Regional Consultative and Capacity Building Workshop on Strengthening Food Fortification Programmes: Monitoring and Surveillance Systems

When

08 October 2018 - 10 October 2018

Where

Location: Johannesburg, South Africa

Objective

The theme of the 2020 conference is Health for All: Accelerate Efforts for Birth Defects Prevention and Care.

The conference recognizes the need to build capacity in lower-income countries for the prevention of birth defects and preterm birth and care of those affected. The goal of these biennial conferences is to provide specific practical tools and approaches that developing country participants can use to implement and strengthen surveillance and health care delivery and influence policy and funding in support.

Agenda

See the agenda and full meeting report.

See the workshop presentations, country reports, and meeting resource material.

Summary

Many countries in the Southern Afrrican Development Community (SADC) are implementing mandatory maize and / or wheat flour fortification or are considering the adoption of this intervention at a national level. Specifically, five countries in the SADC region have mandatory maize and / or wheat flour fortification programs (Malawi, Mozambique, South Africa, Tanzania, and Zimbabwe), six have voluntary maize and / or wheat flour fortification programs (Botswana, Democratic Republic of the Congo, Lesotho, Namibia, Eswatini, and Zambia), and five countries are interested in starting a national cereal grain fortification program but have not done (Angola, Comoros, Madagascar, Mauritius, and Seychelles).

The overall objective of the workshop was to provide guidance to Member States on regulatory monitoring and surveillance good practices and provide an opportunity to learn of each Member State's specific successes and challenges. The workshop focused specifically on cereal grain fortification.

The workshop revealed that in general, mandatory countries need support in the following areas:

Inspector training on new fortification-specific regulatory monitoring practices;
Recommendations for enhanced premix procurement mechanisms to bring down the cost for industry (e.g. pooled or joint premix orders);
Adequate testing laboratories (national and / or regional);
Guidance on which qualitative tests to use as best practice in place of frequent quantitative testing (these should be published as recommended tests);
Effective industry incentives (i.e. tax breaks, etc.);
Exploring alternative intervention options for reaching those that do not consume industrially produced grain products including viable solutions for small-scale fortification;
Generating data on coverage, reach, and impact of fortified foods.

Overall, mandatory countries need to generate monitoring data to understand whether domestic industries and importers comply with national standards. The need due to either a lack of trained inspectors, a lack of capacity to test fortified foods (both qualitatively and quantitatively), and / or a lack of a strong regulatory monitoring framework that outlines how to conduct monitoring and to what institutions the monitoring results should go.

In general, voluntary countries are willing to legislate mandatory fortification with support in the following areas:

High-level ministerial advocacy for a mandatory program;
Consumer-level advocacy to increase demand for fortified foods;
Technical support for standards development and adoption;
Industry engagement, buy-in, and QA/QC trainings;
Regulatory monitoring inspector trainings;
Integration of fortification into food safety parameters and existing surveillance systems;
Generating data on coverage of current and potential food vehicles for fortification.

Voluntary countries could potentially benefit the most from SADC Secretariat support that encourages a regional fortification agenda and mandatory legislation and provides guidance on next steps after legislation is drafted.

Countries that have not yet started fortification generally need support in the following areas:

First and foremost, understanding country-specific needs and collecting data on coverage, consumption, and appropriate potential food vehicles for fortification;
High-level ministerial advocacy for a mandatory program;
Standards creation;
Development of a robust monitoring framework for fortification, which includes ensuring that fortification is integrated into a food safety monitoring framework; and
Industry support and buy-in.

See more photos.

Participants

The workshop drew 60 participants, including 43 delegates from 12 countries and 18 people representing 10 partner organizations.

See the participant list.