Billions of people globally suffer from micronutrient deficiencies. Such deficiencies increase mortality, impose life-long health burdens and reduce labour productivity and economic growth. They affect people across regions and socioeconomic groups, and are especially widespread in low- and middle-income countries. As part of their policy response to address micronutrient deficiencies, many countries have adopted large-scale food fortification (LSFF) alongside other critical nutrition interventions, such as dietary diversification, supplementation and nutrition education.
When employed effectively, LSFF can offer a cost-effective way to help improve micronutrient intake at scale by adding essential micronutrients such as vitamin A or iron to commonly consumed foods such as flour or rice. However, countries often find that mandating staple food fortification does not, on its own, ensure fortified foods reach people in need and alleviate micronutrient deficiencies. Sound regulatory systems enable governments to turn policy intent into actual impact. Moreover, fortification does not replace a healthy diet and should not be used to induce consumption of unhealthy foods such as sugary drinks and cereals.
The Good Practice Principles for Regulating Large-Scale Food Fortification: Advancing nutrition for health, productivity and growth provide clear guidance on translating fortification policy ambitions into results. Six overarching Principles take a whole-of-system approach, drawing on real-world examples across diverse institutional and resource contexts. They start with helping governments determine whether LSFF may be a suitable policy response, and continue through to its effective design and delivery. The box below defines each Principle and sets out associated sub-principles.
Whether fortification achieves the desired impact depends on how regulatory frameworks shape market participation and behaviour. Complex or costly registration or licensing requirements can exclude smaller producers and limit access to fortified foods in rural and low-income areas, whereas streamlined and digitalised procedures make it easier for businesses to participate. Administrative simplification and burden-reduction measures – such as risk-based market entry and digital one-stop shops – can lower compliance costs and help strengthen the business case for companies to engage in fortification.
Similarly, vague or fragmented rules, spread across multiple instruments, can hamper businesses’ understanding of requirements and the consistency of regulators actions, while coherent and well-designed legal frameworks strengthen implementation across the fortification value chain. Clear institutional mandates, integration of fortification oversight into existing food control systems, risk-based supervision, inter-agency co-ordination and adequate laboratory capacity are essential to ensure that fortified foods are correctly produced, accurately dosed and consistently available. Proportionate and graduated enforcement measures, supported by trained inspectors and clear guidance for businesses, strengthen compliance and enable fortification policies to deliver nutrition outcomes at scale.
Effective fortification is also anchored in the systematic use of available evidence, enabling governments to make the best use of limited resources. Data on micronutrient deficiencies, dietary patterns and market structures help inform whether fortification is appropriate, which foods to target and how interventions should be designed. During implementation, information from inspections, laboratory testing and compliance monitoring allows authorities to focus efforts where they matter most, for example on high-risk production activities, key control points, and market segments with the greatest reach. Evaluation provides feedback on what works and where adjustments are needed, supporting more efficient resource allocation and avoiding investments in measures that do not deliver results. Early and continuous systematic stakeholder engagement ensures LSFF policies are well-informed and broadly supported.
Finally, complementary policies – including those affecting trade and public procurement – can either enable or undermine fortification by affecting costs, market access, incentives and commercial viability, particularly for SMEs. When rules, policies, and institutions are aligned, they reinforce one another, making fortification more feasible for industry and more efficient for governments.