Micro-nutrient deficiency, huge challenge for Nigerian govt – Umunna

May 31, 2014

Mr. Larry Umunna

The Country Director, Global Alliance for Improved Nutrition, Mr. Larry Umunna, speaks on the nation’s food security level and the ongoing national food fortification programme, in this interview with STANLEY OPARA

Is micro-nutrient deficiency such a big health problem in Nigeria?

Oh yes, it is still a huge problem of public health significance in Nigeria. Despite their enormous consequences for economic growth and human development, these nutritional problems are often hidden and silent. The warning signs are not always recognised and the victims are often not aware of the problem. This is often referred to as a ‘hidden hunger’.

Out of about 21 widely known micronutrients, five are of public health significance: Vitamin A, iron, iodine, zinc and folate. We have heard many of the statistics so often that they tend to become background noise, but the numbers regarding micronutrient deficiencies deserve to be repeated so often because they are simply so incredible! One in four children under the age of five in Nigeria suffer from Vitamin A deficiency! About 31 per cent of mothers in Nigeria are iodine deficient! More so, the connection between suffering, death and malnutrition is a very real one: the child dying from a common childhood illness who is a casualty of Vitamin A deficiency; the girl not in school because of a poorly developed learning ability suffers because of lack of iodine; the baby emaciated from diarrhoea because she was not breastfed; and the young mother who dies at childbirth because of anaemia. These statistics, these tales of human suffering, make it unimaginable to question the importance of micronutrient in achieving the socio-economic development of any country.

Is there any role the consumers can play in ensuring compliance by manufacturers?

Absolutely! The consumers have a strong role to play in the drive to reduce malnutrition in Nigeria. It is the right of every Nigerian to consume fortified foods. Therefore it is important that the consumers begin to demand for fortified staples. The food industry must be challenged by the consumers to comply with the fortification standards. We are hoping that this ongoing campaign will result in more educated and informed consumers who fully understand the benefits of fortified foods.

What is the essence of the ongoing food fortification campaign in Nigeria?

Food fortification in Nigeria can be traced back to the 1990s as a follow-up to declarations from the World Summit for Children held in New York, USA to eradicate micronutrient deficiency disorders. Following the success of the Universal Salt Iodisation and a benchmark survey in 1995, wheat/corn flour, sugar and vegetable oil were identified as the vehicles for fortification with Vitamin A because of their relative affordability, accessibility and technical feasibility. Fortification of these food vehicles has since been found to be cost-effective, sustainable and capable of achieving high coverage, as even the most vulnerable population uses at least one of the vehicles daily.

Over the year and since the implementation commenced in 2003, the Federal Government, the Global Alliance for Improved Nutrition (GAIN), food manufacturers, UNICEF and other development partners, have deployed considerable efforts to the programme towards achieving a nation-wide consumption of Vitamin A-fortified flours, oil, and sugar in order to provide at least 50 per cent of the recommended daily allowance needed by deficient Nigerian populations. To complement existing efforts, GAIN provided a range of supportive and enabling services in social marketing and capacity building at industry and government levels as well as monitoring and evaluation initiatives. The contributions of development partners led by GAIN, as well as UNICEF and Micronutrient Initiative and other inter-agency initiatives and related investments, have helped to drive the initiative substantially in the last 10 years during which notable achievements have been made, including the review of the existing standards to include Folic acid and Zinc, and revision of the NIS in line with FAO/WHO Guidelines on food fortification.

What has been the response of the consumers to this campaign being the key targets of your social marketing campaign?

The response has been encouraging. In Lagos and Kano (where the campaigns are ongoing), we have seen very strong interest in the programme by consumers. Consumer reactions and feedbacks from the ongoing food fortification are indicative of the fact that the National Agency for Food and Drug Administration and Control, the executing agency is undoubtedly playing a catalytic role in moving the food fortification agenda forward in Nigeria. That is rightly so, being the agency saddled with the statutory responsibility of protecting public health through effective regulation of production and marketing of foods and drugs in Nigeria.

NAFDAC has continued to be at the forefront of coordinating efforts by multi-sectorial stakeholders towards the realisation of the National Food and Nutrition Policy of the Federal Government by pursuing the full implementation of the mandatory Vitamin A food fortification policy. The policy was introduced in September 2002 and it’s aimed at ameliorating the vitamins and minerals deficiency problem in Nigeria.

What major objectives are the supporters/funders of this project seeking to achieve?

The major objective is to reduce the prevalence of micronutrient deficiencies among vulnerable and at-risk populations by 20 per cent. We planned to achieve this by increasing consumer awareness and demand for fortified foods/products; and also stimulating and increasing industry participation in fortifying more staples and food products and in actively marketing/promoting their fortified brands. To put it simply, we want to repeat the feat that Nigeria achieved with the universal Salt Iodisation project in 2007 with 98 per cent household having access to iodised salt.

That explains why the Director General of NAFDAC, Dr. Paul Orhi, has described this current project as a sustainable intervention aimed at curbing the prevalence of micronutrient deficient disorders in Nigeria. Other partners in this project include the National Fortification Alliance whose members cut across government ministries and agencies, civil society organisations, universities and research institutions, industry umbrella associations, professional associations and development partners. This broad participatory membership base is enabling stakeholders to share experience, expertise and facilitate the sustainability of the national fortification programme. The immediate output is to establish monitoring and enforcement systems, and increase the demand for fortified products by the consumers.

Apart from funding support, what else is GAIN doing to help NAFDAC succeed on this project?

GAIN is in partnership with NAFDAC in this third phase of the project, and will continue to support the agency to strengthen its ability to monitor and enforce full compliance with the Nigerian Industrial Standard towards achieving our objective of reaching 111 million Nigerians with fortified food products by June 2015.

There is no doubt that NAFDAC has recorded some milestones in the previous phases of the food fortification project. However, there is need to redouble efforts towards overcoming the low level of compliance with Vitamin A fortification as against expected standards among large scale and medium scale industry, as non-compliance has continued to contribute to the high infant and maternal mortalities in Nigeria.

Available evidence showed that Nigeria has one of the highest rates of child and maternal mortality in the world with vitamin and mineral deficiencies being a major contributory factor. Micronutrient malnutrition has become a major devastating nutritional problem affecting the health of children, pregnant women and lactating mothers.

Therefore, the underlying motivation for this third phase of our food fortification project entitled, “Strengthening Large Scale Fortification in Nigeria through Compliance and Social Marketing,” is to enhance compliance, enforcement and demand creation so as to improve the vitamin and mineral status of Nigerians, by empowering and placing the consumers at the centre of decision-making in the purchase of fortified foods.

That explains why we have taken the campaign to the heart of the markets at the grassroots, hospitals and selected neighbourhoods for effective consumer mobilisation in selected Nigerian cities with Lagos and Kano as pilot areas.