Large-Scale Food Fortification

How We Help /

243M

people had access to adequately fortified foods in 2024–25

516M

people had access to adequately iodized salt in 2024–25

10.9M

newborns protected through maternal consumption in 2024–25

The Need

Micronutrient deficiencies can have devastating health impacts

Health and food systems around the world are facing an urgent and growing need to become more resilient. Challenges like conflicts, climate shocks and disease are threatening the health of people and the stability of the food systems that provide them with healthy, nutritious staple foods.

This is crucial because estimates indicate that more than five billion people globally already do not consume enough iodine, vitamin E and calcium (Passarelli et al, 2024). More than four billion do not consume enough iron, riboflavin, folate and vitamin C.

These dietary inadequacies affect their health, education and wellbeing, but these challenges are made worse when people and food systems experience shocks. Children, adolescents and women feel these heightened negative effects most acutely.

Our Solution

Building a nutrition foundation

Food fortification is the process of adding essential micronutrients to widely consumed staple foods during processing to improve the overall nutritional quality of the food supply. The type of food fortified changes based on local food traditions and availability and can include rice, wheat or maize flour, salt and oil.

Fortifying inexpensive staples and condiments eaten daily by most populations means that food fortification can deliver important health and economic returns: up to $27 for every $1 invested.

Food fortification is foundational for creating population health and building the resilience of individuals and systems. It enables other interventions like education or disease prevention to be more effective, and it ensures that people are healthier when shocks do occur. It also enhances the ability of food systems to provide staple foods with the necessary nutrients throughout crisis situations, including improving the stability of the supply chains that provide those staples.

Food fortification is a crucial component alongside other health system interventions for improving nutrition, individual resilience and food system stability. Together, they can help ensure greater reach and impact.

Our approach: Evidence meets scale

Evidence-based, needs-based and proven at scale

Nutrition International works to improve the coverage, quality and sustainability of evidence-based, needs-based and sustainable fortification programs.

We focus on five key strategic principles:

Needs-based approach: Our food fortification programs are grounded in strong public health justifications (based on local dietary inadequacies), and costing and feasibility analyses. This helps ensure the optimal choice of food vehicles, nutrients and the quantity of nutrients that should be added.
Optimal intervention mix: We support including fortified foods as part of a mix of staple foods and other micronutrient interventions that can be used to address pressing priority nutritional needs based on up-to-date dietary data.
Technical rigour: We provide the public and private sectors with technical support to ensure food fortification approaches that reflect current best practices and global and regional guidance around large-scale food fortification, and that align with our do no harm approach.
Building sustainability and national ownership: Our large-scale food fortification programs strengthen the capacity of government and the public sector to manage, monitor and maintain fortification programs long after Nutrition International’s support ends. We provide guidance and capacity-building support with this goal in mind, supporting government to identify and leverage alternative financing mechanisms for large-scale food fortification, and ensuring that there are trained professionals who can support the needs of the program and continue to train others.
Do no harm. The choice of which nutrients to add to which foods is driven by local need, context and evidence. We prioritize fortifying foods that do not cause adverse health outcomes and support industry to improve the nutritional profile of those foods. We also ensure our work aligns with public health priorities, such as reducing consumption of trans fats and sodium.

By focusing our work in this way, we can help national food fortification programs reach the most people in need with adequate nutrition, and that they can address barriers to supply, quality and reach for years to come.

Our approach: A global framework

The Food Fortification Blueprint

Building on lessons learned, best practices and a review of 19 existing fortification frameworks, the Food Fortification Blueprint was developed through a collaboration between Nutrition International and the Food Fortification Initiative (FFI) in 2021. Intended for large-scale food fortification program managers worldwide, it is designed to strengthen large-scale food fortification program design, implementation, scale-up, monitoring and evaluation. Originally published in 2023, the blueprint informs Nutrition International’s own programming and is being adopted by the broader fortification ecosystem. It has also been translated into an accessible online resource for global use.

Read the blueprint

Our approach: Empowered women and girls

Gender and safeguarding

While fortification interventions benefit an entire population, they have a greater impact on women and girls. This is because micronutrient deficiencies fall primarily on women and children due to their higher nutritional requirements in early development, pregnancy and lactation, and because they often face unequal access to household food.

Nutrition International actively embeds gender across all its large-scale food fortification programs, advancing gender-focused practices, programs and partnerships to ensure that women and girls can thrive.

Without fortified foods, women and girls experience poorer health outcomes, including pre-term births, infant mortality and neural tube disorders. Micronutrient deficiencies can also cause fatigue and increase susceptibility to infection, which can reduce productivity, decrease income and affect economic participation later in life.

Fortification’s population approach can address these issues, improving the health outcomes of women and girls and helping them meet their higher nutritional requirements without increasing their time or labour.

Our Global Projects

Discover our projects around the world

Browse our complete list of projects to learn about how we deliver high-impact, low-cost, evidence-based nutrition programs for those who need it most.

Browse more projects like these

Social Protection Program for Adolescent Nutrition (SOPRAN) for improving…

This project will leverage Pakistan’s leading social safety net initiative to enhance the nutritional status of the population by improving local norms and practices

Social Protection Program for Adolescent Nutrition (SOPRAN) for improving nutrition

Bridging the fortification gap in the Philippines

Nutrition International is leading a collaborative effort to improve the micronutrient status of women, adolescent girls and children in the Philippines by improving fortification policies.

Bridging the fortification gap in the Philippines

Technical assistance on large-scale food fortification in Indonesia

This collaboration with TechnoServe will provide technical assistance to the food fortification industry of Indonesia– strengthening the enabling environment to scale up fortification.

Technical assistance on large-scale food fortification in Indonesia

Institutionalizing mandatory oil and wheat flour fortification in Pakistan

With support from the Bill & Melinda Gates Foundation, we will help to take Pakistan's large-scale food fortification programs to the next level.

hand holding spade of wheat flour in Pakistan

USAID Advancing Food Fortification to Reinforce Diets (AFFORD)

The USAID Advancing Food Fortification to Reinforce Diets (AFFORD) activity puts the food industry at the centre of its work to make large-scale food fortification programs scalable and sustainable.

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