Food fortification : Action Against Hunger’s Operational Guidelines

WHAT IS FOOD FORTIFICATION?

The Guidelines on Food Fortification by WHO and FAO1 defines food fortification as “the practice of deliberately increasing the content of an essential micronutrient, i.e. vitamins and minerals (including trace elements) in a food, so as to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health.”

WHAT FORMS OF FOOD FORTIFICATION EXIST?

• Mass fortification (fortification of foods widely consumed by the general population, staples
• Targeted fortification (fortification designed for specific population subgroups, such as complementary foods for young children or rations for displaced populations)
• Market-driven fortification (voluntarily fortification by food manufacturers)
• Home fortification (fortification at household or community level)

WHY IS THE HUMANITARIAN WORLD INCREASINGLY SPEAKING ABOUT FORTIFIED FOODS?

In 2017, hunger was on the rise for the first time in a decade; 815 million people were suffering from hunger2, a 38 million increase compared to the previous year. Around 155 million children have stunted growth due to poor nutrition, and levels of nutrient deficiencies are alarmingly high: two billion people suffer from micronutrient deficiencies, also known as “hidden hunger”3. At the same time, nutrition public funding is shrinking and donors express their fatigue regarding renewed financial commitments to fight hunger.

They are trying to find new solutions and sources of funding to fight hunger and malnutrition.Since the 1990s, micronutrient fortifications have become a focus of national and international health agencies for addressing population-wide micronutrient deficiencies in low and middle-income countries. Currently, they are increasingly being promoted by donors as a promising solution that can easily involve private sector companies in the fight against hunger. Indeed, private stakeholders involved in agriculture and nutrition usually state that food fortification offers great potential to improve the diets of the populations that are vulnerable to micronutrient deficiencies.

ACTION AGAINST HUNGER’S ANALYSIS OF FORTIFIED FOODS:

While the promotors of food fortification state that this approach can address micronutrient deficiencies in situations where existing food supplies fail to provide adequate levels of certain nutrients in the diet, Action Against Hunger believes that scientific evidence is currently failing to demonstrate its positive impacts in the long term. The stability and bioavailability of the added nutrients, as well as their physical and cooking properties are increasingly questioned. Furthermore, fortified products are often not widely accessible to the most vulnerable and poor population, thus jeopardizing access to diverse foods through markets.

Finally, fortification can be seen as a threat to local environment and food culture because it challenges dietary patterns that are based on fresh and minimally processed foods, and might lead people into thinking that conventional crops are inadequate and need to be enhanced through fortification to make them more nutritious. Therefore, while Action Against Hunger recognizes that the promotion of fortification is currently “high” in donors and the United Nation’s agenda, we believe that we should be cautious in our operational approach.

The following guidelines for the integration of food fortification in our programming reflect this vigilance and aim to ensure that Action Against Hunger always tries to promote the most suitable solution to fight hunger, despite the ongoing political agenda.