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Uzbekistan: taking a lead in the fight against malnutrition

© UNICEF Uzbekistan 2005/Burnett
A journalist with life-saving fortified bread

Urgench, Khorezm, and Nukus, Republic of Karakalpakstan. 22-24 November 2005. Women’s and children’s health is under threat from malnutrition in Uzbekistan. Deficiencies in vitamin A, iodine and particularly iron, are common and have a devastating impact on health and productivity.

Small amounts of iron are essential for women and children’s health. A lack of iron can result in anaemia, a major cause of maternal mortality and of child mortality amongst children born to anaemic mothers; and of impaired mental and physical development in children. Studies in Uzbekistan estimate that 40-60% of 6-24 month-old children are at risk of disrupted brain development, whilst the rate of anaemia in women of childbearing age is over 60%, rising to over 90% in Khorezm and Karakalpakstan*.

"Hidden hunger kills hundreds of thousands every year worldwide," said Reza Hosseini, UNICEF Representative in Uzbekistan, at the launch of a campaign to  reduce anaemia in Khorezm and Karakalpakstan. "Millions of children are robbed of their potential for full growth – mental and physical – and their productivity.”

Uzbekistan and GAIN

Uzbekistan is at the forefront in the fight against hidden hunger. It is one of the first countries to benefit from the Global Alliance for Improved Nutrition’s (GAIN) flour fortification programme, receiving US $2.8 million for a three-year programme. Flour is being fortified with iron and folic acid (the latter is one of the few nutrients known to prevent neural tube birth defects, such as spina bifida - a birth defect resulting from the incorrect development of the spinal cord).

Following resumption of fortification in Tashkent oblast in July 2005, three mills in Khorezm region and another three in Karakalpakstan have began fortifying flour, backed up by an extensive public awareness campaign. The campaign was launched by Mr Islom Babadjanov, the Khokim of Khorezm in Urgench on 22 November. Representatives from UNICEF, local and national government and the press and broadcast media heard about the impact of iron deficiency and how the flour fortification campaign will remedy the situation. 

“What you (flour producers) are going to start today is not only to correct the past but to correct the future. What better focus in the Year of Health than taking this grand initiative”, said Mr Hossaini.

The sound of success

Journalists and government officials visited “Khonka Don Mahsulotlari” flour mill in Khorezm to find out for themselves how flour is fortified. The mill produces 45,000 tonnes of flour per year, enough to cover 65-70% of Khorezm region.

With the sound of the awe-inspiring machinery reverberating around them, the party inspected the fortification equipment and were guided through the fortification process by mill Director, Mr Kutliboy Hudjamuratov. 

"We're delighted to be part of this important initiative that will give health to women and children," said Mr. Hudjmuratov. "We understand our responsibility and will do everything we can to help the vulnerable people in our region."

Small costs --  massive benefits

Mr Hudjamuratov described how many small-scale farmers mill their own wheat or take it to small private mills, “By stressing the health aspects of flour fortification, we aim to attract those farmers to our mill. This will not only benefit the health of the population, but will bring important economic benefits to us and to our staff and their families,” said Mr Hudjamuratov.  

The flour fortification programme is very cost effective. It will cost just 100 Sums (approximately 10 cents) per person, per year, a remarkably low figure considering the long-term benefits both for the health of the population and the potentially positive impact upon economic productivity. “It is much better to prevent illness with a small investment in flour fortification, than to pay anything up to 100,000 sums (approximately US $100), to treat a person when they are ill,” said Mr Hudjamuratov. 

The launch ended with a visit to a bakery, where the party was able to sample some of the fortified bread products.

On 24 November, the launch of the flour fortification programme in Karakalpakstan took place in “JSC Nukus un Zavodi flour mill in Nukus city, Karakalpakstan.  

The National Programme of Flour Fortification

The GAIN flour fortification project commenced in July 2005, with fortification resuming in four flour mills in Tashkent. Eventually all 48 “Uzdonmahsulot” (former state bread and grain company) owned flour mills, together with private mills, will be equipped to produce fortified flour. According to preliminary estimations this will enable up to 90% of the population at risk to be covered. The project is a continuation of an Asian Development Bank (ADB) pilot project, which as part of the existing ‘National Programme of Flour Fortification’, was established in order to improve the quality of flour produced in Uzbekistan.

The GAIN project will be implemented by the Ministry of Health, JSC Uzdonmahsulot (State bread and grain company), UNICEF and the World Bank (acting as agent of GAIN). It will also involve the support of the Ministry of Public Education, Association of Bread Producers “Toshkent non”, other public organizations and foundations, and crucially, the Mass media.

* Source: Damage Assessment Report for Uzbekistan, UNICEF-The Micronutrient Initiative/ Uzbekistan CCA 2003.

For more information:

Bobur Turdiev, Communication Officer, UNICEF Uzbekistan. Tel: (+998 71) 133 95 12, email:




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