USAID

Universal SaltIodization in the

Russian Federation

Kerry PelzmanANE/E&E PHN SOTA Meeting

Washington, DCOctober 9, 2002

USAID

Iodine Deficiency Disorders

• IDD remains the most common cause of

preventable mental retardation -- even

mild IDD IQ by 10-15%

• IDD also results in fetal death,

stillbirth, LBW, birth defects, neonatal &

infant mortality

• > 2 billion people at risk worldwide

USAID

Universal Salt Iodization

• UNGASS for Children: Global Elimination of IDD by 2005 through USI (> 90% coverage)

• Salt consumption universal & uniform

• Iodization cost: 3-5 cents/person/yr

• Commercial fortification: costs borne largely by industry & consumers

• > 2/3 of household salt in developing countries now iodized

USAID

90% or more (31)

50% to 89% (35)

Less than 50% (37)

No Data Available (61)

LEVELS OF IODIZED SALT CONSUMPTION

Global USI

Infants Born Annually Unprotected from IDD

USAID

Health in the Russian Federation

• Population 147 million• IMR 18 (1999)• U5MR 22 (1999)• U5 Underweight 3%• U5 Stunting 13%• EPI >90%• MMR 50• Low political priority for health programs

generally & lack of reforms in health sector

USAID

USI/IDD in the Russian Federation

• Iodine deficiency widespread, but most severe in Siberia & Far East

• IDD virtually eliminated in USSR 1950-1980 (salt iodization & targeted supplementation), but efforts abandoned w/ dissolution in 1991

• 1997 National IDD Program initiated

• Health Commission of Gore-Chernomyrdin Committee (State, HHS, USAID)

USAID

USI/IDD in the Russian Federation

• Regional harmonization of standards

• 6 major domestic salt producers + 20-30% of consumption imported from 2 major producers in Ukraine & Belarus

• Domestic production of iodized salt has increased >10X over past 5 yr, but still < 30% of total consumption

• Decrees, but no national law or comprehensive strategy for USI

USAID

• Global– UNICEF/Kiwanis– USG: USAID, HHS, CDC– Gates, World Bank, CIDA– Network for Sustained Elimination of Iodine

Deficiency– ICCIDD, WHO

• National– Government– Salt Producers– NGOs, Med/Nutrition/Education

Community

Partnership

USAID

USI Program Elements

• Advocacy: Political & Industry

Commitment

• National Legislation & Regulatory

Framework

• Production Capacity & Quality Control

• Marketing & Consumer Demand Creation

• Monitoring: Impact & Sustainability

USAID

Salt Iodization Can Lead the Way

• Almost no prevalence data for other MN deficiencies

• Monotonous diets with lack of animal-source foods, fruits & vegetables

• Salt iodization first national fortification program in Russian Federation

• Wheat flour fortification potential

•