WHO and UNICEF call on Vietnamese authorities to enforce food fortification regulations
Ha Noi, 07 June 2018 - WHO and UNICEF call on the Government of Viet Nam and State agencies to implement the Government Decree 09/2016/ND-CP that mandates the fortification of salt, wheat flour and vegetable oil and the use of fortified salt and wheat flour by the food industry. The issuance of the decree was based on strong evidence that the country needs to step up actions to address severe micronutrient deficiencies among the Vietnamese population. The decree is in line with global recommendations on this highly cost-effective strategy to prevent and control micronutrient deficiency and it highlights the Government’s commitment to improve the health of its population.
However, WHO and UNICEF note that the decree has not been implemented after more than two years since its adoption. This is despite the fact that food fortification, including use of fortified food ingredients in processed foods, is already the global norm, with no detrimental impacts upon the final food product or business profitability and sales. Food fortification contributes to a smart and healthy population, which benefits society and national development, including competitiveness.
Iodine deficiency is a significant cause of intellectual disabilities in children, and stillbirth and miscarriage in women. Viet Nam is among the group of 19 countries remaining in the world with iodine deficiency. The Multiple Indicator Cluster Survey of 2011 indicated that only 45% of households in Viet Nam were consuming iodised salt, which is also far below the 90% global recommendation on universal salt iodisation. Nearly 30% of children under 5 and 37% of pregnant women are anemic. Zinc deficiencies are very high for children (69%) and pregnant women (80%). Iron deficiency increases the risk of maternal death and poor fetal development and impairs motoric and cognitive development in children and productivity for adults. Zinc deficiency increases the incidence of diarrhea, the risk of acute respiratory infection and child mortality.
Fortification of widely consumed staple foods and condiments, such as salt, vegetable and wheat flour, is a globally recognized and highly cost-effective strategy for increasing nutrient intakes without the requirement to change eating behaviors or substantial government budget(1). Every dollar spent on salt iodization and flour fortification would result in benefits of more than US$ 10.(2) WHO recommends that all food-grade salt, used in household and food processing, be fortified with iodine as a safe and effective strategy for the prevention and control of iodine deficiency disorders. There is internationally-proven evidence that the use of iodized salt has no negative impact on the final product’s colour, taste and smell(3). WHO also recommends the fortification of wheat flour when industrially produced flour is regularly consumed by large population groups in a country(4). As a result, fortification of salt, wheat flour and vegetable oil is mandatory in 108, 85 and 29 countries respectively, and 96 of the 108 countries that currently have mandatory legislation for edible salt iodization and 100% of the 85 countries that have mandatory wheat flour fortification include the requirement to use iodized salt in processed foods(5).
The Government of Viet Nam has acted positively to promote public health for the prevention and control of micronutrient deficiencies in past two years and there is need to continue. WHO and UNICEF strongly recommend the Government to fully implement Decree 09, including ensuring the processed foods are made with iodized salt and fortified wheat flour, and that companies are supported to ensure compliance. Food producers and distributors should be supported by clear guiding regulations on compliance requirements and the use of fortified ingredients. In Viet Nam, the main source of dietary salt and wheat flour intake comes from processed food and meals consumed outside the home. Thus, mandatory food fortification as regulated in the Decree 09 is not detrimental to business and industry. Moreover, businesses can apply for exemption in the rare cases when negative impacts on final products or sales are proven.
An important note is that mandatory fortification of salt, wheat flour and vegetable oil are channels of operationalization of recent Communist Party’s Resolution No. 20/NQ-TW to improve people’s health.
The enforcement of Government regulations strengthens human capital of Viet Nam and is in line with the UN Decade of Action on Nutrition. We stand as one behind the Government of Viet Nam in supporting the implementation of Decree 09 for the benefits of the entire nation.
(2) FFI, GAIN, MI, USAID, The World Bank, UNICEF. Investing in the future; A united call to action on vitamin and mineral deficiencies. Global Report 2009.
(5) Global Fortification Data Exchange (Accessed 31 May 2018)