Large-Scale Food Fortification

Large-Scale Food Fortification

Micronutrient deficiency is a lack of the essential vitamins and minerals required for healthy growth, development and functioning. These deficiencies and their negative health consequences affect approximately 2 billion people around the world, and are largely due to overreliance on starchy staples such as maize, wheat and rice. Preventable deficiencies in Vitamin A, D, iron, iodine, folate, and zinc contribute roughly one million child deaths annually, and the economic consequences are also high. In low and middle-income countries alone, micronutrient deficiencies are estimated to cost an annual gross domestic product loss between two and five percent.

One of the fastest and cheapest strategies to reach hundreds of millions with improved intakes of essential nutrients is through food fortification, the practice of adding one or more essential nutrients to a widely consumed food. The Food and Agriculture Organization (FAO) and the World Health Organization (WHO) identify food fortification as one of four main strategies for addressing micronutrient malnutrition. It has been ranked among the top three international development priorities by the Copenhagen Consensus. Fortification is in some places mandatory and in others voluntary. Where national mandatory fortification programmes have been implemented well and reached high coverage and quality, they have helped to significantly decrease micronutrient malnutrition among entire populations.

Since 2002, GAIN has supported the roll-out fortification in approximately 30 low and middle-income countries as an approach to help decrease malnutrition. This support has helped to build, improve and sustain national large-scale food fortification (LSFF) programmes. We have invested over USD 200 million in fortification through grants and technical assistance. As a result of these efforts, 14 countries have now mandated LSFF, and an estimated one billion individuals have sustained access to these fortified foods.

Global projects

Fortification tools developed by GAIN, alone or in partnership with other organisations, include the GAIN Fortification Assessment Coverage Tool (FACT) and the Fortification Management Information System or FortifyMIS, and are used by multiple stakeholders in over 20 countries.

Global platforms include:

  1. The ENABLE Platform – a technical hub offering audit, credit, procurement and capacity building services. ENABLE hosts the GAIN Premix Facility helping countries to procure high-quality, low-cost mineral and vitamin premix; the Terms and Conditions governing the GAIN premix facility's procurement activities are set out in the following documents GAIN's Terms and Conditions for the Sale of Goods and Terms and Conditions for the Purchase of Goods
  2. European Commission Fortification Advisory Services project;
  3. The Global Fortification Data Exchange; and
  4. Hosting of the Global Fortification Technical Advisory Group – a community of practice of over 20 international partners working in fortification.

Country projects

At country level, GAIN primarily supports mandatory fortification of commonly consumed food vehicles including salt, edible oils, wheat flour, maize flour, and rice. Following the recommendations of the Arusha Statement, our national-level technical support prioritises building partnerships between the private sector, government, and civil society (e.g. consumer protection agencies) and providing technical support so that these actors can:

  1. Start or expand fortification programmes where there is a need and an appropriate food vehicle.
  2. Improve compliance of existing national programmes – making sure industry fortifies in line with the standards set by governments.
  3. Monitor, measure and sustain more mature programmes.


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