Why enforcement of food fortification policy is imperative

The growing prevalence of malnutrition and micronutrient deficiencies in Nigeria has become a pressing concern with dire consequences for the nation’s citizens, especially the children. Fortification of staple foods with essential micronutrients is a viable and cost-effective strategy to combat malnutrition. However, compliance with fortification standards remains a challenge in the country. PAUL ADUNWOKE writes

The increasing burden of micronutrient deficiency in Nigeria is currently considered alarming. The World Health Organisation (WHO), had, in 2015 classified micronutrient deficiency as severe. However, in 2016, anemia prevalence in Nigeria was 68.3 percent, 48.8 percent and 57.8 percent among children under five years, non-pregnant women 15 to 49 years, and pregnant women 15 to 49 years of age, respectively.

According to WHO, at least, a third of the anemia cases in the country is attributable to iron deficiency, stating that about 42 percent of children between six and 59 months are Vitamin A deficient.

Overall, WHO noted that an estimated 21 percent of the Nigeria population is at risk of inadequate zinc intake, hence proper nutrition is critical for building a strong immune system and helping the body to fight off diseases and infections.

Worried by the rate of hunger, malnutrition and lack of nutrients that would aid growth mentally and physically among citizenry, especially children under five and workforce, Civil Society Legislative Advocacy Centre (CISLAC) in collaboration with Nigerian Economic Summit Group (NESG) and e-Health Africa organised a media roundtable, where they charged the Federal Government to enforce the legislation of food fortification policy already in existence.
Themed: ‘Fortifying Nigeria’s Future,’ the event held at Sheraton hotel, Lagos, raised awareness on promoting fortification compliance and better workforce nutrition in Nigeria.

Among the guest speakers were Chairman, Senate Committee on Health, Sen. Ibrahim Oloriegbe; Executive Director, CISLAC, Auwal Rafsanjani; President/CEO, Consumer Advocacy for Food Safety and Nutrition Initiative (CAFSANI), Prof. Gbenga Ogunmoyela; President, Nutrition Society of Nigeria, Prof. Wasiu Afolabi; Head Corporate Affairs and Stakeholder Management, NESG, Mrs. Ogechi Obiorah; Project Manager (LSFF Project), e-Health Africa, Toju Ogele and media executives.

The media roundtable on food fortification advocacy, which was motivated by the growing concerns about malnutrition and the need for healthier diets, the organisers believed it could play a critical role in influencing public opinion and driving policy changes in favour of food fortification and improved nutrition in Nigeria.

In his remarks, Senator Oloriegbe called the Federal Government out to strengthen the policy by enacting a law that would compel stakeholders in the food and fortification industry to make it, not only implementable at the production level, but also walk further steps by ensuring related products pushed to the market for consumption are compliant.
 
Senator Oloriegbe, who defined nutrition as the science of food in relation to health and malnutrition, as the lack of proper nutrition, said the nation has reached the point of enacting a law that would enforce compliance with the food fortification policy and compels companies in the sector to prioritise effective workforce programme for their workers.

Speaking further, the senator said, “You may have food, but cannot eat or you can eat but have no food to eat. If you eat food that your body system cannot process, it is the same thing to say that one is susceptible to malnutrition.

“We need a law that compels nutrition companies to provide nutrition for their workforce because, currently, there is no such law as it is optional. There must be such law. A law should compel compliance with food fortification and promotion of workforce nutrition in Nigeria,” Oloriegbe advocated.

“When you talk about nutrition, you have to talk about the health of the woman that is pregnant, then you talk about the baby because it is a healthy body that gives birth to a healthy baby. The workforce is also involved.”

The lawmaker was worried that over two million under age five children in Nigeria are malnourished and called for quick action on the part of government and stakeholders in the food and fortification sector.

He also made case for food intake of the workers in food and fortification industry, saying, “If you don’t have good nutrition as an adult, you are prone to sickness. You will be unproductive where the food you eat has no good nutrition. This is when the human resources are not working well, the industry and, by extension, the nation, are bound to have their productivity level depleted.

Oloriegbe enjoined the media to play their role as ‘opinion shaper.’ “We need to have knowledge. We need to seek more and more information on this issue of nutrition and then use that capacity, knowledge acquired to inform and advocate,” he said.

Earlier, Rafsanjani said the nation is currently facing a serious nutrition crisis, which underscores the organisers’ intervention, positing food fortification as a proven way to go in improving nutrition and wealth of the nation.

He said, “According to the National Demographic and Health Survey (NDHS) 2022, 44.1 percent of children under the age of five in Nigeria are stunted, meaning they are too short for their age. This is a decrease from 46.0 percent in 2018, but still a high number. Stunting is a sign of chronic malnutrition and can have long-term consequences for health and development.

“The NDHS also found that 20.3 percent of children under the age of five in Nigeria are stunted, meaning they are too thin for their height. This is an increase from 19.9 percent in 2018. Wasting is a sign of acute malnutrition and can be a life-threatening condition.

“The NDHS also found that 18.7 percent of adults in Nigeria are overweight and 4.4 percent are obese. This is an increase from 17.4 percent and 3.4 percent, respectively, in 2018. Overweight and obesity are major risk factors for chronic diseases such as heart disease, stroke, type 2 diabetes, and some types of cancer.”

CISLAC boss believes that food fortification is a proven way to improve nutrition and health as it prevents micronutrient deficiencies, such as anemia, vitamin A deficiency, and iodine deficiency.

Although adults spend over half of their active hours of the day at work, the workforce, according Rafsanjani, are vulnerable to malnutrition.  He said: “Workers who are not getting the nutrients they need are more likely to be sick, less productive. This can have a significant impact on the economy.”

But to ensure a healthy workforce, he suggested that employees should provide their workers with the nutrients they need, as fortification can help to reduce absenteeism, increase productivity, and improve safety.

He appealed to the media executives present at the event to help in raising awareness on the importance of food fortification and workforce nutrition as the media plays critical roles in shaping public opinion and influencing policy by shining a spotlight on this issue.

Rafsanjani, who said that the media could help to make a real difference in the lives of millions of Nigerians, also sought for the support of regulators, members of the National Assembly, civil society organisations, and food producers.

“Together, we can work to ensure that the food fortification policy of 2019 is implemented effectively to ensure a healthier Nigerians,” he added. In his paper titled, The Role of Food Fortification in Addressing Micronutrient Deficiency, Prof. Afolabi said adequate diets continue to be a challenge in many parts of the world.

Enumerating the benefits of fortified foods, the university don said a recent systematic review and, meta-analysis revealed that large-scale food fortification reduced anemia by 34 percent, reduced goitre by 74 percent, and reduced neural tube defects by 41 percent.  

Afolabi advocated for more nutrition education through multiple channels on the need to consume an adequate diet for a healthier and strong immune system, less risk of chronic illness, infectious diseases and increased productivity.

Also, in a paper titled, The Challenges and Successes of Fortification Compliance and Opportunities for Promoting Workforce Nutrition in Nigeria, Prof. Ogunmoyela said, “Globally, poverty, hunger and malnutrition remain a nightmare both to the government as vulnerable community usually made up of mostly children and youths…especially in developing countries like Nigeria.

“In fact, today, an estimated 72 percent of Nigerians are believed to be living in extreme poverty with income of less than US$2 per day. Any wonder why our nutritional indices have become one of the worst in the world with stunting rates and malnutrition at up to 60 percent in some states.”

To combat this problems, Prof. Ogunmoyela believed that investments in micronutrients have higher returns than those from investments in trade liberalisation, in malaria, or in water and sanitation as no other technology offers as large an opportunity to improve lives at such low cost and in such a short time.

Why fortification and workforce nutrition, he said nutrition, wellness, health, and food safety issues are quite topical today and present significant challenges and opportunities in a developing economy like Nigeria. 

Food fortification, he noted, is the addition of micronutrients to food at higher levels than what the food can provide naturally for micronutrient deficiency control.

Examples, according to him, include Vitamin A in flour, sugar and vegetable oils, folic acid in flour, iodine in salt, iron in bouillon cubes. Ogunmoyela called for overhaul of the nation’s existing food fortification policy and laws, saying, “The problem is a combination of inadequate regulation policy and poor compliance. The current policy and laws that we have are not adequate enough to address all the issues.”

In her speech, Head Corporate Affairs and Stakeholder Management, NESG, Mrs. Ogechi Obiorah said the food fortification policy is a collective responsibility of stakeholders involved.

Obiorah called on Manufacturers Association of Nigeria (MAN), West African Cotton Companies and other stakeholders involved in food production to rise to the occasion. She also advocated for budgetary allocation and fund releases for relevant government agencies such as Federal Competition and Consumer Protection Commission (FCCPC), National Agency for Food and Drug Administration and Control (NAFDAC) and Standard Organisation of Nigeria (SON) to ensure efficient monitoring of food fortification by producers.

However, recommendations of the Roundtable were detailed in the communiqué, jointly signed by Rafsanjani, Oloriegbe, Ogunmoyela and Afolabi including prioritisation of food fortification across manufacturing process and production chains through proactive media reportage that promotes well-informed citizens on appropriate food choices.

They called for the integration of food fortification into the organisations’ policies coupled with targeted sensitisation and awareness at employees’ levels to activate compliance to workforce nutrition, while enhancing productivity in the work environment.

The organisers also called for formulation and implementation of Food Fortification Policy incorporating effective regulatory framework, compliance to standards and food safety as well as social behavioural change communication for consumers.