision for aBunDance: research and the futureby FRanciS collinSDirector, National Institutes of Health (NIH)

the worlD at the crossroaD: where Do we Go from here? a call to actionby tHoMaS FRiedManColumnist, The New York Times

partner viewpointsInternational Food Information Council (IFIC)Global Harvest InitiativeSTEMconnector

section v: BuilDinG a GloBal action platform

inspirinG leaDershipeditoRial by linda peeK ScHacHtExecutive DirectorNelson and Sue Andrews Institute for Civic Leadership

recommenDations for actioneditoRial by cyntHia H. baRbeRaExecutive Editor, Global Action Report, Founding Leadership Committee, Co-Founder, eGlobal Reader

aBout the cumBerlanD centerTransforming Innovation into Prosperity

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2013 Global action reportBuilding a Global Action Platform: Food, Health, and Prosperity

by dr. Scott t. MaSSey

introdUction


in november 2012, four hundred lead-ers from ten na-tions, representing

the corporate, research, government, media, foundation, and nGo sectors convened at the Global south summit in nashville, tennessee. the goal of this interna-tional gathering was to begin framing an agenda for abundance with a focus on three intercon-nected, issues—food, health, and prosperity.

founDinG mission anD oBJectivesThe mission of the Global South Summit is to convene leaders from around the world to define solutions that create abundance through innova-tion. At the conclusion of the Summit in 2012, an integrated approach to Food, Health and Prosperity were defined as the most critical national and global priorities over the next three to five years.

Similar to Davos, the Clin-ton Global Initiative and the Milken Global Conference, the annual Global South Summit Series is designed to create a singular opportunity to convene top state, national and international C-Level decision-makers. The Global South Summit uniquely integrated the varied perspectives from across key sectors, including corporations, global NGO’s, research universities and non-profit organizations.

Nashville was selected as the “hub” for these discussions due to its outstanding geo-graphical location, connecting wide cross-sector expertise in the food and health industries, with direct access to emerging scientific research and leading investments in regional, nation-al and global initiatives.

The Cumberland Center, headquartered in Nashville, is

the organizer and host for the Global South Summit. With its expanding collaborative networks and long-standing relationships among major research universities, thought leaders and institutions in the United States and throughout the world, CumberlandCenter is the ideal convener of the ongoing annual Summit and Global Action Platform. whY fooD, health anD prosperitY? Founding Leaders creating the project started with an economic concern--how to advance sustainable economic growth and prosperity for a growing world population. The organizers found strong interest in mobilizing cross sector leadership to find new paths and models for economic development aimed at sustain-able prosperity. It became clear that models could be focused on strategies to meet the grow-ing global challenges of food and health with an eye toward expanding, shared prosperity.

This vision of an economic future of growth, sustainability, and expanding opportunity for everyone required a special lens. To balance growth, sustainability, and opportunity leaders needed an adaptable model named the “Global Ac-tion Platform”, a nimble, neu-

tral infrastructure well-suited for the fast-emerging, complex conditions of the 21st century.

The elements of this model include industry clusters, re-gional economies, and strategy for competitiveness, which are of central importance. New technologies, the internet, and innovation are also key to the mix.

a vision of aBunDanceInstead of a focus on scarcity and conflict, Summit founders and participant leaders wanted to look toward the creation of abundance, as a central orga-nizing idea. How can we focus economic activity in regional innovation hubs to expand opportunity and unleash inno-vation? How can the whole hu-man population flourish--while also allowing the environmen-tal and ecosystems that make life possible also flourish?

Initial research and broad conversations with global leaders, major research institu-tions and thought leaders led to a converging focus and integration on issues in food, health, and prosperity. The interconnections were intrigu-ing and compelling--as well as surprising.

introdUction

Dr. francis collins, Director, national institutes of health


introdUction

inteGrateD themes: fooD, health anD prosperitYAs this vision was explored, it became clear that key condi-tions for innovation and prosperity are food and health. If economic growth requires a broad base of talented, innova-tive people working together, then the health and nutrition of society is paramount in determining the prosperity of the future.

In fact, food and health are baseline measures of the asset strength of the major economic driver of today’s economy--human capital.

Food and nutrition are widely discussed as integral to the future of human health and healthcare. The path through healthcare transformation thus led us to conversations on food, food security, food productivity, distribution and safety. Interestingly, food and agriculture are also key founda-tions for economic growth and stability. So, food, health, and prosperity proved to be linked in strategic ways.

health anD health-care: an urGent neeD for new solutionsIn each area of our Summit program, clear challenges exist. How to stimulate economic growth through innovation, how to transform healthcare, how to feed the planet—these were framing questions for our work.

Experts in the health field offered a wide range of op-tions to change healthcare, from proposing a model for a “new medicine” to applying advanced genetic research. Between the current state of affairs and a major transforma-tion lay thorny issues of realign-ing financial incentives while managing the demographic shifts toward an older popula-tion with greater health needs. It was clear from our research and from presentations at the Summit that time is running out and that there is a growing sense of urgency to find trans-formative healthcare solutions.

fooD: a compellinG concern for feeDinG our planetIn the area of food, we found a state of crisis, economic challenge and conflict over the future similar to the parallel challenge in economics and healthcare. We learned that

the world currently produces enough food to feed everyone alive, but we lack the logistics and political consensus to distribute efficiently and safely what we produce. We have se-riously depleted food reserves, which had not been replen-ished since the 2010 drought, putting the world on the edge of major food shortages. Dis-putes are raging over the role of genetically modified foods, the composition of a healthy, nutritious diet, and the role of government to enforce diet, food policies, food safety, and its role in funding research and food relief efforts.

Our advisors pointed toward a need for a trusted convener to bring the sectors and key institutions together to build trust and create consensus; they asked us to help serve that role.

As organizing plans for the 2012 Summit began, plans were also emerging for the next Universal World Expo in Mi-lan, Italy in 2015 to focus on its theme, “Feeding the Planet –Energy for Life.” As the world now begins to prepare for this Expo, we were asked to help launch the global discus-sion on food among cross-sec-tor leaders and participants.

BuilDinG a GloBal action planThe challenge we face now is to frame long term solutions and innovations that have the

Dean steven currall, uc Davis, with summit co-founders cheryl harrison, scott t. massey, chairman, and cynthia Barbera at the plenary luncheon session, nashville

nashville symphony orchestra Brass quintet performing at the 2012 Global south summit


capacity and promise to create abundant food, health, and prosperity for everyone on the planet. Our approach is local, regional and global. In short, we are bringing together cross-sector leaders to imagine, to explore—and to specify—how innovation can create abundance, and how we can efficiently and much more ef-fectively connect and network invested leaders, research institutions and innovators to collaborate in fulfilling the promise of abundance.

The programs, events and initiatives of the Global South Summit are being planned over the next five years, as a way to convene the key leaders who will build a coherent set of ideas and recommendations that culminate in a compre-hensive set of high profile reports into a “Global Action Platform.”

innovation as a human resource Simply put, the future welfare of both human beings and the planet depend on a distinctly human resource—innovation. Our emerging economies demand more timely solutions, access to innovation, improved efficiencies and high impact results. On this there is broad consensus. In order for societ-ies be innovative, people in these societies must be able to thrive; they need food, health, and the tools and systems of in-novation that produce sustain-able prosperity.

As we strive to achieve positive change in our complex world, leaders and innovators will need to collaborate together to create a shared platform for clear, more efficient decision-making and informed actions to guide our future.

the GloBal action reportsReports following the Summit(s) will be published as a series, used to inform and engage leaders in food, health, and economic strategy/innova-

tion, disseminated through partnerships with the Dip-lomatic Courier, The World Bank, CGIAR, USAID, Na-tional Press Club, and a grow-ing network of organizations, agencies, research universities and business partners around the world.

The following report is the first in a series offering three powerful framing essays on the future of food, healthcare, and prosperity by three profound thinkers in these fields. This report summarizes and shares the wide array of innovations and ideas for how to move out of the current crises in these areas to abundant food, health, and prosperity. The report offers initial recommenda-tions for action, distilled from the inaugural Global South Summit in November 2012. Editorials and essays from industry experts add perspec-tive and depth to the findings presented.

This Report is the first in a series that will continue to promote innovation and action for abundance.

report content anD eDitorialsThe Global Report features four major editorial works on three topics of food, health, and prosperity, as noted below:

• “The Future of Health-care”, Dr. William Frist (former Senate Majority Leader, surgeon, and HCA founding family member).

• “The Future of Food,” Juergen Voegele, Direc-tor, Agriculture and Rural Development Division, The World Bank.

• “The Future of Prosper-ity”, Dr. Christian Ketels, MOC Director, Institute for Strategy and Competi-tiveness, Harvard Business School.

The Report also features edito-rial contributions from the

International Food Informa-tion Council (IFIC), Global Harvest Initiative, STEMcon-nector and others.

GloBal DistriBution to leaDers anD maJor institutionsThe 2013 Global Action Report will be previewed with lead editorials distributed in the G8 Summit materials in London, followed by distribu-tion in the G20 materials in St. Petersburg, and a World Bank event in Washington DC.

Later in June 2013, 25,000 copies of the published report will be mailed to a target list of tier-one global corporate ex-ecutives, heads of state, policy makers, foundation leaders, media leaders, and leaders of major international agencies and foundations. Further, an electronic version of the Re-port will be published on the Diplomatic Courier website and the website of the Global South Summit, reaching a global online audience of 1.5 million readers.

The 2012 Global South Sum-mit and this Report are our first steps along this path to create the Global Action Plat-form for the next five years.

We invite you to join us.

introdUction

keynote speaker, thomas friedman, New York Times pu-litzer prize-winning journalist


collaboration | innovation | technology | you

nashville

Tennessee

Global Health.driving innovation through colaboration

Personal Health.leveraging the opportunity to be students of mindful living and improve human performance

Local Impact. reflecting our City’s investments in health, culture and unmatched urban fabric

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The Yard a terraced lawn and community orchard anchor this multi-purpose gathering place.

The WATERSHED water quality gardens double as a series of outdoor rooms for great minds to steep.

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Section iAbundant Food

Feeding the PlAnet

as the world approaches a population of 9 billion, we face an unprecedented challenge: how will we feed our planet while also preserving our environ-ment and the fragile ecosystems that make life possible? it is not just about food. solutions must also include nutrition and healthy diets as funda-mental considerations to our global well-being. leading experts in food, health and nutrition explore the interrelated challenges of sustainably growing abundant food, safely transporting and storing food, transforming food into a nutritious diet, and the cultural experience and values sur-rounding food and food policies.


Section iAbundant Food

Feeding the PlAnet

abUndant Food

the future of foodeditorial by JUergen Voegele, director, agricUltUre and rUral deVelopMent, SUStainable deVelopMent network, the world bank

aGriculture must urGentlY aDDress three sets of issues:

• Reduce the hunger and malnutrition affecting 870 million people. We must address the fact that 165 million children under five years of age are stunted, and the number of stunted children is rising in sub-Saharan Africa, with 52 million children suffering from wasting, and with little improvement globally since 1990. For most of these children, the damage to their growth and development is irreversible and will impact the world for generations.

•Provide sustainable solutions to extensive rural poverty on a large scale. Three-quarters of the world’s very poor people (incomes <US$1.25/day in 2005 $) live in rural areas, and most get their main livelihoods from farming.

•Mitigate 30% GHG which is leading factor in the expected 4 degree Celsius increase in tem-perature...which could wreak havoc on global agriculture.

Producing more food will not solve hunger and malnutrition problems on its own; food security requires ensuring access to sufficient nutritious food every day to every person, which goes beyond what agriculture can do on its own. However, failing to produce at least 60% more food by 2050 will ensure that there will not be enough to go around, with truly catastrophic effects. The way we increase production has a lot to do with the distribution of its benefits for food security. So, we also need to worry about the resilience of production systems, nutritional implications of production systems, and how to reduce waste.

For success in both production growth and ensuring that food gets to those who need it most, small farmers will have to be a big part of the solution. Today roughly 83% of the world’s population lives in developing and emerging countries. There are roughly 400-500 million small farmers in the world, heavily concentrated

in developing countries. Globally, the average farm size (scale of production) declined from 2.1 hectares in 1980-1985 to 1.9 hectares in 2006-2010, with large regional variations.

Resource depletion is beginning to set in. By 2025, nearly two-thirds of all countries in the world will be water-stressed and 2.4 billion people will face absolute water scarcity. Since about 70% of freshwater use is for agriculture, such countries will depend on imports to meet their food needs. Worldwide, about 18% of cropland is irrigated, producing 40% of all crops and 60% of all cereals. Large parts of the world are already living beyond their water means by supporting agriculture based on unsustainable use of groundwater. In addition, about 25% of the world’s crop land is degraded; a further 35% of present African cropland is likely to be unsuitable for cultivation by 2100 due to climate change. And, just between 2000 and 2010, we lost on average 5.2 million hectares of forest every year.

We also face the prospect of as much as 4 degree Celsius warmer world. If this happens, food staple production could decline by 10-15% over current levels, rather than increase as is needed, leading to greatly expanded hardship, conflict, and even mass starvation within the span of one lifetime. We not only need to increase production under conditions that are harder than when the world was responding to a big food crisis in the 1970s, but we also need to pay specific attention to how production occurs to create the benefits of improved livelihoods and better nutrition.

Fortunately, agriculture is in a unique position to help on all these issues. Only agriculture at scale (including forestry) can take carbon out of the atmosphere. Forests cover 25-30% of the earth’s land surface and absorb about 15% of the planet’s GHG emissions, and crops can potentially absorb more. In-depth work in 2008 also showed that agricultural growth is very effective (2 to 4 times more than other sectors)


at reducing poverty. And agricultural growth at the smallholder level can be managed to provide more beneficial nutritional outcomes. It takes proactive investment and policy changes to achieve these outcomes at scale.

The climate-smart agriculture of the future requires that we think in terms of an integrated approach to landscapes. A “landscape approach” means taking both a geographical and socio-economic approach to managing the land, water and forest resources. The World Bank Group is increasingly using landscape approaches to implement strategies that integrate manage-ment of land, water, and living resources, and that promote sustainable use and conservation in an equitable manner. The precedents for this were a few large-scale but highly successful projects in what would now be called emerging countries such as China, India and Brazil. Here, the landscape approach combined with other methods of conservation and development can increase personal income while protecting local landscape.

Examples are now found in Africa as well. In Ethiopia’s Great Rift Valley, the landscape ap-proach has included establishing forest coop-eratives that sustainably manage and reforest the surrounding land using Farmer-Managed Natural Forest Regeneration techniques, thus addressing deforestation that threatens ground-water reserves that provide 65,000 people with potable water. In Rwanda, a landscape ap-proach is being scaled-up to a large area of steep hillsides by providing infrastructure for land husbandry (for example, terracing and down-stream reservoir protection), water harvesting and hillside irrigation. Training is provided for farmers, farmer organizations are supported, and marketing and financing activities are enhanced. As a result, productivity in rain fed areas has tripled, more land is protected against soil ero-sion, and the share of commercialized agricul-tural products has increased. In Western Kenya, some 60,000 farmers on 45,000 hectares of land are now combating erosion using sustainable land management practices to enrich degraded soil. In Niger, new farming systems now include trees that capture nitrogen.

For a landscape approach to work, we need secure land tenure rights, so that individual farmers, especially women, as well as communi-ties have an incentive to invest in improved land and water management and to protect trees and forests. In Indonesia, for example, research by the CGIAR on Forests, Trees and Agroforestry shows that community management and village forest permits not only lessen deforestation and forest degradation, but also reduce risks for smallholder farmers and improve the well-being of forest-dependent communities.

Appropriate pricing regimes are needed to encourage rational use of scarce resources. Regulations backed by strong legitimacy at the local level are needed to control pollution run-off or to avoid free-grazing of animals, while appropriate incentives are in place for private farmers to invest in “public good” activities. An environment conducive to behavioral change is fundamental. Transparent and accountable institutions are critical. And if people do not have access to information they can understand, they do not have an incentive to change behav-ior. The ICT revolution is now widely spread, including in many parts of Africa. This serves to impart information, provide interactive informa-tion exchange, and to collect data.

In summary, agriculture is the “essential sector” for reducing poverty, creating shared prosperity and promoting environmental sustainability. Together, we can harness the power of agricul-ture to meet the world’s challenges.

Juergen Voegele, director, agriculture and rural development, Sustainable developmentnetwork, The world bank

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Feeding the PlAnetWhere do We Stand today?

JuerGen voeGele, is the Director of the Agriculture and Rural Development Department, Sustainable Development at The World Bank. He oversees World Bank global programs for rural poverty alleviation, agriculture and natural resources management. Prior to his current appointment, Mr. Voegele worked in agriculture and natural resources divisions in the Europe and Central Asia Region and in the East Asia and Pacific Region. He also led various assignments for the East Asia and Pacific Region and transferred to the World Bank’s Beijing, ChinaOffice to lead the World Bank’s Agriculture Unit.


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Feeding the PlAnetWhere do We Stand today?

“We can do this! We can harness the power of agriculture to achieve abundant, sustainable safe and nutritious, food for all. We just have to have the will to make it work. Nine billion people are counting on us.” -Mark Cackler, World Bank, Manager of the Agriculture and Rural Development Department

“Food will not represent sustainable breakthrough abundance if it is comprised of hollow calories”.-Harold Schmitz, CSO, Mars Inc.

“I believe that sustainable change can happen. But we alone cannot achieve this change. In order for this change to take place at scale and for it to be sustainable, it requires an enormous number of partners to be working together.” -Prabhu Pingali, Deputy Director, Agriculture, Bill and Melinda Gates Foundation

“Dance with entrepreneurs. Invite entrepreneurs to the table.”-Will Rosensweig, Co-Founder and Managing Partner, Physic Ventures

summit presenters

•mark cackler, Sector Manager, Agriculture and Environmental Services, The World Bank Group•harold schmitz, CSO, Mars Inc.•Bill lacy, Vice Chancellor, UC Davis•april mcmillian, Manager, Secure Biosystems Integration, Oak Ridge National Laboratory• prabhu pingale, Director, Tata-Cornell Initiative, Former Deputy Director, Agriculture, Bill and Melinda Gates Foundation •william rosenzweig, Co-Founder and Managing Partner, Physic Ventures


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“i believe that sustainable change can happen. But we alone can-not achieve this change. in order for this change to take place at scale and for it to be sustainable, it requires an enormous number of partners to be working together.” -Prabhu Pingali, Deputy Director, AgricultureBill and Melinda Gates Foundation

situation

In 2050, we will need to feed nine billion people and increase food production by 70 percent worldwide. Tonight and every other night, one out of eight people in the world–870 million people–will go to bed hungry.

From an evidence-based perspective, we know that food and agriculture comprise a dominant if not the dominant influence on the footprint of the planet when it comes to our health and our environment.

We will need to figure out how to feed nine bil-lion people in way that embraces environmental and ecological sustainability, addresses complex social and cultural issues as well as strengthens the relationship of food and nutrition with public health.

The next three-to-five years presents a criti-cal window to make a difference for the long term. We can provide sustainable, nutritious, abundant food for everyone. But this goal will require trust, innovation, and collabora-tion among farmers, businesses, governments, research institutions, foundations/NGOs, and finance.

We will need to leverage uncommon collabora-tions and build bridges with other “tribes” with expertise in health, energy, transportation, and the environment. It is time to connect the scat-tered global food initiatives and fuel the cycles of innovation in order to achieve our shared goal of feeding the planet.

challenGes

1. price volatility

High and volatile food prices are the new normal. Food prices are becoming more volatile while food stocks in US and around the world are at the lowest level in a generation.

•Worldgrainconsumptioninlastfiveyearshasincreased 2.3 percent per year while production has only increased 1.8 percent per year.

•Foodstockshavebeencomingdownaround20 percent of annual consumption;

•SinceJune2011,cornpricesareup45per-cent, wheat prices have risen 50 percent.

•UScornstocksaredownto7percent,makingus more vulnerable to volatile prices.

There is an absolute correlation between food stocks and price volatility. The drivers of price volatility are not going away:

•IncreasedgrainexportsfromareassuchastheBlack Sea and Latin America, which have higher weather volatility, are contributing significantly to price volatility. Exports of wheat in the 1990’s from those areas were 11 percent; today they are 28 percent.

•Biofuelmandateshaveaddedconstraintsandrigidity to the system.

•Policiessuchastraderestrictionsbycountrieslike Russia, India, Vietnam, and Ukraine who limit their exports, are making a bad problem worse.

All of these have repercussions throughout the world. The Arab Spring was in large part a reac-tion against volatility in food prices. This situa-tion cannot be fixed overnight and will require long-term solutions.

2. poverty

The poor suffer most from food price volatility with consequences that include long-term social and economic disruptions stemming from a lack of nutrition.

Sudden rises in food prices can cause a harm-ful chain reaction in terms of personal health


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and livelihood. Poor families pull their children out of school so they might be another source of income for the family. They will eat cheaper, and less nutritious food. And for those who cannot afford food at all, their children might suffer from malnutrition, which, if untreated in the first two years poses a major threat to brain development and can result in permanent brain damage. Thus, short-term hunger has cata-strophic long-term effects on the health of these citizens, threatening economic growth as well as social stability.

•20-30,000childrenborninIndiatodaywillsuffer from life-long stunting. Food will not represent sustainable breakthrough abundance if it is comprised of hollow calories that contribute to stunting and other issues.

3. climate change

Climate change is undeniably altering the land-scape for food production. Extreme weather is becoming more common causing more flood-ing, heat, and droughts.

We will need more aggressive agricultural research to prepare for climate change such as developing more crops that are tolerant tolerate to extremes in temperature as well as resistant to diseases and pests.

Given that agriculture contributes to 30% of greenhouse gasses, it is time to have agriculture included in discussions surrounding solutions to climate change rather than just be viewed as “part of the problem”.

4. Bad policies

Much of the global food system is dependent on the government policies and regulations that af-fect trade issues, safety issues, and equity. Many of these policies, such as protectionism and bans on exports hinder access of farm products from poor countries to rich countries and are self-defeating.

Many governmental policies also discriminate against the poor and most vulnerable. These include trade policies, protectionism, and laws that discriminate against women when it comes to land tenure. Land grabbing is an increasingly visible issue around the world as the wealthy buy up land in an unjust way from poor farmers.

Another issue is that oceans are being depleted of fish. We must figure out how work together to improve our policies and get long-term agree-ments on the high seas to assure sustainable fisheries.

We also need to change unwise policies that divert food to other uses.

5. food waste

Finally, we waste a lot of food. Depending on the crop, in poor countries between 15-40% of food is lost. The food waste in rich countries each year is equal to all of the annual food pro-duced by Sub-Sahara Africa.

recommenDations

1. invest in agricultural development in developing countries.

No country has been able to achieve sustainable reductions and poverty without massive invest-ments in agricultural development.

Because most of the world’s poor people are farmers, enhancing productivity of small farms is the best way for poor people around the world to grow their way out of poverty. We need to make investments in smallholder agriculture especially in Sub Sahara Africa and South Asia. Every solution doesn’t have to scale or be optimized.

Even small efforts, like teaching farmers how to rotate crops, better soil management, even waste management (ie: composting) can make a big difference.

Gradually higher and more stable food prices, could actually be a good thing, because higher prices can help farmers rise out of poverty.

2. empower women.

Women farmers may be the single most impor-tant development priority.

•Whilewomenmakeup43%ofagriculturelabor force in developing countries, women farmers are less productive than men due to the fact that they have less access to land, water,


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seeds, training and credit. If women had same access as men, their farm yields would increase by 20-30%.

“Feed the Future” which grew out of 2009 G8 Summit, is rooted in partnerships with local gov-ernments, donor organizations and civil society. All of us, including the business sector, would benefit by joining forces with this coordinated effort.

3. make better use of technology.

We need to do a better job of harnessing the power of technology to help farmers.

In 2002, half the people in the world had never made a phone call. Today, people have mobile phones, in the most isolated areas. It is time to make better use of new technologies, such as mobile devices, videos and other modern ways of disseminating and extending knowledge to help farmers.

example: Using GPS technology, we can put sensors on top of a tractor that can help farmers determine what kinds of fertilizers and how much to use to increase the yields on their crops. They can do this on the fly, saving much time with greater efficiency.

example: The Oakridge National Laboratory is monitoring a wide range of data from around the globe through a number of uncommon collaborations–gathering biological, chemical, transportation, economic, and climate informa-tion among other data. The hope is that the combined data will reveal new information to guide planning on future food production and food systems.

4. invest in infrastructure.

To make a difference in global agricultural de-velopment over the long term, the US and other nations will need to work more closely with governments around the world on investments in infrastructure such as roads, ports, irrigation systems and agricultural innovation.

The US itself is a demonstration model of successful long-term government investments in agriculture. Since 1862, the US federal and state governments played a key role in providing funding backed by local resources to support do-mestic agricultural development across America through the land grant university system and ag-ricultural extension. This investment has been a fundamental contributor to America’s abundant food supply and economic success.

5. connect food issues more closely with health

We need to focus much more on policies in rich and poor countries alike that link food produc-tion to nutrition and health outcomes.The FDA, for example could take a much more active role in allowing food-based health ingredi-ents to be protected and marketed so that they can make legitimate claims based on clinical science.

example: Mars, a company that depends very much on cacao for its products, has been researching the health benefits from a natural product that comes from Theobroma cacao. This cacao product has demonstrated to have both cognitive benefits as well as its ability to lower blood pressure.

6. Develop business incentives and invite in entrepreneurs.

It’s time to dance with entrepreneurs. We know the magnitude of the problems, but solutions are moving too slowly.

One of the biggest impediments to change is that the basic food business model works so historically there has been no imperative to raise the game. However, the private sector can be tremendously helpful in introducing new input supply systems, new seed systems, new market systems, and other related systems especially to rural communities where the needs are highest. Private sector research and development can also bring real advances to poor farmers.

To reach our goal of abundant, nutritious food for everyone, we will need to work with the very large food corporations who are doing every-thing possible to optimize their production and, at same time, engage entrepreneurs and venture capital to find innovations that can disrupt cur-rent models in order to make them better. The solution is full of paradoxes, full of tension, but leaders will have to embrace both.

groWing AbundAnt Foodglobal trends in Food Security

un photo/Bz


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7. work collaboratively across disciplines

Sustainable change can happen. Sustainable change can be scaled up. But by working alone we cannot achieve this change. In order for this change to take place at scale, and for it to be sustainable, requires an enormous number of partners to be working together.

example: The CIFAR program at UC Davis is one of the successful programs that includes all the cross-disciplinary collaboration elements needed to make a difference. This outstanding collaborative model grew out of academia and engages business to embrace all inputs.

Perhaps what is needed is the food equivalent of Sputnik–a global strategic imperative that everyone can agree with. Once we establish the strategic imperative, we can work together on the long-term strategy with inputs from business, science and technology along with academia, NGO’s, and government.

We can do this! We can harness the power of agriculture to achieve abundant, sustainable safe and nutritious, food for all. We just have to have the will to make it work. We have technol-ogies for today. We have a way to develop the technologies for tomorrow. Nine billion people are counting on us.

groWing AbundAnt Foodglobal trends in Food Security

summit presenters

•frederick vossenaar, Program Manager, Climate-Smart Agriculture, Ministry of Economic Affairs, Agriculture and Innovation, The Netherlands•kent Bradford, Director, Seed Biology Center, UC Davis •michael Dimock, President, Roots Of Change Fund

situation

What we’re doing as human beings to feed ourselves has the largest impact on the natural world–greater than any other activity.

We face huge challenges: climate change, hun-ger, environmental degradation, degradation of human communities, and challenges to human

health. This tells us that the system isn’t totally working.

Recently, we’ve moved from a period of com-modity abundance, (i.e. more corn, more wheat, etc,) to a period of relative commodity scarcity. The number in terms of productivity and con-sumption are very close: any shock to the system and we will be negative.*

un photo/Bz


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Faced with a growing world population, we must move toward “sustainable intensification”–increasing productivity per unit area–in order to protect our wild lands, preserve biodiversity and reduce the environmental impacts while also providing the food that is needed by our grow-ing population.

Advances of the “green revolution” including genetically engineered crops, improved food varieties, fertilizers, pest control, all allowed us over the last 50 years to triple agricultural yields around the world with only a 10 percent increase in overall area cultivated for agriculture.

Directly due to innovations in biotechnology, between 1987-2007, there has been a 41 percent increase in yield/acre and we have done better on every index in terms of sustainability: energy use, soil loss, irrigation, climate impact and land use.

However, there are many complex issues we still need to grapple with to get to a world of abun-dance. We need a robust debate to reconcile the competing views about how our world will need to evolve.

Some question, for example, the need to increase food production so dramatically when we already waste between 40-45 percent of food

produced each year. Significant other issues sur-round the appropriate use of biotechnology.

To move forward with a clear vision, trust between all parties including producers and consumers alike, becomes a critical priority.

challenGes

In 1960, there were 1 billion hungry people but we were feeding 2 billion. Today, we still have about 1 billion hungry people, but we’re feed-ing 6 billion. We’re actually feeding 3 times as many people while still experiencing persistent hunger among the world’s poorest people.

A new problem is coming soon. In 2050 China and India will have 40 percent of world’s population with only 15 percent of arable land. By some estimates, we will need another 50-70 percent increase in food production to meet the anticipated global food demand in 2050.

If we attempt to meet this demand by expand-ing land area used for production, we will face enormous problems, including considerable carbon loss. Burning rain forests for new land, plowing the land and aerating new lands all release carbon.

The data show that innovations in seed biotech-nology have allowed us to have higher produc-tivity and tackle sustainability issues simultane-ously.

With seed biotechnology, we can use fewer pesticides, less fuel, and lower the impact on environment. For example, we can control weeds through new crops varieties so that we don’t need to plow, reducing carbon release and reducing energy use in the process.

Most agree that the key to meeting increased global demand for food is to continue to maxi-mize crop yields per acre rather than increase land used for production. To accomplish this for our future, many scientists believe the only way is to stop marginalizing biotechnology and think seriously about how we should be using it responsibly to enhance sustainability.

Unfortunately, in food biotechnology, we’re seeing a suppression of entrepreneurship by regulatory and market-based push-back. While locally-sourced food is worth promoting, it rep-resents less than 3 percent of food we eat in the US. We will need all the technologies we have to solve the significant problems ahead of us. There is no reason the two can’t work together.

Nevertheless, significant issues associated with biotechnology merit public debate. These include:

“i am advocating for bio-technology for sustainability. let’s stop marginalizing this technology–let’s think serious about how we should be us-ing it specifically to enhance sustainability.” –Kent Bradford, Director, Seed Biology Center, University of California Davis


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1. ownership of seeds. Only seven or eight companies essentially own all the seeds in the world. While most agree that companies who invest in biotechnology should be able to have a return on their investment, better systems need to be in place to assure more access to these ben-eficial technologies–especially among the world’s poorest populations.

2. who funds the research. If biotechnology research is mostly paid for by the large seed companies, the scientific debate can be easily impeded.

3. regulation. When those who have been working in the industry become the regula-tors, trust is compromised. We need to assure transparency throughout the system so that the science and its products can be trusted.

recommenDations

1. continue to innovate in order to optimize our food systems through biotechnology and other means. some of the proposed biotech-nology innovations with the greatest promise include:nitrogen and phosphorus use efficiency. We don’t have enough phosphorus to maintain our productivity. Nitrogen can be made from the air, but there are consequences to doing this. We need to find ways to optimize the produc-tion and use of nitrogen and phosphorus in our crops.

fertilizers. About half the fertilizers we use goes somewhere, but not into the plants. We need to find ways to make the application of fertilizers more efficient.

nitrogen fixation. Certain plants that can actually fix their own nitrogen. We need to get this into more crops. With biotechnology, this is very doable.

photosynthesis in wheat and rice. If we could get wheat and rice to do photosynthesis as efficiently as corn does we would save water, in-crease productivity and have the next quantum leap we need in productivity.

improving stress tolerance. We know that climate change will increase the variability of global temperatures and other conditions. Crop losses due to drought, salinity, and temperature extremes present critical challenges. We need to embrace the successful strategies that already exist to help farmers withstand these situations.

2. reduce food waste. Food waste is a huge problem…and opportunity. If we could stop waste, we might not need a 70 percent increase in production, we might only need 20 percent.

It’s not about the developed world saving food scraps and shipping them to Africa. The solu-tion is that Africa needs to feed itself. If we empower women, for example, we would see a 20-40 percent increase in food production.

The food waste problem is very different for US than in other places. In America, a lot of food is wasted because people don’t know how to understand the expiration date and good food just gets tossed. In Kenya, on the other hand, half of grain may be wasted due to spoilage after harvest.

3. recognize the value of food. There are a lot of external impacts that are not included in the price of food. It’s very hard to get to sustainabil-ity if we don’t have the right pricing structure that reflects the true costs. Typically, we create taxes to deal with these impacts, but we’re strug-gling with that now.

4. involve the public in more science-based discussions about food to build trust and move appropriate technology innovations forward. Transparency is critical. In our discussions, we need to be “technically correct”, not “politically correct”.

three “e’s” merit focus

“eatable” food. The entire premise of the food system should be about better nutrition, not just more food. We must more actively support health through food.

education. It’s amazing how many people don’t know where their food actually comes from. We need to find ways to educate the public more so that they are more connected to food. Farmers don’t have the time to do this.

un photo/Bz


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entrepreneurship. Unleashing the inventive human spirit can lead the way to solving a lot of agricultural problems. Support both the small farmer as well as the large farmer find better and

more creative ways to produce food with less regulation, especially by people who have never farmed before.

5. engage the private sector in playing a bigger role in agricultural innovation and encourage them to make long-term commitments.

example: Several Dutch seed companies are investing in Sub Sahara Africa knowing they will lose money for the next decade, but confident that in the future they will be successful. They are working to develop markets in countries that many would consider too difficult or too poor to generate results.

We need to make strategic investments in pro-cesses and people that will accelerate pressures on food producers and governments to change the system to make it better.

It is time to think strategically about what we all need to do to sustainably and positively impact agriculture, and then let’s do it!* Global Harvest GAP Report.

From hArveSt to tAblePreservation, logistics, and distributionsummit presenters

•rob howell, VP, Sourcing and Supply Chain Services, Sysco Systems •Jeffrey Brecht, Director, UF/IFAS Center for Food Distribution & Retailing, University of Florida •rich kottmeyer, Senior Executive and Global Agriculture & Food Production Leader, Accenture •edward zhu, CEO, CHIC Group Global

un photo/eskinder Debebe

un photo/forte


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From hArveSt to tAblePreservation, logistics, and distribution

situation

We understand one thing: with more people, more health and more wealth, we will need to move more food. While a lot of people think this is a problem, it is also an opportunity. As three billion people become middle class by United Nations standards, the economy will grow by $1.5 trillion.

That gives us a reason for everyone to get aligned.

A major obstacle to providing food for every-one is the loss of food through waste, spoilage, disease, pests or the lack of adequate logistics for transportation and distribution. According to Rabobank, we already produce enough food to feed every person on earth a diet of 8,000 calories per day–clearly more than we need.

However, after we harvest the food, approximate-ly 60 percent is lost from spoilage or failure to be delivered to where the food is needed. Some-times politics blocks the movement of food; other times it is lack of airports, roads, technol-ogy or other infrastructure. Improper handling, storage or poor regulation also contributes to contamination and loss.

It is not enough to focus solely on producing and harvesting enough food. We also must take thoughtful steps to assure that the right systems are in place to keep food safely moving through the food chain including efficient, cost effective distribution from point of harvest to point of consumption.

challenGes

1. Growing populations and a growing middle class will require more food.

Food distribution is like a pipe: as our global populations grow and as they become more middle class, we’re going to need to put twice as much through the pipe. There are three ways to accomplish this:

1. improve the pipe: This is what companies such as Sysco and others are doing to assure food is distributed efficiently and safely through-out the food chain.

2. optimize the pipe: Improve the velocity of food through the pipe. This is what Accenture and other consulting companies are working on.

3. fix the leaks: Prevent waste and loss of food that has already been produced.

2. food safety is a global concern with large variations between countries.

In developing countries, food safety is especially challenging because the agricultural system is tied to individual small farms that have little or no technology in place to capture or report any data. It is nearly impossible for the government to effectively track food safety issues or put the necessary inspections in place at the central, provincial and local levels.

example: In China, there are 229 million farmers, most with farms that are less than 1 acre. These farmers are largely illiterate and lack the ability to understand the complex, sometimes conflicting agricultural regulations. In India, there are 630 million farmers with similar concerns.

3. regulatory issues are too complex and not globally compatible.

To optimize global and local food distribution, we will need to address the myriad of national systems and standards that are not compatible– some mandatory and some recommended. For example, in China there are approximately eight overlapping and contradictory domestic pesti-cide standards.

Adding to the complexities are large variations in each country’s diet, crops, maximum residue limits for pesticides among other factors that make trade compliance between countries highly challenging.

Recent global efforts to standardize terminol-ogy and cooperate more on food safety such as GFSI* are making a difference, but agriculture remains an area that needs much more focused attention.

un photo/James Bu

“higher performance at scale is good for everyone.” –Rich Kottmeyer Senior Executive and Global Agriculture and Food Production Leader, Accenture


[*Global Food Safety Initiative a business-driven safety initiative managed by The Consumer Goods Forum, the only independent global network for con-sumer goods retailers and manufacturers worldwide, serving CEOs and senior management of nearly 400 members, in over 150 countries.]

4. too much food is wasted or lost.

Loss and waste are different issues requiring different solutions. Loss, which refers to food being destroyed by environmental conditions, eaten in storage by pests or destroyed through decay by microorganisms, tends to be more prob-lematic in developing countries. Waste is more of an issue in developed countries where a lot of good food is discarded due to expiration dates or because it is not cosmetically perfect.

The goal should not be to deliver barely eatable food to consumers. Food must be palatable and nutritionally valuable.

recommenDations

1. support small-holder farmers to improve food safety.

A short-term solution to food safety in develop-ing countries is to install electronic traceability systems such as barcodes that traces food safety issues from food cultivation to harvesting to post harvesting through processing and distribution– all the way to the table. To accomplish this, the larger agriculture companies will need to take a leadership role in helping small-holder farmers.

In long run, the only way to assure food safety is to slowly reduce the number of poor, small-hold-er farmers in order to have technology-based large-scale farming. It will be essential to provide a safety net to ease this transition. Optimally

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this should be provided for through industry and not through government subsidies.

The reality is that we have to improve the performance of small-holder farmers especially in China, India, SE Asia and Sub Sahara Africa because we are going to be working with these small farmers for an indeterminable and prob-ably longer time than we anticipate.

Global agricultural industrial leaders have an opportunity to work with entrepreneurs in China and in other developing countries to help the food chain to improve. By investing in these countries, they not only open new markets, they become new places to source safe products from.

2. celebrate size and scale.

Large size and scale in agriculture brings some-thing to celebrate. If you look at how we got the incredible increases in crop yields over the past half-century, it was because of consolidated power of seed companies and consolidated ac-tion.

Scale issues also refer to supply chains. Across the world, we don’t have to go from really bad practices to instilling modern supply chains over-night. It’s all about getting modest, incremental gains, but doing it at scale.

At the same time we’re working to be scalable, we have to be flexible. For example, can we predict what the Chinese middle class will want to eat in 2040 or how that’s going to impact world food? Anticipating and then planning for these major trends is where technology will play a big role.

un photo/John isaac

un photo/James Bu


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3. promote technology.

Even relatively simple technologies can help quite a bit. While many farmers are illiterate, almost all now have a phone and many have cameras. We can analyze a picture and call farm-ers back to help them understand what’s going on with their crops.

In a lot of cases, especially in the developing world, significant gains can come from a shift from virtually no agricultural practice to modest agricultural practice.

example: In India, Monsanto has demon-strated that a little technology can have consider-able impact. By providing just a little bit of help to farmers over a simple voice-based system the farm yields improved dramatically.

example: In China, the CHIC Group is working to optimize the supply chain and im-prove safety by giving a scanner free of charge to thousands of farmers they work with. Farmers scan every product they are harvesting. What-ever the farmer puts into the system, such as the source or amount of pesticides, fertilizers, etc, can all be traced. Information on the barcode is further linked with the transporting truck, the shifts of the manufacturing plant, the pallet, and the shipping container, thereby connecting information about that food product all the way from the farm to the marketplace.

4. use more data and analytics.

We can look at data as a way to be more respon-sive to the demand forecast in the marketplace. Data and analytics now allow you understand what is being grown as it is being grown as well

as what the quality is going to be. We can aggre-gate all this data and make more sensible supply chain decisions.

We will need to become more granular about the data we collect because food companies and food retailers are saying, “I want to connect people back to the products, the farmer and the ingredients.”

The more efficiently we can aggregate data working with manufacturing partners, the more effectively it can be moved through the supply chain. The biggest challenge is the “cold chain.” We’ve got to be sure we protect the environment of the product from the day it is farmed to the day it reaches the table.

This means we have to take the data not only forward in aggregation but take it back granular. But this is a big challenge, but it has been done in many other industries due to the fact that we can process so many more data and run so many more analytics on it than ever before.

5. scale up and be flexible.

To meet our food needs in the future, we’ve got to either scale or be able to scale up. We don’t need to necessarily need to consolidate farms, but farms will have to act bigger than they are.We’ll have to be more flexible, and that means we’ll have to optimize. It will no longer be acceptable to have plants that have 40 percent operational efficiency because that means we’ll have to build another plant. It is much better to use the plant we already have and get it to 60 percent efficiency.

And, prevent waste by fixing the leaks.

un photo/kibae park


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At the tAblenutrition and health

“I can envision future menus and food choices that can help to reverse obesity, and chronic disease trends, lighten the impact on our environment and still yield delicious flavors that delight our customers”.-Greg Drescher, Culinary Institute of America

“If there were a dream to aspire to, it is that the family comes together again around a table–without the TV–to the eat food that they have prepared together.”-Dr. Roy Elam, Medical Director, Vanderbilt Center for Integrative Health

summit presenters

•roy elam, Medical Director, Vanderbilt Center for Integrative Health, Discussion Leader •Greg Drescher, VP, Strategic Initiatives and Industry Leadership, Culinary Institute of America •David schmidt, President and CEO, International Food and Information Council

situation

We can envision a future where menus and food choices can help to reverse obesity, and chronic disease trends, lighten the impact on our environment and still yield delicious flavors that delight our customers.

It comes down to the average consumer: what’s on the plate? When we consider what is optimal nutrition, we need to look at intersection of sus-tainable, social and equitable food in addition to what foods are delicious and have cultural appeal.

Research shows that the future of health and medicine will focus more and more on human behavior. The focus will shift from interven-ing in a health crisis with massive resources, to behavior that promotes health over a lifetime. While several factors do promote health, per-haps the most central factor is food--a healthy, nutritious diet.

As the world moves toward the goal of sustain-able, abundant food for everyone, the nutrition of that food is critical. It isn’t enough just to produce enough food and distribute it; the food manufactured, cooked, and served also needs to be nutritious and to promote good health and happiness.

Food is deeply cultural, and in almost all human societies, food is deeply connected with reli-gious and spiritual values. Diverse cultural and religious perspectives on food are critical issues to engage and integrate into plans for attaining sustainable abundant food for everyone.

challenGes

Obesity is a big challenge. The culinary com-

“if there were a dream to aspire to, it is that the family comes together again around a table–without the tv–to eat the food that they have prepared together.”-Dr. Roy Elam, Medical Director, Vanderbilt Center for Integrative Health


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munity is, in fact, partially responsible. For example our restaurants tend to equate calories as a function of value. We have the idea that if they serve us more, we are getting more value. This is a perception that may be difficult to change, but should be addressed so that people feel that value comes with nutrition and other positive impacts, not calories.

Other factors that contribute to obesity are envi-ronmental. According to Lee Kaplan, an obesity expert from Massachusetts General at Harvard, four major environmental factors determine the “set-point” for body fat, many caused by advances of the industrial revolution. These factors have literally altered the set point for obesity, a situation that costs our country $200 billion in healthcare costs each year.

1. Stress is the biggest factor that has changed our body fat set-point. All the technology that allows us to move faster in our daily lives, also drives the fight or flight hormones faster and faster into our bodies which changes the set-point for body fat.

2. Food and nutrition–energy intake - changed when processed food was introduced because it became much easier to consume a lot more calories in a meal than previously possible.

3. Burning energy, through exercise, muscle movement matters a great deal. The brain man-ages this set point in a very complex way: it is not just about calories in, calories out.

4. Medications given to patients, such as anti-depression, pain medications and even diabetes medications will change the set-point for fat and often cause more obesity.

recommenDations

There is a huge potential for the culinary com-munity to serve as a positive change agent in guiding the food we purchase and eat by helping to reshape consumer preferences toward foods that improve health and nutrition and support sustainability.

More and more Americans are preparing fewer meals at home and asking culinary chefs to make their food choices for them. Americans currently spend almost half (48 percent) of their consumer food dollars on restaurant food. The food service industry–a $630 billion industry–has many different facets and therefore numerous avenues to affect consumer change. For example, the industry has an opportunity to build excitement about new foods prepared with plant-based protein rather than animal-based protein which doesn’t support optimal nutrition and is unsustainably resource intensive.

As we move now to more plant–based diets, the Culinary Institute of America, is looking for inspiration and guidance from other parts of the world that rely more on plants for their diet. In rural Thailand, for instance, you will find largely-plant-based meals that are delicious because Thai home cooks have been working away at this diet for generations with the local foods that were available. There is enormous cultural genius all around the world that can help us make the transitions to a more nutri-tious, plant-based diet.

The issue of transparency regarding information about the food we purchase and consume will also become a larger factor in affecting consum-er demand. A huge accelerator will be informa-tion about food that will include not only what’s in the product, but also social responsibility, sustainability and ethical issues such as how workers are treated.

It is not only the food we eat, but it’s the context within which we eat. If there were a dream to aspire to, it is that the family comes together again around a table–without the TV–to the eat food that they have prepared together.

Food choice really comes down to people’s imag-ination. Our goal should be to provide enough inspiration so that consumers do things that are going to support a more rational, sustainable, healthier future in terms of diet and health for the planet.

u.s. consumer Data points 76% strongly or somewhat agree that changing information on food makes it hard to know what to believe.

consumers are saying “i’m bombarded with information so i’m going to make my own decisions.”

half of all consumers believe it is easier to do their own taxes than to figure out how to eat healthfully.

only about 15% of consumers actually know how many calories they should be eating.

taste and price drive food and beverage choices more often than healthfulness.

nearly 66% of consumers are favorable or neutral toward the use of biotechnology in food production.

two-thirds of consumers say they have thought about the sustainability of their foods and beverages.

people in developing countries are more willing to see the need for adequate nutrition and in many cases more willing to support biotechnology.


Section iiAbundant health

heAlthcAre SolutionS

practical innovations in patient care, advanced technologies, and a new focus on wellness have the potential to transform our approach to healthcare for the better. how can healthcare providers offer more personalized solutions, preventive care, nutritional guidance, and improve patient outcomes in a more cost-effective way? a healthier world that includes access to quality healthcare for all citizens is critical to our economic future and social vitality. leading industry experts discuss the challenges and outline priorities for a “new medicine.”


Section iiAbundant health

heAlthcAre SolutionS

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the future of healtheditorial by Senator williaM h. FriSt, M.d.

it’s a common refrain that America has the best health care in the world but our people are far from the healthiest. We spend twice as much as any other nation on health services yet rank dismally, behind more than

twenty other countries in basic health metrics like infant mortality and life expectancy. We have more MRI machines, heart transplants, new drug pat-ents, Nobel prize winners than any country in the world and yet people in Greece, Israel and Jordan live longer. How can this be?

The New York Times will tell you that the lack of a true healthcare system, preferably a nationalized and universal system, causes these failures. If only we had a true, equitable and universal system, such as Britain’s or France’s, we could skyrocket up the rankings. This is simply not true.

Data have shown that when all factors are taken into account health services only account for roughly 10% of determining how long we live. The two major factors are personal behavior, account-ing for 40%, and genetics, accounting for 30% (social circumstances and environmental exposure round out the rest at 15% and 5%, respectively). So how do we harness the true drivers of mortality? How do we live healthier, create a more targeted and personalized approach to medicine all while simultaneously cutting costs and eliminating waste?

The answer lies in what I call “New Medicine.” I believe that we are currently at an inflection point in medicine. We are poised to capitalize on decades of innovation, tying together dispa-rate fields including genetics, social networks, supercomputing, the internet, stem cells, cutting edge imaging and sensors, and pharmaceuticals. These forces, unleashed in a dynamic, coordinated fashion can usher in this era of “New Medicine” that treats each patient as an individual, not the average, eliminates waste, adverse side effects and maximizes the outcome of diagnosis and treatment for you specifically, not just for most people or the population in general. We have been building towards this inflection point for decades with seemingly unrelated advanc-es such as the advent of cell phones in the 1970’s,

the discovery of the double helix model of DNA in 1953, or the first MRI on a human being in 1977.

I have written in several forums about some of these advances, most notably pharmacogenomics and the rise of consumerism in healthcare, but today I focus on one breakthrough of incredible potential.

Stem cells hold the power to be a major pillar of the “New Medicine.” Scientists have speculated for years about the awesome potential of stem cells. Conditions as wide ranging as diabetes, spinal cord injuries, burns, limb amputations, heart disease and neurological disorders can all likely be treated by stem cells. But what makes embryonic stem cells so special?

Embryonic stem cells are special for two reasons; first they produce exact copies forever and second they can grow into specialized tissue, which fully formed (or “adult embryonic stem cells” human cells cannot, or at least were not thought able to. Embryonic stem cells are harvested from a five day old embryo, taking the inner cell mass of the blastocyst, generating pluripotent embryonic stem cells. These cells can be differentiated into heart cells, brain cells, basically any cell in the human body.

But there are two problems with embryonic stem cells. First is the ethical issue. It requires the de-struction of embryos, the destruction of something that, left to nature, would become human life. Second, it is “non-self.” Even though these cells can become specialized into any type of cell, they do not come from you and your body knows this. But this approach has yielded remarkable scientific breakthroughs. We have cloned frogs and sheep. I had the great pleasure of visiting Dolly in Scotland, the first cloned sheep, which many may not know was actually named after Dolly Parton, the famous Tennessean entertainer. However, for reasons we don’t fully understand, humans cannot be cloned using this same method.

Thus, the real breakthrough came using a radi-cally different approach. In 2012, the Nobel Prize


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for Medicine and Physiology went to Dr. Shinya Yamanaka (along with Sir John B. Gurdon). Yamanaka induced skin cells to become “Pluripo-tent Stem Cells” (iPS). These “iPS cells” have all the special properties of the magical stem cells. In the simplest terms, Yamanaka was able to take normal, adult skin cells and transform them, using four master genes, into pluripotent stem cells, just as capable of transforming into any cell type, but without the use, and consequent destruction of an embryo. Not only does this solve an incredibly complex moral issue, it also bypasses the issue of embryonic stem cells being foreign or “non-self” to the eventual patient or user. Doctors can simply use the patient’s own skin cells to create the iPS cells needed to treat him.

The first real application of this breakthrough is in the form of regenerative medicine. As a transplant surgeon, I have performed hundreds of operations to extend the life of patients by giving them a new heart or lung. This complex procedure meant that I would get on a plane, fly to the organ donor, remove the donor heart and fly back, transplant-ing it into my patient, all in a matter of hours. The patient receives years, even decades, of life with family and friends. I have many patients who I transplanted more than 25 years ago. But the heart transplant patient has traded a fatal disease for a chronic disease, which requires daily management. The heart a surgeon transplants is “non-self” and thus the body continually attempts to reject it. On top of having just undergone one of the most trau-matic operations a human body can endure, the patient must then take multiple immunosuppres-sant medicines to keep his own body from killing his new heart. Consequently, pneumonia, or even a common cold, becomes deadly.

But this operation may well become a thing of the past, like the iron lung. In the not too distant fu-ture, we will take a patient who needs a heart trans-plant, perform a skin biopsy, create patient-specific iPS cells, grow them into healthy heart cells and then transplant, not a separate heart, but merely the genetically matched healthy heart cells. The body, recognizing its own genetic material, would find no cause for rejection and this operation can be done with a needle, not a bonesaw. There

is also no shortage of organ donors or patients dying while waiting for just the right match. This example represents just one of hundreds of applica-tions. In fact, the first clinical trials for macular degeneration (blindness) will occur this year.

The second application of Yamanaka’s break-through is the huge potential for drug discovery. Let’s take Alzheimer’s Disease for an example. Up to now, all drugs have failed. But what if we could test a new drug specifically on your brain cells to see if it works. Using this technology we can. We simply take adult skin cells, revert them to iPS cells in a test tube and then again into brain cells and then test their response to a potential drug in a dish. Now we can literally conduct “clinical trials in a dish.” It’s a new world.

The Gladstone Institute, where Dr. Yamanaka works, has already made cells for Alzheimer’s, Par-kinson’s, Huntington’s and cardiac disorders. With the ability to test drugs on actual cells of a specific patient, we can take the guesswork out of efficacy and toxicity of drugs. This should, and will, lead to a major rejuvenation of the pharmaceutical indus-try and more targeted, specific and effective care for patients. “New Medicine” is coming. Don’t be left behind.

Senator, william h. Frist, M.d, former US Senate Majority leader, clinical professor of Surgery, heart and lung transplant surgeon.

william h. frist, m.D., is a nationally recog-nized heart and lung transplant surgeon, former U.S. Senate Majority Leader, and partner with the private equity firm Cressey and Company. Senator Frist repre-sented Tennessee in the U.S. Senate for 12 years where he served on both Health and Finance committees. He was elected Majority Leader of the Senate having served fewer total years in Congress than anyone in history. His leadership was instrumental to the passage of the 2003 Medicare Prescription Drug, Improvement and Modernization Act and unprecedented funding to fight HIV/AIDS. He is currently an Adjunct Professor of Surgery at Vanderbilt University and a Clinical Professor of Surgery at Meharry Medical College. He is also a Senior Fellow and Co-Chair of the Health Project at the Bipartisan Policy Center. His board service includes the Robert Wood Johnson Foundation, the Kaiser Family Foundation, and the Center for Strategic and Interna-tional Studies.


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trAnSForming heAlthcArehow collaboration and it create

game-changing innovationsummit presenters

• keith Gregg, Chairman and CEO, JRG Ventures•James lakes, Director US Health and Life Sciences, Microsoft•Douglas wenners, SVP for Provider Engagement, Wellpoint •Jordan shlain, Commissioner SF Health Service Systems, Founder Healthloop

situation

A yawning disconnect exists between patient needs and the ability of America’s healthcare sys-tem to deliver timely and cost-effective services to all populations. This is causing a new face of healthcare to emerge.

Practical innovations that include better use of technology, new uses of big data, collaborative teams and a focus on wellness and preventative care rather than sickness, have the potential to transform health care delivery, improve patient outcomes, save money, and promise all popula-tions a healthier life in the future.

challenGes

1. the cost of healthcare in america has escalated beyond its value to consumers:

•Inlast10years(between2001and2011),there has been a 119% increase in the cost of healthcare insurance premiums.

•Averagecostforinsurance/person-$450/month ; for family of 4 this is $1,600/month.

2. an aging population that is also less healthy:

•Thesenioragegroupisnow,forthefirsttime, the largest in terms of size and percent of the population in the US.

•63percentofallAmericansareeitherobeseor overweight.

3. a massive primary care shortage, combined with a high degree of variation in cost and quality of care:

•Todaythereisanaverage20dayswaitfornon-emergency visit. This results in patients either going to the emergency room for immedi-ate treatment or to specialists who may prescribe the wrong treatment. Both approaches result in higher expenses and reduced overall care for the patient.


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•Muchofthepopulationdoesn’thaveaccessto primary care, causing them to go to the emergency room for care or to no one at all.

4. a failure to use technology to manage patient data across care providers and/or bridge communication between the physician and patient:

•Mostofthehealthcaretechnologywasdevel-oped for doctors primarily for billing purposes. It is time to refocus technology to support the patient. Today, for example, a doctor might not know that their patient went to the emergency room five times in a month because either s/he couldn’t get an appointment or had to wait 28 days, or didn’t comply with a medication trigger-ing an emergency room visit.

•TheElectronicMedicalRecorddoesnotful-fill the data reporting needs that are required to be successful in a modern world. The Electronic Medical Record and the Physician’s Health Record tell you about what happened yesterday; what is really valuable is what is happening today.

•Afocuson“bigdata”ignorestheimportanceof the individual. In the end, a doctor manages one person at a time. We need to use data to support each individual’s health, not aggregated populations.

recommenDations

1. innovations must support doctors helping patients while involving all parties.Our overall approach to healthcare needs to be: “You are the patient, I’m the doctor, together we develop a roadmap. I can invite your family member(s) in on the plan.”

example: At “Healthloop”, it’s all about feedback and involving everyone. If you’re not in the “loop”, you can’t make a decision. At Healthloop, the doctor gets reimbursed for the patient’s participation, not on the diagnosis. When the patient participates, that’s when the doctor gets paid.

2. provide incentives for physicians to maintain contact with patients, while also focusing on wellness and preventive care. We need to take more advantage of the funda-

mental trust people have with their doctors. An e-mail message from the doctor has the potential to have a huge impact. Doctors can personalize messages because they know who their patients are.

example: Wellpoint is experimenting with a $6-8/month fee per patient to physicians to compensate them for personalized care and care coordination.

3. technology solutions need to be directed to the patient’s needs.

Use technology to take the predictive informa-tion that is already available and get it to the pa-tient in a way that is both accessible and useful. It’s the little data that matters; there is no need to invent complex, expensive solutions.

We need our systems to recognize that our pro-fessional life and personal life are closely related. A solution would include offering consumers more seamless communication connections to health care providers with the capability to communicate across all platforms. IBM is one company that is working on building platforms to facilitate this.

Use technology to communicate frequently and involve family members. If patients know they are being observed, they will be more likely to be motivated to do better. Family and friends typically want to help but they frequently don’t know how nor do they have the right informa-tion.

Look at developing technologies that can reach into an HMR (Health Medical Record), extract out pertinent clinical data and marry this with pertinent financial data to provide meaningful information to physicians. So far, no company is doing this adequately.

4. encourage consumers to be more engaged partners in health.

To involve patients more, we need to change some of our language. For example, rather than say “You must take your pill...” suggest: “How can I help you take your pill?”

We all have the same problems, but as individu-als we need to own our problems. Personalized medicine is what happens to you.


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summit presenters

•roy elam, Instructional Systems Specialist, Directorate of Training and Doctrine MCOE, Fort Benning•steve Burd, President and CEO, Safeway, Inc.•Brent parton, Program Director, Shout America•wayne riley, President, Meharry Medical College

the neW medicine

situation

The “New Medicine” is about emerging, disrup-tive innovations that are likely to cause signifi-cant changes in how we approach healthcare. Large and small providers are already beginning to transform our system from one that focused on consumption of disease-based health care services to one based on the consumption of prevention and wellness.

Historically, our healthcare system has worked to solve targeted health emergencies through massive intervention: in the early 20th century, we focused on infectious disease; in the mid 20th century, the focus was on cardiovascular and strokes; and in the latter part of the 20th century, the focus shifted to cures for cancer.

It is time now to focus on health. A healthier world for all citizens–especially those who have been underserved–is tied to economic vitality. We must invest earlier and work together more strategically across teams to promote healthy lifestyles. This is the “New Medicine.”

challenGes

1. there is a deep disconnect in our healthcare delivery system. our entire system is set up for patients to be dependent on physicians for prescriptions, for procedures, and treatments; there is no model for self-care.

example: In Nashville, the capital of health-care with over 300 Healthcare companies, the obesity rate is over 30%; Tennessee has a 10% rate of diabetes. Clearly, the amount of health-care available in the city and state is not helping the local population.

2. we must shore up primary care to assure all populations are provided for–especially the underserved. Primary care is cost effective and more efficient. Currently we do not do an equitable job of serving all populations:

•Bothracialandethnicminoritiesexperiencehigher rates of illness and death than non-minorities.”

•Hispanicsarelesslikelytoreceivemajorproce-


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dures in 38 of 63 different disease categories;•AfricanAmericansaresignificantlylesslikelythan whites to receive major therapeutic proce-dures in 77 disease categories.

3. to solve the health care problem, there are two critical areas to focus on:

a) We must provide better financial incentives for healthcare providers to shift their focus to wellness and prevention in order to change the system. We need to move toward a system that rewards quality of care over time as opposed to rewards for quantity and episodic care.

b) The health care culture needs to change for patients as well as providers: new models of care delivery need to allow–and encourage–the patient to take more responsibility for his or her own health. Patients as well will have to em-brace this new approach to healthcare, recogniz-ing that they share the responsibility. This will take some time.

Bottom line: there is no shortage of money or resources. America’s health care costs are twice as much as any other country. The problem is a shortage of the right care at the right time and the right place.

recommenDations

1. use a more team approach.

This trend is beginning. Healthcare must become more interdisciplinary, with teams work-ing together. We need to work more with nurse practitioners. The whole notion of talking to doctor who is in charge and then there is every-body else, is obsolete.

example: At the Vanderbilt Program for Interprofessional Learning - the medical student, social worker, nurse student and pharmacy student all see patient together as first year students.

2. Break out of the clinic.

example: Telemedicine allows patients to check-in remotely. In addition, we need to en-gage other partners in the community to provide services more conveniently and more frequently.

3. approach traditional problems differently.

The traditional way we have been approaching health problems is too costly and is frequently not effective because it is not approached holisti-cally. For example, treatment of chronic pain costs Medicare $650 billion per year. Chronic pain management and absenteeism from work costs $550 billion per year. Recent research has shown that in fact, chronic pain is primarily a brain disorder.

The solution is to approach health problems more holistically so that multiple facets of a particular condition can be considered at the same time:

example: Vanderbilt Center for Integrative Health developed a care model for chronic pain that is psycho-social focused. The center helps patients with chronic pain control their own brain to mitigate or remove pain with leadership and coaching from the clinician.

example: The number one cause of obesity is stress, not food or exercise which is the tradi-tional “cure”. Stress has a lot to do with the fact that our body systems are turned on so much more now due to the many more stimulations we experience in our lives that cause “fight or flight” processes to work on us. If we can help patients manage stress, we could make a big impact on obesity.

4. take small, manageable steps and take the long view.

example: Safeway has created a culture of “health.” As part of this initiative, the com-pany gives employees a five minute break to close their eyes and de-stress or walk around the block. It encourages employees to take the stairs, not the elevator, and makes this activ-ity a priority.” Safeway says, “You are a part of this culture of health if you choose to step over to this side.” The result? A more productive, competitive firm.

5. Design hospitals differently to promote more wellness.


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example: In one hospital redesign concept, upon entering the hospital, an exercise room and a teaching kitchen are in full view. A walk-ing path around the hospital might allow family members to exercise and relieving stress as their loved ones being treated in the hospital. As folks walk around the hospital, they might see all the programs that they could lean into in the future.

6. promote the health coach

A Health Coach is a healthcare professional skilled at working with patients over a longer period of time to make lifestyle changes such as: helping people stop smoking or drinking, assist-ing with better eating habits, or helping people manage chronic pain more actively rather relying on excessive medication.

It turns out that Health Coaches have been very successful in supporting life-style changes yield-ing economic benefits as well:

example: Kaiser Permanente offered a health coach to 277,000 of their employees (about 50,000 actually used the health coaches.) The result was $2.28/employee/month healthcare

savings for entire 277,000 employee population. example: Research indicates that group coaching over the phone is more appreciated and more effective than one-on-one coaching. With today’s technology we can connect six people on the phone each week with a health-care coach who is trained to help people to move through the barriers from dependency to self-care.

7. engage consumers as a partner in their own health decisions.

In world where insurance companies can’t re-imburse for everything, the patient has to be an arbiter of what is important in terms of quality, in partnership with his or her care providers.

However, the expectation is that if you can make prevention and wellness valuable to the end-user, you’ll get buy-in. That’s very hard to do and it takes time. It took the green move-ment 40 years to get people towant “green” products, but that doesn’t mean it isn’t worth doing. We need to take the long view.

summit presenters

•Jordan asher, CMO and CIO Mission Point Health Partners •martin rash, Chairman and CEO RegionalCare Hospital Partners•Dr. trent nichols, Senior Research Staff, Chief Medical Officer, Secure Biosystems Integration, Oakridge National Lab.• landon Gibbs, Director of Healthcare Initiatives of Clayton & Associates

Future oF hoSPitAl cAre mAnAgement


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situation

Hospitals were originally developed to take care of sick people when there was nowhere else for them to go, and often because they were dying. Over the past century, the role of the hospital shifted dramatically. Hospitals now serve many functions and address many different patient needs at virtually every stage of a person’s life.

Along with these changes, hospitals have evolved from predominately philanthropic institutions to businesses. With healthcare costs growing at an unsustainable rate of seven percent each year, we must envision a more efficient and cost-effective model for hospitals that not only improves patient outcomes but also embraces a new role for hospitals in our overall approach to healthcare.

Driving some of this change is a movement to put the individual consumer more at the center of all activity by constellating relevant services around his or her specific needs. Another is a focus on promoting wellness. How should hospitals redesign themselves to respond to this shift in healthcare? What can hospitals do to improve their patients’ experience while also reducing healthcare costs and at the same time, maintain profitability? What role can hospitals play in improving the overall health of their communities?

challenGes

hospital management is broken in many different places:

1. As a medical hub, a significant focus for hos-pitals is the delivery of primary care. However, rather than represent primary care as provided by the physician, the specialist, or the internist, the delivery of primary care should be presented by hospitals as an integrated service provided by lots of different people with diverse skills at many different times.

3. From a financial point of view, hospitals have few real incentives to keep people healthy. Hos-pital revenues come from services rendered to sick patients; healthy patients don’t pay the bills.

3. Hospitals are not incentivized to keep people healthy. The incentives today are for hospitals to bill patients for services when they are sick; healthy patients don’t pay the bills. 4. A coming shortage of primary care providers threatens to weaken services. Most caregivers in hospitals are baby boomers. When they retire, there will likely be a huge shortage of caregivers.

5. New technology in healthcare tends to in-crease costs–unlike most other fields where tech-nology lowers costs due to greater efficiencies. New technology in hospitals tends to require new rooms, special techs, specialized personnel, and other supports that normally add costs for services rather than reduce them.

6. Policy and concerns over lawsuits often require unnecessary tests or procedures. For example, a hospital might prescribe an MRI only because of fear of a lawsuit, not because the test was necessary.

7. Regulatory pressures have the potential to add considerable costs:

example: Just three items have the poten-tial to add 6% re-imbursement risk starting in 2015/2016: value-based purchasing, 30-day re-admission, hospital acquired infections. In addition, the Affordable Care Act laid out a vari-ety of new pilot programs. By 2018, we’ll see the result of a number of additional new initiatives requiring re-imbursements.

8. Pressure on physicians to reduce care to save money. For example the hospital may want to get the patient out in 2 days to decrease costs de-spite the doctor’s concerns that the patient isn’t ready to go home. Outpatient care is becoming a huge part of the healthcare sector that needs to be addressed.

recommenDations

1. Coordinate services with the patient as the center: we need a more integrated model–likely using technology–in order to work together across all care-givers and coordinate services for the patient.

2. Use financial incentives to improve the qual-ity of care while also saving money:

example: Mission Point Health Partners is developing a shared savings model so that all parties (a company, a hospital or a provider)


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share in the savings. In addition, Mission Point pays for increased access to medical care, such as office hours on Saturday and Sunday. They compensate more for true medication reconcili-ation (if the medical practice has an electronic way to get all the drugs on a patient) as well as if the provider has a way to communicate with pa-tient electronically. These, according to Mission Point, are “quality” metrics that create a better overall healthcare environment overtime.

3. Focus on outpatient care and transitional care to reduce remissions.

Provide the patient with better information when discharged and make sure that the patient understands the information you provide them with. Language, and cultural barriers must be mitigated by having people on staff who can be “cultural brokers”.

4. Partner with home-help agencies and skilled nursing facilities. Assure that all those who take care of patients are fully connected with the patient and other care provides, as well as have access to the pertinent information they need to do a quality job. Take better advantage of nurse practitioners. Partner with “Living Well Cen-ters” to help with lifestyle choices.

5. Create portals to follow-up with patients and assure continuity of care.

Do a better job leveraging technology. Thought question: why is it that we can go almost any-where in the world and do our banking, but with healthcare, we go from one hospital to other, and no one knows our medical history?

6. Include employers in employee healthcare. Employers can control healthcare costs, particu-larly by focusing on the health of their employ-ees and appropriate use of prescription drugs.

7. More focus on clinical analytics.

Any kind of analytics you can provide can help with better diagnosis and treatment. The trend is for real-time, on-demand data.

8. Encourage a more “partnership” relationship with patients.

Patients now have lot more knowledge. It is time to take a partnership approach to their health. Patients are more willing to deal with primary care services vs. just waiting to see their physician.

Patients are also more open to home diagnostic tests rather than waiting six weeks. Overall, con-sumers are taking on a bigger portion of their healthcare costs with higher deductibles, making them more inclined to be involved in their own healthcare decisions.

In the future, we will likely see more consolida-tion in healthcare, with hospitals consumed into bigger campuses or see hospitals that look more like slimmed-down Emergency Rooms or ICU units. As a society, we are all stakeholders in healthcare. We’ve got to get back to what doc-tors have always cared about and always known: improve quality of care in a cost-effective manner where the patient’s experience is enriched.

The new generation will push more for this, which is a good thing.


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PerSonAlized medicine treating the unique

summit presenters

•Jeff Balser, Vice Chancellor, Vanderbilt Medical Center •raymond n. DuBois, Jr., Provost and EVP, The University of Texas MD Anderson Cancer Center •Daniel kraft, Chair of Medicine, Singularity University•Dan m. roden, Assistant Vice Chancellor for Personalized Medicine, Vanderbilt, University School of Medicine

situation

“Personalized medicine” describes the coming transformation in the way we will do medicine and care for patients in our future. Driven by recent breakthroughs in genome sequencing technology and increasingly affordable prices of genome technology, each person will soon have his/her unique genetic information included as a standard part of the electronic health record. This will allow healthcare providers to tailor treatments around each individual’s unique genome and circumstances.

Research reveals that genomic mutations and variations can cause patients to respond very differently to medical treatments and drug therapies. The goal of personalized medicine is to have each patient’s drugs prescribed on the basis of their known genetic information. This will optimize the clinical response to treatment

and enable the patient to experience the least risk from the drug or drugs.

Diet, exercise and stress reduction also have an impact on disease. We must focus more on how to help each individual maintain a healthy lifestyle. This message needs to be a lot stronger than it is now and more ingrained in our overall approach to healthcare.

A more intelligent approach to personalized medicine that includes genomics has already been shown to save valuable time, money and has demonstrated significantly improved im-proved patient outcomes setting a new founda-tion for dramatic transformations in the way we approach healthcare in our future.

challenGes

Because of genetic variations among individuals,


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different patients can respond very differently to medications, with some patients having seri-ous, even catastrophic reactions to commonly prescribed drugs.

Approximately five to six hundred people die each day from adverse drug reactions. This is the sixth leading cause of death in the US. Much of the susceptibility to severe drug reactions has a genetic basis. There are now 58 drugs that FDA have labeled as having genetic stories associated with variability in their outcomes.

Today, heart disease and cancer are the leading cause of death in the US comprising 63 percent of US mortalities. Last year we spent $226 bil-lion taking care of cancer patients in US and we are still experiencing 1500 deaths/day.

Research funding for medical technologies such as genomics from government and other sources is decreasing making it crucial for US research institutions to find new external resources in order to continue to develop new breakthrough medical innovations in genomics and other fields.

Support for personalized medicine based on genomics is further constrained because insur-ance companies do not reimburse for treatments based on genomic information even if the treat-ments are proven to be more effective and cost-effective in the long run. Currently, insurance companies pay only for the drug that works for majority of patients; individualized treatments based on genomics are not understood the insurance system.

Overall, the healthcare system is having a very difficult time adapting because, for example, instead of one form of cancer, we have several hundred forms each with its own paradigm.

recommenDations

1. pharmacogenomics, (the technology that analyzes how an individual’s genetic makeup affects his/her response to drugs), is considered the greatest near-term opportunity for genetic research. Pharmacogenomics aims to develop a rational means of optimizing drug therapy, with respect to the patients’ genotype in order

to produce maximum efficacy with minimal adverse effects.

For example, because cancer is a disease of the genome, through sequencing, we can under-stand why people get cancer earlier or late, why people get complications earlier or late, and why people respond differently to drugs. When doctors have access to this information, they can immediately improve therapies to match patients’ needs.

Leading-edge scientists at research universities such as Vanderbilt University and the University of Texas are discovering new genetic variants that are predisposed to disease or unusual drug responses. They are also discovering associations between new specific genetic variants and low cholesterol or cancer susceptibility that might turn into new drug targets. example: At Vanderbilt University Medical

Center, a new clinical decision-support program called PREDICT has tested more than 7,800 pa-tients for genetic variations that affect responses to several commonly prescribed drugs.

Vanderbilt now includes a field on patients’ medical records designed to display genomic information relevant to drugs. The Vanderbilt University Medical Center also allows patients to access their own genetic information online.

example: The University of Texas MD Anderson Center is doing the full genome sequence, all of the FISH (fluorescence in situ hybridization) analysis for hotspots in the ge-nome, and then pulls the information together to come up with a highly targeted treatment that will be most effective.

“the good physician treats the disease, the great physician treats the patient with the disease.” -Sir. William Osler (1849-1919, considered the “Father of modern medicine”)


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2. personalized medicine based on genomics has already proven to be extremely cost effec-tive. No matter what we’re charging for drugs and tests, keeping people out of the hospital will save money.

example: By using genetic information to determine the right colon cancer therapy, the Khalifa Personalized Cancer Therapy Unit at the MD Anderson Center saved patients $400 mil-lion in the first year. This was accomplished by knowing in advance which patients would not respond to expensive traditional drugs so that they can be targeted with effective alternative therapies.

example: According to recent genetic research among cancer patients with tumors that have a certain mutation, a simple dose of aspirin turns out to yield a much higher probability of survival. The economics of this treatment are very compelling due to the low cost of aspirin and its high impact. (*Source: Khalifa Personal-ized Cancer Therapy Unit.)

We are reaching a point where the approach to medical care will not be about a patient’s particular type of disease is (ie: colon cancer), it will be about the characteristics of the gene the cancer or the disease has affected.

example: At MD Anderson Cancer Center patients with the same gene mutation are put on a similar protocol rather than apply a generic treatment for that particular disease.

3. the role of employers in advocating major changes in healthcare is significant. Increas-ingly, corporate America is self-insured. This means that if an employer wants to cover care based on genomic information, they can do it.

For employers, the metrics traditionally followed to assess drug efficacy, such as survival curves, is of low interest. Of greater interest to employ-ers is how many days the employee had to take off, did the employee come back to work in a timely manner and did he or she make a full recovery.

Therefore, part of the solution is for employers start to demand certain things from the third-party administrators managing their insurance for their employees. For example, 70 percent of insurance market in Tennessee is not insurance, it is self-insurance paid for by employers.

4. regional or national decision support centers are envisioned in the future. These centers would follow the successful liver trans-plant model that concentrates highly specialized health services in a few locations rather than every hospital deciding on their own how to treat certain diseases. It turns out that patient outcomes from these specialized centers are considerably superior to procedures done by a general surgeon.

With personalized medicine, there will be a growing importance between the interface with the person’s healthcare provider (who knows the patient), their genomics, and how they will respond accordingly to treatments.

It is time that we develop a system that focuses on the individual and reimburses for appropri-ate evidence-based care that includes unique genomic information from each patient’s electronic medical record. From a research per-spective, aggregated data from these records can be used as a valuable source of ongoing research and discovery.


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Section iiiAbundant Prosperity building globAl innovAtion hubS

For Food And heAlth

regions that link research universities and foundations with start-up expertise and local business investment are creating thriving local economies with global markets. these regionally concentrated innovation hubs are emerging as the most salient engines of prosperity in today’s global economy. as national and international models demonstrate, success comes from building a regional ecosystem built on trusted relationships. leaders in business, finance, research, and regional economic strategy examine the role of regional innovation hubs as drivers of future sustainable prosperity in today’s global economy.


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the future of prosperity by dr. chriStian ketelS, preSident, the coMpetitiVeneSS inStitUte (tci)

the global economy has had a number of difficult years, and the outlook for the near future doesn’t look much better. Most observers agree that the current quagmire is not just a protracted but ultimately

cyclical challenge. It is a sign that the growth recipes of the previous decade have either failed or lost their effectiveness.

In large parts of the OECD, growth had been fuelled by easy money, driven by a financial sector unleashed by prior deregulation and mon-etary policy that did not step into the way. This period is now decisively over. Macroeconomic stabilization is the focus of today, and is sorely needed to get economies back into balance. Whether to achieve this through front-loaded austerity programs or a more growth-oriented medium-term policy approach is in itself a com-plex and controversial debate. But it is either ultimately a remedy for past ills, not a recipe for future growth.

Many other countries, especially among the emerging economies, have benefited from open-ing up to globalization, serving markets abroad and creating new ones at home. Countries with deposits of natural recourses have prospered, too, benefiting from the growth in the global economy. But both now face at best slow-ing growth rates. Emerging economies need a growth strategy that moves beyond exports based on cheap labor or increasing capital intensity. And natural resource exporters need diversifica-tion to overcome the economic and political pitfalls of their narrow economic base.

It is easy to identify the need for a new growth model; the hard part is to describe what it should be. Economic research offers some answers (beyond explaining why the past ap-proach has failed)? First of all, there is broad consensus that what matters most is productiv-

ity. Locations are prosperous, when they provide conditions for doing business that are produc-tive both in the sense of enabling workers to generate much value and mobilizing a large share of the available workforce to participate in the economy.

Second, there is quite a lot of agreement on what types of policies are conducive to better economic performance: open markets, modest inflation, robust institutions, including property rights, and investments in human skills make the list for a large majority of experts. There are other candidates as well, and there is a wide-discussion on which of these factors matter most and which are endogenous rather than ultimate drivers of performance. But still there is signifi-cant consensus on what is generally good policy.

Third, there is an increasing realization in the academic community that looking for one set of policies, or even worse one policy, as the general answer is ultimately the wrong approach. Policies need to be right given the context in a specific location. And for that, knowing what works ‘on average’ across countries is useful but not sufficiently specific. Increasingly, then, the ques-tion has become how to correctly identify what a specific location should do to enable higher prosperity.

Fourth, practitioners have started to point out that knowing what to do is not enough. What differentiates successful from less success-ful places is the ability to implement action. Successful implementation, it turns out, is a complex result of convincing the right people to act in a coordinated way, it is not just a matter of getting an external advisor to come up with the right analysis.

What to do and how to get it done? The experi-ence from countries at all stages of development suggest that a new model of public-private dia-


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logue is critical to give the right answer to these questions.

Let’s start with the diagnostics. In many situations there is wide disagreement as to the current status of the economy. Having a shared ‘language’ helps, even when different groups focus on different types of information. The competitiveness framework, rooted in the focus on productivity and capturing a broad range of macro- and microeconomic factors, does provide such a language. But often it is not a different conceptual framework but differences in the perceived data that is crucial. A large number of surveys indicate that business leaders and political leaders often have widely diverging assessments about the competitive realities in their country. With such different views on what is, how can one expect a productive debate on what should be done? No one has the complete picture, but together the public and the private sector can arrive at a more realistic view on where their location stands.

Following the analysis, decisions need to be tak-en on what actions to prioritize. Here again, the fragmented nature of the policy dialogue typical today has a clear cost: Governments select what they think has the most beneficial impact on the economy, but lack sufficient understanding of market dynamics to correctly assess impact. Private sector interest groups push at the same time for specific benefits or actions, but fail to concern themselves with overall budget limits or the impact on the wider economy. Everyone is entitled to his or her private interests, but deci-sions that drive sustained growth require a joint focus on the common good.

Ultimately, decisions have to be implemented to have an impact. Governments tend to have an oversized assessment of what the tools that they control can achieve. Often, however, real change only happens if many individual decision

makers, in companies, in universities, and in many others private and public organizations that government doesn’t directly control, make complementary choices about what to do. Imple-menting a national growth agenda is a team effort, not a government policy.

The global debate about prosperity-enhancing economic policy is at an important inflection point. There is increasing consensus on what good policies are. But there is also a growing realization that to get to the right policies in a particular location, process is crucial. An emerg-ing new model of private-public collaboration is a critical element of such a more effective process, leading to better diagnostics, decision-making, implementation and ultimately more sustainable growth.

Dr. ketels has led cluster and competitiveness projects in many parts of the world.

the Future oF AmericAn reSeArch

Dr. christian ketels is a member of the Harvard Business School faculty at Professor Michael E. Porter’s Institute for Strategy and Competitiveness. He holds a PhD (Econ) from the London School of Economics and further degrees from the Kiel Institute for World Economics and Cologne University. He is President of TCI, a global network of professionals in the field of competitiveness, clusters, and innova-tion, Honorary Professor at the European Business School Oestrich-Winckel, and Senior Research Fellow at the Stockholm School of Economics. In 2009 he served as a Visiting Professor at the Lee Kuan Yew School of Public Policy, Singapore. Dr. Ketels has led cluster and competitiveness projects in many parts of the world, has written widely on economic policy is-sues, and is a frequent speaker on competitiveness and strategy in Europe, North America, and Asia.


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the Future oF AmericAn reSeArch

“We are at a critical juncture for the future of our nation and the future of the world.” -Dr. Francis Collins, Director National Institutes of Health

“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 [pubic funding for healthcare] a priority.” -Dr. Francis Collins, Director National Institutes of Health

“I don’t think you incrementally innovate your way out of an impossible situation. Somewhere along the way, when faced with impossibility…you stop and do things differently.” -Ted Abernathey, Jr. President and CEO, Southern Growth Policies Board

summit presenters

•nickolas zeppos, Chancellor, Vanderbilt University •Dr. francis collins, Director, National Institutes of Health •arlene Garrison, VP, University Partnerships, Oak Ridge Associated Universities •ted abernathey, Jr. President and CEO, Southern Growth Policies Board

situation

Research, the fountainhead of innovation econ-omies, continues to be the driver of economic growth for our nation. According to NIH Director, Dr. Francis Collins, the good news is that the pace of scientific discovery in healthcare has never been more rapid. Helped by discover-ies in molecular biology–especially genomics - there are many opportunities in the near future

to make significant inroads into diseases like cancer, Alzheimer’s, HIV AIDS, heart disease, diabetes, and obesity, among others.

The bad news is that the decline in government research funding over the last decade has placed America’s biomedical research under threat, undermining its potential to build on today’s talent and diminishing a promise of support for the next generation of scientists.


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Faced with continued cuts in government-fund-ed research, our nation’s research institutions will need to re-invent themselves to find dif-ferent, creative and cost-effective ways to break down research silos in order to maintain our nation’s global leadership in healthcare innova-tion. We must forge more robust cooperative partnerships between research institutions, foun-dations and private sector enterprises. Finally, regional economies will need to involve small business, the engine of new economic growth.

challenGes

Since World War II, economists agree that more than 50 percent of America’s economic growth came from advances in science and technology. The problem is that the US is no longer in the position to say that its leadership will go unchal-lenged.

We still have the world’s greatest universities, but we are not keeping up with the rest of the world in scientific and biomedical research. Our

nation’s investments in science and technology have been flat for many years while countries like China and India are rapidly catching up.

•Innext5years,Chinawillspend$305billionon science and technology research. This is more in absolute terms than the US will spend.

•Chinaisincreasingitsbiomedicalresearchby20-25% each year. By contrast, the US has lost 20 percent of its purchasing power for biomedi-cal research in the last 10 years.

•Withsequestration,thelossofNIHfundingwill be $2.8 billion.

•Ifyou’reayounginvestigatorwithapromisingidea, your chance of getting funded by the NIH is now only 1 in 6. For most of our history the chances were 1/3.

•NIHspends53percentofitsbudgetonbasicscience research. It is unlikely that the private sector will fund basic science because basic sci-ence research doesn’t immediately connect to a commercial output.

We are at a paradoxical moment. The possibili-ties to prevent and treat disease in the next few years are breathtaking and yet never before has America’s research enterprise been in greater jeopardy.

opportunities

The private sector is hungry for partnerships. For the first time, there is growing enthusiasm for forging meaningful collaborations among the NIH, academia, the private sector, founda-tions and public advocates for research. But the whole enterprise depends upon having the resources to make it happen.

There already are many successful models of multi-disciplinary, multi-institutional activities that are leading breakthroughs in scientific advancement.

example: Oak Ridge Associated Universities is currently working with 105 member universi-ties and 22 sponsoring federal agencies on scores of research initiatives.

example: A global effort, Project “NCODE” which is figuring out how the gene actually func-tions, recently produced a set of papers, all pub-lished in same week by 432 authors from five different countries, representing the culmina-tion of an intensive collaborative effort over five years. This global research model is happening more and more.

The centers of research and innovation in

“if we care about advances in health, if we care about finding answers to cancer and heart disease and diabe-tes, if we care about getting our economy back on track, there would be no better way than to make an effort to make [pubic funding for healthcare] a priority.”-Dr. Francis Collins, Director National Institutes of Health


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America have deepened over the past several decades making collaboration across regions a more productive strategy for innovation. The future of research innovation will be collective; it does not have to be entirely based locally.

example: Nashville, Atlanta, Raleigh Durham each has outstanding universities and research hubs that can be a basis for collabora-tion with other research institutions across the country.

Because of the emerging research strengths in other countries, we will need to continue to develop global partnerships across public and private enterprises. We can’t afford to have research duplication when everyone is feeling financial squeeze.

From a research and development perspective, bridging the so-called “valley of death” (the gap between basic scientific discovery and real-world application) is a priority. Recognizing that 99.9 percent of current efforts to develop a drug fail, the NIH has recently created NCATS (National Center for Advancing Translating Science) to open the bottlenecks in the pipeline of therapeu-tic development.

three examples of what ncats is doing to bridge the research “valley of death” are:

1. crowd sourcing new applications for drugs that have already been safely tested in humans. According to the NIH, there are hundreds of potentially effective drugs sitting in freezers that unfortunately failed the final test for efficacy. While these drugs did not work for the disease they were tested for, they could be effective treat-ing other diseases.

example: AZT, the first successful drug used for HIV AIDS, was initially developed for cancer.

2. exploring better ways to test toxicity rather than relying on animal tests. These approaches include using human cells loaded onto a biochip combined with stem cell technology that can test thousands of compounds.

3. accelerating the development of the next generation of drug targets through an open ac-cess approach to research. This “pre-competitive” approach encourages research institutions and the private sector to work together to determine which drug targets have a higher likelihood of success. Companies can then follow-up and compete with what they do with the new infor-mation; they don’t have to own the target itself.

example: Today, the entire pharmaceutical industry is based on only five to six hundred

drug targets. The human genome project has indicated that there are tens of thousands of potential drug targets, offering vast opportuni-ties for new product development.

Higher education is starting to see its mission begin to fragment. Now, every university is un-der pressure to help its own region with econom-ic development as each location works to figure out where their absolute competitive advantage lies. However, regions have discovered their competition is coming less and less from their neighbors and more from global competitors.

A considerable challenge for stewards of regional development is that investments in new innova-tion hubs do not always translate to more jobs over the long run.

example: Throughout the 1990’s North Carolina had a real drive to develop IT indus-tries, followed by a drive for biotech develop-ment. Since then, North Carolina’s IT product output has tripled, while jobs dropped by 18 percent; biotech output quadrupled while jobs peaked in 2002.

Support for small businesses in healthcare research and development will therefore need to be a growing focus for regions. This is where the many of the innovations and new jobs will come from. While traditionally, larger businesses such as Bell Labs invested in innovation, this is no longer happening.

We will need to continue to find creative ways to help large and small businesses “pick up the research ball.” To that end, we will need to work with our academic institutions to train the next generation of scientists and innovators to be more entrepreneurial.

At the same time we must continuing to advo-cate for government funded scientific research so that our research institutions have the resources they require to maintain our position of global leadership in health innovation in order to meet the health needs of our future.


internAtionAl PerSPectiveS on heAlth, Food, & SuStAinAbility

summit presenters

•Dave schmidt, President and CEO, International Food Information Council Foundation•anne-christine langselius, Founder of Nuwa, CEO My Global Enterprise Solutions

situation

To move to more sustainable practices in food and health we will need to change human behavior. However, the concept of sustainability is not broadly understood by consumers in the US or globally. While the word “sustainable” is vaguely understood to have long-term positive value, the word means different things to differ-ent people and tends not to be a key driver of human behavior in either health or food.

Governments around the world will need to continue to assure accurate information regard-ing food and its related benefits and health risks while also protecting consumers from mislead-ing or bad information. However, our institu-tions–public or private–should stop short of promising they can change behavior. Ultimately individuals will need to take responsibility for their own food choices and their health.

challenGes

Recent studies in purchasing decisions for food indicate that while consumers are concerned with healthfulness of food, they are far less con-cerned about sustainability issues.

Because food that is best for human health may also be the food that is best for the environment, shifting the message to “healthfulness” (for example: a plant-based diet that is low in animal products is more healthy and also helps the environment) may be more effective in changing consumer behavior to more sustainable prac-tices.

In America and throughout more developed countries, the problem is that we are not using food in a way that is making us healthy. There-fore, consumer education on food and health is a high priority. One area of opportunity might


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be to include more food and health as part of the core STEM (Science, Technology, Engineer-ing, Mathematics) curriculum in schools.

There is also a large amount of misinformation about modern food production and biotechnol-ogy. Some estimate that 80 percent of the infor-mation is negative. Nevertheless, 50 percent of US consumers* say they favor use of biotechnol-ogy to grow more crops in order to meet future demands for food. We will need to continue to present both sides of this argument with global considerations in mind. To meet our future needs, we will need both locally-sourced foods and biotechnology.

opportunities

New global ventures in food manufacturing, processing & production are beginning to focus on the intersection of food, health & sustain-ability as priorities. For example in Sweden, new, more high-end businesses are emerging in the eco-food area with companies looking care-fully at how to deliver their products in more a sustainable way.

Globally, more than half of people in all countries, especially in Philippines, perceive the importance of food producer enrolled in a sustainable food production program due to re-duction of production cost and use of pesticides as the key issues. Despite relatively low awareness of biotechnology, people in countries such as In-donesia, South Korea, India and China, are very

much willing to support biotechnology usage in producing sustainable benefits.

The solution to developing healthier eating habits is not just more education. People eat food for many of different reasons: for entertainment, because it makes them feel good, or other reasons. In many cases, consum-ers know what to do, they just don’t do it. The area of behavioral nutrition is one we should develop more fully to understand and address these underlying issues.

From a product-marketing standpoint, it is critical for all products labeled “green” local or global - to meet the same high-quality standards as regular products, and not just be labeled “green” or “sustainable.” Previously a lot of green-tech products were not as effective which undermined their credibility.

In the end, the global movement toward more sustainable approaches in food and health will require a balanced public dialogue that engages the “triple helix” of research, the public sector and the private sector. We will need all three.

*International Food Information Council Foundation (IFIC) estimates.


building liFe Science cluSterS oF innovAtion

summit presenters

•mary walshok, Associate Vice Chancellor, UCSDConnect •alan Bentley, Associate Vice Chancellor, OTTC, Vanderbilt University •thomas cebula, Johns Hopkins, CTO CosmosID; Former FDA Director, Office of Research and Food Safety •martha connolly, Director, Maryland Industrial Partnerships •steven currall, Dean, UC Davis Graduate School of Management

situation

A region can create a powerful local economy by leveraging the research and innovation assets of universities and connecting them with business leadership and entrepreneurs.

Universities are powerful catalysts for innovation clusters. Universities can provide the critical “glue” between students and faculty, alumni and business that helps to span the bridge between all the groups. The critical assets from research universities can serve as the anchor around which to build an entrepreneurial environment.

The key is to develop a regional ecosystem built on trusted relationships between research scien-tists, business leaders, venture capitalists, and supported by strong civic commitment. This is the “connective tissue” that allows a region to develop over time into a self-supporting and sustainable hub of innovation and economic development.

recommenDations

When building an innovation cluster, engage teams that are focused around three areas of expertise: market expertise, technological


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innovations, and entrepreneurial and financial resources. If you do this, the money will follow.

From a strategic standpoint, focus on developing a crop of fundable companies. Financial capital follows human capital. Human capital follows the innovations developed by universities. The private sector will co-invest with universities to enable interdisciplinary, cross-functional conver-sations and ultimately relationships.

four examples:

rice universitY. An Entrepreneurship Center started at Rice University included faculty (many untenured), the venture com-munity, angel investors, and influencers from large companies. Five years later the Entrepre-neurship Center helped to start 160 technology companies, collectively raising $300 million in equity capital.

lonDon. A “Golden Triangle” of leading research institutions between London, Oxford, and Cambridge replicated the entrepreneurial ecosystem at Rice University. This continued to prove to be a successful model despite a rather underdeveloped venture capital com-munity, different research environment and different country.

uc Davis. UC Davis is leveraging its location between Silicon Valley and the State Capitol to be a catalyst for regional activity, building on the strengths of both communities as well as its posi-tion as world leader in food/agriculture research and environmental research.

vanDerBilt. Vanderbilt University is capital-izing on the innovations of its talented faculty, talented students and staff. The university has doubled the size of the office, hired professional staff and PhD’s with a long history of tech com-mercialization and industry experience.

six characteristics of successful innovation clusters:

1. a civic culture that is focused and commit-ted to innovation and capacity.

2. outstanding, world-class scientific institu-tions–such as research universities–that are committed to knowledge transfer and commer-cialization.

3. a nimble, welcoming and partnering busi-ness culture that adapts and supports commer-cialization and new companies. If private sector is co-investing time and resources, the ecosystem can develop much faster.

4. a grass roots, bottom-up convening orga-

nization that involves both the business and academic communities in a long-range vision and extends beyond individual tenures.

5. a commitment to place and an appreciation of the local amenities.

6. an unwavering focus on exceptionality.

case stuDies

san Diego: “world-class innovation cluster from nothing”

San Diego is an example of a region that created a world-class innovation cluster from virtually no base and then continued to re-invent itself as times changed.

San Diego’s growth began without any Fortune 500 companies or major research university. To succeed, highly entrepreneurial people pulled their leadership skills and financial resources to attract the military. Citizens voted to rededicate valuable lands north of the city to “light indus-try” and R&D. Over multiple decades, business and community leaders continued to help the city adapt and re-invent itself as times changed.At every stage, the focus was about exceptional-ity, with super-star scientists in physics, chemis-try and biology recruited to found some of the major institutions including: UCSD, General


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Atomics, SALT Institute, Scripps Institute, and others. These investments in infrastructure, innovation, research and human capital created the platform upon which industrial develop-ment has grown.

connect, the convening platform for San Diego, began with 20 business leaders who each put in $2500. The organization now has a $3.4 million annual budget and is totally self-supported with no government funding and no university funds.

Baltimore: “leveraging research strength in biotechnology”

Baltimore is an example of how a city took advantage of its universities’ strength in biotech-nology research and its proximity to government agencies to become a thriving center of innova-tion in life sciences.

Thirty years ago, the city of Baltimore had a port and the two largest employers were Bethle-hem Steel and GM assembly plant–together em-ploying 55,000. Now the two leading employers in Baltimore are Johns Hopkins University and the University of Maryland; Bethlehem Steel has only about 2,000 employees and the GM assembly plant is gone.

Recognizing this shift, Maryland began to ac-tively focus on developing new, small businesses based on biomedical discoveries developed by its leading universities. To support the effort, the state passed a biotechnology tax credit which offers a 50 percent tax credit that goes into a fund to support small, strategic investments in biotechnology.

One of the leading convening platforms, the Maryland Industrial Partnership is funding a program for early-stage proof of concept projects. The organization funds these projects so that a local company can work directly with faculty members at Maryland’s research universities to further product development.

In one example, after 5 years and following a $100,000 investment from the Partnership in two projects, 135 additional jobs were created yielding about a 40-to-1 return on the invest-ment (considering the state income taxes and sales corporate tax that these companies pay back into the economy.)

San Diego, Baltimore and other examples illustrate the convening power of universities as catalysts for regional clusters. The key is to marry the business and academic communities early in the process and follow a grass-roots, bottom-up approach that allows people to be-come friends and colleagues first, share knowl-edge, share expertise, build trust and then co-venture and make deals.

In the end, all regions have to make strategic choices. The key questions to ask are: what are the activities that we (the public) should be investing in that bring value to our town, how do we leverage our assets, how do we fill the gaps with the expertise we don’t have, and then move forward with focus and purpose.


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deSigning A reSeArch innovAtion model

by cheryl e. harriSon, FoUnding leaderShip coMMittee global action platForMpreSident, harriSon deSign groUp & Uc daViS adViSor

a new competitive lanDscape has causeD a shift from research lead by a single organization to more a col-laborative model that draws on expanded networks and benefits by shared risk across multiple sectors. As a result, companies and universities alike need to collaborate to stay ahead and to thrive. Universities around the world are beginning to realize the advantage of participating in consortia to foster innovation. They can leverage and build upon a commercialization environment to mitigate market risk, while efficiently addressing solutions to critical world issues. This trend towards collaboration leads to the following question: How can we use innovation hubs focused on the integration of food, health, and prosperity to align research with regional economic development strategies?


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the role of the universitY anD research institutions

Universities have a strong role to play in collabo-ration and innovation. Companies and research institutions can readily support partnerships in commercialization by:

•Engagingindustryandprivatesectorparticipation and investment•Leveragingfacultyresearchdiscoveries•Buildingproductivestakeholderrelationships•Commercializingviableopportunities

This dynamic collaborative model can estab-lish strategic industry alliances for win-win relationships. Universities may take on the role of a collaboration host for industry to develop and prototype breakthrough solutions. Major institutional and governmental grants are more than ever seeking collaborative research models. Corporations and stakeholders can benefit from co-competition within a framework of co-creation and secure access to add value and leverage commercialization success.

Within this new collaborative framework, universities will accelerate scientific discoveries to solve real world issues. Licensing opportuni-ties will continue to grow and mature, especially if inventions are patented. Those patents are strategically packaged to offer solutions to real-world issues, and if research licensing terms are conducive to investment and market success. If properly aligned, research can be applied and more rapidly and efficiently commercialized, not just by one company, but uniquely, or on behalf of a consortium of companies—and eventually, throughout a market or industry. With acces-sible expertise and social insights, innovations may be adaptable and scalable to global markets and emerging economies.

Universities can meaningfully influence new industry standards for public benefit, further-ing value creation for consumers, and fulfilling universities’ core mandate. Importantly, land grant institutions across the United States could realize a new framework for research, innova-tion, and economic development by repurposing their existing networks, faculty leadership, exper-tise, and industry partnerships. Small, emerging businesses and economic development offices can also participate in new forms of partnerships with this network, gaining access to critical ex-ternal expertise, knowledge, specialized research facilities and many other resources.

With this collaborative model, research coopera-tion is encouraged among university investiga-tors. The exponential value of collaboration resonates with private sector investors and phil-anthropic funders including individual donors, corporate stakeholders, policy makers, govern-

ment agencies, and institutional grant-makers who choose to invest in research.

BuilDinG a DYnamic innovation moDel

A model of dynamic collaboration can be ef-ficient. It can provide the financial engine to drive applied science through networks and to deliver research innovation where it is needed most. Ideally, the model includes incentives for innovation, awards faculty leaders and strategi-cally guides entrepreneurs. It is accessible to the private sector partners who seek innovation. Ultimately, this model serves for public and consumer benefit, leading to prosperity through globally responsible metrics, guided by the best practices for building sustainable systems. Thus, by adopting this model, universities may fulfill their goals to be a next generation collaboration leaders for applied science.

How might universities and research centers with private sector partners begin to affect this change and foster innovation and commercial-ization?

Within each university, the “Consortia” can be developed with industry investment focus areas. These may be similar to, or spring from existing innovation clusters. Consortia may be founded alongside a university’s established core research competencies, typically integrating and leverag-ing existing academic outreach institutes, initia-tives, and research centers, for example.

keYs to success of the “innovation huB”

To accomplish a successful model for collabora-tion (or “Innovation Hub”), we must create a comprehensive collaborative platform that combines the most important elements of social-media-enabled and in-person engagement. Ultimately, this combination will efficiently ap-ply and commercialize renowned and emerging academic research competencies and innova-tions, especially within integrated fields of food and health systems.


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Patents may be developed, protected and ac-cessed via the innovation platform while incent-ing the collaboration process among all partici-pants such as industry stakeholders and research sponsors, other universities, incubators and early stage VC’s and among all consortium members.

Keys to success include generating new metrics and methods for value creation to more ef-ficiently build and develop consumer markets–locally, regionally, nationally and globally. This “Innovation Hub” concept has the capacity to offer high-level professional expertise to evalu-ate related trends, insights and market/social valuation. It offers critical ‘just in time” services and unique expertise which is made available to consortium sponsors, research institutions and industry partners. Additionally the “Innovation

Hub” should be designed to foster a “flexible and nimble” process and infrastructure that can evolve and adapt. The platform should offer new insights, and valued services to all col-laborators; it should be responsive to pertinent issues that address evolutionary, emerging social, ecological and humanitarian needs. The Global Action Platform introduced in this Report has set a course to design an “Innova-tion Hub” model anchored in university-busi-ness collaboration with a focus on food, health, and prosperity. Early design and technology development is underway, leveraging over three years of development by thought leaders, innova-tion specialists, research faculty, and technology specialists convened by the Cumberland Center and its affiliates and global partners.

customizeD DYnamic content•Fullyintegratedwebsiteandmultimediafunctionality•Offersasinglepointforintegratingresearch,content and communications functions (cloud-based)•Plottingofreal-timedata(dynamicdatatrans-fer, computer entry and/or mobile devices)•EasyWISYWGadaptationandcontentupdates for information, modeling and report-ing, etc.•Customized(personalized)userexperience,unique for each constituent type and profile•Secure,tiereduseraccess

research inteGration•Dataentryfrommultiple(unlimited)online entries from remote sites•Customizedresearchinterfaces,forspecificconstituent types•Real-timeresearchcapabilities(interoperabili-ty through shared interfaces–mobile devices and apps to laptops to cloud-based servers)•Onlineconferencesandpeerreviews•Whitepapers,andresearchresultsindexingfor technology transfer •Patentmanagementsoftware,withlicensingmanagement and oversight •Functionalityformicro-levelsharedrevenuedistribution from royalties

investiGator communitY support•Onlinewebinarsandconferences•Searchabledata,reportsandmultimediaarchives•Real-timeaccesstodataanddynamicsum-mary reports•Researchcollaborationinfrastructureandguidelines and apps•Online,interactiveworkspacesforinterdisci-

plinary research•Activeinvestigatornetworkingsoftware(LinkedIn model)

marketinG & outreach (customized for specific constituent types and profiles)•Dynamicmedia-streamingfunctionality•User-centricinterfaces(researchscientists,industry, policy makers, general public, etc.)•Ondemand,searchablecontent•Newsletters,customizedanddistributedbyprofile type•Pertinentaccess&distributionofcollateraland resources, etc. (eg. for policy-makers and others)

Decision support•Multimediacontenttofacilitatethepresenta-tion of complex information, metric and data•Dynamicdataandvisualdisplaysshowingop-tions and choices to support effective decisions•Decisionsupportbasedonvalues-basedandresearch-based questions•Dynamic“plotting”ofcumulativedata•Graphicdisplaysandmapping

eDucation & traininG•Userprofiling,tracking,coordinationandmanagement (for each constituent relationship)•Customizedlearningcontentandmodules(research, industry, policy makers, general pub-lic, etc.)•Technicalinformationdeployedineasy-to-understand multi-media presentations•Real-timedatacollectionandcomparisons(visual modeling) •Customapps•Socialnetworkbroadcastingandlivecasting•OtherFeatures,asrequired

components of the innovation network moDel


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Section ivPerspectives


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a vision for abundance, research and the futurekeynote by dr. FranciS collinS, director, national inStitUteS oF health

we’re at an inflection point that is challenging our priorities as a nation. Innovative and risk-taking investments by govern-ment–funded research can

transform both science and the economy. Medi-cal science has never been at a more exciting juncture than it is right now. At the same time, reductions in US government research funding are creating unprecedented challenges in our nation’s ability to allow our research engine to keep pace with its potential.

History shows us that our nation’s investment in scientific medical research has yielded substan-tial returns, in healthcare and in our economy.

For example:

•Since1990,ourabilitytosurviveinAmericahas gone up by one year every six years. Accord-ing to economists, this gain in life expectancy is worth $3.2 trillion. This gain in life expect-ance is directly due to medical research that has reduced deaths from heart disease, HIV AIDS, and allowed increased survival rates for cancers, among other diseases.

•Peoplearelivinglongerandtheirqualityoflife is improving: in the last 25 years, the propor-tion of older people with chronic disabilities has dropped by almost one-third.

•Thedeathratefromcancerisfallingonepercent each year. Each percent drop saves our nation $500 billion—a 100-fold return on our $5 billion annual investment in cancer research. A full cure would be worth approximately $50 trillion—more than three times today’s GDP.

•In2011,fundingfromtheNIHsupportedmore than 432,000 jobs at 2,500 institutions, generating $62.13 billion in new economic activ-ity in just that year. Furthermore, the financial support from the NIH for basic science research serves as a foundation for much of the phar-maceutical industry research and development, making the multiplier effect from basic science research investment enormous.

Five “T’s” represent five issues that will shape

the future of biomedical research: technology, translation, talent, threats, and “telling stories”—which together carry significant healthcare and economic implications.

1. technoloGY

Biology is now driven by technologies that have allowed us to make quantum leaps in our ability to understand how life works. For example, critical advances in technology were required for us to be able to read out the three billion letters in the human genome.

The project to map the human genome created a new foundation that has utterly changed the way we do biomedical research. In the near fu-ture, all of our genomes will be accessible as part of our standard technology medical record at a cost of about $1,000 per person. This personal genomic information will influence healthcare decision-making and open up entirely new ways to do science and personalize medicine for each individual.

Now we can look at any individual cancer and sequence the whole genome to find out what’s driving the cells to grow. Individuals with cancer are already able to have their tumors completely sequenced, the drivers of their cancer identified, and pick from a menu of targeted therapies. This is precision medicine.

From an economic standpoint, the genome project has been an overwhelming success. Started with an original investment of $4 billion 50 years ago, the project has generated $796 billion of economic growth in the US alone, creating 3.8 million job years of employment along the way.

2. translation

It is important to get this wonderful outpouring of medical information translated as quickly as possible to therapeutics. Unfortunately, the way we have been developing drugs is a complicated, messy process that takes an average of 14 years with a failure rate of 99.9 percent.

We have opportunity to do something about


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this by identifying the development bottlenecks and work with industry to develop drugs in new and creative ways.

In the next five years at a cost of $140 million, we will be able to turn upside down the way in which we do drug safety testing by putting human cells on a biochip so that they represent different human organs such as liver, heart, kidney, and brain. This is technology we did not have five years ago.

The Wyss Institute in Boston, for example, has created a lung on a chip made up of human cells that essentially functions like a human lung. They can produce and observe the same common lung ailments and then test different treatments to basically “cure” the lung-on-a-chip without testing on animals or putting people at risk.

We need to think about how to take these technologies to low income and developing countries.

3. talent

We must encourage people to take risks. We want today’s pioneers and innovators in medical research to be confident that their careers can be supported. Unfortunately that is difficult now because our resources are so tight.

The talent pool in biomedical research is still underrepresented in African Americans, Native Americans and Latinos. The NIH is trying to increase the appeal of this area with mentor-ing and offer a path forward with promises of success.

The NIH is also working to encourage talent around the world. For example, “H3Africa”, a project supported in part by the NIH, is aimed at developing a large-scale genomics research program in Africa.

4. threats

The emergence of other countries like China, India, Singapore, Brazil, and South Korea as new powerhouses in biomedical research, present new challenges to America’s ability to maintain a leadership role. Declines in US gov-ernment funding for research over last ten years is putting the US at risk of missing out on the heath and economic benefits gained by leading this agenda.

Due to sequestration the NIH budget has been cut 8.2 percent–$2.5 billion. This is reducing the number of grants the NIH can offer this year by 2500 resulting in 35,000 fewer jobs and reducing economic activity by about $5 billion.

The US investment in biomedical research and development is now growing slower than Japan, India, South Korea, Thailand, Singapore, Malay-sia and especially China.

America had the privilege of leading the genome project and enjoyed the economic benefits more than any other country. Now China has the largest investment in genomics. China’s BGI sequencing center in Shenzhen has more capac-ity than all our centers combined.

While Europe is facing its own difficult econom-ic circumstances, the European Union has fig-ured out that the best way to greater prosperity is through research. We, on the other hand are facing real trouble. In the last decade, we have lost about 20 percent of our ability to support research. It will be devastating for our future if this trend continues.

5. tell stories

We need to tell our medical success stories so everyone can be engaged. We can win the battle against Alzheimer’s. We can secure an HIV AIDS-free generation. We can and must reverse the national epidemic of obesity. We can develop the next influenza vaccine that not only protects us against seasonal flu, but also the next pandemic.

To unlock the future of medicine, we need engineers, physicists, we need mathematicians and computer scientists. We need policy makers to wrestle with how to integrate new approaches into our larger healthcare delivery system.We need teachers, private industry, community advocates, patients and we need families.

The promise has never been greater, but it will take every bit of enterprise to make this dream come true.

francis s. collins, m.D., ph.D. is the Director of the National Institutes of Health (NIH). In that role he oversees the work of the largest sup-porter of biomedical research in the world, spanning the spectrum from basic to clinical research. Dr. Collins is a physician-geneticist noted for his land-mark discoveries of disease genes and his leadership of the international Human Genome Project, which culminated in April 2003 with the completion of a finished sequence of the human DNA instruction book. He served as director of the National Human Genome Research Institute at the NIH from 1993-2008. Before coming to the NIH, Dr. Collins was a Howard Hughes Medical Institute investigator at the University of Michigan. He is an elected member of the Institute of Medicine and the National Academy of Sciences, was awarded the Presidential Medal of Freedom in November 2007, and received the Na-tional Medal of Science in 2009.


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the world at the crossroad: where Do we Go from here?

by thoMaS FriedMan, aUthor & colUMniSt, the new york tiMeS

america…its fate, future, vigor and vitality is really the biggest foreign policy issue in the world. We know America makes its share of mis-takes in the world, but on balance,

America provides enormous global public goods that keep the international system stable and leaning forward.

If we go weak as a country, your kids won’t just grow up in a different Nashville, a different Ten-nessee, or a different America. They will grow up in a fundamentally different world: a world ordered by China or Russia or most likely by nobody at all.

So there is something really important at stake right now in our ability to get our country onto the right economic path and the right educa-tion path so that we can pass on our American dream to another generation. This is not just an

economic issue, this is not just a family issue, it is really a global issue.

We will not win the 21st century by default. We need to get our act together because we need to do some big, hard things, and you can only do big hard things together.

I see a country with enormous potetntial fall-ing into the worst sort of decline. It’s a slow decline…just slow enough for us not to stop everything we’re doing and pull together to fix what needs fixing.

I believe America faces three grand challenges:

The first is how we deal with our long-term fiscal imbalances and the promises we made to future generations that we cannot possibly keep.

The second, is energy and climate: how we will

“all the great change in history was done by optimists.”


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power the future middle class and rising middle classes all over the planet without tipping into disruptive climate change.

The third great challenge is the merger of globalization and the IT revolution. We call this the great inflection. This is actually the biggest, most important thing happening on the planet today. It effecting every job, every market, every workplace, every school, but we’re not really talking about it.

In less than a decade, we’ve gone from a con-nected world to a hyper-connected world and that is changing everything.

The signs of a hyper-connected world are telling us that the whole global curve just rose. Every employer today suddenly has cheaper, easier, more efficient access to above-average software, above-average automation, above-average robot-ics, above-average cheap labor, and what’s really new, above-average cheap genius.

What that tells you is the central socio-economic fact of our time is that “average” is officially over.

Something called the high-wage, middle-skilled job–the foundation of the middle class–is disappearing. There will only be a high-wage, high-skilled job. The pressure of this is driving all the reforms in education, in companies, and a lot of the anxiety in our politics including the emergence of the Tea Party.

When I graduated from college I had to find a job. This generation will need to invent a job or re-engineer that job to demonstrate their unique value-add. The world doesn’t care about what you know, because that information is available on Google. The world cares about what you can do with what you know.

Historically our labor market was divided into 3 tiers. The top tier was non-routine work: art-ists and scientists, engineers, athletes, teachers, senior managers. Everyone wanted to be “non-routine.” It’s the work that involves critical thinking and problem-solving.

The second tier is routine work. This is the repetitive factory work or repetitive back-room insurance or banking work. Routine work has been crushed. Anything that can be described by an algorithm is now being outsourced or digitized.

At the other end, is non-routine, local work. This is work that has to be done face-to-face in a specific location. This work includes your butcher, your baker, your nurse, your massage therapist, your lawyer.

But the wages of non-routine local workers will depend on how high the wages are for the non-routine workers. What’s happening in the hyper-connected world is that it isn’t enough to be non-routine anymore, you’ve got to be creative non-routine. You’ve got to bring some-thing extra.

Everyone of us has got to define our unique value add.

Today, you only hire someone if you absolutely have to. That is part of the future. We will all have to justify why we have to be hired, retained or promoted in the hyper-interactive world.

Everyone is looking for the same employee: someone who can do critical thinking and problem-solving. They are looking for people who can invent and re-invent their job while they’re doing it.

lookinG at eDucation, we have three challenGes toDaY:

1. We need to bring our bottom up to our aver-age so much faster. If you do not have a high school degree today which gives you access to post-secondary education without significant re-mediation, there is nothing down there for you that can sustain any decent standard of living. This is all about the three “R’s”–reading writing, and arithmetic.

2. We need to bring our average up to the global heights because that is where the “extra” is defined, nurtured and discovered. Where

“think like a new immigrant: stay hungry. think like an ar-tisan: take pride. think like a starter-upper and always be in ‘beta.’ think like a waitress at perkins pancake house and always think entrepreneurially.”

“we will not win the 21st cen-tury by default. we need to get our act together because we need to do some big hard things, and you can only do big hard things together.”

“the central socio-economic fact of our time and that is that “average” is officially over.”


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does creativity come from? It comes from having multiple specialties and mashing them together. Look at Leonardo DaVinci: he was an artist, writer, scientist, and each specialty nourished the other.

3. The third challenge is that the pace of change is happening so quickly that universities and col-leges cannot keep up with how quickly industry is changing. We will need to adapt a whole new model where we imbed college professors in businesses and imbed business people inside universities. Right now we have a huge skills gap in this country and the only way to close it is by merging these two institutions much more intimately.

We have to keep raising our standards in order to make sure we have enough people to do the work. Otherwise, it becomes too easy to just move jobs to somewhere else. In a hyper-connected world, there is no “out” and no “in.” There is just good, better and best. If I can’t find it here, I’ll go where I can, because other-wise my competitor will do it. So, how do we tell our kids to lean into this world?

1. think like an immiGrant.

How does the new immigrant think? They figure out what the best opportunities are and pursue them with more energy, vigor, persis-tence and adaptability than anybody else. New immigrants are persistent and adaptable. They are paranoid optimists. They stay hungry. We are all new immigrants to the hyper-connected world.

2. think like an artisan.

Artisans make every item individually. The best artisans in the past carved their initials into their work when they were done. Do your job every day as if you will want to put your name on your work. Take pride.

3. think like a starter-upper in silicon valleY.

If you ever believe you’re finished, you are truly finished in a hyper-connected world. So, always live in beta. That means, always consider yourself in need of engineering, re-engineering, re-definition, and more perfection. Never, ever think, “I’m finished.”

4. think like a waitress at perkins pancake house.

Think entrepreneurially about everything you do, no matter how small the task. America has something really unique. People want to emulate us. China tends to need to buy its emulators; Russia tends to need to bludgeon

its emulators. We can get people to follow us voluntarily. People aspire to be here but only if we really provide an example of a country that is pushing out the boundaries in all these areas. As Americans, we forget just how radical our power of example is when we are at our best and when we are at our worst. We should aspire to be at our best everyday. It just doesn’t feel like we’re on a journey right now.

If I could draw a picture of America today, it would look like the space shuttle going up with all this thrust coming from below. The thrust is all the people. But our booster rocket – that’s Washington DC - is all cracked and leaking energy and the pilots are fighting over the flight plan. We can’t achieve escape velocity right now to be all we can be. We can fix the booster rocket if we had just three grand bargains right now: One on debt and deficit, one on immigra-tion, and one on how to exploit this natural gas bounty in an environmentally safe way. If we did this, you would see a melt-up in the stock market like you’ve never seen before.

I think there is a natural journey. The journey is that we want to make this country the greatest launching pad in the world where everyone will want to come to launch their moon shot, their start-up, their innovation or collaboration. We want them to come here because we have the greatest universities, the best intellectual prop-erty protection laws, the best high schools, the best science and tech schools, best rule of law, the best venture capital.

Let’s make America this launching pad. Because if we get everyone wanting to come here to start something, there will be plenty of work for all of us.

thomas frieDman, Author and Columnist for The New York Times is the bestselling author of The World is Flat and a columnist for The New York Times. Known for direct reporting and thor-ough analysis of complex issues in the modern world, Friedman is the winner of three Pulitzer Prizes. He has written for The New York Times since 1981. Friedman’s latest book, a New York Times bestseller co-written with Michael Mandelbaum, is That Used to Be Us: How America Fell Behind in the World It Invented and How We Can Come Back. Some of Friedman’s best-known other books include The World is Flat: A Brief History of the Twenty-First Century and Hot, Flat, and Crowded: Why We Need a Green Revolution—and How It Can Renew America. Fried-man is ranked #2 on The Wall Street Journal’s list of “influential business thinkers” and is a frequent guest on programs such as Meet the Press, Morning Joe, and Charlie Rose.


partner ViewpointS

partner viewpointsto Feed the Future, We need a Feast

of Facts, and a Famine of Fearby daVid b. SchMidt, preSident & ceo

international Food inForMation coUncil & FoUndation

less than three decades from now, in 2041, the United Nations estimates that the population of the world will reach 9 billion people. That’s a lot of mouths to feed, to put it mildly. So how will we do it? How can a world of limited re-

sources possibly adjust to the food and sustenance needs of its people when their numbers will expand by more than one-quarter, and in such a relatively short period of time? How will we cope with what the UN Food and Agriculture Organization estimates will be a 60 percent increase in overall food demand?


partner ViewpointS

The answer is the same as it has always been: technology. And with nearly 2 billion additional inhabitants of our planet to be added just one generation hence, that answer is more impor-tant, and the stakes are higher, than ever before.

At every step of the journey from farm to fork, technology is helping us produce a safe, abun-dant, sustainable and nutritious food supply. Precision agriculture, with the aid of GPS satellites, can target individual crop treatments to the smallest plots of soil, which reduces environmental impacts. Advances in livestock production, from climate control to the nutri-tional qualities of feed, have improved animal health and welfare, and boosted agricultural output. Refrigeration and modern packaging technologies increase the safety of our food, the distance across which it can be transported, and its extended freshness.

Among the most successful and still more promising advances is food biotechnology, which is a range of processes to enhance foods through various breeding and other techniques. At its heart, food biotechnology is the science of employing the tools of modern genetics to enhance beneficial traits of plants, animals, and their food components.

Food biotechnology can help feed our growing planet, while also bringing several additional benefits along the way. Not only do insect-pro-tected and virus-resistant biotech crop varieties produce hardier plants, leading to higher yields, but plants are also being engineered to grow in places where they would not survive before.

The food itself can be more healthful and nutri-tious, as crops with enhanced nutritional traits make their way to the supermarket. These foods can help to combat chronic diseases by provid-ing more healthful compounds, including higher levels of antioxidants and vitamins, and lower amounts of fats we should limit. Scientists have also begun to target allergy-causing proteins.

Biotech crops can also aid in protecting the environment by producing herbicide-tolerant varieties, thereby decreasing the amount of pesticides used in farming. Decreasing pesticide use can have a positive impact on the health and well-being of wildlife, decrease farmers’ exposure to pesticides, and contribute to a cleaner water supply.

But for any technology to be truly useful, it must first be adopted. Barriers to adoption include fear and misperception, both on the part of us-ers and, ultimately, the consumers who stand to benefit from technological progress. That’s why for those who care about the world’s capacity to feed the future, communication and education are critical.

Some opponents would synonymize terms such

as “biotechnology” or “genetic engineering” with “unnatural.” But nothing could be farther from the truth. Biotechnology is merely a refinement on processes that already occur in nature, and a step beyond traditional methods of crossbreed-ing that have been used to genetically enhance agricultural products for centuries.

At the International Food Information Council (IFIC), we have learned that consumers are not predisposed to fear, and that when they under-stand food biotechnology and its benefits, they respond positively. According to the 2012 IFIC survey “Consumer Perceptions of Food Tech-nology & Sustainability,” respondents, when given a basic definition of food biotechnology, react favorably by a ratio of almost two to one (38 percent to 20 percent). By a margin of 35 percent to 20 percent, they expect biotechnology will provide benefits for them or their families within the next five years.

In terms of foods produced through biotechnol-ogy that consumers would be likely to purchase based on specific attributes:

•77percentwouldpurchasefoodsthatre-quired fewer pesticide applications;•69percentwouldpurchasefoodswithbetternutritional qualities;•71percentwouldpurchasefoodsthatpro-vided more healthful fats, such as omega-3 fatty acids; •68percentwouldpurchasefoodswithlesssaturated fat.

Feeding the future will rely on technology, but equally important is a world with access to ac-curate, science-based information about new and emerging technologies.

That’s why just this past April, the IFIC Foundation released the third edition of “Food Biotechnology: A Communicator’s Guide to Increasing Understanding,” which is available at www.foodinsight.org/foodbioguide.aspx. Intended for use by leaders and other commu-nicators in the food, agricultural, nutrition and health communities, the guide offers the latest science and consumer-friendly information in a variety of accessible formats, targeted to different audiences.

Consumers of both today and tomorrow need a climate where fact trumps fear, where cred-ible information is easily attainable, and where evidence outweighs emotion. Only such a climate will be conducive to continued progress across a whole host of technologies that are vital to sustainably produce the safest possible food supply, in the amounts and with the nutritional attributes we need, and in the ways that least impact the environment.

The 9 billion people who will soon occupy our planet are counting on nothing less.


partner ViewpointS

partner viewpointsunleashing the power of innovation

by Margaret M. Zeigler, ph.d.execUtiVe director, global harVeSt initiatiVe

the upcoming global investment competition, Global Food & Health Innovation Challenge, presents an exciting opportunity to stimulate new solutions to age-old problems, especially in the arena of food security and agricultur-

al productivity around the world. The growth in global food demand, driven by increasing population numbers and shifting diets towards more protein-based compo-nents, will require major innovations to grow, produce, process and transport food, while simultaneously reduc-ing agriculture’s impact on land, water, air and forests. Innovations must address the needs of a broad range of farmers, ranchers, pastoralists, fishermen, and producers at all scales and across all regions of the world.


partner ViewpointS

Projected food demand as a result of rising incomes will be particularly high for developing countries and is expected to increase 115 percent between 2000 and 2030 (Figure 1). In particu-lar, innovations must be targeted to resource-poor farmers and producers in developing countries. Unlocking the potential of the 500 million smallholder farmers across the world and ensuring they become more prosperous and more productive will help address the food chal-lenges we face. New technologies and practice systems geared towards these farmers will be part of the long-term solution to feed a planet with nine billion people by 2050.

The Global Harvest Initiative (GHI) is a private-sector voice for productivity growth throughout the entire agricultural value chain to sustainably meet the demands of a growing world. Our member companies of Accenture, DuPont, Elanco, IBM, John Deere and Monsanto are col-laborating to provide solutions to help feed the world’s projected nine billion people by 2050. Improving productivity requires growing more while using less land, water, energy, labor, and other inputs.

Protecting productivity gains in the post-harvest phase and through the entire value chain is equally critical. On-farm productivity increases may be lost by an inability to get harvest or livestock to markets: appropriate innovative technologies can minimize losses by improving infrastructure, processing, and access to finance. The Global Food & Health Innovation Chal-lenge can provide impetus for new technologies and practices all along the agricultural value chain to produce more, waste less, and preserve our natural asset base, all while improving the lives of producers and consumers.

Where should some of these new innovations and technologies be targeted? GHI’s annual Global Agricultural Productivity Report® (GAP Report®) for 2012 found that global agricultural

productivity growth has been keeping up with global demand on average (Figure 2), but that several regions around the world face large gaps where food demand is growing and food produc-tion and productivity is lagging.

Sub-Saharan Africa’s agricultural productiv-ity growth has been very low, with almost all agricultural output growth coming from land expansion and little use of modern inputs. GHI projects that by 2030, only 13 percent of Sub-Saharan Africa’s food demand will be met by production in the region if the current produc-tivity growth rate holds constant (Figure 3).

Raising productivity in Sub-Saharan Africa will require new technologies that are appropriate and adaptable for African smallholder farmers and pastoralists and suitable for local agro-ecological conditions. Information technol-ogy promotes better agricultural practices and helps smallholder farmers produce more. New technologies better store and protect crops to help farmers reduce post-harvest loss, sustaining on-farm gains all the way to market.


partner ViewpointS

Technology innovation alone will not solve problems of food insecurity and low levels of productivity along the value chain. Care must be taken to ensure that new innovations can be deployed and scaled within a specific country context and are supported within a government policy framework that allows their use and promotion.

Unleashing the productive power of women farmers in Africa—targeting them with appropri-ate innovative technology, and enabling them to use land through secure tenure laws—will make a significant impact on food and nutrition security and productivity.

Effective public policies establish an enabling environment that encourages investments in cap-ital, technology, and labor for more productivity growth. Many existing science- and information-based technologies that could help farmers around the world become more productive are not adopted because particular governments erect barriers to their use. Policies and invest-ments also determine whether, and to what extent, such technologies will be made available to farmers, pastoralists, processors, handlers and food companies to achieve greater abundance.

In addition to new technologies, there are ap-propriate and readily available improvements that simply require funding and extension to reach producers that need them most. These technologies include information packages and delivery systems to support better agricultural decisions, extension support via mobile phone technology, and weather information to adapt to the challenges of climate change.

Governments must implement science-based and predictable regulatory systems that allow ap-propriate technology adoption for local environ-ments. Examples include regulatory frameworks that allow use of existing livestock health tech-nologies, a range of crop technologies including biotechnology for higher yield and drought and pest resistance, and policies that facilitate trade and promote mechanization to save labor.

We applaud the new Global Food and Health Innovation Challenge vision for stimulating new technologies and practices. Coupled with ap-propriate policy frameworks, there is boundless opportunity to also extend successful existing technologies and their adoption as part of a broad strategy to achieve abundance and food security by 2050.


partner ViewpointS

partner viewpointsStemconnector’s innovation task force

forms to Drive human capital Developmentby edie FraSer, director, SteMconnector

stemconnectoR is the information resource on Science, Technology, Engineering and Math(STEM) and with our STEM Innova-tion Task Force, we are committed to the vision of the Diplomatic Courier and the Cumberland Center as the forums and thought piece articles drive the application of innovation. It is impor-tant to recognize the success of the Group of Eight (G8), (G20/B20) and their leadership in tackling some of the world’s toughest challenges, which include food security, economic develop-ment, and raising global health standards. The goals of STEMconnector’s Innovation Task Force are closely aligned the Summit in TN, June in the UK and B20 and G20 in Russia. Our STEM innovation Task Force members look forward to participating in the 2013 ses-sions.

Reflecting back to the 2012 Global South Sum-mit, Thomas Friedman was right on point when he declared “average is officially over.” Knowl-edge to Innovation and change is the new order. During last year’s Summit, Freidman laid out the challenges facing the United States in the global interconnected marketplace, compelling us to rise above mediocrity. As the U.S. faces a critical workforce shortage of trained scien-tists and engineers our competitive advantage shrinks, leaving the cornerstone of the global economy in jeopardy.

The grand vision of the STEMconnector In-novation Task Force is, “accelerating sustainable STEM careers and wealth through innovation science and excellence in tomorrow’s new economy.” Through the leadership of a power-ful team of industry, government, and educa-tion experts the task force is identifying and endorsing relevant pathways to careers that are in high demand. The Task Force has aligned on a strategic framework and charter that will prioritize and focus on addressing “human capital development-from knowledge to careers” and -in parallel-develops and promotes STEM as a brand. In addition to the overarching theme

of developing human capital, the task force has created five sub-committees that include: defin-ing STEM Innovation; global breakthroughs; technology/intellectual property transfer between the private sector and government; and “low-cost” innovation.

It is impacting the human capital supply chain with skilled talent to insure productivity and commercialization activity. One critical issue that intricately links the STEMconnector In-novation Task Force to the priorities of the Sum-mits is global food security and related health care technology and other core issues which we embrace for innovative solutions.

The STEM Innovation Task Force chair is Heidi Kleinbach-Sauter who is the Senior Vice-President of R&D Global Foods at Pepsico, the largest U.S. based food and beverage producer. Adding to the experience in the global food industry are leaders like: Jean Spence, Executive Vice President for R&D Quality at Mondelez International; Jeanne McCaherty, Vice President & Regional Director at Cargill; and Michael Norris, Chief Operating Officer at Sodexo. The combined executive level experience on the task force will provide a strong platform to build an industry recognized framework for career path-ways in the global food and beverage industry.

Without a new and strong talent pipeline in food and health related disciples our food supply and especially the invention of affordable foods for low income consumers with high nutritional values will be endangered. Furthermore the securing of water resources and the creation of other fundamental and sustainable food sources all need step changes in innovation to secure the food supply chain for the decades to come. The STEMconnector Innovation Task Force is uniquely positioned to drive step changes thru innovation excellence in developing programs to accelerate the talent pipeline to help secure wealth for our youth and secure the future for our global consumers.


Section vbuilding a global Action Platform


global action platForM

Section vbuilding a global Action Platform

the 2012 GloBal south summit in Nashville offers proof that Dr. Scott Massey and the CumberlandCenter’s university, public, and private sector partners have leveraged a powerful combination of timing, location and focus into a bold platform for change.

Building on Nashville’s entrepreneurial and creative spirit, and its growing reputation as a center of innovative leadership in business, government and education, the first summit’s success led logically to the question: What next? What is the potential for that platform as a cata-lyst for change? What does it look like over the next five years in form and content? How can the Global Action Platform advance abundance through innovation?

As part of ongoing collaborations and discus-sions with key partners, CumberlandCenter convened a target cross sector group of senior advisors with global perspectives for a strategy session on March 26. Leaders were asked to pro-vide ideas for the next critical three to five years of work. The Center commissioned the Nelson and Sue Andrews Civic Leadership Institute to facilitate the meeting and create a report from the results. We are pleased to share a brief sum-mary of those discussions for the 2013 Global Action Report. Consider this a glimpse of our thinking for the future and a catalyst for your recommendations.

Words matter, so we began with definitions. What does abundance through innovation mean? As with any group of creative successful leaders, we benefited from different perspectives. But there were three overwhelming themes:

• Systems thinking–creating an abundance ecosystem—a dynamic “intelligence” fueled by technology and innovation, thriving from enlightened public policy decisions and driven by university-business partner-ships that give individuals and communities the ability to participate in developing solu-tions and to take personal and collective responsibility to implement them.

• Solutions should be localized, participa-tory and interdisciplinary with a focus on public-private partnerships and sustainabil-ity through new enterprises in “innovation hubs”.

• What gets measured gets done. Start with data, measure results, scale up.

what role coulD anD shoulD the Global South Summit play in creating an “abun-dance ecosystem” and the resulting improve-ment of quality of life that comes with access to jobs, food, and health?

Consensus emerged for a few strategic priorities:

• Focus on the interdependence of food, health, and prosperity as key components of abundance.

• Identify, highlight and encourage cross-sector collaboration for the common good with a focus on strategic investment in innovative businesses and public –private partnerships, especially those that form “uncommon collaborations” creating new economic opportunity for all.

• Promote expanding, shared, sustainable prosperity as a key element of abundance, including jobs creation in summit program-ming and projects.

• Stimulate private enterprise around break-through technologies that create abun-dance.

• Engage the public sector through advocacy and education to inspire the political will to undertake innovative public-private partner-ships and make enlightened public policy and regulatory decisions.

• Convene decision makers and innovators from every sector to share results, col-laborate and call others to action through competitions such as the Global Food and Health Innovation Challenge.

And that was just the morning session!

Results of the afternoon session focusing on the people, projects, and ideas that the Global Action Platform will pursue over the next five years will be showcased in the November 2013 Summit. The CumberlandCenter welcomes your comments as the interative and synthesiz-ing process continues to build this global initia-tive as an engine in the creation of abundance through innovation.

We at The Nelson and Sue Andrews Institute for Civic Leadership at Lipscomb University were honored to participatein the planning for the Global Action Platform. We believe great communities are intentional, not accidental, and that guides our work in creating a better world.

by linda peek Schacht, FoUnding execUtiVe directorthe nelSon & SUe andrewS inStitUte For ciVic leaderShip, lipScoMb UniVerSity

inspiring leadership


global action platForMpartner perSpectiVeS

recommendAtionS global South Summit: Key ideas and recommendations for Action

by cynthia h. barbera, execUtiVe editor

the inauGural GloBal south summit was an electrifying experience. Throughout the day, the air literally crackled with fresh ideas, hope, and a sincere de-sire to reach across traditional boundaries to tackle some of the biggest issues facing our nation and world. Foundation leaders spoke with elected officials, international scientists spoke with business leaders, farmers talked with healthcare providers, ven-ture capitalists spoke with researchers. Everyone agreed that positive change is pos-sible. Participants were united in a commitment to feed our planet more sustainably, offer improved healthcare more equitably and enhance economic prospects around the globe for a more prosperous future. While it would be impossible to capture fully all the many outstanding ideas and comments that emerged in formal and informal dialogues, the following is an effort to distill the most actionable opportunities and initiatives presented. Fuller context and background information can be found by consulting the Summit summary section of this Report. The bullet points listed be-low pull all the actionable ideas from the Summit together in a single place for quick reference.



• Establish long-term strategies with cross-disciplinary inputs from business, science and technology, academia, NGO’s, and government.

• Link food policies in both rich and poor countries with nutrition and health out-comes.

• Continue to innovate in order to optimize our food systems through biotechnology and other means.

• Make better use of technology such as mo-bile devices, videos and other modern ways of disseminating and extending knowledge to help farmers around the world.

• Invest in infrastructure in developing coun-tries that supports agricultural development such as roads, ports, irrigation systems and agricultural innovation.

• Empower women who make up 43% of ag-riculture labor force to have the same access to land, water, seeds, training and credit as their male counterparts.

• Invest in agricultural development with particular focus on smallholder farmers in Sub Sahara Africa and South Asia.

• Support “Feed the Future”–an interna-tional, coordinated agricultural initiative focused on small-holder farmers that grew out of 2009 G8 summit and is rooted in partnerships with local governments, donor organizations and civil society.

• Engage entrepreneurs and venture capital to find innovations that can disrupt current models in order to make them better and work with the very large food corporations who are doing everything possible to opti-mize production.

• Reduce food waste by not tossing good, ed-ible food and through reductions in waste from spoilage after harvest.

• Recognize the true value of food by includ-ing the cost of external impacts in the price of food.

• Involve the public in more science-based discussions about food to build trust and move appropriate technology innovations

forward. Be “technically correct”, not “po-litically correct”.

• Engage the private sector to play a bigger role in agricultural innovation and encour-age them to make long-term strategic invest-ments in processes that accelerate pressures on food producers and governments to change food systems for the better.

• Improve food safety by supporting small-holder farmers with technology-based systems such as barcodes that can trace food from food cultivation through harvest, post harvest, processing and distribution—all the way to the table.

• Celebrate size, scale and the consolidated power of seed companies and consolidated action to continue to increase crop yields.

• Use more data and analytics to be more responsive to the demand forecast in the marketplace and then aggregate all this data to make more sensible supply chain decisions.

• Engage the culinary community as an agent for positive change by reshaping consumer preferences toward foods that improve health and nutrition and support sustain-ability.

• Build excitement about new foods pre-pared with plant-based protein rather than animal-based protein which doesn’t support optimal nutrition and is unsustainably resource intensive.

• Capture the cultural genius from cooks all around the world to help us make the transitions to a more nutritious, plant-based diet.

• Consider other factors about food produc-tion and distribution such as social respon-sibility, sustainability and ethics such as how workers are treated.

• Inspire consumers to make purchase deci-sions that support a more rational, sustain-able, healthier future in terms of diet and health on the planet.

recommenDations: abundant food



• Promote innovations that directly support doctors helping patients and also include all involved parties.

• Coordinate services that place the patient at the center and use an integrated care model that includes technology so that all care-givers can be fully informed and involved.

• Provide incentives for physicians to main-tain contact with patients so that they can also focus on wellness and preventive care.

• Offer patients more seamless cross-platform communication connections to health care providers so that available information can get to them right away.

• Encourage consumers to become more involved partners in their own health and well-being.

• Apply a more interdisciplinary, team ap-proach to patient care and engage more nurse practitioners.

• Approach traditional problems more holistically so that multiple facets of a particular condition can be considered at the same time.

• Break out of the clinic by engaging local community partners to provide services more conveniently and use telemedicine to enable patients to check-in remotely.

• Take small, manageable steps to better health care such as encouraging employers to offer five minute breaks to employees so they can close their eyes and de-stress or walk around the block or take the stairs rather than the elevator.

• Design hospitals differently to offer exercise rooms and even cooking classes to promote more nutrition and wellness.

• Promote the concept of a “Health Coach”, a healthcare professional skilled at working with patients over a longer period of time to make lasting lifestyle changes.

• Focus on outpatient and transitional care by providing the patient with better information when discharged to reduce remissions.

• Partner with home-help agencies and skilled nursing facilities. When doing so, assure that all those who take care of patients are fully connected with other care providers and have access to the pertinent informa-tion they need to do a quality job.

• Engage employers more directly in their employees’ healthcare in order to control costs and advocate for more appropriate use of prescription drugs.

• Focus more on real-time, on-demand clini-cal analytics to help with better diagnosis and treatment.

• Promote continued research for pharma-cogenomics, (the technology that analyzes how an individual’s genetic makeup affects his/her response to drugs).

• Continue to invest in genomics to promote more personalized and precision healthcare, generate economic development and create jobs along the way.

• Encourage employers to advocate for major changes in healthcare by demanding cover-age for new medical approaches (ie. care based on genomic information) from third-party administrators that manage health insurance for their employees.

• Concentrate specialized treatments at re-gional or national decision support centers instead of every hospital deciding on their own for certain diseases.

• Translate new medical breakthroughs as quickly as possible to therapeutics.

• Identify development bottlenecks and work with industry to develop drugs in new and creative ways.

• Encourage today’s pioneers and innovators in medical research to take risks and help to support their careers.

• Tell success stories so everyone can be engaged.

recommenDations: abundant health



• Take advantage of the growing enthusiasm for meaningful collaborations among aca-demia, the private sector, foundations and public advocates for research.

• Advocate for government funded scientific research.

• Distribute future research across geographic boundaries.

• Develop global partnerships across public and private enterprises.

• Support small businesses in healthcare R&D where the many of the innovations and new jobs will come from.

• Find creative ways to help large and small businesses “pick up the research ball.”

• Work with academic institutions to train the next generation of scientists and innova-tors to be more entrepreneurial.

• Focus on the intersection of food, health & sustainability as priorities in food manufac-turing, processing & production.

cYnthia h. BarBera, Executive Editor, Global Action Report serves on the Founding Leadership Committee for the Global South Summit. Over the past 30 years, Cynthia has worked with major educational and media institutions on a wide variety of initiatives and is currently co-founder of eGlobal Reader. An international marketing and communications executive, with extensive experience in broadcast, cable and new media, Ms. Barbera has been recognized for her work on Emmy-award winning programs focusing on the issues of education, environment and health. Cynthia helped to draft a new learning model for the Leonard Bernstein Center for Education through the Arts, and served as Executive Director, Strategic Communications for the University of California, Davis. Cynthia holds BA degrees in Journalism and Social Science from UC Berkeley and an Executive MBA from Columbia University.

recommenDations: abundant prosperity

• Support biotechnology usage where this technology produces sustainable benefits.

• Develop the area of behavioral nutrition.

• Assure that all products labeled “green,” meet the same high-quality standards as regular products and are not just be labeled “green” or “sustainable.”

• Promote a balanced public dialogue on food and health that engages the “triple helix” of research, the public sector and the private sector.

• Engage teams that are focused around market expertise, technological innovations, and entrepreneurial and financial resources when building clusters of innovation. Strategically focus on developing a crop of fundable companies.

• Bridge the gap between basic scientific discovery and real-world application as a priority.


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The CumberlandCenter is a universit y busi-ness alliance to transform innovation into prosperit y. The Center is the organizer of the Global South Summit and the Global Action Platform.

• The CumberlandCenter has developed proprietary methodologies and strategies for building partnerships and productive collaborations among universities, private sector, and NGO’s for regional prosperit y, global development and strategic change.

• The CumberlandCenter serves as a neu-tral, trusted convener for Summits, pro-grams and initiatives, providing organiza-tional infrastructure, funding, leadership and administration.

• The CumberlandCenter has established relationships with a growing number of re-search universities and centers throughout North America and countries throughout the world, including an expanding net-work of universities and labs in Europe, Asia, Africa, and South America.


Global South Summit– Nashville

Dr. Scott t. MaSSey is Chairman and CEO of the CumberlandCenter, a universit y- business alliance to transform innovation into prosperit y. Dr. Massey serves as Founding Chairman of the Global South Summit, an annual global event focused on creating abundance through innovation in food, health, and prosperit y. In addition, he is a Professor of Strategy and Competitiveness and a member of Michael Porter’s Microeconomics of Competitiveness global network, Harvard Business School. Dr. Massey served as Founding President and CEO of the Leonard Bernstein Center and Founding Chairman and CEO of The Learning Collaborative. He has served on national Boards and committees, including, Lincoln Center 50th Anniversary Committee, Imagination Conversation; Advisory Board, the Council on Competitiveness; and currently advises the HEAL Foundation, VTM, and YouScience. A published author, speaker, and Emmy-Award nominated television documentary producer, Dr. Massey works on initiatives that connect academic, business, and government sectors, in regional economic development, tech transfer, universit y branding/strategy, and education reform. Dr. Massey holds a Ph.D. from Vanderbilt Universit y, with a focus on cybernetics and the philosophy of science and logic.

For further information, please contact:CumberlandCenter (877) 300-5806 (main) [email protected]

• The Center is closely affiliated with innovation hubs in food, health and prosperit y, and has relationships estab-lished with Vanderbilt Universit y, Har-vard Universit y, Oak Ridge National Laboratory, Wageningen Universit y and is beginning relationships with universities in China, India and South America.

• The Center’s core research network currently manages over $3B in annual U.S. Federal research.

• The CumberlandCenter serves as a neu-tral and nimble institution designed to facilitate innovation initiatives, leverag-ing its unique expertise and networks to bring research into action.

• The CumberlandCenter was established in 2009 with the mission of transform-ing innovation into prosperit y.

The Center welcomes new relationships in the private and public sectors.

About CumberlAndCenter


the changing content landscape

interview

JoHn inGRaMChairman and CEO

ingram COntEnt grOup

tell uS a little about inGRaM content GRoup.

Our mission is helping content reach its destina-tion. We get books and e-books from publishers to the world. As one of the largest trade book and e-book distributors, we serve major retailers in-cluding Barnes & Noble, Amazon, Borders, Ap-ple’s iBookstore, and independent booksellers, as well as libraries and educational institutions around the world. Ingram is also a provider of services to publishers. More than 21,000 publish-ers and 35,000 distribution partners worldwide use our products and services to realize the full business potential of book content. And while many people may have never heard of Ingram, we are a key behind-the-scenes player. I like to think of us as the WD40 that keeps the gears moving and reduces friction.

publiSHinG iS tHe lateSt Media buSineSS to See a MaJoR SHiFt due to cHanGinG tecHnoloGieS and diGital conSuMption. HoW did you appRoacH tHe ReVitalization oF inGRaM’S leGacy buSineSS?

As a company at the center of the publishing world, luckily we were in a position to recognize the industry changes and inherent challenges that were heading our way. More importantly, we’ve been navigating the shift in content over all sectors of publishing for many years. So, it was really about looking to the future and taking an old-line business and retooling it. There’s the

phrase, “You can’t teach an old dog new tricks.” I would disagree because it really depends. Publish-ing is a very traditional business, but I think we’re all realizing that to survive and grow, practices and models have to change. The old dog is the physical book business—and we’ve had to learn new tricks to move it forward. We diversified and redefined our business from a core concentration on traditional wholesale to publisher services, including print and digital distribution, print on demand (POD), and inventory management. We’ve been on the frontline with publishers, cre-ating new distribution models—from innovations in print on demand and inventory management to new models for digital distribution. For exam-ple, several years ago, Macmillan, a top trade pub-lisher, recognized that the future of publishing required rethinking the business model. We got together to create a new model using our print on demand service combined with our physical distribution infrastructure to manage traditional inventory and POD for Macmillan’s “long tail” titles, books that only sold a handful of copies each year. While the Ingram of today is not my father’s Ingram, there are a lot of the qualities that were important to the traditional business that remain central to our company today. Things like efficiency, reliability, speed, selection, choice, fulfillment across lots of different channels, and being a trusted partner. These qualities, in my opinion, are just as important today as they were

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interView | ingRaM

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more than four decades ago, if not maybe more so. The Ingram of today has kept these values and added state-of-the-art technology and innovation.

HoW HaS tHe GRoWtH oF e-booKS aFFected youR buSineSS?

Technology has fundamentally changed how con-tent is created, formatted, designed, stored, print-ed, digitized, distributed, and sold—more content is available to more readers than ever before. This shift has undoubtedly caused, and continues to cause, disruption and challenges for the indus-try at large. But with change comes opportunity. Because we distribute physical as well as digital content, I see e-books affecting our business in a positive way. As physical books are experiencing low to no growth, digital is experiencing explosive growth, and all signs point to that continuing. At Ingram, we are uniquely positioned to offer a true full-service distribution program combining physical, POD, and digital. Our customers—from retailers to libraries to schools to publishers—can take advantage of our full offering. A few challenges the industry is facing include the layers of complexity to the manage-

ment, distribution, and marketing of assets, whether they be physical or digital. But this isn’t just in publishing—and as we adopt new methods of selling, delivering, and promoting products, what we’re finding is the consumers’ expectations are rising. Consumers are looking for some of the convenience and flexibility from the publishing industry that they’re used to getting from other places. We’re at the stage as consumers where we want what we want, when we want it, where we want it, and how we want it. As we’re starting to get products in more places, we’re starting to generalize these expectations across industries. Another challenge we face across the industry as a whole is digital standardization, and the International Digital Publishing Forum (IDPF), of which Ingram is an active member, continues to lead that charge. While there is not a single standard for the industry yet, the management and distribution of multi-format content to a plethora of devices can be managed successfully today. Ingram’s digital asset manage-ment platform CoreSource (think of it as a digital warehouse) gives publishes a tool to manage and deliver content from one platform in multiple formats to multiple devices.


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HoW aRe publiSHeRS adaptinG to tHe RiSinG pop-ulaRity oF e-booKS?

With the explosive growth of books in all formats in recent years, the role of the publisher to select, edit, and promote content is more valuable than ever. Currently, we’re seeing more publishers look to Ingram for sales, content management, and distribution services—both physical and digi-tal—so they can focus more of their energy and re-sources on content acquisition and development, the core of their business. We like to say that just because it’s digital, doesn’t mean it’s easy. Build-ing and supporting the infrastructure to handle a rapidly expanding number of digital assets re-quires siphoning resources from other areas. Pub-lishers still have a lot of the same traditional cost structures, so how are they going to afford all the other digital investments on top of that? One way is to get out of the logistics business. A publisher no longer needs to be an expert in logistics, ware-housing, printing, etc. Ingram can handle all of the backend work, and more publishers are start-ing to go this route.

iS pRint Still a Viable FoRMat FoR booKS?

Several years ago, I gave speech at the O’Reilly Tools of Change conference in New York titled “It’s an Either/And World.” It’s a phrase we came up with to really reflect that it’s about physical and digital. It’s not either/or, it’s really about both. The Book Industry Study Group’s Consumer Attitudes Toward E-Book Reading report, conducted by Bowker Market Research, had some interesting findings this past May: the percentage of e-book consumers who “exclusively or mostly” purchased book content in e-book for-

mat decreased from nearly 70% in August 2011 to 60% in May 2012. During the same period, the percentage of survey respondents who had no preference for either e-book or print formats, or who bought some genres in e-book format and others in print, rose from 25% to 34%. 46. It’s also situational. Who’s been stuck on an airplane waiting for takeoff with only an e-reader that you aren’t allowed to turn on? I always bring a print back-up—a book, magazine, or newspaper. Ingram has been an early adopter of many different technologies, including launch-ing Lightning Source POD more than 15 years ago. In recent years, we’ve expanded our POD capabilities to France, Australia, Brazil and Ger-many. I believe that POD will be a significant piece of the future of print. At Ingram, we can sell a book, print it within hours, and deliver it to consumers worldwide. I’ll share one good ex-ample that’s timely during this election season. Four years ago, a relatively obscure governor from Alaska was suddenly catapulted into the national stage. Voters were clamoring to learn more about this person, but there was only one biography in existence, and there was little to no stock avail-able to meet the demand. I think the thousand or 1,500 copies that physically existed at the time were quickly snapped up by all the journalists in Washington. I’m proud to say that literally over-night we printed massive quantities at Lightning Source. And this was on the Friday of Labor Day weekend. We were able to get the file, and Light-ning Source produced 50,000 copies over the weekend to meet demand until the offset print run could be put in place. It’s true that as more books go digital, publishers are cutting print runs, but print is still a very viable format and that is exactly where


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POD comes in. We’re investing in new POD technologies, including fully automated lights-out manufacturing, where every six seconds a new book is printed. We’ve also made significant advances in color print on demand, an area that was cost-prohibitive for publishers just a year ago is now a real option. Our services enable publish-ers to experiment with business models for the physical side of their business.

HoW do you See tHe RiSe oF diGital aFFectinG bRicK and MoRtaR RetaileRS and libRaRieS?

I think there is definitely still a place for both physical bookstores and libraries in communities. Savvy retailers, whether national chains or an in-dependent bookstores, will differentiate them-selves through author events, children’s activities, unique shopping experiences, and community connections. According to the most current fed-eral statistics report on public libraries published in October of 2011, visitation and circulation per capita have both increased in public libraries over the past 10 years. Per capita visitation increased 5% from the prior year. Visitation and circula-tion were highest in suburban public libraries. The American Library Association’s 2012 State of America’s Libraries Report reveals the important role these institutions play in providing technolo-gy services to communities. From services for job seekers to access to e-government resources—91% of public libraries provide free Wi-Fi, and 74% of report use of Wi-Fi increased in 2011. Clearly, libraries are filling a need in our cities. Ingram is a supporter of both the American Booksellers As-sociation and the American Library Association. Our goal reaching more readers worldwide with more content, so it’s in our best interest, and all of the customers we serve, that all outlets for books, both physical and online, thrive.

WHat iS youR FocuS oVeR tHe next SeVeRal yeaRS?

We have several areas that we’re concentrating on that we think will move not only our business but the industry as a whole ahead. In addition to our investment and continued growth for print on demand, one area of focus is education. Technol-ogy is driving significant changes in higher edu-cation, especially in the development, delivery, and application of educational content. Digital textbook sales are predicted to grow from 6% this year to 44% in 2017. Education is moving from a one-size-fits-all model to one that’s customized. Vital Source, our electronic textbook platform, is one of our fastest-growing businesses. We now have more than two million students using the platform in more than 180 countries. It’s trans-forming the way students interact with educa-tional material, the way educators teach, and the way publishers create content for the classroom.

WHo do you See aS youR biGGeSt coMpetitoR in tHe neW publiSHinG landScape?

Honestly, it’s us. Our ability to adapt and stay rel-evant will be a key factor in our success over the next several years. I think this is one of the most exciting times to be in the publishing business, and the opportunities are great. I look forward to working with our customers from all sides of the publishing to carve out a new path for getting books in all formats into the hands of readers worldwide.

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2013 Innovation Challenge Sponsoring Organizations:

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The 2013 Innovation Challenge Award Competition is now accepting submissions for breakthrough prototypes, technologies, and/or early stage ventures in the food and health industries. The award is open to food and/or healthcare innovators and entrepreneurs around the world.

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2013 Innovation Challenge Award Submission Key Dates: July 22: Deadline for Initial Applications September 3: Semi Finalists Announced September 17: Deadline for Semi Finalist Business Plans November 11: Live Presentations of Plans to Investors November 12: Investment(s) Awarded at the 2013 Global South Summit, Nashville, Tennessee, USA

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2013 Global Action Report: Food, Health, and Prosperity

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Transcript of 2013 Global Action Report: Food, Health, and Prosperity