Almost one third of the world’s population (or close to 2 billion people) suffers from micronutrient (vitamin and mineral) deficiency, or “hidden hunger.” In East, Central and Southern Africa, it is estimated that more than 10 million women and children are affected, with many more at risk. Economic losses total roughly 3⁄4 of a billion US dollars a year. Micronutrient malnutrition has proven to be a serious health problem in Rwanda having plagued this nation for generations sapping economic potential and taking countless lives. National and international agencies have endorsed a handful of strategies as effective and practical means of addressing the problem. Food fortification (the addition of essential vitamins and minerals, such as iron, folic acid, vitamin A, zinc, and iodine to commonly consumed staple foods such as wheat flour or salt) is one of the most cost-effective options. As a result, the number of countries throughout Africa adopting fortification legislation has expanded from two in 2004 (South Africa and Nigeria) to 24 in 2014, according to the Food Fortification Initiative (FFI), with an additional three countries fortifying on a voluntary basis. These include Tanzania, Uganda, Kenya, South Africa, Zambia, Nigeria, Congo, and soon Burundi will implement the programme. This enormous progress will go a long way to decrease rates of morbidity and mortality, improve economic productivity, and ensure greater national progress towards meeting the Millennium Development Goals (MDGs). It should be something the continent is extremely proud of. Yet, where is Rwanda? Why has Rwanda not chosen to provide the same micronutrient-rich foods to those most in need? Statistics from the country’s 2005 and 2010 Demographic and Health Surveys (DHS) indicate that anemia among children 6-59 months and pregnant women is 38% and 20%, respectively, and vitamin A deficiency among children under 6 months of age is 26%. Consequences of such deficiencies at these rates are severe including increased susceptibility to infection and disease, childhood blindness, decreased IQ and mental retardation, stillbirths, and pre-mature death. Certainly, Rwanda produces own sugar, wheat and maize flour to make this a reality. We risk lagging far behind our neighbors both in terms of health consequences and economic potential, not to mention the future implications on trade. The Ministry of Health and Bureau of Standards hold the mandate to ensure such a national fortification programme becomes a reality. Let’s hold them to task and demand further work be done to ensure our staple foods, which are consumed each and every day, contain the nutrients necessary to allow our bodies function at their highest potential. Background Vitamin and mineraldeficiencies are among the leading contributing factors to increased levels of maternal, infant and child mortality and account for the heavy burden of disease and disability among women of reproductive age and children under the age of 5 years. The most common health problems resulting from this form of malnutrition include low birth weight, stunting, underweight, wasting, childhood blindness, reduced mental functioning and mental retardation, reduced physical productivity, decreased immune functioning and increased susceptibility to disease, and severe birth defects. Micronutrients are extremely crucial to a child’s development, particularly during the first 1,000 days, from the window of pregnancy up to the age of two years. Food fortification is the practice of adding essential vitamins and minerals, such as iron, vitamin A, folic acid, zinc, and iodine, to staple foods to improve their nutritional content and prevent malnutrition from occurring. Simply providing additional calories will do little good without the inclusion of essential vitamin and minerals required for our bodies to function properly. Fortification is safe, having been used around the world since the 1920s, and has proven to be the mostcost-effective way to improve rates of deficiency. Commonly fortified foods include staple products such as salt, maize flour, wheat flour, sugar, vegetable oil, and rice. It has been estimated by the Copenhagen Consensus (a group of expert economists) that every $1 spent on fortification results in $9 in benefits to the economy. An initial investment is required to purchase both the equipment and the vitamin and mineral premix, but overall costs of fortification are extremely low. Price increases are roughly 1-2%, less than normal price variation. The writer is the Director of Rwanda Consumer’s association & chair of Rwanda National Fortification Alliance.
