Policymaking initiatives in agriculture and public health are often pursued in a parallel and unconnected fashion. Yet coherent, joint action in agriculture and health could have large potential benefits and substantially reduce risks for the poor. Among development professionals there is growing recognition that agriculture influences health, and health influences agriculture, and that both in turn have profound implications for poverty reduction.

This case study explores the development, dissemination, adoption, and impact of improved tree fallows in rural western Kenya. The processes of technology development and dissemination throughout the region are described and analyzed. To analyze adoption and impact, the paper applies a variety of different data collection methods as well as samples from both pilot areas where researchers maintained a significant presence and non-pilot areas where farmers learned of the technologies through other channels.

"Good health and productive agriculture are both essential in the fight against poverty. In a rapidly changing world, agriculture faces many challenges, both old (natural resource constraints, extreme weather conditions, and agricultural pests) and new (globalization, environmental degradation, problems of maintaining production in conflict situations). At the same time, new global health threats emerge, such as HIV/AIDS, SARS, and avian influenza, while old ones persist.

Agriculture produces food fundamental for human health. It therefore seems obvious that agriculture, food, and health are related! Agriculture affects whether people have enough food to eat, whether it is of sufficient nutritional value, and whether it is safe, all of which affect human health. But it is not so simple: history has taught that there are different ways of looking at the relationships between agriculture, food, and health. Agricultural connections to food and health are mediated by the natural environment, human culture, and technological change.

"Agriculture is the main source of livelihood of the majority of people affected by HIV and AIDS globally, and it is being progressively undermined by the disease. In Sub-Saharan Africa AIDS is affecting the rural landscape in ways that demand a rethinking of development policy and practice, and parts of South Asia may soon face a similar situation.... There is clearly tremendous scope for agricultural policy to become more HIV-responsive, both to further AIDS-related objectives and to help achieve agricultural objectives. Yet there are no magic bullets.

"Agriculture is the main source of livelihood of the majority of people affected by HIV and AIDS globally, and it is being progressively undermined by the disease. In Sub-Saharan Africa AIDS is affecting the rural landscape in ways that demand a rethinking of development policy and practice, and parts of South Asia may soon face a similar situation.... There is clearly tremendous scope for agricultural policy to become more HIV-responsive, both to further AIDS-related objectives and to help achieve agricultural objectives. Yet there are no magic bullets.

"For the practice of agroforestry to yield its full potential, it needs to bring health and nutrition to the fore.

Agriculture is fundamental to achieving nutrition goals: it produces the food, energy, and nutrients essential for human health and well-being. Gains in food production have played a key role in feeding growing and malnourished populations. Yet they have not translated into a hunger-free world nor prevented the development of further nutritional challenges. Micronutrient deficiencies (for example, of vitamin A, iron, iodine, and zinc) are now recognized as being even more limiting for human growth, development, health, and productivity than energy deficits.

"In contrast to popular predictions of Africa’s worsening economic decline, recent research supports an alternative and more positive vision of Africa’s future. New political commitment and African ownership of the development agenda, combined with a renewed focus on and investments in smallholder-led agriculture, have the potential to halt or reverse the current downward spiral of hunger, poverty, environmental degradation, disease, and civil strife.

This book brings together briefs and articles generated by the 2020 Vision initiative that remain highly relevant to the ongoing dialog and debate and, given the nature of the topics addressed, are likely to remain so for some time to come.

"To end hunger and prevent the recurrence of famine and starvation, we need to take the following steps: invest in public health, child nutrition, education, women’s and girls’ social status, and other components of human capital; reform public institutions and create innovative funding and partnership arrangements; change government policies at all levels to be both pro-poor and pro-growth; increase funding for scientific and technological research to boost agricultural production and efficiency; and develop specific policies and institutions to deal with environmental degradation caused