Fortification generally utilises large-scale production systems which can exclude the most vulnerable who buy from small-scale mills. Pakistan offers an example of how engaging small mills offers big opportunities.

Food fortification of commonly eaten foods is usually done through large-scale food production systems. However, in many LMIC most people, including the poorest and most at risk of malnutrition, buy their wheat flour from small-scale mills. In Pakistan there are 70,000 small-scale mills, which produce 0.5 to 2 metric tonnes per day and sell directly to local households. The WFP Pakistan Country Office therefore launched a pilot supporting ten small-scale mills to fortify their wholemeal flour initially using a business case for social good. The results were surprising and could assist others as they explore ways to expand fortification initiatives to reach the hard to reach.