Progress Through Partnerships
Regional strategies led to widespread wheat flour fortification in the Middle East and the Americas before 2002, but no global body focused on this cost-effective strategy at the time. The first public meeting to organize global efforts to fortify flour was a “Policy Planning Forum” on 24 October 2002 in Mauritius, and that event launched FFI.
We were a public-private partnership even at that formative stage. The forum was initiated by Glen Maberly, then a professor at Emory University in Atlanta, Georgia, USA. It was co-hosted by the Nutrition International (formerly the Micronutrient Initiative) based in Canada, and the U.S. Centers for Disease Control and Prevention (CDC). The forum was held in conjunction with a regional meeting of the Association of Operative Millers, later renamed the International Association of Operative Millers (IAOM).
By 2003, the global movement was called the Flour Fortification Initiative (FFI). In time, industrially milled maize flour and rice were added to the work, and in 2014, the name was changed to the Food Fortification Initiative. Rice is generally not eaten as flour and was not reflected in the original name. Wheat, maize, and rice are the most commonly consumed grains worldwide, and the fortification of each represents tremendous opportunities to improve global health.
Countries determine the type and quantity of nutrients to include in fortification based on their population’s typical eating patterns and specific health concerns. International meetings in 2004 and 2008 led to global guidelines to help countries make these decisions for wheat and maize flour. In 2016, the World Health Organization published separate guidelines for maize flour fortification. Proposed nutrients and nutrient levels for rice fortification are here.
Ultimately fortification is most successful when national leaders drive the process. At an FFI Leadership Forum in 2004, participants agreed that one focus of FFI would be to stimulate interaction between network partners which would in turn facilitate national action.
From its beginning, FFI has offered technical expertise to millers. Now this includes quality assurance and quality control training for industry leaders as well as government food safety authorities. FFI’s partners are encouraging countries which have been fortifying grains for decades to update their fortification standards based on the newest scientific evidence. Technical support is available for countries wanting to monitor fortification programs for their health impact.
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In 2002, many flour millers hadn't thought about what iron deficiency had to do with somebody who makes and sells flour. Now millers see fortification as an investment in their customers and their countries.
- Tim Burleigh, FFI's first industry liaison