Sustainable Food Fortification in Central Asia and Mongolia JFPR 9052 Regional Grant Assistance Project

The governments of Kazakhstan, Kyrgyz Republic, Mongolia, Tajikistan, and Uzbekistan all aim to eliminate iodine deficiency and reduce IDA and folic acid deficiency. These deficiencies, which are more common in Central Asia than many other developing countries, have a major impact on the educability and productivity of large segments of the countries' populations, straining education and health systems, lowering productivity, and raising levels of sustained poverty.

Due to the direct and catalytic effects of JFPR 9005 Project (2001-2004), these countries have moved toward universal salt iodization (USI) and begun fortifying wheat flour. In three years the Project resulted in substantial increases in iodized salt production and the passage of supporting legislation. While only the Kyrgyz Republic had USI legislation at the beginning of JFPR 9005, Tajikistan enacted USI legislation in 2002, and Kazakhstan and Mongolia in 2003. Uzbekistan is drafting similar legislation. The iodization level has been adjusted to the world standard. Some salt industries have made a significant shift from free supply of potassium iodate to partial cost sharing for potassium iodate.

All countries also initiated production of fortified flour in a few provinces following successful project-supported actions that resulted in much-needed legislative and regulatory action. Pilot production introduced a world-standard fortification system enabled by competent flourmill engineers, which will help the countries access cheaper equipment in the long run. The equipment supplier has developed a much cheaper version of fortification equipment for the Central Asian market.

In contrast to the pilot nature of JFPR 9005, the JFPR 9052 Project will primarily build capacity of the public and private sectors to sustain food fortification. The Project will focus on sustaining salt and flour fortification, which JFPR 9005 has proven technically feasible. The Project will work with the private sector and government agencies nationwide rather than in a few pilot districts. The Project will help the private salt enterprises and flour mills access information, and tender and procure fortificants and equipment by themselves. The Project will also deal with the difficult issue of premix procurement by establishing links between global producers of premix and by encouraging production of premix within the region. The Project will also strengthen and upgrade the quality assurance system of public and private sectors to ensure that consumers receive fortified food that meets quality standards.

An enhanced and expanded social-marketing campaign, joining millers with civil-society groups and the media, will greatly increase demand for the new fortified wheat flour and its products, especially among poor families, who are at greatest risk from IDA. The Project will also help consumers monitor the quality of iodized salt. Universal salt iodization will ensure that the poor will have access to quality iodized salt. Fortified flour has been sold at the same prices as unfortified flour. To increase access of poor and rural households to fortified flour, the Project will review how it is distributed, and support testing cost-effectiveness of different means of fortification, including flour fortification at smaller mills and use of fortification packets at home.

The Project will build on the achievements of JFPR 9005, including impact monitoring, region-wide communication exchange of technical information, multi-country training, and sharing of lessons learned through project Web site participation. Using the system developed in the first project will increase cost-effectiveness and overall technical resources available to all the countries involved. International technical assistance will be continued but on a limited basis and focused on critical tasks related to major goals. Region-wide technical assistance for project impact monitoring and Web site development and maintenance will be supported through the Kazakh Academy of Nutrition. Finally, project management strategies for the new Project will also draw on well-developed and trained groups in place. This will exploit the considerable investment already made during JFPR 9005 in training country and regional teams in procurement, administration, finance, and reporting procedures and ensure that the Project is cost-efficient.

The Project emphasizes close cooperation among stakeholders in government organizations, private and government producers of salt and wheat flour, technical and research institutes, and a wide variety of consumer organizations and other NGOs in civil society. The broad participatory approach will be assured in the Project because it will build on the organizational achievements of the first project, which also emphasized broad participation. In the five countries, civil-society project support groups have been formed and demonstrated their competency in social mobilization and social marketing.