Deficiencies in iron, zinc and vitamin A (known as ‘hidden hunger’) pose serious and widespread threats to health and economic development.ⁱ The conventional response has been supplementation or food fortification, but these involve substantial recurrent costs,ⁱⁱ can be hard to organize in poor rural areas, and cannot always solve the problems.ⁱⁱⁱ

CGIAR’s biofortification programs were born from the idea that a cost-effective and sustainable way to improve vitamin and mineral intake would be ‘biofortification’: that is, to breed micronutrients into the staple crops that make up a large part of the diet of the poorest farmers and consumers worldwide. Dr Howarth “Howdy” Bouis initially conceived the idea as a young CGIAR researcher in the 1990s^iv and in 2016, he was awarded the World Food Prize, along with CGIAR colleagues working on Orange Fleshed Sweet Potato^v – Drs Maria Andrade, Jan Low and Robert Mwanga – in recognition of their vision, leadership, and effectiveness.^vi

You have to have a fundamentally sound idea that is scientifically and economically feasible – and then perseverance. When you try things the first time, they often don’t work and then you say, ‘OK, what did we do wrong? How can we improve this?
Dr. Howarth “Howdy” Bouis, Founding Director, interviewed June 4, 2018

HarvestPlus, which leads work on biofortification for the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), is coming to the end of its third five-year phase, where the focus has been to learn about, and to demonstrate feasibility, dissemination and scaling up. To date, more than 290 new varieties of 12 biofortified crops (Figure 1) have been released or are in testing in 60 countries.^viiviii In 2017, 3.2 million farming households used biofortified planting material, bringing the total estimated number of farming households benefiting from biofortified crops globally to 10 million.^ixxPeer-reviewed published studies demonstrate that biofortified foods improve nutrition and health, contributing to reductions in anemia and prevalence and duration of diarrhea, improved micronutrient status, vision, and cognitive and physical performance.

Now is the time to reflect on the factors that have generated high performance, as well as the continued challenges faced in turning research outputs into development goals, that are common to many agricultural research programs.

The focus on a well-defined goal, of bringing biofortified crops to farming households to improve their nutrition, enabled us to be more cost-effective and targeted in our work.
Dr. Ekin Birol, Head of HarvestPlus impact and strategy

Several key factors have been highlighted in the success of CGIAR’s biofortification programs to date,^xi including:

• Taking a chance: Agricultural research is an inherently risky and long-term investment, but has been shown to give large returns.^xii In the face of initial skepticism, work on biofortification was made possible by early grants from Denmark and the United States Agency for International Development (USAID) that enabled CGIAR breeders and nutritionists to develop evidence supporting the proof of concept which then led to the approval in 2002 of the Biofortification Challenge Program, later renamed HarvestPlus.^xiii By the end of 2017, HarvestPlus had invested about USD 400 million in breeding, releasing and disseminating biofortified varieties, with the Bill & Melinda Gates Foundation and the UK Department for International Development each contributing about one-third of the total funding.¹ That investment is now paying off.
• Perseverance: Biofortification work has now been going for 15 years, and was a further 10 years in the making. This is a common timeline for agricultural research to move to uptake and impact.
• Partnership: Partnership has been fundamental to biofortification success. For example, HarvestPlus works with more than 500 partners around the world. In addition to Funders and national governments, these include: 100 research entities, including CGIAR centers and universities, which conduct crop breeding, nutrition studies, consumer preference surveys, monitoring and evaluation, economic analysis, and other research; more than 240 non-governmental organization (NGO) partners, the majority of whom play an important role in reaching farmers; and more than 120 private sector partners in the seed, food processing, and retail sectors.
• Building the evidence quickly for the value of biofortification through ex ante cost-benefit analyses^xiv and some convincing studies on effectiveness in the field^xvxvi have been important to keep funders on board. This has required large investments; as Dr Bouis explained² in a pilot dissemination study of Orange Fleshed Sweet Potato, “we spent around 50% to implement and 50% to study and document what the impact had been.”
• Clear vision of the pathways to impact, and using program research systematically to check the assumptions in those pathways,^xvii for example: Will farmers want to grow the new biofortified crops? Will consumers want to eat enough of them? If they do eat them, will this sufficiently improve their micronutrient status? HarvestPlus has set up dedicated nutrition and impact research teams that work closely with the field delivery teams to generate the evidence needed.^xviii
• Investing in monitoring and evaluation (around 10% of annual program costs^xix), both to document results for accountability purposes, and to feed evidence into decision making.
• A critical mass of coordinated investment for one main area of work created a virtuous circle, making it possible for HarvestPlus to invest sufficiently in evidence generation and M&E. The evidence generated has helped to maintain interest and investment.

Figure 1. Biofortified crops bred by CGIAR Centers and partners

CGIAR biofortification programs now face some major opportunities and risks, as they move from early counts of ‘households reached’ with the new biofortified varieties to a focus on long-term, sustained uptake.

Agriculture is a challenging sector to work in.^xx A new ‘biofortified’ crop variety is not like a medicine: it needs to be voluntarily grown by millions of scattered farmers, and promoted through many private sector and other channels, in the face of competing crop varieties. As the global climate changes, biofortified varieties must be ‘future proofed’^xxi as well as being attractive to farmers, processors, and consumers.

The world’s diets are also changing rapidly. Eating more meat, fish, fruits, and vegetables could overcome many  micronutrient deficiencies, and CGIAR is also investing major research resources in those pathways to better nutrition^xxii. However, the persistence of micronutrient malnutrition in many wealthier countries shows that more money translates into better dietary quality only slowly.^xxiii As the leader of the CGIAR dietary diversity research group concluded^xxiv: “Biofortification should not be seen as a rival or even a complement to dietary diversification, but as an integral component of food-based solutions to improve nutrition and public health by providing people with an array of healthier food choices.”

Main elements of the HarvestPlus Monitoring & Evaluation system

• Impact pathways: for each major crop/country combination, setting out the planned route from research to impact, along with the (testable) assumptions.
• Monitoring: of more than 30 indicators, from processes to outputs, outcomes and impact. HarvestPlus employs 13 people directly to coordinate monitoring, carry out data quality checks and train partners.
• Monitoring surveys: early checks on how biofortified varieties are liked, grown and consumed in practice.
• Adoption surveys: to measure long-term outcomes, including adoption, diffusion, sales and consumption.
• Simulation models: which help estimate population level outcome and impact from the necessarily limited numbers of households that can be surveyed.

HarvestPlus is still improving all aspects of its M&E, while also working with partner countries and international agencies to integrate key indicators into their own monitoring.

Ensuring that all varieties of key staple crops have high levels of nutrients would be the ideal. CGIAR, which accounts for the majority of breeding programs aimed at small-scale farmers, has committed to integrate breeding for micronutrients across its programs, referred to as ‘mainstreaming’.^xxv Biofortification will ‘piggyback’ on the best agronomic lines being developed at CGIAR Centers. However, this will take at least another ten years, so reliance on this strategy will leave a gap, which HarvestPlus along with the sweet potato program led by the International Potato Center (CIP) (see Box), is well poised to fill.

The tension between getting quick results and achieving long-term sustainability lies at the heart of much of CGIAR’s work. The poorest countries in the world are the main target for many CGIAR innovations, but these countries often also have relatively weak systems for seed production and for providing advice to farmers and consumers, so simply developing improved crop varieties is not enough to achieve impact at scale. Moreover, strengthening these systems has already been the subject of many years of external assistance programs, which have largely failed to overcome the deep-seated structural obstacles^xxvi, so it’s not a simple question of integrating ‘sustainability’ elements into a short-term project. The question, therefore, is to what extent (and depth) should CGIAR and its immediate partners get involved in facilitating or co-organizing agricultural extension, seed production, consumer education and the like in its partner countries?

The experience of CGIAR biofortification programs shows that catalytic steps can be taken and can be initially successful, but long-term institutional sustainability will require expanded commitment by all players across the value chain. This challenge is equally faced by other international programs attempting to tackle a major global problem affecting low-income countries^xxvii. HarvestPlus and partners have worked hard to encourage changes in policy and practice, both globally and in direct partner countries. For example, 21 countries have integrated biofortification into their national policies to date, and several private seed and food companies have invested in biofortification. However, more remains to be done before they can ‘hand over the baton’.

Figure 2. Biofortified crops: What is available where

Footnotes

¹ This does not include the funding invested in Orange Fleshed Sweet Potato.
² Dr. Howdy Bouis, interviewed 4 June 2018

References

ⁱ J.C. Ruel-Bergeron et al., “Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index,” PLOS ONE 10, no. 12 (December 16, 2015): e0143497, https://doi.org/10.1371/journal.pone.0143497; R.L. Bailey, K.P. West Jr., and Robert E. Black, “The Epidemiology of Global Micronutrient Deficiencies,” Annals of Nutrition and Metabolism 66, no. Suppl. 2 (2015): 22–33, https://doi.org/10.1159/000371618.
ⁱⁱ An estimated $10 billion has been spent on vitamin A supplements over the past 20 years. (based on UNICEF and World Bank estimates)
ⁱⁱⁱ S.A. Tanumihardjo, B. Gannon, and C. Kaliwile, “Controversy Regarding Widespread Vitamin A Fortification in Africa and Asia,” Advances in Nutrition 7, no. 1 (January 1, 2016): 5A-5A, https://academic.oup.com/advances/article/7/1/5A/4524024; H. Pachón, “Chapter 12- Wheat and Maize Flour Fortification,” in Food Fortification in a Globalized World, ed. M.G. Venkatesh Mannar and R.F. Hurrell (Academic Press, 2018), 123–29, https://doi.org/10.1016/B978-0-12-802861-2.00012-2; J.M. et al., “Vitamin A Policies Need Rethinking,” International Journal of Epidemiology 44, no. 1 (February 1, 2015): 283–92, https://doi.org/10.1093/ije/dyu194.
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^v J.W. Low et al., “Tackling Vitamin A Deficiency with Biofortified Sweetpotato in Sub-Saharan Africa,” Global Food Security 14 (2017): 23–30, https://www.sciencedirect.com/science/article/pii/S2211912417300044; A. de Brauw, D.O. Gilligan, and J. Low, “Introducing Orange Sweet Potato: Tracing the Evolution of Evidence on Its Effectiveness,” African Journal of Food, Agriculture, Nutrition and Development 17, no. 2 (2017): 12106–15, https://www.ajol.info/index.php/ajfand/article/download/155138/144755.
^vi https://www.worldfoodprize.org/en/laureates/2010__2017_laureates/2016__andrade_mwanga_low_and_bouis/
^vii H.E. Bouis and A. Saltzman, “Improving Nutrition through Biofortification: A Review of Evidence from HarvestPlus, 2003 through 2016,” Global Food Security 12 (March 1, 2017): 49–58, https://doi.org/10.1016/j.gfs.2017.01.009.
^viii http://www.harvestplus.org/content/evidence-document and crop map http://www.harvestplus.org/file/2426/download?token=X7xFOr53
^ix This figure includes an estimated 4 million households reached with Orange Fleshed Sweet Potato (see Box)
^x As reported by HarvestPlus monitoring systems: http://www.harvestplus.org/sites/default/files/publications/2017_AnnualReport_vF_July26.pdf
^xi Abt Associates Inc., “Evaluation of HarvestPlus Phase II” (Seattle, WA: Bill & Melinda Gates Foundation, December 2012); J. Compton et al., “Independent CRP-Commissioned External Evaluation of the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH),” 2015, http://iea.cgiar.org/evaluating/crp-commissioned-external-evaluation-ccee-agriculture-for-nutrition-and-health-a4nh/.
^xii M. Renkow and D. Byerlee, “The Impacts of CGIAR Research: A Review of Recent Evidence,” Food Policy 35, no. 5 (October 1, 2010): 391–402, https://doi.org/10.1016/j.foodpol.2010.04.006.
^xiii http://www.harvestplus.org/about/our-history
^xiv J.V. Meenakshi, “Biofortification. Best Practice Paper: New Advice from CC08” (Copenhagen Consensus Center, 2009), https://www.copenhagenconsensus.com/sites/default/files/biofortification.pdf.
^xv e.g. C. Hotz et al., “A Large-Scale Intervention to Introduce Orange Sweet Potato in Rural Mozambique Increases Vitamin A Intakes among Children and Women,” British Journal of Nutrition 108, no. 1 (2012): 163–76.
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^xvii N. Johnson et al., “Building the Case for Biofortification: Measuring and Maximizing Impact in the HarvestPlus Program,” African Journal of Food, Agriculture, Nutrition and Development 17, no. 2 (2017): 12078–91.
^xviii http://www.harvestplus.org/what-we-do/evidence
^xix Information from HarvestPlus team
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^xxi C. Weyant et al., “Anticipated Burden and Mitigation of Carbon-Dioxide-Induced Nutritional Deficiencies and Related Diseases: A Simulation Modeling Study,” PLOS Medicine 15, no. 7 (July 3, 2018): e1002586, https://doi.org/10.1371/journal.pmed.1002586.
^xxii e.g. Delia Grace and others, ‘The Influence of Livestock-Derived Foods on Nutrition during the First 1,000 Days of Life’, 2018; G. B. Keding and others, ‘Fruit Production and Consumption: Practices, Preferences and Attitudes of Women in Rural Western Kenya’, Food Security, 2017 <https://cgspace.cgiar.org/handle/10568/81170> [accessed 10 September 2018]; Bioversity, ‘Better Data for Better Nutrition: The Agrobiodiversity Diet Diagnosis Interventions Toolkit’ <https://www.bioversityinternational.org/news/detail/better-data-for-better-nutrition/?utm_source=feedburner&utm_ medium=feed&utm_campaign=Feed%3A+BioversityInternationalNews+%28Bioversity+International+News%29>.
^xxiii GNR team, “Global Nutrition Report” (Washington, DC: International Food Policy Research Institute, 2014), http://ebrary.ifpri.org/cdm/ref/collection/p15738coll2/id/128484.
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^xxv http://a4nh.cgiar.org/2014/04/02/getting-nutritious-foods-to-people-2/
^xxvi World Bank IEG, “World Bank Assistance to Agriculture in Sub-Saharan Africa : An IEG Review” (World Bank, 2007); D.J. Spielman and A. Kennedy, “Towards Better Metrics and Policymaking for Seed System Development: Insights from Asia’s Seed Industry,” Agricultural Systems 147 (September 1, 2016): 111–22, https://doi.org/10.1016/j.agsy.2016.05.015.
^xxvii https://www.pepfar.gov/about/agendas/sustainability/index.htm

Photo by H. Rutherford/CIP.