Dijkhuizen Marjoleine Amma, Wieringa Frank Tammo, Soekarjo Damayanti, Van Khan Tran, Laillou Arnaud
Department of International Health, Copenhagen University, Denmark.
Food Nutr Bull. 2013 Jun;34(2 Suppl):S112-23. doi: 10.1177/15648265130342S113.
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.
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.
Fortification efforts in Indonesia and Vietnam are evaluated using published data as well as unpublished data from detailed evaluation reports, and compared with respect to the specific circumstances, constraints, objectives and results in each country.
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.
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.
食品强化是一种经济高效、强有力且可持续的应对微量营养素缺乏的策略，有潜力以最小的成本和努力惠及大部分人口。然而，在全国性项目等层面系统且大规模地实施食品强化往往具有挑战性。
本文深入研究越南和印度尼西亚的食品强化举措及立法机制，以确定法律框架中对强化项目成功至关重要的具体因素和组成部分。
利用已发表的数据以及详细评估报告中的未发表数据对印度尼西亚和越南的强化工作进行评估，并就每个国家的具体情况、制约因素、目标和成果进行比较。
法律框架是食品强化项目成功的关键因素，因为它在很大程度上塑造了食品强化的实施情况。法律框架有助于确保食品强化的质量、安全、可及性、成本效益和可持续性。首先，法律框架应明确规定强化剂和强化水平，以及载体食品和强化程序。此外，它应确保政策制定者和生产者对强化的承诺，规范成本核算，描述并确保信息传播，如产品标签，将社会营销纳入实施过程，并提供监测和执行强化的手段。明确的公共卫生目标，以及对特定国家环境所决定的选择和限制的审慎考虑，将有助于制定能优化食品强化策略潜在成功的法律框架。
这些经验教训表明，采用强制性的强化方法，明确界定成本核算、监测和执行以及社会营销，并将其很好地融入法律框架和实施结构中，是有效、可持续且可行的食品强化项目的最佳基础。
