Moving Mountains: Collaborating to Accelerate Access to Essential Nutrients

Photo: Andrzej Kubik / Shutterstock

By Shawn Baker, Chief Program Officer, Helen Keller Intl and Saskia Osendarp, Executive Director, Micronutrient Forum

The personal cost of micronutrient deficiency  

It was silent in the packed room and everyone had tears in their eyes when Beza Beshah talked about the loss of her son. Her little boy suffered from fatal spina bifida and died at a very young age when he still had his entire life in front of him. Beza has to live with the unbearable knowledge that his death could have been easily prevented, if only her diet had been sufficient in folate when she was pregnant with her son. 

This life-altering experience prompted Beza to dedicate her life to a singular mission – preventing others from having to undergo the same fate in her home country, Ethiopia, which has one of the highest levels of folate deficiency in the world.1 

Beza’s heartbreaking story is a sobering reminder of the human cost behind the staggering statistic: 1.6 billion women and children suffer from deficiencies in vitamins and minerals,2 also known as “hidden hunger.” Deficiencies in essential vitamins and minerals (micronutrients) can have devastating consequences for children, women, families, and societies. 

The power of food fortification

One of the easiest and most cost effective ways to prevent micronutrient deficiencies is the fortification of staple foods or condiments with folic acid and other micronutrients. Fortification has 100 years of history – Michigan State started fortifying salt with iodine in May 1924 leading to virtual elimination of iodine deficiency in the United States.3

Photo: GAIN

The WHA76.19 resolution: a victory for global nutrition 

In May 2023, at the 76th World Health Assembly (WHA), member states unanimously approved the adoption of the WHA76.19 resolution titled, “Accelerating efforts for preventing micronutrient deficiencies and their consequences, including spina bifida and other neural tube defects, through safe and effective food fortification.” This resolution was presented by Colombia and 35 other member states and garnered wide support from civil society organizations worldwide.

The successful passing of the resolution is a testament to the power of collaboration. Stakeholders across sectors, including neurosurgeons, spina bifida patient federations, and nutrition and health organizations, proved that when we step out of our silos and work together, we can move mountains. 

The Cape Town convening: collaborating for accelerated action

A similar spirit of collaboration was sensed in the room where Beza told her story, during a convening of practitioners working on large scale food fortification from government bodies, regional and united nations organizations, donors, civil society, academia, and private sector industry. The group convened in Cape Town, South Africa, in April 2024, to analyze the key barriers and identify critical steps to accelerate action in large scale food fortification and concluded that success will not be possible unless we change the way we collaborate across sectors.  

Illustration: Patti Dobrowolski

While large scale food fortification isn’t a panacea for solving all malnutrition challenges, it is a proven strategy with a century of knowledge and experience behind it. It is one of the solutions that is poised to rapidly increase access to these essential nutrients through the food system in a sustainable way.  

The Cape Town convening was imbued with a sense of urgency. Participants were united in their commitment to strengthen the delivery of food fortification to maximize impact on the health of vulnerable populations.  Because this isn’t merely about implementing a technology; this is about changing lives and securing futures. Real lives and futures like those of Beza and her late son.

Read the Manifesto for Accelerated Action on Fortificaiton


  1. Gebremichael B, Roba HS, Getachew A, Tesfaye D, Asmerom H. Folate deficiency among women of reproductive age in Ethiopia: A systematic review and meta-analysis. PLoS One. 2023 May 8;18(5):e0285281. doi: 10.1371/journal.pone.0285281.
  2. Stevens GA, Beal T, Mbuya MNN, Luo H, Neufeld LM; Global Micronutrient Deficiencies Research Group. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys. Lancet Glob Health. 2022 Nov;10(11):e1590-e1599. doi: 10.1016/S2214-109X(22)00367-9.
  3. Leung AM, Braverman LE, Pearce EN. History of U.S. iodine fortification and supplementation. Nutrients. 2012 Nov 13;4(11):1740-6. doi: 10.3390/nu4111740.

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