Billions of people globally suffer from micronutrient deficiencies, which are linked to increased mortality and morbidity, and reduced productivity and cognitive function. The economic burden of micronutrient malnutrition and its associated health effects is substantial, costing nations billions in healthcare and lost productivity, with the World Bank estimating that inaction on undernutrition would cost an estimated USD 21 trillion in lost economic productivity over 10 years.
Many countries worldwide use large scale food fortification as part of their policy mix to address micronutrient deficiencies because of its cost-effectiveness and because it does not require behavioral change. Food fortification is best employed as a complementary measure to promoting a healthy diet, not as a substitute, and its suitability needs to be informed by evidence.
Countries often find that mandating staple food fortification does not, on its own, ensure fortified foods reach people in need and alleviate micronutrient deficiencies. Whether fortification delivers impact depends on how regulatory frameworks shape market participation and behaviour. Fragmented regulation, unclear institutional roles, weak enforcement, unnecessary regulatory burden, insufficient evidence use, and inadequate consideration of economic and market realities limits impact. At the same time, fortification programmes governed by effective and simple rules and policies can transform public health outcomes, support industry compliance, and foster consumer confidence.