lack of clear guidelines from WHO. This action prevented provinces from ordering it, and pregnant women from accessing it. In 2018, Sight and Life undertook a policy and programmatic analysis , conducting interviews with key informants in the country to fill the gaps in the knowledge required to build a strong consensus for MMS in South Africa's policy landscape and advocate for MMS being reintroduced into the EML (Figure 1 and Box 1). " In 2018, Sight and Life undertook a policy and programmatic analysis to build a strong consensus for MMS in South Africa's policy landscape" In the first section of this article, we provide an overview of the policy hurdles for MMS in South Africa to set the context. In The rise and fall of MMS in South Africa Between 2010 and 2015, South Africa was the only LMIC that provided MMS through government channels. In 2016, the national government dropped MMS from the national EML because of the lack of knowledge about the strong evidence base for MMS and the Key messages • For 6 years, between 2010 and 2016, most provinces in South Africa provided multiple micronutrient supplements (MMS) to all pregnant and lactating women, but removal from the national essential medicines list (EML) led to the discontinuation of provision in late 2016. Sight and Life documented South Africa's MMS journey in 2018. • Based on Sight and Life's case study, transitioning from iron and folic acid (IFA) to MMS has been shown to be cost-effective for the South African context, and translates into substantial future social and public health benefits and economic savings for South Africa. • Transitioning from IFA to MMS has been shown to be relatively straightforward, but investing in training and social and behavioral change communication is important because this strengthens uptake and adherence, which in turn will amplify the health impact. • Given the strong scientific evidence, the South African national government and international bodies can help to restart the provision of MMS. A strategy for reintroduction and a four-step action plan are outlined in this article. • We also present a suggested table of contents, for advocacy purposes, that was co-created with MMS champions in South Africa. This can be adapted to suit the local contexts of other low-and middle-income countries (LMICs) considering the inclusion of MMS in their EMLs. figure 1: The three South African provincial nutrition departments interviewed by Sight and Life Northern Cape Eastern Cape Kwazulu Natal