Inclusive business and food fortification: opportunities and challenges in Bangladesh

When we sat with DFID Bangladesh last year to discuss the Business Innovation Facility country strategy, we agreed to see whether BIF could support any companies that are interested in producing fortified food products.

Fortification is the addition of micro-nutrients to foods to increase the intake of one or more nutrients that are inadequate in the food supply, and fortified foods are either raw ingredients (eg rice, milk or salt) or processed products that already have market presence (eg biscuits, flavourings or sauces). The purpose of fortifying food can be to restore the nutrients lost during food processing, to increase the level of a nutrient above that normally found in the food, or to add nutrients that are not normally present in a food which is nevertheless a good vehicle for delivering micronutrients to the consumer.

There is a growing awareness that addressing poor nutrition is both a vital, but also very smart, way for donors and other to assist countries with their development. As the World Food Programme say in their brochure ‘Right Food at the Right Time’: ‘the battle against child undernutrition is urgent and winnable. There is a window of opportunity from conception to two years old when good nutrition can make all the difference. We need to build and nourish the next generation.’

Working with companies in the food industry would appear to be a powerful way to take the fortification agenda forward, either to ensure that there is a supply of high quality fortified food for public procurement, or to make them a part of their commercial offering direct to consumers. This latter approach – which is the ‘inclusive business’ method – could be a scalable and sustainable contribution to the fight against under-nutrition.

Steve Godfrey from GAIN, in his recent blog on the new ‘nutrition zone’ on Business Fights Poverty, summarises the case:

‘The lowest income consumer groups, often called the base of the pyramid (BoP) have less than a few dollars to spend every day. Despite the limited financial resources, these populations don’t want to live off handouts or relief. They want to manage for themselves– but lack access to high quality, affordable products. Tapping into this market is challenging, but when done right it is an effective and sustainable approach to tackling malnutrition.’

In Bangladesh the Business Innovation Facility has three potential food fortification projects in the pipeline, and we hope to be able to share more details of these soon. However these companies will face a number of challenges.

Firstly, there are significant concerns in Bangladesh about private companies selling fortified food products to infants. For complementary food products (for babies under the age of two) the sentiments against business engagement can be particularly strong.

For example, a recent publication on bdnews24.com starts as follows:

‘As Bangladesh is gearing up to launch a strong fight against malnutrition with natural and locally available solutions, experts say a 'new threat' is coming to infant feeding and nutrition. They say various international agencies and global manufacturers are out to promote this new threat -ready-to-use-therapeutic-food (RUTF)-in Bangladesh given the high prevalence of malnutrition among children.
Faced with outright rejection in many countries, the promoters have eyed Bangladesh as a potential market, but the experts say this food cannot be an alternative to breastfeeding and homemade food given to the children for their proper growth.’ (No to 'ready-to-use therapeutic food', bdnews24.com, Tue, May 1st, 2012)

Ready to use therapeutic food is a form of fortified food that does not require mixing and is therefore easy to distribute and use, and can avoid some of the problems that can arise when foods have to be mixed with contaminated water. The article goes on to quote a senior health official talking about the experience with a RUTF in India. He says: ‘They drove away the company back to their home', implying that Bangladesh would do the same with a company that tried to enter this market.

This emotive language arises because the context to these remarks was the experience with breast-milk substitutes. Companies are perceived to be undermining breast feeding by selling powdered milk. However these kinds of comments cause confusion when fortified food products, rather than breast milk substitutes, are aimed at children less than 2 years old (and even older children) - even when the research data shows that these fortified foods are extremely beneficial.

Another challenge is strongly linked to this issue. Companies are not allowed to promote any food products that are primarily aimed at children under the age of two in Bangladesh.

A third challenge is that some fortified food products are not yet recognised by the authorities. Lipid-based nutrient supplements (LNS) are a family of products designed to deliver nutrients to vulnerable people. They are considered “lipid-based” because the majority of the energy provided by these products is from lipids (fats). Some LNS fall into the RUTF category, but others have much less energy content and are served in small doses to add a full complement of micronutrients. Are these, some people wonder, actually an over the counter pharmaceutical rather than a food? Of course this could have huge implications on the safety and testing regime required for the product to be registered by the authorities.

We in BIF are happy that we have been able to follow through on our country strategy in Bangladesh in respect of inclusive business opportunities that can strengthen poor people’s access to fortified food. However we are also learning fast about some of the challenges that these companies face. I hope to be able to report back later in the year with an update on how some of these companies are addressing these challenges.