Introduction
Basil Kransdorff is addressing the critical problem of malnutrition in Africa and changing the realm of food production and consumption through the introduction of “bio available” food supplements into mainstream African society.
The New Idea
Nutrient repleteness – or our body’s ability to absorb micronutrients – is the basis of good health, well-being, and sustainable development. Making human beings nutrient replete and therefore physiologically functional is the new paradigm Basil wants to bring to the world. Moving away from activities that deliver partial solutions and an approach to food that is focused on quantity (or calories), his innovative approach helps change the “rules” and shifts the emphasis to food quality (or nutrient content). The result: a food system in which all decisions are designed to achieve nutrient repleteness. Nutrient repleteness encourages a holistic approach to solutions that include changing the way food is grown, processed and prepared. It encourages new scientific approaches to fortification that mimic nature to ensure better bioavailability of nutrients.
Basil has invented a unique nutritional supplement in the form of a modified version of a staple food in Southern Africa called ‘pap’. He has taken ‘pap,’ which is a porridge made from ground maize and soy, and invented ‘e’Pap’, which is an affordable package of ready to eat, fortified food. Basil, and his business partner and wife Rose, developed this technology approach to achieve “nutrient repleteness” to combat malnutrition and poverty. The objective of nutrient repleteness hinges on the hypothesis that the body performs optimally when it absorbs the necessary quantities of nutrients. The objective - a physiologically functional human being.
Basil wants to help decision makers better understand the issues to fix our food chain so that all human beings can become nutrient replete. The e’Pap technology approach shows how it is possible to bring a human being back to nutrient repleteness. It is necessary to bring understanding as to why current approaches to address the “nutritional crisis” are part of our problem. The lessons learnt and the technologies and science that supports e’Pap Technologies can be applied to not only how we grow our food but also to how we process package and distribute our food chain.
Through the development and promotion of micronutrient rich foods, Basil is cost effectively improving the health and well being of malnourished people in over 15 countries across rural and urban Africa. Furthermore, Basil is changing agricultural norms around food production and the value placed on nutrient dense foods. The effect of the new idea, taken to its logical conclusion, will revolutionize the way a farmer is incentivized to approach food production. Rather than being paid according to weight, or in terms of a product’s appearance, the measure of commercial value would be the nutrient content of the food? And Basil is also transforming the way big agribusinesses, COs, and the international donor community manage food production and aid. With the locally produced e’Pap, countries can become less dependent on foreign food aid, pharmaceutical supplements, unhealthy processed foods, and expensive imported fortified foods.
The Problem
The idea of “nutrient repleteness” was pioneered decades ago in terms of how our bodies operate. There are many studies that highlight the fact that micronutrients in the “wrong form” are not taken up effectively by the body because they have been refined into what is called an “isolate from”. It has been aptly described as trying to post an envelope without an address. Because refined nutrients are seen by the bodies’ biological machinery as “foreign objects”, they are then filtered out by “body processes” and tend to collect in the liver and other organs or liberated out though urine and faeces. Large accumulations in the body can sometimes become toxic. In Africa the urgency of the need for “nutrient dense” food has several dimensions, from healthcare implications to food security and sustainable development.
There is a well-known need for those suffering from chronic diseases to eat as nutritiously as possible so they can fight off opportunistic infections and absorb strong medications. An HIV/AIDS patient, for example, who is consuming a diet that is micronutrient deficient or otherwise malnourished, is less likely to adhere to treatment plans and take anti-retrovirals, because an undernourished person’s constitution is not able to effectively handle harsh medications. In addition to non-compliance with HIV treatment in those who are malnourished, TB patients also have a significant need for nutrient replete foods. In South Africa, it is estimated that 70% of people carry TB in their lungs. TB is a poverty related disease and shifts from being present and dormant, to being active if a person is nutrient depleted. In South Africa, there are 6 million people living with HIV/AIDS and it is estimated that 80% of TB cases are co-infections with HIV. Currently, 20% of all TB cases in South Africa are reported as drug resistant. If nutrient replete foods are available to TB patients and their families, then the risk to TB infections will be reduced and most common forms of TB can rapidly respond to drugs.
In addition to health issues, in Africa, and especially in countries that rely heavily on food aid and food subsidies to meet basic nutritional needs, a key element to the problem of malnutrition is ignorance or disagreement with the emerging science around “nutrition repleteness.” Like the naysayers who chose to underplay the importance of climate change, the science that supports the cheapest forms of food fortification revolves around protecting vested interests, and this often results in non-effective interventions. The placement of inactive micronutrients in foods is supported by the pharmaceutical industry and mainstream international guidelines. The result are low levels of biological uptake, higher levels of micronutrient recommended daily intakes and a consequence of a range of questionable side effects, some known, some still under investigation.
Countries that are receiving aid are at the whim of industrial giants who often place political and business objectives as well as profit considerations over the actual well being of their aid recipients. Aid organisations have developed a “common practice” over the past sixty years that precludes real change in thought.
Current approaches to food security and nutrition such as the fortification of processed foods and the development of resistant strains of crops are often expensive and inappropriate solutions to problems of food scarcity and agricultural output. The traditional pharmaceutical approach to food fortification using isolated refined nutrients are not effective in addressing the deficiencies and often can create more problems because of the toxic effects of a build up of nutrients not biologically absorbed by the body. The public is often confused, “hoping” that organic foods are more nutrient rich than regular goods. Organic foods may be on the right track and might omit pesticides, but that does not necessarily make that food effectively “nutrient dense”. Maximising nutrient density of food involves the health of the soil. What is needed in the farming industry is a closer examination of a range of agricultural practices to see which growing approaches deliver the high concentrations of bio-available nutrients. In the same vein, optimal growing practices might include a combination of non-organic applications, depending on the specific environment in which food is being cultivated.
Local farmers are undermined in the current model of food aid, big agri-business and international pharmaceuticals and foodstuff companies. Mass food fortification of cereals is often ineffective because of the addition of the wrong form of nutrients. At the moment, no one is incentivized to produce food that is nutrient dense. Nutrient dense food could be a great opportunity for farmers to increase the value of their crops, tap into new markets, and generate sustainable streams of income.
The Strategy
Basil has embarked upon a multipronged strategy to change how producers and consumers view nutrient replete foods through targeted research, education and marketing efforts.
His current strategy rests on three key insights gained over the last ten years:
1) National government contracts are often so riddled with “hidden agendas” that it is not possible to sell into them. 2) Until there is a recognized set of standards around achieving an objective of nutrient repleteness as a diagnosis of human condition, the measurement of a food’s value in terms of its ability to achieve nutrient repleteness is unlikely to change. 3) Until the protocols change, the best way to proceed is to use existing academic institutions, NGO networks, and local supermarkets to spread word of the products’ value.
Given these findings, Basil’s strategy to date has been to work through the citizen and corporate sectors to increase awareness around an objective and the importance of achieving nutrient repleteness as the basis to market e’Pap, and to spread word of its effectiveness.
Basil and the e’Pap team have devised a specific strategy involving academic institutions and accredited scientific research to legitimize and popularize the concept of nutrient replete foods. They are currently conducting a clinical investigation into the use and benefit of e’Pap in conjunction with the School of Public Health at Witwatersrand Medical School, a leading academic institution. Part of this research will focus on developing a non-invasive measurement technique of nutrient repleteness to evaluate and determine the cost benefit ratio of their products. The establishment of a scientific accreditation around measuring the condition of nutrient repleteness will be groundbreaking in terms of showcasing the humanitarian and nutritional implications of effective supplements. It will be a critical tipping point to change traditional thinking around creating an objective to achieve nutrient replete human beings. It positions e’Pap as a leader in this emerging field. It could also shift the way food is valued: i.e. priced for nutritional value based on how effectively the nutrients are bio availably absorbed.
Well-recognized South African bodies have conducted studies on the efficacy of e’Pap. This has strengthened Basil and Rose’s legitimacy and increased the spread of their idea. According to the South African Tuberculosis Association (SANTA), patients who are fed a regular diet of e’Pap have a 39% higher cure rate. They also have evidence that regular consumption of nutrients reduces the likelihood of TB recurrence by 75%. The reality is that 80% of TB patients in SA are now co-infections with HIV and nearly half of the infections are now re-infections. With an HIV infection pool of over 6 million people living with HIV in South Africa, this represents an enormous potential TB threat. There is clinical evidence that indicates the re-infections can be reduced by as much as 60% if the patient is kept nutrient replete. Basil believes that co-infections of HIV patients with TB could be reduced dramatically if the patients are made nutrient replete. Fortunately, the South African TB Association has officially endorsed e’Pap, and is currently seeking to finance the feeding of e’Pap to the entire TB infected population of South Africa and their families, as a way of safeguarding them.
Where people start ART therapy from very low CD counts, complications often result in morbidity. A recent investigation done by PEPFAR confirmed there is a 6 fold higher morbidity for malnourished people on ARV’s than for those who were better nourished. In South Africa, where ARV’s are now available to all, there is a 15% drop out. Medical practitioners partly explain this drop out being as a result of the nausea and lack of drug compliance that results from using drugs on malnourished bodies. Getting a body back to nutrient repleteness prior to ART treatment with e’Pap addresses this challenge and also makes the benefits of ART more effective.
This new approach results in healthy weight gain, and their studies show that people eat a nutrient replete diet, weight gain are not just “fat” based (BMI), but rather attributed to muscle gain (lean body mass). There are documented cases of highly malnourished people eating e’Pap as a morning food supplement and putting on between 2-5 kilograms within 2-4 weeks. In addition to healthy weight gain, studies show that the consumption of e’Pap increases energy and concentration; suppressed medical conditions become visible and treatable; and the slowing of AIDS related diseases and opportunistic infections. Particularly relevant in the African context, e’Pap has proven to improve digestion and lessen cases of diarrhoea, a serious condition for the malnourished and those suffering from HIV, TB and dysentery.
The e’Pap team has done contextually appropriate clinical research to support the safety and efficacy of their work as a way to ensure the uptake of e’Pap and the Kransdorffs are systematically spreading their idea by disseminating results from their research and expertise in nutrition workshops, conferences, under trees in rural communities, township meetings, and high-level briefings to interested parties across the continent. They share information about bioavailability through Internet forums as well.
Through these outreach efforts, Basil is shifting the way people perceive the importance of nutrition. Historically, there has been the prevailing notion that fortified foods are intended only for those inflicted with HIV/AIDS and other diseases. They are currently marketing e’Pap in the Alexandra Township, just outside Johannesburg effectively re-branding e’Pap as a food that is good for young children. Within South Africa and in numerous countries in Africa, the Kransdorffs are developing marketing opportunities to ensure that their products are recognised for their superior nutritional value. They have engaged the international donor community and corporate sectors as partners.
In terms of awareness and brand recognition, the strategy has been to develop familiar food products that local communities recognise and, in most cases, are already part of their daily diet. In South Africa, the production of fortified maize porridge, e’Pap, has been the product of choice as it forms part of the local staple diet. With the expansion into the rest of Africa and possibly to the Far East, products like bread, spreads, fortified drinks, soup, rice and cereal facilitate for assimilation of the products in other regions of the world. Basil’s ability to repackage e’Pap products to suit the market and to produce foodstuffs with nutritional value, but with mass appeal, has created a noticeable impact in terms of their ability to scale. In the last two years, their products are beginning to emerge in mainstream supermarkets as healthy alternative foods.
There are 15 African countries that currently sell and distribute e’Pap as well as the extension products of e’Drink and e’Soup. Over 100 million food portions have been sold into malnourished communities. There are increasing numbers of farmers, corporate entities, international donor and aid organisations from both within South Africa and the rest of Africa that are using the product. Basil has put in place a retail distribution scheme and is bringing large international CSOs, governments and everyday consumers to understand the importance of nutrient repleteness. This understanding is resulting in e’Pap being used as a priority foodstuff for health and social service programs as well as disaster relief efforts.
The e’Pap business is self-funding and growing exponentially. The profits from the business are reinvested into the company, and used to finance the development of the manufacturing processes, equipment, and the entire economic value chain to get the product to market. To date, Basil and e’Pap have donated over R2 million Rand of their profits to CSO’s working in communities in countries across Africa. The initial start-up capital was funded out of family resources. Today the highly mechanized factory has a current monthly production capacity of 200 tons and is expandable up to 500 tons. The unit cost of an e’Pap meal is affordable to the average South African. It is equivalent to about 16 US cents and going to scale will bring that price down.
As part of building the e’Pap business internationally, they have started a HACCP certification process in food safety that results in international accreditation. e’Pap is registered with the following authorities: South African Department of Health, South African Medical Control Council, SAFSIS Food Safety Certification, Glycemic Institute. It has received both Kosher and Halaal certification.
The Person
Basil was born into an entrepreneurial family in Zimbabwe. As a child he worked with his mother to create an arts and crafts business that utilised the talents of local women in the country. Starting from a zero base, the business in ten years had a turnover of a quarter of a million rand month and provided jobs and sustainable income to thousands of rural craft workers. Basil set up a business that innovated solutions on how to maintain workable deep level mining environments miles underground and how to deploy technological applications for what to do with mining slurry.
e’Pap Technologies resulted from a project his wife Rose was doing helping Jenny Marcus start a project to support people in HIV lines at Johannesburg Hospital. The HIV pandemic was just hitting South Africa in 2000. There were no drugs available and the only advice for patients was to go home and eat a healthy well balanced diet. It was advice that few poor South African could afford. Rose was able to help facilitate a large donation from the Elton John Foundation to set up the support group called CARE (Community Aids Response). Part of this donor support was food parcels and their involvement was to bring some science to the package.
It was the “miracle stories” that resulted from those first unmarked pre-cooked fortified foods that Basil and Rose distributed in the food parcels and the requests from patients to purchase it that sparked the Kransdorffs to set up Econocom Foods. As social entrepreneurs, they decided to distribute the product via a “job creation” and community distribution network as a way to empower those living in the community and those with HIV. The business model they created allowed them to make large cash and product donations to those at the forefront of fighting the pandemic.
Basil’s partner in business and life is his wife, Rose. To e’Pap she brings many experiences gained as a qualified social worker, advocate for social justice, management consultant, and community empowerment worker with work experience in South Africa, France, and Australia. Working extensively with communities, corporations, and vast networks, Rose recognised the need for nutritionally replete food as a basis for health, education and overcoming poverty. She joined Basil at Econocom Foods to design, manufacture and distribute e’Pap.