Natia Mgeladze, the IFC Global Lead of Food Safety, Food Loss Prevention, and Food Fortification Advisory Program, speaks with Việt Nam News about strategies for addressing malnutrition in Việt Nam and other countries through the promotion of best food practices and international collaboration initiatives. — VNS Photo Bồ Xuân Hiệp

Malnutrition and micronutrient deficiencies are significant global challenges, particularly in Việt Nam, a major agricultural producer and food exporter to developing countries. These issues not only impact health, human potential, and child development but also lead to significant economic losses in terms of productivity and healthcare expenses annually.

Việt Nam News' reporter Bồ Xuân Hiệp spoke with Natia Mgeladze, the IFC Global Lead of Food Safety, Food Loss Prevention, and Food Fortification Advisory Programme, about strategies for addressing malnutrition in Việt Nam and other countries through the promotion of best food practices and international collaboration initiatives.

What are the implications of micronutrient deficiencies and malnutrition on the health and productivity of individuals in Việt Nam?

Malnutrition, which includes undernutrition (such as stunting and wasting), overnutrition (overweight and obesity), and micronutrient deficiencies (referred to as hidden hunger), are significant global public health challenges.

According to the World Health Organization (WHO), over two billion people worldwide suffer from micronutrient deficiencies.

In Việt Nam, efforts to address these deficiencies have shown some positive results but challenges remain.

High rates of deficiencies, including iron deficiency (50.3 per cent in pregnant women, 52.3 per cent in children under five), anemia, preclinical vitamin A deficiency, and zinc deficiency, continue to be major public health concerns in the country.

The health impacts of these deficiencies are significant with Iodine deficiency leading to mental retardation, stillbirth, and miscarriage.

Iron deficiency increases maternal mortality, hinders fetal and child development, and reduces adult labor productivity.

Meanwhile, zinc deficiency, which is still classified as “severe” under the 2015-2020 WHO assessment, contributes to diarrhea, respiratory infections, child mortality, and affects both physical and intellectual development,

Could you explain the economic impact of the problems?

The economic impacts are also substantial, as micronutrient deficiencies result in a loss equivalent to 2-3 per cent of GDP, while malnutrition can reduce GDP by up to 11 per cent in Asian and African nations.

These productivity declines can be especially detrimental to countries such as Việt Nam, where human resources are crucial for agricultural activities.

Rice is a key agricultural product, especially for food-insecure and low-income countries.

Therefore, I believe that fortifying rice is essential for combating malnutrition and micronutrient deficiencies. For Việt Nam, in particular, as a major rice exporter in the world, fortification of rice could also help create a competitive edge.

What do you think are the most effective solutions for the issues?

There are three key solutions, including food fortification, food diversification, and supplementation, among which food fortification is the most cost-effective with a cost of only $0.06 per person per year.

The cost-effectiveness of fortified foods can be attributed to the active involvement of the State in policymaking, enterprises in product manufacturing and distribution, and the community in purchasing and using affordable products.

Given the high prevalence of malnutrition and inadequate intake of micronutrients in Vietnamese diets, proactive interventions are vital to prevent deficiencies, reduce stunting, and enhance human resources.

Micronutrient fortification in staple foods is a simple, actionable, and cost-effective intervention, costing less than 1 per cent of alternative strategies such as direct supplementation or food diversification.

The widespread availability of fortified staple foods plays a crucial role in preventing and controlling micronutrient deficiencies, as well as improving child stunting and malnutrition.

Investing in food fortification yields remarkable returns, with every dollar invested resulting in a benefit of $9.91.

A five-year investment of $1.2 billion in micronutrient fortification is projected to generate a benefit of $15.3 billion, promoting good health, reducing diseases, decreasing mortality rates, and enhancing labour productivity.

How widely is food fortification implemented in other countries and what impact does it have on Việt Nam as a major food exporter globally?

Food fortification with micronutrients is a prevalent practice in many countries worldwide.

For instance, iodine fortification in salt is mandatory in 126 countries, while 114 countries require the use of iodized salt for food processing.

In addition, 90 countries mandate the addition of iron and zinc to wheat flour, and 33 countries, including Indonesia, require the addition of vitamin A to cooking oil.

India also has a programme to fortify cooking oil with vitamin A, while the Philippines requires fortification of rice with iron.

These countries represent large and crucial export markets for Việt Nam.

Therefore, if Việt Nam wants to implement a micronutrient fortification programme, its products will have a competitive edge in these markets.

What are the challenges facing Vietnamese food producers when adopting food fortification?

Enterprises in production and trading of foods fortified with micronutrients still face many difficulties and challenges.

That is, Việt Nam has too many regulations, including one law, 10 decrees, six circulars and 10 technical standards, on food safety management related to food fortification with micronutrients.

Multiple agencies such as the ministries of Health, Industry and Trade, and Agriculture and Rural Development, jointly manage the food sector. But there is no agency responsible for implementation of foods fortification with micronutrients nationwide, nor is there any funding for programme implementation.

There is also no specific direction or guidance from the three management ministries on inspection and sharing of information on management of foods fortified with micronutrients.

What should be done to promote food fortification practices in Việt Nam and other low-income countries?

Collaboration between the private and public sectors is vital for advancing food fortification practices in Việt Nam and other low-income countries.

By working together, a conducive environment and legal framework can be established for the private sector to effectively contribute to this cause.

It is vital for the private sector to adhere to existing laws, fulfill their duties, and partner with the Government, public sector, and communities to combat malnutrition and micronutrient deficiencies.

The private sector should make a transition from traditional food processing, which often involves the excessive use of fat, sugar, salt, and additives, to promoting healthier diets through fortifying foods with essential micronutrients.

In addition, leveraging international nutrition initiatives is also essential for sharing valuable insights, experiences, expertise, business cases, financial resources, human resources, and capacity-building efforts.

Global organisations such as the WHO, UNICEF, World Bank Group, FAO, and WFP currently advocate for food fortification with essential micronutrients. — VNS