F

Improving the
quality of milled
grains

a call to tackle hidden

hunger in Africa

commonly consumed foods including grains - has been ranked by

the World Bank and the Copenhagen Consensus as one of the best
investments in development in terms of cost-effectiveness and
cost:benefit because it improves people's health while indirectly
boosting productivity and economic progress. It has led to the
virtual eradication of goitre, pellagra, rickets and beriberi in the
North and evidence is building of its impact in Asia and Africa.
Globally, this intervention has gained traction and gone to scale.
79 countries now have mandated wheat flour or maize meal
fortification and more undertake it voluntarily. It is estimated
that 31 percent of the worlds industrially milled wheat flour is
fortified with at least some iron or folic acid through mandatory
and voluntary efforts. In Africa alone, 21 countries have now
mandated the fortification of wheat and/or maize meal.

Solutions

GAIN: The Global Alliance for Improved Nutrition in

Africa

by Greg S. Garrett, Director, Food

Fortification at Global Alliance for
Improved Nutrition (GAIN)

oday one in nine people 805 million

worldwide, many of whom reside
in Africa still go to bed hungry
every night. Many more suffer from
micronutrient malnutrition. This
hidden hunger is of great public
health concern. Vitamin A, iron and
folate deficiencies are debilitating:
vitamin A is critical for preventing
childhood blindness and protecting the immune system; iron
helps prevent iron deficiency anaemia; and folic acid can prevent
life-long neural-tube birth defects. These deficiencies hold entire
populations back. Children do not develop fully, parents cannot
work efficiently and far too much money is spent on the medical
treatment of nutrition-related health problems.
However, there are affordable and easy solutions which
work and which can be implemented by the private sector. For
example, staple food fortification - the practice of deliberately
increasing essential micronutrients during the processing of

79 countries now have mandated wheat flour or maize meal

fortification and more undertake it voluntarily

54 | Milling and Grain

GAIN has been leading many of these efforts over the last
decade to catalyse national flour fortification in Africa. GAIN
believes that food fortification should be an integral part of
African countries nutrition strategies where existing food
supplies and limited access fail to provide adequate levels of
nutrients in the diet.
In Africa, GAIN has provided grants or technical assistance to
Egypt, Ethiopia, Kenya, Morocco, Mozambique, Nigeria, South
Africa, Tanzania, Uganda, Zambia and Zimbabwe as well as
throughout West Africa.
Created in 2002 at a Special Session of the UN General
Assembly on Children, GAIN supports public-private
partnerships to increase access to missing nutrients in diets
necessary for people, communities and economies to be healthier.
GAIN is a Swiss foundation headquartered in Geneva with a
special international status granted by the Swiss government. It is
the only international organisation exclusively focused on ending
malnutrition.

GAIN is committed
to helping address
bottlenecks to
sustainability,
compliance and
impact of fortification
programmes

GAIN works in more than 30 countries to support

fortification of staple foods and increase access to nutritious
foods; demonstrates large-scale impact in maternal and child
health; integrates agriculture and nutrition; provides locally
relevant solutions specific to the needs of poor communities;
builds capacity along the value chain; and helps shape the
global nutrition agenda by setting standards and establishing
platforms.
Today, thanks to the efforts of GAINs many public and private
sector partners including milling companies, over 350 million
people in these countries and regions in Africa are receiving more
nutritious wheat flour and maize meal. This has led to reductions
in neural-tube defects in South Africa and iron deficiency anemia
in Nigeria and Morocco, and very high coverage in Senegal
resulting in the majority of poor women of reproductive age
receiving higher intakes of iron and thus contributing to better
health.

Next steps to ensure milled grains

contribute to better health in
Africa

While this success is worth

celebrating, there is so much more
to do to harness the power of the
worlds most affordable development
intervention. Many of the countries in
Africa that still suffer from high rates
of hidden hunger have populations
which consume high levels of wheat
flour and maize meal. For these
countries, the private and public
sectors should come together and aim
to adequately fortify all industrially
milled wheat and maize. In many
countries where there are national
flour and maize meal fortification
programmes, ongoing maintenance
56 | Milling and Grain

and strengthening is required. For example, quality, compliance

and coverage issues plague many of these existing programmes,
which in turn adversely influences potential for impact. There
are also other quality and safety needs of grains which should
be addressed by the fortification programmes and associated
regulatory monitoring, thereby linking fortification to overall
value addition processes and practices.
GAIN is committed to helping address bottlenecks to
sustainability, compliance and impact of fortification
programmes. Working with African governments and
the industry as well as with partners like the World Food
Programme, UNICEF, the Food Fortification Initiative, PATH,
HKI and the Micronutrient Initiative, GAIN aims to support
and drive continent-wide replication, new innovations including
fortification and testing technology and raise the profile of
wheat flour and maize meal fortification. Market-based delivery,
school meals, public distribution and humanitarian assistance all
can play a part to ensure fortified foods are
consumed throughout the continent by those
that need them.
From 9 to 11 September 2015 in
Arusha, Tanzania, hundreds of leaders
from around the world representing the
public and private sectors, civil society,
financiers and academia will be gathering
for a global summit on food fortification.
This international gathering will be an
opportunity to review successes to date in
tackling hidden hunger, understand the gaps
in fortification programming and agree on
next steps to ensure one of the worlds most
cost effective interventions is delivered to
many more hundreds of millions across
Africa. GAIN hopes to see the milling
community actively participate at this event
as we aim to purge hidden hunger from
Africa.