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September-December

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September-December

Ministry of Agriculture of Georgia

Quality Monitoring of Iodinated Salt

    Full Report

     Project leader: Ketevan Laperashvili

     Doctor of Biological Science

    Tbilisi

    2007

     According to the country action plan, drawn up by and between Government of Georgia

    and The United Nations Children’s Fund (UNICEF) in 2006-2010, by Food Safety, Veterinary

    and Plant Protection National Service of Ministry of Agriculture of Georgia with the support of

    UNICEF Georgia, in September-December of 2007 throughout the country, according to the

    regions, quality monitoring of Iodinated Salt was performed in retail objects.

     We express special gratitude towards the UNICEF Representative in Georgia Ms.

    Giovanna Barberis for the assistance she expressed towards our country and with her diligence

    and financial assistance the mentioned project was performed, we thank Minister of Agriculture,

    Mr. Petre Tsiskarishvili, first deputy minister Mr. Bakur Kvezereli, deputy ministers Ms. Lili

    Begiashvili and Ms. Alexandre Tsintsadze, Ms. Tamar Ugulava, health officer of Tbilisi

    Regional Office of UN Organizations Children’s Fund, Mr. Orkoshneli, head of Food Safety,

    Veterinary and Plant Protection National Service, Mr. Paata Gogolidze - director of

    Accreditation National Center of Accreditation Unitary National Authority of Ministry of

    Economy of Georgia, Mr. Grigol Gobejishvili head of Revenue Service of the Ministry of

    Finance, Mr. O. Manjgaladze, Ms. D. Zoidze, Ms. M. Kharadze, Mr. T. Pilishvili, Mr. N. Ilauri,

    Ms. N. Mgeladze - heads of accredited laboratories, salt importers, owners of retail objects and

    all those people, who helped us in implementing the project.

    Introduction

    Different International organizations, among them: International Council of Iodide deficiency diseases (ICCIDD), Micronutrient Initiative (MI), program “Facilities of Food

    Provision with Nutrients(OMNI), program of micronutrients shortage prevention(PAMM),

    UN Organizations Children’s Fund (UNICEF), World Health Organization (WHO) of USA,

    International Development Agency (USAID) have admitted that in the public health system

    essential achievement of the last ten years is the achieved progress in the prevention of Iodide

    deficiency diseases by salt full iodating; though stability of achieved results is important for

    decision making, and this needs strong political support and stimulation. Considering the

    International experience, the problem, connected with the quality assurance of iodinated salt,

    should be settled by effective propaganda, public relations, implementation of regular monitoring

    of iodinated salt quality, legislative and law-enforcement way.

Project objective

    Project implementation sets itself as an objective to supply the country with iodinated salt and

    this will become possible only after:

    1. The following will be researched:

    a. General background of distribution of imported iodinated salt in trade objects of Georgia.

    b. Percent of iodinated/non-iodinated salt on retail level during 2007.

    2. Definition of the loss of iodine and factors, influencing it;

    3. Decreasing the factors of iodinated salt falsification;

    4. Approbation and implementation of the system of quality monitoring of iodinated salt that will

    be implemented by state controlling unit;

    5. Exact definition of the problem, processing of the recommendations and definition of long-

    term and urgent actions in order to liquidate existing violations.

    Full implementation of the measures, considered by the project will stimulate the stability of salt

    universal iodinating program in the country and accordingly by prevention of Iodide deficiency

    diseases improve the health level of population.

    1. Theoretical Base of Monitoring Fulfilment

     AS the world experience shows, by implementing salt general iodination, the achieved

    progress revealed two main questions: the first question fulfilment of effective and regular

    monitoring of iodinated salt quality and the second one provision of stability of achieved

    results.

    Generally in the country, the criteria of this instrument as liquidation of IDD are as following:

    Import of the iodinated salt in the quantity to satisfy the potential request of the population

    (nearly4-5 kg. salt for one person during a year);

    95% 0f the salt, used by the population should be iodinated and correspond the state standards,

    acting in the country;

On the intraeconomic level, 90% of the population, chosen by the representativeness principle

    should use iodinated salt of no less than 15 ppm iodine;

In the imported salt, the mass fraction quantity as on the retail trade level as in the intraeconomic

    level should be defined by titration method, it is also admitted to use certified testing for express-

    analysis in field conditions;

    The materials of regional and general national monitoring should be based on the information,

    gained during last two years;

    It is also known that besides ten program indicators, stated below eight should be executed.

    The indicators are:

    ? Effective functional national body, responsible before the Government for the execution

    of national program of Iodide deficiency diseases, specialists of different fields should be

    involved into it, among them doctors of different profiles, representatives of education

    field, representatives of mass media and consumers’ right protection organizations;

    ? Political will and accordingly making political decision on salt full and general iodination

    in the country;

    ? Appointment of the person, responsible for execution of liquidation program of Iodide

    deficiency diseases;

    ? Law or adoption of other statutory act, which will establish salt general iodination (in

    ideal case law or statutory act should contain salt, usable as by people as in animal

    breeding, though if the last condition is not performed, for the county it cannot become

    harmful factor of free status assignment from iodine deficit diseases

    ? Important condition is estimation of real situation, for this purpose the existence of the

    laboratories is important, which will define iodine composition in the iodinated salt and

    ioduria;

    ? Program of public education and social mobilization, which contains studies about Iodide

    deficiency diseases and iodinated salt consumption;

    ? Regular gaining of information on the enterprise, wholesale, retail trade and

    intraeconomic level about iodine composition in the salt;

    ? Regular analysis of ioduria among children of school age, residing in the zones of high

    risk;

    ? Cooperation with salt producers (importers) with the purpose of creation of control

    mechanism of iodinated salt quality;

    ? Creation of database of regular monitoring of defining iodine composition in the salt and

    ioduria monitoring.

    What is the situation in Georgia from this point of view?

    1.1 Salt General Iodination Policy in Georgia.

    Analysis of Statutory Documentations

Iodide deficiency diseases for Georgia have always been endemic medicine and its mountain

    regions have been known as goiter endemic region since long times;

At first, goiter opposite republic clinic was opened in Tbilisi in 1935.

In 1939 in Kutaisi salt iodination was organized, endemic hard regions Kvemo Svaneti, Oni,

    Ambrolauri were supplied with the salt of local production;

In 1938-1944 using the iodinated salt goiter frequency was deceased from 42,7% to 14%.

    thIn the 70 years the principal changes in endemic goiter were achieved; the illusion of problem

    final liquidation was created; this was followed by the strategic mistake, import of iodinated salt

    was decreased;

    th years less attention was paid to keeping of achieved success; In the80

    In the 90th years social-economic crisis in the country assisted the import of iodinated salt and

    damage of delivery system;

    That is why it was logic, that:

    In 1995-1998 with the assistance of WHO and UNICEF, according to the results of the

    epidemiologic researches, performed by the Georgian doctors throughout the country, 36-93%

    had goiter frequency. In the same period the expeditions were organized nearly in all regions of

    Georgia and according to the epidemiologic researches, frequency of endemic goiter among

    children of 6-12 age made up 320-370 on each 1000 child.

    According to the aforesaid, the necessity of acceptance of national program of salt general

    iodination arises, that is decision making phase matures, which contains salt general iodination, creation of correspondent statutory base and plan of program fulfillment;

In 1996 “State program of prevention of deceases, caused by the iodine deficitwas processed,

    its purpose was IDD effective management by complex activities performance, its decrease and

    minimizing; IDD struggling national council was established.

On July 24, 1996 President of Georgia issued an order #480 “About provision of population with

    iodinated salt;

On October 24, 1996 President of Georgia issued an order #480 “About struggling coordination

    council against of deceases, caused by the iodine deficit”, which proved the staff of coordination council and working activities plan;

Since March, 1997 program of abnormalities prevention of the deceases, caused by the iodine

    deficit has been implemented by Ministry of Health of Georgia. All regional and endocrinous

    services are financed and established within the program scope;

    On March 30, 1998 pursuant to the decree #109 of President of Georgia “About prevention, treatment among population of Georgia of diseases, caused by the lack of iodine, microelements,

    necessary for life and diseases, caused by the lack of vitamin and additional activities of their

    further liquidation”, establishing of stringent control for continuous provision of country

    population with standardized iodinated salt and also working out of controlling system was

    defined on iodinated salt import, keeping, distribution and consumption level; special

attention is paid to strengthening communication component, coverage of diseases prevention

    tasks, caused by iodine (and other microelements) deficit by television, radio, other information-

    printing means.

    On December 24, 1998 President of Georgia issued the order #711 “About prevention of diseases, caused by the deficit of iodine, other microelements and vitamins”;

In 1998 imported iodinated salt was released from VAT (20%);

In 1998 Georgian food industry scientific research Institute worked out state standard of Georgia

    Common salt iodinated” - GSS 19-98. General technical terms; standard was approved and put

    into use by Georgian Standard on the basic of the order # 70 on May 15, 1998. According to the

    standard, for salt iodination sub-periodic acid potassium salt (potassium iodate KIO) was 3used as fortifier; iodine mass fraction was defined and established by calculating on dry

    4substance (40?10)X 10-, titration method of iodine composition defining in the salt is given in

    the standard;

    In 1999 nearly 2100 tones of iodinated salt was imported into the country;

    In 2001 Commonwealth of Independent States agreement “About Prevention of Iodide deficiency diseases among the population of Commonwealth of Independent States” was signed,

    thin accordance with its 9 article, country-participant established that the essential term of

    imported iodinated products supply and selling is the attached documentation, issued by county-

    exporter, which proves its quality and safety producer’s (supplier’s) certificate and/or specifications, issued by officially enabling authority of country-supplier; it should be mentioned,

    that agreement validity term has been defined for 5 years, after expiration date it is tacitly

    prolonged during next 5 years (article 14);

On May 18, 2002 President of Georgia issued an order #242 “About additional activities of

    diseases, caused by the lack of vitamin and of their further liquidation”, in accordance which,

    with the purpose of decreasing and liquidation of diseases, caused by iodine lack, interprofile

    coordination council of diseases liquidation, caused by iodine lack was established and their

    thactivity directions were defined; pursuant to the 7 item of the same order, the International

    organizations were asked for assistance in effective implementation of activities of iodine deficit

    liquidation.

    In 2003 the quantity of imported iodinated salt increased for 34 000 tones;

On September 27, 2003 the order #466 of President of Georgia “About interprofile 2004-2008

    program confirmation of disease prevention, caused by iodine lack” was issued; the present order defined program objectives, terms of its implementation, program object and its stability.

    According to the program, Ministry of Agriculture of Georgia was charged to perform

    system monitoring of iodine composition in food products, also iodinated salt import and

    development of local production and provision of accessibility for population with

    iodinated salt of appropriate standard with necessary quantity; though quality monitoring of iodinated salt has not been performed until now.

On December 16, 2004 in the committee of health care and social affairs tasks of Parliament of

    Georgia, with the help of UNICEF, working group of “Prevention of diseases, caused by

    microelemets lack with fortification food”, and its purpose is, with fortification (enriched) food, the assistance of prevention of diseases, caused by the lack of microelements and vitamins,

    necessary for peoples’ health in Georgia, and its tasks are the following:

    ? working out of fortification national policy;

    ? creation of legislative base;

    ? implementation of law;

    ? coordination of government and non-government sectors;

    ? actualization of public opinion;

    ? support of new undertakings in nutricism and food fortification;

    ? epidemiological research;

    In 2005 salt was generally iodinated. Parliament accepted the law “About prevention of the

    diseases, caused by iodine, other microelements and vitamins lack”, pursuant to which it is

    thforbidden to import and sell non-iodinated white salt, except the requirements, defined by the 5

    article of the mentioned law, when import and selling of non-iodinated salt in Georgia is allowed:

    a) with the medicine purpose; b) with industrial-use and for production of nonfoods; non-

    iodinated salt with the medicine purpose is allowed to be imported on the permit basic of

    Ministry of Labour, Health and Social Affairs and its selling is allowed only from the

    pharmacy network.

    thPursuant to the 6 article of the present law, import and selling of iodinated salt and other

    fortification foods in Georgia is forbidden without obligatory certificate and production

license. At the same time, during iodinated salt import, conformance certificate together

    with the tax return will be submitted to the customs authorities.

    For today, according to the information, submitted by revenue service of Ministry of Finance of

    Georgia, during salt import, in relation to the tasks of conformance certification regulation, it

    was established, that during import of each single consignment of iodinated salt, country-export

    th conformance certificate will be submitted to the customs clearance groups. Pursuant to the 15

    article of Georgian Law “About Product and Service Certification”, conformance certificate, issued abroad, is accepted according to the orders, provided by the international agreements.

For 2005 with the joint effort of Georgian Government and UNICEF number of Iodide

    deficiency diseases decreased from 55-58% to 36-37%;

On February 25, 2005 in Georgian law “Georgian Code of Administrative violation” the

    4 following additions were made: 44article was added to the code, according to which “selling of non-iodinated salt, import and selling of expired iodinated salt and other faulty fortified

    stdthfoods (except cases, provided by the 1 and 3 items of the 5 article of Georgian law “About prevention of diseases, caused by iodine, other microelements and vitamin deficit”), import or selling of expired iodinated salt or other faulty fortified foods will be followed by the fine at the amount of 500-2000 Gel”.

    On December 29, 2006 the changes were made to the Georgian law “About prevention of diseases, caused by iodine, other microelements and vitamin deficit”, according to which

    “Ministry of Labour, Health and Social Affairs of Georgia, Ministry of Agriculture and

    appropriate service of Ministry of Finance of Georgia control the correspondence of

    iodinated salt and other fortification foods with national standards” (article 9);

On October 19, 2007 pursuant to the order # 300/B of Minister of Labour, Health and Social

    dthththAffairs of Georgia, sub-item q” of the 3 article and the 4 and 5 items of the 27 article of the Georgian law “About Public Health”, according to which, with the purpose of the public health

    provision the Ministry establishes the obligatory technical regulations, norms of fortification

    foods and define the policy of struggling with the violations, caused by foods lack, “technical regulations of food-stuff fortification” was approved, hygienic requirements for common salt

    thiodination were defined, according to the 6 article of the order iodate potassium is used for white salt iodination, as it is in the national standard, also potassium iodide. During both

    4usage of fortification iodine, mass fraction should make up (40?10)X 10-, mkg/g. Sodium

thiosulfate is used as potassium iodide stabilizer, and its mass fraction should not exceed 250 +

    - 50 mkg/g. Moreover, humidity of iodinated salt should not exceed 1%;

     Besides this, it is essential, that the technical regulations make the indication of additional fortifier on marking obligatory,

     It was defined, that the date of keeping the salt, fortified with potassium iodide

    should not exceed 6 months and 9-12 months with potassium iodate.

Marking

During monitoring of iodinated salt quality, important component is consumers’ informing by

    th article of Georgian law “About Consumers’ rights protection”, means of label, pursuant to the 6

    which refers to the information about production, according to the item 2, sub-items a) (a) z)

    th(g) and 4 item “consumer should receive the information in Georgian language and it should be

    placed on production package, label or tag, but because of their small size or other respectable

    reasons this is impossible, it should be placed on list, attached on each unit or by any other form,

    accepted in industry.

    Label should contain the following important information:

    ? name;

    ? producer’s firm name and address, name of the country the iodinated salt has been

    produced;

    ? date expiry, final date of iodinated salt usage;

    ? date of production and expiration date;

    ? date of grade (quality);

    ? quantity (net);

    ? technical regulation or other statutory-technical documentation noting;

    ? storage conditions;

    ? title “iodinated”;

    ? name of the iodine additions;

    ? iodine composition;

    ? information about certification;

    dthAccording to the 2 item of the 6 article of “Food-stuff fortification technical regulation”,

    “form of additional iodine should be mentioned on the iodinated salt marking, (iodate potassium

    or potassium iodide), iodine composition, date of production and storage date. At the same time

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