Larry Umunna, the regional director, West Africa for TechnoServe an organisation promoting food fortification in Nigerian, in this interview with SUNDAY ISUWA, explained how they will tackle the scourge of malnutrition in the country among other issues.
On the issue of malnutrition, how is Nigeria fairing compared to other countries?
According to the 2018 National Health Demographic Survey, the national prevalence of under-five stunting is 37 percent, significantly greater in Nigeria than the developing country average of 29 per cent. The under-five wasting prevalence is 10.8 per cent, also greater than the developing country average of 8.9 per cent. For further insight, UNICEF estimates that over two million Nigerian children under five years of age suffer from severe acute malnutrition. This places Nigeria as the country with the second highest number of stunted children in the world after India.
How has malnutrition evolved over the years in Nigeria? Is the country better or worse off? What are the factors that affect malnutrition indicators?
There have been varying levels of progress over the years but the prevalence of various forms of malnutrition in Nigeria is still quite high. We’re still at a point where an estimated 361,000 Nigerian children die annually from malnutrition and other related diseases, and a key factor contributing to this crisis is poverty. Approximately half of the population live below the poverty line (i.e. earning less than $2 a day), so many households do not have access to a varied selection of nutritious foods. Essentially, they cannot afford a balanced diet; they consume mostly grain and tuber products that lack essential nutrients. When you consider this in today’s context of the times – COVID-19 has triggered an economic recession, food inflation is at its highest levels in five years – this means that Nigerians are not only spending more on food than they did in 2016, but the Naira is able to buy much less in volume and nutritional value. A major cause of concern is that many families will potentially witness a reduction in the quantity and quality of food consumed, leading to fatalities, a higher prevalence of malnutrition across the country and an inevitable decline in progress made against malnutrition thus far.
In the modern world, who are the actors responsible for providing solutions to malnutrition?
In the modern world, there are a wide range of stakeholders that have a part to play in every developmental issue. It’s important to note that these issues are often cross-sectoral, we cannot end all forms of hunger and malnutrition in the world without cooperation from health and agriculture stakeholders, across International Organisations, Non-Governmental Organisations, governments, civil society organisations and private businesses also. In Nigeria, as it pertains to malnutrition, the federal and state governments implement several nutrition supplementation programmes nationwide. They often partner with various non-governmental organisations to deliver the necessary services effectively. However, many direct intervention programmes are targeted at providing emergency care in crisis situations, like in the North-East.
How can the public-private partnership model be applied to the fight against malnutrition in Nigeria?
As with most things, consumers and the wider industry benefit when both private and public sector players come to the table for the advancement of a shared goal- in this case, food fortification as a catalyst for a reduction in malnutrition rates. The nutrition of most Nigerians is directly impacted by the quality of foods they buy and consume. Realising this, and being aware of the importance of developing a healthy population, the Nigerian government introduced mandatory regulations necessitating the fortification of a selection of staple foods – wheat flour, semolina flour, maize flour, sugar, and edible oils, with micronutrients.
The fortification of staple foods is regarded as a proven method for tackling malnutrition at scale because of their high demand, and the wide reach food processors have through their distribution channels. Thus, the law compels Nigerian food processors to supplement their products with extra vitamins and minerals that contribute to overall health and wellbeing of society. Government regulators monitor the processors to ensure that products meet national micronutrient fortification standards. The processors in turn are expected to do their bit to ensure compliance and any additional industry-driven processes that aid and even encourage improved compliance is of benefit.
What do improved public-private solutions look like in practice?
Under our current model, regulatory compliance levels have varied with each staple food carrier, generally tending to be significantly below the legal requirements. In the edible oils sector for example, research has shown that 60-70 per cent of all the vegetable oils consumed in Nigeria are either smuggled or are domestically produced unbranded oils which tend not to meet the quality and fortification measures stipulated by law. This occurs because there are limited market or demand-driven incentives for compliance as well as limited repercussions for non-compliance.
Notable steps have been taken towards making compliance more attractive to processors: the 2018 Nigerian Food Processing and Nutrition Leadership Forum was the first time Nigerian nutrition stakeholders and processors gathered for that purpose. They articulated a strategy which led to the inception of the Micronutrient Fortification Index (MFI), a cost-effective strategy that provides systemic and market-driven incentives for processors to comply with food fortification standards. It supports pre-established government regulatory systems with an industry-driven tool that effectively differentiates companies by the extent to which they meet industry benchmarks, including compliance, against Nigerian standards.
You’ve developed an innovative industry tool designed to track and encourage fortification compliance across the processing industry. Can you provide insight into how this is being implemented?
The MFI was piloted successfully in 2019. Since then, the tool has been adopted by over 70 per cent of the flour market with participation from Honeywell Flour Mills, OLAM, and Flour Mills of Nigeria, as well as PZ Wilmar in the edible oils sector, to mention a few. Recently, the MFI tool has been adapted to encourage the participation of small and medium sized enterprises, especially within the fragmented edible oils sector which is dominated by many smaller ventures across the country.
How will the MFI help to institutionalise practice that will help tackle malnutrition at scale?
The MFI tool is not a replacement for government regulatory mechanisms, it is only meant to support the process by enabling more effective deployment of monitoring, providing a consistent benchmark for testing, supplying the resources required to carry out monitoring, and creating national recognition of compliant brands. The tool also supports food processors’ corporate benchmarks and responsibility to provide high quality and nutrient fortified products, by helping to identify areas of improvement and providing a third-party testing mechanism which validates the initial self-assessment. Adopting the tool should significantly lower the risk of regulatory failure, increase overall efficiency in making quality food products accessible to increasingly knowledgeable consumers, and make a worthy contribution to the elimination of malnutrition in Nigeria. The tool makes realising global best practices accessible to all relevant parties.
How successful has the tool been so far?
Currently, twelve processors including Flour Mills of Nigeria Plc, PZ Wilmar Limited, Olam (DFW) and Honeywell Flour Mills Plc have signed up to the index, others have shown a keenness to participate. TechnoServe has also recently launched a version of the MFI self-assessment component that is better-suited to small and medium sized enterprises to deepen the reach of this initiative. We view this as considerable success and an indication of the appetite from the processing industry for something that aids in the achievement of best practice processes.
What are plans for the MFI in the medium and long term?
It is expected that with wider and consistent MFI participation, food processing companies will aspire to higher index placement, recognizing their key role in the strategic development and growth of their markets, as well as their duty to serve the wellbeing of the community. Furthermore, the COVID-19 crisis has created a new sense of urgency, as nutrient deficiency has been identified as a potential risk factor responsible for severe symptoms from the disease. We hope to leverage this moment of health consciousness to achieve long-lasting change.