24/02/2026
The progress made in fortification initiatives across East and Southern Africa is noteworthy, with widespread salt iodization and increasing adoption of fortified wheat, maize flour, and oil programs. However, the ongoing prevalence of micronutrient deficiencies reveals a critical truth: mandates alone do not ensure effectiveness. Data from the WHO and national surveys indicate that fortified foods often do not reach at-risk populations due to issues such as high costs, inadequate distribution, and a preference for unfortified staples.
While regional trade appears to offer a solution for addressing supply shortages, such as importing salt from high-production countries like Kenya to areas in Tanzania facing deficits, labeling it as the primary solution may be an exaggeration. Intra-African trade in staple foods remains below 20% of total trade, as reported by AfCFTA, hindered by non-tariff barriers like conflicting standards, exemplified by the discrepancies between Zambia's and Malawi's maize flour specifications. Additionally, logistics costs can inflate prices by 30-50% across borders, diminishing potential economies of scale, while the perishability of products like oils and sugar, along with the dominance of local production, further limits benefits.
A more effective approach would involve harmonizing standards through SADC/EAC frameworks and subsidizing last-mile distribution, complemented by behavior-change campaigns. While trade can play a supportive role, addressing fundamental issues such as poverty-driven underconsumption is essential for achieving lasting impact. The report raises important questions regarding the relationship between fortification coverage rates and actual trends in micronutrient deficiencies.
