GBCHealth Case Study of the Month Newsletter | Cookstoves

Introduction

Zinc & Health | Teck
This month, GBCHealth features Teck's Zinc & Health Program, an initiative aimed at reducing child mortality from diarrhea-related illnesses due to zinc deficiency.

Zinc is fundamental for human health. It is crucial for growth and brain development and helps fight dangerous infections, especially in children. Sadly, zinc deficiency affects two billion people worldwide and contributes to the death of nearly 450,000 children under five years old each year. More infants die from diarrhea-related illnesses associated with zinc deficiency than from malaria, HIV/AIDS and measles combined.

Zinc deficiency is the result of a diet that is too low in zinc, such as plant-based diets common in developing countries. Children with zinc deficiency are particularly susceptible to diarrhea, which is often deadly in the developing world.

Cooking over a traditional cookstove
It costs less than $0.50 for a 10-14 day course of zinc treatments and oral rehydration salts to treat acute diarrhea and save a child’s life.

Teck’s Zinc & Health Program includes five components:

  1. Therapeutic Zinc
  2. Zinc Supplementation
  3. Food Fortification
  4. Crop Nutrition
  5. Awareness & Advocacy

The program has already achieved tremendous success in its early stages, supporting UNICEF in the distribution of 12 million packets of micronutrient powder in Nepal and mobilizing community health workers across Senegal to provide zinc and oral rehydration salts (ORS) to treat child diarrhea. The program has educated farmers in China about zinc fertilizer’s ability to improve crop yield and nutritional quality, and has reached an audience of more than four million Twitter users through a social media awareness campaign.

About the Program

Teck is Canada’s largest diversified resource company and one of the world’s largest producers of zinc. Teck’s Zinc & Health program, launched in 2011, seeks to implement long-term, sustainable solutions to reduce deaths of children under five and to accelerate progress on the Millennium Development Goals (MDGs) related to alleviating hunger, maternal and child mortality and highly prevalent diseases. The program has five key components:

1. Therapeutic Zinc

The Zinc Alliance for Child Health (ZACH) is a public-private-civil society alliance created to develop and sustain zinc treatment programs that will help save children’s lives. The first partnership under ZACH is a CAD$20 million commitment by Teck, the Micronutrient Initiative and the Government of Canada, aimed at scaling up zinc and oral rehydration salts (ORS) as a diarrhea treatment in countries with high under five death rates in sub-Saharan Africa.

In May 2012, ZACH launched its first pilot project to support the Ministry of Health in Senegal. The project is dramatically scaling up zinc treatments for children and aims to treat more than two million cases of diarrhea in Senegalese children under five over the next three years. Zinc and ORS treatment will be delivered by health care workers at 4,000 health facilities in Senegal. By the end of the three-year project, ZACH aims to:

ZACH aims to treat more than two million cases of diarrhea in Senegalese children over the next three years.
  • ensure that all distribution points are sufficiently supplied to cumulatively treat more than seven million diarrhea episodes;
  • benefit up to over 1.5 million children under the age of five per year by 2015; and
  • train up to 12,000 health workers per year.

Other activities include behavior change interventions, including health education for mothers, and monitoring the program to track progress. As a result of ongoing advocacy and consultation by ZACH, zinc and ORS are now provided free of charge in public health facilities by the Ministry of Health in Senegal.

In June 2012, the ZACH partners signed the “Declaration on Scaling Up Treatment of Diarrhea and Pneumonia” with the U.S. Government, the World Health Organization and other leading global health groups to allocate $15 million to treat diarrhea in high-burden countries. The Declaration is aimed at harnessing the resources, expertise and innovation of the private sector, development partners, and governments to maximize impact and reduce deaths from these two leading killers of children.

In February 2013, ZACH launched pilot projects in Burkina Faso and Ethiopia. In Ethiopia, the ZACH scale up project aims to treat 6.5 million cases of diarrhea by 2015, while in Burkina Faso, the program’s goal is to treat more than seven million cases over the next three years.

Achievements
Since the ZACH pilot project launched in May 2012, more than 800,000 zinc treatments have been provided to health centers in Senegal. In addition, 13,129 community health volunteers in 2,562 community-based health service delivery points (1,570 health huts and 992 village delivery sites) have been mobilized to distribute zinc supplements and ORS for the treatment of childhood diarrhea.


2. Zinc Supplementation

In 2008, the Copenhagen Consensus, a group of internationally acclaimed economists, including five Nobel Laureates, concluded that combating the world's malnutrition problem through zinc and vitamin A ranked highest among the various cost-effective solutions to the world's pressing problems. They calculated that for every dollar invested in zinc supplements, there would be a return of US$17.

Health care professionals and female community health volunteers working to raise awareness about zinc deficiency in Nepal. Photo courtesy of UNICEFTeck led the creation of Zinc Saves Kids in 2009, an initiative of the International Zinc Association (IZA), to improve the survival, growth and development of undernourished children with micronutrient deficiencies by funding UNICEF's zinc supplementation programs in Nepal and Peru. Members of the IZA committed to contributing US$3 million over a three-year period with a goal of saving more than 200,000 lives annually by 2015. In addition to fund-raising, Zinc Saves Kids engages in global advocacy efforts with governments, development organizations and other donors through social media campaigns, advertising and promotional materials.

Achievements
UNICEF programs in Nepal and Peru, funded by Zinc Saves Kids, have so far achieved the following:

Nepal:

  • 101,838 children aged 6-23 months have received micronutrient powder (MNP) supplementation;
  • 12 million sachets of MNP were distributed;
  • 10,731 personnel, including female community health volunteers, health workers, community agents and municipal staff in the six pilot districts have been educated on MNP and zinc treatments for diarrhea;
  • 88,956 mothers were educated on zinc’s benefits by Female Community Health Volunteers;
  • Over 70% of targeted children received the first micronutrient supplement dose and over 50% received the second dose;
  • Awareness efforts reached 50,382 people and schools, pharmacies, government agencies and community-based organizations.

Peru:

  • 101,000 children under the age of three participated in the supplementation program;
  • 75% of children who participated completed the 18-month supplementation cycle;
  • 200 health professionals have been trained;
  • Due to positive results, the program has expanded to 16 of the 24 regions of Peru, covering a total of 424,665 children.

Marcelito is a Peruvian boy who suffered from malnutrition. Thanks to taking micronutrient supplements with zinc for six months he is now an active and healthy child. Phoot courtesy of UNICEF.Fifty percent of the Peruvian children who sought diarrhea treatment in health establishments in Ayacucho and Ventanilla received zinc and ORS. All children who received the treatment survived. This is a major success as the program began only recently, and many health professionals were initially reluctant to administer zinc for diarrhea treatment.

3. Food Fortification

At the World Economic Forum in January 2012, Teck announced a three-year agreement with the chemical company BASF to jointly develop innovative and affordable zinc fortification solutions, with the goal of reducing zinc deficiency in developing countries. The partnership aims to make food fortification solutions available to populations at risk of zinc deficiency. Zinc from Teck’s smelter in British Columbia will be turned into high-grade zinc oxide by GH Chemicals in Montreal, which BASF will use to make food fortification supplements.

Teck’s three-year partnership with BASF leverages the competencies of each company, including BASF’s cost-effective micronutrient solutions, formulation expertise and quality control know-how and distribution partnerships, as well as Teck’s high quality, affordable zinc products. Teck and BASF anticipate that up to 100 million people will consume food fortified under the Teck BASF partnership over the three-year program.

Achievements
Teck and BASF have developed a zinc test kit, “iCheck,” to determine the zinc levels in staple foods and premixes. The portable, easy-to-use zinc test kit will allow local producers to prove the nutritional content of their food, increasing program sustainability and reliability.

4.Crop Nutrition

Zinc deficiency affects more than half of the world’s agricultural soils. For example, approximately 61 percent of the arable land in China is deficient in zinc. Crop yield, food security and nutritional quality can all be improved by ensuring that crops have adequate zinc. Research shows a direct link between the zinc deficient soils and incidence of zinc deficiency in people.

In March 2012, Teck signed a two-year sponsorship agreement with the National Agricultural Technology Extension Service Centre of the Ministry of Agriculture of China (NATESC) to expand the use of zinc fertilizers.

Teck’s goal is to educate farmers about the benefits of zinc fertilizer and to encourage fertilizer producers to develop zinc fertilizer products to meet the growing demands of Chinese agricultural production.

Achievements
Since March 2011, NATESC has been working with the International Zinc Association to carry out more than 40 field trials in China as well as promotional and education programs, including national workshops and training courses. The trials have resulted in increased crop yields, ranging from 3 percent to 40 percent and a value-cost ratio as high as 5 to 15 times for farmers.

Raising awareness in rural communities is imperative to ensuring this solution is used at the farm level. Farmers can now see firsthand the benefits of zinc fertilizer on crops at education centers across China.

5. Awareness & Advocacy

Teck educates and engages employees thruogh a number of social media platforms
A major objective of the Zinc & Health program is to educate Teck employees and the public about zinc deficiency and the devastating effects of diarrhea. Teck has developed employee-driven initiatives, including education sessions, a Zinc & Health quarterly newsletter, and a weekly zinc factoid sent to employees. Every new employee at Teck’s corporate head office is briefed about the Zinc & Health program on their first day of work.

In addition, each of Teck’s 13 operations has a Zinc & Health Captain. Captains participate in regular Zinc & Health workshops and lead employee engagement programs. The company’s senior management team frequently speaks about Zinc & Health at conferences, student workshops and mining expositions.

Teck has built an engaged online community and regularly responds to inquiries relating to zinc deficiency and the health benefits of zinc through its educational website, www.zincsaveslives.com, and Zinc Saves Lives' social media channels.

Achievements
In 2011, Teck partnered with Free The Children to raise awareness about zinc deficiency at We Day events across Canada, an annual youth empowerment event that motivates young people to take action on local and global issues. For each retweet on Twitter during We Day events, Teck donated $0.50 to Zinc Saves Kids—the cost of a life-saving zinc treatment. The One Tweet, One Life Twitter campaign reached more than four million Twitter users and received 21,156 retweets. Its hashtag, #1tweet1life, was among the most popular topics on Twitter in Canada on the day of the event.

Teck employees have taken the Zinc & Health message out into the communities. The children of employees have created school science fair projects on zinc deficiency and led classroom fundraisers for Zinc Saves Kids. Teck’s Zinc Captains have presented at local high schools and liaised with teachers to conduct zinc-rich soil experiments in science classes and help students learn how to cook zinc-rich meals in home economics classes.

Critical Success Factors

Getting the Word Out
The challenge the world faces is not producing more zinc. In fact, the amount of zinc required to meet the total need for solving zinc deficiency is less than 0.2 percent of total world production. The challenge is getting zinc into the diets of people suffering from zinc deficiency. This requires education, better distribution networks and greater awareness of the dangers of zinc deficiency. Teck worked at three levels to raise awareness:

  • Within its own workforce, Teck engaged employees from all levels and business units to grow the program;
  • Teck harnessed social media to raise public consciousness on zinc’s potential to save lives;
  • Teck developed strategic partnerships with governments, private sector businesses and implementing organizations to leverage strengths and improve access to zinc in the developing world.

Rigorous results evaluation
Teck measures its progress through a range of quantitative and qualitative indicators, including monitoring the:

  • proportion of children with diarrhea who received full doses of zinc supplements;
  • number of children receiving micronutrient supplements;
  • micronutrient supplement knowledge rates;
  • zinc supplies at health facilities to ensure adequate stocks; and
  • social media metrics (visitors, followers, likes and shares on website, Facebook, Twitter, etc.).

Lessons Learned

Expect delays. Working in developing countries is always an ambitious undertaking, particularly in the early stages of a program. The ZACH project in Senegal has faced delays in implementation, and Teck is adjusting target projections and budgets to compensate.

Know your partners. Teck learned the importance of detailed work plans by project partners and implementers on the ground. Procurement policies and procedures of project implementers should be assessed in advance as part of any organization's ability to deliver services in order to avoid delays to project implementation.

A mother and child visit a health post in Senegal to learn about the best way to treat the child’s diarrhea.Understand your program's beneficiaries. While implementing the program, Teck found that the treatment of children with zinc deficiency may be hindered by various external factors. In many countries, there is limited demand by families for zinc treatment due to inadequate knowledge and misperceptions of the benefits of treatment. Diarrhea is seen as part of growing up and, therefore, caregivers often delay seeking treatment. Considering that many people go to private pharmacies and drug retail shops for diarrhea treatment, there is a need to provide orientation to pharmacies and retailers and improve prescription practices of healthcare workers.

Just because it's good for you doesn't mean you'll buy it. Research shows that nutritional benefits, while an important feature, are a low purchase priority for consumers. Price, taste, packaging, accessibility and convenience are almost invariably of higher priority. Moreover, the benefits of fortification are subtle. Because fortified foods offer a preventative rather than a therapeutic benefit, no immediate satisfaction is felt by the consumer. Thus, consumers need to be educated about the long-term health benefits of zinc and the importance of zinc for human health.

Demonstrate your impact. The key challenge in zinc fortification of fertilizers is education along the entire supply chain up to, and including, the farmers. It is especially challenging where it is needed most: low-income farmers on small plots of land. The single most important initiative has been implementing demonstration plots where farmers can see the effect on soils similar to their own, to reduce the perceived risk of investing in a new fertilizer.

Learn More

Explore the Zinc & Health program:


To learn more about the Zinc & Health program,
please contact Pam Bolton at pbolton@gbchealth.org.