Number of Countries with Fortification Legislation Doubles in Eight Years
Atlanta, 15 May 2012 – The Republic of Moldova and the West Africa nations of Togo and Benin have recently passed legislation requiring the addition of vitamins and minerals to wheat flour. Now 68 countries have mandates to fortify wheat flour with at least iron or folic acid, compared to 33 countries with such legislation in 2004. The combined population of the 68 countries with fortification legislation now is more than 2 billion.
The Flour Fortification Initiative (FFI) was formally launched in 2004 as a network of partners working together to make flour fortification standard industrial milling practice around the world. At that time, 33 countries required fortification of wheat flour, and the countries were primarily in the Americas and the Middle East.
“The growth in countries passing legislation is the result of the determination of country leaders to improve the health of their populations and the hard work of our many public, private, and civic sector partners,” said Scott Montgomery, FFI Director. “This milestone of doubling the number of countries is an achievement we can all celebrate.”
When flour is fortified, foods subsequently made with fortified flour provide additional essential nutrients to consumers. To develop appropriate fortification standards, countries evaluate their population’s food consumption patterns, the type of flour most commonly consumed, and evidence of nutrient deficiencies.
In Moldova, flour will be fortified with iron and folic acid, a B vitamin. The country’s three largest industrial mills will begin fortifying in 2012, and in 2013 all bakeries will be required to use fortified flour in their products.
The decrees in Togo and Benin likewise call for adding iron and folic acid to wheat flour. Other nutrients such as zinc and additional B vitamins can be included voluntarily, and most milling companies include the mandatory and voluntary nutrients. Some maize flour is also voluntarily fortified.
All people need iron to make hemoglobin which carries oxygen to tissues and muscles. Iron improves adults’ capacity for physical activity and work productivity. Iron is also essential for a child’s physical and mental development, and iron is also critical for the health of a pregnant woman and her unborn child. Yet iron deficiency is “one of the most prevalent nutrient deficiencies in the world,” according to the World Health Organization.
People need folic acid to produce and maintain healthy cells, and women who might become pregnant especially need folic acid. Four hundred micrograms daily at least one month before conception and in the early stages of pregnancy has proven to prevent 50 to 70 percent of neural tube birth defects, according to the U.S. Centers for Disease Control and Prevention. The most common of these birth defects is spina bifida in which the baby’s spine does not form correctly. Children born with spina bifida will undergo a lifetime of surgeries and face many health issues. Spina bifida cannot be cured. Another neural tube defect is anencephaly in which the brain does not form properly. Anencephaly is always fatal.
The legislation in the West African nations also requires adding vitamin A to cooking oil. Vitamin A deficiency is the leading cause of preventable blindness in children, and it increases the risk of disease and death from severe infections. Flour can be fortified with vitamin A, but it increases the cost of fortification and shortens the shelf life of flour. Consequently many countries chose to fortify oil or sugar rather than flour with vitamin A.
All four major cooking oil industries and two wheat flour milling industries in Benin and Togo have been trained in using proper equipment, securing quality premix, and conducting quality assurance procedures. Industries in both countries have been complying with regional standards since December 2009. The mandatory legislation will also oblige all importers to ensure full compliance with the standard.
In addition to national leaders who advocated for fortification in each of these countries, several international partners were involved in the process. These include UNICEF, Helen Keller International, the Commission of the West Africa Economic and Monetary Union (UEMOA), the West African Health Organization (WAHO), the Micronutrient Initiative, and the Michael and Susan Dell Foundation. The Togo and Benin action is part of the “Fortify West Africa” initiative which is largely funded by the United States Agency for International Development.