Post-2015 Consensus: Food Security and Nutrition Viewpoint, Spohrer
Writing on behalf of Global Alliance for Improved Nutrition, Rebecca Spohrer welcomes the argument by Horton and Hoddinott that reducing stunting is not only a more meaningful target than underweight, but also extremely cost-effective. However stunting is just the tip of the iceberg of the overall problem, with an estimated two billion people in total suffering from under-nutrition. This is often correctly referred to as ‘hidden hunger’. For example, iodine deficiency only results in visible symptoms in a small proportion of sufferers, but leads typically to an IQ reduction of 10-15 points. In her view, there is also a strong case to be made for micronutrient interventions since, for example, anaemia resulting from iron, folate and Vitamin B12 deficiencies is an important cause of low birth weight.
Various approaches can be taken, but food fortification –the addition of small amounts of micronutrients to staple foods such as flour, vegetable oil, or salt – is a stand-out in terms of cost-effectiveness. The additional costs to fortify foods such as wheat flour and vegetable oil vary, but are usually less than a fraction of 1 percent more than the non-fortified food. The cost-benefit ratio is outstanding. For example, a study in Chile found that every dollar spent on adding folic acid to flour saved $12 in treatment and care of children born with spina bifida. Some have estimated that under-nutrition can lower GDP by as much as 12%. While food fortification is not a standalone tool — dietary diversity and affordable access to nutritious foods both remain crucial in the fight against malnutrition — it is a powerful tool enabling schoolchildren to achieve their academic potential, preparing mothers for healthy pregnancies and fighting disease.