Despite the potential benefits of food fortification, the practice is not yet widespread in Nigeria.
Malnutrition affects millions of people in the country, with vitamin and mineral deficiencies being particularly prevalent.
Food fortification involves adding essential nutrients to staple foods such as flour, salt, and oil, and it has the potential to improve the health and well-being of Nigerians.
According to the Global Fortification Data Exchange, only 28 per cent of wheat flour and 17 per cent of edible oil are fortified in the country. Salt fortification is more widespread, with 96 per cent of salt being iodized. However, there is still room for improvement, as the recommended level of iodine in salt is 30-40 parts per million (ppm), while the average level in Nigeria is 20 ppm.
To boost the adoption of food fortification in the country, the Nigerian Economic Summit Group (NESG), in collaboration with Civil Society Legislative Advocacy Centre (CISLAC), and eHealth Africa, in furtherance of the campaign to promote food fortification at an industrial scale, held an Interface Session on Promoting Food Fortification Compliance and Workforce Nutrition on with stakeholders in Lagos.
The stakeholders who spoke in unison said they believe that when there is strong nutrition the disease burden in the society will go down. Also, awareness is needed on importance of food fortification, generating demand for fortified food products. It is also their believe that some industries are cutting corners against monitoring and enforcement of compliance.
The meeting which was a follow up to an earlier one, was attended by over 50 participants including representatives of regulatory agencies, legislators, nutritionists, large-scale food producers, civil society groups and journalists from various media outfits and involved an assessment of the progress so far, the challenges and came up with a communiqué detailing their observations and recommendations.
The programme, was aimed at stimulating advocacy around food fortification compliance, identifying efforts and draw up actionable recommendations that will encourage industrial fortification.
In his remarks, NESG CEO, Mr. Laoye Jaiyeola, called for the underlying determinants including poverty, food insecurity addressed.
At the interface session, on Wednesday, Jaiyeola who was represented by NESG director of Strategic Communication, Mr Olayinka Iyinokakan, said, “One important step required to reduce malnutrition sustainably is the upscaling of nutrition-sensitive policies and programs that address the underlying determinants of malnutrition, including poverty, food insecurity, and lack of access to the components of healthy diets.
“Ultimately, these interventions should focus on Improving household access to and the intake of high-quality diets such as fortified food products, which can help improve their immune functions and cognitive skills,” he said
Health system development expert, Ibrahim Yahaya Oloriegbe remarked that malnutrition is a persistent barrier to the country‘s growth, noting that people at the household level may recognise malnutrition but usually have difficulty associating it with food with spiritual problems.
He reiterated that culture, food habits of people, power dynamics in a family and socio-economic issues such as the purchasing power of individuals and the environment may significantly affect or encourage malnutrition.
„To solve this, educating traditional institutions and religious leaders on the importance of consuming fortified foods will go a long way in reducing micronutrient deficiencies. It is also important to engage with governments at all levels, especially the local governments, as they have market access and provide food palliatives to a lot of communities,“ he stated.
In his opening remarks, the country director of Global Alliance for Improved Nutrition (GAIN), Dr. Michael Ojo, said that the third-party advocacy is a partnership between the NESG, eHealth Africa and CISLAC with technical support from GAIN,
Dr Ojo said despite Nigeria‘s rich agricultural resources, it finds itself with the challenge of micronutrient deficiency, which has profound socio-economic implications.
Dr Ojo said the government has taken action in terms of policy which encourages the fortification of staple foods and agencies such as the National Food Drug Administration and Control (NAFDAC), the Standards Organisation of Nigeria (SON) and the Federal Competition & Consumer Protection Council (FCCPC) have been entrusted with ensuring adherence and monitoring of producers to ensuring fortification compliance.
He commended the private sector, a pioneer in enforcing fortification at the industrial level, but noted that many producers need to catch up, underscoring the need for collaboration between all sectors. He reiterated that the Micronutrient Fortification Index (MFI) championed by TechnoServe is producing advances in fortification processes and that Food fortification is a cost-effective strategy, which is pivotal in reducing Micronutrient deficiency.
The global programme lead for food fortification at GAIN, Mr Penjani Mkambula, stated that over the years, fortification has been helpful not only in reducing micronutrient deficiencies but also in reducing certain disease burdens and medical conditions such as Goitre, which was reduced through the introduction of iodised salt.
He noted that food fortification goes back as far as 1925 in countries such as Denmark and over the years with the Fortification of Milk with vitamins A and C.
Head Food Group, Standards Organisation of Nigeria (SON), Mr YB Mohammed, who was represented by the Chief Technical Officer and acting state coordinator, Lagos State Office, Mrs Aderonke Apim, said that food fortification compliance can have a severe impact on the health of the public by helping to reduce cognitive and physical development in some children.
She revealed that compliance can be achieved through a robust regulatory framework that includes audit, training and education on standards while noting that some of the challenges of food fortification compliance include a lack of awareness about standards, limited capacity to enforce standards, lack of resource to ensure compliance and cultural and political bias.
The head of research and quality assurance, Honeywell Flour, Mr Dapo Arowona, said when fortification kicked off in 2002, there were initial challenges as the mills were not designed to accept external ingredients or premixes that contain micronutrients which resulted in modifications that came at a considerable cost to food producers.
He noted that a lot of producers are willing to comply with fortification standards, but a significant constraint impeding fortification compliance is customs duty on certain micronutrient premixes, such as Vitamin A, which is classified as a finished product with a 20% duty rate.
Mr Arowona reiterated that the ease of doing business is a bigger reality, and if duty rates are reviewed downwards, fortification compliance will increase as food producers will be encouraged to comply better.
In his goodwill remarks, Hon Amos Magaji (Kaduna State), Chairman House Committee on Health Institutions, spoke to the issue of political will on food fortification and workforce nutrition policy enforcement and, to the extent, advocated for a legislation and tasked the authorities of the country on ensuring political will in all aspects of enforcement to make food fortification possible for the good health of the masses of the Nigerian people and development of national economy.
Talking about the issue of health, Magaji said, “When there is strong nutrition the disease burden in the society will go down. Issues of storage is another problem,” he said, citing storage by chemical based preservatives as one of the reasons for poisoned food that kill people en-masse.
He posited that what needs to be done is not just about fortifying the food but ensuring that the food items are safe for human consumption from the stage of storage.
Hon Dennis Idahosa (Edo State), Chairman House Committee on Healthcare Services, In his own remarks, simply said that awareness needed to be raised on the importance of food fortification as a way to generating demand for fortified food products.
Idaosa said this while also explaining that the problem with achieving effective food fortification was not because the nation lacks a work-plan or law but that the country needed to strengthen the regulations for its enforcement.
Also speaking, Mr. John Uruakpa, Director, Micro-nutrient Deficiency Control, Federal Ministry of Health, who gave the well wishes from the Minister of Health and Permanent Secretary of the Ministry, said food fortification is one of the most cost effective ways in ensuring good health but said Nigeria, having been involved in the programme for over 20 years, “shouldn’t be talking about compliance but about improvement on achievements on ground. He said “some of the industries are cutting corners” against monitoring and enforcement of compliance, adding that “At the level of regulation, what the Federal Ministry of Health has found out is that there is compliance but when it gets to the market, there is problem.
Earlier in his welcome address, the Executive Director of Civil Society Legislative and Advocacy Centre (CISLAC), Mallam Auwal Ibrahim Musa (Rafsanjani), like he said in May this year, started by calling attention of participants to the fact that Nigeria, as a nation, continues to face a serious nutrition crisis, which underscores the organisers’ intervention positing food fortification as a proven way to go in improving nutrition and health as well as the wealth of the nation.
According to the National Demographic and Health Survey (NDHS) 2022, 44.1% of children under the age of 5 in Nigeria are stunted, meaning they are too short for their age. This is a decrease from 46.0% in 2018, but it is still a high number. Stunting is a sign of chronic malnutrition and can have long-term consequences for health and development.
“The NDHS also found that 20.3% of children under the age of 5 in Nigeria are wasted, meaning they are too thin for their height. This is an increase from 19.9% in 2018. Wasting is a sign of acute malnutrition and can be a life-threatening condition.
“The NDHS also found that 18.7% of adults in Nigeria are overweight and 4.4% are obese. This is an increase from 17.4% and 3.4%, respectively, in 2018. Overweight and obesity are major risk factors for chronic diseases such as heart disease, stroke, type 2 diabetes, and some types of cancer” but which can only be controlled with effective and sustainable food fortification compliance and workforce nutrition in Nigeria, Rafsanjaji said.
He made this position with a task challenging organisations concerned to take the issues of workforce nutrition more seriously to improve the productivity level of their employees by implementing relevant measures.
He then made a case for food fortification as the proven way forward because, according to him, “It is a simple, cost-effective intervention that can be used to add essential nutrients to foods that are commonly consumed by large populations.”.
“The government of Nigeria developed regulations and mandatory food fortification policies in 2009 and 2019 respectively to promote food fortification which is being implemented by three (3) key agencies present here today (NAFDAC, FCCPC and SON).
“It is worthy to note that since the existence of the policy document, these agencies have been working within their mandates to implement the policy, and monitor compliance, with measure of progresses recorded as would be presented today.”
The fact that problem of malnutrition is still high made the interface session that happened at Ikeja on Wednesday imperative for the organisers and other participants to brainstorm on what next was needed to be done, despite the effort of government at achieving a well nourished population with its regulations and mandatory food fortification policies.
The CISLAC ED, Auwal Ibrahim Musa a.k.a. Rafsanjani, charged that, “We need to work together to ensure that all mandatory food vehicles (local and imported) sold in Nigeria are fortified with essential vitamins and minerals. We have a number of challenges to overcome, but I am confident that we can achieve this goal if we work together.”