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Food fortification could help reduce poverty & undernutrition in East Asia: Governments urged to make flour fortication mandatory


22 August, Kuala Lumpur, Malaysia – With prevailing under-nutrition threatening millions of unborn babies and children throughout the region with birth defects, stunted growth or even death, members of the Flour Fortification Initiative network meeting here have urged governments in East Asia and the Pacific to offer protection by requiring staple foods to be fortified with micronutrients.

Deficiencies of vitamins and minerals in diets make people vulnerable to infection and disease. Globally, such deficiencies contribute annually to the death of 1 million children younger than 5 and approximately 50,000 young women during pregnancy and childbirth, and cause 200,000 serious birth defects a year.

In East Asia and the Pacific, 22 million children are under-nourished. UNICEF estimates that 25 per cent of reproductive-age women and 17 per cent of children under the age of 5 in China are anaemic; about one-third of Filipino children are stunted and underweight; more than a quarter of children younger than 5 are underweight in Indonesia and Vietnam; and 38 percent of pregnant women are anemic in Malaysia.
The call for increased fortification came at the first regional flour-fortification workshop, which has been jointly organized by the Flour Fortification Initiative (a public-private partnership network), UNICEF and InterFlour, one of the largest private milling companies in the region. The event is part of regional efforts to create an enabling regulatory and business environment for the mandatory fortification of flour, an important staple that can be easily fortified with micronutrients.The 70 delegates include representatives from the flour industry as well as public health experts and government officials from China, Indonesia, Malaysia, Philippines, Thailand and Viet Nam. A special session on flour fortification will run concurrently during the 10th ASEAN Food conference.

“By confronting the scourge of this hidden hunger and making sure that people automatically have the needed micronutrients in their diet through fortification, we can begin to break the vicious cycle of poor health, poor productivity and poverty that keep so many families and communities trapped,” said Kul Gautam, UNICEF Deputy Director, speaking at the ASEAN Food Conference.

Good nutrition entails a diet packed with food that contains essential vitamins and minerals. Yet, people often rely on nutrient-poor staples that lead to vitamin and mineral deficiencies that can take a terrible toll on children’s growth and development and on adult productivity.

One in every four people throughout the world suffers from vitamin and mineral deficiencies. Lack of some of the more common micronutrients – iodine, vitamin A, iron, folate, and zinc – although difficult to detect, can have devastating consequences. Micronutrient deficiencies can cause blindness, brain damage, induce still-births, and make people fatigued and lethargic. Deficiencies impair both physical and cognitive development. 

According to economists, if nutritional deficiencies are not significantly reduced, they will cost  the global economy an estimated US$180-$250 billion over the next ten years in terms of mental impairment, damage to the immune systems, maternal and child deaths and loss of national productivity and growth.  Yet the total public investment needed to address these deficiencies is estimated to be around $4– $5 billion.


Fortification of staple foods has proven to be a simple and cost-effective way to increase micronutrients in everyone’s diet.  When there is a widespread and consistent nutritional deficit in a population’s diet, it is possible to obtain the minute quantities of micronutrients needed for normal growth and development by adding them to a suitable staple food.

The success of the global campaign to iodize salt is proof of the potential of the fortifying approach, which relies on collaboration between public and private partners. In just over 10 years, the combination of sustained commitment by the salt industry and the enabling environment created by governments, public health advocates and NGOs, as well as a public investment of just U.S. 3-5 cents per person, means that now approximately two-thirds of the developing world’s salt is iodized.  The pay-off for children has been enormous: Each year, 90 million newborns are protected against the threat of mental impairment from iodine deficiency.

“Experience has demonstrated that food manufacturers are critical partners in the larger public health effort to improve nutrition.  As the main agents of production and distribution of food, they can play a central role in addressing malnutrition,” said Glen Maberly, FFI Coordinator. “But to make this a reality, we need to create a level playing field for the industry that establishes fortification as the norm.  This ultimately means that governments need to put in place legislation to make it mandatory.”

“As a food ingredient manufacturer, it is our main aim and responsibility to provide good quality product to our customers. The well being of our consumers is very important to us” said Greg Harvey, CEO Interflour Group “Fortification of our flour is obviously another step toward improving the nutritional status of the community. We believe that this is the right thing to do. The Interflour Group of mills are actively involved in this global effort”.

Already a well-established practice in many developed countries, fortifying flour with iron and folic acid has contributed to a dramatic decrease in micronutrient deficiencies.  In the United States, Canada and Chile, for example, serious birth defects went down by more than one-third in five years following the the introduction of mandatory folic acid fortification. 

Some 50 countries have enacted laws to fortify cereal flours. In this region, the Philippines, Indonesia, Australia and Fiji have introduced mandatory legislation for flour fortification.

As part of the Millennium Development Goals, governments agreed to halve the proportion of people who are underweight.  In 2002, the UN General Assembly also set specific targets to reduce vitamin and mineral deficiencies, including putting an end to vitamin A deficiency and to reducing anaemia, including iron deficiency by 2010.

Fortification, combined with targeted supplementation to pregnant women and young children and overall improvement in diets, is a key strategy to achieving these targets and ultimately ensuring millions of children can grow up to lead healthy and productive lives.


Conference presentations

Regional Overview of Health and Economic Impact of Vitamin and Mineral Deficiencies

Statement by Kul Gautum, Deputy Executive Director, UNICEF

Flour fortification- a food safety & quality issue

Wheat flour fortification experience and process in indonesia




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