A Canadian Breakthrough: Fortifying Lives Through Nutrition

Almost one in three people -- 2 billion globally -- suffer from vitamin and mineral deficiencies impacting child survival, growth, development, learning capacity and earning potential.
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From the discovery of insulin to treat diabetes to the development of the Blackberry, Canadians have a long and proud history of inventions that change the world and people's lives. But remarkably, one of the most impactful discoveries improving lives around the world in modern times is largely unknown in Canada.

The earliest stages in a child's life make or break their ability to optimally develop physically and mentally. To give a sense of scale and impact, 150 million children suffer from iron deficiency and anemia globally, making it the most common nutritional disorder in the world. In 1997, Stanley Zlotkin at Toronto's Hospital for Sick Children, responded to this challenge by building a team that would ultimately develop the world's first micronutrient powders designed for low income populations across the developing world.

Throughout the world, micronutrient deficiencies are a significant cause of illness and death. Almost one in three people -- 2 billion globally -- suffer from vitamin and mineral deficiencies impacting child survival, growth, development, learning capacity and earning potential. In the developing world, the challenge is particularly dire, where nearly 20 percent of the population suffers from iodine deficiency, 25 percent of children have vitamin A deficiency and as many as 60 percent suffer from anemia.

The micronutrient powder -- also known as "Sprinkles" -- developed by Dr. Zlotkin and his team in Toronto is available in small sachets, costing less than five cents per package, and formulated to meet a child's daily micronutrient requirements.

Part of its appeal is the adaptability -- it can be mixed into virtually any food to compliment breastfeeding after six months of age, meaning local foods and traditions can be upheld.

This approach has led to the successful testing, proven efficacy and adoption of Sprinkles™ throughout the world.

Now, there are approximately 22 manufacturers globally producing multinutrient powders, reaching more than 6 million vulnerable children. However, in the 36 high-burden countries, the need exceeds 700 million, which include adolescent girls, mothers and children under five -- those vulnerable populations who stand to benefit the most from the use of these products.

An additional challenge that Sprinkles™ helps overcome is frequency of use -- since it only needs to be consumed two or three times per week to foster the healthy development of a child's mind and body, it's affordable and easy to integrate into local diets.

In Bangladesh, consuming 60 sachets of Sprinkles™ containing iron was associated with a significant decrease in the prevalence of anemia -- from 72 percent at baseline to 30 percent after 120 days.

Today, through a GAIN-sponsored project, millions of sachets are being sold to families across Bangladesh through a partnership with Renata Limited, the manufacturer, and BRAC, which distributes the product throughout the country via its large, community-based network of health workers. In Kenya, GAIN works with both public and private sector partners to improve access to Sprinkles among the most vulnerable women and children -- as seen on the video "Missing Ingredient."

Research shows that adequate maternal and child nutrition during the 1,000 day window from pregnancy through age two shapes a child's future. For less than $20 a year, using Sprinkles™ -- and other similar multinutrient powders -- a child in the developing world will gain the quality nutrition she needs to grow, learn and ultimately become a productive and contributing member of her society.

While recently speaking with Dr. Zlotkin, he remarked on the complicated and global nature of the project. When first charged by UNICEF with developing a concept for improving childhood nutrition through fortification, he didn't anticipate he would be undertaking a project that would take upwards of a decade to see through and involve local tests in 15 markets as diverse as Pakistan, Nigeria and Indonesia.

Prior fortifying powders and liquid drops had challenges like imprecise dosing and consistency of use. For example, iron on its own oxidizes foods, turning rice green and staining the teeth of children. Although perfectly safe, this resulted in lower adoption rates, since it understandably created concern among parents. The breakthrough came when Zlotkin identified the pharmaceutical technique of micro-encapsulation, so the nutrients would be distributed once they hit the stomach. After recruiting local market pharmaceutical companies to take the project on, despite no immediate promise of profit, UNICEF green-lit the initiative and rolled it out globally.

As a result, Zlotkin and his team identified a new means of creating an effective and acceptable solution that can be brought to scale and distributed in local markets, making a significant dent on childhood malnutrition. Additionally, there is no patent protection on the product, so these can be made by anyone, anywhere. Parents can now easily sprinkle this fortifying powder over common foods, not affecting the taste but making a dramatic impact on nutrition levels of common staples in the developing world. Already, it has reached 10 million children with 500 million sachets produced.

While it may not be widely known as one of the greatest Canadian inventions, there can be no doubt the impact micronutrient Sprinkles are having on lives and communities the world over, and its impact will only continue to grow, fortifying the future. Through simple and smart investments and innovations, particularly in nutrition at the earliest stages of development, Canadians can continue to play a major role in helping create a healthier, prosperous and more sustainable world.

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