The programme in Chile
Chile’s milk fluoridation programme began in 1994 with a pilot scheme in the rural community of Codegua, 6th region. It provided approximately a thousand children under six years old with fluoridated milk products. The country has a National Complementary Feeding Programme (PNAC) under which each Chilean child is entitled to receive, at no charge, powdered milk products, from birth until six years of age. This programme was used to provide fluoridated milk products. Positive evaluation of the project after five years stimulated the authorities to considering introducing milk fluoridation on a wider basis.
A programme operated by the Junta Nacional de Auxilio Escolar y Becas, National School Assistance and Scholarship Board. JUNAEB, an agency supported by the Ministry of Education, which seeks to achieve equality for the country’s school children, was considered as a possible means of providing school children with fluoridated milk. In 2000 a scheme was implemented in the 9th region, and then into more districts at an impressive rate. The programme now reaches over 146,000 children aged 6 - 14 years in 3,600 schools. These are spread across 242 municipalities, in 11 of the country’s 15 regions.
Many of these schools are in remote mountainous areas which are almost inaccessible during winter. JUNAEB has proved an excellent vehicle for the delivery of fluoride to children living in these rural communities, and complements a national strategy for water fluoridation. Approximately 70% of Chileans benefit from fluoridated water, but for technical reasons this intervention is restricted to urban and semi-urban areas. To date Chile has been the only country to provide fluoridated powdered milk.
The work of Instituto de Nutriçion Technologia de los Alimentos, University of Chile (INTA), has been key in advancing milk fluoridation in Chile. INTA has provided essential technical support to JUNAEB in programme implementation, monitoring and evaluation, and has worked more generally with JUNAEB to facilitate the expansion of the programme.
The programme in Thailand
The Department of Health, Ministry of Public Health, has faced challenges to the long-standing milk fluoridation programme implemented through the Bangkok Metropolitan Administration and eleven provincial health authorities across the country. These have caused the programme to stall. The Department of Health is addressing these issues and indications are that supply of fluoridated milk to children in schools could be re-established.The Royal Chitralada Projects, a unique centre for agricultural research and development, located in the heart of Bangkok, has from the outset played a vital role in the development of milk fluoridation in Thailand, and the technical support it provides to the Department of Health will be essential in the efforts to reinstate the programme.
The programme in the United Kingdom
The Foundation has been pleased to provide support to assist with the development of two schemes being promoted in north-west England where the levels of dental decay are particularly high. A scheme in Manchester reaches children aged 5-11 years in schools and nurseries, and is gradually expanding. In Blackpool all primary school children are entitled to free breakfast and milk under a scheme to improve the health and well-being of the town’s young residents. In November 2016, as part of this initiative, parents were given the opportunity to choose fluoridated milk for their children.