CS122586

FFI Global Update

What is Flour Fortification?

Fortification is adding

vitamins and

minerals to flour

during the milling

process so that

staple foods are

more nutritious.

Modern mill with three feeder lines

3

0%

20%

40%

60%

80%

100%

120%

Wholemeal Normalwhite flour

ThiaminRiboflavinVit. B6FolateIronNiacin

Wheat and maize lose much of their nutrients in the milling process.

Fortification replaces those and can add other vitamins and minerals

as needed.

Essential Nutrients

Burden of Deficiencies

• Impair millions of growing minds and lowers national IQ

• Cause damage to immune systems and deaths of more than a million children a year

• Cause 300,000 serious birth defects annually

• Contribute to the death of approximately 60,000 young women a year during pregnancy and childbirth

• Impair millions of growing minds and lowers national IQ

• Cause damage to immune systems and deaths of more than a million children a year

• Cause 300,000 serious birth defects annually

• Contribute to the death of approximately 60,000 young women a year during pregnancy and childbirth

Vitamin and Mineral Deficiencies:

Micronutrient Initiative, UNICEF, and March of Dimes

Burden of Iron Deficiency

World Health Organization: http://www.who.int/nutrition/topics/ida/en/index.html

Leading cause of anemia which:

• Reduces work capacity

• Impairs a child’s physical and intellectual development

• Contributes to 20% of all maternal deaths

• 17% lower productivity in

heavy manual labor

• 5% lower productivity in

other manual labor

• Estimated 4% loss of

earnings due to lower

cognitive skills.

Economic Burden of Anemia

The Economics of Food Fortification (2006) by Sue Horton

Burden of Folic Acid Deficiency

• Leads to neural tube defects (NTDs) such as spina bifida and anencephaly.

• 50% to 70% of these birth defects are preventable.

Anencephaly is malformation of the baby’s brain. It is always fatal.

Spina bifida is malformation of the baby’s spine. It causes permanent disability.

Centers for Disease Control and Prevention: http://www.cdc.gov/ncbddd/folicacid/faqs.html

Centers for Disease Control and Prevention , “Folic Acid in the Prevention of Birth Defects” Public Health Grand Rounds, February 18, 2010

Neural tubebirth defects

per 10,000live births

-37%

1998USA

0

2

4

6

8

10

12

14

16

18

Before fortification After fortification

10.8

6.6

- 46%

1998Canada

15.8

8.6

- 41%

2000Chile

10.1

17.0

- 31%

2003South Africa

14.1

9.8

- 35%

1998Costa Rica

9.7

6.3

Birth Defect Reduction

Savings From Preventing Spina Bifida

Chile

United States

South Africa

Economic Burden of neural Tube Defects and Impact of Prevention With Folic Acid: A Literature ReviewEuropean Journal of Pediatrics published online 19 May 2011

FFI is network of partners

working together to make flour

fortification standard milling

practice so that people

worldwide are smarter, stronger

and healthier.

FFI Network

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Private Sector

Public Sector

Civic Sector

FFIAgencies of the United Nations, government

agencies and other national entities, non-government organizations, academic

organizations

Agencies of the United Nations, government

agencies and other national entities, non-government organizations, academic

organizations

Disability groups, advocacy associations, other civil organizations

Disability groups, advocacy associations, other civil organizations

Millers, equipment and flour-product companies, wheat traders and baking

organizations, other affiliated businesses

Millers, equipment and flour-product companies, wheat traders and baking

organizations, other affiliated businesses

FFI Stimulates Network Interaction

Mandatory

Planning

Voluntary

No Flour Fortification

Flour Fortification StatusJune 2011: Fortifying with at least iron and/or folic acid

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Flour Fortification Progress

Since 2004:

Nearly 2 billion people now have potential access to fortified flour - 858 million more than in 2004.

Growth in fortified flour from roller mills increased from 18% to 30%

The number of countries with documented national regulations for mandatory wheat flour fortification increased from 33 to 60.

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CondimentsCondiments

OilOil

RiceRice

Wheat & CornWheat & Corn

Multi-faceted Approach

SprinklesSprinkles

SupplementsSupplements

PopulationWith Market Access

PopulationWithout Market Access

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Impact on Nutrition Security

Fortifying flour puts more vitamins and

minerals in staple foods which people

continue to purchase and consume

during economic downturns.

As food prices go up, consumers often stop buying as many meats, fruits and vegetables

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Cost to Fortify

Recurring costs of buying quality premix ranges from US$2 to US$3 for iron, folic acid, and other B vitamins. The per person, per year cost to fortify wheat flour may be as little as eight to ten cents.

One metric tonne of flour is about 2,200 pounds, as pictured here.

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Rank Solution Challenge

1 Micronutrient supplements for children(Vitamin A and zinc)

Malnutrition

2 The Doha development agenda Trade

3 Micronutrient fortification(iron and salt iodization)

Malnutrition

4 Expanded children’s immunization Diseases

5 Biofortification Malnutrition

6 Deworming and school nutrition programs Malnutrition and education

7 Lowering the price of schooling Education

8 Increase and improve girls’ schooling Women

9 Community-based nutrition promotion Malnutrition

10 Provide support for women’s reproductive role Women

Nutrition interventions are five of the top 10 most cost effective means to address global challenges, according to the 2008 Copenhagen Consensus

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• Flour fortification is most successful when it is driven by national leaders.

• Multiple sectors must work together.

• Success of flour fortification in one country can have an accelerating influence in the region.

• A national standard approach is the most effective way forward.

• Reaching the top decision makers is essential.

Focus On National Partnerships

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STRATEGY 1. Catalyse, support and sustain the operation of national partnerships

STRATEGY 2. Create and disseminate communication & training and technical support materials in key areas

STRATEGY 3. Through the Leaders’ Group ensure that organizations are enabled to work together

STRATEGY 4. Secure adequate human and financial resources at national and global levels both for national activities and for the network in total.

STRATEGY 5. Monitor all national fortification programmes.

FFI Strategies