India: a beacon for the world’s food fortification

If the future is to be fortified then we also need to fortify the awareness of governments, industry and communities to its benefits, says GAIN’s Executive Director, Lawrence Haddad in his latest blog.

Last week, I was lucky enough to spend some time in Delhi and Jaipur with the GAIN India team (in particular Tarun Vij, our Country Director and Deepti Gulati our Senior Technical Specialist).  Much of my time was spent meeting our excellent partners and learning about large scale food fortification.

Some quick takeaways:

  1. There is a great deal of enthusiasm for fortification in India right now. This is a big deal because India is one sixth of the world’s population. The drivers are the Food Safety and Standards Authority of India (and their dynamic CEO Pawan Agarwal) as well as first mover states such as Rajasthan (and their equally dynamic Principal Secretary for Food Civil Supplies and Consumer Affairs, Dr Subodh Agarwal) and Haryana. If oil, milk, wheat flour and rice can be fortified at scale in the next five years a lot more people will have access to micronutrients at affordable prices.
  1. The controversy around fortification is still present in India, but it feels muted. Controversies revolve around (a) Does fortification slow down the drive for increased dietary diversity? (b) Does the fortification of milk reach enough of the most vulnerable in urban areas (processed milk purchases are an urban phenomenon)? and (c) Does the fortification of packaged foods (still a relatively small share of food baskets—although growing) encourage the consumption of packaged foods? (Note: not all packaged foods are terribly healthy if consumed too frequently). These are important questions to bear in mind and to find local answers for.
  1. The pathway to fortification at scale varies from place to place, from food to food and micronutrient to micronutrient. In some instances, the best strategy is to go to voluntary fortification (companies can opt in or out) and then move to mandatory legislation. In some instances it makes sense to have a “voluntary-mandatory” approach where in principle companies can in theory opt out, but due to peer pressure and government pressure it is difficult to do so. Sometimes going straight to mandatory compliance can be counterproductive because industry will negotiate a “getting ready for compliance” period which tends to slip and slip and slip and so mandatory compliance is realised only after a long time.
  1. Fortification is one of those interventions that it is easy to overestimate and overlook. By overestimate, I mean that I was under the impression that far more foods were fortified in far more countries with far greater effective coverage rates than is actually the case. By overlook, I mean that not that many people outside the technical fortification experts actually know about fortification: its impacts, costs and coverage.

For sure, fortification is only a part of the solution to malnutrition, but it is one that is low risk and has a dependable impact. It should form a plank in any national nutrition strategy and then it should be implemented.

If the future is to be fortified then we also need to fortify the awareness of governments, industry and communities to its benefits. India can be its beacon.

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Published 6 February 2017