How Ethiopia can transform health, lift GDP with policy to fortify foods

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A recent report published by the Global Alliance for Improved Nutrition (GAIN) details the costs and benefits of introducing mandatory food fortification in Ethiopia.
According to the findings, a government that spends over $3.8 million over the next 10 years could save tens of thousands of lives, reduce healthcare costs, and raise the country’s productivity. It could also reduce funding of up to $520 million allocated to fight vitamin deficiencies.
Decades of records with the United Nations’ Food and Agricultural Organization show that carbohydrates make up more than 70 percent of Ethiopia’s national diet, delivering energy, but very few of the vitamins and minerals that humans need to be healthy. More than 80 countries that face these challenges have added nutrients to staple foods in order to reach a wide population without significantly changing national eating habits.
The analysis found that for every $1 spent by a government to fortify flour with critical nutrients results in $13 of economic benefits to Ethiopia. Improved healthcare costs, lives saved from illness and improved productivity were also some other benefits listed.
Ethiopia is currently seeking a resolution for its problems of severe deficiency of Folic acid and Vitamin A. Ethiopians’ average consumption of folic acid, which plays a critical role in ensuring the health of a fetus during pregnancy, runs at less than 200 micrograms per day. It is a stark contrast to the 400 micrograms needed to sustain one’s health per day. As a result, 84 percent of Ethiopian women aged 15 upto 49 years old are at risk of giving birth to babies with Neural Tube Defects (NTD). A baby born in Ethiopia is therefore 11 times more likely to be born with an NTD than in any other African country.
To counter such challenges, countries such as Kenya, Nigeria, Rwanda, Tanzania, Uganda, and Zimbabwe have fortified common staple foods like flour with folic acid, reducing the number of NTD pregnancies by an average 41 per cent.
Ideally, it is expected to follow the country’s success in tackling malnutrition, reducing the prevalence from 58 percent in 2000 to 37 percent in 2019.
The report also highlights the ongoing costs of the country’s challenges as a result of Vitamin A deficiencies, which cause night blindness and a loss of immunity to infections. Recent studies found around 80 per cent of all Ethiopian children – from 92 per cent in Amhara to 55 per cent in Gambella – do not get enough intake of Vitamin A. Ethiopian women at the reproductive age are at 82 percent.
“Extremely deficient diets are continuing to deliver ill health to almost every Ethiopian and need urgently addressing,” said Ton Thomas Haverkort, GAIN’s Ethiopia Country Director. “Food fortification is simply a universal solution, which for less than half-a-million dollars a year of government spending can transform Ethiopia’s public health and productivity.”
Ethiopia has taken significant steps towards scaling up fortification programmes, such as preparing standards for fortification. Yet, it has not yet mandated the fortification of flour and edible oil.