FIGHTING MALNUTRITION TO THE GRASS-ROOT

LEVEL BY ADIMA O. CHIKA

FCT/09B/1762

NAFDAC EID H/Q (GAIN OFFICE) 16TH JUNE 2009

Definitions of key words:

Fight Malnutrition Grass-Root Level

INTRODUCTION Malnutrition is a global issue that affects billions. According to Wikipedia; “Malnutrition is the insufficient, excessive or imbalance consumption of Nutrients. A number of nutrition disorders may arise, depending on which nutrients are under or overabundant in the diet”.

The World Health Organization (WHO) cites malnutrition as the gravest threat to the world’s public health. Improving nutrition is widely regarded as the most effective form of aid.

According to Global Alliance for Improved Nutrition (GAIN), in her report; “Malnutrition kills 3.5 million children every year and is directly or indirectly associated with nearly 60% of all child mortality. More than two (2) billion people across the world suffer from malnutrition including vitamins and mineral deficiencies. It seriously limits the growth of 178 million children per year”.

According to Jean Ziegler (the United Nations Special Rapporteur on the Right to Food for 2000 to March 2008), mortality due to malnutrition accounted for 58% of the total mortality in 2006: "In the world, approximately 62 million people, all causes of death combined, die each year. One in twelve people worldwide is malnourished. In 2006, more than 36 millions died of hunger or diseases due to deficiencies in micronutrients.

SOME DISEASES ASSOCIATED

WITH MALNUTRITION:

Kwashiorkor Rabbit starvation

Sodium Hyponatremia Hypernatremia, Hypertension

Iron Anemia Cirrhosis, heart disease

Iodine Goiter, hypothyroidism Iodine toxicity

Vitamin A Xerophthalmia, Night Blindness

Hypervitaminosis A (Cirrhosis, hair loss)

Vitamin B1 Beri-Beri

Vitamin B2 Cracking of skin and Corneal Ulceration

Vitamin B3 Pellagra Dyspepsia, birth defects

Vitamin B12 Pernicious anemia

Vitamin C Scurvy Diarrhea

Vitamin D Rickets Hypervitaminosis D

Vitamin E Nervous disorders Hypervitaminosis E

Vitamin K Hemorrhage

Source: WHO

List of countries by percentage of population suffering from

undernourishment as defined by UN world food Programme & UN

FAO in its “The State of Food Insecurity in the World “ 2009

report

Ranking Country % in 1990-92 % in 2004-2006

1 DRC 29% 75%

2 Eritrea 67% 66%

3 Burundi 44% 63%

4 Haiti 63% 58%

5 Sierra Leone 45% 46%

30 Cameroon 34% 23%

30 Pakistan 22% 23%

57 Paraguay 16% 12%

62 China 15% 10%

69 Ghana 34% 8%

69 NIGERIA 15% 8% 72 Brazil 10% 6%

76 Tunisia <5% <5%

76 Ukraine <5% <5%

EEFORTS AND PROGRESS TOWARDS

COMBATING THE MENACE IN NIGERIA By Gov. Agencies

By NGOs (Dev. Agencies)

By Industries

Gov. Agencies/Min

NAFDAC

SON

FMOH

NPC

FMOA

NSDC

NAFDAC/SON According to Mrs. P. C. Monwuba (DD EID/Programme Manager Nig.-GAIN Project in her report on monitoring and enforcement of food fortification programme in Nigeria; “efforts to curb or eliminate micronutrients deficiency disorders in Nig. Started as a result of recommendation made during the World Summit for children of 1990 in N/Y, USA. In 1992 at the International conference on Nutrition (ICN), and the World Nutrition declaration in Rome, participants called for the virtual elimination of micronutrient deficiencies by the year 2000 A.D. These resolutions were further adopted by the OAU at Dakar meeting later in the year 1992. Available evidence also showed that Nig had (and still has) one of the highest rates of child maternal mortality in the world and Vit. A deficiency (VAD) has been a major contributing factor. Micronutrient malnutrition (a.k.a. Hidden Hunger) has become a major devastating problem affecting health, especially that of children, pregnant women and lactating mothers.. These are majorly IDD, VAD and IDA.

The fortification standards were launched by SON in 2000 and mandatory fortification took off officially in Sept. 2002. the National formal Launch organized by NAFDAC took place on 28th Oct., 2004

It was also later found necessary for SON to set standards for Vitamin-Mineral Premixes (Fortificants) as well defined code of practice.

Furthermore, NAFDAC put in place regulations to give full effect to the SON legislation. The NAFDAC food fortification with Vit. A regulations, 2004 addresses the following areas:

Prohibition of sales of the specified food vehicles without adequate fortification with Vit. A.

Labeling of Vit. A fortified foods, which include an Eye Logo for its identification- an eye with capital letter “A” inside it.

Proper packaging.

Advert materials to be censored and granted permit by NAFDAC before airing.

Penalty for non-compliance.

CHOICE OF FOOD VEHICLE

Flour (wheat and maize ad their meals e.g. Semolina)

Sugar

Edible vegetable oil

Margarine/Butter

Salt

DEVELOPMENT PARTNERS

UNICEF

GAIN

MI

USAID

HKI

WHO

GAIN GAIN - The Global Alliance for Improved Nutrition is an alliance driven by the vision of a world without malnutrition. GAIN's mission is to reduce malnutrition through food fortification and other sustainable strategies aimed at improving the health and nutrition of populations at risk.

GAIN was created in 2002 at a Special Session of the UN General Assembly on Children and became a Swiss foundation in 2003.

INDUSTRY PARTNERS

AFBTE

DANGOTE

FLOUR MILLS NIG. PLC

NESTLE

BIO-ORGANICS

HONEYWELL FLOURS

NATIONAL FORTIFICATION ALLIANCE (NFA)

NFA was inaugurated in 2003 by the Hon. Minister of health.

According to Dr Paul Orhii (DG NAFDAC) in his address on the occasion of the second NFA meeting in Lagos, he said “The NFA whose responsibility it is to mid-wife the mandatory food fortification policy of the Fed. Gov., is a true Public-private partnership with members cutting across Gov. Ministries, Agencies, Civil Society Organizations, Universities, Research institutions, Industry partners, professional Associations and Development partners. It is also a veritable platform for sharing experiences and expertise that is available locally for the reduction of the prevalence of micronutrient deficiencies disorders and its effects on vulnerable and risk group in the population.

NFA MANDATE NFA sets for itself the following targets by end of 2012: The reduction of the prevalence of anemia among children under 5, from the then current 27.5% to 17% and that of women of reproductive age from 59.6% to 24%. The reduction of the prevalence of VAD among children under 5 from 29.% to 15% and that of women of reproductive age from 32.5% to 15% To assess the level or prevalence and severity of Folic acid, Zinc and Selenium deficiency disorders among women of reproductive age. To review the National standards and regulations on wheat/maize flours and semolina to include requirements for Folic acid, Zinc and Selenium as well as review the existing mandatory levels of Vit. A and Iron in these products. To increase consumer awareness on the benefits of fortified wheat/maize flours, sugar and vegetable oil from current levels to 80% To ensure the compliance of small-scale and cottage producers of maize flour and vegetable oil comply with the requirements of the mandatory food fortification policy and thereby ensuring that the rural and urban-poor households have greater access to and consume fortified products on regular basis.

The NFA through its partnership and support from GAIN (The Nigeria-GAIN Project) which started in March 2007 in its first phase with NPC as their EA. The project is currently in its second phase now with NAFDAC as their EA and it is to run till Dec. 2011 has really done so much towards combating this menace which has helped immensely in strengthening the country’s efforts to monitor and enforce the food fortification programme, and as such should be commended.

POSSIBLE WAY FORWARD There is a need for intensified effort by all stake holders.

Enabling environment especially for industry partners, mostly with premix procurement.

Need for house-hold/market survey on the awareness and utilization of fortified food products.

More media publicity.

Strict enforcement of laws and penalties to defaulters on production and sales of fortified food products.

CONCLUSION Malnutrition by no doubt is a severe Global issue and a concern for every Nigerian as it affects us all directly or indirectly.

We must applaud the Gov. of Nigeria through her Ministries and agencies that are responsible for this fight.

Also, we have to acknowledge the massive impact being made by development partners and most especially the NFA for their immense efforts so far.

Finally, there is still a lot left to be done and all hands must be on desk to fight and eradicate the menace by leaving no stone on turn.

THANK YOU!