When in 2007 a team of health specialists conducted a developmental assessment of the pupils at Dandelion Middle School near Beijing – an institution for children of migrant workers – it found that one of the factors hampering their ability to learn was not mental but physical. Many of the children had iron-related anaemia and were deficient in vitamins A and B.
During the course of 10 months, the children were fed a diet that included rice fortified with micronutrients. The impact was dramatic. There was a fall in the anaemia rate from 13.7 per cent to 2.5 per cent, and vitamin B1 deficiency dropped from 24.8 to 4.5 per cent, while vitamin B2 deficiency fell from 17.7 to 7.9 per cent. As a result, the children’s attention rates increased considerably and their performance improved markedly.
While the Dandelion school project demonstrates the impact of vitamins and minerals on health and development – and at a relatively low cost – many of the world’s poorest communities still lack access to sufficient levels of these micronutrients. Individuals who are deficient in these vitamins and minerals may experience stunted growth, slower mental development and an increased risk of infections from diseases.
Almost one-third of the world’s population, for example, lacks sufficient iodine, according to the United Nations World Food Programme (WFP), a deficiency that in infants has far-reaching implications, since iodine is a critical micronutrient in the early stages of brain development.
Other issues arise from micronutrient deficiency. “If a child is vitamin deficient, they have a 30 per cent increase in the risk of dying from simple conditions such as diarrhoea,” says Martin Bloem, head of the nutrition unit at the WFP.
Even in countries with low levels of malnutrition, the prevalence of micronutrient deficiency may still be high. It is estimated that 2bn people worldwide eat enough calories to live, but have a diet deficient in the vitamins and minerals necessary for their physical health.
Moreover, the economics of addressing the issue look compelling. In 2008, the Copenhagen Consensus, a meeting of leading international economists, deemed the provision among children of micronutrients (particularly vitamin A and zinc) to be one of best investments for global problems. “Nutrition is a relatively low-cost intervention for a very high output,” says Bloem.
In spite of this, so-called “hidden hunger” often attracts less attention than infectious diseases or famine, partly because the condition is not easy to detect. “A person might look normal but they could be anaemic,” says Bloem.
The business community – particularly the food sector – has joined forces to address hidden hunger. In Bangladesh, Groupe Danone, the French food company, has launched a pilot factory producing nutrient-rich yoghurt for poor consumers, while in Poland it has developed affordable milk porridge for low-income families. In India and Ghana, Unilever, the Anglo-Dutch consumer products group, has developed Annapurna, an iodised salt.
Tetra Pak, the carton manufacturer, has been involved in school milk programmes since the 1960s. Through its Food for Development Office (FfDO), it is developing other nutritious drinks in partnership with governments and nongovernmental organisations.
And Tetra Pak’s initiative is not only focused on health, since government milk programmes have also been catalysts for increasing demand of locally produced milk, boosting the incomes of nearby dairy farmers.
“So it helps develop the private sector,” says Ulla Holm, head of Tetra Pak’s FfDO. “And that’s where Tetra Pak comes in with our core experience to help local entrepreneurs with distribution and packaging, and helping farmers increase milk production per cow.”
Supporting these kinds of initiatives are the International Business Leaders Forum (IBLF), a non-profit-making corporate responsibility body and the Global Alliance for Improved Nutrition (Gain), another non-profit group that promotes public-private partnerships to fight malnutrition. In 2008, Gain and the IBLF launched the Award for Innovation in Nutrition to encourage more companies to turn their energies and expertise to devising solutions to hidden hunger.
The first winner of the award was DSM, the Dutch life and material sciences group, which, in partnership with Bühler, the Swiss food technology firm, developed NutriRice, the fortified rice used in the Dandelion school project.
The technology DSM and Bühler devised allows micronutrients inside the rice kernel – elements that are lost in the whitening, polishing and washing process – to be restored. The NutriRice process uses extrusion (combining high temperature with pressure) to turn broken rice kernels back into rice-shaped grains to which vitamins and minerals can be added.
The process allows the reconstituted rice to be produced in different shapes and lengths, mimicking the rice varieties that will appeal to each group of consumers. Moreover, only a proportion of the fortified rice needs to be eaten to gain the nutritional benefits of the product, so it can be added to whatever natural rice is most popular in a particular region.
“The idea is to take the normal food consumed by target populations and add to it the needed micronutrients,” explains Mauricio Adade, president of human nutrition and health at DSM. “So it’s not making the target population change their habits – because if you do, then it becomes more difficult.”
DSM’s activities, while rooted in corporate responsibility, are based on market principles rather than charity to increase the availability and take up of fortified foods. “There’s an increasing recognition that the bottom billion [of the world’s poorest people] hold potentially profitable opportunities for the right product,” says Olive Boles, director of global health partnerships at IBLF.
However, to reach those markets, partnerships with government and development organisations are also critical, particularly on the demand side. “When it comes to generating demand in the communities, people need to be educated as to why these products might be the best ones for them and their families,” says Boles.
For example, in Ghana where Unilever developed a low-cost iodised salt, the role of Unicef, the UN’s child development agency, was critical to the success of the product.
“The success we had in Ghana with iodised salt was because of Unicef ’s realisation of the need to create market demand for the product by building awareness and then allowing private sector companies, such as ourselves, to follow in afterwards with the products that addressed that need,” says Gavin Neath, head of communications and sustainability at Unilever.
Neath says the biggest obstacle, particularly in the food sector, is developing food products that can be manufactured and distributed at a price that is affordable to poor target populations.
“We get quite a far way down and have distribution systems that allow us to get to some of the poorest people on the planet, but getting to them with prices that are affordable on a regular basis is more of a challenge,” he says.
But even if food fortification projects remain, in the short term, unprofitable and dependent on corporate altruism, companies find there are other benefits to being involved in this area.
For a start, it helps them enter new markets. “Most of the growth in dairy in the past four years has come from emerging markets like China and the Middle East,” says Tetra Pak’s Holm.
And research and development investments can pay off elsewhere. Adade cites the example of vitamin A, which is sensitive to heat and requires a specific formulation to be added to foods. Because the extrusion process applied to NutriRice can also be used to produce cereals, the R&D behind it can be employed in the fortification of mature-market products.
“What we invest in developing the technology helps us better understand what’s important for our main business,” he says.
Sarah Murray is an FT contributor
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