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Food fortification is key to fighting malnutrition

By Marc van Ameringen

Thursday, Jun 26, 2008, Page 9

ILLUSTRATION: MOUNTAIN PEOPLE

Every year, 3.5 million mothers and children below the age of five die in poor countries because they do not have the nutrition they need to fight common diseases. Three-quarters of them could have survived diarrhea or malaria if they had been properly nourished.

For those who do survive, the future looks grim: All studies show that children who are undernourished in the first two years of life suffer health problems and lag in development for the rest of their lives. Insufficient nourishment impedes their capacity to learn, fitness to work and ability to develop their talents.

Besides the human suffering, the economic costs of malnutrition are huge: World Bank data shows that countries where malnutrition is most prevalent lose, on average, between 2 percent and 3 percent of their GDP.

The issue is not severe and acute malnutrition, which hits populations suddenly, usually as a result of conflict. The question is how we attract the attention of the EU and the G8 countries to the malnutrition that experts call “hidden hunger,” which affects one in every three people worldwide. It is caused by imbalanced nutrition or a lack of vitamins and essential minerals that enable the human body to grow and that maintain its vital functions.

For example, recent data show that even a moderate deficiency of vitamin A results in higher mortality. In fact, we could avoid the death of at least 1 million children every year by improving their intake of it.

Doing so would not be difficult. Humans have added essential vitamins or minerals to their foods since time immemorial; indeed, since the beginning of the 20th century, food fortification has been a major government policy in developed countries to reduce nutritional deficiencies and improve public health. All scientific studies of such interventions prove that fortification of basic foodstuffs works.

Chile promoted the addition of iron to milk, resulting in a 66 percent reduction of anemia among babies.

The fortification of maize meal with folic acid in South Africa — one of the projects supported by the Global Alliance for Improved Nutrition (GAIN) — was followed by a 40 percent reduction in spina bifida, a serious deformation of the neural tube in newborn babies.

Moreover, these essential interventions cost little and deliver a lot: To enrich cooking oil with vitamin A costs less than US$0.10 per liter, and fortification in general has a benefit-to-cost ratio of at least eight to one.

What is missing is the willingness to act. At GAIN, we are convinced that there is an urgent need to fight malnutrition if the world wants to achieve the UN’s Millennium Development Goals, which commit the world to halving global poverty and hunger by 2015.

Fighting malnutrition is the first step toward reaching this objective. Science has demonstrated the cost-effectiveness of food fortification, and the technologies and know-how are available in the private sector, which has the capacity to innovate and deliver products to the poorest.

Europe and the G8 must act. Not only do they need to make the fight against malnutrition a policy priority; they also must invest. The equation is straightforward: 160 million euros (US$250 million) for fortification programs could improve the health of 1 billion people.

To put that amount into perspective, the regular move of EU institutions between Brussels and Strasbourg costs 200 million euros per year.

While the latter is an understandable expense historically, the time has come for the EU and the G8 to make different political choices that help keep 3.5 million mothers and children alive and well.



Marc van Ameringen is executive director of the Global Alliance for Improved Nutrition.

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