Related Experiment Video
Updated: Aug 5, 2026
The Caco-2 Cell Bioassay for Measurement of Food Iron Bioavailability
Published on: April 28, 2022
Cost-Effectiveness Analysis of Iron, Vitamin A, and Zinc Biofortification in Selected Low- and Middle-Income
Wu Zeng1, Janice Nam2, Tianjiao Gao1
1Department of Global Health, Georgetown University, Washington, DC, United States.
Background:
Crop biofortification is an important tool to improve micronutrient deficiency, but the evidence of its cost-effectiveness remains limited.
Objectives:
This study aims to estimate the cost-effectiveness of biofortified crops to address iron, zinc, and vitamin A deficiency in 13 countries.
Methods:
We used the burden of disease measured in disability-adjusted life years (DALYs) compiled by the Institute for Health Metrics and Evaluation, supplemented by a literature review, to quantify DALYs resulting from micronutrient deficiencies. Data and assumptions from the Food and Agriculture Organization of the United Nations were used to estimate micronutrient intake and the potential impact of biofortification on micronutrient intake to calculate the efficacy of biofortification in reducing DALYs under conservative, moderate, and optimistic scenarios. The cost was estimated for 30 y (2024-2053), whereas the benefits were for 20 y (2034-2053). An incremental cost-effectiveness ratio (ICER), defined as additional cost per DALY averted, was estimated.
Results:
The total cost of biofortification programs varied across countries, ranging from $4.28 million in Guatemala to $34.04 million in Nigeria over 30 y. The ICERs of biofortification varied by type of crop and country; regardless, all are cost effective using gross domestic product based cutoffs, except for biofortified cassava and sweet potatoes in Zimbabwe. For example, for iron biofortification of beans under the conservative scenario, ICER was as low as $58.04 per DALY averted in Kenya and as high as $535.52 per DALY averted in Zimbabwe, demonstrating the range of cost-effectiveness of the intervention among the countries selected for the study. A similar pattern was found for iron biofortification of pearl millet; vitamin A biofortification of cassava, maize, and sweet potatoes; and zinc biofortification of rice, wheat, and maize in most countries.
Conclusions:
Biofortification of staple crops by selective plant breeding is potentially cost effective to address iron, zinc, and vitamin A deficiencies.
