Sara Qamar

Food Fortification in the Midst of Political Turmoil: Can a functioning “nutrient economy” become part of the solution in Egypt?

Political turmoil and related conflicts can dictate the amount and quality of nutrients accessible to everyday people. Coverage of the Arab Spring has brought to light the dire circumstances still faced by many in the Middle East and North Africa (MENA) region. Some activists found success in overthrowing authoritarian governments, but the post-revolution economic improvements for which protesters fought have not been as forthcoming as many had hoped.

In Egypt, the Arab Spring continues with the ousting of President Mohamed Morsi by the military, a move sparked by massive street demonstrations against him. Morsi was the first democratically elected leader since Hosni Mubarak was deposed by protests in 2011. Many of Morsi’s opponents felt the economic situation had only worsened since he came into office in 2012. Though GDP had been in decline before his leadership, they felt he did not do enough to manage the situation. And with inflation having been on the rise and food insecurity worsening, average Egyptians have struggled to balance expenses with the daily task of not further compromising their bread baskets.

So where do nutrients come into the conversation for Egypt moving forward? Can a functioning “nutrient economy” become part of the solution? Rates of malnutrition are around 30 percent and rising in the country. Over the course of events in the past two years, less focus has been put on the riots that broke out across the region in response to rising food prices, which many say may have sparked the Arab Spring movement. In the 2011 demonstrations, protesters often chanted the popular slogan, “Bread, freedom and social justice!” However, with inflation on the rise this year and costs for staple crops and vegetables having increased, the results for at least the first part of that demand were not well met.

A majority of the lower-income population depend on government subsidized baladi bread to make ends meet. Bread is a staple in the Egyptian diet, and the country’s high consumption of it usually helps make Egypt the top wheat importer in the world.

In the past, the loss of access to affordable bread has led to significant social unrest in Egypt, seen in the wide-spread bread riots in 1977 and 2008. Today, the average household spends more than 40 percent of its earnings on food, and that rate rises to more than 50 percent for the poorest households. The under-served often buy less expensive, often less nutritious foods.

The good news is that as a staple in the Egyptian diet, baladi bread is the perfect vehicle for nutrient fortification and an affordable intervention for malnutrition. It helps that fortified baladi bread looks, tastes, and feels just like the original.

“Often people don’t realize that they actually have a micro-nutrient deficiency. It’s the hidden hunger,” said Nada Elhusseiny, an Egypt consultant with Global Alliance for Improved Nutrition (GAIN), which for years has worked with country partners to integrate food fortification programs permanently into national agendas.

“Egypt is no different from a lot of other countries in a similar situation. Sure income levels affect your food basket. What you can afford, depending on how large your family, is directly affected by income,” she said.

GAIN helped implement a nutrient fortification program in Egypt beginning in 2007 after approval by the government. It was a response based on results from several studies by national research and donor organizations. According to GAIN, by 2010 30 percent of the population was consuming wheat flour fortified with iron and folic acid. After the completion of GAIN’s project in 2011, the baladi bread food fortification program became solely government-run. In her interview before Morsi’s ousting, Elhusseiny said that politics in Egypt had not affected the food fortification program. The current status is unclear.

GAIN’s mission appeared to get a boost from Morsi, who added the raising of nutritional value and productivity of bread flour to his list of promises when elected. The trouble is that in the beginning of 2013, the Morsi government allegedly cut back on imports and proposed a bread ration.

Though government subsidized baladi bread now reaches 68 percent of the population, the current system excludes 19 percent of the most vulnerable households due to poor and limited targeting. That may be a contributing factor in increased rates of food insecurity.

According to a WFP report, in 2011 more than 17 percent of Egyptians suffered from food insecurity compared to 14 percent in 2009. The most serious indicator of the rising rate of malnutrition is the prevalence of stunting amongst children under five, which rose from 23 percent in 2005 to 31 percent in 2011, above the WHO “high” range of 30 to 39. But also, according to a Demographic Health Survey, 2010 data for nine governorates across the country suggest rates of anemia in children under five to be over 50 percent.

So though subsidized food does help a portion of the low-income population, the ration system needs a serious update and, alone, is not enough to propel people out of poverty. Between 2009 and 2011, about 15 percent of the population moved into poverty, which is twice the number of those who moved out of it.

Food fortification alone cannot meet protesters’ loaded demand for “bread,” and it certainly cannot solve all the problems that lead protesters to the streets. Policies need to be implemented by the next leaders of Egypt to reverse the trajectory Egypt has been on for several years. Food fortification is, however, a good start in solving cyclical health problems that contribute to conditions of little social mobility. Certainly, it’s better than the alternative: not having a food fortification program at all. The current effort is only the skeletal base of the nutritional initiative which needs to be built upon. If given enough focus, food fortification could help ensure a nutritionally conscious food production process that would aid in wellness and vitality for much of the population.

If you would like to donate to aid in GAIN’s efforts for food fortification, you can check out their public awareness campaign:

Editor’s Note: This post was written by Ashoka contributor and journalist Sara Qamar, and was originally published on the Ashoka Forbes blog.

Agriculture, Health Care