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WHO & UNICEF call for full implementation of food decree

Released at: 17:02, 07/06/2018

WHO & UNICEF call for full implementation of food decree

Photo: Duc Thanh

WHO and UNICEF ask authorities to enforce prevailing decree on food fortification to address a number of health deficiencies.

by Nghi Do

The World Health Organization (WHO) and UNICEF on June 7 called on the government and State agencies to implement Decree No. 09/2016/ND-CP, which mandates the fortification of salt, wheat flour and vegetable oil and the use of fortified salt and wheat flour by the food industry.

The issuance of the decree was based on strong evidence that the country needs to step up efforts to address severe micronutrient deficiencies among the Vietnamese population. 

The decree is in line with global recommendations on this highly cost-effective strategy to prevent and control micronutrient deficiency and highlights the government’s commitment to improving the health of the population. 

WHO and UNICEF, however, noted that the decree has not yet been implemented more than two years after being adopted. This is despite the fact that food fortification, including the use of fortified food ingredients in processed foods, is already the global norm, with no detrimental impact upon the final food product or business profitability and sales. Food fortification contributes to a smart and healthy population, which benefits society and national development, including competitiveness.

Iodine deficiency is a significant cause of intellectual disabilities in children and stillbirth and miscarriage in women. Vietnam is among a group of 19 countries still battling iodine deficiency.

The Multiple Indicator Cluster Survey of 2011 indicated that only 45 per cent of households in Vietnam were consuming iodized salt, which is also far below the 90 per cent global recommendation on universal salt iodization. Nearly 30 per cent of children under 5 and 37 per cent of pregnant women are anemic. Zinc deficiencies are very high for children (69 per cent) and pregnant women (80 per cent). Iron deficiency increases the risk of maternal death and poor fetal development and impairs motoric and cognitive development in children and productivity among adults. Zinc deficiency increases the incidence of diarrhea, the risk of acute respiratory infection, and child mortality.

Fortification of widely consumed staple foods and condiments such as salt, vegetable oil and wheat flour is a globally recognized and highly cost-effective strategy for increasing nutrient intakes without the need to change eating behaviors or outlay substantial government funds. Every dollar spent on salt iodization and flour fortification would result in benefits of more than $10. 

WHO recommends that all food-grade salt used in households and food processing be fortified with iodine as a safe and effective strategy for the prevention and control of iodine deficiency disorders. There is internationally-proven evidence that the use of iodized salt has no negative impact on the final product’s color, taste and smell.

WHO also recommends the fortification of wheat flour when industrially-produced flour is regularly consumed by large population groups in a country. As a result, the fortification of salt, wheat flour, and vegetable oil is mandatory in 108, 85 and 29 countries, respectively, and 96 of the 108 countries that currently have mandatory legislation for edible salt iodization and all 85 countries that have mandatory wheat flour fortification include the requirement to use iodized salt in processed foods.

The Vietnamese Government has acted positively to promote public health for the prevention and control of micronutrient deficiencies over the past two years and there is a need to continue.

WHO and UNICEF strongly recommend the government fully implement Decree No. 09, including ensuring that processed foods are made with iodized salt and fortified wheat flour and that companies are supported to ensure compliance.

Food producers and distributors should be supported by clear guiding regulations on compliance requirements and the use of fortified ingredients. In Vietnam, the main source of dietary salt and wheat flour intake comes from processed food and meals consumed outside the home.

Thus, mandatory food fortification as regulated in Decree No. 09 is not detrimental to business and industry. Moreover, businesses can apply for exemptions in the rare cases when negative impacts on final products or sales are proven.

An important note is that the mandatory fortification of salt, wheat flour and vegetable oil are channels of operationalization of the recent Communist Party Resolution No. 20/NQ-TW to improve people’s health.

The enforcement of government regulations strengthens human capital in Vietnam and is in line with the UN Decade of Action on Nutrition. WHO and UNICEF stand as one behind the government in supporting the implementation of Decree No. 09 for the benefits of the entire country.

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