April 5, 2018
Amal Kandeel, Non-resident Scholar, Middle East Institute
Micronutrient deficiency and particularly Iron Deficiency Anemia (IDA) are prevalent in Egypt. The government’s IDA mitigation strategy is focused on consumer-level interventions. Given fast-paced population growth, rising water scarcity, and poverty, a strategy that integrates upstream measures would strengthen the policy response and better support its public health targets.
Population growth continues to deepen the scarcity of Egypt’s agricultural land and water resources. Recent economic reforms, particularly the currency’s flotation (November 2016) and reductions in energy subsidies, have also contributed to sharp food price rises in local markets. Market inefficiencies aggravate this inflation, which in December remained a staggering 22%. Nutritious food is becoming less and less affordable to many in Egypt.
Poor diets can lead to low iron intake, a common cause of IDA, which can impair child cognitive development, and compromise mental and physical performance at all ages. Meat is an important source of micronutrients, particularly heme iron that has higher bioavailability compared to nonheme iron. Meat prices have escalated with general inflation since November 2016. People need only consume small amounts of meat for a healthy diet, but even these quantities are beyond the reach of the poor.
IDA is a significant public health concern in Egypt among children, adolescents, and women. Poverty is the biggest obstacle to food and nutrition security in Egypt, where food insecurity is largely an access problem. In 2011, 35% of the population consumed micronutrient-poor diets, and only 5.6% obtained 40% of their caloric intake from meat. An increase in food insecurity and low-quality diets during 2009-2011 was attributed to growing poverty that compromised the consumption of micronutrient-rich foods including meats. It can be expected that this situation has worsened since November 2016.
In 2008 the Egyptian government launched an iron and folic-acid fortification program for wheat flour used in making subsidized Baladi bread, which 76% of the population consumes. Yet follow-up testing is still necessary to determine the extent to which IDA has been mitigated.
Notwithstanding fortification programs’ advantages, the best way to improve iron intake is to maintain iron-rich diets. Part of the Egyptian government’s overhaul of the national food subsidy program in 2014 was the expansion of the list of subsidized foodstuff items that subsidy beneficiaries can buy at designated government outlets. Instead of just three items (vegetable oil, rice, and sugar) previously accessible under the old system, 33 subsidized items that include fresh and frozen beef have been made available. While decisions to purchase subsidized products are made at the household level, the discounts at which meat products are offered under that system compared to market prices would enable and incentivize subsidy beneficiaries to consume more of them.
Meat’s availability and affordability depend, among other things, on the livestock sector’s productivity. Improving this productivity is crucial not only to increase meat’s availability and affordability, but also in light of global commodity markets’ price volatility, water scarcity, and climate change. Without appropriate adjustments, these factors could undermine further the availability and affordability of meat for all in Egypt. One place to look for remedies, thus for problems initially, is the country’s livestock sector.
Egypt is one of the world’s largest importers of corn, which is used largely as feed. In 2017 it imported twice as much corn as it did in 2000 and 20% more than 2017’s domestic corn production. The Egyptian pound’s devaluation has doubled corn costs and slowed down imports. Financial difficulties due to unmanageable production costs could force many small-scale livestock operations out of the market, increasing pressures on meat prices and crowding out low-income consumers.
Upstream measures that support the financial sustainability of livestock operations could yield multiple direct and indirect benefits for food and nutrition security. These measures can include, for example, improving agricultural water’s productivity and reducing domestic feed wastage.
There is room for irrigation efficiency improvements in Egypt. Programs that enable corn farmers to shift to higher efficiency irrigation methods or corn cultivars with lower water requirements would strengthen agricultural productivity and corn yields. Additionally, post-harvest corn losses are high, often due to pests and humidity in inadequate storage. In 2013 corn wastage was equivalent to 20% of corn imports and 15% of domestic production. Investing in and maintaining reliable storage facilities would substantially reduce import needs and feed costs, and boost domestic livestock production without further strain on land and water resources.
While upstream interventions intended to strengthen the livestock sector’s viability might seem like a long-distance throw when tackling IDA, these measures would partially counter the negative downstream implications of inflated production costs on food security, and micronutrient and iron deficiency. They are consistent with the necessity to adjust to intensifying water scarcity, a growing challenge facing public health in Egypt.