One of the major types of malnutrition in countries like Pakistan is characterised by micronutrient deficiencies. According to the National Nutrition Survey (NNS) 2011 (the only recent one), more than half of the women and children suffered from micronutrient malnutrition back then. And the situation has little changed since then as indicated by the country’s worsening position on various global health, food and nutrition indicators.

What makes food fortification extremely useful? Micronutrient deficiencies involve a shortage of essential vitamins or minerals that might not show in early stages or might not be visible for a long period of time but have far-reaching impact on human health. These deficiencies have been particularly noticed in pregnant and non-pregnant women and children. And while the actions needed to address malnutrition are innumerable and multilevel, a key proven method to account for micronutrient deficiencies is food fortification.

Fortification or food enrichment is like hitting the bull’s eye when making food nutritional by adding essential minerals and vitamins. Governments all around the world and international organisations have identified various kinds of food fortification at household, community, industrial and mass level to address these nutritional deficiencies. The Food and Agricultural Organization (FAO) and the World Health Organization (WHO) have identified fortification as a key strategy in reducing the prevalence of malnutrition in underdeveloped countries.

Given the situation in Pakistan, investing in targeted nutrition and nutrition-sensitive interventions such as staple food fortification can prove instrumental in tackling malnutrition and undernourishment in children and women especially for lacking areas like iron, zinc, folic acid, iodine, vitamin A, vitamin B12, and vitamin D.

Food fortification is a cost-effective strategy that requires no change in eating habits or purchasing patterns. While there has been some activity in food fortification, it’s ironic that Pakistan still faces iodine deficiency that has seen significant improvement globally. The government’s Vision 2025 envisaged to reduce food-insecure population from 60 percent to 30 percent. For this, the plan involved innovative and cost-effective strategies like ready-to-use fortified food for breast feeding mothers and pregnant women; nutrition specific and sensitive interventions; ready to use fortified food supplementation, fortification and bio-fortification among others.

Fortification of staples like wheat flour, oil and salt can substantially enhance micronutrients in food. The last economic survey highlighted that in addition to Universal Salt Iodisation (USI) Program in 110 districts through Public Private Partnership, Food Fortification Program in Pakistan (FFP) would be set up, to provide support to industry to adequately fortify wheat flour and edible oil/ghee, besides helping the government to improve food fortification regulatory system, and help in raising awareness to formulate policies to combat micronutrient deficiencies in Pakistan.

So far, FFP Punjab has been launched with 132 flour mills registered with the programme, which is 15 percent of flour being fortified; and 33 oil/ghee mill registered with the program, which is 89 percent oil/ghee fortified.

After National Fortification Alliance (NFA), Provincial Fortification Alliances have been established by all provinces in 2016. And while there has been some activity regarding Universal Salt Iodisation (USI) legislation and rules on the protection of breastfeeding, the federal and the provincial governments must hastily enact laws for iodized salt.

There is still a need for a collective political will, a comprehensive food fortification policy, mandatory standards and legislations, technical capacity building of the industry, and increasing demand and access to fortified food and staples.