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The Importance of investing in Nutrition
Larry UmunnaGlobal Alliance for Improved NutritionAfrica Regional OfficeJohannesburg, South Africa
‘’Opportunities in the Value Chain’’ conferenceAddis Ababa, Ethiopia
October 24, 2007
P.O. Box 1234, MidrandHalfway House 1685South Africa
Tel. +27 12 657 9265Fax +27 12 657 9269www.gainhealth.org
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Outline of Presentation
• The scourge of Malnutrition
• Effect of Malnutrition on the economy
• Costs of Malnutrition
• Current Initiatives
• Opportunities
• Challenges
• Recommendation
• Conclusion
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South Africa: Rugby Champions of the World
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Will these children become World Champions?
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The reality..
• Sports: A fast route to:– Nation-building
– Foreign Exchange earnings for Individuals and Country
– Economic development
• However, adequate Nutrition is required for Sportsmen
• But the reality is that only a tiny percentage of the
population has access to adequate nutrition!
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The scourge of Malnutrition
South African Children (1 -6 years):
• 21.6% children - chronically malnourished
• 10.3% - underweight
• 3.6% - severely malnourished
• 7.7% - overweight
• 21.4% - anaemic
• 33% of children are deficient in Vitamin A
• Infant Mortality Rate: 55 per 1000 live births
• <5 Mortality Rate: 68 per 1000 live births• Source: UNICEF South Africa Report; May 2007
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Ethiopia
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Ethiopia: Nutritional Status
• Infant Mortality rate (2005) : 109 per 1000 live births
• Under-5 Mortality rate (2005) : 164 per 1000 live births
• Malnutrition Prevalence, weight for age (% of children under 5) :
47
• About 130,000 children under 5 suffer from severe acute
malnutrition at any given time in Ethiopia
• Malnutrition is underlying cause of more than 50% of all child
deathsSource: The State of the World’s Children 2007
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The situation in Africa
•
337 million Africans consume less than 2,100KCal per day
•
200 million are chronically malnourished
•
5 million die of hunger annually
•
126 million children are underweight
•
About 50% children are stunted
•
25 million live with HIV/AIDS
•
Vitamin Mineral Deficiencies unacceptably high
•
12 deaths per minute due to hunger and malnutrition
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Protein - Energy Malnutrition
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Iodine Deficiency
• Goitre• Goitre
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Vitamin A Deficiency
Effects on vision:Effects on vision:
• night blindness
• total blindness
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Vitamin A DeficiencyU
NIC
EF/C
79-5
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Also damages:Also damages:
• immune system
• lungs, intestines . . .
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IDA Effects on Infants
UN
ICEF
/C-7
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•
stillbirth
•
infant death
•
brain damage
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Health and other Implications
• Nutrition related Non-Communicable Diseases:
– Cardiovascular diseases
– high blood pressure
– Obesity
• High disease burden esp. communicable diseases HIV/AIDS
(double burden of diseases in developing world)
• High medical costs – compromised health services
• Poor and slow economic development
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Economic Costs Enormous:
• 20% reduction in productivity • 5% reduction in educational achievement• Indirect losses from poor cognitive losses and loss in
schooling• 13.5 point reduction in IQ due to IDD• Losses in resources from increased healthcare costs
• GDP lost to malnutrition as high as 2 – 3 %
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The vicious cycle of Poverty and Malnutrition• Source: World Bank 2002
Income Poverty
Low food intake
Frequent infections
Hard Physical Labour
Frequent Pregnancies
Large Families
Malnutrition
Indirect loss in productivity from poor cognitive development and
schooling
Direct loss in productivity from
poor physical status
Loss in resources from increased
health care costs
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Costs
• The returns on investing in nutrition are high
• Vitamin A fortification of sugar : US$ 0.69 per person
per year
• Salt Iodization: US$ 0.20 per person per year
• Fortification is a cheaper intervention than
Supplementation– Iron: US$ 0.09(fortification) vs US$3.17 (Supplementation)
– Vitamin A : US$ 0.17 vs US$ 0.9
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Investing in Nutrition
• The Journey so far………
• Governments, Development partners, Industry, etc
are beginning to invest in Nutrition
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• 1990: World Summit for Children
• 1991: Ending Hidden Hunger Conference
• 1992: International Conference on Nutrition
• 1996: World Food Summit
International Commitments
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Millennium Development Goals - 2015
1. Eradicate extreme poverty and hunger2. Achieve universal primary education3. Promote gender equality and empower women4. Reduce child mortality5. Improve maternal health6. Combat HIV/AIDS, malaria and other diseases7. Ensure environmental sustainability8. Develop a global partnership for development
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Committment from African Leaders
Abuja Declaration 2006AFRICAN UNION UNION AFRICAINE
UNIÃO AFRICANA
Addis Ababa, ETHIOPIA P. O. Box 3243 Telephone: +251-11-5517700 Fax: +251-11-5517844 website: www.africa-union.org
Summit on Food Security in AfricaDecember 4-7, 2006
Abuja, Nigeria FS/Res (I)
Resolution of the Abuja Food Security Summit
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Stakeholder involvement
IMPROVED NUTRITION
Customers (Retailers)
Suppliers
Consumers
NGOs/ConsumerOrganisations
Communities
Governments /Regulators
Media
International Agencies
Employees/unions
Scientific Community
Food Industry
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Companies are now investing in Nutrition..
• Danone – Grameen Bank
• Tetra Pak / Food for Development
• Unilever
• Procter and Gamble
• The Solae Company – Nutrition for Sustainable
Development
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Industry Associations are also investing …
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GAIN’s Global Food Fortification Programs
Bolivia: milk, vegetable oil and
wheat flour
Dominica republic: sugar and wheat flour
China: Soya sauce and wheat
flour
Vietnam: Fish sauce
Bangladesh : vegetable oil
Uganda : Maize meal, vegetable oil and wheat
flourSouth Africa:
wheat flour, and maize meal
Zambia: Maize meal
Morocco: wheat flour and vegetable oil
Ivory coast and Ghana: wheat flour
and vegetable oil
Mali: vegetable oil
Nigeria: wheat flour, sugar and
vegetable oil
Egypt : Wheat flour
Pakistan : Wheat flour
Georgia : Wheat flour
Uzbekistan: wheat flour
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Food Fortification
• Alliance model – government, private sector and civil society•19 programs in 17 different countries approved, 14 operational.• Six countries have fortified foods on the market with GAIN technical assistance and funds• Current reach of 129 million individuals; expected to reach an estimated 600 million
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Infant and Young Child Nutrition
Focus on children 6 to 24 monthsDesigned to stimulate innovative market-based sustainable complementary foods and complementary food supplements that are high quality and affordable by poor households in regions where children are most in needAssistance to projects from private sector and public-private partnerships Selection through competitive RFP processes; the most promising to be scaled-up and replicatedSmall assistance could be available immediately for pilots
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Investment & Partnership Programme
Business can play a larger role in addressing malnutrition
Business Alliance: a network of almost 200 committed companies dedicated to finding solutions and to making investments to combat malnutrition globally. Regional chapters in North America, Europe, China, Africa and India
Some examplesNasarawa Pilot School Feeding Program in Nigeria: a GAIN - Tetra Pak partnershipDanone-Grameen partnership led by Nobel Peace Prize winner Mohammad YunusBritannia fortifies biscuits for a school feeding programme in India
PARTNERSHIPS
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Copenhagen Consensus
• May 2004 – Gathering of Eminent Economists
(including Several Nobel laureates)
• ‘’..investments in micronutrients have higher returns
than those from investments in trade liberalization, in
malaria, or in water and sanitation….No other
technology offers an opportunity to improve lives at
such low cost and in such a short time.’’
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Fortified Products
Wheat and Maize flours Vitamin A, iron , folic acid,B vitamins, zinc
Fish sauce Iron EDTA
Soy sauce Iron EDTA
Edible oilsVitamin A
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CADBURY BOURNVITACADBURY BOURNVITA
CONCEPT: MULTIVITAMIN INSTANT CHOCOLATE BEVERAGEMICRONUTRIENT CONTENT:(per 100 g) % RDA*
Vitamin A 6000 IU 34Vitamin B1 2.0 mg 20Vitamin B2 2.0 mg 20Niacin 25 mgVitamin B6 2.5 mg 20Vitamin D 500 IU 20Pantothenate 12.0 mg 20Iron 15 mg 25Calcium 300 mgMagnesium 190 mgPhosphorus 250 mg
* US RDA HEALTH CLAIMS: Total Vitality, full of multivitamin goodness.
Vitamin A - For good vision.Vitamin B1 , B2 , Niacin & B6 - Helps release energy from food and promote proper circulation of blood for healthy heart and nervous system. Important for good appetite.Vitamin D - Necessary for strong teeth and bones.Pantothenate - Helps in producing energy from both fat and carbohydrate.
MANUFACTURER: Cadbury Nigeria PLCLagos, Nigeria
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NESTLE CEREVITA NESTLE CEREVITA CONCEPT: VITAMIN/MINERAL ENRICHED INSTANT MAIZE
PORRIDGE
MICRONUTRIENT CONTENT(per serving 50 g) Vitamin A 1500 IU powder + 250 ml Vitamin D 120 IUwater) Vitamin C 18 mg
Vitamin B1 0.45 mgVitamin B2 0.51 mgNiacin 6.0 mgVitamin B6 0.6 mgIron 5.5 mgIodine 45 mcg
HEALTH CLAIMS: Enriched with vitamins
MANUFACTURER: Nestle Ghana LtdAccra, Ghana
2001
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AND MORE…
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Opportunities..
• Stability in Africa (democracy, corporate governance)
• Success stories:– Salt iodization, Oil and Wheat Flour Fortification
• Growing support for capacity building in area of food and nutrition security in Africa
• Increasing aspiration of consumers• Partnership with Non-Food companies
– Sustainability vs Handouts
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Opportunities..
• Renewed global commitment to address problem
• Growing partnership-building for support– NEPAD/African Union/ WAHO/ECSA– 10-Year Strategy – Business Alliances / NFAs
• School Feeding• More Votes during elections (for
Government)
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Shifts in demographic & economic growth
• Stagnant and falling populations in key markets (EU, US, Japan) versus
• New population growth in low income groups in developing countries
• Low economic growth in US, EU, Japan versus• High expected growth in future in emerging economies
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Challenges
• Nutrition: the forgotten child of Development!
• Poverty
• Lack of appreciation of the importance of investing in
maternal nutrition
• Inadequate knowledge about the benefits of nutrition
• Poor understanding of the human and economic costs
of malnutrition
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Challenges
• Linkage between Nutrition and Agriculture
• Food industry reluctant to be innovative due to fear of
failure
• Lack of effective, well developed and sustainable
policies
• Poor Monitoring and enforcement regulations
• Uncoordinated activities of Development partners
• Scale up of nutrition programs
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Recommendations
• Make Nutrition central to development (allocation of resources,
etc)
• The entire value chain (from farm to fork) should be considered in
the development of nutrition programs
• Reward for innovative companies that are able to develop
affordable, nutritious products
• Demonstrate the impact of investing in nutrition
• New Product development should take into consideration the food
consumption patterns and nutritional status of the country
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Conclusion
• Investing in Nutrition can increase national economic
productivity
• The Returns from investing far outweigh the costs
• Government, Development Partners, Industry, etc all
have a responsibility to invest in nutrition
• Investing in Nutrition can result in creation of new
markets for private sector
• It is the right to thing to do!!
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Return on investment
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THANK YOU
AMESEGINALEHU
