Senior Advisor , Institute of Nutrition , Mahidol U.
Chairman of the Planning Committee on Strategic Frame work for Food Management (SFFM) in Thailand of the National Food Committee
Presentation at the WFD, Bangkok, 26 November 2013
Prof. Kraisid Tontisirin M.D., Ph.D
• Has succeeded in reduced maternal and child malnutrition since the eighty by mutistakeholder efforts under the Poverty Alleviation Plan (PAP)
• Currently Thailand is facing with double burden of malnutrition (DBM), a coexistence of under and over
nutrition, and related non-communicable diseases
(NCDs) 2
Kraisid Tontisirin, Mahidol University
• Promotion• Protection• Treatment
Food Nutrition Health• Agriculture/• Food supply/• Service
Nutrition is a link between food and health, regarding the fulfillment of nutrient and non-nutrient
requirements from food in human life cycle.
Nutrition well-being for all
Ultimate Goals
Kraisid Tontisirin, Mahidol University
Poverty Alleviation Plan (PAP)• From 1982 onward• Malnutrition was considered as symptom of poverty• With organization changes for management of rural development• With 5 basic principles: poor area, basic services, appropriate technology, self-help and community participation
PAP
Fd/Nut.Prog. PHC BMN indicatorsKraisid Tontisirin, Mahidol University
Community-Based Approaches
• Is an integrated program implemented at local level (district level and below)
• National commitment with sound nutrition improvement strategies and goals
• Community actions: basic services, mass mobilization, mutual efforts/actions to reach all people and to prevent malnutrition
Kraisid Tontisirin, Mahidol University
Minimum Basic Services(Health, Education, Agr. Extension)
Supportive System•Training•Funding
•Problem Solving•Supervision
Interface(service providers and
community leaders)•Plan/goals
•Implementation•Monitoring/evaluation
Community LeadersFamily
Individual
Basic Minimum Needs Goals/Indicators
Menus (Activities)•Antenatal Cares (ANC)Antenatal Cares (ANC)•Growth Monitoring and Growth Monitoring and Promotion (GMP)Promotion (GMP)•Food productionFood production•Food and nutrition Food and nutrition educationeducation•Food sanitation & Food sanitation & safetysafety•School lunch and milkSchool lunch and milk program since 1992 program since 1992 •Other activitiesOther activities Mobilizers
(1:10 households)
Facilitators
Components of a successful community based program Components of a successful community based program
Kraisid Tontisirin, Mahidol University
Maternal and child nutrition andhealth Thailand, 1980-2006
Kraisid Tontisirin, Mahidol University
1980 1990 2006ANC coverage % 35 75 95Anemia in preg. %
50-75 18.8 10
LBW % 16 10 <10PEM (Wt/Age of U 5)% 51 20 <10
Trend of nutritional status of children
aged 1-5 years*
Stunting Underweight Overweight&Obesity
NHES 2; Holistic Development of Thai Children; NFNS 5; NHES 4
%
*Courtesy from Dr. Umaporn Suthutvaravut
Roles of agriculture and food systems
• Food production for subsistence economy: for consumption and income
• Promote local healthy snacks as food supplement for pregnant mothers
• Promote complementary food for infants and young children: at household and community levels
• School gardens and school lunch program• Local daily farm for school milk program: a win-
win activities
Kraisid Tontisirin, Mahidol University
Multi-stakeholder Comm.
Nutrition goals and healthindicators are incorporatedto strategies and actions.
Community basedapproaches
National Rural Development Committee
Poverty Alleviation Plan
Provision of basic services with mass mobilization:1volunteer /10 households Agri.& food production
for subsistence econ.,
suppl. food for mothers, complementary food for IYC & dairy farm for sch.
Kraisid Tontisirin, Mahidol University
• Population 64.6 millions • 12th largest exporter of agriculture and food products
• Main food exported products : e.g. Rice Processed Chicken Processed Pineapples Fishery Products
11Kraisid Tontisirin, Mahidol University
Thailand
-- Kitchen of the World --
12
Export Value of Food in 2011
27,809.47 million US$and was 34,330
millions $ in 2012
Kraisid Tontisirin, Mahidol University
Thailand: Current Thailand: Current situationsituation
Facing with the double burden of
malnutrition (DBM) and food
safety issue
Kraisid Tontisirin, Mahidol University
Thailand National Thailand National Food Committee Act of 2008Food Committee Act of 2008
FoodSafety
FoodSecurity
11 related ministries , 30 national agencies, 30 relevant Acts
FoodQuality
Ministry of Commerce
Ministry of Interior
Ministry of Science
Ministry of Education
Ministry of Agriculture
Ministry of Finance
Ministry of Foreign Affairs
Ministry of Social Development
and Human SecurityMinistry of
IndustryMinistry of
Public HealthMinistry of
Defense
The National Security Council
The National Economic and Social Development board
The Consumer Protection Board
The national Healthcommittee
Kraisid Tontisirin, Mahidol University
Chairman : Prime Minister (or designated Deputy-Prime Minister)
7 Resource persons in :-Food Security (2) -Food Safety (1) -Food Quality (1) -Law (1) -Economic and Trade (1) -Food Innovation (1)
Secretary: FDA, Ministry of Public HealthCo-secretary : ACFS, Ministry of Agriculture
The National Food Committee Component
Committee / Sub-Committee
Committee membersCommittee members
Ministry of Commerce
Ministry of Interior
Ministry of Science
Ministry of Education
Ministry of Agriculture and Commodity
Ministry of Finance
Ministry of Foreign Affairs
Ministry of Social development
and human securityMinistry of
IndustryMinistry of
Public HealthMinistry of Defense
The National Security Council
The National Economic and Social Development board
The Consumer Protection board
The national healthcommittee
11 related ministries, 4 executive administrators
15Kraisid Tontisirin, Mahidol University
The Authority of the National Food The Authority of the National Food CommitteeCommittee
Setting policy, planning strategies, monitoring and assessing
Advices and provisions of guidance to the related ministries / authorities
Advices the cabinet in case of food disaster or bioterrorism for action
and land uses
Meeting at least 2 times a year
16Kraisid Tontisirin, Mahidol University
SO
W
T
Strength1. Fertile food production resources 2. Food contribute significantly to
socio-economic and cultural development
3. Thai foods are unique and well accepted internationally
4. Continued improvement in food production and agro-industry
Threat1. Agriculture and food production sectors are not popular among young generation2. Competition for agriculture production resources for food, feed, fuel, bioproduct and non- food crop 3. New threats from global warming , plant/ animals diseases4. Trade competition and barriers
Weakness1. Complexity in food management 2. Inadequate inputs for small food producers 3. Degradation and deterioration of
land and water in certain areas 4. Low investment in R&D5. High l ogistic cost related to food 6. Weak consumer awareness
Opportunity1.Increasing demand of high quality,
safe and nutritious food2. Global recognition of Thai food and
food culture3. Food is always in demand and
more in crisis situations4. Geographical Location of the
country is conductive to trade5. New innovation and technology in
food17
SWOT Analysis
Kraisid Tontisirin, Mahidol University
• Food production• Nutrition orientation for healthy diet• Food, feed and fuel and bio-products• Climate changes
• Promotion• Protection• Treatment
Food Nutrition Health• Agriculture• Food supply• Food Service
• Nutrient needs• Dietary intakes• Nutritional wellbeing• Nutrition literacy
• Food quality• Food safety(Consumer and Trade)
F o o d C u l t u r e
F o o d S e c u r i t y
F o o d a n d N u t r i t i o n E d u c a t i o n
Continuum from Agriculture to Health
• Safe from Hazards Good health
18Kraisid Tontisirin, Mahidol University
Safe and Nutritious
Food
Good Hygienic Practices
Good Manufacturing Practices
Good Agricultural Practices
Land Use Water Management
Plant and Animal Agro- Biodiversity (Genetics)
Plant and Animal Diseases Prevention and
Control
Nutrition For Plant and
Animal
OUTCOMES
GOOD PRACTICES
BASIC ISSUES
Food ChainApproach
19Kraisid Tontisirin, Mahidol University
1. Efficient and effective management of food production resources2. Ensuring high quality, safe and nutritious food produced at
household, community, and industrial levels3. Promotion of R&D and utilization of knowledge along the food chain4. Strengthening food management systems (food law, food database,
etc.)5. Ensuring food security in both normal and crisis situation at the
household, community and national levels 20
Kraisid Tontisirin, Mahidol University
21
THEMES, THEMES, STRATEGIES & STRATEGIES & MEASURES :MEASURES :
Kraisid Tontisirin, Mahidol University
Principle : Ensuring a sustainable food security and effective management of food production resources by active stakeholders participation
Natural & Agricultural Resources
Kraisid Tontisirin, Mahidol University
Production Supply & Access
Establish Crisis Management Systems
• Land & Water Mgt/Reforming• Balancing Food,
Feed & Fuel
• Innovation & Technology • Food Production Zoning
• Enhancing Food Access at Household & Communities
• Logistics Improvement
Active Stakeholders Participation
R & D Along the Food Chain
• Capacity Development & Career
22
Theme 2Theme 2 : Food Quality and Safety: Food Quality and Safety
Community Food Production Food Industry
Food Standards
Principle : Ensuring high quality and safe food to protect consumer health and to facilitate domestic/international trade
Kraisid Tontisirin, Mahidol University
• Strengthening Community Food Processing (food loss reduction / value added)
• Strengthening - Value Added - Enhance Production Practices
• Establishment of harmonized standards • Strengthening of food quality and safety assurance systems• Trading & marketing promotion
• Quality• Safety• Nutrition
23
Theme 3Theme 3 : Food Education : Food Education Principle : R&D and knowledge utilization through engaging
stakeholders in sustainable and effective use of food production resources along the food chain and also strengthening desirable consumption behavior for well-being
Knowledge Integration
R&D
Knowledge Utilization
Knowledge Utilization & Practice
Basic
Best Practice
Output Research and Knowledge Development
Knowledge Dissemination
24Kraisid Tontisirin, Mahidol University
Theme 4Theme 4 : System Management: System ManagementPrinciple : Effective food management systems along the
food chainto deal with current and emerging issues in food
Reorganization &
Strengthening
Revise and Reform
Database & Management
System
Organization
Legal system
25Kraisid Tontisirin, Mahidol University
A Cabinet Resolution on A Cabinet Resolution on ““Thailand Food Thailand Food Strategy”Strategy”
ApprovedApproved The Strategic The Strategic
Framework of Food Framework of Food Management Management
on 25 November 2010 on 25 November 2010 by the Cabinetby the Cabinet
26Kraisid Tontisirin, Mahidol University
Implementation of the Strategic Framework of Food Management
(SFFM)1. Integrated the SFFM in the 11th National
Economic & Social Development Plan 2012-2016
2. Each sector implementing the SFFM & reports back to the National Food Committee
3. Three thematic committees for promotion the implementation on: Food Security, Food Quality
& Safety, and Linking of Food to Nutrition& Health
Kraisid Tontisirin, Mahidol University
Safe
and
Nutritio
us
Food
Good H
ygie
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ractice
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Good M
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Good A
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Land U
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Pla
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Agro
-Bio
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(G
enetics)
Pla
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Dise
ase
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Contro
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Nutritio
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or
Pla
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Safe
and
Nutritio
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Food
Good H
ygie
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ractice
s
Good M
anufa
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ctices
Good A
gricu
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ctices
Land U
seW
ate
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(G
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Information /Standard and Knowledge based
Safety
Quality /
Diversity
Linking of Food, Nutrition and Health
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ProductionProduction
Safe and Nutritious
Food
►Access►knowledge►Behavior - Diet pattern/Sanitary - Life style /Exercise
►Domestic/ Imported Food - Primary Product - OTOP - Industrial
►Restaurant ►Catering►Mobile Food Service Facility►School ►Household►Market
SupSupplyply
ServiServicece
Good Good NutritiNutrition&on&Good Good HealthHealth
ConsuConsumptiomptio
nn
Surveillance
Kraisid Tontisirin, Mahidol University
1. Standards & indicators on nutrition & related disease2. Food based dietary guidelines (FBDGs)3. Food, nutrition & dietetic education4. Promotion for more vegetable & fruit consumption5. Reduction of sugar, fat & salt in food6. School food & nutrition program7. Community based nutrition program to promote nutrition & health8. Nutrition & related disease surveillance & survey 9. Food and nutrition management during crisis
Key Issues Linking Food, Nutrition & Key Issues Linking Food, Nutrition & HealthHealth
Kraisid Tontisirin, Mahidol University
Community Based Program for Food, Nutrition & Health Community Based Program for Food, Nutrition & Health
Interface
Kraisid Tontisirin, Mahidol University
Minimum Basic Services(Health, Education, Agricultural
Extension)
(service providers and community leaders)• Plan/goals• Implementation• Monitoring/evaluation
Supportive Supportive SystemSystem• Training
• Funding• Problem Solving• Supervision
Community LeadersFamily
Individual
Minimum Indicators of well-being & NCDs
Volunteers(1:10 households)
Facilitators
:
Menu (Activities)• Antenatal careAntenatal care• Growth monitoringGrowth monitoring /promotion/promotion•Elderly caresElderly cares•Cares of NCDsCares of NCDs• Food productionFood production• Nutrition educationNutrition education• Food sanitation Food sanitation & safety& safety• Other activitiesOther activities (Tobacco and alcoholic (Tobacco and alcoholic consumption control)consumption control)•Recreation and physical Recreation and physical activities)activities)•Etc.Etc.
Roles of agriculture and food systems beyond the year 2015 for nutrition
• Ensuring nutritious and safe food supply of healthy diets through human life course
• Be a key partner to prevent DBM and NCDs by supplying adequate fruits & vegetables; low sugar, fat and sodium foods; healthy fats…etc
• Care for environment and sustainable development
• As a source of income
Kraisid Tontisirin, Mahidol University
Multi-stakeholder Comm.
SFFM covers: FoodSecurity, Quality & Safety,Education & Research,Management
Linking of food, nutrition &health implemented atcentral & community levelsfor nutrition and p/c of NCDs.
National Food Committee
Str Framewk for Food Mgt (SFFM)
Roles of agriculture and food systems: •Ensuring nutritious and safe food supply e.g.fruits & veg; low sugar, fat & sodium foods; legume & fishes …etc •Caring of environment & sustainable agriculture.
Kraisid Tontisirin, Mahidol University
1962
1967
1972
1977
1982
1987
1992
1997
2002
2007
2012
1st NEDP
2nd NEDP
3rd NEDP
4th NESDP
5th NESDP
6th NESDP
7th NESDP
8th NESDP
9th NESDP
10th NESDP
11th NESDP
2017
: Economic Infrastructure, Sectoral Plans
: + Poverty Alleviation Plan (PAP) + Integrated and implemented PHC + FNP and Basic Minimum Needs (BMN) Indicators in rural/urban communities
: + Social Plan + Food and Nutrition Plan (FNP) + Primary Health Care (PHC)
: Improvement of Agriculture, Infrastructure
: 1992 + School Lunch Program (SLP) + School Milk Program (SMP)
19601 - Anaemia in preg: 57%; - B1 deficiency: 23%; - B2 deficiency: 47%; - Low serum retinal: 38%; - Goitre in school children: 29% - PEM cases
19812 - PEM (Wt/Age of U 5): > 50%
19863 - PEM (Wt/Age of U 5): 30%
19956 - B1 deficiency: < 1%; - B2 deficiency: < 1%
19894 - Goitre in school children: 19%
1996 - PEM3 (Wt/Age of U 5): 15% - Anaemia in preg5: 13%; - Goiter in school children4: 4%
20034 - Goitre in school children: 1%
20067 - PEM (Wt/Age of U 5): 9% 2007 - UI in preg8 < 150 µg/L: 61%; - Low serum retinal9: 16%20088 - UI in preg < 150 µg/L: 56% 20108 - UI in preg < 150 µg/L: 43% 201210 - PEM (Wt/Age of U 5): 7%
19915 - Anaemia in preg: 18%
: 2008 + National Food Committee Act : 2010 + Strategic Framework for Food Management (SFFM) approved by cabinet : Integration of the SFFM and the 11th NESDP
: Promote cooperation and integration of all relevant sectors, academia, business and NGOs to strengthen national food and nutrition security : 2012 - Triferidine tablet (iron+folate+iodine)
: 2011 - Universal salt iodisation (USI)
2005 - Anaemia in preg: 10%
Nutrition Situation Thailand’s Development Plans
Policies and Strategies
Figure Milestones of Thailand’s National Social and Economical Development Plan related to food and nutrition
(Started working in nutrition since 1974)
(Worked at FAO, 2000-2006)
Kraisid Tontisirin, Mahidol University
Food Systems in ThailandTraditional Food Systems Modern Food Systems
• Food supply at household & community level.
• Include production for business in small & medium scales • Use primary food preservation (e.g. smoking, sun drying,
fermentation, salting)
•Mass production/ Large scale•Apply scientific knowledge & technology in food processing•Aware of food quality & safety•Advance in trade information systems
How both systems could contribute for healthy agriculture, health diets &nutrition, and healthy people and prosperity
Challenge
Conclusion 1• Thailand had been successful in alleviation of
undernutrition under the National Rural development Committee implementing the Poverty alleviation Plan but currently is hfacing with the Double Burden of Malnutrition (DBM)
• Agriculture and food systems are fundamental for ensuring safe and nutritious food supply of fresh and processed foods at household, community, national and global levels.
Kraisid Tontisirin, Mahidol University
Conclusion 2• Multiple strategies and actions linking between
macro policy and strategies with actions at community level will lead to the success outcomes and impacts on nutrition.
• Under the National Food Committee, the Strategic Framework for Food Management (SFFM) had been approved by the Cabinet and has been implementing with aims for food and nutrition security, food quality and safety, and sustainable development.
Kraisid Tontisirin, Mahidol University
Conclusion 3
Ultimate goals of the SFFM in Thailand are healthy agriculture and food systems,
health nutrition, health people and prosperity.
Kraisid Tontisirin, Mahidol University
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Kraisid Tontisirin, Mahidol University