The Food Fortification Programme is a five-year investment by the UK Government and aims to support government at federal, provincial and district level and to support the wheat flour and edible oil/ghee industries through technical assistance. FFP will launch communications campaigns in districts to build consumer demand and generate evidence-based data through research studies to improve the implementation of food fortification in Pakistan. Given the major public health challenge of micronutrient malnutrition in Pakistan, the Food Fortification Programme (FFP) has been established. FFP will provide support to industry to adequately fortify wheat flour and edible oil/ghee in Pakistan, the Government to improve food fortification regulatory system, awareness raising and generating evidence to formulate relevant policies to combat micronutrient deficiencies in Pakistan.

FFP seeks to contribute to the improvement of the nutritional status of people in Pakistan, particularly women of childbearing age and young children.

Micronutrient malnutrition can be addressed by using low cost and proven interventions such as food fortification. Food fortification is the most cost-effective strategy, providing nutritional benefits without requiring people to change their eating habits or purchasing patterns. In Pakistan, food fortification is central to overcoming these deficiencies. National standards now require that wheat flour be fortified with iron, folic acid, Vitamin B12 and zinc, and edible oil/ghee fortified with Vitamins A and D. Adequate nutrients supplied through fortified wheat flour and edible oil/ghee should ideally form part of a balanced diet.

Pakistan is losing 2 -3 percent of its GDP annually due to a high burden of malnutrition which unfortunately has not changed over the last four decades. The National Nutrition Survey (NNS) 2011 revealed very high rates of micronutrient deficiencies – 51% of pregnant women are anaemic, 37% iron deficient, 46% deficient in vitamin A, and 69% in vitamin D. The problem repeats itself in children with 62% of under 5s suffering from anaemia and 54% from vitamin A deficiency. The lack of iron, vitamins A and D and other minerals limits ability to fight disease, making it a major contributor to high maternal new born and child death rates. Malnourishment also affects cognitive and physical development, ultimately leading to reduced learning abilities and lower productivity in adulthood. Pakistan’s rates of malnutrition are stagnating compared to reductions seen in neighbouring countries.

Main Activities Under FFP:

We are working with federal, provincial and district government institutions, specifically food departments, food authorities, health departments and education departments to make fortification universal, which includes changing laws and regulatory enforcement mechanisms to ensure fortification is carried out effectively.

FFP is providing technical assistance to the public sector to develop fortification standards, mandatory legislation, rules and regulations and compliance mechanisms for food fortification. These legitimate enforcement mechanisms are essential for fortification to become universal, thereby benefitting the people of Pakistan, specifically vulnerable and marginalized populations.

The participation of the wheat flour and edible oil/ghee milling industries is essential for the production of fortified food. FFP is working with all businesses involved in these industries in Pakistan.

• We are providing the micro feeder equipment needed for flour fortification to wheat flour mills. Mills will contribute to the installation and an upfront four-year warranty cost.
• We are training wheat flour and edible oil/ghee millers in fortification processes and internal quality assurance processes. We are setting up qualitative testing facilities for clusters of wheat flour mills within a six-mile radius.
• We are providing an initial premix subsidy to edible oil/ghee and wheat flour mills to help offset the increased costs of production. The subsidy will be gradually reduced and brought to zero in two years.

he three key advocacy objectives for the FFP are to:

• build political commitment for ensuring governance of food fortification (appropriate standards, legislation and oversight).
• Motivate industry to participate in the programme and
• increase awareness of the benefits of fortified food among consumers.

The advocacy strategy is thus structured around these three streams.

The purpose of targeted research studies will be to improve implementation strategies of the programme. This will also generate evidence for supporting policy change on food fortification. The key priority areas for research proposed under FFP project are: operations, market, political commitment, consumer behaviour and innovations to improve wheat flour and edible oil/ghee fortification programmes.

FFP is commissioning a District Rolling Study which will measure consumption patterns of fortified foods at district level and track changes as the programme rolls out. This is important for assessing who is benefitting from the programme. A second study will be commissioned to examine millers’ incentives for participating in fortification activities and will help the programme to fine-tune its policy on subsidies. More studies will be commissioned as the programme evolves.

FFP has established a Research & Technical Advisory Group (RTAG) to inform the selection of studies, provide technical and advisory services and review results.

The RTAG is made up of in-house and contracted experts, supported by independent internationally recognised academics in food fortification and nutrition. The RTAG provides independent and impartial advice on the research requirements to guide the overall implementation of FFP.