JSI’s work in Nicaragua began in the mid-1990s, when it implemented the USAID-funded Opportunities for Micronutrient Interventions (OMNI) program. The project sought to increase the population’s intake of essential nutrients, like vitamin A and iron, through the fortification of commonly used food staples, such as flour and sugar. JSI went on to manage the Environmental Health Project (EHP) in Nicaragua, an initiative to reduce exposure to infectious agents through the improvement of sanitation systems. Since then, JSI has improved health service and commodity procurement systems that combat HIV, tuberculosis, malaria, avian influenza, and other infectious diseases.