Impact Overview
Every month, millions of people in India avoid malnutrition and anaemia because of Fortify Health’s wheat flour (atta) fortification programmes.
In early 2026, we reached over 20 million people per month. Now, our goal is to reach the 400 million who still need fortification to thrive.
Anaemia affects more than half of pregnant women and more than two-thirds of children under five in India. It causes fatigue, impairs cognitive development, reduces productivity across entire communities, and can cause life-threatening complications – especially for pregnant women and newborns.
The most common cause of anaemia is iron deficiency, and iron deficiency is preventable through flour fortification.
By working with flour mills across India to add key micronutrients to wheat flour (chakki atta) at the point of production, Fortify Health makes a targeted change to the food supply with a broad impact on public health.
In early 2026, we reached over 20 million people per month. Now, our goal is to reach the 400 million who still need fortification to thrive.
Anaemia affects more than half of pregnant women and more than two-thirds of children under five in India. It causes fatigue, impairs cognitive development, reduces productivity across entire communities, and can cause life-threatening complications – especially for pregnant women and newborns.
The most common cause of anaemia is iron deficiency, and iron deficiency is preventable through flour fortification.
By working with flour mills across India to add key micronutrients to wheat flour (chakki atta) at the point of production, Fortify Health makes a targeted change to the food supply with a broad impact on public health.
Our impact at every level
Our goal is to reduce the number of people suffering from anaemia and reverse these effects at scale. Supporting mills to fortify wheat flour at scale is how we do it. This single change in the food supply has a significant impact, from individual families all the way to India's national health and economy.
For Families
Regularly consuming fortified flour averts the risk of anaemia and means children can develop fully, mothers have safer pregnancies, and adults have the energy to work, learn and raise healthy families. It is estimated that consumption of fortified wheat flour leads to:
For Millers
Our hassle-free model means mills can fortify their flour accurately and efficiently at no extra cost to their business or their customers. As of 2026, we are:
For Partners
Our open market success has created a proven, replicable system that governments and public health programmes can adopt and scale to reach hundreds of millions more.
As of 2026:
Widespread flour fortification could eliminate one of India's most persistent public health challenges — reducing healthcare costs, improving productivity, and building a healthier population for generations to come.
For Families
Regularly consuming fortified flour averts the risk of anaemia and means children can develop fully, mothers have safer pregnancies, and adults have the energy to work, learn and raise healthy families. It is estimated that consumption of fortified wheat flour leads to:
- ● 30% drop in anaemia risk with regular consumption of fortified flour
- ● 3.2 neonatal deaths averted per 100,000 beneficiaries
- ● 105,000+ years lived with disability averted annually over the next two years
For Millers
Our hassle-free model means mills can fortify their flour accurately and efficiently at no extra cost to their business or their customers. As of 2026, we are:
- ● Partnering with 300+ mill partnerships across 16 states
- ● Launching mill partnerships in just 90 days
- ● Improving quality compliance from 72% in 2023 to >92%
For Partners
Our open market success has created a proven, replicable system that governments and public health programmes can adopt and scale to reach hundreds of millions more.
As of 2026:
- ● 15% of India's total packaged flour market is now fortified
- ● 568,000+ schoolchildren and 3,500+ industrial workers reached through partnership programmes
- ● Opportunity to reach 400 million people through new government meal programmes
Widespread flour fortification could eliminate one of India's most persistent public health challenges — reducing healthcare costs, improving productivity, and building a healthier population for generations to come.
- ● Anaemia drains $25.8B+ from India's GDP annually
- ● $1 of programme spending generates $32.50 of additional income
- ● Our programmes are expected to avert 125,000+ years lived with anaemia by 2030
The Evidence: Is Fortification Actually Impactful?
Fortification is one of public health's greatest success stories, and the WHO endorses it as one of the most cost-effective nutritional interventions available. Here’s why our wheat flour fortification stands apart as a public health intervention:
A Simple, Scalable Solution
Flour is already consumed by over 600 million people in India. Fortification is implemented through existing supply chains. There’s no consumer behaviour change required, no additional cost to the mills or customer.
A Proven Model
Our impact model draws on Field et al. (2021), a meta-analysis of six wheat flour fortification studies, which found that fortification reduces anaemia prevalence by approximately 30%. We apply a small downward adjustment for study applicability to our context, and a small upward adjustment because the iron compound used by our mill partners (NaFeEDTA) is more bioavailable than compounds used in some of the reviewed studies. Our working estimate is a 28% reduction in anaemia prevalence among beneficiaries who regularly consume our partners' fortified flour.
This has been stress-tested and validated by GiveWell — one of the world's most rigorous independent charity evaluators — whose ongoing engagement has sharpened both our analysis and our confidence in the estimates.
Extremely Cost-Effective
Fortification is a low-cost intervention; providing fortified flour for one person costs approximately $0.16 (₹13) per year. Our programmes are estimated to be 16.5x more cost-effective than providing direct cash transfers (as estimated independently by GiveWell).
A Simple, Scalable Solution
Flour is already consumed by over 600 million people in India. Fortification is implemented through existing supply chains. There’s no consumer behaviour change required, no additional cost to the mills or customer.
A Proven Model
Our impact model draws on Field et al. (2021), a meta-analysis of six wheat flour fortification studies, which found that fortification reduces anaemia prevalence by approximately 30%. We apply a small downward adjustment for study applicability to our context, and a small upward adjustment because the iron compound used by our mill partners (NaFeEDTA) is more bioavailable than compounds used in some of the reviewed studies. Our working estimate is a 28% reduction in anaemia prevalence among beneficiaries who regularly consume our partners' fortified flour.
This has been stress-tested and validated by GiveWell — one of the world's most rigorous independent charity evaluators — whose ongoing engagement has sharpened both our analysis and our confidence in the estimates.
Extremely Cost-Effective
Fortification is a low-cost intervention; providing fortified flour for one person costs approximately $0.16 (₹13) per year. Our programmes are estimated to be 16.5x more cost-effective than providing direct cash transfers (as estimated independently by GiveWell).
Our Uncertainties
Rigorous impact means being honest about what we don’t know yet. We actively work to address three key uncertainties:
- ● Who is consuming our flour (and how much)
- • We track metric tonnes produced and fortification quality, but until recently had limited data on exactly who consumes our flour and how consistently. In late 2025, IDinsight conducted a consumption study across 469 households in three states, finding that average per capita consumption of fortified flour is 105g/day. This exceeds the WHO threshold of 75g/day needed for anaemia reduction. Women and adolescent girls also met minimum intake thresholds. This significantly increased our confidence that the right people are consuming enough fortified flour for our intervention to be effective.
- ● How well the flour is fortified
- • Not every batch leaves a mill perfectly fortified. We test samples systematically and have invested heavily in training and quality technology, which has increased compliance from 72% in 2023 to 92% in 2025. Our goal is to close the remaining gap.
- ● Absorption in real-world conditions
- • Around a quarter of people in our study consume tea with or shortly after eating atta-based meals. Tea polyphenols can reduce iron absorption, which may reduce impact for some groups. We're investigating this further.
Our Future Impact: What’s Possible?
Fortify Health began with a small number of mills in one Indian state. Today we operate across 16 states, with over 250 mill partnerships and reach tens of millions of people every month. But our biggest chapter is still ahead.
Use Open Market Success to Support Government Welfare Programmes
India's government welfare programmes like the Public Distribution System and PM POSHAN mid-day meal scheme already reach over 400 million people daily. Our next chapter is to engage more partnership programs and India’s government to ensure the flour they distribute in welfare programmes is fortified. Our open market success is the proof of concept, not the ceiling.
A government scheme that mandates fortified flour doesn't need Fortify Health present at every mill indefinitely. It creates a self-sustaining system that continues delivering impact long after our direct involvement ends.
Change the Food System at Scale
We have already helped make more than 15% of India's total packaged flour market fortified. As that number grows, industry standards, consumer expectations, and eventually policy can shift toward fortification as the norm.
What's Possible by 2030
With our current programme, by 2030 we expect to:
Beyond 2030, our ambition is to reach all 600 million people in India who regularly consume wheat flour and help make anaemia a problem of the past.
Use Open Market Success to Support Government Welfare Programmes
India's government welfare programmes like the Public Distribution System and PM POSHAN mid-day meal scheme already reach over 400 million people daily. Our next chapter is to engage more partnership programs and India’s government to ensure the flour they distribute in welfare programmes is fortified. Our open market success is the proof of concept, not the ceiling.
A government scheme that mandates fortified flour doesn't need Fortify Health present at every mill indefinitely. It creates a self-sustaining system that continues delivering impact long after our direct involvement ends.
Change the Food System at Scale
We have already helped make more than 15% of India's total packaged flour market fortified. As that number grows, industry standards, consumer expectations, and eventually policy can shift toward fortification as the norm.
- ● Millers who fortify see quality improvements and stronger customer relationships.
- ● Partners who adopt our model reach more people with less effort.
- ● Governments that mandate fortification unlock population-level health gains without major new infrastructure.
What's Possible by 2030
With our current programme, by 2030 we expect to:
- ● Fortify 40% of India's packaged wheat flour
- ● Provide fortified flour to over 64 million people
- ● Avert more than 125,000 years lived with anaemia annually
- ● Help secure wheat flour fortification as a permanent, government-backed feature of India's food system
- Projections informed by our forthcoming Impact Report.
Beyond 2030, our ambition is to reach all 600 million people in India who regularly consume wheat flour and help make anaemia a problem of the past.
Make Your Impact: Support Our Work
Help us reach the 400 million+ people who still need fortified flour to thrive.
Over 400 million people in India who consume wheat flour regularly are not yet getting the nutrients they need to live healthy lives. Our model is built to scale to these levels with the right support.
At $0.16 (₹13) per person per year, supporting Fortify Health’s fortification programme is one of the most cost-effective ways to improve lives at scale.
All donations go directly toward onboarding new mill partners, maintaining quality monitoring, deepening government engagement, and developing policies that make fortification the national standard.
Whether you are an individual donor, a foundation, or an organisation looking for a high-impact giving opportunity, we would love to hear from you.
Over 400 million people in India who consume wheat flour regularly are not yet getting the nutrients they need to live healthy lives. Our model is built to scale to these levels with the right support.
At $0.16 (₹13) per person per year, supporting Fortify Health’s fortification programme is one of the most cost-effective ways to improve lives at scale.
All donations go directly toward onboarding new mill partners, maintaining quality monitoring, deepening government engagement, and developing policies that make fortification the national standard.
Whether you are an individual donor, a foundation, or an organisation looking for a high-impact giving opportunity, we would love to hear from you.
