Legal framework for food fortification: examples from Vietnam and Indonesia.
BACKGROUND
Food fortification is a cost-effective, powerful, and sustainable strategy to combat micronutrient deficiency, with the potential to reach large sections of the population with minimal cost and effort. However, the implementation of food fortification on a systematic and large scale, for instance in national programs, has often been challenging.


OBJECTIVE
This paper takes a closer look at food fortification efforts and legislation mechanisms in Vietnam and Indonesia in order to determine specific factors and components in the legal framework that are crucial to the success of fortification programs.


METHODS
Fortification efforts in Indonesia and Vietnam are evaluated using published data as well as unpublished data from detailed evaluation reports, and compared with respect to the specific circumstances, constraints, objectives and results in each country.


RESULTS
The legal framework is a crucial factor for the success of food fortification programs, as it shapes to a large extent the implementation of food fortification. The legal framework is instrumental to ensure the quality, safety, availability, cost-effectiveness, and sustainability of food fortification. In the first place, the legal framework should specify the fortificants and fortification levels, as well as the food vehicles and the fortification procedures. In addition, it should ensure the commitment of policy makers and producers to fortification, regulate the costing, describe and ensure information and communication such as product labeling integrate social marketing into the implementation, and provide the means to monitor and enforce fortification. A clear public health objective, together with careful consideration of the choices and restrictions dictated by the specific national environments, will help to develop legal frameworks that optimize the potential success of food fortification strategies.


CONCLUSIONS
The lessons from these experiences show that a mandatory approach to fortification, with costing, monitoring and enforcement, and social marketing clearly defined and well embedded in the legal framework and in the implementation structures, is the best foundation for an effective, sustainable, and feasible food fortification program.
Department of International Health, Copenhagen University, Denmark. madijkhuizen@gmail.com
Marjoleine Amma
MA
Dijkhuizen
Frank Tammo
FT
Wieringa
Damayanti
D
Soekarjo
Khan Tran
KT
Van
Arnaud
A
Laillou
D003362:Cost-Benefit Analysis; D019649:Food Industry / Q000331:legislation & jurisprudence*; D063427:Food Quality; D005527:Food, Fortified / Q000191:economics; D006801:Humans; D007214:Indonesia; D007881:Legislation, Food; D018977:Micronutrients / Q000172:deficiency; D015397:Program Evaluation; D014744:Vietnam
D018977:Micronutrients