In Abidjan, the Ivory Coast’s largest city, a small success story in the fight against hunger can be found. The supermarkets stock Marie Konaté’s children’s cereal, the extraordinary aspects of which remain hidden to most customers. Not only is it produced locally, it contains a high level of vitamins and nutrients.
The trick is simple. Marie’s company, Protein Kissèe-La (PKL), supplements the cereal with powdered vitamins that are provided by the Global Alliance for Improved Nutrition (GAIN). “Many people in our country don’t eat enough fruit and vegetables and overcooking their food leads to the loss of valuable vitamins and minerals. Cereal belongs to the daily diet of many people here. My cereal not only changes eating habits, but provides all the nutrients people need,” said Konaté.
An alliance of international organisations and development foundations are now calling for Marie’s super-cereal to be rolled out in schools. The fortification of food with vitamins and minerals is the most cost-effective option in the fight against hunger, the alliance emphasised in an international conference in Arusha, Tanzania.
“Food fortification should become a critical pillar of national food and nutrition security plans. Unless we can rapidly scale up the availability and consumption of fortified foods in countries, the achievement of some Sustainable Development Goals (SDGs) will be impossible,” read the final statement drafted by, among others, GAIN, the World Food Programme (WFP), the African Union, the UN’s Food and Agriculture Organisation (FAO), UNICEF and the Gates Foundation.
Fortification: The “most cost-effective measure against malnutrition”
The idea of using fortification is not new. In the past decade, a lot has been achieved in this area, through the iodine-enrichment of salt. But in the past few years acute famine and armed conflicts have pushed the issue of malnutrition out of the spotlight. “We must not lose the positive momentum that we built up in the past,” read the Arusha declaration.
The consequences of hidden hunger are fatal. According to a recent study by GAIN, around 50% of infants dying under the age of five could have survived if they had been better nourished. Iron deficiency accounts for 20% of deaths among mothers. A quarter of children worldwide suffer with delayed development. The FAO estimates that annual economic losses reach 2 to 3% globally.
$150 million for a billion people
GAIN’s report makes great mention of the fact that fortification is very cost-effective. The authors refer to the Copenhagen Consensus research group’s figures from 2008. According to their data, iodine fortification costs five US cents per head. Therefore, there would be an investment return of 30 times that figure. Through higher productivity from workers and relief on national health systems, a return of $26 per person would be shown.
The signatories of the Arusha declaration called for more public money to fund the fortification programme. Around €150 million would be enough to establish the programme for 15 years in 25 developing countries. An additional billion people would benefit from such a scheme. In addition, the organisations called for “a massive effort” to improve the supervision and regulation of the programme. Industrialised countries should assist developing countries to legislate and carry out inspections, so that the food being produced is of a high quality.
World Hunger Aid: fortification only fights the symptoms
The German organisation World Hunger Aid (Welthungerhilfe) believes that fortification and dietary supplements are indeed useful during crises and disasters, as well as during pregnancy and motherhood. However, this approach should not been seen as the pinnacle of the fight against malnutrition, warns one of World Hunger Aid’s nutritionists, Andrea Sonntag. “Fortification only fights the symptoms of malnutrition, not the causes,” she said in an interview with EurActiv.de.
Ending malnutrition requires a holistic strategy for development cooperation, with goals such as agricultural diversification, a balanced diet, clean drinking water, education, empowerment of women and an increase in local income paramount to this. “The chief cause of malnutrition is that those affected by it cannot afford healthy food,” explained Sonntag.
She also warned against conflicts of interest, “Through fortification programmes, international organisations and governments open up new markets for the private sector.” The aim of international assistance should be the improved health of developing countries. According to Sonntag, “the concerns of multinational corporations, for example, the enriching of soft drinks with vitamins and minerals in order to promote a healthy lifestyle, should not be legitimised or supported in the fight against malnutrition”.
The nutrition expert believes that the request for more public money for fortification is superfluous. “The private sector is capable of financing fortification themselves. “Public money should be better appropriated, by using it to promote a balanced diet based on locally available, nutritious foods.” So far, the potential has gone underexploited, for example, the fruit of the baobab tree in Kenya, which is rich in vitamin C and calcium,” added Sonntag.
GAIN chief Marc van Ameringen does not agree. “Yes, there are many ways to combat malnutrition. Yet food fortification has been shown to be one of the safest and most cost-effective measures to tackle hidden hunger on a large scale,” Ameringen told EurActiv.de. One must bear in mind that staples like wheat, cereals and rice are all a part of the daily diet of mothers and children. “Food fortification is designed to build up micronutrient stores in people over time and without risk.”
Children and new mothers are particularly susceptible to malnutrition, particularly during the first 1,000 days. Mothers need adequate nutrition to aid the development of unborn and breastfeeding children. Around 50% of children under the age of five are affected by anaemia, as well as by impaired cognitive and physical development. An estimated190 million pre-school children suffer from vitamin A deficiency, which can lead to early childhood blindness and a weakened immune system. According to experts, a balanced diet improves the performance of children in school. As adults, this can lead to increased earnings of up to 20%.