Anemia. Neural tube defects. Weakened immune systems and blindness. Impaired brain function and reduced productivity. Morbidity and mortality.
The major underlying condition that causes all of these devastating outcomes is micronutrient deficiencies or ‘’hidden hunger.’’ Thankfully, large-scale food fortification has proven to be an intervention that can contribute substantially to preventing them.
Given its potential to improve public health with one of the most impressive benefit-cost ratios—at 27-to-1—it is our opinion that food fortification is one of the most underinvested interventions in our global health and development efforts. And we sincerely hope that this is about to change.
Food fortification is the process of adding essential vitamins and minerals—like iron, folic acid, and vitamin A—to commonly consumed foods like salt, wheat and maize flour, and cooking oil. As even the poorest consumers often have access to these basic staples, it is one way we can ensure that everyone has a baseline of vitamin and mineral security built into their diets.
For four consecutive years, the world’s poorest have felt the impacts of concurrent and cascading global crises. The pandemic, the growing pressures of the climate crisis, and a global food price crisis have resulted in one of the worst food and nutrition emergencies the world has ever seen. By establishing a new norm for fortified staple foods, broadly supported by both governments and the private sector, we can build resilience into our food systems and help protect vulnerable populations against future shocks.
Food fortification also helps prevent severe diseases before they happen. Fortifying salt with iodine is one of the greatest success stories in public health—virtually eliminating goiter and contributing to significant cognitive gains across populations. And fortification increases the effectiveness of other interventions, such as vaccinations, which are more successful at preventing infectious diseases when individuals are better nourished and have stronger immune systems.
Food fortification also increases food autonomy and security. Since most fortification occurs in local mills, it increases local ownership of nutritious food value chains and job creation. And by supporting local mills to integrate fortification into their business process, we can build an infrastructure that improves the sustainability and resilience of food systems overall.
Despite widespread evidence demonstrating its effectiveness, food fortification continues to be underutilized. But there are reasons to be hopeful. On May 29, the World Health Assembly passed a pivotal resolution to strengthen food fortification programs. At least 84 countries could benefit from new fortification programs, and most existing programs can and must be strengthened to reach more people. The passing of this resolution has not only unlocked further support but also demonstrates the political will and desire to expand and improve food fortification programs worldwide.
In response to the deepening food and hunger crises that have attended the COVID pandemic and the war in Ukraine, the African Union is redoubling its efforts to strengthen nutrition and food security across the continent, including through food fortification programs. Last year, the African Union Heads of State and Government adopted a hallmark declaration to scale up food fortification and biofortification in Africa. So far, 29 African countries have made food fortification mandatory. Central to the African Union’s long-term vision are well-nourished citizens in good health, including women, adolescents, and children. Realising human potential is key for development, leading to higher earnings, stronger economies, and improved lives.
We are witnessing a rare moment in the global spotlight for food fortification. This intervention, in combination with other nutrition interventions, is a critical component of any food-systems strategy that aims to improve the health of both people and the planet. Utilizing food fortification to its full potential helps ensure that the next generation has the ability to develop and thrive.
Amb. Josefa Leonel Correia Sacko is African Union Commissioner for Agriculture, Rural Development, Blue Economy and Sustainable Development; Member of the Scaling Up Nutrition (SUN) Movement Lead Group
Lawrence Haddad is the Executive Director of the Global Alliance for Improved Nutrition (GAIN)