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Executive Summary
Pages 1-8

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From page 1...
... At the same time, global food aid deliveries have declined continuously since 1993. The United States contributes a variety of food commodities to global food aid through the Food for Peace Program authorized by Public Law (P.L.)
From page 2...
... The stated purpose of the increased vitamin C fortification of these blended foods was to improve the health of food aid recipients, particularly new mothers and infants, and to reduce the need for, and cost of, later medical interventions. An initial study commissioned by USAID on various options for appropriate micronutrient fortification recommended that vitamin C fortification not be increased until additional information was obtained on the stability of vitamin C during transport, storage, and preparation.
From page 3...
... Committee staff conducted an extensive literature search to attain a more global view of the reported incidence of scurvy in refugee populations, the effects of vitamin C on iron absorption, and other potential health effects of vitamin C supplementation. At the second meeting, the committee reviewed SUSTAIN's final report of the results of the pilot program, conducted a videoconference with USAID and SUSTAIN representatives, and teleconferenced with a representative of the United Nations' World Food Programme for further insights into global food aid needs.
From page 4...
... Furthermore, results of SUSTAIN's pilot program identified unacceptable variability in the fortification levels of vitamin C in CSB, which raises serious questions about the ability of manufacturers to meet specified nutrient levels in the final product. None of the four CSB plants sampled consistently achieved target fortification levels, and two of them were outside specifications almost 60 percent of the time.
From page 5...
... ; duration of stay in a refugee camp; seasonality: dry season and inability to cultivate; market failure, limited local supplies of fresh produce, or lack of resources to trade for other food sources; poor acceptance of donated foods, especially the blended, fortified foods, resulting from cultural preferences; and difficult access by relief organizations because of war or remoteness. At the individual level, risk factors include age and physiological status (young children, pregnant and lactating women, and the elderly have been found more susceptible)
From page 6...
... plan a preventive system to identify key areas of process control to avoid food safety risks. Measurements of improvement include analytical sampling and analysis of key fortification nutrients, regular audits of plant performance, maintenance of calibration records for all metering equipment, and maintenance of usage records for all vitamin and mineral premixes.
From page 7...
... More information is needed on the amounts of blended foods distributed to those at risk for scurvy in displaced populations. Currently, no good information is available on actual quantities distributed.


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