Why it matters
Adding essential vitamins and minerals (micronutrients) to everyday foods—a process known as food fortification—can help reduce malnutrition and prevent illness and death worldwide. But is fortification affordable and good value for money? To answer this, we reviewed all the global evidence on the economic benefits of food fortification.

What we did
We systematically reviewed 56 studies (from 63 countries, including over 40 low- and middle-income countries) that analysed the costs and benefits of adding micronutrients like vitamin A, iron, folic acid, and iodine to staple foods such as flour, oils, sugar, and salt. We focused on whether these programmes are cost-effective compared to doing nothing.

What we found

• Most studies showed that fortification programmes are very cost-effective, often costing less than $150 to save a healthy life year (known as a DALY).

• Around 85% of studies in lower-income settings showed that fortification programmes offered good value for money, when judged against realistic thresholds based on each country’s economic situation.

• In many cases, fortification programmes saved money overall—they cost less than treating the problems caused by nutrient deficiencies.

• In 47 different benefit–cost analyses, the benefits always outweighed the costs—sometimes by as much as 100 times.

Why this matters for policy
Our findings show that food fortification is not only a proven public health intervention but also a smart investment, especially for resource-limited countries. Decision-makers can use this evidence to justify starting or expanding fortification programmes in their countries, helping to fight malnutrition and improve population health efficiently.

In summary
Food fortification saves lives, reduces malnutrition, and is likely to be a cost-effective investment in most countries worldwide. Our research can help governments and global health organisations make informed, evidence-based decisions about funding and scaling up fortification efforts.