Sanku: from 7 million to ~70 million people in three years — what we’ve learned and what it would take to scale much further

Published on October 15, 2026 1:13 AM GMT TL;DR Food fortification is a well-established, highly cost-effective way to address micronutrient deficiencies, but in many countries the main constraint is implementation. Standards may already exist, while weak enforcement, fragmented milling sectors, unreliable premix supply, limited technology and quality systems, and difficult commercial incentives prevent fortification from working consistently at scale. Sanku works across these implementation barriers to make fortification more reliable and scalable. Sanku has grown from helping millers fortify flour consumed by around 7 million people in 2023 to around 70 million today. Over the same period, net donor cost per person has fallen from $0.55 to around $0.10 per year[1], driven by economies of scale and a growing commercial revenue base. We recently commissioned Rethink Priorities (RP) to conduct a cost-effectiveness analysis of our work. The results vary substantially across countries and highlight important uncertainties, but they also identify practical opportunities to improve impact. We are already acting on the findings by improving baseline data, strengthening our evidence and M&E, and sharpening how cost-effectiveness informs expansion decisions. Our goal is for the ongoing cost of fortification to become fully market-funded. Commercial revenue covered around one-third of operating costs in FY26, and our current financial model projects that share to rise substantially as we scale, with Sanku reaching operating break-even around FY34. Philanthropy funds expansion, infrastructure and the other investments needed to build the system to much greater scale. Over the next 10 years, we plan to scale from around 70 million people reached today to around one billion people reached each year, while achieving commercial break-even. We estimate that this will require just over $100 million in additional philanthropic capital over the next eight years. Earlier commitments could bring forward country expansion, manufacturing, evidence and organisational investments, allowing us to get micronutrients to more people who need them sooner. The EA community has been important to Sanku’s growth, and we hope it can help shape and support the next phase. We are sharing this update partly to report back on what that support has helped build, and partly because we would value funding, advice, collaboration, introductions and interest from people who may want to work with Sanku. Connect at EAG. Felix will be at EAG NYC (16–18 Oct), with a side trip to the Bay Area afterwards, as well as EAGxAustralasia in Melbourne and EAG SF 2027. TED Talk: For a short introduction to micronutrient deficiency, the case for food fortification, and Sanku’s approach, watch Sanku Co-Founder and CEO Felix Brooks-church’s TED Talk, recorded at the annual TED Conference in Vancouver in April this year. Introduction Sanku has grown roughly tenfold in three years while reducing the amount of philanthropy required per person reached. In 2023, we were helping millers fortify flour consumed by around 7 million people. Today, we estimate that around 70 million people consume flour fortified through Sanku-supported mills across Tanzania, Kenya and Ethiopia. Sanku is also now beginning work in Uganda, our fourth country, where operations are just getting underway. Net donor cost per person has fallen over the same period from $0.55 to around $0.10 per year. Sanku has also changed considerably since many people in the EA community may have last encountered it. Our early Sanku model focused primarily on reaching small and medium mills that conventional large-scale fortification systems often missed. The Dosifier we invented to address that problem remains core to our work, but Sanku now works with mills of all sizes and has built local nutrient manufacturing, supply chains, field operations, quality systems, commercial revenue streams and government partnerships around the technology. The EA community and people influenced by its ideas helped Sanku reach this stage. Sanku began as an initiative within Project Healthy Children (PHC), which was recognised by GiveWell as a Standout Charity from 2016 to 2021, when GiveWell retired the category. Sanku remains recommended by The Life You Can Save. We wanted to share what that support has helped build, what we have learned from scaling across Tanzania, Kenya and Ethiopia, and where we think the next opportunities and uncertainties lie. The timing also feels relevant to two current discussions in global health and EA: food fortification and absorptive capacity. GiveWell is actively exploring large-scale food fortification opportunities in Africa and has described the intervention as the most promising category within its current anaemia-control search.[2] At the same time, recent discussion in global health and in EA has focused on whether organisations with promising interventions also have the leadership, syst