A successful intervention
They found that existing programs prevent 7 billion people from receiving inadequate micronutrients every year at a global cost of $1.06 billion ($0.18 per person). Iodine fortification of salt accounts for nearly half of all benefits, followed by iron fortification of flour. The team calculated implementation costs across five fortified foods — wheat flour, maize flour, rice, oil and salt — and posted their data and analysis code online.
Despite the success of current programs, an estimated 38.6 billion micronutrient inadequacies persist worldwide — driven by poor diet quality, suboptimal fortification standards, low industry compliance and limited program coverage in some regions. The curiously large number reflects the fact that some people have inadequacies in more than one micronutrient, contributing to the global count multiple times, Free explained.
This means there’s untapped potential. The study identified three priority actions that could dramatically expand impact. Improving compliance with existing standards to 90% could prevent an additional 6.1 billion inadequacies at a cost of $0.23 per person annually. Meanwhile, aligning national standards with guidelines from the World Health Organization while improving compliance could prevent 10.3 billion additional inadequacies at $0.63 per person. Expanding programs to high-need countries with appropriate food vehicles — combined with improved standards and compliance — could prevent 17.7 billion additional inadequacies at $1.15 per person.
“Although many countries require food processors to fortify staple foods, compliance is often low,” said Free. “Improving compliance with current laws could prevent 6.1 billion more inadequacies at an additional cost of only $0.05 a person annually.”
