Message-ID: <96Mar26.161053est.53616@gateway.jsi.com> Date: Tue, 26 Mar 1996 13:40:31 -0500 From: Project Omni <mailto:omni_project@JSI.COM> Subject: FORTIFYING SUGAR WITH VITAMIN A: A PRACTICAL SOLUTION To: Multiple recipients of list DEVEL-L <mailto:DEVEL-L@AMERICAN.EDU>
c**************************************************************************** FORTIFYING SUGAR WITH VITAMIN A: A PRACTICAL SOLUTION BEING IMPLEMENTED BY USAID-FUNDED OPPORTUNITIES FOR MICRONUTRIENT INTERVENTIONS (OMNI) ****************************************************************************The theme of the XVII International Vitamin A Consultative Group (IVACG) Meeting is "Virtual Elimination of Vitamin A Deficiency: Obstacles and Solutions for the Year 2000." In keeping with the theme, this OMNI Electronic Update focuses on solutions for reducing vitamin A deficiency.
Fortification of sugar with vitamin A is one of the safest, most cost-effective interventions to prevent and control vitamin A deficiency (VAD). It's a practical solution because it doesn't require changing the food intake patterns of the target population or putting expensive distribution systems in place. Furthermore, the costs can be passed on to the consumer through small price increases, making the program sustainable.
Research on sugar fortification with vitamin A first began at the Institute of Nutrition of Central America and Panama (INCAP) in the 1960s. The technology was developed, with USAID support, over a ten-year period. In Central America- where vitamin A deficiency can be attributed to a diet low in food sources of vitamin A and a high prevalence of diarrheal diseases-fortifying sugar with vitamin A was adopted by several countries in the 1970s as their primary strategy for reducing vitamin A deficiency. But after being in effect a few years, the fortification program was not as effective as expected due to weak quality assurance systems in place. Nationwide studies from the late 1980s showed that vitamin A deficiency was still a widespread public health problem in most of the region, which led to the reappearance and strengthening of national programs for sugar fortification.
Success in Guatemala
In Guatemala?often regarded as a model for fortification programs to combat vitamin A deficiency?sugar fortification was initiated in the late 1970s, temporarily interrupted in the early 1980s, and revitalized in 1987-88. Guatemalan law requires that all sugar that is processed and marketed be fortified with vitamin A. The legislation specifies that fortified sugar must contain 15ug of vitamin A per gram of sugar. The law mandating sugar fortification also specifies the roles and responsibilities of the four public and private institutions involved in the program: the Guatemalan Sugar Producers' Association (ASAZGUA), the Ministry of Health's Department of Registry and Control of Foods (DRCA), the Ministry of Health's Unified Laboratory for Control of Food and Medicines, and the Guatemalan Commission for Norms (COGUANOR). INCAP provides technical support for the program in Guatemala and other Central American countries.
Impact studies of the program over a five year period indicate that there was a 50% reduction in vitamin A deficiency levels among preschool children. A Guatemalan study estimated the cost of sugar fortification at US $.98 per person per year for the population at risk and at $.29 per person per year for the entire population, making sugar fortification the most cost-effective strategy for reducing vitamin A deficiency.
OMNI in Bolivia Launches VitAzucar
USAID support over the years has helped to ensure that sugar fortification programs have improved in Central America and has encouraged development of programs in other Latin American countries, such as Bolivia and Nicaragua. Building on the Guatemala experience, Bolivia is now in the midst of a 12-month pilot project to test the production, distribution, and consumer acceptance of vitamin A-fortified sugar Oruro, one of Bolivia?s poorest departments. The ultimate objective of the trial (which began in September 1995) is to encourage all sugar processors to fortify their total national sugar production voluntarily. USAID, through OMNI, is providing the funds and technical assistance for the social marketing and quality control components of the trial. The other partners are the National Secretary of Health, which implements and oversees the monitoring and evaluation of the project; UNICEF, which provided technical and financial assistance for the production of fortified sugar, including the active ingredient and the machinery to mix it into the processed sugar; UNAGRO, the sugar producer manufacturing partner; and PAHO.
The new product, VitAzucar, was launched on September 18th by the First Lady of Bolivia, Ximena Iturralde de Sanchez de Lozada, and the Secretary of Health, Dr. Joaquin Monasterios, with a national press conference held in Oruro. The preliminary results of the first monitoring of this project indicate that most people living in the urban areas, but not those in rural areas whose access to radio and television is very limited, are aware of VitAzucar and of the potential benefits of vitamin A.
OMNI Developes Sugar Fortification Manual
In order to share the experiences of those involved in sugar fortification in Central America so that other countries can plan and implement this important intervention, OMNI supported the production of a Manual for Sugar Fortification with Vitamin A. The three volume manual, available in both English and Spanish, presents technical guidelines to systematize and facilitate the establishment and implementation of a vitamin A sugar fortification program.
The authors of the manual are Dr. Guillermo Arroyave, former head of the biochemistry lab at INCAP and pioneer of sugar fortification in Guatemala in the 1970s, and Dr. Omar Dary, the current head of the biochemistry lab at INCAP, who is actively involved in sugar fortification in Central America.
Further information on OMNI?s fortification activities or to receive a copy of the Sugar Fortification manual in English or Spanish can be obtained by contacting the OMNI project
***************************************************************************** OPPORTUNITIES FOR MICRONUTRIENT INTERVENTIONS (OMNI) is funded by the Office of Health and Nutrition of the U.S. Agency for International Development (USAID) in Washington, D.C. and managed by John Snow, Inc. OMNI's mission is accomplished by developing integrated, comprehensive programs and strategies to reduce and eliminate major micronutrient deficiencies throughout the developing world. Participating countries are based on their micronutrient malnutrition problems, commitment by local officials (public and private) to micronutrient activities, and their capacity to achieve and sustain a demonstrable impact.
****************************************************************************** OMNI is located at 1616 North Fort Myer Dr, Suite 1100, Arlington, Virginia 22209 USA Tel: 703 528-7474 Fax: 703 528-7480 E-mail: mailto:omni@jsi.com WWW: http://www.jsi.com/intl/omni/home
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