In tandem with private sector action, it is important for the public sector to set standards, signal appropriate practices, and enable business environments. In addition, the private sector must be incentivized to ensure that nutrient-rich, safe, and affordable foods and food products become accessible in all market settings.
In all cases, accountability and transparency of action must be greatly enhanced, and the role of healthy diets in addressing all forms of malnutrition needs to be more explicit in all public sector actions. It will also be important for both parties to look for “win-wins” which address the many competing agendas of the private sector; for example, relating to jobs, growth, environmental sustainability, and social responsibility. Identifying common ground will help to accelerate action and progress.
Two examples of the work the World Food Programme (WFP) is undertaking in partnerships with governments and the private sector to unlock hidden hunger include Vitamino micronutrient powders in Sudan and the Good Food Logo in Zambia. In Sudan, micronutrient deficiencies are widespread, the most common being iron, vitamin A, and iodine. Anemia rates are very high, estimated to affect 88% of preschool-aged children, 58% of pregnant women, and 43% of non-pregnant women. WFP Sudan entered a partnership with Moataman Maaz Medical Company (MMMC) to facilitate the retail of Vitamino, micronutrient powders packaged in small 1-g sachets which contain 15 micronutrients. Vitamino is available through accredited pharmacies and supermarkets for less than USD 1 per month, making it the most affordable nutritional product in Sudan. This partnership ensures a larger percentage of the population in need is reached with the product and, importantly, it builds a sustainable model that can, in the future, work without WFP’s support. MMMC manages the supply chain of Vitamino (purchase, import, and distribution to end users) and ensures product availability in locations where WFP does not have an operational presence. They use their capacity and knowledge on marketing and retailing of nutritious products to ensure the product is successful in the market. WFP complements their efforts by providing funds to support a comprehensive social and behavior change communication campaign on nutrition, aligned with the Ministry of Health’s messages. This support ensures that the price of Vitamino remains affordable. Additionally, the initiative is currently reaching 45,000 children aged under 5 years through 257 pharmacies and 33 supermarkets for less than USD 1 per child per month. Developed by the Scaling Up Nutrition (SUN) Business Network and the Zambia National Food and Nutrition Commission and Zambia Bureau of Standards, the Good Food Logo is a front-of-pack nutrition mark or seal for eligible products that meet predefined criteria and nutrition-related standards across the various food groups to help consumers identify nutritious foods in-store. The SUN Business Network is one of the multi-stakeholder networks in the SUN movement. The Network aims to reduce malnutrition in all its forms through mobilizing business to invest and innovate in responsible and sustainable actions. The SUN Business Network is convened globally by WFP and the Global Alliance for Improved Nutrition (GAIN). A total of 18 countries already have an established SUN Business Network and WFP is currently supporting the development of 6 additional networks. The nutrition brand logo aims to introduce a simple, positive mark to “help Zambian people make better food choices” in store with the objective of increasing the intake of micronutrients and reducing the consumption of ingredients that lead to overweight, obesity, and non-communicable diseases (NCDs). Furthermore, the Good Food Logo aims to reduce overweight, obesity, NCDs, micronutrient deficiencies, and encourage food companies to reformulate existing products and develop new ones with a healthier product composition. The goal of improving nutrition awareness and demand aligns with the SUN Business Network Zambia strategy, as well as the Zambia National Food and Nutrition Strategic Plan 2017–2021. Government agency is to implement the certification mark to ensure sustainability and ownership.
Recommendations
The following recommendations are proposed to bring hidden hunger to the agenda and to ensure healthy diets.
Recommendation Number 1. Practical steps should be taken at all points across the food systems to retain/increase the micronutrient density; policymakers should look for actions across food systems and align them towards a common objective. A focus should be placed not just on the production or supply-side aspects of the food system, but also on demand-side interventions that support consumers to have both the agency and the impetus to make better food choices for themselves and their families.
Recommendation Number 2. Governments and the private sector need to work together on aligning individual food systems, attaining healthy diets, and tackling micronutrient deficiencies. Extensive inter- and multi-stakeholder dialogue is required for these two parties to do this.
Recommendation Number 3. Accountability should be improved at all levels and governments committed to tackling micronutrient deficiencies and other forms of malnutrition need to set targets.
Recommendation Number 4. Health information systems need to address key micronutrient deficiencies, relevant to the specific country context. There is a need for more data so that response efforts can be better informed and tailored accordingly.
Public-private partnerships have enormous potential to end hidden hunger. Working together across the food system, governments, private actors, and other stakeholders can ensure that interventions to address food and nutrition security are connected and considered as a system. A multidimensional, multi-stakeholder approach tailored to country-specific contexts is necessary. Engagement with the private sector is essential in order to address long-term economic and livelihood-based success that can lead to the development and implementation of sustainable opportunities and interventions to end hidden hunger.
References
1Development Initiatives: 2018 Global Nutrition Report: shining a light to spur action on nutrition. Bristol, Development Initiatives, 2018.
2Our World in Data: Micronutrient deficiency (accessed July 19, 2019). https://ourworldindata.org/micronutrient-deficiency
3Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008;371:243–260.
4GAIN, UNICEF, Brighter Futures: Protecting early brain development through salt iodization – the UNICEF-GAIN partnership project. New York, UNICEF, 2018.
5Young MF: Maternal anaemia and risk of mortality: a call for action. Lancet Glob Health 2018;6:e479–e480.
Briony Stevens
United Nations World Food Programme
Via Cesare Giulio Viola 68
Parco dei Medici, IT–00148 Rome (Italy)
Published online:
Biesalski HK (ed): Hidden Hunger and the Transformation of Food Systems. How to Combat the Double Burden of Malnutrition? World Rev Nutr Diet. Basel, Karger, 2020, vol 121, pp 21–30 (DOI:10.1159/000507499)
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