Fast Facts About Malnutrition

General information

  • Two billion people in the world suffer from various forms of malnutrition.1
  • Malnutrition is an underlying cause of death of 2.6 million children each year – a third of child deaths globally.2,3
  • 1 in 4 of the world’s children are stunted 4; in developing countries this is as high as one in three.5  This means their bodies fail to develop fully as a result of malnutrition.
  • Undernutrition accounts for 11 per cent of the global burden of disease and is considered the number one risk to health worldwide. 5

Economic impact

  • Adults who were malnourished as children earn at least 20% less on average than those who weren’t. 6
  • Countries may lose two to three percent of their Gross Domestic Product (GDP) as a result of iron, iodine, and zinc deficiencies. 7
  • Estimates show annual investments of US$ 347 million to provide micronutrients to 80 percent of the world’s malnourished would yield US$ 5 billion in improved earnings and healthcare spending.  7
  • It is calculated that each dollar spent on nutrition delivers between US$ 8 and US$138 of benefits. 8

Micronutrient deficiencies

  • It is estimated half of anaemia cases are due to iron deficiency.9  Almost half of children in low- and middle-income countries – 47% of under-fives – are affected by anaemia, impairing cognitive and physical development.10  Iron is a key component of micronutrient blends which are used in large-scale and targeted fortification programs.
  • Iodine deficiency is the greatest single cause of mental retardation and brain damage. It can easily be prevented by adding iodine to salt. 11 Between 1990 and 2009, the number of households consuming iodized salt rose from 20% to 70%. Coincidently, the number of countries in which iodine-deficiency disorders were considered a public health concern reduced by 43% between 1993 and 2007. 12
  • Vitamin A deficiency causes early childhood blindness and increases the severity of infections and anaemia. It affects an estimated 190 million pre-school aged children, and 19 million pregnant and breastfeeding women globally. Vitamin A can be added to cooking oil as well as wheat and maize flour. It is also included in micronutrient powders. 13
  • Zinc deficiency affects children’s health and physical growth; it is also essential for mothers during pregnancy. It is estimated to cause 4% of deaths in pre-school aged children in lower-income countries. 5  Zinc supplementation improves growth in stunted children and can be included in wheat flour, maize flour or rice.

GAIN’s mission

The Global Alliance for Improved Nutrition (GAIN) is an alliance driven by the vision of a world without malnutrition.

Created in 2002 at a Special Session of the UN General Assembly on Children, GAIN supports public-private partnerships to increase access to the missing nutrients in diets necessary for people, communities and economies to be stronger and healthier.

In less than a decade, GAIN has been able to scale its operations  by working in partnership with governments and international agencies, and through projects involving more than 600 companies and civil society organisations in more than 30 countries, reaching an estimated 667 million people with nutritionally enhanced food products. About half of the beneficiaries are women and children. GAIN’s goal is to reach 1 billion people with foods that have sustainable nutritional impact.

GAIN is a Swiss foundation headquartered in Geneva with a special international status granted by the Swiss government.  Its worldwide presence includes country offices in Abuja, Accra, Addis Ababa, Dhaka, Kabul, Jakarta, Nairobi, and New Delhi. It also has representative offices in Amsterdam, London, Singapore and Washington D.C.

The cornerstones of GAIN’s programs

Scalability. GAIN has made nutritious foods available to an estimated 667 million people.
Sustainability. Creating enabling environments for on-going production and availability of nutritious foods.
Innovation. Developing creative concepts that bring nutritious foods into the markets of developing economies.
Partnerships. Providing a multi-stakeholder platform for more than 600 partners, inspiring 50 collaborations in over 30 countries.
Impact. For example, a GAIN-supported partnership measured a 30 percent decrease in neural tube defects in South Africa after folic acid was added to maize meal and wheat flour.

Main Activities

GAIN’s programs primarily target women and children, with a focus on the critical 1,000 Day Window of Opportunity. Good quality nutrition during this timeframe – from pregnancy to a child’s second birthday – makes a lifelong impact in terms of health and development. GAIN achieves this through focusing its activities across four key areas.

Improving nutrition for entire populations with large scale food fortification.
Food fortification – the process of adding vitamins and minerals to staple foods and condiments – was the primary focus of GAIN’s programs during early efforts to fight malnutrition. With GAIN support, more nutritious foods and condiments such as wheat flour, maize meal, salt and vegetable oil are now available in over 28 countries. Through effective advocacy and guidance for the food industry at the country-level, the appropriate quantities of micronutrients are now added to products to improve nutrition for entire nations.

**Fact: GAIN’s large scale food fortification projects currently reach 667 million individuals. These are expected to reach more 1 billion by 2015** **Fact: The GAIN-UNICEF Universal Salt Iodization Partnership aims to reach approximately 500 million beneficiaries not yet covered by worldwide salt iodization programs**

 Improving the availability of nutritious foods for mothers and young children.
GAIN is working to strengthen the availability of affordable foods for infants falling within the 1,000 Day Window of Opportunity. For the first six months of a child’s life, only breast milk is the ideal food source for infants. Afterwards, however, this alone cannot provide the nutrients and calories needed for infants to develop and grow sufficiently.

GAIN catalyzes local production and development of fortified complementary and supplementary foods, which should be included in diets of infants aged between 6 to 24 months. It is also improving the provision of nutritious foods for pregnant and women who are breast feeding.

**Fact: With GAIN support, 321 million women and children globally are now receiving more nutritious foods.**

Scaling up targeted nutrition interventions with multinutrient supplements (MNPs)
Developments in nutrition science means the daily essential vitamins and minerals for a child are now available in small sachets. Easily added to locally prepared dishes, the nutritional quality of foods and diets can be improved at mealtimes.

GAIN helps develop, market and deliver small and affordable packets of multinutrient supplements to families placed in regions of poor nutrition. It encourages the private sector to support the development of these products, specifically targeting vulnerable groups and populations.

 Case Story: In Bangladesh, GAIN has partnered with Renata Ltd, a national pharmaceutical company to develop and deliver micronutrient powders to rural areas. With assistance from BRAC, the world’s largest NGO, monthly sales of Pushtikona-branded sachets are growing. In March 2012, 1.4 million sachets alone were sold through this partnership.

Improving the nutritional quality of food through agricultural practices.
Food can lose its nutritional quality through adverse agricultural practices and processing. GAIN is currently identifying possible market-based interventions which can help retain the nutritional benefits of food through the agricultural supply chain. Supporting these programs at the national and international level can enhance access and consumption of nutritious foods in undernourished populations.

Advocating for policies which increase demand and consumption of nutritious foods.
GAIN is elevating the visibility of nutrition with the aim of shaping policy, creating an environment which enables increased investments in nutrition. Raising awareness of nutrition on the global, regional and national agendas ultimately leads to increased consumption of nutritious foods by vulnerable populations.

Across east Africa, GAIN has offered support at the country level to make food fortification mandatory in Tanzania, Uganda and Kenya. By 2013, an estimated 45.6 million people in Tanzania and Uganda will purchase foods of improved nutritional quality. Meanwhile, Kenya is in the process of finalizing similar legislation.

 Project highlight: The GAIN Premix Facility assists producers of fortified foods access high quality blends of vitamins and minerals for their food products. To date, the GPF has reached an estimated 242 million consumers through premix orders in 34 countries.

Worldwide presence

With our staff of 125, GAIN is delivering sustainable solutions to address malnutrition across the world. It works in over 30 countries with presence in each of its strategic priority countries. GAIN is headquartered in Geneva.  Its worldwide presence includes country offices in Abuja, Accra, Addis Ababa, Dhaka, Kabul, Jakarta, Nairobi, and New Delhi. It also has representative offices in Amsterdam, London, Singapore and Washington D.C.

Initiative Reach

GAIN’s reach by priority country and initiative.

The reach of GAIN’s programs has more than tripled in the last three years, from 200  million in June 2009 to 667 million in July 2012. These figures include women and children, where access to better quality nutrition has also increased from 108 million to 321 million.

GAIN targets its efforts where a high burden of malnutrition exists, through focusing on innovative solutions in nine priority countries.

  Table 1. Reach (in millions) by country 
Initiative ILarge Scale Food Fortification Initiative IIMicronutrient Powders Initiative IIINutrition for mothers and children Initiative IVAg-nutrition Strategic Investments Aggregate Reach
Afghanistan 7.0 To be launched n/a In pilot 7.0
Bangladesh 45.3 0.1 n/a In pilot 45.3
Ethiopia 36.9 n/a n/a In pilot 36.9
Ghana 15.2 n/a To be launched In pilot 15.2
India 56.5 n/a 4.5 In pilot 176.0 176.0
Indonesia 17.1 n/a n/a In pilot 17.1
Kenya 10.2 n/a 0.27 In pilot 10.2
Nigeria 55.7 n/a n/a In pilot 55.7
South Africa 30.0 0.003 n/a In pilot 30.0
Total 204.1 0.6 3.5   176.0 393.4

*Note: Figures as of February 2012.

Working in partnership to end malnutrition

Innovative partnerships are a significant element of GAIN’s approach to fighting malnutrition, and private sector can form part of these collaborative efforts.

The GAIN Business Alliance is a rapidly expanding global business network dedicated to promoting market-based solutions. Its goal is to mobilize business to play a greater role in combating malnutrition through engagement in the Base of the Pyramid market. This consumer segment has just a few dollars to spend every day, and is identified as being critical in tackling malnutrition.

The Amsterdam Initiative against Malnutrition (AIM) unites the Dutch public and private sector to improve access to nutritious food for base of the pyramid consumers. It facilitates public-private partnerships and brings together the considerable strengths and expertise The Netherlands has to offer in nutrition, health and food-systems. AIM’s coalition of partners and country scope is consistently growing, as its approach to eliminating malnutrition encompasses the entire value chain, from farm to fork.

 Scaling Up Nutrition (SUN) MovementThe SUN movement is a global drive to address the challenge of malnutrition in the first 1,000 days of a child’s life. Selected countries are now committed as SUN ‘early riser’ countries, ready to effectively address malnutrition and stimulate the social wellbeing and economic growth of their populations. GAIN supports the SUN movement by engaging like-minded public and private sector stakeholders to deliver nutrition.

How is GAIN unique?

GAIN’s work depends upon the innovative collaborations between Governments, the private sector, international organizations, the United Nations, academia and civil society. This ‘Collective Impact’ approach to fighting malnutrition delivers programmatic impact at a scale no single organization could achieve alone.

GAIN’s innovative approach to tackling malnutrition has received funding from a number of public and private sector donors, including:
–    Bill and Melinda Gates Foundation;
–    Canadian International Development Agency (CIDA);
–    World Bank;
–    Children’s Investment Fund Foundations (CIFF);
–    Dubai Cares;
–    Goldsmith Foundation;
–    Government of the Netherlands;
–    Khalifa Bin Zayed Al Nahyan Foundation (KBZF);
–    United States Agency for International Development (USAID);
–    Department for International Development (DFID);
–    Irish Aid and;
–    Wellcome Trust.

GAIN is composed of a Board and a Secretariat. The GAIN Board comprises leaders from the donor, UN, development, research, business and civil society communities. GAIN also receives advisory services from its Partnership Council which represents a larger group of innovative thinkers and implementers from the above mentioned sectors. The GAIN secretariat is a team of technical professionals and support staff who manage the daily operations of the foundation.

Legal status
GAIN is a Swiss foundation headquartered in Geneva with special international status.

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8 J Hoddinott, M Rosegrant and M Torero (2012) ‘Challenge Paper: Hunger and Malnutrition’ Copenhagen Consensus.
9 World Health Organization (2001) Iron Deficiency Anaemia: Assessment, prevention, and control – A guide for programme managers.
10 Y Balarajan, et al, ‘Anaemia in low-income and middle-income countries’, The Lancet, 378: 2123–35, August 2, 2011
11 World Nutrition Situation 5th report , UN Standing Committee on Nutrition 2005.
12 Flour Fortification Initiative, The Global Alliance For Improved Nutrition, Micronutrient Initiative, UNICEF, USAID, World Bank and World Health Organization, Investing in the Future: A united call to action on vitamin and mineral deficiencies, Global report 2009,http://…
13 World Health Organization. Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO Global Database on Vitamin A Deficiency. Geneva: WHO, 2009.

Published 5 November 2012