The food fortification rules are due to come into effect in mid-October, with wheat flour and corn meal to be fortified with iron, zinc, folic acid and vitamin B12, and flour optionally with vitamin A, thiamine, riboflavin, niacin and vitamin B6.
Cooking oil and sugar will be fortified with vitamin A, while salt will be fortified with iodine.
This move marks the culmination of a process which started in 2010, when the Mozambican government approved a plan to reduce chronic malnutrition, and created the National Committee for Food Fortification in Mozambique (CONFAM).
The committee developed standards between 2012 and 2015, and started to introduce voluntary food fortification from 2013 onwards.
Food fortification is widely recognised as one of the most effective public health interventions available to combat micronutrient deficiencies, and so reduce chronic malnutrition. Fortification has been linked with reducing rates of anaemia in women and conditions such as neural tube defects in infants.
Important milestone
Katia Santos Dias, country director for Mozambique at the Global Alliance for Improved Nutrition (GAIN), welcomed the new law.
“GAIN believes an important milestone has been achieved in Mozambique. The mandatory fortification will contribute to the reduction of chronic malnutrition and micronutrient deficiencies in the country, improving the lives of millions of Mozambicans.
“GAIN, in partnership with the World Food Programme (WFP) and Hellen Keller International (HKI), have been supporting the National Program since 2011, thanks the contribution of several donors, including the Bill and Melinda Gates Foundation, Irish Aid, the European Union and Danida. We will continue to be engaged in the fortification agenda in Mozambique, through technical and financial support,” she added.
According to Helena Pachón, senior nutrition scientist at the Food Fortification Initiative, which has also been involved in Mozambique’s fortification programme, the process of bringing in mandatory fortification is a significant challenge for a country.
“Passing the legislation, which is a huge, huge milestone, usually takes upwards of five years – I can’t think of a country where this has been a very fast process.
"So you need someone, or a group of people, in the country who are dedicated to following this process through – they will see it through multiple administrations, they themselves may change jobs. You really need a dedicated group of people who believe in this, and really help usher it through – it’s a long, drawn-out process,” said Pachón.
A long road ahead
She said that even though the legislation had now been passed, there remains a lot of work to do, including developing clear standards with food producers, training and equipping inspectors, and for industry, installing the equipment required to add micronutrients to food products.
Mozambique’s legislation exempts the smallest producers from mandatory fortification, leaving its 13 roller maize mills, 13 hammer mills and 10 industrial wheat mills as the main implementers of the policy.
Pachón said Mozambican authorities may also perform baseline measurements with a view to measuring the public health impact of food fortification once it is fully in force.
She said Mozambique is fortunate in that a number of hospitals throughout the country already collect relevant data, such as the number of babies born with particular birth defects, which can be reviewed to measure impact.
“From the outside cheerleader perspective, it’s really great to see a country that, while it’s going through really hard economic times right now, has managed to maintain its focus on fortification over many, many years. Seeing the promise of the public health impact, in the face of so many other priorities, it’s really encouraging to see that they’ve stuck to their guns and come this far,” said Pachón.
“There’s a lot of groups which are interested in helping to support fortification, so we’re fortunate and Mozambique is fortunate that there are a lot of partner agencies that are helping them to be as successful as possible,” she added.