Food Quality, a Critical Issue Saskia de Pee, Tina van den Briel, Martin Bloem World Food Programme, Rome, Italy

Financial times 25/2/08: High food prices may force aid rationing. WFP warns it considers rationing aid in the face of dramatically rising food prices. Commodity costs have gone up by 40% since mid 2007, due to –Rising oil and energy prices, affecting the entire food chain –Economic boom in countries such as China and India drives up demand –Bad harvests due to climate and weather changes –Competition between food and fuel (food at fuel prices) Riots taking place over food prices in several countries The quality of the diet of the poor will suffer increasingly Needs of WFP beneficiaries increase and number of people needing food assistance increases

Thus, Poverty is one of the key determinants of malnutrition Price of staple food is key determinant of malnutrition rates at population level through indirect effect on non-grain food expenditure (i.e. quality food) of households But, lower price of staples is not enough to reach MDG-goals, interventions are needed to improve quality of food consumed by these populations Dramatic increase of price of staple foods seen over past 8 months will result in increase of malnutrition rates across the world

% WFP FOOD FORTIFIED % MICRONUTRIENT NEEDS MET FORTIFICATION Specially formulated, fortified foods Micronutrient Powder Fortified Blended Foods General Food Basket Cereals, Pulses, Legumes, FBF, Vegetable Oil, Salt WFP Nutrition Strategy FEEDING BETTER FOOD… DSM is playing a critical strategic role in enabling WFP to launch the strategy at the global level. + micronutrients

Challenges Whole grains (wheat, rice) Local purchasing (capacity and practice of processing industry) Tendering system

Distinguishing different forms of malnutrition among young children Kind of malnutritionCause and among whom SAMSerious food/nutrition insecurity often combined with morbidity Underweight, at risk of becoming SAM - Underwt due to wasting related to shortage of food, continued lack of food main risk, as well as morbidity - Underwt due to stunting, morbidity main risk factor >=24 mo, stunted underweight children, MND widely prevalent Inadequate quality of food, i.e. few animal source and fortified foods, after 24 mo, focus on alleviating MND 6-23 mo, high risk of growth faltering, moribidity, MND Older infants and young children just introduced to poor quality complementary foods

Solutions needed for different forms malnutrition among young children Kind of malnutritionSolution available / required SAMRUTF, F100, F75 (cases with complications) Underweight, at risk of becoming SAM - Underwt (wasting) due to food shortage, requires energy and MN dense CF/CFS/RUSF (MN, milk and EFA’s esp. important for 6-23 mo, >=24 mo energy & MN) - Underwt due to stunting, morbidity main risk factor, requires MN’s Stunted underweight children, MND widely prevalent 24-mo and older, requires MN’s. In case of food insecurity, FBFs with good MN profile. Avoid much weight gain. High risk of growth faltering, moribidity, MND 6-23 mo, need to make up for nutrients lacking in a diet with few ASF and fortified foods, i.e. CF or CFS (milk, EFA’s, MN)

Joint Statement WHO/UNICEF/WFP: Community-based management of severe malnutrition WFP, Internal and External Communication

Fortified Blended Foods (CSB, WSB) One of the few foods provided in processed form and therefore fortified –Increases weight (for supplementary feeding young children receive it mixed with oil and sugar) –Good protein profile, but no impact on linear growth –High fiber content –Consumption does not reduce anemia, due to low bioavailability of minerals Therefore, focus on improvements –Dehulling to reduce fiber content –Improving MN specs –Better specification of appropriate target groups –Assess impact of mixing with milk powder for specific groups

Joint Statement WHO/UNICEF/WFP: Preventing and controlling micronutrient deficiencies in populations affected by an emergency

Micronutrient Powder To increase MN intake of specific target groups: –Underfives that consume too little staple foods –Pregnant and lactating women (PLW) –Entire families when food is consumed from shared plate –Institutional feeding –Where general food fortification is not available Issues: –Malaria-endemic areas –Provision of other fortified commodities (oil with VA, iodized salt) –Existing interventions for PLW –New commodity, needs explanation

Moderately wasted children and at-risk group of 6-23 mo old children Awaiting outcome of WHO MM meeting, but meanwhile Developing RUSF in India Developing improved CSB with milk/whey powder Both to be compared with regard to impact on linear growth and MN status to –Plumpy Doz, among moderately wasted children –Nutributter among 6-23 mo old children

Note on costs of production (excl transport and distribution) RUTF: 3 USD/kg, i.e. 40 USD/child, needs donating CSB: 0.3 USD/kg, but limited impact CF or CFS with g milk powder/100g: 2.5 USD/kg, but needs are lower, at g/d costs are USD/d MNP: USD/dose, 180/yr=0.008 USD/d

Private sector involvement

WFP and Public-Private Partnerships Private Sector Partners, contribute –Expertise (QA, QC, MN specs, packaging) –CB of local processing industry –Support for programmatic research and pilots –Enhancing capacity of WFP DSM, GAIN, Unilever, Kemin, TNT

How Public and Private Sector in Development Facilitate WFP’s work Increased availability of fortified foods facilitates WFP purchasing and obtaining quality products Where good CF, CFS, MNP are already available and known to the population, their purchasing and distribution by WFP to specific groups will be greatly facilitated

Towards a nutritious meal for all Thank You