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Tariq Sarwar Awan
Pakistan Flour Mills Association (PFMA)
2
WHEAT FLOUR FORTIFICATION
STATUS IN PAKISTAN &
ENTERPRENEURIAL
APPROACHES
Major Allies
Pakistan Flour Mills Association
Global Alliance for Improved Nutrition
NIFSAT UAF
International Scenario-Fortification
• 600 million MT of Wheat and Maize is milled
annually by Commercial Roller Mills and
consumed as Noodles, Breads, Pasta and Other
Flour Products.
• It is estimated that proportion of industrial scale
wheat flour being fortified is
• America 97%
• Africa 31%
• East Meditranian 44%
• South East Asia 21%
• Europe 6%
• West Pacific Regions 4%
Pneumonia
15%
Injuries, 3%
Other, 19%
Neonatal 42%
HIV/AIDS 1%
Diarrhoea
19%
Measles 1%
Malaria
1%
45%
attributable to
undernutrition
Source: Lancet Series on Maternal and Child Undernutrition, 2013
Globally 45% of under-five deaths are
attributable to under nutrition
Wheat Flour Average Consumption Ranges
• < 75 g/day
• 75-150 g/day
• 150-300 g/day
• > 300 g/day
Findings of NNS 2011
According to National Nutritional Survey 2011, Pakistan
Very little progress has been made in terms of micronutrient
deficiencies among women and children, with exception in
Iodized salt usage & huge reductions in moderate & severe
iodine deficiency rates
Maternal Anaemia:
-Pregnant = 52% & -Non Pregnant =
51%
IDA – Low serum ferritin
-Pregnant = 38.2% & -Non
Pregnant = 26.8%
Children
Childhood Anaemia = 62%
-Moderate (7-10.99) = 57% &
Severe (< 7) = 5%
IDA- Low serum Ferritin =
43.8%
7
Cont…….
• One in five pregnant and lactating women and
one in three children under the age of 5 were
anemic due to iron deficiency
• Night blindness affected 16% of pregnant
women, and more than 50% of children were
vitamin A deficient.
• About 40% of women and children were
deficient in zinc
• 70% of pregnant women and 40% of children
were deficient in vitamin D.
Cont…….
• persistent high rates of stunting (44%) and
wasting (15%) among children under 5
• Food fortification is safe and cost-effective in
the prevention of micronutrient deficiencies
and has been widely practiced in developed
countries for well over a century
MILLS CHAKKIS
Registered Mills with
Pakistan Flour Mills
Association
1,575 Maximum Chakkis are in
Central Punjab
Punjab 925 5,193
Sindh 325 2,467
KPK 265 1,005
Balochistan 60 260
Structure of Flour Industry
10
Potential Actions required for Fortification
• Various potential actions for improving the
regulatory environment for food fortification
are necessary
• continued advocacy for legislation standards
• expanding and improving inspection and food
sample collection capacity
• expanding and improving laboratory analytical
capacity
• investigating the barriers to effective
prosecution for non-compliance
Fortification in Pakistan
• In Pakistan, fortification of edible oil was mandated by
legislation at the federal level in 1965 and has been
retained in the provincial food laws in all four provinces
• No provincial legislation is in place for wheat flour
fortification
• Currently only Sindh legislates the compulsory
iodization of salt
• Khyber Pakhtunkhwa and Balochistan both mandate
salt iodization province-wide through amendments to
the regulations that attend the provincial food laws
• the majority of districts in Punjab have implemented
by-law amendments to the same effect.
The role of the private sector
In the context of the privately owned wheat flour and edible
oil/ghee industries in Pakistan, the barriers to
implementing fortification cluster in two main areas at the
level of the manufacturing unit are:
• Procurement of additional production inputs, including:
• Fortificant premixes
• Capital equipment
• Establishing sufficient internal quality control, including:
• Equipment calibration and appropriate premix storage and
dispensing
• Internal analytical capacity for sample testing
• Independent external laboratory analyses
Potential agricultural solutions
• Biofortification through plant breeding
techniques
• biofortified high-zinc wheat
• With about 80% of the cultivated area in
Pakistan deficient in zinc, the use of zinc-
fortified fertilizer is another agricultural
strategy for increasing the micronutrient
content of staple crops
4 important steps
• wheat flour fortification with iron & folic acid
• edible oil/ghee fortification with vitamin A & D
• Biofortification to address iron and zinc
content of wheat
• zinc-fortified fertilizers
The regulatory environment for food
fortification in Pakistan
• Legislation
• Pure Food Laws and national standards
• In each province, current food quality and safety
law is derived from the West Pakistan Pure Food
Ordinance of 1960, its amendment Act in 1963,
and the associated Rules promulgated in 1965.
• In Punjab, the Pure Food Ordinance of 1965 was
fully repealed and replaced by the Punjab Food
Authority Act in 2011, along with new Punjab
Pure Food Rules.
Current status of legislation on the
fortification of wheat flour
• There is currently no provincial legislation in
place for the mandatory fortification of wheat
flour. A national standard specification has been
developed, distinguishing fortified flour from
regular flour by the addition of one or more of
vitamins or minerals: calcium carbonate, iron,
thiamine, riboflavin and niacin. Folic acid is not
listed. A permissible range for the addition of
calcium carbonate is given, but no further
specification on fortification levels is included.
Current status of legislation on the
fortification of edible oil/ghee
• The fortification of edible oils and ghee with
vitamin A was mandated under the West
Pakistan Pure Food Rules of 1965 and this
provision has been retained in the Pure Food
Rules in all provinces. The current Pakistan
Standard Specification requires the addition of
33,000 international units of vitamin A per
kilogram of finished product, and this national
standard is reflected across the provincial Pure
Food Rules.
Current status of legislation on salt
iodization
Monitoring & enforcement framework
• Role of the Provincial Health Department
• Role of the Provincial Food Department
• PSQCA
Other institutions supporting monitoring and
enforcement
• PCSIR
• NIH
• National Institute of Food Science and
Technology, University of Agriculture , Faisalabad
• Nutrition Research Laboratory, Aga Khan
University
Existing constraints on effective regulation
• Lack of legislation for mandatory wheat flour
fortification
• Limited quantity and technical capacity of food
inspectors
• Limited quantity and analytical capacity of public
sector and other accredited laboratories for
testing food samples, with respect to
micronutrient characteristics of wheat flour and
edible oil/ghee
• Coordinating capacity for monitoring and
enforcement activities
National Wheat Flour Fortification Programme
• The National Wheat Flour Fortification
Programme (NWFFP) was launched in 2005, with
funding support from GAIN, technical support
from MI, and substantial industry commitment
from the Pakistan Flour Mills Association (PFMA).
• in 2010, about 125 flour mills had started
fortifying flour, mostly with mill-purchased
microfeeders and GAIN-subsidized premix
• Programme operations were suspended with the
dissolution of the federal Ministry of Health, the
legal entity to which GAIN provided support
Revival
• In collaboration with the Government of
Punjab and PFMA, GAIN-supported wheat
flour fortification activities resumed in
October 2013 in Collaboration with PFMA ,
with a renewed focus on legislation as well as
on capacity development in quality assurance
and mill-level quality control.
• Now NIFSAT is integral part of this National
Fortification Programme to play a major role.
Cont……
• Domestic wheat production in Pakistan was
estimated at 23.5 million metric tonnes (MT)
with 75% of all wheat produced in Punjab
province
• Domestic food consumption of wheat was
estimated at 21.8 million MT with a per capita
consumption of about 121 kg/year or
332g/day.
Pakistan Flour Mills Association
Cont…..
• The wheat flour milling industry in Pakistan is
privately owned.
• 1575 wheat flour mills are registered with the
Pakistan Flour Mills Association (PFMA), the main
industry representative body
• with a collective installed capacity of 300,000 MT
per day.
• Many mills operate at only a fraction of their
installed capacity, with many smaller ones
processing only their wheat quota, which is
sufficient for three hours of milling.
Further opportunities for promoting
food fortification in the private sector
• Wheat flour fortification at the village level
• Fortification of complementary food for
infants and young children
• Fortification of dairy foods
Agricultural interventions for food
fortification in Pakistan
• Biofortification
• NR-421 (Candidate Wheat Variety) Contains zinc > 37
microgram per gram, iron > 70 microgram per gram, and
high in protein content
• NR-419 (Candidate Wheat Variety) Contains > 37
microgram zinc per gram and >70 microgram iron per gram
• NR-439 (Potential Wheat Line)
• Contains > 37 microgram zinc per gram and sufficient
quantity of iron
•
•
Development of Biofortified seeds
Further needed ?
• Marketing development of fortified seeds and
products
• Seed financing
• Micronutrient fertilizers
• Crop diversification
Evidence of effect and prospects for
implementation and scale-up in Pakistan
• Wheat flour fortification with iron and folic
acid
• Fortification of edible oil/ghee with vitamin A
• Biofortification of wheat with zinc
• Fortification of fertilizer with zinc
Fortification status
 There are no specified rules at national and
provincial levels for wheat flour fortification
 Almost all stakeholders including
• Government
• Monitoring and Control Authorities in Health
• Food departments
• Flour millers agree on mandatory fortification
Fortification status in Pakistan
32
cont…..
Provincial Food Departments states that wheat
flour fortification should be done at the cost of
the consumer instead of being subsidized by
the Government
33
Projected benefits and costs
Benefit
Funds required
Dosage recommended
• Iron NaFeEDTA 20 PPM
• Folic Acid 1.3 PPM
• Vit B12 0.01 PPM
• Vit A 1.5
• Zinc Low Extraction 40 PPM
• ZINC High Extraction 80 PPM
Recommendations
• Potential actions to improve the regulatory
environment for food fortification in Pakistan
• Legislation and standards
• Monitoring and enforcement
Inspection and sample collection
Analytical capacity
Regulation of internal quality control capacity
Prosecution and penalties
39

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WHEAT FLOUR FORTIFICATION STATUS IN PAKISTAN AND ENTREPRENEURIAL APPROACHES

  • 1. 1
  • 2. Tariq Sarwar Awan Pakistan Flour Mills Association (PFMA) 2
  • 3. WHEAT FLOUR FORTIFICATION STATUS IN PAKISTAN & ENTERPRENEURIAL APPROACHES Major Allies Pakistan Flour Mills Association Global Alliance for Improved Nutrition NIFSAT UAF
  • 4. International Scenario-Fortification • 600 million MT of Wheat and Maize is milled annually by Commercial Roller Mills and consumed as Noodles, Breads, Pasta and Other Flour Products. • It is estimated that proportion of industrial scale wheat flour being fortified is • America 97% • Africa 31% • East Meditranian 44% • South East Asia 21% • Europe 6% • West Pacific Regions 4%
  • 5. Pneumonia 15% Injuries, 3% Other, 19% Neonatal 42% HIV/AIDS 1% Diarrhoea 19% Measles 1% Malaria 1% 45% attributable to undernutrition Source: Lancet Series on Maternal and Child Undernutrition, 2013 Globally 45% of under-five deaths are attributable to under nutrition
  • 6. Wheat Flour Average Consumption Ranges • < 75 g/day • 75-150 g/day • 150-300 g/day • > 300 g/day
  • 7. Findings of NNS 2011 According to National Nutritional Survey 2011, Pakistan Very little progress has been made in terms of micronutrient deficiencies among women and children, with exception in Iodized salt usage & huge reductions in moderate & severe iodine deficiency rates Maternal Anaemia: -Pregnant = 52% & -Non Pregnant = 51% IDA – Low serum ferritin -Pregnant = 38.2% & -Non Pregnant = 26.8% Children Childhood Anaemia = 62% -Moderate (7-10.99) = 57% & Severe (< 7) = 5% IDA- Low serum Ferritin = 43.8% 7
  • 8. Cont……. • One in five pregnant and lactating women and one in three children under the age of 5 were anemic due to iron deficiency • Night blindness affected 16% of pregnant women, and more than 50% of children were vitamin A deficient. • About 40% of women and children were deficient in zinc • 70% of pregnant women and 40% of children were deficient in vitamin D.
  • 9. Cont……. • persistent high rates of stunting (44%) and wasting (15%) among children under 5 • Food fortification is safe and cost-effective in the prevention of micronutrient deficiencies and has been widely practiced in developed countries for well over a century
  • 10. MILLS CHAKKIS Registered Mills with Pakistan Flour Mills Association 1,575 Maximum Chakkis are in Central Punjab Punjab 925 5,193 Sindh 325 2,467 KPK 265 1,005 Balochistan 60 260 Structure of Flour Industry 10
  • 11. Potential Actions required for Fortification • Various potential actions for improving the regulatory environment for food fortification are necessary • continued advocacy for legislation standards • expanding and improving inspection and food sample collection capacity • expanding and improving laboratory analytical capacity • investigating the barriers to effective prosecution for non-compliance
  • 12. Fortification in Pakistan • In Pakistan, fortification of edible oil was mandated by legislation at the federal level in 1965 and has been retained in the provincial food laws in all four provinces • No provincial legislation is in place for wheat flour fortification • Currently only Sindh legislates the compulsory iodization of salt • Khyber Pakhtunkhwa and Balochistan both mandate salt iodization province-wide through amendments to the regulations that attend the provincial food laws • the majority of districts in Punjab have implemented by-law amendments to the same effect.
  • 13. The role of the private sector In the context of the privately owned wheat flour and edible oil/ghee industries in Pakistan, the barriers to implementing fortification cluster in two main areas at the level of the manufacturing unit are: • Procurement of additional production inputs, including: • Fortificant premixes • Capital equipment • Establishing sufficient internal quality control, including: • Equipment calibration and appropriate premix storage and dispensing • Internal analytical capacity for sample testing • Independent external laboratory analyses
  • 14. Potential agricultural solutions • Biofortification through plant breeding techniques • biofortified high-zinc wheat • With about 80% of the cultivated area in Pakistan deficient in zinc, the use of zinc- fortified fertilizer is another agricultural strategy for increasing the micronutrient content of staple crops
  • 15. 4 important steps • wheat flour fortification with iron & folic acid • edible oil/ghee fortification with vitamin A & D • Biofortification to address iron and zinc content of wheat • zinc-fortified fertilizers
  • 16. The regulatory environment for food fortification in Pakistan • Legislation • Pure Food Laws and national standards • In each province, current food quality and safety law is derived from the West Pakistan Pure Food Ordinance of 1960, its amendment Act in 1963, and the associated Rules promulgated in 1965. • In Punjab, the Pure Food Ordinance of 1965 was fully repealed and replaced by the Punjab Food Authority Act in 2011, along with new Punjab Pure Food Rules.
  • 17. Current status of legislation on the fortification of wheat flour • There is currently no provincial legislation in place for the mandatory fortification of wheat flour. A national standard specification has been developed, distinguishing fortified flour from regular flour by the addition of one or more of vitamins or minerals: calcium carbonate, iron, thiamine, riboflavin and niacin. Folic acid is not listed. A permissible range for the addition of calcium carbonate is given, but no further specification on fortification levels is included.
  • 18. Current status of legislation on the fortification of edible oil/ghee • The fortification of edible oils and ghee with vitamin A was mandated under the West Pakistan Pure Food Rules of 1965 and this provision has been retained in the Pure Food Rules in all provinces. The current Pakistan Standard Specification requires the addition of 33,000 international units of vitamin A per kilogram of finished product, and this national standard is reflected across the provincial Pure Food Rules.
  • 19. Current status of legislation on salt iodization
  • 20. Monitoring & enforcement framework • Role of the Provincial Health Department • Role of the Provincial Food Department • PSQCA Other institutions supporting monitoring and enforcement • PCSIR • NIH • National Institute of Food Science and Technology, University of Agriculture , Faisalabad • Nutrition Research Laboratory, Aga Khan University
  • 21. Existing constraints on effective regulation • Lack of legislation for mandatory wheat flour fortification • Limited quantity and technical capacity of food inspectors • Limited quantity and analytical capacity of public sector and other accredited laboratories for testing food samples, with respect to micronutrient characteristics of wheat flour and edible oil/ghee • Coordinating capacity for monitoring and enforcement activities
  • 22. National Wheat Flour Fortification Programme • The National Wheat Flour Fortification Programme (NWFFP) was launched in 2005, with funding support from GAIN, technical support from MI, and substantial industry commitment from the Pakistan Flour Mills Association (PFMA). • in 2010, about 125 flour mills had started fortifying flour, mostly with mill-purchased microfeeders and GAIN-subsidized premix • Programme operations were suspended with the dissolution of the federal Ministry of Health, the legal entity to which GAIN provided support
  • 23. Revival • In collaboration with the Government of Punjab and PFMA, GAIN-supported wheat flour fortification activities resumed in October 2013 in Collaboration with PFMA , with a renewed focus on legislation as well as on capacity development in quality assurance and mill-level quality control. • Now NIFSAT is integral part of this National Fortification Programme to play a major role.
  • 24. Cont…… • Domestic wheat production in Pakistan was estimated at 23.5 million metric tonnes (MT) with 75% of all wheat produced in Punjab province • Domestic food consumption of wheat was estimated at 21.8 million MT with a per capita consumption of about 121 kg/year or 332g/day.
  • 25. Pakistan Flour Mills Association
  • 26. Cont….. • The wheat flour milling industry in Pakistan is privately owned. • 1575 wheat flour mills are registered with the Pakistan Flour Mills Association (PFMA), the main industry representative body • with a collective installed capacity of 300,000 MT per day. • Many mills operate at only a fraction of their installed capacity, with many smaller ones processing only their wheat quota, which is sufficient for three hours of milling.
  • 27. Further opportunities for promoting food fortification in the private sector • Wheat flour fortification at the village level • Fortification of complementary food for infants and young children • Fortification of dairy foods
  • 28. Agricultural interventions for food fortification in Pakistan • Biofortification • NR-421 (Candidate Wheat Variety) Contains zinc > 37 microgram per gram, iron > 70 microgram per gram, and high in protein content • NR-419 (Candidate Wheat Variety) Contains > 37 microgram zinc per gram and >70 microgram iron per gram • NR-439 (Potential Wheat Line) • Contains > 37 microgram zinc per gram and sufficient quantity of iron • •
  • 30. Further needed ? • Marketing development of fortified seeds and products • Seed financing • Micronutrient fertilizers • Crop diversification
  • 31. Evidence of effect and prospects for implementation and scale-up in Pakistan • Wheat flour fortification with iron and folic acid • Fortification of edible oil/ghee with vitamin A • Biofortification of wheat with zinc • Fortification of fertilizer with zinc
  • 32. Fortification status  There are no specified rules at national and provincial levels for wheat flour fortification  Almost all stakeholders including • Government • Monitoring and Control Authorities in Health • Food departments • Flour millers agree on mandatory fortification Fortification status in Pakistan 32
  • 33. cont….. Provincial Food Departments states that wheat flour fortification should be done at the cost of the consumer instead of being subsidized by the Government 33
  • 37. Dosage recommended • Iron NaFeEDTA 20 PPM • Folic Acid 1.3 PPM • Vit B12 0.01 PPM • Vit A 1.5 • Zinc Low Extraction 40 PPM • ZINC High Extraction 80 PPM
  • 38. Recommendations • Potential actions to improve the regulatory environment for food fortification in Pakistan • Legislation and standards • Monitoring and enforcement Inspection and sample collection Analytical capacity Regulation of internal quality control capacity Prosecution and penalties
  • 39. 39