Epidemiologist and former WHO Chronic Diseases Director Derek Yach was interviewed recently by Riva Greenberg, a diabetes advocate and blogger on the Huffington Post. Yach is employed by PepsiCo as Senior Vice President on Global Health and Agricultural Policy, a unique position as far as we know for an epidemiologist.

Greenberg described Yach as “a noble fish trying to change the sea around him,” and said Yach's mission is to help address global challenges such as hunger and obesity, and the ills they cause, by finding ways for PepsiCo to be a part of the solution. These intriguing remarks led us to read the two-part interview and to present some of the excerpts below. 

Greenberg: When you were at the World Health Organization you were instrumental in reducing smoking. Why is it so much harder to get food companies and consumers on the path of producing and eating healthy food?

Yach: Reducing tobacco use was much simpler. You demonize the industry, then tax it to the sky, ban marketing and reduce smoking in public places. Those are all very crude, easy things to do. They don't have the nuance of a diet, the complexity of the thousands of things available for people to eat or the numerous invested parties.

Greenberg: What has to happen regarding agricultural policies in order to help stem the tide of obesity and diabetes?

Yach: Simply, we need a far more nutrition-focused perspective embedded in agricultural policy. In terms of health, our food policies have failed miserably. The escalation of diabetes around the world is an indicator of how off course we've gone.

As an epidemiologist I look at trends and see problems before they begin and things getting better before it's noticed.

The public hasn't yet seen our agricultural policies translate into a direct impact on diabetes-related death, but it has. And, they are having significant consequences regarding increased diabetes, ill health and health care costs.

Greenberg: How can governments and businesses work more closely with agriculture to stem the tide of obesity and produce more healthful foods?

Yach: That's the critical question. When I was at the WHO, one of the things we failed to do when working on diet and physical activity policy was persuade agricultural organizations to look at what agricultural supply would be if it was meeting the health and nutrient needs of the world. I think that's the intimate bridge between what gets grown and what is needed from a health point of view.

Greenberg: What initiatives is PepsiCo involved in to help produce more nutritious foods?

Yach: We're investing in small farmers around the world and we're involved all along the chain, from the seed and development of farming practices to the final product and its consumption. We've partnered with the World Food Program and the United States Agency for International Development to fund better seeds and drip irrigation systems in Ethiopia so farmers can improve their yield of chickpeas. We believe this project can potentially reduce famine in Africa over the long term. Excess chick peas PepsiCo doesn't use, the World Food Program is using in a ready-to-eat food product to address famine in Pakistan.

PepsiCo is also fortifying many of its products to get micro-nutrients into millions of people's diets. For example, we're addressing iron deficiency in India with an iron-fortified cookie. In Mexico, we're fortifying some of our more nutritious cookies with Vitamin A.

Greenberg: Why don’t more companies feel a moral obligation to move in this direction?

Yach: I can't answer for other companies but I think a great business is one that is doing things that are both right for the business and right for society.

It's less the moral case but the business case that needs to be made inside companies for doing this.

Greenberg: Was there any resistance within or without PepsiCo to move in this direction?

Yach: Yes, but being a South African growing up in a period of profound national change, I have seen there will always be resistance to change. When you have a senior team all speaking the same message, a CEO, Indra Nooyi, who sees the business growth opportunities that come with developing healthier products and investment in research and development, suddenly the change that seems so tough, happens. And suddenly, the investment in innovation you made is no longer visionary, but business as usual.

Greenberg: How do you reconcile doing this work in a company that's also the largest producer of what we think of as less than healthy snack foods?

Yach: I can answer that by saying there are two big strategies underway. One is to take many of our products and make sure that the salt, sugar and fat levels are at the lowest possible level and that they meet nutrition criteria, without sacrificing the great taste consumers expect from PepsiCo products.

While we invest in our core brands, we're also growing other parts of the company in order to build that $30 billion health and wellness portfolio that I mentioned earlier.

Greenberg: You sound enormously hopeful.

Yach: Absolutely. If you look at the trends for demanding healthier foods the trend lines are upward in every market in the world. Even in the current economic environment with people turning, in part, to comfort foods, the overall trend toward improving health and nutrition seems to universally be going in the right direction. And the trend lines are echoed by steadily improving life expectancy and steadily declining diseases we thought we would never be able to conquer.

I was in South Africa at the start of the upswing of the AIDS epidemic. The evidence is now that it's starting to go down. I was very involved in tobacco control and now we've seen dramatic decline in tobacco-related mortality like lung cancer. That was unthinkable 15 or 20 years ago. I've seen the almost complete collapse of measles and almost complete eradication of polio.

Over the course of my career I've seen changes that people thought would be impossible.

I've also seen that individual and community action can make a big difference to global health. And as an epidemiologist I'm stimulated by changing the shape of the trend line to make sure as bad things are going up we can slow them down and bring them back down sooner.

We're starting to see the peak of obesity in a number of European countries and a slowdown or first indication of reduction in parts of the U.S. I think a decade from now we'll be looking at a reversal of the diabetes epidemic in many parts of the world and a continued upward trend of people living longer, healthier lives.

The full interview is available online at http://www.huffingtonpost.com/riva-greenberg