Opinion: Fighting hidden hunger with data

Photo by: GFDx Core Group

This piece was written jointly by members of the Global Fortification Data Exchange core group. Lawrence Haddad is the executive director of GAIN; Scott J. Montgomery is director of the Food Fortification Initiative; Dr. Jonathan Gorstein is executive director of the Iodine Global Network; and Homero Martinez is senior advisor to the Micronutrient Forum Secretariat.

What do blindness, stunted growth, and brain damage in children all have in common? They can all be caused by a form of malnutrition that is largely invisible and nearly entirely preventable — micronutrient deficiency, also known as hidden hunger.

Deficiency of essential vitamins and minerals such as vitamin A, iron, folic acid, and iodine can have devastating effects. While these nutrients are only needed in very small amounts, they are essential for normal growth and optimal health. Deficiency can prevent an expectant mother from carrying to term or cause a child to endure irreversible brain damage and thereby limit his or her ability to learn, earn a living, or live a healthy life. These debilitating consequences damage whole communities, as well as economies.

Past estimates from the World Health Organization indicate that millions of people may be at risk of iodine deficiency, and 2.8 million people die annually from iron, vitamin A, or zinc deficiency.

“Access to data on food fortification can enable data-driven policy and programming decisions that will affect the health and well-being of populations.”

— GFDx Core group

One simple, safe, effective, and inexpensive solution is food fortification. Adding minerals and vitamins to staple foods and condiments has led to a dramatic decline in hidden hunger globally. Even so, millions of people worldwide remain vulnerable, with children and pregnant women in low-income countries disproportionately affected.

For those working to combat hidden hunger with food fortification, a new global data tool sheds light on the status of national food fortification programs, and provides data to guide informed actions toward achieving optimal micronutrient intake through food fortification.

An effective solution in need of a roadmap

GFDx: Delivering on a shared commitment to data

The GFDx emerged out of a consensus on the critical need for more and better data on food fortification to end hidden hunger. At the first Global Summit on Food Fortification — held in Arusha, Tanzania, in 2015 — leaders agreed that it was critical to improve access to data. They made a collective commitment, captured in the 2015 Arusha Statement on Food Fortification.

Following that dialogue, the Food Fortification Initiative, Global Alliance for Improved Nutrition, Iodine Global Network, and Micronutrient Forum, established the GFDx as a global hub for micronutrient food fortification data. Each group acts as a steward of global micronutrient fortification data. Brought together in the GFDx, their data will drive evidence-based change in policy and action against hidden hunger.

The Global Fortification Data Exchange, or GFDx, launched on Sept. 6, 2017, presents data from more than 230 countries and territories for the five most commonly fortified staple foods and condiments: wheat flour, maize flour, rice, edible oils, and salt.

As fortification uses existing supply chains and provides micronutrients through the foods people eat already, it offers a way to affordably reach broad segments of the population. Many countries have nearly eliminated nutrition-related diseases such as goiter and rickets as a direct result of effective food fortification.

Micronutrient-deficiency control interventions, including food fortification, are among the most cost-effective global development investments, according to the Copenhagen Consensus, with a cost benefit ratio of roughly 1:30. By preventing undernutrition, fortification can save national economies of an estimated 2-3 percent of gross domestic product.

While food fortification has tremendous potential to significantly improve nutrition, coverage of this proven intervention is highly variable throughout the world. In many countries, progress has stalled due to a lack of investment and political will, low adherence to mandatory policies and standards, and insufficient data. Today, some of the most undernourished households have no access to fortified foods.

Harvesting data for nutrition

The GFDx presents a common set of indicators across multiple fortified foods at a global scale using novel interactive maps and charts. It houses data on food fortification legislation from 1942 to the present, available regulatory standards, food availability, and intake. Users can compare information and visualizations across geographies and food vehicles.

Stakeholders — including nongovernmental organizations advocating for fortification in a country, national health ministries, and legislative bodies wanting to know which neighboring countries have fortification legislation — can use the GFDx to identify areas of need and opportunities to implement food fortification programs based on experiences in other countries. Access to data on food fortification can enable data-driven policy and programming decisions that will affect the health and well-being of the populations. The GFDx is designed to answer specific and practical questions and project the potential of food fortification to meet nutrient requirements. With multiple visualization options, people can use the GFDx to generate custom maps, charts, and tables within the tool, or to download data for offline analysis.

The path ahead: A call to action for more and better data

At present, the GFDx relies on data from governments, nongovernmental organizations, program implementers, normative agencies, donors, academia, and the private sector. The success of this resource is dependent on the ongoing contribution of data from partner organizations.

Access to a reliable, collaborative resource for tracking fortification efforts around the globe is the first step toward successful policies and programs. By consolidating all available data, the tool exposes data gaps and identifies areas where others in the nutrition community might contribute.

The GFDx is a resource to address, with unprecedented confluence of evidence, one of the most wide-reaching global health problems. Hidden hunger damages communities and the economies of entire nations; it puts expectant mothers at risk, increases mortality and impairs cognitive development of newborns, all of which undermine the efforts to end global poverty. It will take collective, sustained commitment to translate momentum into results to eliminate hidden hunger.

To find out more about your country’s fortification status or to join the conversation around data’s role in fighting hidden hunger, click here.

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