August Network E-Bulletin

Salt Iodization in Guatemala

Sandra Recinos (UNICEF, Guatemala) and Erick Boy (MI, Ottawa)

Iodine deficiency control program in Guatemala started in 1954 with a compulsory national salt iodization, yet it has performed erratically over its long history. Salt iodization fell from 85% (1995) to under 50% (2002). During the last decade much effort has been invested in strengthening the capacity of producers (for better quality salt, cooperative organization and quality assurance system) and the public sector (for improved monitoring and enforcement). Particularly during 2004 the program was strengthened through coordinated efforts of the National Food Fortification Commission (CONAFOR) and UNICEF leadership in the following areas:

•  Legal framework and national policies

•  Approval of Food Security Legislation (March 2004), which includes Food Fortification Programs as one of its basic components to fight against malnutrition.

•  Salt fortification guidelines for the addition of iodine and fluorine were issued by the government to implement the revised General Food Fortification Legislation. The new guidelines were introduced to small, medium-sized and large salt producers.

•  Monitoring coverage of salt fortification:

•  The annual school-based survey of household salt samples was carried out with a revised national sample of 450 new communities.

•  Salt iodization increased by 69%, from 49% in 2002 to 83% in 2004 (Figure 1). Sixty-three percent of all the household salt samples were adequately fortified (>15 ppm).

•  Empowerment and social auditing component

•  Only commercialisation of salt with authorised and registered brands is allowed in accordance with the legislation. Monitoring of fortified salt is done regularly, covering a larger national area and with participation of both the Ministry of Public Health and the Ministry of Commerce & Economy.

•  Small salt producers have strengthened their quality control activities and iodization capacity, as well as their salt commercialisation capability through the reactivation of the Central Supply and Processing Center.

•  Social communication messages in 9 Mayan languages have been disseminated by national radio to increase popular demand for iodized salt.

Regional USI Meeting in West Africa MI South Africa

As a follow up of the West African Regional Consultation Meeting at Dakar in October 2004, a regional Meeting on "Standardization, Quality Control, Trade and Taxation in the Framework of Universal Salt Iodization in West Africa" was held on July 25-27, 2005 in Ouagadougou. The meeting was organised under the auspices of West African Health Organization (WAHO), with the technical and financial support of its partners HKI, MI, UNICEF, ICCIDD, WHO and Économique et Monétaire Ouest Africaine ( UEMOA). The Economic Community of West African States ( ECOWAS) technical commissions and UEMOA country member experts on standardization, salt producers from Ghana and Senegal, and an NGO involved in social marketing were also participated in the meeting.

The main objective of the meeting was to en sure a functional and effective coalition at sub-regional level in order to contribute to Universal Salt Iodisation. The meeting specifically addressed the following issues:

•  Define and set up a legal framework, for salt iodisation standards at the levels of production, import /export and sites of distribution in West Africa;

•  Identify taxes and barriers that may prevent smooth trade of iodized salt across the sub-region;

•  Identify the minimum quality standards which can be adopted across the sub-region;

•  Define the coordinating mechanisms for the sub-regional coalition and for monitoring actions to be implemented ;

•  Harmonise salt production, iodization and trade policies in the ECOWAS (and implicitly UEOMOA) countries;

•  Develop an action and a follow-up plan of the recommendations at country and regional levels

Ban on non-iodized salt back in India
News Report provided by MI India

NEW DELHI, June 15. - Close on the heels of controversial ban on smoking scenes on the silver screen, the Union health ministry re-imposed the ban on non-iodized salt that was lifted five years ago, possibly signaling another row with the producers of normal salt. The Union health minister, Dr Anbumani Ramadoss, cited as a reason the health risk emanating from iodine and iron deficiency for the reinstatement of the ban. He also said that double fortification of salt with iron and iodine would soon be made compulsory. "We are giving two months to manufacturers. The ban on non-iodized salt will be enforced from 15 August this year," Dr Ramadoss said here after a UNICEF-government strategy review meeting on reproductive and child health.

However well-intentioned the move may be, it could still receive flak from the large number of manufacturers of normal salt. They had lobbied strongly with the then National Democratic Alliance ( NDA) government to lift the ban. The leader of the alliance, the Bharatiya Janta Party ( BJP), has a large number of supporters from the trade, including normal salt producers. The lobby had argued that iodized salt was being "pushed" by big industries to the detriment of small scale industries. It had also contended that not all the people of the country required iodized salt and even questioned the efficacy of this salt in curing diseases such as goiter.

The lobby has a supporter in Mahatma Gandhi's great-grandson, Mr Tushar Gandhi, who has also questioned the rationale of promoting iodized salt for the entire population of India. Mr Gandhi, president of the Mumbai-based Mahatma Gandhi Foundation, has said that all the health talk regarding iodized salt was inspired by big industries producing it.

Dr Ramadoss said: "Serious health setbacks" were noticed after the government lifted the ban in 2000. Consumption of adequately iodized salt fell from 49 per cent of population to 37 per cent. Ruling out price hike in the wake of ban, there would at the most a 10 paise per kilogram rise". He claimed the ban would not hit small producers, saying even crystallized salt could be iodized.

USI Progress in Pakistan MI Pakistan

The first national country wide salt sector survey is currently on going. A national strategic Plan has been developed and approved by the Government of Pakistan early this year. A five year phased out national action plan, 2005-10 was prepared in three phases. Ministry of Health, UNICEF, MI and Salt sector have been in closed coordination and some progresses have been made:

•  Salt sector survey is being carried out by the Micronutrient Initiative.

•  UNICEF continues providing KIO3 (until arrangements of importation - which is currently being developed - is established)

•  Private sector involvement in importation of KIO3, its distribution and proper utilization will be entrusted to some motivated and interested party such as HUB PAK salt industry.

•  Provincial Health Department especially those of Punjab and Sindh have been involved in promulgation of USI legislation and quality control. 

•  A good move in North-West Frontier Province (NWFP) is the establishment of Association of Salt Industry has been established in NWFP and they will be involved in the storage and distribution of KIO3 and regulation of salt processing units. 

•  A National Coalition on IDD control and USI is currently being formalized.

Iodized Salt drive raises money for packaging plant in Georgia

Arthur Wedler, A Call to Serve USA (July 1, 2005)

In the past, Columbians ( Columbia, MO, USA) have been asked to contribute salt and money as part of the yearly salt campaign coordinated by "A Call to Serve," a nonprofit international humanitarian aid organization, to buy salt for Columbia's sister city Kutaisi, Georgia. This year, Columbians are asked to make financial contributions to help purchase equipment that would be used to repackage iodized salt.

Before the campaigns began in 2001, more than half of Kutaisi's children had been diagnosed with goiter, a condition caused by iodine deficiency. Previous campaigns have succeeded at reducing the diagnoses of goiter by 28 percent in the population, said Dr. Trish Blair, president of A Call to Serve. In its fourth year, the Columbia campaign is aiming to provide funding to establish a sustainable supply of iodized salt for Kutaisi, but so far the campaign has fallen short of its $100,000 goal. Close to $30,000 has been raised by the campaign, which has an "aggressive goal," said Rick Rowden, salt steering committee chairman. The focus of previous salt campaigns has been to raise money to purchase 26-ounce cans of salt to be shipped to Kutaisi. This year, the plan is to open a facility that would allow iodized salt to be shipped in bulk. The bulk price of salt is 25 to 50 percent less than salt in canisters, Rowden said.

The campaign's goals include upgrading a building to food grade standards for iodine testing and repackaging, which will cost $40,000, purchasing machines to repackage salt, hiring and training workers and buying a vehicle to transport salt. Iodized salt will be bought in bulk from Austria, which is guaranteed to be iodized.

"The adoption of the law by Georgia is a major step forward towards achieving the global commitment to eliminate iodine deficiency disorders through universal salt iodization by 2005. This is within our reach, if governments lead the way and everyone works together", says Ismail Ould Cheikh Ahmed, UNICEF Representative in Georgia.

The Law will contribute to a National Policy on Food Fortification as well as setting standards for the import and production of iodized salt and other fortified food products. It also aims to strengthen State supervision and inter-agency coordination.  Measures will be put in place in September 2005 to ensure that the legislation is effective once it comes into force. These include setting up reliable quality control mechanisms as well as ensuring easy access to iodized salt for the population.

The law is the result of joint efforts by the Government of Georgia and UNICEF. The active involvement of Georgia's First Lady Sandra Elisabeth Roelofs in the fight against iodine deficiency has also led to positive changes. "The commitment of the Government of Georgia in setting up quality monitoring mechanisms is evident and highly appreciated. The fact that the law lays the foundation for other food fortification programmes is also of paramount importance. Within the coming months we will be working with the Government to create a solid base for putting the law into practice", says Ismail Ould Cheikh Ahmed. 

Iodine deficiency disorders are endemic in Georgia. They are caused by low iodine levels in water and soil and, therefore, in locally produced food products. In 1990, with the onset of the socio-economic crisis in Georgia, the system of iodized salt import and distribution was completely disrupted. The effects were soon apparent. A survey conducted in 1998 showed various degrees of iodine deficiency in 55-58 per cent of the population.

UNICEF has worked on this problem with the Government of Georgia since 1996. Thanks to this partnership, goitre prevalence among children has decreased from 55 to 38 per cent, imports of iodized salt have increased 16-fold, and consumption of iodized salt has increased from 8.1 per cent of families in 1999 to about 60 per cent in 2003.

The Network Network E-Bulletin is prepared by the Network for Sustained Elimination of Iodine Deficiency and posted on its website, www.iodinenetwork.net . If you have any information to share or queries please contact Dr. Juliawati Untoro , IDD Network Secretary at info@iodinenetwork.net