Pakistan has a history of fortifying staple foods to address micronutrient deficiencies. In the 1960s, oil/ghee was mandated to be fortified with vitamins A and D. In the 1980s, salt iodization became voluntary. A National Fortification Alliance was established in 2003 and 2005 saw the start of a wheat flour fortification program. Current efforts focus on fortifying wheat flour and oil/ghee through legislation, industry standards, and quality control. A 2017 survey found progress but also challenges in reaching small mills. Next steps include continued education campaigns to ensure fortified foods reach those most at risk of deficiencies.

1. Wheat and Cooking Oil / Ghee
Fortification in Pakistan
Amna Ejaz
International Food Policy Research Institute – Pakistan
Yangon, Myanmar | October 31, 2019

2. Pakistan’s History with Fortification
 1960s  National legislation mandating the fortification of oil/ghee with
vitamin A and D.
 1980s  Voluntarily salt iodization
 2003  National Plan of Action for the Control of Micronutrient
Deficiencies.
o 2003  National Fortification Alliance
 2005  National Wheat Flour Fortification Programme (NWFFP)
o 2007 - Voluntary wheat flour fortification with iron and folic acid.
o Discontinued in 2010

3.  2013  Re-notification of National Fortification Alliance (NFA) (after reconstitution
of federal Ministry of NHSR&C
o Provincial Fortification Alliances
o Members
o Objectives
42 42
27
67
58
0
10
20
30
40
50
60
70
80
Vitamin-A Zinc Iron Vitamin-D Calcium
Micronutrient Deficiencies in WRA
(percentage of women)
Source: National Nutrition Survey 2011

4. Objectives of NFA
 To support the relevant multi-sectoral policy framework and develop /
put into action the legislative instruments
 To acts as a coordination body for partner supported projects, guiding
their development and implementation and ensuring cohesion with
national priorities.
 To provide technical leadership for guiding research and identifying
sustainable solutions.
 To strengthen the quality control and regulatory monitoring system at all
levels

5. Current Developments

6. Current Developments in Fortification
 Food Fortification Program (2016-2021):
o Support the government at federal, provincial, and district levels to
establish the necessary legislative and regulatory frameworks.
o Fortify wheat flour produced at commercial mills with iron and folic acid,
as well as edible oil/ghee with vitamins A and D;
o Technical assistance to wheat flour and edible oil/ghee industries.
o Communications campaigns to build consumer demand.

7. Achievements
 Wheat flour and edible oil and ghee now compulsory (or close to becoming
so) in three of the four provinces
 Provincial fortification standards currently developed and notified in line
with national standards and the Pakistan Standards and Quality Control
Authority (PSQCA)
 Quality assurance and quality control (QAQC) manuals and training have
been delivered to all stakeholders to maintain the vital levels of added
micronutrient
 Brought down the cost of importing microfeeders  by persuading federal
government to waive the 3% custom duty, 1% additional duty and 17%
sales tax that it charges.

8. Fortification Information System
https://www.fortis.pk

9. Fortification Information System
https://www.fortis.pk

10. Successes and
Challenges Ahead

11. Challenge: Fortification Standards
Fortification Assessment Coverage Toolkit (FACT) Survey -
2017
Source: Global Alliance for Improved Nutrition and Oxford Policy Management (2018). Fortification Assessment
Coverage Toolkit (FACT) Survey in Pakistan, 2017. Global Alliance for Improved Nutrition: Geneva, Switzerland.

12. Challenge: Small / Medium Scale ‘Chakki’ Mills
Source: Global Alliance for Improved Nutrition and Oxford Policy Management (2018). Fortification Assessment
Coverage Toolkit (FACT) Survey in Pakistan, 2017. Global Alliance for Improved Nutrition: Geneva, Switzerland.

13. Iodized Salt Coverage
Source: National Nutrition Survey 2019.

14. Next Steps
 Media campaigns
 Information dissemination
 Behavioral Change Communication

15. Thank You!