F consumed staple foods across all socioeconomic groups. The implications of this for diseases prevention, improved productivity and increased economic potential are enormous and require relatively low levels of investment. If we look at the example of flour fortification, it costs an estimated $US0.12 per person per year to fortify wheat flour with iron and as little as US$0.06-0.24 per person per year to fortify wheat flour with zinc. These costs are minimal compared, for example, to the cost of treating children with spina bifida and immeasurable impact on families. It has been estimated that fortifying flour with folic acid contributes to healthcare savings of US$ 2.3 million in Chile, 40.6 million Rand in South Africa, and US$ 603 million in the US. Moreover, fortification costs can easily be recovered through sales of “value added” product in the markets. Fortification is not only cost-effective, but also impactful. Where flour fortification is mandatory, countries have experienced between 31-58 percent reductions in NTDs. Global NTDs prevalence is around 24 in 10,000 births, but typically it drops to below 10 in 10,000 births after fortification with folic acid.

The role of the private sector

The private sector, especially millers and producers who fortify,

are the gatekeepers to the nutritional health of the populations in their distribution network. It is therefore critical for the private sector to fully engage in the fortification process, and to ensure that quality control and good manufacturing practices are in place. This will allow households to consistently have access to high quality, safe, and adequately fortified foods. It is estimated that currently, in low and middle income countries, less than 50 percent of products claimed as “fortified” are adequately fortified to the levels indicated in their respective national standards. These include countries where food

Milling and Grain - July 2016 | 55