The country of Malawi achieved a major milestone by passing the technical standards for mandatory fortification of refined sugar, raw sugar, edible oils, wheat flour, and maize. The fast-tracking of this process (which normally takes a year or more) is a notable achievement that demonstrates Government’s commitment to develop a truly comprehensive national fortification program. The consumption data from the 2009 National Micronutrient Survey and modeling of the impact of different fortification levels completed by Project Healthy Children served as the foundation for this work.
The technical committees that carried out the review comprised a wide variety of stakeholders from government, industry, academia, and civil society. PHC was privileged to participate on behalf of the Office of President and Cabinet Department of Nutrition and HIV/AIDS, and present the public health argument for fortification to each group. Approval at this technical level represents the first of four major steps in adopting mandatory fortification standards. The remaining steps (a public comment period, government policy review, and official adoption by the Malawi Standards Board) are scheduled for completion in January 2011.
Due to the importance of sufficient Vitamin A, the current high level of deficiency (40% of children under five years of age), and its compatibility with different foods, Vitamin A has been included in the standards for several foods. Because Vitamin A can be harmful if consumed in large amounts, it was critical to look at standards for all the foods at once. Projected intake based on consumption data from the 2009 National Micronutrient Survey showed that under the revised standards, even those consuming extremely high amounts of fortified foods (an unlikely scenario) would not be in danger.
Given the alarmingly high rates of micronutrient deficiency it is critical that all efforts to address the problem are strengthened. Supplementation, fortification, dietary diversification, and the development and adoption of micronutrient-rich crop varieties are complementary approaches that need to be implemented in parallel. As part of that effort, PHC is proud to be working with the Department of Nutrition and HIV/AIDS and other partners to scale up a national fortification program as soon as possible.
If you have questions, please feel free to contact us at info@projecthealthychildren.org.