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The private sector in nutrition - a player by default or choice? Reflections from a multi-stakeholder meeting

By Dr. Charulatha Banerjee on 16 July 2018

I participated in a Round Table organised by South Asia Food and Nutrition Security Initiative SAFANSI In Colombo in June which was titled “Putting the Lens on the Consumer in Nutrition-Sensitive Agriculture and Food Systems in South Asia”.

Before I share highlights from the 2-day event, here is some background on SAFANSI -

SAFANSI, which is now in its second phase, is a multi-donor trust fund administered by the World Bank with the goal to foster cross-cutting actions that will lead to measurable improvements in Food and Nutrition Security. The fund finances activities in any of the countries of the South Asia Region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka) or regional activities, covering two or more South Asian countries. It was perhaps telling of the complexity of achieving good nutrition that the meeting was held in Sri Lanka which always finds mention as an outlier in South Asia – with single digit infant mortality rates and very high literacy rates comparable to developed countries but where nutrition indicators have remained stagnant.

The meeting in June brought together a mixed group of policymakers and programme planners, agriculture and nutrition experts working in public and private sectors, business, donor and civil society organisations. Private sector representation included 2 leading supermarket chains in Sri Lanka and one global company working in food, agriculture, financial and industrial products and services.

Headline nutrition data for South Asia, provided the backdrop to the discussion. South Asia:

  1. Is home to 40% of the world’s stunted and 50% of the world’s wasted children and with only 1 in 5 children (under 5) in this region eating a minimally acceptable diet.
  2. Has seen improved economic development and widespread presence of food and nutrition security programmes, but these have not always led to improved nutrition outcomes
  3. Is experiencing rapid urbanization with very poor living conditions in poor urban settlements. Food consumption patterns in urban environments are now very different to those in rural areas
  4. Has a growing private sector which is marketing aggressively to consumers (including infants and children), shaping demand for processed, packaged foods including unhealthy foods and beverages. This, coupled with erosion of traditional family structures and support systems, and loss of traditional food habits, can be seen to be one of the causes for very poor dietary diversity in children.
  5. Is predicted to be impacted by climate change where studies show a likely decrease in food production and increase in food prices
  6. Is showing a trend towards increasing consumption of non-cereal foods across wealth quintiles and simultaneously consumption of foods high in sugar, salt and fat (data from India and Bangladesh).

The June meeting looked at various aspects of the food system and interactions between the different actors with some examples of work from the participating countries. The discussions over 2 days aimed to answer a few key questions:

What are governments in South Asia doing to ensure safe and nutritious food for their populations?

What is the role of the private sector in these countries as a prominent player in the Food system?

  1. Bringing on board small and medium sized enterprises rather than limiting membership to large corporate houses.
  2. Having a clear well-crafted strategy in place which allows all players to understand their roles and to manage expectations
  3. Identifying focus themes – e.g. the Pakistan SBN priorities included – Food fortification, BCC strategy and, complementary feeding.
  1. The Corporate Social Responsibility Law in India which mandates all companies of a certain size to invest a share of their profits in developmental activities in the country. Learn more about this from this interview.
  2. The SAFANSI Milk Fortification Project in India is a good example of Public Private partnership involving The World Bank, The National Dairy Development Board, FSSAI and Tata Trusts which is a philanthropic trust set up by one of India’s oldest industrial families aims to fortify 2 million metric tonnes of milk and reach 30 million consumers by the end of 2 years. The implementing Agencies are Dairy Federations, Producer Companies and Milk Unions and currently 13 projects are in place with 14 more approved proposals to be implemented very soon.

SAFANSI meetingJune18

How can consumer behaviour be modified?

This will have to be influenced on the basis of local context and lived realities of families and households vulnerable to malnutrition. As more women work outside of the home, increasing spending power is gained at the household level but it does not necessarily translate into access to the correct information regarding safe and nutritious foods for children in the household.  The South Asia region has the lowest consumption of animal source foods by infants and young children, even in countries where meat is not taboo. Price plays a major role and so ways and means to make these first-class proteins available to growing children must be devised.

Special mention must be made of a session which presented the research on biofortification from Bangladesh and India and the challenges around it. Bangladesh has been one of the first countries in the region to have embraced this new technology and is currently in the middle of upscaling cultivation and commercial production of Zn fortified rice, Zinc and Iron Fortified Lentils, Vitamin A rich Sweet Potato and Zinc fortified wheat. Zinc Fortified Rice is now available widely across the country in 62 districts through a network involving Government distribution channels, NGOs and Private sector companies. Similar research in India on Iron fortification of Pearl millet. ENN published an article on Biofortification which might interest readers who would like more information. Bio fortified produce like post-harvest fortified staples needs to be mainstreamed through Public distribution systems.

Final thoughts…

This meeting covered a lot of ground and did well to bring multiple stakeholders to the table.  

With hindsight there may have been one missed opportunity though. Let me explain-

All countries in the region are signed up to the International Code of Marketing of Breast milk substitutes and have their own legislations and guidelines to implement the code. This has been achieved through many years of hard work of professionals, social workers and activists. Breastfeeding is a practice which needs the unstinting and vociferous support of all powers and which has strong scientific evidence backing its importance. Despite this, there has been consistent (and sadly) successful undermining of breast feeding practices by Formula Milk manufacturers. This, more than anything else, has constrained collaboration with the private sector when it comes to Nutrition. But, as demonstrated above, there are many ways in which the private sector can collaborate successfully with the public health and nutrition agenda.  I would therefore have liked to see an unequivocal statement from all present at the meeting that there is consensus and commitment from private sector, Governments and other stakeholders to abide by the Code and in doing so committing to protecting infants and young children.

This seems now even more important keeping in mind the recent attempts by the USA to block a resolution on IYCF at the World Health Assembly held in Geneva.

This meeting gave me an opportunity to hear a wide range of perspective but 2 statements from prominent actors in nutrition still ring in my ear – “Profit is not bad- exploitation is” and “Profit must be legitimate and equitable”. To enable this it is clear that partnerships must be forged across sectors and that all actors must be brought to the table for dialogue but with no compromise on rights of infants and young children.  

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