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Public health experts have called on the Federal Government to introduce mandatory folate and vitamin B12 fortification of bouillon cubes, arguing that the policy could significantly reduce the incidence of neural tube defects (NTDs) and prevent nearly 11,000 birth defect cases annually in Nigeria.
The experts made the recommendation following a new policy narrative that advocates stronger regulatory action, warning that Nigeria’s current voluntary fortification standards have failed to deliver the desired public health outcomes.
According to the experts, enforceable regulations are needed to address what they describe as a “hidden nutritional crisis” and help Nigeria meet the World Health Organization (WHO) African Region’s nutrition targets by 2030.
The call is backed by findings from the Condiment Micronutrient Innovation Trial (CoMIT), a double-blind randomized controlled study involving more than 2,000 participants across West Africa.
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The study found that fortified bouillon significantly improved serum folate and vitamin B12 levels, reducing population-level risks associated with neural tube defects.
What they are saying
Speaking on the burden of neural tube defects in Nigeria, gynecologist Dr. Bimbo Okusanya said the condition remains one of the most common but underreported birth defects in the country.
- “In Nigeria and many parts of Africa, studies estimate about 2 per 1,000 births, but the real number may be higher because not all cases are reported. NTD is one of the more common major birth defects.”
Neural tube defects—including spina bifida, anencephaly and encephalocele—develop within the first 28 days of pregnancy, often before many women are aware they are pregnant. This limits the effectiveness of supplementation programmes, making food fortification a more reliable intervention.
With an estimated five million births annually and an NTD prevalence of 14.2 cases per 10,000 live births, Nigeria accounts for a significant share of preventable birth defects in Sub-Saharan Africa.
According to the CoMIT study, population-wide fortification could reduce NTD risks by as much as 70%.
- “Population-level fortification reduces NTD risk by up to 70% without requiring any individual action, making it one of the highest-impact public health interventions available.”
Why experts are focusing on bouillon
Health professionals argue that bouillon cubes offer a practical and cost-effective channel for delivering essential micronutrients because they are consumed daily in most Nigerian households.
They highlighted several advantages of using bouillon as a fortification vehicle:
- Widespread household consumption across regions and income groups.
- Automatic reach to nutritionally vulnerable populations.
- No behavioural change required from consumers.
- Stability of folate and vitamin B12 during cooking.
- No noticeable change in taste, colour or smell.
- Minimal cost relative to the health benefits.
Experts also stressed the importance of vitamin B12, noting that it works alongside folate and is essential for healthy neurological development. Deficiency can result in irreversible neurological damage, particularly among infants and young children.
Calls for stronger regulations
Nigeria introduced voluntary standards for bouillon fortification in September 2024, but experts say implementation has been slow and insufficient.
They noted that the country failed to meet its 2025 anaemia reduction targets, prompting the WHO to extend regional nutrition goals to 2030.
Nutrition experts are now calling for mandatory fortification requirements covering bouillon, flour, edible oils and other staple foods.
Nutritionist Nonso Ode said stronger enforcement of existing fortification policies, alongside the inclusion of rice and bouillon, would help reach more women of reproductive age.
- “Add folic acid to staple foods everyone eats. Nigeria already has a policy to fortify flour, maize meal and semolina with folic acid. Stronger enforcement and adding rice and bouillon would help reach more women.”
Get up to speed
The renewed call for mandatory fortification comes amid broader government efforts to improve nutrition outcomes nationwide.
Earlier this year, the Federal Government directed all states and the Federal Capital Territory to establish State Councils on Nutrition as part of efforts to strengthen coordination and implementation of nutrition programmes.
- The initiative aligns with the Nutrition 774 Programme, launched by the National Economic Council in February 2025 to address malnutrition across all 774 local government areas.
Nutrition 774 focuses on reducing malnutrition among children and pregnant women, improving food security, strengthening nutrition education and healthcare systems, and expanding collaboration with the private sector and development partners.
What you should know
Nigeria continues to face significant micronutrient deficiencies despite various nutrition interventions.
Health experts argue that mandatory food fortification remains one of the most cost-effective strategies for reducing preventable birth defects, improving maternal health and supporting child development.
They warn that without stronger enforcement and broader adoption of fortified staple foods, the country may struggle to achieve its nutrition and public health targets by 2030.
