Building a stronger nation through wheat flour fortification
Wheat flour fortification offers a promising solution to address the widespread burden of micronutrient deficiencies in Indonesia. Nutrition International’s Herrio Hattu and Surabhi Mittal explore how the program’s revised standards have the potential to improve health outcomes, lower healthcare costs and enhance productivity to build a stronger nation.
Posted on August 4, 2023
Malnutrition is a pressing issue that demands immediate attention in Indonesia, with far-reaching implications for both individuals and the whole nation. At the individual level, malnutrition contributes to a multitude of health problems and hampers productivity. Beyond personal well-being, malnutrition also impedes economic growth.
One of the major malnutrition statistics that Indonesia is grappling with is that of anaemia. According to the 2018 Basic Health Research (Riskesdas), the prevalence of anaemia in Indonesia increased from 21.7 percent in 2013 to 23.7 percent in 2018 for the total population. In 2018, three out of 10 Indonesian teenagers were affected by anaemia, and 62.6 percent of anaemia cases were attributed to iron deficiency.
To address the challenge of iron deficiency anaemia, Indonesia took a significant step in 2002 when it enacted mandatory legislation on wheat flour fortification (WFF). This crucial program focuses on fortifying wheat flour with the five essential micronutrients of vitamin B1, vitamin B2, zinc, folic acid and iron, making it an optimal vehicle for delivering these vital nutrients to a large segment of wheat flour consumers in the population.
Recognizing the need for continuous improvement, the government proactively strengthened the program by revising the legislation and introducing the new Indonesian National Standard (SNI 3751:2018), which aligns with with recommendations from the World Health Organization. This updated standard mandates the use of more bioavailable iron compounds, such as ferrous fumarate, ferrous sulfate and ferric sodium EDTA, ensuring even greater iron absorption.
These efforts reflect Indonesia’s commitment to effectively combating anaemia and maximizing the potential of its WFF program, which not only holds promising implications for productivity and overall well-being but also aims to alleviate nutrient deficiencies and improve individuals’ health.
A recent study conducted by Nutrition International under the guidance of the Industry Ministry reflects that WFF is projected to reduce the national prevalence of iron deficiency anaemia by 7.2-9.9 percent and zinc deficiency by 15.6-21.6 percent annually in children and adults between 2023-2032. Over the next decade, a total of 45 million cases of iron deficiency anaemia and zinc deficiency could be prevented in Indonesia through the WFF program. Additionally, the national rate of birth defects associated with folate deficiency is predicted to decrease by approximately 25 percent.
Wheat flour fortification, coupled with nutritious diets and micronutrient supplementation, presents an optimal strategy to address malnutrition issues in Indonesia. Addressing micronutrient deficiencies could also impact the economic growth and future of the nation.
“A recent study conducted by Nutrition International reveals that the government’s wheat flour fortification program could potentially prevent economic losses of $3 billion. These savings would come in the form of reduced mortality rates and improved future productivity.”
Nutrition International’s study reveals that by investing around US$181 million in fortifying wheat flour over a period of 10 years in 2023-2032, the government’s WFF program could potentially prevent economic losses of $3 billion. These savings would come in the form of reduced mortality rates and improved future productivity, as reflected in the net present value.
Investing in the WFF program has economic benefits for Indonesia. The study affirms that every $1 invested in the program will generate a return of $14.6 in increased economic activity over the next decade, demonstrating the program’s potential to stimulate economic growth and alleviate the economic burdens associated with malnutrition in the country.
Acknowledging the critical role of nutrition in national development, the government has taken proactive measures to support its WFF program. Collaborating with private sector partners and civil society organizations, the Industry Ministry has established regulations and guidelines to ensure the program’s successful implementation nationwide. This multi-stakeholder approach exemplifies a commitment to improving nutrition outcomes and fostering a healthier, more productive workforce.
Through strategic investment in the WFF program, Indonesia can achieve remarkable economic benefits while combating the pervasive issue of iron deficiency anaemia. Fortifying wheat flour with essential micronutrients, such as iron, zinc and folate, has the potential to improve the overall health and well-being of the population.
Moreover, this investment will improve health outcomes, lower healthcare costs, and enhance productivity. It will also promote collaboration between the government, private sector and civil society, which is crucial for expanding and sustaining the program.
In doing so, Indonesia can build a stronger nation with improved well-being and sustainable economic growth.
This article was originally published in the Jakarta Post on August 3, 2023.