Ethiopia loses 55.5 billion birr annually to malnutrition
Industries warned of an increase in the price of wheat flour and edible oil as a result of a new rule that made fortification of the two commodities mandatory.
The National Standard Council passed the mandatory fortification of basic foods, six years after the proposal was tabled but delayed due to a lack of consensus among members of the Council of Ministers. The new law reversed the voluntary law enacted before.
Wheat flour and edible oil are selected as vehicles to carry micronutrients. Wheat flour is required to contain vitamins B1, 2, 3, 6, 9, folic acid, and zinc. Edible oil will be fortified with Vitamin A and D.
Beginning July 10, 2022, the Ministry of Industry started enforcing the new law on edible oil and wheat flour processors. The Council gave a one-year grace period for the industry before taking measures on those who sell unfortified flour and edible oil.
Following the addition of the micronutrients, which are called premixes, the price of edible oil and wheat flour is expected to see a slight increase. The additional costs of fortification are expected to be transferred onto consumers.
The cost per kilo of fortified wheat flour is about 0.24 to 0.30 birr, while the cost per liter of fortified edible oil is about 0.20 to 0.80 birr.
Fortificants and laboratory reagents are exempt from duty tax. A one-birr investment in fortifying wheat flour with folic acid and zinc would yield a 13-birr gain, while a one-birr investment in fortifying edible oil with Vitamin A would yield a 2.75-birr gain. A two birr investment in wheat flour and edible oil fortification would have a return on investment value of 15.75 birr, according to a study by the Ministry of Health.
One of the measures taken was the voluntary standard for food fortification enforced in 2017. However, assessments conducted to industries both in wheat flour milling and edible oil producing industries showed that voluntary fortification is not implemented.
“Based on this learning experience, the government has currently approved the mandatory food fortification standard. Hence, Ethiopia has currently put in place the necessary enabling policy environment for improving the supply of fortified food. Food fortification is a low cost and high return on investment,” said Sisay Sinamo, (MD, MPH, PhD), senior program manager at the federal program delivery unit for the Seqota Declaration, which aims to end stunting by 2030. Despite a drop in the stunt rate from 58 to 37 percent over the course of the study, the figure increased in real terms.
Though most African countries have mandatory food fortification, Ethiopia had mandatory fortification only for iodized salt.
The council reversed the existing voluntary fortification after studies by the Ethiopian Public Health Institute (EPHI) and the Addis Ababa University nutrition center revealed the exacerbating prevalence rates of malnutrition, according to Aynaddis Tamene (PhD), food science and nutrition lecturer at AAU and member of the national committee on fortification standards.
The technical committee is comprised of research institutions (EAIR, EPHI, and FBPIDI), AAU, industries and producers, Consumer Protection Authorities, Ethiopian Conformity Assessment, FDA, and others. The Ethiopian Standard Institute (ESI) is secretary and host of the committee.
“The mandatory fortification of wheat and edible oil should have been done at least six years ago. The current ministers have a better understanding of the severity of malnutrition,” said Aynaddis.
Ethiopia ratified the National Food and Nutrition Strategy last year, which covers the period between 2021 and 2031.
Industries are willing and in preparation to install the new equipment required to mix the micronutrients with edible oil and wheat flour, according to Abel Ahmed, food fortification advisor at the Food and Beverage Industry Research and Development Center and coordinator for the implementation of the mandatory fortification laws. Once the grace period of one year is over, small-scale processors of edible oil and wheat flour factories cannot directly sell to consumers but must supply to large-scale industries that have the mixing equipment.
According to the studies, 40 percent of the society can access wheat flour, while 57 percent can access edible oil.
This means the mandatory fortification of wheat flour can reach 47 million people (40 percent) and, through edible oil fortification, 79 million people (57 percent), based on the EPHI study. The rest of the society is expected to access the micronutrients through bio-fortification and food diversification.
Ethiopia loses 55.5 billion birr annually to malnutrition, according to Abel, due to medical expenses for threats like malnutrition deficiency diseases, school dropouts, and overall human productivity in the economy.