Hidden hunger - Reflecting on the first-ever summit on food fortification and hidden hunger

8/20/2019 Hidden hunger - Reflecting on the first-ever summit on food fortification and hidden hunger

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T

hree weeks ago we closed the ground-

breaking Global Summit on Food

Fortication in Arusha, Tanzania.

The momentum from this event is

creating the environment needed to

ensure the world’s most cost-effective

development solution is scaled-up

throughout Africa and Asia to help end

hidden hunger.

The Summit was formally opened by Africa Union

Nutrition Champion, King Letsie III of Lesotho as well as

the Prime Minister of Tanzania. Two different African Union

Commissioners gave plenary speeches and President Kikwete of

Tanzania paid a visit to the Summit organising team on the nal

day. Over a dozen ministers of health and industry from low-and

middle-income countries attended among the 29 government

delegations. These delegations made various commitments to

scale up fortication with essential vitamins and minerals in order

to better address hidden hunger, representing well over a billion

additional at-risk individuals in their respective countries who

can benet from these renewed efforts.Dr Chris Elias, President of the Global Development Program

for the Bill and Melinda Gates Foundation stated on day two:

“After a decade long investment and food fortication being such

a well proven, tested, method – why has it taken us so long to

hold this very important conference?”

After the event, even the New York Times reported on the

great opportunity fortication offers to help address malnutrition

globally.

For me personally it was rewarding to see many months spent

planning pay off. It was also an opportunity to present results

from a recent study and publication I co-authored on an area of

great concern and interest, for example, improving the quality

and compliance of fortied foods.

Closing the ground-breaking summit, H.E Tumusiime Rhoda

Peace, African Union Commissioner for Rural Economy and

Agriculture, delivered an impassioned Statement on behalf

of the co-hosts (the Government of Tanzania and GAIN) and

co-conveners (WFP, UNICEF, SUN Secretariat, African Union,

USAID and the Bill and Melinda Gates Foundation) in the form

of the Arusha Statement on Food Fortication.

I’d like to leave you with some of the highlights from that

statement which should excite us as we aim to reach a billion

more people with better food and nutrition and end hidden

hunger:

We leave Arusha with a determination to build a new

movement, a future fortied with improved food and nutritionsecurity. We have the tools, we need to nish the job started a

hundred years ago and make the benets of this simple and cost

effective approach to an improved diet available to all.

Preventable deciencies of critical vitamins and minerals

such as Vitamin A, D, iron, iodine, folic acid and zinc

Reecting on the rst-ever summit on

food fortication and hidden hunger

Hidden hunger

by Greg S. Garrett, Director, Global Alliance for Improved Nutrition (GAIN)

52 | October 2015 - Milling and Grain

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contribute to up to three million

child deaths annually. The best

available estimates are that two

billion people are affected by

micronutrient malnutrition, but

the true burden is probably even

greater, as we lack precise data.

This has far-reaching effects

on individuals and impedes the

economic development of nations.

GDP losses from under-nutrition

can be 2 % - 3 % per year.

The central message of this

Summit is that food fortication

should become a critical pillar

of national food and nutrition

security plans. Unless we can

rapidly scale up the availability

and consumption of fortied foods

in countries, the achievement of

some Sustainable Development Goals (SDGs) will be impossible.

Food fortication is a vital tool to make progress towards theWorld Health Assembly goal to reduce anaemia among women of

reproductive age.

But without further investment, we risk losing this momentum.

We have the unprecedented opportunity to virtually eliminate

iodine deciency if we scale up salt iodization efforts. Through

effective fortication with iron of grains we can expect to achieve

a 2.4 percent reduction per annum in anaemia. Fortication of

wheat our with folic acid in 18 countries in Africa and Asia

could prevent over 50,000 debilitating neural tube defects

annually. We cannot lose these opportunities.

Food systems and eating habits are changing rapidly dueto urbanisation, changing climate, land and water use and a

younger population. While food fortication alone cannot end

malnutrition, it is critical to micronutrient deciency prevention

and control strategies, and is an underexploited public health tool.

What are the critical areas for action highlighted at this

Summit?

First, modest but new investment is essential. Fortication

is cost-effective and largely self-sustainable, costs are built

into markets and typically do not require further or continuous

Milling and Grain - October 2015 | 53

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public subsidy. Governments need to invest in technical support,

oversight and compliance.

The new investments are needed to build, improve and sustain

fortication programs. It was estimated that the additional donor

costs over 15 years to build, improve and sustain fortication in

25 low and middle-income countries for multiple food vehicleswould be $150m. This could effectively cover an additional

billion people.

Second, there is need for a major effort to improve oversight

and enforcement of food fortication standards and regulations.

Poor compliance with laws and regulation limits potential for

impact and undermines effectiveness. Available data show

adequate compliance with standards as low as 50 percent in

many contexts. Governments should improve their inspection

and enforcement systems to ensure high quality fortication

and a level playing eld for the producers. Effective regulatory

monitoring and enforcement will notably require more robust

national budget allocations.

Third, there is a need to generate more evidence to guide

fortication policy and program design, to continually improve

programmes and demonstrate impact. For example, there is a lack

of detail of foods consumed by various target groups, limiting our

understanding of potential food vehicles, use of fortied foods

and quantication of the dietary gap we must address for some

nutrients.

Fourth, progress requires more transparent accountability and

global reporting. We support the call for a global observatory or

annual report of the state of fortication.

Fifth, continuing advocacy is a high priority, and we will work

together with stakeholders such as the SUN movement and

African Union to advocate for greater attention by governments.We leave Arusha with a determination to build a new

movement, a future fortied with improved food and nutrition

security. We have the tools, we need to nish the job started a

hundred years ago and make the benets of this simple and cost

effective approach to an improved diet available to all.

54 | October 2015 - Milling and Grain

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Hidden hunger - Reflecting on the first-ever summit on food fortification and hidden hunger