LARGE SCALE FOOD FORTIFICATION

In an ideal world, we would all have access to a wide variety of nutrient rich foods which provide all the vitamins and minerals we need. Unfortunately, for many people, especially in poorer countries, this is often not feasible or affordable. That’s why fortifying food staples such as flour, cooking oils and condiments with essential micronutrients is a crucial component of our work at GAIN.

GAIN is the global leader in large-scale food fortification, building the necessary public private partnerships, strengthening local supply by working on building quality assurance and quality control capacity with food processors and regulators and setting up monitoring and evaluation system to ensure this intervention is delivered in a sustainable way.

Our food fortification programs have reached 800 million people in more than 30 countries around the world.  We help fortify vegetable oil with vitamins A and D; wheat and maize flour with iron, folic acid, other B vitamins and zinc; soy sauce with iron and salt with iodine. Once an initial capital investment is made, continuing costs are only a few US cents per person per year. Food fortification also helps economies by reducing malnutrition, preventing estimated losses to the economy of as much as 2.65% of GDP according to the World Bank.

An example of a successful alliance for micronutrients is the GAIN-UNICEF Universal Salt Iodization Partnership, working in 14 countries from 2008-2015. This project protected an additional 466 million people against iodine deficiency, including an estimated 18.2 million pregnant and lactating women and 113 million children aged 6 months to 15 years old who are no longer at risk of its debilitating effects.

 

ENABLE PLATFORM

Launched by GAIN in 2017, the ENABLE Platform is a set of integrated services designed to establish, optimise and maintain food fortification and safety programs in developing countries around the world. Including the GAIN Premix Facility (GPF), the pioneering procurement model we introduced in 2009 which has brought high-quality micronutrients worth more than $60 million to food producers in 43 countries, reaching around 150 million people every year across Africa and Asia, the new platform flexibly addresses the political, technical and economic factors which challenge the ongoing success of food fortification programs.

Building alliances with governments, NGOs, private-sector businesses, civil society, academic institutions and others that allow programs to deliver sustainable impacts at scale, we identify the needs of each country we work in and tailor a solution to them. We provide producers who lack the upfront funds to start fortifying foods with extended credit. We support governments seeking to mandate fortification and encourage them to invest in stringent, skilled regulation systems. We offer technical support and professional training to build capacity for testing and enforcing quality standards, and introduce processes to hold producers accountable for compliant quality. Increasingly, we conduct food-safety interventions both within and beyond our fortification programs, and spread the advances these drive through international food systems. And we continue to amass evidence based on our unmatched experience in this field, creating best-practice templates that anyone can use to shape their own food fortification programs.

Find out more

 

USAID logo - portal

CENTRAL ASIA REGIONAL FORTIFICATION PORTAL

The USAID-funded Afghanistan, Pakistan and Central Asia Republics Regional Fortification Initiative aims to build capacity for food fortification with essential vitamins and minerals in order to improve micronutrient intakes across the region, and in particular for Afghanistan. The initiative is forming essential partnerships between governmental bodies, the private sector as well as civil society partners to embed fortification within the regional and national food systems to achieve sustainable fortification which leads to health impact. Key objectives include establishing and strengthening regulations and monitoring, facilitating harmonization of regional fortification standards; and strengthening quality control and enforcement. This portal offers essential USAID-funded technical outputs and information related to food fortification in Afghanistan, Pakistan and the Central Asian Republics.

 Regional Documents

Afghanistan

Micronutrient deficiencies including iron, zinc, vitamin D, and vitamin A are widespread in Afghanistan. More than 50% of children under five years are deficient in vitamin A, and 64% are deficient in vitamin D while 14% are iron deficient, all severe public health problems. GAIN and USAID are supporting in-country efforts aimed at creating an enabling environment to increase the availability and access to fortified foods in Afghanistan by strengthening fortification regulations and capacity for monitoring and enforcement, with a special focus on imports of fortified wheat flour and edible oil from neighbouring countries.

Fortification Standards

Workshop Reports

Kazakhstan 

Wheat flour is a critical staple food in Central Asia, accounting for between 50-70% of caloric intake. Kazakhstan is among the top wheat flour exporting countries in the world. Neighbouring countries in the region, especially Afghanistan, import part of their wheat flour from Kazakhstan, which, if fortified, would have a significant impact. GAIN and USAID are working with key stakeholders including the Kazakh Academy of Nutrition and the Kazakh Union of Grain Processors, to raise awareness and create an enabling environment for increased production and trade of adequately fortified wheat flour in Kazakhstan and throughout the region, with an emphasis on improving fortification processes, regulations and monitoring.

 Fortification Standards

Workshop Reports

Pakistan

In Pakistan, most children and women of reproductive age suffer from multiple micronutrient deficiencies. Half of the women and 62% children under five in Pakistan are iron deficient. Vitamin A deficiency is also of concern with 42% of non-pregnant women and 54% of the under-fives with low serum retinol levels. At the same time, Pakistan is a major producer and exporter of both wheat flour and edible oil in the region. More than half of Afghanistan’s wheat flour is imported from Pakistan. Mandatory regulations for the fortification of edible oils with vitamin A are in place, wheat flour fortification is starting. USAID and GAIN are supporting industries to set up the right tools and processes to produce fortified wheat flour and edible oil; supporting strengthening the regulatory monitoring system for compliance; and raising awareness about the economic and health benefits of consuming fortified foods to industries, consumers, and government stakeholders.

Reports and Assessments

Workshop Reports

Tajikistan

Despite economic progress, micronutrient deficiencies Tajikistan remain high. Iron deficiency anaemia affects an estimated 24% of women of reproductive age and 28% of children under the age of five. Bread is the main staple food, and therefore wheat flour is an ideal vehicle for fortification with iron and folic acid. GAIN and USAID are supporting the Government of Tajikistan in the development of appropriate fortification legislation and policies, and building capacities of food industries and food control authorities for the fortification of wheat flour to improve iron and folate status in the Tajik population.

Fortification Standards

Reports and Assessments

Workshop Reports

 

GLOBAL TRACKING

GAIN collaborates with its partners to collect and publish national data and track fortification efforts globally. While GAIN is tracking information on oil and condiments as fortified vehicles, the Food Fortification Initiative takes the lead on tracking progress on cereal grains, and the Iodine Global Network tracks salt.

Vegetable oils and fats  

Vegetable oils and fats, such as margarine or ghee, are typically fortified with vitamins A and D. While some countries may have legislation covering all types of vegetable oils, the below information is valid if a country mandates at least one type of vegetable oil or fat.

As of October 2016:

  • 49 countries mandate fortification of vegetable oils or margarine with vitamin A and 20 of these also include vitamin D in their standards.
  • 10 countries allow voluntary fortification with vitamin A and 6 also include vitamin D in their standards.

Find out more about the levels of vitamins A and D allowed by national standards.

 

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Condiments and sauces

Condiments and sauces, such as fish sauce, soy sauce, MSG, and bouillon cubes are increasingly being utilized as flavor enhancers for many foods, reducing salt intakes in some cases. Condiments and sauces can be fortified with iodine, iron, vitamin A, or multiple micronutrients depending on the condiment and the population need.

As of October 2016:

  • 2 countries mandate fortification of fish and soy sauces (Thailand and Cambodia).
  • Vietnam allows for voluntary fortification of fish and soy sauces and China allows for voluntary fortification of soy sauce only.
  • 2 countries allow voluntary fortification of MSG (Philippines and Indonesia).
  • 7 countries in West Africa are currently within the Nestle Maggi fortified bouillon cubes distribution area.

Find out more about the levels of vitamins and minerals allowed by national standards.

 

 

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If you would like to amend or update any information on this page, please contact cluthringer@gainhealth.org