Nutrition Sovereignty Needs Iron: What the Accra Reset Means for the Micronutrient Forum

By Gavin Armstrong, Founder & CEO, Lucky Iron Life®

This week, I’m in Accra with the Lucky Iron Life team for the Micronutrient Forum’s 7th Global Conference. It’s hard to imagine better timing. Just days before we arrived, Ghana’s President John Mahama was in New York marking one year of the Accra Reset, an initiative that began here in Accra and is now helping reshape how the world thinks about global health governance, financing and ownership.

What is the Accra Reset?

President Mahama launched the Accra Reset in 2025 as an Africa-led effort to rethink global health governance and the traditional model of international development. At UNGA this month, he launched A Sovereign Future for Health, a report calling for greater domestic capability, stronger local health systems and new models of international cooperation built around what he described as “pragmatic interdependence.”

The message is not that international cooperation should end. It is that the relationship needs to change, with countries having greater control over their health priorities, resources and systems.

One line from Mahama has stayed with me: “No ownership without control, and no control without absolute accountability.”

Maternal and child health is the first test

Here’s where the Reset and this week’s Forum meet.

Maternal and child health has been identified as a critical measure of whether health systems are delivering meaningful improvements for people. You cannot have strong maternal and child health outcomes without addressing anemia, and iron deficiency is one of the most important contributors to iron deficiency anemia.

The numbers in Ghana make the challenge clear. According to the 2022 Ghana Demographic and Health Survey, 49% of children aged 6 to 59 months were anemic, down significantly from 66% in 2014. In the Northern Region, prevalence was 69%.

That progress is real and worth celebrating. But it also means that roughly one in two young children is still affected by anemia, a condition associated with fatigue and impaired cognitive and physical development.

If maternal and child health is one of the Reset’s first tests, iron is certainly one of the questions we need to answer.

“Nutrition at the Frontiers of a Changing Environment”

This year’s Micronutrient Forum theme, “Nutrition at the Frontiers of a Changing Environment,” could hardly be more relevant.

The Forum is examining evidence, policy and innovation across nutrition, food systems, climate and development, with a strong emphasis on equity and leadership from Africa and other low- and middle-income countries. More than half of conference participants are expected to come from Africa and other LMICs.

And the changing environment isn’t just climate and conflict. It is also the changing global financing landscape.

The Forum’s program explicitly asks how we can sustain nutrition progress in a new reality of funding cuts, conflict and displacement, including through its track on “Doing Better with Less.”

Put the two conversations together and a shared question emerges:

How do we sustain and accelerate progress on nutrition when the old aid model is changing and countries rightly want to lead?

This is not theoretical for us

For Lucky Iron Life, this conversation is personal.

Our work in Africa did not begin this week in Accra. Lucky Iron Life has worked across the continent, including in Tanzania, Benin and Senegal, through partnerships with organizations including World Vision, CARE and Catholic Relief Services. These projects have combined the Lucky Iron Fish with training, nutrition education and locally led implementation.

In Benin, for example, our work with CARE took a broader approach to nutrition, incorporating education on dietary diversity and gender equality through a train-the-trainer model. The experience reinforced something we have learned repeatedly: sustainable nutrition solutions are not simply delivered to communities. They need to be built with local partners, adapted to local contexts and integrated into the systems and daily lives of the people they are designed to serve.

That distinction matters.

A product can be imported. A program can be funded. A target can be written into a strategy document.

But lasting impact requires local knowledge, local leadership, local capacity and solutions that make sense within people’s everyday lives.

That is one reason the conversation around the Accra Reset resonates so strongly with me. The question is not simply whether the international community can continue to deliver nutrition interventions. It is whether we can help build the capacity, evidence, partnerships and tools that allow countries to lead those interventions themselves.

Three connections I’m seeing on the ground

1. Solutions need to be owned, not just delivered.

The Reset challenges a system in which countries have often been asked to “own” programs they did not fully control.

For nutrition, that means interventions need to fit into daily life and be sustainable beyond a donor-funded project cycle.

That is the thinking behind Lucky Iron Life: developing practical, reusable tools that can become part of the cooking and nutrition practices families already have, while working with local organizations that understand their communities.

2. “Doing better with less” is an iron conversation.

When budgets tighten, cost-effectiveness stops being a talking point and becomes part of the strategy.

Nutrition interventions need to be affordable, practical and scalable. Solutions that do not depend on cold chains or constant resupply can offer governments and communities additional options as they build more resilient systems.

3. Evidence has to travel with the product.

Sovereignty does not mean lower standards. It means countries should be able to choose among evidence-based options that fit their priorities and systems.

That creates a responsibility for organizations like ours: to generate rigorous evidence, share what we know, be honest about what we are still learning, and work alongside researchers, governments and implementation partners.

Lucky Iron Life’s Fish and Leaf have been evaluated through independent clinical and laboratory research in different populations, and our social-impact programs are designed around partnerships with community organizations and locally tailored training.

The opportunity in Accra

There is something fitting about this conversation happening in the city whose name is now attached to a global health reform agenda.

The Accra Reset is asking a fundamental question: how do we move from systems built around dependency toward systems built around ownership and capability?

The Micronutrient Forum is asking a related question: how do we protect and accelerate nutrition progress in a world of climate shocks, conflict and constrained financing?

From where I sit, iron deficiency is one place where those questions can meet.

We need interventions that are evidence-based, affordable, practical and capable of being integrated into the systems countries are building for themselves. We need international partnerships that strengthen local capacity rather than substitute for it. And we need to keep listening to the researchers, policymakers, practitioners and communities closest to the problem.

That is the work we have been trying to do at Lucky Iron Life, in Africa and around the world.

Standing in Accra this week, that work feels more relevant than ever.

Find us at MNF 2026 in Accra, or reach out anytime to talk about partnerships.