Fortify our Food Systems: Securing Access to Mighty Nutrients

Whenever I visit my second home in Senegal, or elsewhere in West Africa, I take inordinate pleasure in walking through market stalls, corner stores and supermarkets checking bottles of cooking oil and packages of flour for the “Enrichi” logo. This smiling figure heralds an often overlooked partnership that delivers essential vitamins and minerals across the region that began two decades ago. The Fortify West Africa partnership provides many lessons on how to deliver essential nutrients through the food system. It also highlights three critical gaps that still need to be addressed to fulfill the promise of this powerful solution.

For those of us in the U.S., we seldom worry about getting enough vitamin A, iodine, iron, folate or zinc. Nutritionists refer to these nutrients and other essential vitamins and minerals as micronutrients – which is probably a mistake. While the quantities we need for good health are “micro”, the impacts are mighty.

Vitamin A is essential for eyesight and our immune system and can save hundreds of thousands of children’s lives a year. Iodine supports brain development. Iron is essential for brain development and fighting infections, as well as preventing nutrition-related anemia. Folate prevents devastating neural tube defects. Zinc supports our immune system and children’s growth.

The U.S. has recognized the might of these nutrients for almost a century - iodized salt first became available on grocery shelves in Michigan in 1924. If you go to a grocery store in the U.S., you will see how many foods are fortified with essential nutrients.

For more than 50 years, USAID has led global efforts on food fortification to bring this cutting-edge and impactful solution to the rest of the world. In West Africa, USAID has supported a coalition of food processors, partner governments, regional economic communities, technical agencies and other donors to fortify cooking oil, wheat flour and salt. The strategic inclusion of the Economic Community of West African States and the Union Monétaire et Economique Ouest Africaine elevated the issue, harmonized standards across all 15 member countries and joined up a regional public health priority with regional trade. With the active fortification of salt, flour and oil in all 15 countries, West Africa has become a model of fortifying food systems. ??

Reaching people with the mighty power of micronutrients in West Africa and around the world is more important now than ever. One of the signature messages of this year’s State of Food Security and Nutrition in the World is the daunting challenge of affording a healthy diet. Pre-pandemic, 3 billion people a year could not afford a healthy diet. The International Food Policy Research Institute projects this could increase by 267.6 million due to the impacts of the pandemic.

The COVID-19 crisis, like other crises before it, has some of the biggest impacts on the poorest households and their purchasing power. Low-income households have to spend much of their income on food and, when faced with a shock, deprioritize nutritious foods, such as meat, poultry, fish, dairy, eggs, fruits and vegetables, in favor of belly-filling staples. Fortification can secure access to these mighty nutrients by putting them into staple foods and condiments like cooking oil, flour, and salt that households will continue to rely on when nutritious foods are out of reach.

This year's United Nations Food Systems Summit aspires to be a “… solutions summit that will require everyone to take action to transform the world’s food systems.” Fortifying commonly consumed foods is a ready-made solution for the food system to deliver these mighty nutrients. To realize the promise of food fortification, we need to address three gaps: performance, design and innovation.

Performance gap: Most countries have some fortification standards. However, these standards may have limitations or are not being fully applied by food processors. Improving data and supporting industries to fortify to standard can quickly close this gap.

Design gap: Dietary patterns and nutrition science are changing rapidly. Many countries need to adjust their programs to respond to the current dietary and nutritional realities of their populations. Updating standards to identify the fortifiable foods most consumed by at-risk households and using the best vitamin and mineral ingredients will further improve impact.

Food technology innovation gap: We still rely on the usual nutrients in the usual foods. We can work with food technologists to find solutions to add nutrients to commonly consumed staple foods and condiments that will further expand access to these essential nutrients.

Back in 1990, the world promised “ … to eliminate vitamin A deficiency and iodine deficiency disorders and to reduce nutritional anaemia significantly” by the year 2000. There have been some impressive gains, but there is more work yet to be done to fully secure access to these and other mighty nutrients. With decades of experience and evidence behind us, the UN Food Systems Summit offers the perfect opportunity to galvanize action to eliminate deficiencies in essential vitamins and minerals and position food fortification as a mighty solution we can deliver on now.?