IDD and USI progress and problems Robizon Tsiklauri NCDC/Georgia 2015

What’s the progress in USI strategy: 1.Law / on “Prevention of Iodine and Other Microelements and Vitamins Disorders”/ Quality/increased/iodized adequately: 8,1% ; 90.6%-2005; 78,8%-2008; 99.9% List of importers /increased/6-2005; Salt amount/increased/ 7,000 tons -2000; 29,000 tons – Awareness /increased/almost the whole population is aware of IS health benefits 6.IS consumption level /increased/ only IS is consumed by Georgian population 7.IDD prevalence /decreased/goiter among children 55%-1998; 32.5%-2005,

What’s the problems (gap) in IDD&USI strategy: 1.Quality control/of iodized salt/not systematically 2.Monitoring and surveillance/ not effective IDD&IS surveillance system

3 levels (points) of IS quality control: - At the state border of country “+” (Ministry of finances) - At the central level (big cities) “+” /3 from 28 (10%) samples were below the quality line (<15 ppm)-2014/NFA. - At the HH level “-“ 3 levels of IS Monitoring: - IS import “+” - IS distribution/realization “- +” - IS consumption “-”

IDD monitoring & surveillance: - Clinical/epidemiological “-” - Biological (UE)/epidemiological “-” - Clinical/statistical “+” 2 main criteria to meet requirement: - Quality - Amount – “sufficient” /5 kg/year per capita = 15 g IS/day per capita

The on-going actions in the road map: / by the NCDC of Georgia has been prepared the drafts of Food & Nutrition national strategy, and Action Plan (for 5 Years), where one component is food product fortification for preventing and elimination of micronutrient deficiency (mainly Iron and Iodine) / by the NCDC of Georgia has been submitted the special project for grant (to CDC of USA), on: I.Studding of micronutrient deficiencies prevalence in Georgian Population (Children, pregnant)/(Iron, Iodine, Folic acid) to define exactly the premixes, needed for fortification of flour as a priority for Georgia. II.STRENGTHENING OF SURVEILLANCE OF MICRONUTRIENT DEFICIENCY IN GEORGIA / Implementing practical and effective surveillance system, which will be essential to control micronutrient deficiency successfully, using the sentinel surveillance approach. 3, 2015/ By the UNICEF initiative has been prepared the draft of Memorandum (UNICEF, NCDC Georgia, Ministry of Labour, Health and Social Affairs, Health Committee of Parliament of Georgia, and CDC USA) on understanding and collaboration of combating micronutrient deficiencies in Georgia

The next actions in the road map: 1.Enforcement of mandatory wheat flour fortification in Georgia through amending the Law on “Prevention of Disorders caused by Iodine, other Micronutrients and Vitamins Deficiency”. 2. Develop the local fortification strategy 3.Providing 6-24 months children in Georgia with the multiple micronutrient powders (WHO/UNICEF recommended composition) for in home fortification.

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