Annual Report 2005-2006
Malnutrition remains the world’s most serious health problem, according to a World Bank Report published in 2006. It is associated, directly or indirectly, with more than 50 percent of all child mortality. In low and middle income countries, nearly one-third of all people suffer deficiencies of micronutrients. These deficiencies can undermine one’s health, education and productivity, cause life-long damage and be passed on from one generation to the next — the children of underweight, stunted mothers are often themselves underweight and stunted. The report highlights the growing global consensus for large-scale action to improve nutrition and the most promising interventions. Above all, the World Bank calls for investments in nutrition for pregnant women and children under two. These rank above investments in trade liberalization, malaria, and water and sanitation, in terms of immediate benefits. Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Development, Washington, DC, World Bank, 2006.
CONTENT
Introduction: A businesslike approach to fighting malnutrition 4 Message from the Chair: A catalyst for ending malnutrition
5
Message from the Executive Director: New alliances promise better nutrition worldwide
6
GAIN makes the 6th Annual Fast 50 List
8
GAIN’s Alliance Role
9
GAIN Business Alliance Progress Report 2005-2006
10
GAIN Business Alliance: the concept
11
Everyone benefits when business tackles malnutrition
12
Accountability governs strategic partnerships
14
Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies
15
A world of projects
17
Performance measurement and research
26
Advocacy and communication
28
Infant and young child nutrition
30
Board of Directors
32
Financial Statement
35
Auditor’s Report
38
Acknowledgement and photo credits
39
GAIN’s mission is to reduce malnutrition through the use of food fortification and other strategies aimed at improving the health and nutrition of populations at risk, particularly children and women.
2005 - 2006 Annual Report
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A businesslike approach to fighting malnutrition
GAIN was created at the United Nations General Assembly’s Special Session on Children in 2002. Established as a Swiss foundation, this Global Alliance is now funded by the Bill and Melinda Gates Foundation, the United States Agency for International Development (USAID) and the Canadian International Development Agency (CIDA). A key partner is the World Bank, which acts as interim trustee and supports program implementation. GAIN also has extensive and active partnerships with businesses, governments and civil society organizations and works closely with a range of international agencies.
| Global Alliance for Improved Nutrition
GAIN fulfils its mission by building alliances of public and private partners and providing financial support and technical expertise for improving nutrition. In its work with the private sector, GAIN has already distinguished itself by promoting the use of innovative business models to mobilize commercial markets in a sustainable way to fight malnutrition. GAIN also places a critical emphasis on performance management to ensure that its programs provide the maximum benefit to target populations. GAIN focuses on: u Food fortification u Infant and young child nutrition u Investment and partnerships u Performance measurement and research u Communication and advocacy
GAIN has set itself a target of reaching 1 billion people with food fortification programs. Current projects are expected to reach 600 million people when at full scale and new strategies are being developed to reach 400 million more.
A catalyst for ending malnutrition As a definitive 2006 World Bank report notes, malnutrition is associated with more than half of all deaths among children, and nearly one-third of all people in developing countries suffer from micronutrient deficiencies. The health and social consequences are appalling, particularly for children and mothers. A diet lacking in vital nutrients stunts a person's growth and results in lower-than-average weight, weak muscles and impaired vision. Poor nutrition also undermines cognitive development and resistance to common illnesses. Those who survive malnutrition in childhood may experience the negative effects throughout their lives, as fragile health limits their growth and undermines their ability to learn in school. In its first four years, GAIN has focused hard on identifying new ways to overcome nutritional deficiencies. It has used its experience and expertise to help establish innovative public-private investments to put nutritious, affordable foods on the market and reduce malnutrition. GAIN's greatest strength is its technical assistance and power as a catalyst–marshalling the technological and commercial acumen of the food industry to meet the nutritional standards set by national governments. This year GAIN has made further progress in developing a global forum of companies working together to identify new business models and mechanisms for meeting the nutritional needs of hundreds of millions of consumers. With offices in China, India and South Africa, as well as Geneva, GAIN is now at the forefront of efforts to address malnutrition and on track to achieve its goal of helping a billion people worldwide improve their nutrition and lead healthier, more productive lives.
Jay Naidoo Chair, Global Alliance for Improved Nutrition
ÂRepositioning Nutrition as Central to Development: A Strategy for Large-Scale Development, Washington, DC, World Bank, 2006 p. ix.
2005 - 2006 Annual Report
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New alliances promise better nutrition worldwide In 2005-2006, GAIN increased its global leverage to improve nutrition, and took strides towards its ambitious goals. Working with business, policy-makers and governments, we have again been able to devise and implement the best solutions to address malnutrition. When the new projects approved in 2006 are added to our portfolio, and all are brought to full scale, GAIN will be supporting the fortification of foods for 600 million people. Grants awarded by GAIN, mostly through a competitive process, are now funding major projects in 18 countries. Our most recent food fortification projects will add vitamins and minerals to wheat flour in Egypt, vegetable oil in Bangladesh, and oil and flour in Uganda. Four country projects are about to complete their threeyear life cycle. GAIN is also funding and providing technical assistance to targeted projects, for example by providing nutrient-dense meals to people living with HIV in India. More than 200 global and local companies have now joined GAIN’s Business Alliance, which tackles malnutrition on a global basis through regional Alliances in North America, Europe, Africa, India and China. The Global Annual Forum, held first in Beijing in 2005 and most recently in New Delhi in March 2007, has created a space for companies to learn from each other and collaborate nationally, regionally and globally in the development and marketing of fortified foods. This report will focus in part on the increasing role that business is now playing in the field of nutrition and examine the partnerships being forged. GAIN’s partnership program is subject to careful performance measurement and monitoring with results reported regularly to GAIN’s Board. As the evidence now clearly shows, addressing malnutrition is among the most direct ways of improving the health of people, particularly if we focus on the early years of a child’s life. GAIN has therefore established a second grant program for Infant and Young Child Nutrition (IYCN). Time is short for those suffering malnutrition and the damage wrought can be lifelong. We are mindful of this as we marshal resources and mobilize globally towards our ambitious goals.
Marc Van Ameringen Executive Director, GAIN
| Global Alliance for Improved Nutrition
GAIN is included in the 2007 Fast 50! Geneva-based Global Alliance for Improved Nutrition (GAIN), along with food giants such as Groupe Danone, Unilever, and Cargill, are working to fight “hidden hunger.” Unlike traditional aid campaigns, GAIN looks to build new and sustainable markets for nutritious foods. “Our job is really to be a catalyst and make sure the private sector delivers food to the poor in the long term,” says Bérangère Magarinos, senior manager of GAIN’s Investments and Partnerships Program. “If the company defines the project as charitable only, we would not be involved. It’s got to go through a business model.”
GAIN makes the 6th Annual Fast 50 List “The Fast 50 is Fast Company magazine’s annual readers’ challenge, a worldwide search for ordinary people doing extraordinary things. Fast 50’s goal is to remind the world of all the good that’s created when passionate people with big ideas and strong convictions are determined to make a difference. Each year, the challenge generates thousands of entries and tens of thousands of comments from around the world, and results in highprofile recognition of 50 leaders, innovators, and technology pioneers.” http://www.fastcompany.com/fast50_07/aboutthefast50.html
The 6th
Annual
FAST 50
REPORT FROM THE FUTURE: 50 PROFIT-DRIVEN SOLUTIONS FOR WHAT AILS THE PLANET
Fast Company March 2007, p 82, ISSN 1085-9241
A selection of fortified products brought to the market through GAIN’s partnerships. | Global Alliance for Improved Nutrition
GAIN’s Alliance Role
“Business leaders increasingly go beyond just meeting the bottom line. A growing number are aiming to change the world they live in, find new ways to get things done and contribute to broader goals such as improving the nutrition and health status of those who are at risk, especially the poor. These are the people who make up the GAIN Business Alliance and they are the ones, who, through collaborative action, will help make malnutrition a thing of the past.” Paulus Verschuren Senior Director, Partnership Development, Unilever Chair of the GAIN Business Alliance 2005 - 2006 Annual Report
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GAIN Business Alliance Progress Report 2005-2006 Events and projects 2005
2006
u
September: First GAIN commitment for the International Clinton Initiative focusing on the Creation of the GAIN Business Alliance.
u
February: Signing of the GAIN - Danone MOU focusing on GAIN technical assistance in Bangladesh.
u
September: Signing of the GAIN - Seabord MOU focusing on flour fortification in Democratic Republic of Congo (DRC).
u
u
October: Inaugural meeting of the GAIN Global Business Alliance in Beijing attracts 150 leaders from throughout the food industry, academia, the Chinese government and civil society. The meeting concludes with the Beijing Declaration on Food Fortification, the launch of the China Regional Business Alliance and agreement by Unilever to serve as the first chair of the Business Alliance.
March: Launch of the GAIN Business Alliance Europe Chapter in London. Twenty European business leaders, academics and public officials meet to promote the involvement of businesses in food fortification in developing countries.
u
June: GAIN Business Alliance Working Group meets in Geneva, Switzerland to further develop the alliance structure.
u
August: Inaugural meeting with Captains of Indian Industry, New Delhi. Thirty senior executives from the food and beverage, packaging, condiment and information technology industries meet to explore options to eliminate micronutrient deficiencies and how Indian businesses can help.
u
September: Marc Van Ameringen updates the GAIN Commitment to the International Clinton Initiative, announcing the creation of a GAIN Business Alliance India Chapter.
u
September: Launch of the Nasarawa School Feeding project supported by Tetra Pak (West Africa) and GAIN.
u
October: First meeting of the GAIN Business Alliance Africa Advisory Group, Johannesburg. Thirty-one business leaders from eight countries meet to boost actions by companies, development partners and governments, and to advise on ways to expand the role of African business in tackling malnutrition.
u
November: Launch of the GAIN Business Alliance North American Chapter in Seattle, USA. More than 150 representatives of food, agribusiness, milling, transportation and retail industries attend. Procter & Gamble agrees to serve as Chair. Cargill commits to work with GAIN on oil production and to increase access to fortified products in emergencies. Cargill GAIN MOU is signed.
u
November: GAIN hosts a CEOs’ Dinner in New Delhi in preparation for the 2007 launch of GAIN Business Alliance India. Sixty leaders from the food, flour, media and health sectors attend, together with officials, including the Indian Minister of State for External Affairs Anand Sharma.
u
December: Annual Meeting of the China Regional Business Alliance, Beijing. International and Chinese producers of fortified food, distributors and retailers, Chinese government officials, media and academic representatives are among the 45 participants.
u
March-December: GAIN develops social marketing plan for Grameen Danone Foods project. GAIN also began an efficacy study of the product’s impact on nutritional status.
u
October: GAIN - Tetra Pak MOU is signed.
u
December: First Planning Meeting of the China Regional Business Alliance, Beijing.
u
December: Launch of Tetra Pak – Helen Keller International (HKI) Partnership for school feeding program in Nigeria.
French football star Zinedine Zidane signing an autograph in Bangladesh during the launch of the Danone fortified dairy project.
10 | Global Alliance for Improved Nutrition
GAIN Business Alliance: the concept The GAIN Business Alliance is a global network dedicated to marketbased solutions to reduce vitamin and mineral deficiencies. Its work complements GAIN’s national and international programs. Markets in the developing world are expanding rapidly with purchasing power now in the hands of some 4 billion consumers. Academics and policy experts call this group the “base of the pyramid”, however it is a fragile base as many of its members are among the 2 billion people who lack the vitamins and minerals necessary to lead healthy and productive lives. Both consumers and companies stand to gain by the development of high-quality fortified foods for growing markets in India, China, Brazil, South Africa and elsewhere. The innovative initiatives of Grameen Danone Foods in Bangladesh and of Tetra Pak in Nigeria demonstrate this. Over the past year, the strength of this business case has convinced a growing number of major players worldwide to join the GAIN Business Alliance. The conceptual framework for the GAIN Business Alliance has been developed with the assistance of partners from the academic, private, public and civil society sectors. Dr. Jane Nelson, Director of Harvard University’s Corporate Social Responsibility Initiative and one of the primary architects of the Business Alliance approach, notes that private sector action is critical
1
to tackling malnutrition. Governments must take the lead in enacting legislation and developing policy guidelines, she notes, but proven interventions and technologies exist to address undernutrition, and the corporate sector’s role is to take them to scale.1 Individual and collective action The GAIN Business Alliance is based on the principle that companies do best when they address malnutrition by working in their own sectors and collectively through local and global business alliances. In the words of Dr. Nelson, this “leadership alliance” framework helps “harness business resources, provides a potential opportunity for companies to leverage their individual contributions, spread their risks, share lessons, and over time increase their impact on-theground”.2 Food fortification is among the most cost-effective and promising ways to address world hunger and poverty — so it is the right thing to do. But it also makes sound business sense. Nearly every step in fortified food production and consumption offers opportunities for business, as it calls for technical and research expertise, production capacity, distribution systems and community partnerships. It also allows for the development of large and sustainable new markets, as it improves not only the health, but also the prosperity, of billions of potential new consumers.
Jane Nelson, Business as a Partner in Overcoming Malnutrition: An Agenda for Action, Cambridge, Mass./New York/Washington, Harvard University/Clinton Global Initiative/World Bank, 2006.
2
“The size and complexity of these public health challenges require a partnership approach that brings together the collective skills, competencies and resources from the public sector, private sector and civil society. I am confident that GAIN and its business alliance partners can develop effective and sustainable solutions.” Paulus Verschuren Senior Director, Partnership Development, Unilever Chair of the GAIN Business Alliance
Jane Nelson, 2006. 2005 - 2006 Annual Report
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Grameen Danone feeds children, fuels economies Established in March 2006, Grameen Danone Foods brings together the acumen of the celebrated microfinance and social business enterprise with the expertise of one of the world’s leading food companies. Grameen Danone Foods’ mission is to make healthy nutritious food accessible on a daily basis to people in Bangladesh with low incomes and vitamin and mineral deficiencies. As well, it aims to alleviate poverty through the implementation of an innovative business model. Grameen Danone Foods will support, for example, the creation of independent businesses and job opportunities in the farming, processing, sales and distribution sectors. Special emphasis will be placed on micro-financing solutions together with professional training to local partners. The initiative will begin with the launch of an affordable yogurt product, specifically developed to meet the nutritional needs of Bangladeshi children. GAIN is designing and rolling out a social marketing campaign for the yogurt and conducting an efficacy study. The prospective randomized controlled trial will recruit six-to-nine-year-old children living in the Bogra district of Bangladesh to examine how the consumption of the iron-, zinc-, vitamin A- and iodine-fortified yogurt affects their physical growth and mental and motor development and intelligence-quotient.
Everyone benefits when business tackles malnutrition Vitamin and mineral deficiencies harm one in three people in low and middle income countries — impairing minds, bodies, productivity, and the economic progress of nations. GAIN and its Business Alliance make the case, therefore, that tackling malnutrition is not only good for global health, it’s good for business. Bringing better food to the world’s poor is a first step in developing new markets — including up to 4 billion people in the developing world. Although per capita income in this market is low, sheer numbers ensure increased profitability through economies of scale. As well, research has shown that people entering the “base of the pyramid” have purchasing power, are brand conscious and are eager for new products tailored to their needs and aspirations. Companies that focus at this level stand to grow their market share and maintain a competitive advantage.
“P&G has a long history of developing fortified products. We are prepared to share the knowledge, experience and expertise we’ve acquired from the successes and challenges that have come from marketing these products and we hope other companies will follow this example.” Ethel Cormier,
Associate Director, Procter & Gamble and Chair of the North American chapter of the GAIN Business Alliance, November 2006 12 | Global Alliance for Improved Nutrition
Tetra Pak partnership boosts nutrition in Nigerian schools
Increasing the supply of, and access to, fortified foods also provides long-term support for local economies by building infrastructure, creating jobs and stimulating sustained demand for products. Governments, civil society and philanthropic agencies all have a role to play in food fortification, but businesses are best equipped to develop and deliver fortified foods. GAIN’s partnerships encourage the participation of a wide range of public and private stakeholders and this approach is already bearing fruit. By partnering with private companies, public and not-forprofit agencies can enhance their influence within industry sectors and communities. By partnering with public agencies and civil society groups, businesses benefit in complex ways that may lead to improvements in their core operations, research and development opportunities and market expansion. GAIN and its Business Alliance are demonstrating that it is both economically viable and socially responsible to harness the capacity of industry and market-based approaches to improve nutrition.
In September 2005, the President of Nigeria endorsed the implementation of a Pilot School Feeding Program through a partnership between the State of Nasarawa and Tetra Pak Food for Development (West Africa) Ltd. The program, which has the support of Tetra Pak’s Global Office, aims to distribute a fortified liquid supplement called Nutri-Sip™ to all primary school children in Nasarawa State, estimated at approximately 400,000. Nutri-Sip is a nutritious drink based on maize and soy, and fortified with 27 micronutrients. Tetra Pak is providing technical advice to the program, assisting in the development of management structures, addressing logistical challenges and helping to raise awareness about the program in communities. GAIN is assisting Tetra Pak (West Africa) Ltd. by conducting an efficacy study of Nutri-Sip among Nigerian primary school children. Conducted in partnership with Helen Keller International (HKI) and the Nutrition Division of Cornell University, the study looks at the effect of Nutri-Sip on blood levels of hemoglobin, iron, zinc, and vitamin A and on growth and school performance. GAIN’s introduction of scientific best practices to generate the efficacy data is expected to contribute significantly to the next step in the program—scaling up to reach 27 million primary school children throughout Nigeria.
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Accountability governs strategic partnerships GAIN's raison d'être has always been to forge a dynamic publicprivate alliance in which the corporate sector plays a central role in innovative food fortification programs. One of its first tasks in 2003, therefore, was to develop guidelines for partnerships in this alliance, with a clear definition of roles and responsibilities and an emphasis on due diligence. Updated guidelines for business partnerships
GAIN’s were
approved by the GAIN Board in November 2006. They are adapted from the Partnership Governance and Accountability (PGA) Framework developed by AccountAbility1 and USAID. The Guidelines provide management tools or filters to enhance the effectiveness, accountability and governance of partnerships, from
partner and project selection through work planning and monitoring to evaluation. Partnership projects are also subject to the same design and review process as other GAIN projects. This means that decisions are based not only on the selection of a corporate partner, but also on other strategic considerations. These include the expected beneficiary reach of a project, its outreach to specific vulnerable groups and its coherence with the national nutrition program and with other GAIN activities in the country. As well, GAIN looks for projects that have the potential to raise awareness about malnutrition, and that can leverage other resources — globally and locally — for its elimination.
"Well designed food fortification programs are essential to improving the health of people in the developing world, especially children. Partnership initiatives like the GAIN Business Alliance have the opportunity to help tackle these issues in the most effective and efficient way possible." Daniel Runde Director, Office of Global Development Alliances, U.S. Agency for International Development, Seattle, November 2006.
1
AccountAbility is a London-based, not-for-profit research institute dedicated to the promotion of approaches to accountability that support sustainable development. The institute's Chief Executive Officer is Dr. Simon Zadek.
14 | Global Alliance for Improved Nutrition
Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies Improving nutrition is now widely understood as key to achieving the United Nations Millennium Development Goals by 2015 and to reducing poverty. With this in mind, individuals representing governments, non-governmental organizations, academia and the private sector have forged a global coalition to promote a Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies. GAIN has facilitated the develop-
trient malnutrition, and the feasibility of promoting a global strategy to reduce vitamin and mineral deficiencies. The resulting Vitamin and Mineral Deficiencies Technical Situation Analysis looks at four key issues: the magnitude of malnutrition worldwide; ways of reducing deficiencies in vitamin A, iron, iodine, zinc and folate; the costs and benefits of reducing these deficiencies; and the role of international orga-
ment of the Strategy which receives operational support from the World Bank. Members of the Strategy’s executive Reference Group include GAIN as well as the Academy for Educational Development, the Bill & Melinda Gates Foundation, the Development Bank of Southern Africa, H.J. Heinz Company, Harvest Plus/IFPRI, Helen Keller International, International Business Leaders Forum, the Micronutrient Initiative, New Economic Partnership for Africa’s Development, Unilever, UNICEF, United States Agency for International Development, U.S. Centers for Disease Control and Prevention, the World Bank, World Food Programme, and World Health Organization. New partners will come on board as the process evolves.
nizations in the drive to improve the micronutrient health of those most in need. It argues that serious gaps remain in addressing this public health crisis and there are few safeguards to ensure that the gains already made are sustained. It also emphasizes that malnutrition has long-lasting effects on individuals and can undermine the socio-economic development of countries.
Work on the Strategy began in 2005 and has, to date, unfolded in two phases.
Phase II: Strategic Framework
Phase I: Situational analysis During its first year, September 2005 – August 2006, the Reference Group commissioned a study of the nature and magnitude of micronu-
The Stakeholder Perceptions Analysis, meanwhile, reveals that key inter-governmental and nongovernmental organizations, private corporations, academic institutions and donor agencies would support a global strategy to address the challenges of micronutrient malnutrition.
other food-based approaches will vary depending on local needs. Another was that public-private collaboration should be integral to the framework. Working Groups serve as the pillars of the framework, and are responsible for informing the strategy. Working Groups have been formed to address: data; fortification; supplementation; other food-based approaches; regional strategies for Africa, Asia and Latin America; and advocacy, social mobilization and communications. The Groups bring together expertise from across the spectrum of partner organizations, including the private sector and civil society; a different agency is responsible for overseeing each Group. The Working Groups have four global objectives all aimed at integrated programing on micronutrients at the country level: identifying priority actions for the short and medium terms; agreeing on the division of labour, roles and responsibilities; identifying champions and projects worthy of pilot studies and scale-up; and assessing resource requirements and planning for the mobilization of these resources.
The Reference Group’s other key task was to outline a framework for the Strategy. A founding premise was that different solutions to micronutrient malnutrition are needed in different contexts, and that the combination of fortification, supplementation and 2005 - 2006 Annual Report
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Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies Group rallies support for strategy in Africa The Africa Working Group provides an example of a Working Group in action. Its objective is to formulate a regional strategy that respects national specificities, builds on existing ini-
tiatives in countries, allows for the scale-up of chosen projects, and enables greater investment in reducing vitamin and mineral deficiencies. To begin work towards this objective, the Group created a technical team of experts from the Development Bank of Southern Africa, New Partnership for Africa’s Development and GAIN to consult widely in the region, hear national concerns and mobilize support for the Ten Year Strategy. At the end of this process, the team presented a policy brief, which won the endorsement of African states attending the Food Security Summit in Abuja, Nigeria in December 2006. This official endorsement sets the stage for implementation at the sub-regional and national levels. The second phase of the Group’s work program is focused on strengthening and creating new strategic partnerships, facilitating the design and implementation of pilot projects in high-burden countries, and increasing coordination for more effective alignment of resources.
16 | Global Alliance for Improved Nutrition
A world of projects As well as forging alliances, GAIN provides grants on a competitive basis to support food fortification projects at the national and regional levels. This seed money acts as a catalyst for promising multisectoral initiatives to add essential vitamins and minerals to basic foods — flour, cooking oil, fish and soy sauce, for example — that are consumed by populations most in need. The next section of this report gives an overview of GAIN’s growing portfolio of projects, underway, worldwide. It also provides snapshots of four of GAIN’s most advanced countrylevel projects: in China, Pakistan, South Africa and Morocco.
National projects GAIN has awarded grants worth US$ 44.2 million, supporting 19 projects in 17 countries around the world. Some are new projects, others have been running for almost three years and are nearing full-scale. By 2011, when at full-scale, GAIN estimates that they will provide affordable, high-quality fortified foods to no fewer than 600 million people in Asia, Africa and the Americas. Wherever GAIN funds a national project, it also supports the establishment of a National Fortification Alliance which helps businesses partner with government agencies and civil society groups to fast-track food fortification. Most national projects support five components: • production and distribution of fortified food; • strengthening the regulatory and legislative environment in support of quality assurance and food safety; • social marketing and communication; • public health monitoring and evaluation; and • program management. GAIN awards grants through a competitive bidding process open to National Fortification Alliances. Depending on the grants, GAIN may cover the development of legislation, the cost of new fortification equipment and premix, the strengthening of food control systems, and the initial vitamins and minerals to be added to foods. GAIN also provides technical support and training to its project partners — factory managers and millers, business and community leaders, government officials and others — so that they are able take over ownership of the project as GAIN’s involvement comes to an end.
Project profiles Over the next year, four of GAIN’s projects will be coming to the end of their initial three year phase; the following synopses gives an indication of results achieved and lessons learnt. 2005 - 2006 Annual Report
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Dominican Republic p™ ´©o°
Morocco l™ ´©o°t Mali n o
Fortified food n
Cotton seed oil
u
Fish sauce
m
Maize meal
q
Milk
¢
Soy sauce
p
Sugar
l
Vegetable oil
Côte d’Ivoire ™l ´©o Ghana ™l ´©o°Æ
Bolivia ql™ ´©o°Æt
™ Wheat flour Vitamins and nutrients ´
Iron
© Folic acid o
Vitamin A
°
Other B-vitamins
Æ
Zinc
t
Vitamine C, D and E
Country
Food vehicle
Projected reach (number of people in millions) when at full-scale 128.4 7.7
Bangladesh Bolivia
Vegetable oil Vegetable oil, wheat flour, milk
China (flour)
Wheat flour
China (flour policy) China (soy) Côte d’Ivoire
Wheat flour Soy sauce Vegetable oil, wheat flour Sugar, wheat flour
N/A 97.0 15.0
Wheat flour Wheat flour Vegetable oil, wheat flour
50.0 4.3 19.5
Dominican Republic
Egypt Georgia Ghana
18 | Global Alliance for Improved Nutrition
9.4
6.9
Fortificant
Grant awarded US$ millions
Vitamin A Oil: vitamin A Wheat: iron, folic acid, and other B-vitamins Milk: iron, zinc, vitamin A, C, D and E
3.0 2.6
Iron (NaFeEDTA), zinc, folic acid and other B-vitamins N/A Iron (NaFeEDTA) Oil: vitamin A Wheat: Iron, folic acid Sugar: vitamin A Wheat: iron, folic acid, and other B-vitamins Iron, folic acid Iron, folic acid Oil: vitamin A Wheat: iron, zinc, vitamin A, folic acid, and other B-vitamins
1.8 0.6 3.0 3.0 1.9
3.0 1.2 1.8
Uzbekistan ™ ´©°Æ
Georgia ™ ´©
China (soy) Egypt ™ ´©
¢
´
Pakistan ™ ´© Nigeria pl™ ´o°
China (wheat) ™ ´©°Æ Bangladesh
Uganda ™lm ´©o°Æ
l o
Viet Nam u
´
Zambia m ´©o°Æ
South Africa m™ ´©o°Æ
Country
Food vehicle
Projected reach (number of people in millions) when at full-scale
Fortificant
Grant awarded US$ millions
Mali
Cottonseed oil
10.0
Vitamin A
1.1
Morocco
Vegetable oil, wheat flour
30.5
Oil: vitamin A, vitamin D Wheat: iron, folic acid and other B-vitamins
3.0
Nigeria
Wheat flour, vegetable oil, sugar
95.9
Wheat: iron, vitamin A, B-vitamins Oil: vitamin A Sugar: vitamin A
2.4
Pakistan
Wheat flour (Atta)
74.2
Iron (NaFeEDTA), folic acid
3.0
South Africa
Maize meal, wheat flour
38.7
Iron, zinc, vitamin A, folic acid, and other B-vitamins
2.8
Uganda
Vegetable oil, wheat flour, maize meal
26.4
Oil: vitamin A Wheat and Maize: iron, vitamin A, folic acid, zinc, and other B-vitamins
2.4
Uzbekistan
Wheat flour
9.6
Iron, zinc, folic acid, and other B-vitamins
2.2
Viet Nam
Fish sauce
21.0
Zambia
Maize meal
6.1
Iron (NaFeEDTA)
3.0
Iron (NaFeEDTA), zinc, vitamin A, folic acid and other B-vitamins
2.4
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Fortifying soy sauce in China Project period
September 2003 - March 2007
Food Vehicle
Soy sauce
Fortificant
Iron (NaFeEDTA)
Jilin BEIJING Hebei Jiangsu Guizhou Guangxi
Grant awarded US$ 3 million Population reach*
97 million
Executing agency
Chinese Center for Disease Control and Prevention
*Projection of those reached when project is at full scale (five years after its start).
Achievements
¸
19 manufacturers have been registered, trained and equipped to fortify soy sauce. Production exceeded over 80,000 MT/year.
¸
20 sentinel sites established for monitoring impact on iron deficiency and knowledge, attitude and practice (KAP) among those consuming the soy sauce. Sixteen sites have completed a oneyear survey after launching and found on average a reduction of 28% in anemia rates among women of reproductive age.
¸
Quality control and assurance system established. Regular inspections and testing found soy sauce samples in compliance with existing national standards.
¸
Consumer education launched in seven provinces, attracting extensive media coverage.
¸
Chinese (www.cdc-ffo.cn) and English (www. cdc-ffo.cn/en) project web sites created.
20 | Global Alliance for Improved Nutrition
Guangdong
Background Prevalence rates of iron deficiency anemia in many rural areas of China can be as high as 41.2% among women of reproductive age and 50.3% among children aged 6-12 months. The government of China has recognized the urgent need to address the problem of vitamin and mineral deficiencies. Food fortification was identified as a key strategy in 1997 and has been integrated into several national strategic plans and government policy papers related to nutrition.
GAIN’s soy sauce project Soy sauce was identified as an ideal vehicle for fortification with iron since it is widely consumed on a consistent basis by 70% of the population. The project is managed by the Chinese Center for Disease Control and Prevention in cooperation with the NFA. GAIN provides seed money to establish large-scale iron fortification of soy sauce in seven Chinese provinces. National legislation allows for participation on a voluntary basis.
Fortifying flour in Pakistan Project period
July 2005 - June 2008
Food vehicle
Wheat flour (atta)
Fortificant
Iron (NaFeEDTA), folic acid
Grant awarded
US$ 3 million
Population reach*
74.2 million
Executing agency
Nutrition Wing, Ministry of Health
*Projection of those reached when project is at full scale (five years after its start).
Achievements
¸
Project Management Unit (PMU) under the Nutrition Wing of the Ministry of Health has been established and is fully functional.
¸
The atta wheat flour market study is underway, with results to be available mid 2007.
¸
Bids for micro-feeders and fortificant have been reviewed and final selection of firms will take place mid 2007.
¸
Guidelines and training materials for industrial quality assurance and control, as well as for inspection and enforcement, will be finalized soon.
¸
The case for the initiation of the legislative process has been forwarded to the Minister.
¸
A comprehensive social marketing and communication strategy, covering education and advocacy materials, as well as fortification logo and tagline, has been finalized.
¸
Baseline survey of consumer knowledge, attitudes and practices (KAP) is nearing completion.
¸
Project launched at national level with participation of Prime Minister Shaukat Aziz.
¸
Launch of the fortification process at mill-level with Minister of Health MOHammed Naseer Khan.
Background In response to anemia prevalence among women of reproductive age and young children at 50% percent and 36% respectively, Pakistan developed a ten-year program to fortify atta wheat flour with iron and folic acid. Wheat is the major staple food in Pakistan with people at all levels of society consuming up to 9.27 kg per month. The country is self-sufficient in wheat production. In its first five years, the project is focusing on enabling largeand medium-sized millers to fortify their production. Thereafter, 50,000 small-scale grinders, known as chakkies, will be included in the program. Lessons learnt from other food fortification projects underway in Pakistan, including those for salt and ghee oil, will inform the new project.
GAIN’s atta flour project The GAIN-funded atta wheat flour fortification project started in July 2005. The project is managed by a highly motivated Project Management Unit under the Nutrition Wing of the Ministry of Health in collaboration with the multi-sectoral NFA, the Micronutrient Initiative (MI) and the Flour Millers Association. The GAIN grant was awarded to establish large-scale wheat flour fortification in Pakistan and to lay the foundation for universal wheat flour fortification. Within the first three years, 300 roller mills will be gradually upgraded and by year five, 600 mills will participate in the program. Quality assurance as well as advocacy and public education campaigns are being made a priority to ensure the availability of high–quality, affordable fortified flour and to stimulate demand. It is estimated that when the project is running at full scale in 2010, 45% of Pakistan’s atta flour will be fortified and 74.2 million people will be consuming this product regularly. Efforts will also be made to pass legislation that makes flour fortification mandatory.
GAIN funding used to leverage additional contributions from public and private partners and send micronutrient malnutrition to the top of the national agenda. In Pakistan, the GAIN project has been used to increase the visibility of micronutrient malnutrition and catalyse national action. The PMU/MOH and other NFA partners have successfully advocated for additional resources from both public and private sector sources. The US$ 3 million GAIN grant will leverage an additional US$ 2.5 million commitment from the Ministry of Health and an additional US$ 7.7 million commitment from private sector partners during the next two years to ensure that atta flour prices remain stable and affordable to low income consumers. 2005 - 2006 Annual Report
| 21
Fortifying flour in South Africa Project period
January 2004 – June 2007
Food vehicle
Maize meal and wheat flour
Fortificant
Iron, vitamin A, zinc, folic acid and other B-vitamins
Grant awarded
US$ 2.8 million
Population reach*
38.7 million
Executing agency
UNICEF
*Projection of those reached when project is at full scale (five years after its start).
Achievements
¸
Over 90% of wheat flour and 70-85% of maize meal is now fortified.
¸
These fortified foods are now estimated to be benefiting 30 million South Africans.
¸
The multisectoral National Fortification Alliance, one of the first public-private alliances in the field of public health in South Africa, has demonstrated its worth and widespread benefits.
¸
A large-scale, 14-week radio campaign aired on nine African-language stations.
¸
The project helped establish a regulatory monitoring program supported by more than 1,500 trained environmental health practitioners.
Background Wheat flour and maize meal are widely consumed in South Africa with maize meal being the staple food for the poorest segment of the population, including over 80% of all children under three. As early as 1996, stakeholders discussed the development of a national staple food fortification program and produced a set of recommendations. The following year this led to the formation of a multisectoral National Food Fortification Task Group and, prior to 2001, several preparatory activities were implemented with support from the Micronutrient Initiative (MI) and UNICEF. These activities generated broad political support. Fresh research meanwhile highlighted the scope of micronutrient deficiencies in the country, leading to calls for further government action. In October 2002, the South African government introduced legislation in support of mandatory fortification of wheat flour and maize meal with eight vitamins and minerals. These fortifying elements are expected to provide up to 40% of the Recommended Daily Allowance.
GAIN’s project GAIN’s grant allowed the national fortification program, previously supported by MI, UNICEF and USAID/MOST, to expand throughout South Africa. The country’s milling industry is highly centralized and an important number of millers are affiliated to the National Chamber of Millers (NCM) and the National Association of Maize Millers (NAMM). Members of these two bodies produce 97% of the wheat flour and 70-85% of the maize meal in South Africa. The large market share and strong commitment of the associated millers and other stakeholders made it possible to rapidly scale up and provide almost universal fortification of the two staple foods within a short period. It remains a challenge, however, to develop the commitment of small-scale millers at the local level, as these producers are largely unregulated. Small maize millers account for up to 30% of market share and serve some of the poorest people. 22 | Global Alliance for Improved Nutrition
Fortifying flour and oil in Morocco Project period
December 2004 – December 2007
Food vehicle
Wheat flour and vegetable oil
Fortificant
Wheat: Iron, folic acid and other B-vitamins Oil: Vitamin A, vitamin D
Grant awarded
US$ 2.92 million
Population reach* 30.5 million Executing agency UNICEF *Projection of those reached when project is at full scale (five years after its start).
Achievements
¸
95% of oil available in commercial markets is now fortified.
¸ The
Moroccan government has passed the legislation that makes the fortification of flour mandatory as of May 2007.
¸
17 millers were participating in the wheat flour fortification project at the end of 2006.
¸
Suppliers of fortificants have trained government laboratory staff.
¸
Project has established a sentinel monitoring system, which tracks the consumption and availability of fortified wheat and oil throughout a network of 38 health clinics, schools, and retail stores throughout the 16 regions of Morocco.
Background Iron deficiency anemia affects about a third of women of childbearing age and children under five in Morocco. At least one third of young children also suffer from vitamin A deficiency, which compromises immune systems, opening the doors to disease and causing an estimated 1,500 deaths each year. Faced with this problem, the Kingdom of Morocco has set objectives for the reduction of micronutrient deficiencies and the Ministry of Health has developed an integrated strategy with four principal components: supplementation for vulnerable population groups; fortification of staple foods; nutritional education; and the reinforcement of nutrition-related health programs. The action plan includes full implementation of wheat flour fortification and a new program to fortify vegetable oil. These are both staple foods available to low-income populations at affordable prices, distributed through nationwide networks.
The GAIN flour and oil project Fortification of staple foods through the GAIN project is an essential element of the Ministry of Health's integrated micronutrient deficiency control program. The project was developed in 2002 by a National Fortification Alliance, comprised of public, private and non-governmental organizations, led by the Ministry of Health. Launched in April 2005, the project enables mills to produce flour fortified with iron, folic acid and B vitamins, and major producers of cooking oil to fortify their products with vitamin A and D. The project is managed by the Rabat office of UNICEF, in close collaboration with the MOH. The seed money provided by GAIN, US$ 2.92 million, was timely and tactical: supporting the development of legislation, training of mill staff and laboratory technicians, supplies and training for inspection, a communication campaign for fortified foods, and a monitoring and evaluation system. Most important, perhaps, it helped to secure government and industry contributions that bring the project budget to a total US$35.5 million. Among other components, this provides for food production and distribution, food control, communication, program monitoring and evaluation and program management support. 2005 - 2006 Annual Report
| 23
Targeted projects in India • In partnership with the World Food Programme (WFP), GAIN will support the provision of fortified complementary food for children 6 months to 36 months in the ICDS centres throughout Gujarat. • In Tamil Nadu in association with WFP and NACO (National Aids Control Organisation) GAIN will support the provision of nutrient dense meals to people living with HIV. • Large scale activities are planned in Rajasthan where GAIN, in collaboration with UNICEF, expects to support home fortification of complementary foods with sprinkles. Sachets containing essential nutrients will be distributed to mothers at ICDS centres. • In collaboration with the Naandi Foundation GAIN is working on a project to provide fortified midday meals in all kitchens run by the foundation which supplies meals to schools in both Andhra Pradesh and Rajasthan. • GAIN will be making a major investment to further the cause of food fortification in all three public food aid programs, ICDS, MDM and PDS, throughout Rajasthan. The state government, civil society, academia and the private sector are involved in deliberations to devise the most appropriate strategy. • A pilot project for fortified rice is planned in cooperation with the Naandi foundation in Andhra Pradesh.
24 | Global Alliance for Improved Nutrition
Targeted projects To support innovative sub-national and regional food fortification projects, GAIN has initiated a second stream of funding that facilitates the development of projects outside the full National Fortification Alliance framework. India is one country that has benefited from this more flexible funding.
GAIN’s contribution to tackling malnutrition in India In India GAIN’s program focus is on food fortification, utilizing the well developed existing publicly-funded food aid programs which are aimed at the most vulnerable sections of society: the Integrated Child Development Scheme (ICDS), the Midday Meal (MDM) and the Public Distribution System (PDS). ICDS targets children under 6 and pregnant or lactating mothers. Along with health education and propagation of exclusive breast feeding until 6 months, the scheme provides supplementary nutrition for mother and child. 36 million children are fed under the scheme. GAIN would like to ensure that over the next 2 years around 10% of these 36 million children receive nutritionally appropriate complementary foods that is fortified with essential vitamins and minerals. The Midday Meal program supplies free meals to some 120 million primary school children all over India. Menus differ in different parts of the country and food is prepared locally so fortification is a challenging task. GAIN hopes to cover 10 million children in the next 2 to 3 years through innovations to fortify midday meals. Focus will be on innovations that can be scaled. The PDS has a distribution network of 465,000 fair price shops where subsidized cereals, fuel and sugar are sold along with cooking oil. GAIN plans on conducting demonstration projects where wheat flour and cooking oil that is distributed to the population below the poverty line is fortified with iron and vitamins.
Britannia’s fortified biscuits distributed with school meals delivered by the Naandi Foundation in Andra Predesh and Rajasthan
Performance measurement and research
2005 - 2006 Annual Report
| 25
Performance measurement and research A distinguishing feature of GAIN is the strong emphasis it gives to measuring the outcomes and impacts of its programs. In 2006, GAIN began implementing its Performance Measurement Framework. This establishes 17 indicators for tracking organizational performance (see Figure 1), including commercial availability of fortified foods, coverage of target groups, reduction in micronutrient deficiencies and Disability Adjusted Life Years (DALYs) saved. The framework also allows for the measurement of fund-raising, overhead costs and private sector commitment. To implement the new framework, GAIN has collaborated with country teams in China, Côte d’Ivoire, Pakistan, Zambia and Ghana. These joint efforts are allowing for the development of comprehensive monitoring and evaluation plans, peer review of protocols for fortified food, knowledge, attitudes and practices (KAP) surveys and for
26 | Global Alliance for Improved Nutrition
surveys of micronutrient deficiency. GAIN also passed an important milestone in supporting Mali’s firstever survey of vitamin A deficiency among women of reproductive age. The results provide a solid baseline for Mali’s oil fortification program. GAIN is in the final stages of developing a performance measurement tool-kit and arranging for technical assistance to build the capacity of research institutes in developing countries to ensure that studies and surveys are well designed with standardized methodologies and indicators. Key partners here include the U.S. Centers for Disease Control (CDC), UNICEF, the A 2 Z project (funded by the United States Agency for International Development), and individual public health and nutrition experts. The tool-kit will be published in 2007 following peer-reviews by GAIN’s Technical Advisory Group and its Board. In 2006, GAIN presented to its Board of Directors its first Annual
Performance Report using the new framework. The report set a baseline and estimated five-year population reach and coverage targets for GAIN’s existing project portfolio. The organization also conducted a series of case studies to draw lessons learnt from its most mature country projects (for soy sauce in China and wheat flour and maize meal in South Africa and cottonseed oil in Mali). In 2005-2006, GAIN also added research to its Performance Measurement program. This will fill knowledge gaps in the micronutrient sector and assist in developing new strategies to reach target groups. The first research to be completed includes a study to develop sustainable business models to eliminate iodine deficiency and an analysis of the global investment required for large-scale expansion of fortification programs over the next 10 years.
Figure 1: GAIN’s Performance Measurement Framework RESULTS GOAL • To save lives and improve health, productivity and cognitive function
PERFORMANCE INDICATORS
1.
2. PURPOSE • To reduce the prevalence of micronutrient deficiencies by 30% among target groups
3.
KEY PROGRAM OBJECTIVE • To increase regular 4. consumption of fortified foods among target groups 5. 6.
DALYs (Disability-Adjusted Life Years) gained (specific micronutrient impact indicators include mortality rate, disability incidence, physical growth, intelligence quotient, school performance, productivity, etc) Cost-per-DALY gained
Numbers (and % prevalence) of individuals with micronutrient deficiencies
Coverage: numbers (and %) of target populations consuming fortified foods (disaggregated according to age-sex groups most affected by specific deficiencies and by income) Cost-per-target individual covered Reach: absolute numbers of individuals consuming fortified foods
COMPONENT PROGRAM OBJECTIVES • Increase 7. Absolute aMOUnt (and market share) of fortified production and food available (domestic production and imports) distribution of 8. Absolute aMOUnt of sales of fortified foods high-quality, affordable, fortified foods •
Increase consumer awareness of benefits of fortified foods
9.
% of targeted consumers who correctly recall health messages associated with logo / fortified foods / specific micronutrient deficiencies
•
Increase public and private commitment
10.
Existence of legislation and additional financial commitments by governments (US$) Additional financial commitments by private sector (US$) Additional donor investment in GAIN’s programs
11. 12.
GAIN PROGRAM ACTIVITIES • Deliver financial 13. and technical 14. resources to countries
Actual disbursements against cash forecast Total overhead costs as % of disbursements
•
Build national and international alliances
15.
Action and commitment rating index for national and international fortification alliances and partnerships
•
Create an enabling international policy environment
16.
Description of international plans and declarations that commit public and private sector bodies to action
•
Consolidate the evidence base for fortification
17.
GAIN board, staff and alliance partners’ quality ratings for performance information validity, clarity and utility 2005 - 2006 Annual Report
| 27
Moving malnutrition up the global agenda Staff and members of the Board meet regularly with decision-makers in the public and private sectors to press for action to address vitamin and mineral deficiencies— often with success. In March 2006, for example, a meeting with senior officials at the United Kingdom’s Department for International Development led to an invitation to GAIN Chair of the Board Jay Naidoo to address the International Development Committee of the British House of Commons. As a result, GAIN’s market-driven programs were described as “a model of success” in the formal recommendations of the Committee on private sector development issued in July 2006.
Advocacy and communication
BBC documentary focuses on GAIN project in Zambia In September 2006, BBC World broadcast a 30-minute program (titled We are what we eat) on micronutrient deficiencies to its global audience of over 250 million households. Filmed in Zambia, the documentary touched on the history of food fortification in that country and focused on the current GAIN-funded program to fortify maize meal with vitamins and minerals. The documentary was shot in the country’s capital, Lusaka, and in Mansa, an area where sight problems linked to vitamin A deficiency are common. The filmmakers interviewed teachers, nutritionists, millers, sugar producers, Ministry of Health officials and GAIN staff, among others, and showed the necessity of having all sectors work together for effective food fortification. BBC World documentaries such as this one have proved very popular with global audiences and have served to raise awareness about a number of health and development issues. The episode on micronutrients was given an 80% approval rating by the BBC’s viewer panel — where anything over 70% is considered excellent. Copies of the film are available from GAIN and footage from the production will be used to produce a corporate DVD, and used as b-roll supplied to media outlets.
After three years of operations the Global Alliance for Improved Nutrition is in a new phase of activity, shifting towards increased receptivity and appreciation of the tangible contributions to the micronutrient challenge that can be made by the private sector.
28 | Global Alliance for Improved Nutrition
Swiss media coverage of an interview with Regina Moench-Pfanner (left) and Bérangère Magarinos (right).
Publications
News coverage promotes GAIN Meetings of GAIN’s Business Alliances and milestones in GAIN’s country projects have attracted extensive media coverage in the last year. London’s Financial Times, The New York Times, Fortune Magazine, World Grain Magazine and media in China, India, South Africa, and Uzbekistan are among those that have highlighted GAIN’s work. Events that have generated coverage include: •
Beijing launch of the GAIN Business Alliance in October 2005 and the first meeting of the China Business Alliance in December 2005 drew extensive coverage in Chinese and international newspapers as well as on the internet.
•
Interview with GAIN Senior Manager, Investments and Partnerships Program, Bérangère Magarinos led to a Financial Times (London) Special Report in January 2006 describing how the GAIN Business Alliance for food fortification goes beyond corporate social responsibility (www.undp.org/partners/business/ gsb/FT_article06.pdf).
•
Inaugural European Business Alliance meeting, in London in March 2006, and the simultaneous announcement of a US$ 20 million grant from the Bill & Melinda Gates Foundation, generated television coverage in Africa and Asia, radio coverage in South Africa, and print and web coverage from a range of countries including the UK and Europe.
•
News releases about GAIN’s country projects in Zambia and Mali triggered reports in national and international media.
•
News about Muhammad Yunus and social business enterprise led to an article in Fortune featuring ‘the yogurt experiment’ in Bangladesh, Danone and GAIN’s views on new business partnership models.
•
The launch of the India Business Alliance and the signing of the MOU between GAIN and Brittania Biscuits attracted wide coverage in the Indian press.
In addition to the Annual Report, GAIN has published two reports in the past year, both linked to the global Ten Year Strategy: •
Vitamin and Mineral Deficiencies: Technical Situation Analysis. Geneva, GAIN (Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies), 2006.
•
Vitamin and Mineral Deficiencies: Stakeholder Perceptions Analysis. Geneva, GAIN (Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies), 2006.
The Technical Situation Analysis report will also be published as a special supplement to the Food and Nutrition Bulletin (FNB), a peer-reviewed journal published in hard-copy and online by the United Nations University. GAIN was the focus of a Harvard University School of Government case study: •
Bekefi T. Business as a Partner in Tackling Micronutrient Deficiency: Lessons in Multisector Partnership. Cambridge, MA, Harvard University, 2006 (John F. Kennedy School of Government Corporate Social Responsibility Initiative Report, No.7).
GAIN’s partnership model was also featured in a book published by the United Nations Global Compact Office: •
Witte, Jan Martin et al. Business UNusual: Facilitating United Nations Reform Through Partnerships. New York, UN Global Compact Office, 2005.
2005 - 2006 Annual Report
| 29
Infant and young child nutrition Improved nutrition for children, particularly those under two, is key to limiting the lifelong damage wrought by malnutrition. Mindful of this, GAIN has established a second grant program for Infant and Young Child Nutrition (IYCN), linked closely to that of food fortification and mobilizing additional parterships including business investment. While
exclusive
breastfeeding
meets nutritional needs until six months, from this age onwards, children need high quality, nutrientdense foods to complement breast milk. High quality complementary foods are available in developed countries and for the rich in developing countries, yet affordable quality products for the poor in developing countries — those most
‘All age groups benefit from micronutrients but the deficiencies are particularly damaging and difficult to reverse when they occur during fetal development and in early childhood.’ Tina Sanghvi, Jay Ross, Helen Heyman, The links between VMDs and survival, health, education and productivity in Food and Nutrition Bulletin, vol. 28, no 1 (supplement); Tina Sanghvi, Marc Van Ameringen, Jean Barker, John Fiedler, guest editors; ISSN: 0379-5721; p S167-173
30 | Global Alliance for Improved Nutrition
at risk of undernutrition — are not available. GAIN’s IYCN program will stimulate new partnerships and private sector innovation to produce high-quality, affordable fortified complementary foods and complementary food supplements for low income groups. Funding from the Bill & Melinda Gates Foundation will allow GAIN to support eight projects that will focus on high-burden regions and be selected through competitive bidding. The program is expected to reach 10 million children. In addition, as part of a USAID-funded consortium on IYCN, GAIN will also work with alliance partners to build the regulatory and policy environment to support the expansion and replication of IYCN programs in developing countries.
Board of Directors Jay Naidoo, Chair Chairman, Development Bank of Southern Africa; Chairman, J&J Group, Johannesburg, South Africa. In his role as Chair of the GAIN Board, Mr Naidoo is a tireless proponent for the Global Alliance for Improved Nutrition. His rich background in development includes experience as the Minister for Reconstruction and Development, and subsequently Minister of Telecommunications, Post and Broadcasting, in the government of President Nelson Mandela in South Africa. His contribution to international development includes membership of the Advisory Committee on Information and Communication Technologies (ICT) set up by the former UN Secretary General Kofi Annan. His commitment to global development was recently recognized by the award of the Chevalier de la Légion d’Honneur, the French Government’s highest honour.
David Fleming, Vice-chair Director for Global Health Strategies, Bill & Melinda Gates Foundation, Seattle, USA. Dr Fleming oversees the Bill and Melinda Gates Foundation’s portfolios in vaccine-preventable diseases, nutrition, newborn and child health, leadership, emergency relief, and cross-cutting strategies to improve access to health tools in developing countries. He came to the Foundation from the US Centers for Disease Control and Prevention (CDC).
Chunming Chen
Kul Gautam Deputy Executive Director, UNICEF, New York, USA. Mr Gautam has had a distinguished career with UNICEF, beginning in 1973. He is now responsible for providing leadership in strategic planning, policy guidance, program development, research, and promoting partnerships for children and development among UN agencies, donors and civil society organizations.
Pierre Henchoz Partner, Lombard Odier Darier Hentsch & Co, Lausanne, Switzerland. Mr Henchoz has a wealth of financial experience in both public and private sectors. He serves on the boards of a number of pension funds and other organisations and from 1986 to 1990 was Chief of Investment Management Services for the UN Joint Staff Pension Fund. He is currently a member of the Economic Advisory Board of the Canton de Vaud.
Richard Hurrell Professor, Institute of Food Science and Nutrition, Swiss Federal Institute of Technology, Zurich, Switzerland. Dr Hurrell is an experienced nutritionist, who specializes in iron fortification. Together with Dr P.A. Finot, he was awarded the International Prize for Modern Nutrition for studies on the influence of food processing and preparation on food quality.
Catherine Le Galès-Camus
Senior Advisor, Chinese Center for Disease Control and Prevention; Director, International Life Science Institute, Beijing, China.
Assistant Director General, Noncommunicable Diseases and Mental Health, World Health Organization, Geneva, Switzerland.
Professor Chen is an international expert in nutrition and shifting dietary patterns related to economic change. She is founder of the Union School of Public Health, Beijing Union Medical University and was a member of WHO’s Expert Advisory Panel on Nutrition, and a member of FAO’s Expert Panel on Ethics of Food and Agriculture.
Dr Le Galès-Camus is a leading authority on the growing epidemic of noncommunicable diseases that are imposing a double-burden on the world’s poorest countries. She has also served as a scientific advisor to the Director General of Health in France, responsible for defining the country’s public health objectives for 2004 to 2008.
Frances Davidson Health Science Specialist, Office of Health and Nutrition, Bureau for Global Programs, U.S. Agency for International Development, Washington DC, USA.
Christopher Elias President, PATH, Seattle, USA. As President of PATH, Dr Elias is responsible for strategic, programmatic, financial, and management operations aimed at identifying sustainable, culturally relevant solutions that enable communities worldwide to break long-standing cycles of poor health. Prior to joining PATH, Dr Elias was a Senior Associate in the International Programs Division of the Population Council.
32 | Global Alliance for Improved Nutrition
Ernest Loevinsohn Director General, Program Against Malnutrition and Disease, Multilateral Programs Branch, Canadian International Development Agency. Dr Loevinsohn was a founding board member of the Micronutrient Initiative and serves on the boards of numerous national and international organizations. He is Chairman of the board of Results, a nongovernmental organization working on hunger and poverty, economic empowerment, health and education.
Ex-officio members Jacques Baudouy Franck Riboud Président Directeur Général, Groupe Danone, Paris, France. Mr Riboud joined Groupe Danone in 1980 and has since then amassed extensive experience in many aspects of the food industry. In 1990 he was nominated Managing Director of Evian Mineral Waters and in 1992 took on the role of VP Corporate Development. Following his appointment as Vice-Chairman in 1994, he was nominated in 1996 to his present position.
Anji Reddy Executive Chairman, Dr Reddy’s Laboratories Ltd, India. Under Dr Reddy’s leadership, Dr Reddy’s Laboratories has become a pioneer in transforming the Indian pharmaceutical industry into the innovative, exportoriented industry that it is today. Dr Reddy serves on numerous boards, including the Prime Minister’s Council on Trade & Industry and the National Institute of Pharmaceutical Education and Research.
Nicolas Tsikhlakis Vice-President, Modern Flour Mills & Macaroni Factories Co, Amman, Jordan. Nicolas Tsikhlakis is Chief Operations Officer and Partner of the Modern Flour Mills and Pasta Factories in Amman, Jordan. The company conducts extensive research and development work on new products and adaptations. Mr Tsikhlakis has over 15 years of experience in milling.
Paulus Verschuren Senior Director, Partnership Development, Unilever Health Institute, Unilever R&D, Vlaardingen, Netherlands. Apart from his wide experience with Unilever dating from 1981, Paulus Verschuren has served as Executive Director of the International Life Sciences Institute (ILSI Europe), as Chairman of the Board of ILSI Europe and as member of the ILSI Global Executive Committee. With the Unilever Partnership Development Group he aims to develop global nutrition and health partnerships creating both social and business value.
Director, Health, Nutrition and Population International Bank for Reconstruction and Development, The World Bank, Washington DC, USA.
Marc Van Ameringen Executive Director, Global Alliance for Improved Nutrition, Geneva, Switzerland A Canadian national, with a background in international political economy, Mr Van Ameringen has spent most of his career in Africa implementing and managing programs, across a range of areas. Prior to joining GAIN, he was Vice-President of the Canadian-based Micronutrient Initiative. From 1992 to 2002, Mr Van Ameringen was a Director based in Johannesburg, South Africa for the International Development Research Centre (IDRC).
Observers Venkatesh Mannar, Executive Director, The Micronutrient Initiative, Ottawa, Canada. Kei Kawabata, Sector Manager, Health, Nutrition and Population Sector Unit, World Bank, Washington DC, USA. Katharine Kreis, Senior Program Officer, Maternal & Child Health and Nutrition, Global Health Program, Bill & Melinda Gates Foundation, Seattle, USA. Ian Darnton-Hill, Senior Adviser, OIC, Nutrition Section, Child Survival and Nutrition UNICEF, New York, USA.
Executive Committee Jay Naidoo, Chair David Fleming Catherine Le Galès-Camus Ernest Loevinsohn Marc Van Ameringen (ex officio)
Finance and Audit Committee Pierre Henchoz, Chair Chunming Chen Frances R. Davidson Paulus Verschuren Marc Van Ameringen (ex officio) Edward Atkinson (ex officio), Chief Financial Officer, Global Alliance for Improved Nutrition
2005 - 2006 Annual Report
| 33
34 | Global Alliance for Improved Nutrition
Financial Statement Statement of Income and Auditor’s Report
and
Expenditure
for
the
Year
ended
June 30, 2006
Balance sheet at June 30, 2005 (with 2005 comparative figures)
(expressed in US dollars)
2006
2005
7,053,713 554,490 77
9,550,000 98,377 -
7,608,280
9,648,377
6,148,260 25,000
4,452,951 405,248
6,173,260
4,858,199
3,994,828 177,367 390,502 1,699,343 953,540 72,938 42,465
2,173,982 170,832 662,138 1,228,349 874,208 47,608 40,813
35,936 29,054
34,991 47
13,569,233
10,091,167
(5,960,953)
(442,790)
6,915,199
7,357,989
954,246
6,915,199
INCOME: Donations received Bank interest Sundry income Total income
EXPENDITURE: Project related costs: Project grant expenditures Project supervision fees
General administration expenses: Staff related expenses Office rental Secretariat operational expenses Professional, technical and legal fees Travel and meeting expenses Depreciation Other miscellaneous Finance related expenses: Bank charges Exchange difference, net
Total expenditure EXCESS OF EXPENDITURE INCOME Surplus, beginning of year Surplus, end year
OVER
See notes to financial statement
2005 - 2006 Annual Report
| 35
Balance Sheet as at June 30, 2006 (with 2005 comparative figures)
(expressed in US dollars) NOTES
2006
2005
10,580,590
14,588,510
Advances to UNDP and UNOPS
311,223
1,056,991
Other receivables
236,108
-
Prepaid expenses
62,626
322,388
11,190,547
15,967,889
189,131
144,114
11,379,678
16,112,003
47,859
164,757
240,120
362,872
21,150
-
608,802
440,492
ASSETS CURRENT ASSETS Cash at bank
Total current assets
FIXED ASSETS, net
3
TOTAL ASSETS LIABILITIES CURRENT LIABILITIES Bank overdraft Accounts payable Other creditors Accrued expenses Grants payable
4
6,797,524
1,965,643
Project supervision fee
4
328,793
479,057
8,044,248
3,412,821
2,344,997
5,747,796
36,187
36,187
Surplus
954,246
6,915,199
Total capital and reserves
990,433
6,951,386
11,379,678
16,112,003
Total current liabilities
LONG TERM LIABILITIES Grants payable after one year
CAPITAL AND RESERVES Foundation capital
5
Total LIABILITIES
NOTES TO FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2006 (with 2005 comparative figures) 1. GENERAL
(expressed in US dollars)
The Global Alliance for Improved Nutrition (GAIN) is an independent non-profit Foundation created under Article 80 of the Swiss Civil Code, and is registered with the Geneva Register of Commerce under statutes dated March 26, 2003. The Foundation has been established to support food fortification and other sustainable nutrition strategies in order to save and improve health, productivity and cognitive function. In pursuing this objective, the Foundation intends to improve the micronutrient status of individuals living in developing countries, contributing to the following goals: • • • •
Reduce child and maternal morbidity and mortality; Improve productivity; Promote the ability of populations to achieve their physical and intellectual potential; Reduce healthcare costs.
In order to attain these goals, the Foundation shall support developing countries in food fortification efforts, undertaken in the context of broader micronutrient strategies that will reduce micronutrient malnutrition in developing countries, particularly through increased consumption of micronutrient-rich foods. The Bill & Melinda Gates Foundation and certain governments and other contributors have made available initial resources to support the projects and programs to be supported by GAIN. 36 | Global Alliance for Improved Nutrition
These resources are managed by the International Bank for Reconstruction and Development (World Bank) via a Trust Fund administered by the World Bank as trustee on behalf of GAIN.
Donations may also be received directly by GAIN. The initial projects satisfactorily appraised by the World Bank and approved by the GAIN Board of Directors shall be administered and supervised directly by the World Bank in accordance with the written agreement between the World Bank and GAIN. With respect to each such project, the World Bank shall, as administrator on behalf of GAIN, enter into a grant agreement with the recipient of such grant. The World Bank shall solely be responsible for the supervision of the project activities under the Grant Agreement. Any other projects approved by the GAIN Board of Directors shall be administered and supervised by the GAIN. The World Bank shall provide to GAIN an aMOUnt equal to the budgeted annual operating costs of the GAIN Secretariat as approved by the GAIN Board of Directors. Until June 30, 2005, GAIN had no direct employees. The majority of personnel and related costs, including current and post employment benefits were provided and managed by the UNDP and WHO (World Health Organization) and charged in full to GAIN, covered by written agreements. Following agreement with UNDP and WHO, GAIN starting employing staff directly is no longer relying on the services of UNDP and WHO. Certain personnel and related costs are provided and managed by the World Bank, and are paid directly from the Trust Fund and are not charged to GAIN.
2.
SIGNIFICANT ACCOUNTING POLICIES
Basis of accounting - The accounting policies comply with the Swiss Code of Obligations. Donations received - The donations received are recorded on a cash basis. Foreign currency - Accounting records are maintained is US dollars. Income and expenditures in the other currencies are recorded at the rates ruling at the date of the transactions. Period-end balances for assets and liabilities in other currencies are translated into US dollars at rates of exchange prevailing at balance sheet date. Exchange gains and losses are included in the determination of the net income. Fixed assets - Fixed assets are stated at cost less accumulated depreciation. The Foundation applies the straight-line method for the depreciation of these assets using a rate of 20% per year for office equipment and 50% per year for computer equipment. Grants committed for projects - All grants are governed by a written grant agreement. All expenses are accounted for at the moment of the signature of the agreement. Grants or portions of grants that have not been disbursed at the balance sheet date are recorded as short and long-term liabilities. Certain agreements provide that the payments of part of the grants occur when defined milestones have been met.
3.
FIXED ASSETS, net
Fixed assets held at June 30, 2006, are as follows : Office equipment 227,982
Computer equipment 110,637
Total 338,619
Accumulated depreciation
(89,205)
(60,283)
(149,488)
Net book value
138,777
50,354
189,131
Gross Book value
The fire insurance covers aMOUnts to : USD 160,400 - CHF 200,000 (2005 - USD 158,128 - CHF 200,000).
4.
GRANTS AND PROJECT SUPERVISION FEES PAYABLE
5.
Foundation Capital
The Foundation capital aMOUnts to CHF 50,000 (equivalent at USD 36,187 at the March 26, 2003 exchange rate).
6.
RENT AND LEASING COMMITMENTS
At June 30, 2006, the Foundation had future minimum office rental commitments aMOUnting to USD 821,295 (2004 - USD 126,832), corresponding to expected rental fees until the end of the lease (April 30, 2011). The Foundation has also entered into a leasing contract for computer equipment for which the remaining commitments as at June 30, 2005 aMOUnt to USD 22,510 (2005 - USD 55,457). 2005 - 2006 Annual Report
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Auditor’s Report
38 | Global Alliance for Improved Nutrition
Acknowledgement and photo credits Published by: Global Alliance for Improved Nutrition Rue de Vermont 37-39 PO Box 55 CH- 1211 Geneva Switzerland Tel: +41 22 749 1850 Fax: +41 22 749 1851 Email: info@gaingeneva.org Internet: www.gainhealth.org Executive Director: Marc Van Ameringen Written and complied by GAIN staff
Photos: Cover Top row: Child’s face, Françoise Chomé, Burkina Faso. Oil bottles, Françoise Chomé, Burkina Faso. Mother child, Clipart photos, India. Middle row: Deep fried dumplings Miklos Fejes, Zambia. Girls face, UNICEF, Central Asia. Bread, Africa. Bottom row: Two children, Matt Green, Hungry Eye Images, China. Hand shake, Ashish Sabharwal, India. Boy, Miklos Fejes, Zambia. Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page Page
2: 6: 7: 8: 9: 10: 12: 13: 14: 16: 17: 20: 22: 23: 24: 25: 26: 27: 28: 28: 30: 29: 30: 39:
Bags of wheat, Miklos Fejes. Marc Van Ameringen, Françoise Chomé, Switzerland. Children, Sebastien Rich, Hungry Eye Images, Nicaragua. Food products, Gelise McCullough, Switzerland. Women of Rajesthan, Felix Topete, India. Signing photos, Bérangère Magarinos, Bangladesh. Football, Bérangère Magarinos, Bangladesh. Nutri-Sip project, Mandla Mbau, Nigeria. Mother and child, Richard S. Ehrlich, Hungry Eye Images, Bangladesh. Boys jumping, Alex Saint-Hilaire, Dominican Republic. Man working, Miklos Fejes, Zambia. Man with bottle of soy sauce, Guiyang, China. Women flour, Miklos Fejes. South Africa. Flour products, Ministry of Health, Morocco. Tiger biscuits, Gelise McCullough, Switzerland. Girls with flour, Maia Tskitishvili, Georgia. Research, Louise Sserungogi, Uganda. Women and baby, HKI, Mali. Three photos from film, Sebastien Rich, Hungry Eye Images, Nicaragua. Office photo, Gelise McCullough, Switzerland. Group of children, Miklos Fejes, Zambia. Nursery worker, Greg English, Hungry Eye Images, China. Nutri-Sip project, Mandla Mbau, Nigeria. Girl, Françoise Chomé, Mali.
Copyright © The Global Alliance for Improved Nutrition, 2007 All rights reserved. Any use of information contained in this Annual Report is subject to a permission request to be addressed to GAIN, to the attention of the Manager, Communications.
“Investments in micronutrients rank above those in trade liberalization, malaria, and water and sanitation, in terms of immediate benefits for eradicating disease and poverty.� World Bank, 2006.
Rue de Vermont 37-39 PO Box 55 1211 Geneva 20 Switzerland
Tel. +41 22 749 1850 Fax +41 22 749 1851 www.gainhealth.org