Progress of Fortification in Indonesia

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1). Salt Fortification

A regulation requiring iodization to people salt has actually been issued during the Dutch occupation in 1927. Salt in Indonesia was produced only by PN GARAM. This means that Indonesia has already considered to conduct fortification since era of Dutch occupation when the technology was newly founded in the western. Since 1945 in which salt is no longer the monopoly of PN GARAM, the regulation for salt iodization is no longer executed.

The idea to fortify especially for salt and wheat flour has become a discourse since early 1970’s, at seminars on food and nutrition. With UNICEF advocacy, attention is directed primarily to tackle iodine deficiency through salt fortification with iodine, known as salt iodization. Through coordination with BAPPENAS and Ministry of Health, the idea of salt iodization was brought up nationally, involving discussions with Ministry of Industry and Trade and Ministry of Home Affairs.

The dialogues among stakeholders have produced a Joint Decree in 1982 among three Ministries – Health, Industry and Trade, and Home Affairs, on the commencement of iodization of people salt. This Joint Decree is expanded in 1985 into a joint decree among 4-Ministers by including Ministry of Agriculture. Finally it became Presidential Decree 69 of 1994 which regulate salt iodization as mandatory. Since then salt iodization is mandatory by law in Indonesia. Issuance of inter-ministerial decree, plus lobby of nutrition experts and UNICEF on the importance of salt iodization, has gained attention of policy makers and development planners in BAPPENAS. In 1989, fortification program policy is included in the third Five-Year Plan and beyond. Salt iodization become the first national fortification program in the Five-Year Plan.

In 2003 the implementation of mandatory salt iodization was evaluated. There was a significant progress. There is an increase from only 30% of households using iodized salt in 1980, to 64% in 2003. The latest data in 2006 has shown further increase to 78%, although 30% of districts  has iodized salt consumption below 50%. One of the outstanding problems is false iodized salt. The label has mentioned iodine content but no iodine being added.

2). Flour Fortification

The fortification policy at the Third Five-Years Plan is further reinforced by Food Law 1996. Article 27 of Chapter III of the Law, on Food Quality and Nutrition, is as follow as: ” in the occurrence of deficiency and/or reduction of community nutrition status, the government could define requirement for food improvement or enrichment”. The term “enrichment” at the Food Law means  fortification.  Food Law was initiated and developed by State Ministry for Food which was established in 1993.

In response to the release of the Food Law, Ministry of Health has issued a Ministerial Decree dated 16 June 1996 on Wheat Flour Fortification. Meanwhile, State Ministry of Food has established a cross sectoral team, called Fortification Commission. Technical discussion of implementation of wheat flour fortification begin in this commission with intensive support from UNICEF. A national level discussion was held at Widyakarya (workshop) for Food and Nutrition in 1998, organized by National Science Institute

Since then, various experiments on wheat flour fortification begins with funding support for premix procurement from UNICEF, U.S. AID and CIDA. Operation of the fortification started in 1998 in one of the flour mills in Jakarta. Finally, on January 14, 1999, program on wheat flour fortification with iron was officially declared by the government, represented by the State Minister for Food and witnessed by UNICEF representative for Indonesia. Two years later this fortification became mandatory after issuance of the Minister of Industry and Trade Decree 153 of 2001, concerning Indonesian National Standard for Wheat Flour. This standard enforce fortification of wheat flour with iron, zinc, folic acid, vitamin B1 and B2.

Despite the mandatory regulation, imported non-fortified wheat flour is still available in the distribution. Furthermore, the community including government officials, do not have sufficient understanding on the purpose and benefit of fortification. For example, wheat flour fortification policy was once suspected as hidden maneuver for trade monopoly of wheat flour in Indonesia. There are government officials who made misleading statements in the printed media and radio, mentioning that food fortification gives no benefit to community.

The skepticism which was originated from lack of knowledge about fortification, has reached its peak in February 2008. National Standard (SNI) on mandatory wheat flour fortification revoked by the government. Revocation has received a stern challenge from the press and  experts of nutrition and health, including UNICEF. In 2008/2009 the price of basic foodstuffs including wheat flour increased sharply. Fortification of wheat flour was accused as one of its causes. These misperceptions can be corrected following the explanation by the Indonesian Nutrition Foundation for Fortification (known as KFI), as an independent and non-governmental organization. The government is quite responsive in law enforcement. SNI mandatory fortification of wheat flour is in effect again in July 2008.

To reduce and then eliminate export non-fortified wheat flour from any country, an independent non-governmental organization is established at the global level. It is called Flour Fortification Initiative (FFI). The agency is based in the United States (at Emory University) with the vision and mission to reach universal fortification of wheat flour. It is expected that in the next few years all wheat flour in the world market are fortified with iron and other fortificant.

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