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This story describes the DGIS-funded Voice for Change Partnership (V4CP) programme’s work to improve food and nutrition security in Rwanda. It illustrates how, by working together with local civil society organisations (CSOs), the programme managed to convince the Government of Rwanda to prioritise a vital, yet neglected, law to make food fortification mandatory.

The story highlights the development of an influential partnership between CSOs and a wide range of stakeholders from both the public and private sectors. Their collaborative efforts have brought about the systemic changes required to increase the production of - and access to - fortified foods in Rwanda.

This progress will have a positive effect on the country’s economy in the longer term. Not only will it contribute towards a healthier and more productive population by alleviating malnutrition for millions of people, it will also stimulate private investment and markets.

The cost of malnutrition

Malnutrition continues to challenge Rwanda, in spite of the country’s significant scientific, economic and technological advances. As a result, far too many people suffer related health conditions such as stunted growth, which affects almost half of young children in rural areas.

This not only has a significant social cost, it also undermines the country’s economic growth because malnutrition is linked to low school attainment, low productivity as an adult, and low lifetime earning potential[1]. In 2014, the associated total economic loss was estimated at US$820 million[2] a year - equivalent to 11.5 percent of Gross Domestic Product in 2012. In addition, it is thought that almost US$50 million is lost to the economy every year as a result of vitamin and mineral deficiencies[3].

A strategic solution

One of the most efficient ways to tackle widespread malnutrition is to add micronutrients, such as iron, vitamin A, folic acid and iodine to staple, processed foods in order to improve their nutritional content.

While efforts had been made to stimulate fortified food production by the Government of Rwanda, the legislation in place was only voluntary and did not oblige the sector to fortify staple foods. As a result, when the V4CP began its food and nutrition programme in the country in 2016, fortified food production was limited. Private investment in the sector remained low, and the service systems required to distribute fortified food to the population were inadequate.

It was clear to the V4CP programme’s experts that the market would not be stimulated through increased public demand alone. This was because those with the greatest need for additional micronutrients were often poor and could not afford fortified food. Furthermore, those who could afford it were unaware of its benefits. At that time, most demand came from programmes that supplied vulnerable people, such as babies, toddlers and pregnant or breastfeeding women from poor households.  

This highlighted the need for systemic change, including a change in the law. While a bill to make fortified food production mandatory had been drawn up in 2019, unlike most other east African countries, the Government of Rwanda had still not finalised or implemented it. To push the forgotten bill up the Government’s agenda, further evidence of its potential benefits was required, along with an increase in the capacity of local food and nutrition experts to advocate for a mandatory law. 

Alliance for change

The V4CP programme works with local CSOs who have knowledge of the issues as well as the country context. In Rwanda, it partnered with a spectrum of CSOs to jointly implement the food and nutrition security agenda. These were: Scaling Up Nutrition (SUN) Alliance; the Rwandan Farmers Federation (IMBARAGA); CARITAS; the Rwanda Consumers' Rights Protection Organization (ADECOR); the Rwanda Development Organisation (RDO); and the Action for Integrated Rural Development (DUHAMIC ADRI). The V4CP set about developing the capacity of the CSOs and gave them ‘on the job’ coaching to improve their leadership and advocacy skills, as well as their utilisation of data and evidence, knowledge of relevant issues and business development in their particular sector. 

Key to amplifying advocacy for the mandatory food fortification law was the formation of the National Fortification Alliance (NFA) in 2017. Chaired by ADECOR, this helped build support and mobilise energy towards a common goal among the various public and private sector stakeholders.

With the alliance in place, the V4CP programme advocated a range of strategies for change, including inviting key influencers across the food value chain to join the alliance. It organised face to face meetings, workshops and roundtable discussions with relevant actors from public, private and civil society. In addition, it engaged the media and initiated community campaigns to raise public awareness of fortified foods in order to stimulate market demand.

However, one of the barriers to progress was a lack of evidence of the impacts of fortifying food. There was insufficient data on the status of nutrition and food fortification across the population, and poor monitoring data for fortification programmes, as well inadequate risk management.

To bridge the gap, ADECOR and DUHAMIC-ADRI worked with IFPRI and generated evidence products such as a report entitled the ‘Status of Food Fortification in Rwanda’. Using this as a basis, V4CP developed advocacy interventions and engagement strategies to raise awareness of the benefits of fortified foods. It reached out to communities in order to increase market demand and held learning and discussion events to inspire a wide range of multi-sector stakeholders, from government entities to private sector and international non-governmental organisations, to speak as one voice. 

Over the following two years their evidence-based advocacy efforts started to bear fruit. During a roundtable discussion on food fortification on 16 December 2016, Mr. Jean Louis Uwimana, Director General in charge of trade and industry at the Ministry of Trade, Industry and East African Affairs, said:

“Children should have better access to nutritional foods…We need healthy people to be more productive...The government is supportive of civil society initiatives and fully encourages the private sector to invest more in cost-effective fortification.”

High level support for food fortification continued to grow and, in December 2017, the Government announced the introduction of a new Rwanda Food and Drug Authority, under the Ministry of Health to increase the priority of food fortification.

Evidence for advocacy

However, to engage the new authority and further galvanise change, additional evidence was required into the availability, accessibility and affordability of fortified food, as well as on the barriers to increased consumption. Therefore, in early 2019, IFPRI, in collaboration with the CSOs, compiled a synthesis report on the status of food fortification in Rwanda. The report presented a convincing, evidence-based argument that industry, including importers, should be responsible for fortifying food. It also underlined that food producers who voluntarily fortified food may attract more customers.

Through ADECOR, the V4CP presented the report during a series of workshops and meetings, which resulted in the Government setting up a task force to review and improve the draft food fortification law that had been pending for so long. It invited the V4CP to help it revise the draft mandatory law.

Collaboration for change

In August 2018, the V4CP presented the report to the Government during a food fortification roundtable discussion in Kigali, organised by the alliance. The event was attended by Dr Charles Karangwa, Director General of the Food and Drug Authority, as well as representatives from the private sector, government institutions, donors and the media. The V4CP invited the only three companies that were currently fortifying food in Rwanda to present during the meeting. These companies demonstrated that, contrary to common belief, fortifying food is relatively inexpensive when compared to other forms of food processing.

Representatives from SOSOMA and Africa Improved Food share experiences.

Representatives from SOSOMA and Africa Improved Food share experiences.

The powerful evidence-based advocacy case presented by the V4CP, along with the first-hand testimonies from industry, inspired the Government to commit to introducing the long awaited, mandatory regulation on food fortification in Rwanda.

Not only did this event signal the dawning of the new law, it also marked a step change in the strength of partnership between the private sector and the Government. It led to a greater number of processing companies opening their eyes to the benefits of fortifying food, both for profit and for community health.

During his speech at a subsequent roundtable discussion on November 15 2018, Dr Charles Karangwa thanked SNV’s V4CP and ADECOR for pushing for this law and promised to continue working with them to ensure its was properly enforced. He concluded by stating that Rwanda Food and Drugs Authority would closely work with other partners, including business people, development partners and CSOs, to promote investment in food fortification.

“Food fortification is critical to contribute to fight malnutrition as key nutrients are added into the staple foods. Hidden hunger due to micronutrient deficiencies poses a threat to the attainment of good nutrition as well.” – Dr Charles Karangwa

Dr Charles Karangwa, Director General of the Rwandan Food and Drug Authority.

Fortifying nutrition

By early 2019, the V4CP was working closely with the Rwanda Food and Drug Authority. Together, they organised an intensive workshop with different stakeholders and drew up revised technical regulations for the draft mandatory law. They encouraged food processors to increase investment in food fortification and managed to strengthen the enforcement of regulations on food fortification through workshops and media engagement to further increase the awareness of stakeholders from the sector.

In October 2019, the “Regulations on food fortification in Rwanda” was signed, making fortification mandatory for maize flour, wheat flour, edible oil, sugar and salt. This took concerted effort by a wide range of CSOs, private sector and government institutions. The Ministry of Health and the Rwanda Food and Drugs Authority chaired the process of drafting the regulations and signed them. The National Early Childhood Development Program (NECDP), the body in charge of coordinating nutrition activities at national level, supported the process by establishing National Nutrition Technical Working Group meetings. The Rwanda Standards Board (RSB) set standards for regulating the fortification of different products, including those that fall under the new, mandatory law.

The implementation of this law will improve the availability of fortified products on the market and, over time, it will better align the food system with societal needs and lead to improved and equitable nutrition. Undernourished people - and the population in general – will have greater access to nutritious food which will create a healthier society. Furthermore, a stronger Rwandan food sector will boost the economy; it will be more competitive and attractive to investors.

Sustaining progress

The multi-stakeholder approach taken by the CSOs, involving a wide range of both public institutions and private companies in the advocacy process - and in drafting the new law - will lead to increased investment in fortification and to improved outcomes in the longer term. The breadth of involvement continues to grow, as membership of the National Fortification Alliance, chaired by ADECOR, expands. Crucially, a significant portion of its membership comes from the private sector.

The new law is shifting the norms for this sector, and its involvement in, and ownership of, the issue will help sustain the availability of fortified products into the future. Food processing companies, such as African Improved Food (AIF), MINIMEX, SOSOMA and others, are significantly improving the coordination of food fortification initiatives and have devised strategies to create better access to, and use of, fortified products in Rwanda. Food fortification companies have started to increase their investment, and large producers are now both able and willing to increase supply.

Towards the future

Today, the Government of Rwanda is making a significant investment into food fortification. Rwanda FDA has requested the Ministry of Finance and Economic Planning for tax exemptions on the importation of machinery and premixes to food fortification industries and has made 107 qualified staff available to monitor compliance. It is ensuring these staff have access to information on where food is processed so that they can ensure that only fortified food is entering the market. It has also stepped up risk management by assigning inspectors to check that imported fortified foods meet quality standards. The V4CP is currently pushing for ADECOR to become part of the Food and Drug inspection committee.

To further stimulate market demand, the Government has agreed to a new national fortification logo, in collaboration with the NFA, so that consumers can easily identify fortified products. This is being used by processors, as well as importers, as a mark of compliance with the new fortification law.

The Rwanda Food and Drugs Authority has made it clear that it appreciates the work done by the CSOs and today, it considers them to be key, collaborative partners. V4CP will continue to support the implementation and enforcement of the new law and its guidelines. It will also continue to advocate for increased investment and consumer awareness into the benefits of fortified food.

“We are very pleased as the new mandatory food fortification regulation will enable consumers, mostly the families with malnourished kids, to reach out to more nutritious fortified food because they will now be more available and affordable on the market.”

Who we are

The Voice for Change Partnership strengthens the capacities of civil society organisations to foster collaboration among relevant stakeholders, influence agenda-setting and hold the government and private sector accountable for their promises and actions. It is funded by the Dutch Ministry of Foreign Affairs.

References:

[1] Hoddinott et al. 2013

[2] Cost of Hunger in Rwanda, World Food Programme, 2013 https://docs.wfp.org/api/documents/WFP-0000071300/download/?_ga=2.41553570.1841864551.1581523949-892761600.1581523949

[3] World Bank, 2013

Mr. NDIZEYE Damien, Executive Secretary of ADECOR and Chair of the NFA.

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