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Reducing Vitamin and Mineral Deficiencies in AsiaJoseph Michael Hunt (jhunt@adb.org)
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 Correcting the iodine, vitamin A, and iron deficiencies in Asia and the Pacific could improve the population-wide IQ by 10–15 points and decrease infant and childhood mortality by 40 percent. (Photograph by Ian Gill) |
Ways to improve public and private sector partnerships in reducing mineral and vitamin deficiencies in Asia and the Pacific were discussed at a forum on food fortification policy held at the Asian Development Bank (ADB) headquarters in Manila in early 2000. The meeting was cosponsored by the Micronutrient Initiative and the International Life Sciences Institute.
Teams from the People’s Republic of China (PRC), Fiji Islands, India, Indonesia, Kyrgyz Republic, Philippines, Thailand, and Viet Nam attended, represented by captains of the food industry and government health and food officials. The United Nations and other international organizations, including the World Trade Organization, and the Asian consumers’ movement were also represented.
In Asia today, well over a billion people lack the essential minerals and vitamins needed for healthy physical growth and mental development. Three out of four of the world’s micronutrient deficient persons live in the region.
Only tiny amounts of micronutrients are needed for normal human development and people in developed countries obtain what they need through enriched diets or supplements provided mostly by the private sector. For example, iodine deficiency, which causes mental retardation, is being gradually eliminated through national salt iodization programs.
In Asia and the Pacific, there are also widespread deficiencies in vitamin A, iron, zinc, folic acid, and fluoride. Most serious is the lack of iron, which causes anemia in 60 percent of pregnant women, 50 percent of reproductive-age women and infants, and 40 percent of school-age children. The cost of malnutrition in terms of health care, wasted education, loss of work, lower productivity, and wages can run higher than 5 percent of gross domestic product in developing countries.
Eliminating these deficiencies is extremely cost-effective. It is estimated that correcting the iodine, vitamin A, and iron deficiencies could improve the population-wide IQ by 10–15 points, reduce maternal deaths by one third, decrease infant and childhood mortality by 40 percent, and increase work capacity by almost half. Improved nutrition is essential for sustained economic growth.
The objective of the Forum was to reach an agreement on a regional strategy to establish fortified foods as standards for a range of staple foods widely consumed by the poor. These include salt, flour, oils, infant foods, condiments, sugar, and dairy products. This would make micronutrients readily available to those who need them most at least cost. The programs are self-sustaining because, after research and testing, fortification adds little to the retail cost.
Health and nutrition experts discussed ways to deliver micronutrients to large populations by using the resources of the private and public sectors. The country teams and the sponsors reached an agreement on priority actions at the national and regional levels. The Forum recommended action plans to expand food fortification and define the role of donor organizations and public-private collaboration in achieving this at the national and regional levels.
National priorities include establishing communication approaches to create demand for fortified staples among the poor, creating a fair and transparent regulatory environment for industry, and developing tax and tariff incentives for major food producers to make possible industrywide shifts toward universal fortification of essential staples consumed by the poor.
Regional priorities include harmonization of standards, regulations, and guidelines to promote fortified food production, marketing and trade, and establishing centers of excellence for food science, food safety research, and monitoring health of populations.
The results will go toward an ADB regional technical assistance project to develop detailed national plans in selected countries for donor financing and private sector investment. The regional project will also address transfer of food technology, regulation and trade environments, and the food and nutrition needs of infants. ADB will organize an investment round table in 2001 to target mobilized resources for eliminating micronutrient malnutrition. Leading donors, international financial institutions, and foundations will be invited to support the countries’ 10-year investment plans to eliminate the problem.
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