Commercial pathway to addressing malnutrition?

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How the Rural Resilience Activity team in Nigeria are addressing this

May 6, 2023, 4:37 p.m.

Isidro Navarro Paya

Dear John, When discussing about malnutrition we have to bear in mind that inadequate food intake is not the only reason for malnutrition. Looking to the UNICEF Conceptual framework for malnutrition we see that poor hygiene, inadequate access to health care and potable water as well as inadequate childcare/ negligence also contribute to making children malnourished. Therefore, our work has to be based on a comprehensive analysis of the causes of malnutrition to come up with an intervention that successfully addresses those causes. The solution can be rich nutrient foods, but it may also be improved hygiene/sanitation or simply that parents have the time to take care of their children instead of being always working far from them. Regarding the participation of the private sector when I was in Southeast Asia there were many companies selling products fortified with micro-nutrients (e.g., iron fortified sauce, iodized salt, instant noodles with a micro-nutrients sachet, etc). If I remember properly Vietnam had a government policy on this that some humanitarian actors were advocating for neighbouring countries to replicate so that the private sector would play an active role in this issue. Maybe this could be part of the solution? Kindly Isidro

May 4, 2023, 9:19 a.m.

John Rachkara

Well-nourished people are resilient people, but there is no straitjacket to address malnutrition. When aiming to shoot into the moon, please don’t say it is so far. Try, aim high, and shoot. If you miss, you may land on one of the stars. This is what the Rural Resilience Activity team is up for and trying. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 37%, or 6 million children are stunted (chronically malnourished or low height for age), more than half of them severely. In addition, 18% of children suffer from wasting (acutely malnourished or low weight for height), half of them severely. 29% of children are underweight (acutely and chronically malnourished or low weight for age), and almost half are severe. We have always questioned whether and how we could challenge malnutrition with a disruptive business model that targets the low-income/Bottom of pyramid market with nutrition-dense foods. We didn’t know if the private sector would be interested in investing or whether we had enough evidence to convince them. With insufficient data, it took us months to convince ourselves/team members to try. We took the pitch to several food companies, hoping they could be convinced and take up the challenge. In one of our internal debates, one team member said, “The reason why people get malnourished is because they can’t afford some foods, and now you want to target the same malnourished persons with commercial products?” The room went silent for a while, but there was no need to agree/disagree. The question is, is there a case for the private sector companies? Fast forward, three companies agreed to collaborate with us. Two of three companies are hitting the market with 2,000,000 packs of nutrition-enhanced products, mainly designed for poor/low-income/malnourished households. The products cost between 50 – 500 naira (USD$0.11 – 1.1) and can feed an individual and a family of 5 persons per day, respectively. The products are manufactured with malnutrition cases in mind. In between the supply chains, several youths and women have found an opportunity to sell the products and earn through commissions. They don’t need to worry about working capital. Malnutrition is being prevented rather than waiting to be cured through RUTF and other means. 300,000 packs have been sold within a month, and the demand is growing daily. We have not even paid for anything. It is a win-win-win. While we haven’t yet reached a tipping point, there are certain things we are learning. First, even under extreme conditions, impoverished people use markets and are convinced that markets offer vital solutions to almost any problem. Secondly, under all circumstances, a potential sweet spot could generate viable, sustainable, scalable business activities that create jobs, grow income, or guarantee access to vital services. Three, there are commercial pathways to solving the malnutrition equation, even among the ultra-poor. The core role is for facilitators to identify a suitable business case/model. In this case, the private sector players did not know the potential customers. While they already had the products, they did not see the business model that could make and deliver to these customers in an affordable and valuable manner. We are observing and learning. If we reach a tipping point, supporting these first movers to mobilize investment for scale would be justifiable. We will also share what we are learning with other food manufacturers. This could be one of the many ways of overcoming malnutrition in crisis-affected markets like Northeast Nigeria. While we are in the early days, we think this can go a long way. Happy to learn from the experience of others