Fortifying Pakistan’s future

Improving nutrition isn’t as easy as just fitting equipment to flour mills

The writer is head of the UK’s Department for International Development in Pakistan

Malnutrition is a tragedy wherever it occurs. It is, however, a tragedy that we can fix. Around the world, one in three people are affected by malnutrition. Women and children suffer the most. Malnutrition hurts the development of individuals, their productivity and their health, but it also holds back the economic and social development of their community, their country and the world.

This is a global problem that needs global cooperation, but Pakistan has a specific challenge. It is home to 6% of the world’s chronically malnourished children, and has the third-highest level of chronic malnutrition in the world.

One of the biggest challenges for people who are malnourished is the lack of certain vitamins and nutrients. This has a wider impact on a person’s health. The lack of iron and vitamins A and D, for example, limits the ability to fight disease. This means that too many newborn babies and children are dying of minor illnesses. According to Unicef, every year over 200,000 children die in Pakistan of factors relating to malnutrition before reaching their fifth birthday.

Malnutrition also inhibits the brain growth of babies and children. Malnourished children enrol in school later have reduced learning ability and have lower productivity when they reach adulthood. The damage from chronic malnutrition in the first two years of life is irreversible. It leads to and keeps people in poverty. The UN estimates that malnutrition costs Pakistan 2% to 3% of its GDP a year.

The number of people affected in Pakistan is significant. According to the most recent survey by the UN Food and Agriculture Organisation, published in 2011, 44% of children under five years old were stunted, 32% underweight, 62% with anaemia and 54% with vitamin A deficiency. Some 51% of pregnant women in Pakistan had anaemia and 69% vitamin D deficiency.

Pakistan and the UK working together on this can make a difference.


Global experience shows food fortification to be one of the most cost effective solutions to address chronic micronutrient deficiencies. Given that wheat flour, edible oils and ghee are consumed daily by most people in Pakistan, fortification of these staple foods can enhance micronutrients in food without requiring changes in eating habits.

Combating malnutrition is at the heart of the UK’s work in Pakistan. Working with the government and provinces of Pakistan, UK Aid is investing more than six billion rupees over the next five years to improve the nutritional status of people in Pakistan, particularly women of child-bearing age and young children, through food fortification. The programme will achieve this by improving access to and consumption of wheat flour which is fortified with iron and folic acid, and edible oils and ghee fortified with vitamins A and D.

This week, we launched our food fortification initiative in Punjab. Working alongside the province and local producers, we have started fitting micro-feeder equipment in flour mills — the machines that the flour producers will use to add vitamins and nutrients, while providing quality assurance equipment to both the mills and public laboratories for the testing of fortification standards by Pakistan in Pakistan.

Improving nutrition isn’t as easy as just fitting equipment to flour mills. More provinces need to introduce legislation mandating fortification in wheat flour, and enforcement of legislation needs to be stepped up. Food manufacturers need support to increase technical capacity, and consumers need to understand the benefit of choosing fortified food for their families. The Food Fortification Programme will not be able to do this on its own. We are therefore working with different levels of government, as well as producers and manufacturers.

We are excited about what we will be able to achieve together. In the next three years, the Food Fortification Programme aims to ensure that around half of the population of Pakistan is consuming fortified wheat flour and over two-thirds are using fortified edible oil and ghee. This will mean Pakistan has a population that is healthier, more productive and better able to meet its enormous potential.

Published in The Express Tribune, October 22nd, 2017.

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