In her cramped, dimly lit kitchen, Idowu Bello leans over a gas cooker while stirring a pot of eba, the thick, starchy West African staple made from cassava root. Kidney problems and chronic exhaustion forced the 56-year-old Nigerian woman to retire from teaching, and she switches between cooking with gas or over a wood fire depending on the fuel she can afford.
Financial constraints also limit the food Bello has on hand even though doctors have recommended a nutrient-rich diet both to improve her weakening health and to help her teenage daughter, Fatima, grow. Along with eba, on the menu today is melon soup with ponmo, an inexpensive condiment made from dried cowhide.
"Fish, meat, eggs, fruits, vegetables and even milk are costly these days," Bello, 56, said, her lean face etched with worry.
If public health advocates and the Nigerian government have their way, malnourished households in the West African nation soon will have a simple ingredient available to improve their intake of key vitamins and minerals. Government regulators on Tuesday are launching a code of standards for adding iron, zinc, folic acid and vitamin B12 to bouillon cubes at minimum levels recommended by experts.
While the standards will be voluntary for manufacturers for now, their adoption could help accelerate progress against diets deficient in essential micronutrients, or what is known in nutrition and public health circles as "hidden hunger." Fortified bouillon cubes could avert up to 16.6 million cases of anemia and up to 11,000 deaths from neural tube defects in Nigeria, according to a new report from the Bill & Melinda Gates Foundation.
"Regardless of economic situation or income level, everyone uses seasoning cubes," Bello said as she unwrapped and dropped one in her melon soup.
A growing and multipronged problem
Making do with smaller portions and less nutritious foods is common among many Nigerian households, according to a recent government survey on dietary intake and micronutrients. The survey estimated that 79% of Nigerian households are food insecure.
The climate crisis, which has seen extreme heat and unpredictable rainfall patterns hobble agriculture in Africa's troubled Sahel region, will worsen the problem, with several million children expected to experience growth problems due to malnutrition between now and 2050, according to the Gates Foundation report released Tuesday.
"Farmlands are destroyed, you have a shortage of food, the system is strained, leading to inflation making it difficult for the people to access foods, including animal-based proteins," Augustine Okoruwa, a regional program manager at Helen Keller Intl, said, highlighting the link between malnutrition and climate change.
Dietary deficiencies of the micronutrients the government wants added to bouillon cubes already have caused a public health crisis in Nigeria, including a high prevalence of anemia in women of child-bearing age, neural tube defects in newborn babies and stunted growth among children, according to Okoruwa.
Helen Keller Intl, a New York-based nonprofit that works to address the causes of blindness and malnutrition, has partnered with the Gates Foundation and businesses and government agencies in Africa to promote food fortification.
In Nigeria, recent economic policies such as the cancellation of gasoline subsidies are driving the country's worst cost-of-living crisis in generations, further deepening food hardship for the low-income earners who form the majority of the country's working population.
Globally, nearly 3 billion people are unable to access healthy diets, 71% of them in developing countries, according to the World Health Organization.
The large-scale production of fortified foods would unlock a new way to "increase micronutrients in the food staples of low-income countries to create resilience for vulnerable families," the Gates Foundation said.
Bouillon cubes as the vehicle
Bouillon cubes — those small blocks of evaporated meat or vegetable extracts and seasonings that typically are used to flavor soups and stews — are widely consumed in many African countries, nearing 100% household penetration in countries like Nigeria, Senegal, Ivory Coast, and Cameroon, according to a study by Helen Keller Intl.
That makes the cubes the "most cost-effective way" to add minerals and vitamins to the diets of millions of people, Okoruwa said.
