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Biofortification of Staple Food Crops: Justification, Progress, and Future Activities

Howarth Bouis February 17, 2016

Copyright: Micronutrient InitiativeWhy are Mineral and Vitamin Deficiencies Such A Significant Public Health Problem?

Dietary Diversity

Severity of Micronutrient Deficiencies: Vitamin A, Iron, and Zinc

Source: World Health Organization (WHO) children under 5 prevalence data

Consequences Mineral & Vitamin Deficiencies

Vitamin A deficiency• Supplements reduced child mortality by 23%• 375,000 children go blind each year

4

Zinc deficiency• increased incidence/severity diarrhea/pneumonia; stunting• 2 billion people; 450,000 deaths each year

Iron deficiency• Impaired cognitive abilities that cannot be reversed• 82% of children < 2 years in India are anemic

Consequences of Zinc Deficiency

• Zinc essential for the function of many enzymes and metabolic processes

• Zinc deficiency is common in developing countries with high mortality

• Zinc commonly the most deficient nutrient in complementary food mixtures fed to infants during weaning

• Zinc interventions are among those proposed to help reduce child deaths globally by 63% (Lancet, 2003;2008)

• Regular zinc supplements can greatly reduce common infant morbidities in developing countries (strength of evidence)• Diarrhea • Pneumonia • Stunting ?

162 million children with stunted growth in 2012

Source: UNICEF, WHO, The World Bank. Joint Child Malnutrition Estimate (UNICEF, New York; WHO, Geneva; The World Bank, Washington, DC; 2013

Some Zinc Supplementation Trials Show Reductions in Stunting

Biofortification-breeding food crops that are more nutritious

75% of the poor 25%

Empowering women farmers

Cost-effective: central one time investment

Photo: ICRISAT

Copenhagen ConsensusTOP FIVE SOLUTIONS CHALLENGE

1 Micronutrient supplements for children (vitamin A and zinc) Malnutrition

2 The Doha development agenda Trade

3 Micronutrient fortification (iron and salt iodization) Malnutrition

4 Expanded immunization coverage for children Diseases

5 Biofortification Malnutrition

Biofortification – One Piece of the Puzzle

Supplementation Commercial Fortification

Agricultural Interventions

Dietary Diversity

Present Reach of Biofortification

14

Human Nutrition Efficacy Trials

Fourteen Efficacy Trials either completed or in process

–High iron crops +• Meta-analysis completed for beans and pearl millet

–High pro-vitamin A crops • Multiple efficacy trials completed for sweetpotato,

maize, and cassava

–High zinc crops• Bioavailability studies positive, efficacy trials in the field

Nutrition Impacts• Efficacy trials with iron biofortified crops have

also shown improved functional outcomes:–Improved cognitive function–Better work performance

• Biofortified crops, as consumed, provide an extra 40% of estimated average requirement each day – substituting one-for-one the biofortified variety for the existing non-biofortified variety.

Three Million Households Targeted in 2016

400,000250,000 60,000

20,000195,000

600,000360,000

175,000

75,000

85,00055,000

85,000480,000

130,000 11,000

Iron Bean Rwanda Iron Bean DRC Iron Bean UgandaIron Bean Zimbabwe Iron Pearl Millet India Vita-A Cassava NigeriaVita-A Cassava DRC Vita-A Maize Zambia Vita-A Maize NigeriaVita-A Maize Zimbabwe Vita-A Maize DRC Vita-A OSP UgandaZinc Rice Bangladesh Zinc Wheat India Zinc Wheat Pakistan

Orange Sweet Potato

• Vitamin A-rich orange sweet potato (OSP) was released to 24,000 households in Mozambique and Uganda from 2007-2009

• Findings from the project have shown high rates of adoption and consumption, resulting in increased vitamin A intakes among women and children

• Distribution of OSP has been scaled-up in Uganda by HarvestPlus to reach 225,000 households by 2016

Photo: HarvestPlus

Impact on vitamin A intakes

Vitamin A OSP Reduces Diarrhea(Two Years After Extension

Stopped)• Diarrhea is one of the leading causes

of death in children < 5 in developing countries.

• Eating orange sweet potato (OSP) reduces the incidence and duration of diarrhea in children. – For children < 3 likelihood of developing

diarrhea was reduced by more than 50% and duration of diarrhea reduced by more than 25%.

– For children < 5 likelihood of developing diarrhea was reduced by more than 40% and duration of diarrhea reduced by more than 10%.

Incremental Changes in the Prevalence of Inadequate Zinc

Intake, Bangladesh

Comparison of Annual Biofortification and Fortification

Costs, Bangladesh

TRANSGENIC FE- AND ZN-DENSE RICE

Trijatmiko et al., 2016

Proof of concept achieved:

Fe Zn