East Africa's Promising Flour Fortification Efforts

An increasing number of small and medium wheat and maize flour millers in East Africa are partnering with a private organization to produce subsidized fortified flour at a time governments in the region are stepping up implementation of food fortification regulations.

At least 1,256 millers in Tanzania, Kenya, and Ethiopia have been onboarded into a flour fortification program targeting 150 million flour consumers in East Africa, a region where malnutrition, obesity, and stunting remain major health issues.

The millers, in partnership with Sanku, a global micronutrient fortification company, have designed a business model that ensures even with the expected increased cost of nutrient premix and packaging, flour millers remain profitable and produce fortified flour that is affordable for the millions exposed to low-nutritional-value foods.
Sanku has installed patented Internet of Things-enabled smart dosing machines at partnered maize and wheat flour mills to ease the process of adding premix to milled flour without raising costs for consumers.

“The fully automated dosing machines add precise and safe amounts of critical nutrients to the staple food people eat,” Sanku said in a statement.
“Sanku’s multistep solution and sustainable model helps enable millers to provide flour fortified with nutrients to consumers without raising costs, improving nutrition outcomes without compromising affordability,” the organization adds.

Flour fortification does not necessarily translate into increased operational cost for the miller or higher price for the consumer, according to a study performed in Uganda, where Sanku is yet to make inroads.

USAISD Study
The Uganda study by the U.S. Agency for International Development (USAID) – in partnership with the Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) program – found “no relation between fortification and increased prices at the market.”

A report from the study titled “State of Maize Flour Fortification in Uganda” identified the cost of maize grains as the “main cost driver across all producers of maize flour.”
Capital investment for millers planning to fortify was found to be the greatest expense while premix accounted for nearly 95% of the fortification cost, especially because it is a recurring cost.

Within 12 months, the USAID/SPRING study found a miller fortifying its flour “will incur additional costs over a miller who does not fortify, but these costs are not high.”
“From this study, we can conclude that maize flour fortification is still a challenge in Uganda even with the adoption of the mandatory fortification regulation,” the report concluded.

Sanku’s Intervention
But for the small and medium flour millers in Kenya, Tanzania, and Ethiopia, the cost of embracing fortification may have been neutralized by the intervention of Sanku, which not only manufactures and supply key inputs that millers need to fortify such as packaging material and nutrient premix but has also put at the disposal of the millers its own last mile distribution infrastructure throughout East Africa.

Sanku, which has the backing of the World Food Program and more than 15 other donors, says it incentivizes millers by offsetting their nutrient premix costs with the margins from bulk manufacturing and the purchase of key inputs such as fortificants and flour bags.

Therefore, the organization adds, “the cost of fortified flour is neutralized, and these margins sustain their operations at scale.”

This partnership between wheat and maize flour millers with Sanku coincides with a time when governments in the region such as Kenya, Tanzania, and Ethiopia are exploring better ways of implementing food fortification regulations that have may have been ignored, despite the persistent problem of malnutrition and stunting, particularly among children under the age of five.

Fortification Efforts
Countries in East Africa that are members of the East African Community (EAC) – an intergovernmental organization of six countries including Tanzania, Kenya, and Uganda – have enacted the East Africa Standard’s fortified composite flour specifications to guide the region’s fortification process.
The specifications were developed through technical committees comprising of stakeholders drawn from government, academia, consumer groups, private sector, and other interested parties from among the six countries.

In Kenya, the Ministry of Health says, “malnutrition remains a public health concern that negatively impacts the foundations of economic, social, and cultural life of the country.”
The ministry estimates 20-29% of children under five years are stunted, with the country’s overall protein energy malnutrition remaining high with stunting rates of 26%, wasting at 4%, and underweight at 11%.

Sanku appears to have heeded to the proposal by Kenya’s government for improvement in access and distribution of premixes and dosers “to facilitate production of fortified foods.”
“Industries need to have in place (or continue to improve) commercial distribution systems for fortified foods to reach the consumers across the country,” the ministry of health’s report adds.

Only 47 of Kenya’s 103 registered maize millers fortify their flour, which is only 37% of the maize flour available in the country’s market.

Moreover, statistics by the Kenya Bureau of Standards, the country’s state-owned quality regulatory body, show existence of 24 wheat millers, located mainly in urban areas, and which fortify 80% of wheat flour in the Kenyan market. There are also three large-scale salt producers and a few salt packers iodizing salt.

Elsewhere, in Tanzania, official reports indicate prevalent chronic malnutrition with stunting rates of 30% despite “the significant progress made in addressing all forms of malnutrition among children under five over the last decade” according to a Tanzania Demographic Survey.

At least a third of children in Tanzania lack of essential micronutrients such as vitamin A, iron, zinc, folic acid, and iodine.

Addressing Malnutrition
To address high malnutrition levels, Sanku picked Tanzania to host East Africa’s biggest premix plant.
“With enough capacity to meet the needs of over 100 million people by 2030, this factory allows Sanku to keep premix stocked locally and available in local currency, making it easier and more affordable for millers to fortify their flour,” Sanku adds.

Meanwhile, Uganda has included flour fortification in its Food and Drug Act targeting mainly millers of maize flour.

The act requires millers to “fortify their products with a regulated blend of vitamins and minerals aimed at reducing national micronutrient deficiency.”

However, the regulation requires only large-scale maize flour millers to fortify; small and medium flour producers are encouraged to fortify, albeit on a voluntary basis.

The entry of quasi-milling organizations such as Sanku in East Africa’s milling market not only helps small and medium flour millers increase penetration of the regional market but would ultimately transform the socio-economic status of rural areas in countries such as Tanzania and Kenya.

Shem Oirere is a freelance writer based in Nairobi, Kenya. He can be reached at shem@shemoirere.com, +254-722-167-733.