Situation analysis of procurement and production of multiple micronutrient supplements in 12 lower and upper middle‐income countries

Abstract

Globally, there are few vitamin and mineral ingredient manufacturers. To support local, in-country or regional procurement and production of multiple micronutrient supplements (MMS), the following production scenarios are possible: (a) straight ingredients of vitamins and minerals forms imported or locally produced that are mixed, tableted, or encapsulated and packaged by a local manufacturer; (b) import or local production of a vitamin and minerals premix that is tableted or encapsulated and packaged locally; (c) import of a bulk, finished product (tablets or capsules) that is packaged and branded; and (d) or import of a branded packaged product. This paper is a situation analysis of the market, manufacturing, and policy factors that are driving the production of MMS in 12 lower and upper middle-income countries. Key informants completed a self-administered structured questionnaire, which examined the local context of products available in the market and their cost, regulations and policies, in Brazil, Colombia, Guatemala, Mexico, Peru, Bangladesh, India, Vietnam, Ghana, Kenya, Nigeria, and South Africa. Our study found that although most countries have the capacity to produce locally MMS, the major barriers observed for sustainable and affordable production include (a) poor technical capacity and policies for ensuring quality along the value chain and (b) lack of policy coherence to incentivize local production and lower the manufacture and retail price of MMS. Also, better guidelines and government oversight will be required because not one country had an MMS formulation that matched the globally recommended formulation of the United Nations Multiple Micronutrient Preparation (UNIMMAP).

Multiple micronutrient supplements in pregnancy: Implementation considerations for integration as part of quality services in routine antenatal care. Objectives, results, and conclusions of the meeting

“…This paper presented a situation analysis of the market, manufacturing, and policy factors that were driving the production of MMN in 12 low‐, middle‐, and high‐income countries. Key informants completed a self‐administered structured questionnaire, which examined the local context of products available in the market and their cost, regulations, and policies, in Brazil, Colombia, Guatemala, Mexico, Peru, Bangladesh, India, Vietnam, Ghana, Kenya, Nigeria, and South Africa (Monterrosa et al, ). The study found that although most countries have the capacity to produce locally MMS, the major barriers observed for sustainable and affordable production included poor technical capacity and policies for ensuring quality along the value chain and lack of policy coherence to incentivise local production and lower the manufacture and retail price of MMS.…”

Small and Medium Enterprises’ Perspectives on Food Fortification Amid the Growing Burden of Malnutrition

“…In countries such as Mexico, Brazil, Colombia, Vietnam and India, the tax rate varies from 0% to 16%. Africa has the highest tax rate for premixes, yet it is one of the regions most impacted by micronutrient deficiency worldwide; for instance, the tax rate for premixes in Ghana ranges from 38% to 40% [43,44]. Finally, in Bangladesh, the adequate fortification of cooking oil is hampered by the incorrect and misleading labelling of fortified products by producers and inconsistent law enforcement [45].…”

“…Government agencies can implement mandatory and voluntary fortification policies or adapt existing regulations by taking into consideration the nutritional context, dietary patterns, food access and availability, and challenges for food fortification. For instance, incentives such as extra SME-specific capacity training could be provided to help SMEs comply with food fortification standards [44]. In addition, governments can adjust tax policies to address the high taxation of imported micronutrient premixes [44] (i.e., offer tax breaks such as deductions, exemptions or tax returns), making it a more favorable environment for SMEs to implement food fortification practices.…”

“…For instance, incentives such as extra SME-specific capacity training could be provided to help SMEs comply with food fortification standards [44]. In addition, governments can adjust tax policies to address the high taxation of imported micronutrient premixes [44] (i.e., offer tax breaks such as deductions, exemptions or tax returns), making it a more favorable environment for SMEs to implement food fortification practices. Additionally, there is a need to oversee and ensure adequate regulatory mechanisms and tools based on the country's capabilities [34,47].…”