Tackling Malnutrition through the Food System – Why Public-Private Partnerships are necessary.

Key Insights

Mr. Ajit Singh, Chairman, ACG Worldwide & Founder president of HADSA (The Health Foods & Dietary Supplements Association Of India) delivered the welcome address at the commencement of the webinar. Highlighting the fatal effects of Malnutrition he said that, “In a country of 1.4 billion people hundreds and thousands of people are afflicted with malnutrition and this is frightening,this is as much as a pandemic and therefore does not need any vaccination, instead this needs cooperation, consciousness and global partnership between countries.” He also spoke about HADSA and the initiatives they have been taking to combat malnutrition.

Speaking about malnutrition and Hunger In India, Ms. Pritee Chaudhary, IRS, Regional Director West & East Region Food Safety Standards Authority of India (FSSAI), said that, “ Hunger is not just about fulfilling the energy needs, instead, it’s about the wholesomeness of the Nutrition that we should perceive. A certain set of the population can access supplements and good quality food but still, there is a huge set of the population that does not have access to basic food.

Private-Public partnerships are the need of the hour which can fill the missing gaps. The private sector should do more CSR activities, PDS in a more effective manner helping the masses especially the lower economic strata.”

Dr Vaibhav Kulkarni, Hon. Secretary, HADSA & Director & Senior Leadership Team Member – Regulatory Affairs – Abbott Nutrition Regulatory Affairs, Abbott Nutrition highlighted that The private sector in this purview can ensure that more nutritious food is available to large masses, & at affordable prices. Private companies need to collaborate with the Government & development sector to solve the perennial problem of Malnutrition because healthy citizens will make up a healthy society.

With the Govt. of India supporting initiatives like Rice Fortification will ensure that nutritious products are widely available at an affordable price. The implications for policymakers and the public play a very important role in the success of the partnership initiatives.” Many studies and research suggest that Lack of Governance, power Imbalance, and mistrust are some of the key factors responsible for the failure of food and nutrition-related public-private partnerships. I am sure initiatives like this webinar will touch base points and will promote evidence-based dietary guidelines which will increase the efficacy of the whole ecosystem, he added further.

Dr Nikhil Kelkar, Group Jt. Managing Director, Hexagon Nutrition gave an Introductory Address on the social impact of Food Fortification through Public-Private partnerships. “India has a very high burden of Malnutrition & Hidden Hunger. There is a double burden of malnutrition across the life course and for women, it’s a vicious cycle based on societal & environmental factors. Early detection of malnutrition & intervention, Nutrition Education, Breastfeeding, Complementary Feeding, appropriate micronutrient supplementation, therapeutic nutrition & Food Fortification are some of the key strategies to combat malnutrition. The cost impact of Fortifying foods is extremely low and is highly cost-effective which can impact millions and millions of lives.” Further, he added that the Fortified foods look the same, taste the same but have the superpower to improve your health manifold. Transparent & aligned objectives, Unified legal & regulatory framework, Clear Communication strategy, and effective governance and monitoring mechanisms are some of the key success factors for an effective Public-Private Partnership. Let us all join hands to bring a bigger social impact.

Moderating the panel discussion, Ms. Deepti Gulati, Nutrition & Public Health Specialist emphasized that Malnutrition impacts physical & Mental development and if we don’t partner or collaborate the nutritional status of India will become a demographic liability rather than a demographic dividend. We have the solutions and political will but still, something is missing as we continue to fight the battle of malnutrition.

The round table discussions included understanding the various perspectives – industrial & Nutrition & Public Health Domain as to why malnutrition is so rampant.

Sheryl Salis, an RD, Diabetes Educator, Insulin Pump Specialist, Founder – Nurture Health Solutions shared her perspectives and experience from her current practice. “Covid-19 has impacted the income inflow in many households and thus impacting the nutritional status of the people especially people from the low economic strata. Conditions such as Iron deficiency anemia, PCOD, Hypothyroidism, obesity, etc. are definitely on the rise especially in adolescents and young adults. The nutrient quality is highly impaired in children during pandemic times. Physical Inactivity, easy accessibility of food via food delivery apps, Skipping of major meals, and unhealthy snacking have made the scenario even worse. Awareness about the right nutrition especially right from the start is the need of the hour. A lot of Fad diets are emerging every day which requires eliminating one important food group which might lead to micronutrient deficiencies”, she said

To combat malnutrition all the nutrition professionals can play a very important role in making people aware at the grassroots level via community-related programs. Themes such as Paudhe se poshan etc have the potential of making a difference from farm to fork. Even before conception & focusing on the first 1000 days are very important when we speak about nutrition education, she further added.

Mr. Sadanand Kulkarni, Head – Medical Regulatory, Vigilance, Quality, Fresenius Kabi, India highlighted that “Nutrition is an integral part of our ecosystem and more recently a lot of collaborations in the pandemic world have happened between therapeutic and public health nutrition organizations. Community nutrition companies have a bigger role to play more so than clinical nutrition companies which are centered more around hospital Nutrition.

Awareness generation in hospitals has been largely done but we need to take a step further if we have to catch the young population. We should also include nutrition not just limited to pediatric and geriatric populations but also should go to specialties like MBBS, BDS curriculums as well. Teaching institutions and educational institutes and corporates should be collaborated with to penetrate deep down the population at large.”

Ms. Poornima Shanker, Nutritionist, The Himalaya Drug Company said that “The Govt. has taken many initiatives in promoting the role of the private sector on Nutrition in general. Poshan Abhiyaan has been an impactful enabler. Although nutrition activities, CSR initiatives have proved to be beneficial, it’s mainly the vision and mission of an individual industry which is going to make the difference. Hence, when employee wellness programs, CSR activities are undertaken and budgets are allocated via strategic thinking then only it will make a huge difference in the overall nutrition status of the people. Branding of the food products plays a very important role hence a part of nutrition should be included while branding the food product. The roles and responsibilities of the private sector should be laid very clearly so that institutions such as PPEs can execute the right & robust health messaging.”

It’s high time brands allocate a certain amount of budget to the right health messaging for the population at large. Health and communications should be a priority for the employee workforce to increase their productivity percentage, she added

Dr. Sirimavo Nair, Professor, Dept. of Foods & Nutrition, The M.S. University of Baroda, Vadodara, Gujarat, Tackling malnutrition via a public-private partnership is a very righteous thing to highlight. There have been a lot of initiatives from the Government’s end but still, a lot of awareness and behavioral change campaigns need to be organized at various levels to sensitize people around like Jan Andolan.

Targeted programs such as Poshan Abhiyan have been proved to be beneficial to reduce malnutrition across masses. Standards of staple food fortification have been laid by esteemed bodies such as FSSAI, still, a lot of education needs to be imparted on need, requirement, toxicity levels, and actual intake of the micronutrients. She reassured us that, As a member of the scientific committee of food fortification, while making these guidelines we looked into vitamin toxicity details, calculations in depth which made us conclude that fortified staples are safe to consume within permissible limits.

The govt. has initiated campaigns like Poshan Abhiyan involving both public & private organizations to address the malnutrition status in India by promoting the right message to the right target audience.

This has also shown some great outcomes.

Mr. Arun Om Lal, Sr. Vice President, Hexagon Nutrition spoke on Collaboration with the Institutional & Developmental sectors to improve the nutrition status through Food Fortification. Highlighting the importance of Public-Private partnerships he said, “Effective collaboration between the industry, institutions & development sector partners helps to provide safe and nutritious food to all. Our partnerships should aim to expand the science-based solutions & options for improved nutrition. The food industry, private sector partners, and corporate partners play a huge role in scaling up nutrition inventions.

Creating awareness about nutrition issues, ensuring availability and accessibility of safe and nutritious food through different channels, support in distributing nutritional kits under CSR, setting up sustainable systems for an uninterrupted supply chain of food and medicines, and forging technical collaborations are some of the ways of doing it.”

At Hexagon Nutrition we have partnered with NIFTEM, Sion Hospital, Universities, and development sector partners to spearhead a food fortification and nutritional awareness drive aimed at eradicating malnutrition which continues to be a major challenge in India, he further added.

Hexagon nutrition works upon a commitment to cause taking food fortification into perspective. Trust & Transparency at an operational level is very important to deliver quality assured services to society.

Mr. Akshat Khandelwal, Founder & CEO at NuFlower Foods & Nutrition, Skymettle Infrastructure & President CMAM Association of India, spoke on the community-based management of acute malnutrition association of India. He also highlighted the burden of SAM (Severe Acute Malnutrition), its management, and CMAM Components. SAM is the most disastrous form of Malnutrition. “Close to half our children are very low weight for their height and severe muscle wasting. The case fatality rate (CFR) in children with SAM routinely crosses 20% which is multifold high as compared to the CFR of Covid-19 making SAM a pandemic of its own. Therefore the solution to the SAM problem is a community-based management strategy which includes identification and screening of SAM children, community engagement of mothers and caregivers, weekly monitoring, follow-ups on discharge & nutrition support through solutions such as RUTF (a high lipid-based energy-dense, high protein, and micronutrient enhanced paste).

A community-based model such as the CMAM Association of India can help to address the critical need of reducing SAM amongst children in India. Bringing expertise, scale & precision in manufacturing nutritional solutions such as RUTF, RUSF, etc, and promoting community-based programs in-country can support the government in any other way in its fight against malnutrition”, he said.

Ms. Deepti Gulati, Nutrition & Public Health Specialist touched upon almost all of the Q& A’s asked at the end of the webinar. The Q&A section saw discussions on the impact of nutraceutical supplements on undernutrition and overnutrition, Food fortification, fortificants, and their bioavailability.

The webinar ended with the closing remarks and vote of thanks by Kaushik Desai, Secretary General HADSA.