Fortification assessment — the little things put in your bread by big companies

Sedonia Peterson (43), a civil worker, stands by the roadworks in Brixton, Johannesburg. Her favourite starch to accompany food is pap and she usually has a tomato gravy alongside it, or eggs, or atcha. She’s not a veggie lover, but she likes salads now (if they are not soggy). 

“I’m an old-school girl, I like dumplings, vetkoek, rotis,” Peterson told Daily Maverick. She buys flour rather than bread, because TikTok has recipes. She likes porridge mielie meal in the mornings, and she loves a thick slice of bread with butter. 

Nearby is an assistant shopkeeper, Brian Chauke* (18). Seven days a week on the way to work, he buys a plain vetkoek. 

“I eat pap like seven days a week,” he said. Sometimes he has a tomato gravy, sometimes he eats it with vegetables. 

Staples like pap and bread are fortified with essential micronutrients (vitamins and minerals) to improve the nutritional quality of the food supply. Many South Africans eat mielie meal at least once a day. It’s cheap and filling, as Peterson said. 

According to the Pietermaritzburg Economic Justice & Dignity group, about 30.4 million people in South Africa live on R55 a day, and 13.8 million on R27 a day. That’s the upper-bound poverty line and the food poverty line. 

Fortification in South Africa 

Only flour and sifted and unsifted maize meal are fortified by legal requirements in South Africa. However, there is a lack of compliance in the country. 

Fortificants are the source of micronutrients, while micronutrient premixes refer to the mixture of fortificants that are added to a food vehicle, according to Unicef. 

Fortification companies compile the micronutrient premixes, sell those to various companies, such as Nestlé and General Mills, or independent small millers, and NGOs such as the World Food Programme (which receives its premixes from DSM-Firmenich). Companies then add the premix into the food or beverage, and then it goes to retail stores. 

These companies up the value chain have to take into consideration the concentration of the fortificant (so it’s effective and safe) as well its absorptive properties, stability, and how it’ll taste. 

As of November 2023, Millhouse International (Pty) Ltd, Hexagon Nutrition (Exports) Pvt Ltd, Mobile Therapy CC t/a MJ Labs, and DSM Nutritional Products South Africa are the only government-registered fortification suppliers for import in South Africa. 

However, SternVitamin GmbH & Co. KG, BASF SE, DSM-Firmenich AG and Glanbia PLC also operate in South Africa. 

Hexagon, SternVitamin, BASF, DSM-Firmenich and Glanbia are some of the companies assessed by ATNi. ATNi (Access to Nutrition initiative) assessed the companies to see how they preserve quality down the value chain – so that people actually consume the micronutrients inside the foods. 

Why does it matter? 

Mild to moderate micronutrient deficiency is hidden, and is often why people who suffer from micronutrient malnutrition are often not aware of it. 

“We know that if we also look at the issues of food security, people don’t have access to a diverse range of foods that would give them all the nutrients that they need… and that’s where food fortification can really help fill the gaps,” said Nadine Nasser, research analyst at ATNi and lead researcher of the pilot VitaMin Premix Supplier Assessment, studying the world’s largest fortificant producers. “Studies have shown the impact that they [fortificants] have on health outcomes.” 

“Shouldn’t people just be able to eat a diverse diet? Ultimately, that would be the goal. But there are challenges also, in terms of seasonality, cold chain, distribution, the costs of all of that make that so difficult,” explains Katherine Pittore, head of policy and communications at ATNi. She adds that while the goal is to get everyone eating fresh fruit and vegetables, “we’re not there yet… At this point in time, it’s a good measure.” 

How are the 11 biggest companies doing? 

ATNi’s VitaMin Premix Supplier Assessment, studying the world’s largest fortificant producers, focused on how these companies operated in Kenya and India. They called for sector-wide alignment and greater accountability and transparency. 

DSM-Firmenich, Hexagon Nutrition, Zhejiang NHU had full engagement with ATNi’s assessment, while BASF, Mirpain Gida and Sudeep Nutrition did a partial engagement, and the rest either opted out, did not engage or gave no response to ATNi. Those were Piramal Group, AQC, SternVitamin/Muhlenchemie, Glanbia and Zhejiang Medicine Co LTD. 

In the assessment, ATNi welcomed Hexagon’s improved public disclosure following the assessment. 

“We always strive to highlight the best practices of the company so that other companies can follow suit. This is the main reason we believe that disclosure is important and that transparency can lead to better practice in place, and then also to reach the end goal, to benefit the general public,” Marina Plyta told Daily Maverick. She is the project lead, as partnerships manager at ATNi.

These companies are further up the value chain, and so are not consumer-facing companies like other food producers. This is likely to been the first time they have been assessed in this way. 

Generally, people haven’t ever heard of any of these premixed suppliers. Even if a consumer buys a fortified product, they would have no idea where the fortification certificate came from.  

While many countries have fortification standards for at least one staple, compliance remains low due to limited access to quality fortificants and insufficient technical capacity, said ATNi. 

Key findings 

ATNi found that only DSM-Firmenich and Hexagon integrated nutrition into their core business strategy with measurable goals.

In terms of technical support to customers, they found that seven companies provide some kind of assistance – such as capacity building or testing – but none demonstrated a structured framework with measurable goals to ensure high quality end-product outcomes.

When it comes to distributor practices, four companies – BASF, DSM-Firmenich, Hexagon and Zhejiang NHU – provide handling and storage guidelines to distributors, though these are not linked to formal agreements. While Mirpain Gida and Sudeep mention procedures, they did not provide supporting evidence. 

Five companies extend technical assistance to millers beyond their direct customer base. DSM-Firmenich and Hexagon offer structured support. 

Broader collaborative fortification efforts – such as supporting the implementation of regulations, subsidising premix or donating equipment – were also identified for five companies (BASF, DSM-Firmenich, Hexagon, SternVitamin/Mühlenchemie and Zhejiang NHU). However, limited disclosure of the planned activities and objectives makes it difficult to assess the implementation and the impact of these efforts.

Five companies – BASF, DSM-Firmenich, Glanbia, Hexagon and SternVitamin/Mühlenchemie – disclosed initiatives aligned with at least one workforce nutrition pillar, such as healthy food at work, nutrition education, nutrition-focused health checks or breastfeeding support. 

ATNi found that Kenya, compared with India, had clear standards and guidance when it came to fortification, but limited monitoring and enforcement of fortification with their maize meal, explained Nasser. 

“We’ve also heard concerns about the cost of these products, because there is no local production of micronutrients or premixed blends. These are mainly imported from other countries, and because they’re being imported there, they have these additional charges on these products. 

“We know that the government is working to cut down these costs, but what we’ve heard is there isn’t enough awareness, for example, on how to classify this product, making sure that it is classified as a premix, because then if it’s misclassified, then you have these additional charges imposed on the imported product.”  

Pittore said it is a fragmented landscape. 

“If you have one company producing most of product x that’s consumed, wheat flour, etc, it’s much easier. But usually the rural poor are the ones who are consuming from small-scale millers, and this is one of the challenges of fortification.”

They assessed whether these companies were helping the broader community – going above and beyond – and what the role of government was in that. 

“Because these are small-scale. They’re micro enterprises. There’s one guy with a small mill, how can he have the capacity to do that?” 

Nasser explained that another criteria in terms of selecting the suppliers was to ensure it was supplying micronutrients that are key in public health; iron, folate, zinc and other vitamins. Another criteria was if their production facilities were certified by a GAIN premix facility since that indicated high-quality fortificants. 

“We also did consult with stakeholders in the space, and they did share that a lot of the issues with quality actually come up during the distribution of these products. If they’re not handled in the right way, they’re not stored in the right conditions, their quality basically becomes poor quality. And then it’s even if it’s used in fortification, it’s just not going to be as effective,” added Nasser. DM

* Brian Chauke’s name has been changed to protect his identity.