By Dr. Saskia Osendarp and Paul Newnham
The latest available figures from 2020 tell us that 3.1 billion peoplecannot afford a healthy diet.
Worryingly, this global figure of 3.1 billion only partially reflects the impact of food price shocks linked to the COVID-19 pandemic and does not account for the effects of spikes in food, fertiliser and fuel prices caused by the war in Ukraine as well as the cost of living crisis – all of which we know are significantly increasing the cost of a nutrient-rich diet. In a world where healthy diets are increasingly inaccessible and we face a cycle of food crises, we need to urgently scale up solutions that improve the nutrition status of our populations and build nutrition resilience to future crises.
This month, the World Health Assembly (WHA) will consider a resolution on Large Scale Food Fortification. Food fortification may sound like a wonky technical concept – and it is! – but it is also a terrific example of food systems delivering on nutrition and health.
Large scale food fortification is the inclusion of extra vitamins and minerals (such as Vitamin A or folic acid) during the food processing stage to make it more nutritious. Large scale food fortification leverages popular foods that are regularly consumed, such as salt, flour or oil, which have existing supply chains that can be utilised to reach billions of people with additional micronutrients.
While food fortification is by no means a silver bullet, the resolution is a positive step towards curtailing the growing global burden of malnutrition and a much-needed win in the face of the global food crisis. In anticipation of the WHA in just a few week’s time, we reflect on the standout moments from the recent webinar Fortifying our Future and why scaling up food fortification globally is critical to tackling micronutrient deficiencies.
“The impact of a well designed and implemented fortification policy will be life changing,” said Papatya Alkan Genca of the Turkish Spina Bifida Association, who captured the feeling of hope embodied by the resolution and shared among the webinar’s panellists. Hosted by a broad group of nutrition, health and food systems actors, the webinar gathered civil society, industry, medical and academic voices to share their insights on large scale food fortification for the audience of 320+ participants.
The burden of micronutrient deficiencies globally is enormous, with an estimated 1 in 2 children under-five and 2 in 3 women suffering from at least one micronutrient deficiency globally. Although the human body only needs a small amount of micronutrients, deficiencies in these minerals and vitamins have irreversible and devastating long-term health and development impacts, particularly for children who are at key growing stages.
Panellists Sylvia Roozen of IFSBH and Papatya Alkan Genca spoke passionately about the power of large scale food fortification for the prevention of congenital defects (such as spina bifida and hydrocephalus) and the importance of accessible micronutrients for a life of dignity.
Large scale fortified foods are a systems-level solution to prevent micronutrient deficiencies that are cost-effective for both consumers and producers. Fortification adds an average of less than 2% to the retail price for consumers while the production cost for fortified salt is less than 5 cents per person per year. Panellists clearly noted that food fortification is complementary to efforts to improve the affordability, accessibility, and availability of diverse and healthy diets.
Penjani Mkambula of GAIN highlighted iodised salt as a fortification success story: “In 1993, 115 countries were classified as iodine deficient. If you look at the number of countries today that are deficient, that number has come down to 20. And what is the fundamental shift? It is because we started giving people iodine through salt. Modelling has shown that almost 720 million cases of goiter have been prevented.” This example shows the tremendous impact of well-funded fortification programmes for transformative health outcomes that should be protected with continued resourcing to reach future generations.
Sharing insights on large scale food fortification from a country perspective, Haymanot Asfaw of wheat milling company Mintu Investment Group explained Ethiopia’s present challenges of drought, conflict and population displacement as motivating factors for the government’s support of the resolution, raising the importance of fortification as a tool for resilience building. Haymanot noted some of the barriers limiting the scale up of Ethiopia’s fortification industry, ranging from the difficulty in accessing foreign currency for the importation of key inputs, to insufficient capacity building and knowledge exchange for milling implementation.
With the endorsement of 37 Member States and counting, the Large Scale Food Fortification Resolution is the first food systems resolution in 10 years at the World Health Assembly and made possible by broad support and collaboration across government, civil society and academia working on disability rights, health and nutrition.
If the resolution passes this month, Member States will have recognised micronutrient deficiencies as a global public health problem and committed to delivering on this resolution in their respective countries.
“The resolution creates global accountability,” explained panellist Luz De Regil of WHO on the potential impact of this resolution. With the world off track to reach the 2025 World Health Assembly targets, this resolution is one critical way that we can scale up cost-effective solutions to reduce the burden of malnutrition.
Get involved!
Listen to the webinar hosted by the Mighty Nutrients Coalition, Micronutrient Forum, the Global Alliance for Improved Nutrition, the Global Alliance for the Prevention of Spina Bifida, the Global Alliance for Obstetric Trauma and Anesthesia Care, Helen Keller International and the International Federation for Spina Bifida and Hydrocephalus, the Iodine Global Network, International Zinc Nutrition Consultative Group, Micronutrient Data Innovation Alliance, and SDG2 Advocacy Hub.
Read the WHA Resolution here and find here advocacy resources to promote this exciting opportunity, including a social media toolkit.
Watch history in the making and follow the WHA discussions on the Resolution here. If you’re in Geneva, RSVP to join the WHA Side Event – Accelerating efforts for preventing micronutrient deficiencies and their consequences through safe and effective food fortification on 23 May.
