Vitamin A deficiency affects over 140 million preschool children in 118 countries
Vitamin A deficiency (VAD) is one of the most pernicious forms of undernourishment in the developing world. It limits growth, weakens immunity, affects sight and increases mortality. Afflicting over 140 million preschool children in 118 countries and more than seven million pregnant women, it is the leading cause of child blindness in developing countries. Between 250,000 and 500,000 vitamin A-deficient children go blind every year, half of them dying within 12 months of losing their sight. VAD also weakens the immune system, increasing their risk children under five years of age dying from diarrhea, measles and malaria by 20–24 percent.
Orange fleshed sweetpotato providing high levels of vitamin A to vulnerable populations
Orange fleshed sweetpotato (OFSP), when coupled with community nutritional education, offer a promising solution by providing high levels of vitamin A. But gathering the evidence needed to scale this solution did not come easily. One small boiled root of most OFSP varieties provides 100% of the recommended daily intake of vitamin A for children and one medium root provides all of the needs for most women of reproductive age. OFSP is a good source of energy, a number of B vitamins, several minerals (phosphorus, postassium) and vitamins C and K. These are vital benefits for the majority of people affected by VAD who live in rural areas where conventional VAD interventions such as supplementation and food fortification are less effective.
Bringing the nutritional benefits of OFSP to nearly 2 million households in countries across sub-Saharan Africa affected by vitamin A deficiency
The International Potato Center (CIP) is working to bring the nutritional benefits of OFSP to nearly 2 million households in countries across sub-Saharan Africa affected by vitamin A deficiency. Over many years of working on OFSP, CIP has demonstrated that rigorous research in agriculture and health sciences can be combined to create solutions for global nutrition challenges and that these can be scaled up to reach millions of vulnerable families.
Initially CIP, set out to see if communities in Sub-Saharan Africa (SSA) would accept biofortified OFSP, that the prevalence of VAD could be reduced by eating it, and that countries would adopt it. CIP has successfully shown that bio-fortified OFSP can play a key role at the nutritional forefront of the battle against hidden hunger in Sub-Saharan Africa (SSA).
Biofortified sweetpotato is now firmly on the menu of 14 countries in Africa and contributes to saving the eyesight and strengthening the immune system of hundreds of thousands of children. Under-nutrition has increased in many countries in Asia and Africa, and the number of those suffering from ‘hidden hunger’, or micronutrient deficiency, is around two billion which makes food based approaches to VAD very important.
CIP researchers have established evidence for the benefits of this food-based, nutrition-sensitive approach and have been successful in brining about diversified use of OFSP and opening up new market opportunities for farmers. In sub Saharan Africa, most sweetpotato is eaten boiled or steamed. CIP has worked to develop new markets for processed products, such as bread, biscuits, and juice, helps OFSP break into urban centers. With the African continent being the fastest urbanizing continent in the world, reaching urban consumers with fresh roots using improved storage and transport systems and processed products is critical. Commercialized OFSP products have been developed in both Rwanda and Kenya and small scale processing has been widely promoted at the household level in many other countries.
Measuring impact in integrated agriculture-nutrition interventions
Integrated agriculture-nutrition interventions often require very expensive consumption studies and blood samples to demonstrate increased micronutrient intakes and improved nutritional status. Mozambique has some of the VAD rates among young children—69%. So what better place to test when an integrated agriculture-nutrition strategy can work? A two-year proof-of-concept study in Zambézia province demonstrated that young children in households producing and eating biofortified OFSP significantly increased vitamin A intakes, with a 15% decline in the prevalence of VAD. This was followed by a randomized control trial which demonstrated that 14,000 households could be reached cost-effectively with just one year of community-level nutrition education and access to OFSP. Because of these studies, the OFSP integrated approach is well-known as one of the few food-based interventions with solid evidence.
These study results paved the way for development agencies to funds to International Potato Center (CIP) to make Mozambique the hub for breeding for drought-tolerant OFSP in Africa and collaborate with many partners in the dissemination of OFSP.
The beauty of OFSP is that it does not require a large field to make a difference in terms of vitamin A supply. Using the varieties of OFSP that the team developed, just 500 square meters of an OFSP yielding 10 t/h meets the annual vitamin A needs of a family of five. The Sweetpotato for Profit and Health Initiative (SPHI) set up under the guidance of Dr Low has changed the image of sweetpotato as a crop of poor women to a healthy food for all. CIP coordinates the Sweetpotato for Profit and Health Initiative, which in collaboration with seven NGO partners and many government institutions, has reached 5.3 million households in 15 sub-Saharan African countries with improved sweetpotato varieties, promoting their diversified use. Through SPHI, CIP has spearheaded the development of OFSP puree (steamed and mashed) as a cost-effective, nutritious ingredient in baked products.
Developing OFSP varieties with high retinol concentrations, increased productivity and with resistance to sweetpotato virus disease
Dr Robert Mwanga, a sweetptoato breeder, has developed OFSP varieties with high retinol concentrations, increased productivity and with resistance to sweetpotato virus disease. The program sent 481,310 botanical seeds (breeding populations) to 11 countries (Ghana, Nigeria, Burkina Faso, Ethiopia, Burundi, Rwanda, Kenya, Tanzania, Madagascar, Malawi, and South Africa). Uganda, Rwanda, Kenya, Tanzania, Malawi, Mozambique, Madagascar and Ethiopia have all released OFSP lines. The area under cultivation of the OFSP cultivars is expanding rapidly in countries such as Ethiopia, Rwanda,Tanzania, Nigeria, Malawai, Zambia and Kenya due to promotion of OFSP to alleviate VAD by development partners. Over 10 million vine cuttings have been distributed and planted by farmers in East Africa by 2012.This level of progress can be sustained for the long term.
Biofortified cultivars can contribute significantly to a viable, long-term, effective and sustainable food-based approach to prevent VAD. For example, sweetpotato yields (both white and orange) in Uganda were very low (4.4 t/ha) compared the global average of 13.7 t/ha. The OFSP varieties bred by Dr. Mwanga in Uganda have yields above 10 t/ha on farmer’s fields. In addition, compared to other crops, the fortified varieties require fewer inputs and less labor, making them particularly suitable for households impacted by migration or diseases such as HIV/AIDS. Moreover, farmers earn income by selling planting material. In eastern and central Uganda a single farmer can earn about US$400 per month from the sale of planting materials and sweetpotato products at the beginning of the rains.
Government recognition that biofortified OFSP can be promoted to reduce the country’s high VAD rate
Dr Maria Andrade has spearheaded CIPs work in Southern Africa and the Government of Mozambique has officially recognized that biofortified OFSP can be promoted to reduce the country’s high VAD rate. OFSP is now well known as a key crop for food and nutrition security in Mozambique, and a ‘business card’ for the bio-fortification work in Africa. After several interventions under El Nino and La Nina emergencies in Mozambique, sweetpotato has also been recognized as one of the most important crops for disaster relief and recovery. OFSP has become an essential food security crop known by the popular slogan, “the sweet that gives health.”
Convinced by previous results, USAID provided funds in 2012 to disseminate vines of the new varieties to 120,000 households in the major sweetpotato-producing areas of the country. Before the program about 20% of the families were growing any type of sweetpotato. After 24 months, 70% of households were growing on average 400 m2 of OFSP. By 2013, an estimated 26% of all sweetpotato grown in Mozambique was OFSP.
Marketing strategies involving food based approaches initiated in 2000 in Mozambique expanded to 14 countries in Africa. More than 3,000 promotional events were carried out so far. Since 2001 more than 1 million households have received improved high yielding OFSP planting materials. Since 2009, 15 improved drought-tolerant varieties were released and over 500,000 households in Mozambique are now growing OFSP. OFSP now comprises 32% of all sweetpotato production in the country. Roughly 55% of the household members who received the drought tolerant planting material were women. More than 300 Training-the-Trainer workshops were conducted and more than 1 million farmers trained in sweetpotato production and protection. Using a new accelerated breeding method, 4 additional drought-tolerant OFSP varieties were released in early 2016.
For more information: about the International Potato Centers work in sub-Saharan Africa and around the world please visit the links below.
CIP staff collaborated to produce the text for this story. Compiled by: Sara Quinn, Regional Communications Specialist, International Potato Center.
Cover picture: A mother and child prepare orange fleshed sweetpotato for taste testing in rural Malawi as part of the DFID funded Scaling up Sweetpotato through Agriculture and Nutrition (SUSTAIN) project
World Food Prize Laureates 2016
The International Potato Center salutes the 2016 World Food Prize Laureates Drs. Jan Low, Maria Andrade, and Robert Mwanga of the International Potato Center (CIP) and Howarth Bouis of Harvest Plus for their work on biofortified crops to reduce hidden hunger and specifically vitamin A deficiency (VAD), one of the most pernicious forms of undernourishment in the developing world.
Vitamin A deficiency causes blindness, limits growth, weakens immunity, and increases mortality. Afflicting over 140 million preschool children in 118 countries and more than seven million pregnant women, it is the leading cause of child blindness in developing countries. Between 250,000 and 500,000 vitamin A-deficient children go blind every year, half of them dying within 12 months of losing their sight. VAD also weakens the immune system in under-fives, increasing their risk of dying from diarrhea, measles and malaria by 20–24 percent.
The CIP and HarvestPlus team set out to prove that the local people in Sub-Saharan Africa would accept biofortified Orange Fleshed Sweetpotato (OFSP) into their diets, that vitamin A deficiency could be prevented by eating it, and that countries would adopt it. In this they have succeeded. Biofortified sweetpotato is firmly on the menu of 14 countries in Africa and contributing to saving the eyesight and improving the nutrition of hundreds of thousands of children and food security of the entire family.