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Flour Fortification Initiative A Private-Public-Civic Investment in Each Nation

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Flour Fortification Initiative A Private-Public-Civic Investment in Each Nation

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    1. Flour Fortification Initiative A Private-Public-Civic Investment in Each Nation Karen Codling Executive Officer FFI Secretariat for East Asia and the Pacific

    3. Consumption of Wheat and Products (per capita/g/day)

    6. Mandatory Fortification Already In Place Philippines Adoption in 2000; full implementation by 2004 Food Fortification Law covers also sugar, rice and cooking oil Only flour fully fortified to date; with iron and vitamin A Programme review planned for 2009 Indonesia Adoption in 2001; iron, zinc, folic acid and B vitamins Temporary revocation of mandatory standard this year (lobbying by importers - standard is a barrier to trade) Evaluation study in urban areas underway (ADB)

    7. Impact of Mandatory Flour Fortification in Indonesia?

    8. Countries in East Asia Working towards Mandatory Fortification of Wheat Flour Malaysia: High government commitment (Health, Industry and Economic Planning Unit), moderate deficiencies and NTDs, high flour consumption. Supported by FFI. China: High levels of anaemia and NTDs, regions of high levels of flour consumption. 23.5% of world roller mill flour. Ministry of Health interest but concerns about small mills and mandatory. Several trials and pilots. Supported by FFI and GAIN. Mongolia: Very high flour consumption, unsophisticated wheat flour industry + imports from China. Legislation for fortification of all domestically milled flour. Previously supported by ADB. Viet Nam: High level of MN deficiencies though relatively low flour consumption. Proposal being developed. Supported by FFI and ADB. Thailand: Relatively low flour consumption. Examination of issue; concern about folic acid deficiency. Supported by FFI.

    9. Countries in East & South Asia NOT Working towards Wheat Flour Fortification Cambodia, Laos, Myanmar: Low flour consumption and small/non-existent wheat milling industry. Taiwan: Moderate flour consumption, limited MN deficiencies, lack of political interest.

    10. Case Study of Malaysia 11 April 2005 - Advisory Committee on Maternal, Newborn and Child Health: all flour to be fortified with folic acid to prevent neural tube defects. 3 March 2006 - Technical Committee for Folic Acid Fortification formed. 11 September 2006 - Seminar on Micronutrient Fortification for Better Health: advocacy and discussion on whether FF to be voluntary or mandatory. Concluded mandatory fortification. 5 July 2007 National Technical Committee on Folic Acid Fortification: agreed to add iron also to prevent anaemia. August 2007- Regional FFI meeting on flour fortification in Malaysia: increased motivation and provided technical support

    11. Case Study of Malaysia August 2007 July 2008: MOH preparation Proposal for Mandatory Fortification of Wheat Flour with Iron And Folic Acid July 2008 presentation by Health of Proposal to meeting of flour millers organized by Industry (UNICEF & FFI) August 2008 endorsement of Proposal by Economic Planning Unit (UNICEF) Late 2008 economic analysis: benefit cost ratio of 54:1 November 2008 Meeting of stakeholders hosted by Economic Planning Unit December 2008 Endorsement of Cabinet of mandatory flour fortification.

    12. Summary of Key Lessons Learnt Basic information needed: extent and impact of MN deficiencies, flour consumption levels and patterns, structure of the milling industry/importers Need for comprehensive advocacy / justification package Address concerns of all sectors and present benefits to be gained Led by one government ministry (eg. health) but endorsement and support of others (eg. industry, finance, planning) Importance of a champion Value of a network and mechanism for bringing different players together and combining forces for common goal Value of common standards to facilitate trade and benefit millers Need for evaluation and demonstration of impact in Asian context to increase evidence base for flour fortification

    13. FFI East Asia Leaders Group

    14. FFI Executive Management Team As a network, it is essential that FFIs work be compatible with our partners goals as well. As a network, it is essential that FFIs work be compatible with our partners goals as well.

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