In October 2014, a student from Mageyo Primary School in Burundi approached a program manager from Project Healthy Children (PHC). The child asked about food fortification and the PHC program manager explained the program’s purpose and how it worked in the context of Burundi. After listening intently, the primary school student explained, “You see, my mother died three years ago because of a lack of iron while giving birth. Why didn’t you bring food fortification to Burundi earlier?”
The Global Alliance for Improved Nutrition (GAIN) and Project Healthy Children (PHC) — two non-profit organizations recommended by The Life You Can Save — have recently announced a partnership to improve the quality and delivery of one of the world’s most cost-effective interventions: food fortification.
“The opportunity we have to change lives through improving the quality of fortification is immense,” says Greg S. Garrett, Food Fortification, GAIN. “Our new partnership with PHC, will accelerate action with government and business leadership to achieve health impact.”
The hidden hunger problem
Despite progress in tackling hunger over the last decade, poor nutrition and in particular micronutrient malnutrition — also known as ‘hidden hunger’ ‚ remain one the biggest challenges of our time. Today, hundreds of millions of people lack the essential vitamins and nutrients needed to grow and live healthy lives. While hidden hunger rarely shows visible signs in those who are affected, its consequences can be disastrous. Without essential micronutrients, such as vitamins A, D, iron, zinc, folic acid and iodine, among many others, health consequences can range from serious physical disabilities to life-threatening disorders.
For example, annually more than one million children under the age of five die due to vitamin A and zinc deficiencies. Anemia – often due to iron deficiency – affects nearly one-third of the world’s population and contributes to 20 percent of all maternal deaths. Similarly, iodine deficiency, if not prevented early on, can cause stillbirth, spontaneous abortion, and congenital brain abnormalities that may lead to irreversible and severe mental impairment. The impact of iodine deficiency lasts a lifetime, limiting a child’s ability to learn, earn a living, and potentially decreasing a child’s IQ by as much as 13 points.
The World Health Organization (WHO) has identified iodine, iron, vitamin A and zinc deﬁciency as among the world’s most serious health risk factors, responsible for a significant portion of the global burden of disease, and an enormous drain on national economies. Malnutrition is in fact a massive barrier to economic growth, resulting in losses of up to 11% of GNP across Africa and Asia. Health and opportunity costs associated with malnutrition result in losses of an estimated $3.5 trillion dollars from the global economy annually.
A proven, scalable and cost-effective nutrition intervention
Food fortification — adding small and safe amounts of micronutrients to staple foods and condiments — is a simple, scalable and highly cost-effective development intervention that is reaching billions across the world and can play a significant role in the prevention of micronutrient deficiencies across entire populations, if implemented properly.
In the US, for example, common fortified foods such as enriched wheat flour and iodized salt have helped to drastically decrease national rates of neural tube defects – a severe form of birth defects – and virtually eradicate other insidious diseases, like pellagra and goiter. However, in low- and middle-income countries, where the programs are needed most, the impact of the intervention has been limited and vitamin and mineral deficiencies persist, leading to decreases in national economic growth and the impaired physical and mental development of entire populations.
The good news is that in the last decade fortification has scaled up. Today, over 150 countries are implementing salt iodization programs, 86 countries have mandated at least one kind of cereal grain fortification and dozens more have large-scale fortification programs which focus on fortifying edible oils, sauces and condiments. However, available data show that programs in low- and middle-income countries struggle to ensure fortified products actually contain the correct amount and vitamins and mineral per the national standard. This means that programs may not be delivering a sufficient quantity of nutrients needed to have a nutritional impact on the population.
Why this partnership matters
GAIN and PHC have committed to help improve the situation by working together with food control and food industry in low- and middle-income countries that have mandated food fortification. By leveraging their respective skills and networks, these two organizations aim to build strong in-country leadership, strengthen quality assurance, and improve regulatory practices by rolling out new technologies; advocating for enhanced, practical approaches; and engaging with civil society.
The end goal is an improvement in the quality of fortified foods, increased intakes of essential vitamins and minerals among vulnerable populations, and a boost in the overall health of communities.
We’re in an unprecedented position to fix issues of hidden hunger. This effort builds on others in the international food and nutrition sector which if successful will lead to incredible gains. In 5-10 years, we can control iodine deficiency at a population level, in a sustainable way, globally. Similarly, if we can ensure industrially milled wheat flour is fortified with folic acid according to WHO guidelines in 18 countries in Africa and Asia, over 50,000 neural tube defects could be prevented annually through fortification in these countries. Through fortification with iron according to WHO guidelines, we can expect to achieve a reduction in anaemia of over 2 percent per year.
“There is an urgent need to address the quality of fortified foods if we want to see programs deliver their intended nutrition impact,” says Laura Rowe, President, PHC. “We are excited to work together with GAIN, leveraging our joint expertise, to address gaps in programming that we believe will enable a meaningful contribution to ending many forms of micronutrient malnutrition.”
This #GivingTuesday, join us in the fight against hidden hunger and help us reach millions of people in need with better nutrition.
Support GAIN’s programs here and PHC’s programs here
Read more about the GAIN and PHC agreement here