25 September 2013

Africa: Can the B-Word Beat Malnutrition?

Dakar — While fortifying staple foods, such as wheat flour and salt, has become routine in urban parts of malnutrition-prone West Africa, bio-fortification - the breeding of more nutritious vegetables, grains and pulses - is still a relatively new phenomenon for the region, but it is set to explode over the next decade, say food security experts.

The International Food Policy Research Institute (IFPRI) houses HarvestPlus, a programme that breeds varieties of sweet potato, cassava, plantain, corn, rice and other staples enriched with vitamin A, zinc and iron - the nutrients that the World Health Organization says people in developing countries are most deficient in.

Projects using these plants to tackle malnutrition are taking place across Asia and in Africa, including Mozambique and Uganda.

In Senegal, food security NGO Yaajeende, supported by USAID, has teamed up with HarvestPlus to re-introduce the vitamin A-rich orange-flesh sweet potato to the country (it died out for reasons that remain unclear) and to replace the currently used millet seed with iron-enriched pearl millet. Eventually, they hope to introduce zinc-enriched rice and vitamin A-enriched orange corn.

"We want to reach a point where you see more orange sweet potato than any other kind in Senegal," Todd Crosby, head of Yaajeende, told IRIN.

He added, "We hope to have replaced existing millet seed with bio-fortified millet by our project's end," in five to 10 years' time.

Bio-fortification technology was introduced to Africa several years ago, but take-up is expected to accelerate, with the involvement of not just governments, research institutes and nonprofits, but huge multinational corporations as well. Nestlé, for example, has long worked in micro-nutrient fortification and is now embracing bio-fortification, with plans to integrate vitamin A-enriched cassava and iron- and zinc-enriched rice varieties from Nigeria and Madagascar, respectively, into its future product lines.

In 2008, the Copenhagen Consensus identified bio-fortification as one of its top five solutions to global development challenges.

Nutrient deficiencies

According to IFRPRI's Global Hidden Hunger index, released in June 2013, 18 of the 20 countries with the highest micronutrient deficiency rates are in sub-Saharan Africa.

Micronutrient deficiency is often called a "hidden hunger" because it goes unnoticed. "Stunting consequences are much more in-our-face. But problems appear with severe anaemia, or with vitamin A deficiency, that may cause children to become blind. Before that, you don't know how serious it can be," said Kinday Samba, the World Food Programme's (WFP) West Africa nutrition advisor.

High malnutrition and stunting rates "are normally accompanied by high deficiency in vitamins and anaemia," she added.

Three-quarters of children under age five and 56 percent of women aged 15 to 49 are iron-deficient in Senegal, in line with startlingly high iron deficiency rates across West Africa. In its more moderate forms, anaemia can causes lethargy, impairs development and can cause irreversible brain damage; in its most severe form, it can kill.

Each year, 1.1 million children under age five die from lack of vitamin A or zinc. Extreme zinc deficiency causes abrasions on the skin and other types of ill health, and vitamin A deficiency results in visible eye damage in approximately three million pre-school age children globally.

From white to orange

Substituting white sweet potato seedlings for the orange variety took two years to scale up.

HarvestPlus gave the Senegalese Agricultural Research Institute (ISRA) 150 seedlings of 25 varieties, which ISRA turned into 8,800 plants. Yaajeende distributed these to women farmers through a network of some 5,000 mother-to-mother clubs and also to commercial farmers and traders, targeting the country's two largest production zones: Sadel in Matam Region in the northeast and Aroundou in Bakel Region in the east.

By targeting these zones, which produce and market 80 percent of the country's sweet potatoes, they hope to eventually supplant white sweet potatoes altogether. "You need to understand the market before you can make the change," said Pape Sene, senior technical adviser and former head of Yaajeende. This involves figuring out where the bulk of a crop is grown and traded, who is growing it, and how it reaches local, national and regional markets.

HarvestPlus also supplied a few bags of pearl millet to ISRA a couple of years ago, which ISRA turned into 2,400kg of seed, or enough to supply 600 hectares, each of which can produce 1-1.5 tons. By the project's end, they will have replaced a less nutritious form of millet with the iron-enriched variety, estimates Crosby.

Supplements, fortification and bio-fortification

Fifteen years ago, international agencies started giving doses of vitamin A as part of their health efforts, and watched children's mortality significantly drop. Now, most African countries engage in some sort of vitamin A supplementation for children aged six to 59 months.

Another approach to filling nutrition gaps in Senegal is fortification. The National Alliance for Food Fortification (COSFAM) has been working with NGOs Helen Keller International, Micronutrient Initiative and the Global Alliance for Improved Nutrition, to fortify cooking oil with Vitamin A and flour with folic acid, for several years.

Those involved in bio-fortification do not knock these approaches but say people also need to learn how to take charge of their own nutrition needs to steer themselves to better health.

Bio-fortification is sustainable and relatively cheap, as only an initial seed injection is needed, Crosby stressed, and it is not vulnerable to the kinds of supply-chain challenges that can complicate mass supplement campaigns. "It's a way of people taking control of their nutritional destiny through agriculture," said Crosby. "It's affordable nutrition."

Fortified foods are accessible in cities but are often less so in rural areas, say market analysts.

However, encouraging farmers to grow more nutritious crops does not mean that people - particularly women and children - will eat them. Education, behaviour-change initiatives and public health awareness-raising are all needed.

To reduce nutrient deficiencies in Senegal, "we need a comprehensive approach that deals with its multiple causes," said WFP's Samba. "These include poor diet diversification, lack of consumption of animal products, malaria, parasites, feeding in the first months of life - all of which might result in anaemia."

People must also be encouraged to change how they cook vegetables - to avoid over-cooking them, which depletes their nutrients, said UNICEF nutritionist Helene Schwartz.

Receptivity to change

Unless people manage their own change, nothing will work, said Sene. Yaajeende targets mothers' clubs with education about better nutrition and healthcare as well as gardening and farming techniques and business opportunities, he said.

Thus far, Senegalese in both rural and urban areas have been receptive to using fortified foods where they are available, said UNICEF regional nutrition specialist Roland Kupka, citing uptake of iron- and folic acid-enriched flour and vitamin A-enriched cooking oil.

Yaajeende hopes that Senegalese consumers will embrace orange sweet potatoes as well, given that they are softer and sweeter than the white. But to boost acceptance, they plan to launch a "Mangez Orange" - "Eat Orange" - campaign later this year, pushing all orange fruit and vegetables from papayas to carrots to orange corn.

Farmers are also expected to welcome the enriched millet seed, which matures in 60 rather than 90 days.

To have long-term traction, fortification and bio-fortification must be proactively led by governments, and clear policies be outlined to guide its development, said Banda Ndiaye, director of the Micronutrient Initiative in Senegal.

This requires a shift in mind set, from thinking of agriculture as a means to end food insecurity to seeing it also as a means to combat poor nutrition. "Nutrition-led agriculture - taking an epidemiological approach to it - is still a very new concept," said Crosby.

And to ensure bio-fortification remains locally owned, national or regional research institutes must be empowered to bring it to scale before multinationals step in and take over, he warned.

[This report does not necessarily reflect the views of the United Nations.]

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