(i) Outline what is meant by the term “diseases of affluence”.

(ii) Briefly describe the global distribution of diseases of affluence.

Referring to one named water-borne or vector-borne disease, distinguish between policies relating to its prevention and policies relating to its treatment.

Examine the effects of transnational corporations (TNCs) and fair trade on the level of sustainability of agriculture.

(i)

Award [1] for each valid point from the following:

• mainly affect wealthier people
• due to longevity/sedentary lifestyle/diet/lifestyle choices
• or an example, eg cancer.

(ii)

Primarily economically wealthy countries [1], but also in some socio-economic groups within less wealthy countries [1].

Award maximum [3] if no specific disease named, or disease is not either water-borne or vector-borne, eg HIV/AIDS, Ebola.

Award maximum [4] if policies only relate to either prevention or treatment.

For example:
Malaria is a vector-borne disease, carried by mosquitoes [1].

Policies related to malaria prevention include: Award [1] each.

• removing/covering open bodies of still water (ponds, buckets, puddles)
• eradicating mosquitoes (spraying)
• encouraging use of bednets, preferably pre-sprayed with mosquito pesticide
• encouraging use of anti-malarial tablets.

Policies related to malaria treatment include: Award [1] each.

• ensuring rapid diagnosis (provision of laboratories, training of medical staff, including doctors) ensuring easy access to medical attention and medicines needed to treat malaria (healthcare systems, education, purchase of stockpiles of malarial medicines)
• establishing a national database of malarial patients so that they might be treated more effectively and appropriately.

The relationship between TNCs and sustainability is complex. While some TNCs probably increase agricultural sustainability, others probably decrease it. Equally, the actions of some TNCs probably have no effect on sustainability whatsoever.

An example of how sustainability might be increased is when TNCs introduce/adopt more efficient irrigation techniques (such as drip feed instead of flood irrigation) to grow crops. However, sustainability is only increased if the pumping of water for the new irrigation system does not involve using large amounts of additional energy coming from non-renewable sources.

On the other hand, TNCs that introduce GM herbicide-resistant crops may decrease sustainability. For example, some TNCs have patented or otherwise protected their rights to certain types of seed, meaning that farmers have to purchase new seed every year and are no longer allowed to use seed from a previous crop, as is normally done in conventional farming. This may be economically unsustainable, especially over the long term. In other cases, for example where the seed of some hybrid crops will not germinate and grow new crops, the changes brought by TNCs may be ecologically unsustainable.

The adoption of fair trade is designed to increase sustainability, especially the social and economic aspects of sustainability. The discussion of fair trade might extend into considering the sustainability of marketing and supply chains. This should not be penalized but is likely to be self-limiting given the wording of the question.

TNCs and fair trade are not always mutually exclusive. One example of an overlap between TNCs and fair trade is Starbucks coffee. The firm is a TNC, but it advertises and commercializes fair trade products.

Candidates are expected to show some awareness that the concept of sustainability has several strands, including economic, environmental and social. It is also likely that many candidates will refer to ways in which sustainability can be measured/assessed. The strongest responses are likely to include references to food miles and/or energy efficiency as measures of sustainability.

It is not necessary for TNCs and fair trade to be discussed in equal depth for the award of full marks. A strong, evidenced discussion of TNCs may well offset a weaker discussion of fair trade, or vice versa.

Responses at band D are likely to describe some ways in which TNCs and/or fair trade affect sustainability of agriculture.

At band E, expect either greater explanation of how TNCs and fair trade affect sustainability of agriculture or some explicit examination of what is meant by sustainable agriculture.

At band F, expect both.

Marks should be allocated according to the markbands.

(i/ii) There were few problems with this. Relatively few candidates recognized that diseases of affluence can occur in less wealthy countries.

This was generally well answered. The question specifically required one named water-borne or vector-borne disease*; Ebola is neither, although some credit was given. Policies of prevention were often answered better than treatment. Unfortunately, some candidates wrote (erroneously) that there is a vaccination for malaria.

* The geography guide requires case studies of two diseases, chosen from two of the following three: vector-borne, water-borne, or sexually transmitted.

This question required an understanding of TNCs, fair trade and sustainability of agriculture. There were some very good, detailed responses, using examples. Others had an imperfect understanding of fair trade, confusing it with free trade. Many focused on environmental impacts and sustainability, with less consideration of social and economic aspects. Some recognized that TNCs and fair trade are not mutually exclusive.