Large-scale food fortification: An overview of trends and challenges in low- and middle-income countries in 2017
This report (PDF) by the Micronutrient Forum provides an overview of the state of large-scale food fortification in the world. It has an emphasis on gaps and challenges to the scaling-up of the fortification of staple foods to populations that would benefit. Fortification of staples adds to the nutrient intakes of nearly everyone in a population and remains a critical and necessarily ongoing public health nutrition intervention in all countries. Currently, 86 countries have legislation to mandate fortification of at least one industrially milled fortified grain (85 countries plus the Punjab for wheat flour; 16 for maize; 6 for rice). Whereas 84 countries mandate both iron and folic acid, Australia does not include iron and five countries do not include folic acid. Such programs have resulted in the fortification of 30% of the world’s industrially-milled wheat flour, 48% of maize flour and 1% of rice. Five critical areas of action are: 1) Modest but new investment is essential. 2) A major effort is needed to improve oversight and enforcement of food fortification standards and regulations; poor compliance with laws and regulations limits potential for impact and undermines effectiveness. 3) More evidence must be generated to guide fortification policy and program design, to continually improve programs and demonstrate impact. 4) Progress requires more transparent accountability and global reporting. The authors support the call for a global observatory or annual report of the state of fortification. 5) Continuing advocacy is a high priority for all stakeholders such as the SUN movement and African Union to advocate for greater attention by governments.