Improving nutrition for 150 million people

Walk into a pharmacy, small shop or supermarket in Abidjan, the largest city in Côte d’Ivoire, and you’re likely to see Marie Konate’s brightly coloured children’s cereals for sale. Marie’s company Protein Kissèe-La (PKL) gets feedback from customers bi-annually but most don’t comment on the fact that they contain 11 vitamins and seven minerals. “Customers might feedback that the cereals are too sweet, or not sweet enough,” she says. “Or parents who buy our cereals for under-fives comment on how they can see their children growing, but they don’t mention the vitamins and minerals.”

According to the National Nutrition Programme, malnutrition is responsible for 54% of deaths and over a third of ailments among children under five in Cote d’Ivoire. In this country, food fortification is mandatory for certain products. Since 2010, Marie has brought powder containing a blend of vitamins and minerals – called premix – for her product from the GAIN Premix Facility (GPF). Globally, premix sourced by the GPF has helped to improve the health of 150 million people who have consumed it through staple food products in the past year – even if they’re not aware of it.

“We have a real problem with malnutrition here and food fortification is a necessity,” says Marie. “People don’t have enough fruit in their diet and if they do eat vegetables, they are too cooked and the vitamins and minerals are lost. They don’t need to change their diet to get the nutrients they need if they eat our cereals; people are used to eating maize-based products. Before the GPF, we couldn’t be sure of what was in the premix we were buying or how much it would cost. Now, we can get quality, affordable premix within around four weeks of ordering it through GAIN.”

Providing quality micronutrients
Food fortification is a priority for GAIN, an organization focused on finding solutions to end malnutrition within our lifetimes. The Geneva-based foundation launched the GAIN premix facility in 2009 so food producers like PKL, and others, have access to an easier, more cost effective way of procuring high quality premix. As well as cereals, popular fortified end products are flour, vegetable oil, biscuits, sugar, condiments, soy or fish sauce and salt. In July 2014, the facility turned five. To date, it has sourced around US$ 47 million worth of premix and micronutrients in more than 40 countries. “The GPF has gone to scale,” says Greg S. Garrett, Director of Large Scale Food Fortification at GAIN. “There’s no other specialist facility that offers its customers the chance to procure quality premix, obtain credit to buy it and receive relevant technical assistance.”

To ensure quality and choice, the GPF currently has 21 certified premix blenders and 40 certified micronutrient suppliers. GPF partners with a company called Intertek to audit potential blenders and suppliers, checking that they meet minimum standards. “We provide feedback to companies who fall below the required standards to improve their criteria. GAIN is able to facilitate this due to their impartiality,” says Sandra Meixner, Head of Analytical Customer Service at Intertek. “Organisations might not succeed because of water, hygiene or storage problems, which lead to bacteria in the premix or micronutrient raw materials.” Intertek also checks a sample from every order a customer places with the GPF, which GAIN, not the customer, pays for. This process is vital because it ensures that the premix contains the correct level of micronutrients that will benefit people’s health.

Another company, London-based Crown Agents, manages the GPF’s procurement process and credit function. Thanks to seed funding from the Dutch government and the Bill & Melinda Gates Foundation, the GPF has provided extended credit to businesses like Baktygul Djangazieva’s Kyrgyz Association of Salt Producers (KASP) in Kyrgyzstan. Baktygul’s company started working with the GPF in 2010 to help local producers get quality potassium iodate to iodize salt. Iodine is essential for healthy brain development in young children and iodine deficiency can negatively affect the health of women. In Kyrgyzstan, it became mandatory to iodize salt in 2001 and studies show pregnant women especially still need more iodine in their diet in the country. KASP and GAIN partner UNICEF recommended that the organisation start working with GAIN to source quality potassium iodate. The GPF now supplies potassium iodate to KASP on a regular basis and Baktygul only pays for it when she has sold it on. “Before we worked with GAIN, our salt producers had to pay for potassium iodate up front and it was also a lot in taxes,” says Baktygul. “Cash flow for the business was difficult. Through the GPF, we can buy potassium iodate on credit and the price competes with informally imported and lower quality potassium iodate. We can pass on the lower costs to our customers and people who need iodized salt in Kyrgyzstan.”

Reducing the cost of fortified food
GAIN and Crown Agents source quotes from suppliers and blenders when organisations like Baktygul’s place an order with the GPF. They evaluate bids and advise the GPF which one to recommend to clients, based on cost and how urgently they can deliver. “The procurement model has opened up the market for smaller producers who can approach major manufacturers,” says Louisa Bare, Head of Trading Operations at Crown Agents. It’s also benefiting people living in countries which have mandatory food fortification because they are getting the quality nutrients they need at a more reasonable cost.

Some local companies, governments and non-governmental organisations have started to use the GPF’s online supplier list  to order premix directly with our certified suppliers. Greg says this demonstrates that GAIN has established a recognised quality standard for sustainable systems of procurement. He thinks the facility will have more of a focus on providing technical expertise in the future. For example, they will continue to distribute and provide training on fortification equipment including hand-held micronutrient checkers, for government and industry. Such devices allow food producers like PKL, distributors like KASP, as well as monitoring agencies and others, to measure micronutrients in food themselves.

As more countries make food fortification mandatory, the GPF’s staff’s expertise will be vital in assisting with what products and premix they should concentrate on to best improve people’s health. Legislation in each country is different. So, fortified flour in Tanzania is different to fortified flour in Morocco because the needs of the populations are different.  “We’ll support countries embarking on fortification to find the best food vehicle to tackle micronutrient deficiencies,” says Adeline Provent, Junior Associate at the GAIN premix facility. “We can also help countries to monitor food fortification better.”

Fighting malnutrition
The GPF now supplies almost all of the World Food Programme’s approved suppliers with premix for products like Super Cereal, a fortified porridge for adults and children. Adeline says that while food fortification isn’t the only answer to malnutrition – because ideally, people need access to diverse diets – it’s a good medium term response. Greg agrees. “It’s not the panacea but arguably the cheapest and easiest way of contributing towards the decrease and eventual elimination of malnutrition,” says Greg. “We’re adding nutrients to food which people would be consuming anyway and we’re not having to invest heavily in social marketing but are still reaching many, many people.”

Salt distributor Baktygul plans to reach many more people in the future, with GPF’s help. She wants to distribute iodized salt to more customers and the whole of Kyrgyzstan. Marie would also like to work with the GPF to fortify more foods that people eat on a daily basis so that they can get the nutrients they need. “We’re looking at fortifying orange juice and cassava flour,” says Marie. “Food fortification has become a fashionable enterprise in Cote d’Ivoire now as its mandatory. The GPF makes the whole process of getting quality premix simpler and helps fight malnutrition. It’s so important.”

What the GAIN Premix Facility has achieved over the past five years: 

  1. Delivering and funding premix to fortify food for people affected by emergency situations in Haiti and Pakistan in 2010 and the Horn of Africa in 2011, in partnership with the World Food Programme
  2. Sourcing around US$ 47 million worth of premix and micronutrients in 41 countries.
  3. Creating a pool of 21 certified premix blenders and 40 certified micronutrient suppliers.
  4. Supporting the diet of over 150 million people in the last year that will have eaten food fortified by premix sourced through the GPF.
  5. Delivering 250 hand-held micronutrient checkers to 24 more than 20 countries.

Vitamin and mineral deficiencies affect a third of the world’s population. Each year, malnutrition kills 3.1 million children under five and leaves 161 million stunted, trapping generations in lives of poverty and unfulfilled potential. GAIN-supported school nutrition programmes in India reach approximately 1 million children with fortified hot meals.

Published 8 December 2014

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