Discussion of food fortification in the context of food aid programmes was based on the working paper 'Requirements for Effective Fortification in Food Aid Programmes' (CONFORT 6) which has been attached as Annex 6, for clarity. Fortification of food aid for displaced persons and refugees was endorsed at the ICN in the World Plan of Action for Nutrition, which included the following recommendation:
"...donor countries and involved organizations must ... ensure that the nutrient content of food used in emergency food aid meets the nutritional requirements if necessary through fortification, or ultimately supplementation..." (FAO/WHO, 1992).
The Consultation discussed two types of food aid programmes with relevance to food fortification. One is regular programmes which include products for maternal and child health, Food-for-Work programmes and concessional food programme sales to governments.
The second type of food aid programme are those designed for emergency relief of refugees, displaced populations or natural disasters. Because these emergency programmes aim to cover the complete nutritional requirements of the target population, food fortification must be designed to meet these needs and to prevent micronutrient deficiency diseases. More than 40% of today's food aid is oriented towards emergency programmes, and this figure is increasing. This demonstrates that a growing proportion of food aid recipients rely entirely on food aid programmes to meet their nutritional requirements. It is essential, therefore, that appropriate fortification of foods distributed through food aid programmes, be practised.
There are several challenges to achieving effective fortification in the context of food aid programmes which include: varying uses of a given fortified commodity, and; varying fortification and enrichment policies and practices by donor countries. These factors are discussed in Annex 6. Although some guidelines already exist for the enrichment of food commodities, there are no overall international guidelines for the enrichment and fortification of food aid commodities. The Consultation recommended the development of international guidelines to advise food aid donors on acceptable and safe fortification practices, as a means of overcoming some of the problems currently encountered. It was emphasised, however, that guidelines should not impede the ability of food donors to respond to emergency requests.
Increased monitoring is needed of micronutrient levels, bioavailability, stability and shelf-life of fortified food used in food aid programmes. Most countries in need of food aid do not have the capability to implement adequate food control procedures locally and therefore provisions must be made by producers and/or donors of the foods to ensure adequate levels of nutrients at the point of consumption, based on a realistic estimate of food intake. All required nutritional information must be provided through appropriate labelling of all fortified foods distributed through these programmes.
Countries receiving food aid should be made fully aware of existing mechanisms by which they can request fortified foods for their food aid programmes. If fortified foods are used in these programmes, the increased costs incurred mean that decreased quantities of food will be available. The stimulation, where possible, of local fortification of the unfortified food aid commodities may help overcome this problem.