Islamabad, 11th July, 2019: Heartfile, WHO Pakistan and the Nutrition Wing of the Ministry of National Health Services Regulation and Coordination (MoNHSRC) co-hosted a dissemination event in Serena Hotel in Islamabad on 11th July 2019, to present findings from research on trans-fatty acids (TFAs) in Pakistan to key government and non-government stakeholders with a view to arrive at a common understanding on the regulatory steps required for its elimination. The event was attended by a number of key government and non-government stakeholders including provincial food authorities from Punjab, Sindh, Khyber Pakhtunkhwa, Baluchistan, Pakistan Standards and Quality Control Authority, provincial health and nutrition departments, UNICEF, GAIN, SUN Network, NCD Alliance Pakistan, the Food Fortification Program, and the Network for Consumer Protection among others.
Commencing the proceedings, National Nutrition Coordinator for MoNHSRC Dr. Khawaja Masoud Ahmed welcomed the participants and spoke about the importance of focusing policy attention on this critical matter, which threatened the lives and health of millions of Pakistanis. He said Pakistan was the 2nd highest TFA-consuming country in the WHO-EMRO region and was one of the leading causes of mortality and morbidity related to cardiovascular disease (CVD). He said the situation merited a concerted multi-stakeholder response that addressed both demand and supply factors to reduce TFA consumption in the country.
Addressing the gathering, Federal Minister and Advisor to the Prime Minister on Social Protection Dr. Sania Nishtar said that it was important that policymakers take a clear view of the public health challenge posed by TFA and undertake a coordinated countrywide approach to ensure that no loopholes remained in the regulatory system. She said that the most important factor in controlling TFA intake and NCDs at large was changing population consumption and behavioral patterns, for which concerted and sustained thought and interventions were necessary. She said the federal government would put its support behind the fight for TFA elimination and stressed o the need to develop a common regulatory approach.
Dr. Palitha, Country Head WHO Pakistan, also spoke on the occasion and said that eliminating TFA was among WHO-EMRO’s key priorities for the region and WHO Pakistan was available to provide technical support for authorities for the achievement of this objective by 2023. He said that the fight against NCD risk factors was something that required multi-sectoral efforts and sustained engagement and joint action of all relevant stakeholders, including government, civil society and the private sector.
Dr. Omar Mukhtar Tarar presented the findings from the study he conducted for MoNHSRC with WHO’s support, which focused on the TFA (as well as saturated fatty acid, salt and sugar) contents in locally produced, traditional as well as imported food in order to guide establishment of measures towards a regulatory framework for elimination of TFAs. He said that some of the main dietary sources of TFA in Pakistan’s context included partially hydrogenated oils (PHOs) like vanaspati ghee, margarines, and bakery shortenings, among others, which led to TFA being found in a wide variety of food products including including biscuits, chocolates, parathas, pastries, breakfast foods, french fries, and breakfast cereals. He said that the bulk of TFA in Pakistan (over 98%) were produced locally and thus addressing the supply required the regulation of local production. He outlined how the WHO’s REPLACE framework could help address the issue of TFA production and consumption.
Speaking on the occasion, Ammar Rashid of Heartfile presented findings from Heartfile’s situational analysis of the regulatory and policy environment regarding TFA elimination in Pakistan, which included a review of best practices from other countries. He said that other countries’ experiences with TFA elimination showed that establishing mandatory limits on TFA in foods backed by credible penalties was the most effective route to TFA elimination. He said, in addition, mandatory nutrition labeling, product reformulation and TFA replacement, multi-sectoral approaches involving civil society, industry and academia, research on consumption, and strong stewardship by government institutions tended to be key ingredients of successful efforts. He then laid out the key challenges in Pakistan’s regulatory context including a fragmented decentralized regulatory system with varying regulations, lack of enforcement capacity and laboratory testing constraints as among the key obstacles that needed to be addressed.
Both presenters laid out key measures that needed to be taken to achieve TFA elimination in Pakistan in the coming months and years, as per the REPLACE framework. These included the harmonization of federal and provincial standards for TFA limits with penalties, consistent and mandatory labeling requirements, an extension of the ban on Vanaspati ghee to other provinces, building enforcement and testing capacity of provincial authorities, generating data on TFA consumption, multi-stakeholder research on TFA replacement and healthier alternatives to PHOs, and improving awareness about TFA among the public, retailers and producers.
Following the presentations, participants at the event broke into two groups to achieve consensus on the necessary regulatory and advocacy measures required to achieve TFA elimination. Following discussions, each group then proposed a refined set of regulatory and advocacy measures, which were then noted by representatives of the ministry of health and provincial authorities and departments, with pledges to follow up on them for eliminating TFA. It was decided that the research and regulatory proposals stemming from the discussion would be officially approved and responsibilities for them assigned by the technical working group for TFA elimination, which would monitor their progress, while the advocacy measures would be further taken up at WHO’s upcoming advocacy seminar in NCDs in August.
The TFA report can be accessed here.