Prof. Kraisid Tontisirin M.D., Ph.D
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
Thailand:
Current situation
• 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
• Agriculture/
• Food supply/
• Service
Food
Nutrition
Health
• Promotion
• Protection
• Treatment
Nutrition is a link between food and health,
regarding the fulfillment of nutrient and non-nutrient
requirements from food in human life cycle.
Ultimate Goals
Nutrition well-being for all
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
PAP
participation
Fd/Nut.Prog.
PHC
BMN indicators
Kraisid 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
Components of a successful community based program
Minimum Basic Services
(Health, Education, Agr. Extension)
Menus (Activities)
•Antenatal Cares (ANC)
•Growth Monitoring and
Promotion (GMP)
•Food production
•Food and nutrition
education
•Food sanitation &
safety
•School lunch and milk
program since 1992
•Other activities
Supportive System
•Training
•Funding
•Problem Solving
•Supervision
Facilitators
Interface
(service providers and
community leaders)
•Plan/goals
•Implementation
•Monitoring/evaluation
Community Leaders
Family
Individual
Mobilizers
(1:10 households)
Basic Minimum Needs Goals/Indicators
Kraisid Tontisirin, Mahidol University
Maternal and child nutrition and
health Thailand, 1980-2006
1980
1990
2006
35
75
95
50-75
18.8
10
LBW %
16
10
<10
PEM (Wt/Age of U 5)%
51
20
<10
ANC coverage %
Anemia in preg. %
Kraisid Tontisirin, Mahidol University
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
National Rural Development
Committee
Poverty Alleviation Plan
Multi-stakeholder Comm.
Nutrition goals and health
indicators are incorporated
to strategies and actions.
Community based
approaches
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
Thailand:
Current situation
• 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
11
Kraisid Tontisirin, Mahidol University
-- Kitchen of the World --
Thailand
Export Value of
Food in 2011
27,809.47 million US$
and was 34,330
millions $ in 2012
12
Kraisid Tontisirin, Mahidol University
Thailand: Current
situation
Facing with the
double burden of
malnutrition
(DBM) and food
safety issue
Kraisid Tontisirin, Mahidol University
Thailand National
Food Committee Act of 2008
Food
Security
Food
Quality
Food
Safety
Food
Education
11 related ministries, 30 national agencies, 30 relevant Acts
Ministry of
Defense
Ministry of
Finance
Ministry of
Commerce
The National
Security Council
Ministry of
Foreign Affairs
Ministry of
Interior
Ministry of Social
Development
and Human Security
Ministry of
Science
The National
Economic and Social
Development board
Ministry of
Industry
Ministry of
Education
Ministry of
Public Health
Ministry of
Agriculture
The Consumer
The national Health
Protection Board
committee
Kraisid Tontisirin, Mahidol University
The National Food Committee Component
Chairman : Prime Minister
(or designated Deputy-Prime Minister)
Secretary
7 Resource persons in :
: FDA, Ministry of Public Health
-Food Security (2) -Food Safety (1)
-Food Quality (1) -Law (1)
-Economic and Trade (1)
-Food Innovation (1)
Co-secretary
: ACFS, Ministry of Agriculture
Committee members
11 related ministries, 4 executive administrators
Ministry of
Finance
Ministry of
Defense
Ministry of
Commerce
Ministry of
Foreign Affairs
Ministry of
Interior
The National
Security Council
Ministry of Social
development
and human security
Ministry of
Science
The National
Economic and Social
Development board
Ministry of
Industry
Ministry of
Education
Ministry of
Public Health
Ministry of
Agriculture and Commodity
The Consumer
The national health
Protection board
committee
Committee / Sub-Committee
15
Kraisid Tontisirin, Mahidol University
The Authority of the National Food Committee
Setting policy, planning strategies, monitoring and
assessing
Food Security
Food Safety
Food Quality
Food Education
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
16
Kraisid Tontisirin, Mahidol University
SWOT Analysis
Strength
S
1. Fertile food production resources
2. Food contribute significantly to socioeconomic and cultural development
3. Thai foods are unique and well accepted
internationally
4. Continued improvement in food
production and agro-industry
Weakness
W
1. 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&D
5. High logistic cost related to food
6. Weak consumer awareness
Threat
Opportunity
1.Increasing demand of high quality, safe
and nutritious food
2. Global recognition of Thai food and
food culture
3. Food is always in demand and more in
crisis situations
4. Geographical Location of the country is
conductive to trade
5. New innovation and technology in food
O
1. Agriculture and food production
sectors are not popular among
young generation
2. Competition for agriculture production
resources for food, feed, fuel,
bioproduct and non- food crop
3. New threats from global warming ,
plant/ animals diseases
4. Trade competition and barriers
T
17
Kraisid Tontisirin, Mahidol University
Continuum from Agriculture to Health
• Agriculture
• Food supply
• Food Service
Food
Nutrition
Health
• Promotion
• Protection
• Treatment
• Food production
• Nutrition orientation • Food quality
for healthy diet
• Food safety
• Food, feed and fuel (Consumer and Trade)
and bio-products
• Climate changes
Food
• Nutrient needs
• Safe from Hazards
• Dietary intakes
Good health
• Nutritional wellbeing
• Nutrition literacy
Security
Food and Nutrition Education
Food
Culture
18
Kraisid Tontisirin, Mahidol University
Food Chain
Approach
OUTCOMES
Safe and
Nutritious
Food
Good Manufacturing
Practices
GOOD
PRACTICES
Good Hygienic Practices
Good Agricultural Practices
Plant and Animal
Agro- Biodiversity
(Genetics)
Land Use
Nutrition For
Plant and Animal
Plant and Animal
Diseases
Prevention and
Control
BASIC ISSUES
Water Management
19
Kraisid Tontisirin, Mahidol University
1. Efficient and effective management of food production resources
2. Ensuring high quality, safe and nutritious food produced at household,
community, and industrial levels
3. Promotion of R&D and utilization of knowledge along the food chain
4. 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
THEMES,
STRATEGIES &
MEASURES :
Food Security
• 10 strategies
• 41 measures
Food Quality
and Safety
• 6 strategies
• 33 measures
Food
Education
• 5 strategies
• 17 measures
Management
• 3 strategies
• 12 measures
21
Kraisid Tontisirin, Mahidol University
Principle : Ensuring a sustainable food security and effective
management of food production resources by active
stakeholders participation
Natural &
Agricultural
Resources
• Land & Water
Mgt/Reforming
• Balancing Food,
Feed & Fuel
Supply
& Access
Production
• Enhancing Food Access
at Household &
Communities
• Logistics
Improvement
• Food Production Zoning
• Innovation & Technology
• Capacity Development &
Career
Establish Crisis Management Systems
R & D Along the Food Chain
Active Stakeholders Participation
22
Kraisid Tontisirin, Mahidol University
Theme 2 : Food Quality and Safety
Principle : Ensuring high quality and safe food to protect consumer
health and to facilitate domestic/international trade
Community Food
Production
Food
Standards
• Quality
• Safety
Food Industry
• Nutrition
• Strengthening Community Food Processing
• Strengthening
- Value Added
- Enhance Production Practices
(food loss reduction / value added)
• Establishment of harmonized standards
• Strengthening of food quality and safety assurance systems
• Trading & marketing promotion
23
Kraisid Tontisirin, Mahidol University
Theme 3 : 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
R&D
Output
Best
Practice
 Research and Knowledge Development
 Knowledge Integration
 Knowledge Dissemination
 Knowledge Utilization
& Practice
Basic
Knowledge
Utilization
24
Kraisid Tontisirin, Mahidol University
Theme 4 : System Management
Principle : Effective food management systems along the food chain
to deal with current and emerging issues in food
Organization
Database &
Management
System
Reorganization
& Strengthening
Legal system
Revise and
Reform
25
Kraisid Tontisirin, Mahidol University
A Cabinet Resolution on “Thailand Food Strategy”
Approved
The Strategic Framework
of Food Management
on 25 November 2010
by the Cabinet
26
Kraisid 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
Linking of Food, Nutrition and Health
Surveillance
Safety
Safe and
Nutritious
Food
Practices
Good Manufacturing
Plant and Animal
Diseases
Prevention and
Control
Good Hygienic Practices
Nutrition For
Plant and Animal
Water Management
Good Agricultural Practices
Plant and Animal
Agro- Biodiversity
(Genetics)
Land Use
Safe and
Nutritious Food
Supply
Service
►Domestic/
►Restaurant
Imported Food ►Catering
- Primary Product ►Mobile Food
Production
- OTOP
- Industrial
Service Facility
►School
►Household
►Market
Consumption
Good
Nutrition&
Good Health
Quality /
►Access
►knowledge Diversity
►Behavior
- Diet pattern/Sanitary
- Life style /Exercise
Information /Standard and Knowledge based
28
Kraisid Tontisirin, Mahidol University
Key Issues Linking Food, Nutrition & Health
1. Standards & indicators on nutrition & related disease
2. Food based dietary guidelines (FBDGs)
3. Food, nutrition & dietetic education
4. Promotion for more vegetable & fruit consumption
5. Reduction of sugar, fat & salt in food
6. School food & nutrition program
7. Community based nutrition program
to promote nutrition & health
8. Nutrition & related disease surveillance & survey
9. Food and nutrition management during crisis
Kraisid Tontisirin, Mahidol University
Community Based Program for Food, Nutrition & Health
Minimum Basic Services
(Health, Education, Agricultural Extension)
Supportive System
Menu (Activities)
• Training
• Funding
• Problem Solving
• Supervision
• Antenatal care
• Growth monitoring /promotion
•Elderly cares
Interface
•Cares of NCDs
(service providers and community leaders)
• Food production
• Plan/goals
• Nutrition education
• Implementation
• Food sanitation
• Monitoring/evaluation
& safety
• Other activities
Community Leaders
(Tobacco and alcoholic
Family
consumption control)
Individual
•Recreation and physical
Minimum Indicators
activities)
•Etc.
of well-being & NCDs
Facilitators
:
Volunteers
(1:10 households)
Kraisid Tontisirin, Mahidol University
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
National Food Committee
Str Framewk for Food Mgt
(SFFM)
Multi-stakeholder Comm.
SFFM covers: Food
Security, Quality & Safety,
Education & Research,
Management
Linking of food, nutrition &
health implemented at
central & community levels
for nutrition and p/c of NCDs
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
Nutrition Situation
19601 - Anaemia in preg: 57%;
- B1 deficiency: 23%;
- B2 deficiency: 47%;
- Low serum retinal: 38%;
- Goitre in school children: 29%
- PEM cases
Thailand’s Development
Plans
Policies and Strategies
1962
1st NEDP
: Economic Infrastructure, Sectoral Plans
2nd NEDP
: Improvement of Agriculture, Infrastructure
3rd NEDP
(Started working in nutrition since 1974)
4th NESDP
: + Social Plan + Food and Nutrition Plan (FNP)
+ Primary Health Care (PHC)
5th NESDP
: + Poverty Alleviation Plan (PAP) + Integrated and implemented
PHC
+ FNP and Basic Minimum Needs (BMN) Indicators in
rural/urban communities
1967
1972
1977
19812 - PEM (Wt/Age of U 5): > 50%
19863 - PEM (Wt/Age of U 5): 30%
19894 - Goitre in school children:
19%
19915 - Anaemia in preg: 18%
19956 - B1 deficiency: < 1%;
- B2 deficiency: < 1%
1996 - PEM3 (Wt/Age of U 5): 15%
- Anaemia in preg5: 13%;
- Goiter in school children4: 4%
20034 - Goitre in school children: 1%
2005 - Anaemia in preg: 10%
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%
1982
1987
6th NESDP
1992
7th NESDP
: 1992 + School Lunch Program (SLP) + School Milk Program
(SMP)
1997
8th NESDP
(Worked at FAO, 2000-2006)
2002
9th
NESDP
2007
10th NESDP
2012
11th NESDP
2017
: 2008 + National Food Committee Act
: 2010 + Strategic Framework for Food Management (SFFM)
approved by cabinet
: Integration of the SFFM and the 11th NESDP
: 2011 - Universal salt iodisation (USI)
: 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)
Figure Milestones of Thailand’s National Social and Economical Development Plan related to food and nutrition
Kraisid Tontisirin, Mahidol University
Food Systems in Thailand
Traditional 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
Challenge
How both systems could contribute for healthy agriculture,
health diets &nutrition, and healthy people and prosperity
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
38
Kraisid Tontisirin, Mahidol University