West Africa understands the   importance of food fortification as a   proven   and   cost-effective approach to prevent micronutrient deficiencies, i.e., “hidden hunger.” Nearly two decades ago, countries in West Africa analyzed the diets of vulnerable populations across the region to better understand   and   address   gaps   in   nutrition.

They   found   that   a   handful   of   staple   foods   and condiments—like vegetable oil, wheat flour, and salt—were eaten by over 70 per cent of the target population, regardless of where they lived or household budget. These foods were to be used for the region’s fortification program—one of the most ambitious in Africa’s history.

Today, as we face growing health, food and nutrition security, and economic crises, West Africa has a critical opportunity to build on this legacy and renew our commitment to improve food diversity and micronutrient intake. Despite   some   progress, the   prevalence   of   micronutrient   deficiencies—caused by   a   lack   of essential   vitamins   and   minerals   in   diets—remain   high   across   the   region,with   devastating impacts.

Approximately, half of women ages 15-49 suffer from anemia, and 15 per cent of children are born with low birth weight and potential birth defects due to micronutrient deficiencies. This significant public health problem has only been made worse by the concurrent crises.

The West African Health  Organization (WAHO), the official health agency of the   Economic Community of   West   African   States (ECOWAS), has   a strong   history   of   leadership   on food fortification—galvanizing   public-private   partnerships,collaborating   with   global   partners   and NGOs, to support food fortification.

To   date, all Member States of ECOWAS  have national policies and regulations to support the fortification of widely consumed foods, such as edible oils, cereals, salt,milk, and sugar. These   policies   and   regulations   are   critical   to   bringing micronutrient-fortified staples to   millions across West Africa,and we   have   seen   promising results.In Nigeria, between 2017 and 2020, coverage of wheat flour fortified with iron and folic acid—which helps protect against anemia and serious birth defects—increased from 54 per cent to 92 per cent to reach   73.5   million   additional   Nigerians.

Coverage   of   sugar   fortified   with   vitamin   A—which promotes eyesight and strengthens the immune system—has more than tripled to reach 96 per cent of the   population.  Salt  iodization   levels   have   remained   constant   at   an   impressive   95 per cent.   The Promoting Rice Fortification in Nigeria (PRIFN) project aims to build a roadmap to fortify another staple of Nigerian diets and expand local production of fortified rice—boosting health and local economies.New initiatives like PRIFN are critical to growing the impact of fortification.

Today, we are on the brink of further progress. Last May, with   broad   support   from  ECOWAS   Member   States,the   Bill   &   Melinda   Gates Foundation, and many   partners, the   Assembly of the   World Health   Organisation passed a landmark   resolution   to   strengthen   food   fortification   programs. Following   this   assembly, stakeholders from the West African region came together to recommit to food fortification as a leading strategy for nutritional policy and committed to establishing a regional Alliance for food fortification.
In doing this, we have sent a clear signal to the international community: “we have the political will   and   desire   to   expand   and   improve   food   fortification   programs.”  It   is   time   to   turn   this momentum in to action, set responsible regional goals, measure our impact,and make real progress on fortification.

Today, West African leaders are at a crossroads. The impact of climate change, inflation and general   cost   of   living   have   made   healthy diets   even   more   expensive   and   inaccessible. Therefore, it is paramount that we prioritize programmes that support the nutritional needs of all people, especially the most vulnerable. Despite the challenges, we can reinforce capacity and develop   effective   support   systems, facilities,and   tools   to   help   standardize   the   fortification processes. We can establish strong external monitoring and regulatory systems. We look forward to collaborating with others across Africa, and especially here in West Africa, to continue this important work. We all have a role to play in making our vision of fortification a reality. By seizing this opportunity, West Africa can ensure the food and nutrition security of its population and, above all, improve their health and well-being.

• Dr Melchior Athanase Joël C. Aïssi is the Director General of the West African Health Organization and Natasha Kofoworola Quist is the Regional Director,West and Central Africa for the Bill & Melinda Gates Foundation.