Harnessing the power of the private sector to fight a growing ‘double burden’
A health volunteer explains how to use a growth monitoring chart to a mother in Rwanda. What role can the private sector play in finding a sustainable, widespread and lasting solution to the growing “double burden” of stunting and undernourishment, and obesity and diabetes? Photo by: Juozas Cernius / Global Communities / USAID / CC BY-NC-ND
The most recent statistics on child malnutrition are bleak: Nearly half of the deaths of children under the age of 5 in Africa and Asia can be attributed to this preventable condition, according to UNICEF. That translates to approximately 3 million unnecessary deaths each year.
Of those who do survive, malnutrition cuts to the core of the child’s development, permanently impacting both their cognitive and physical capabilities later in life. This year’s World Health Day theme is diabetes. Although at first glance, it may seem that malnutrition, obesity and diabetes have little in common, in many cases they are linked.
Ensuring that the fetus, and then the child, receive adequate nutrition for the first 1,000 days, starting from conception, is proven to be a particularly critical window: Nutritional deficiencies during this time put children at risk for not only stunting, but also obesity and diabetes later in life, compared to children who received adequate nutrition.
It’s no surprise then that developing countries are increasingly struggling to fight a growing “double burden,” both of stunting and undernourishment on one hand, and obesity and diabetes on the other.
It’s also an example of a problem for which working closely with the private sector is critical if we are to find a sustainable, widespread and lasting solution. Devex spoke to a number of organizations and companies working to fight global malnutrition to see what the private sector is doing well, where companies can go wrong, and how their roles can be expanded.
No solution to global malnutrition without the private sector
Most Sustainable Development Goals will require partnerships between the public and private sectors and civil society, if we are to achieve them. But when it comes to SDG 2.2 — ending all forms of malnutrition by 2030 — success or failure hinges on effective partnerships. And because of scale and the nature of the problem of malnutrition, the private sector — particularly companies that make, market and sell food to consumers at the base of the pyramid — have a critical role to play.
“The private sector has a deep expertise in how to create systems to ensure a high quality of food throughout the value chain,” said Shawn Baker, director of the nutrition team at the Bill & Melinda Gates Foundation. “So as private sector companies — both small and medium-sized enterprises — start bringing their expertise to solving bottlenecks, that can have a huge impact on improving the overall nutritional value of the food system.”
Companies also have the potential to do a great deal of unintentional harm: For example, by aggressively marketing so-called nutritional products to families with infants and toddlers that do not actually meet the specific nutritional needs of infants and young children and help prevent stunting.
The most extreme example of companies doing harm is inappropriate marketing of infant formula — also known as breast milk substitutes. Because of concerns that infant formula was preventing new mothers from breast-feeding, 194 countries adopted the International Code for the Marketing of Breastmilk Substitutes at the World Health Assembly in 1981 to limit the marketing and promotion of infant formula to new mothers in hospitals and other health care settings. However, there are still routine violations of the international code, according to Baker.
In order to avoid such harmful practices in the future, it is vital that companies creating and distributing nutritional products for pregnant women and children work closely with organizations that have the technical knowledge — including the World Food Program, the Food and Agricultural Organization, the World Health Organization and the Global Alliance for Improved Nutrition, among others — and with governments to create responsible, nutritious products, advertise them accurately, and ensure they reach those who need them most.
“One really critical component of effective partnerships around the issue of malnutrition is to ensure a harmonization of messages across all sectors, so new mothers are getting accurate and consistent information,” said Dominic Schofield, senior technical adviser and president of GAIN in Canada. “We have a powerful means to end malnutrition when we combine private sector consumer insights on what motivates consumers, with nonprofit sector and government channels of delivery.”
How to leverage CSR initiatives
Done right, corporate social responsibility initiatives can be powerful tools in the fight against malnutrition.
One example is the Amway Nutrilite Power of 5 Campaign, which aims to fight child malnutrition among children under the age of 5. Amway created a product — Nutrilite Little Bits sachets — that contains 15 key micronutrients necessary to prevent undernutrition and stunting. Knowing that their products were not always accessible to the families that needed them, they partnered with local nongovernmental organizations such as CARE, that already had relationships with the people they were hoping to reach to distribute the sachets to their intended recipients.
The campaign is now active in 14 different countries and is supporting 8,000 children. By the end of this year, Amway aims to reach more than half-a-million children, and intends to exponentially increase its reach each year thereafter up until 2019.
“Addressing malnutrition is a complex and hard road, and if we can create partnerships that bring together different complementary assets — that is where we can begin to see scale that we can sustain.”
— Dominic Schofield, senior technical adviser and president of GAIN in Canada
“CSR for Amway is an extension of our core competency and business,” explained Jeff Terry, head of global CSR at Amway Corp.
Because Amway doesn’t necessarily have access to all the families that might need the supplement, it made sense to partner with NGOs.
“They have core competencies that we don’t have — they have the built relationships on the ground, and already have the trust with the families. That’s needed,” he said. “Our support comes in by ensuring that they have the resources necessary to take care of these kids and these families, the products they need and the educational component.”
According to Terry, this is one of the advantages of addressing child malnutrition through CSR, rather than directly through the business.
“It allows us to test different approaches and models to see what works best,” he said. “Then, when we hit on one that works, we can take it to scale.”
Terry believes that Amway’s long-term commitment to the project is a critical component to the campaign’s large-scale success: Launched in 2009, Amway invested in the Power of 5 Campaign as a long-term strategy, with goals beyond 2019.
And although Amway’s campaign is a CSR initiative, Terry believes that it will end up benefiting the company financially in the long run.
“It goes beyond brand loyalty — we are creating new markets. The project is also helping to inform our future business opportunities, improve society, and ensure that our business is developing in the right way,” he said. “I truly believe that this is an approach more companies need to take — incorporating CSR into their core business strategies.”
Beyond food fortification
The large-scale fortification of food products such as cereal flours, cooking oil and salt with vital micronutrients, is perhaps one of the most effective proven strategies that many companies use to address malnutrition, according to Baker.
“Food fortification works because it’s built directly into the company’s core business,” he said. “So it’s very easy for them to incorporate and market fortified products.”
But there is so much more that companies — even those that do not work directly with producing or marketing food products — can do.
Schofield sees a lot of untapped potential that he’d like to see more private sector players unlock.
“I think that the best way to start is an asset-based approach — what are you strong in? Is it a niche market, or a product, or in services? Once you identify your unique strength, how can that be leveraged?” said Schofield. “Addressing malnutrition is a complex and hard road, and if we can create partnerships that bring together different complementary assets — that is where we can begin to see scale that we can sustain.”
As a good example of how companies outside of food manufacturing and production can contribute to fighting malnutrition, Schofield points to one successful public-private partnership between GAIN and mobile media and communications specialist Thumbtribe in South Africa, in which GAIN sent quizzes over text message about important health topics promoted by the South African government — including malnutrition. Those who answered correctly were rewarded with free talk time. The strategy allowed them not only to distribute accurate health information, but also to target and track where the messages were being received, and in which areas more public education was necessary.
Dr. Martin Bloem, senior nutrition adviser at the World Food Program, has seen successful partnerships in which private sector companies loan technical expertise and in-kind services to international organizations in order to formulate nutritious health supplements to give to babies and new mothers.
There are areas that still need more work, however: Given that more and more international organizations give out cash aid rather than food aid, Bloem wants to see the private sector more involved in developing markets, and selling high-quality complementary food products to the consumers at the base of the pyramid in developing countries.
“This is an area that’s often ignored — but it’s critical to addressing large-scale malnutrition,” he said, adding that in the absence of formal markets, small-scale entrepreneurs from the same communities often end up selling food and water products that are substandard. This, he said, sometimes even leads to disease, in addition to contributing to malnutrition.
In reality, there are many entry points for businesses that want to join the fight against malnutrition.
“It’s such a large-scale problem,” explained Terry. “There are so many ways that private companies can get involved. It’s just a matter of taking on one small piece of the problem, and dedicating resources to solving that part. As more and more companies do that, that’s when we’re going to start really seeing results.”
What role do you think the private sector should play in fighting malnutrition? Have your say by adding a comment below.