Nutrition International’s large-scale food fortification (LSFF) programs operate in nine countries across Africa and Asia, supporting the fortification of foods such as wheat flour, maize flour, rice, cooking oil and condiments, tailored to each country’s unique needs. These include, but are not limited, iron, folic acid, B vitamins (such as thiamine, riboflavin and niacin), zinc, vitamin A and iodine.
We work alongside governments, industry, civil society and development partners to strengthen the structures that guide fortification — from updating policies, legislation and standards to enhancing regulatory oversight and building the capacity of producers to deliver adequately fortified foods. Our approach leverages both market-based platforms and social safety net programs to reach the populations who need them most.
Last year, we advanced LSFF programs in multiple countries. In Ethiopia, India and Pakistan, we provided technical assistance to support the roll-out of national digital platforms to track fortified food production and then trained government and industry stakeholders on their use. In Senegal, we strengthened the salt iodization program by supporting regulations, boosting enforcement and quality monitoring, while in Kenya we partnered with the Ministry of Health to design an integrated food safety and surveillance system.
In Indonesia, we played a key role in the development of the national standard for fortified rice kernels, providing technical input throughout the process, which was led by the National Food Agency. This milestone paves the way for capacity building with producers, aligning procurement mechanisms and advocating for the integration of fortified rice into public programs.
Nutrition International also continues to scale up universal salt iodization (USI) by helping micro- and small-scale processors improve iodization practices, and by integrating USI into national LSFF agendas to eliminate iodine deficiency disorders. For example, in Tanzania, our technical support and advocacy contributed to the launch of the Mandatory Food Fortification Regulations of 2024, which consolidate and strengthen existing regulations for maize flour, wheat flour, edible oil and iodized salt.
At the global level, we worked with the World Health Organization and the Food and Agriculture Organization to update the 2006 Guidelines on Food Fortification with Micronutrients, expected to be released in 2026. We also completed the second phase of our collaboration with the Harvard T.H. Chan School of Public Health to assess the intergenerational impact of LSFF on non-communicable diseases in low- and middle-income countries, including a new model to estimate lives saved and reductions in disease burden through scaled fortification.
Together with the Gates Foundation, we convened a group of global salt researchers to spearhead research on double-fortified salt with iodine and folic acid in Ethiopia. Informed by promising results from the randomized control trial, we are now preparing to launch a pilot phase to introduce the product to the market before scaling to the national level.
As a result of our efforts, more than 242 million people, including 58 million women aged 15 to 49, had improved access to fortified foods, which resulted in approximately 8.6 million cases of anaemia being averted. Additionally, more than 516 million people, including 124 million women aged 15 to 49, were reached with adequately iodized salt, averting over 240,000 mental impairments in children and protecting 10.8 million newborns from iodine deficiency disorders.
