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Efforts to achieve optimal iodine intake through salt iodisation have focussed primarily on iodisation of household salt. However, there is strong evidence that in most regions of the world, industrially processed foods and condiments are an increasingly important source of dietary salt. In this context The Iodine Global Network (IGN) and partners developed programme guidance to help national programme managers assess the potential contribution of widely consumed industrially processed foods and condiments to iodine intake. The programme guidance additionally aimed to facilitate better understanding of iodised salt use by the processed food industry, review existing salt iodisation legislation for inclusion of food industry salt, and investigate how regulatory monitoring of food industry practices could be strengthened if needed. To evaluate the utility of the guidance in practice and identify areas where it could be improved, the IGN requested expressions of interest to pilot test implementation. Five pilots were implemented in Kenya, North Macedonia, The Republic of Moldova, Sri Lanka and Thailand, with remote technical support from IGN. The pilots demonstrated how evidence from implementation could be used to strengthen existing salt iodisation initiatives. In particular, how modelling existing processed food intake data enhanced understanding of potential or actual iodised salt intake and provided an evidence base for strategic change, as well as encouraging alignment with salt reduction programmes. In summary, the guidance provided a useful framework for national teams to conduct a relatively rapid assessment of the existing programme for achieving optimal iodine nutrition and opportunities to strengthen it. National teams involved with the pilot implementation were highly engaged and motivated by the outcomes. The pilot implementation process resulted in the development of strategic recommendations nationally and provided invaluable feedback to IGN on the utility of the guidance, facilitating development of an improved version. [ABSTRACT FROM AUTHOR]

Nepal is located in what was once known as the Himalayan Goitre Belt and once had one of the highest prevalence's of iodine deficiency disorders in the world. However, through a well‐executed universal salt iodization program implemented over the past 25 years, it has achieved optimal iodine intake for its population, effectively eliminating the adverse consequences of iodine deficiency disorders. A comprehensive review of policy and legislation, surveys, and program reports was undertaken to examine the key elements contributing to the success of this program. The paper reviews the origins and maturation of salt iodization in Nepal, as well as trends in the coverage of iodized salt, the iodine content in salt, and population iodine status over the past two decades. The paper describes critical components of the program including advocacy efforts, trade issues with India, the role of the Salt Trading Corporation, monitoring, and periodic program reviews. The paper discusses the recent findings from the 2016 national micronutrient survey demonstrating the success of the salt iodization program and describes emerging challenges facing the program in the future. [ABSTRACT FROM AUTHOR]

The addition of iodine to edible salt has been one of the most important public health successes of the past half century, enabling most countries to achieve optimal iodine intake and protect the brains of unborn children from the adverse consequences of iodine deficiency. Salt has been an ideal vehicle for this effort because of its near universal and narrow range of consumption, relative ease of technology for salt iodization, and capacity for virtually all salt producers to add iodine. As a result of the success of salt iodization, there has been growing interest in using salt as a vehicle for other important micronutrients, particularly the addition of iron to iodized salt to produce double-fortified salt (DFS), to combat the persistent problem of iron deficiency and iron deficiency anemia. Because of this growing interest in DFS and the need for a comprehensive review of evidence to support the viability of this intervention, the Iodine Global Network (IGN) initiated a global consultation to gather all available data on different aspects of DFS. IGN identified 4 key areas considered essential to understand for a successful fortification intervention: 1) efficacy and effectiveness, or how well DFS produces a health impact in controlled and real-life settings; 2) technical considerations for production, or what are the minimum requirements to manufacture DFS; 3) program implementation to describe experiences thus far with the delivery of DFS across multiple platforms; and 4) comparison of DFS with other iron fortification efforts to determine the comparative advantage of DFS to improve iron intake and prevent iron deficiency anemia. This preface provides an overview of the DFS Consultation objectives, process, and objectives. [ABSTRACT FROM AUTHOR]

Fortifying salt with diethylcarbamazine (DEC) is a safe, low-cost and effective strategy to eliminate transmission of lymphatic filariasis. DEC-fortified salt has been used successfully in pilot projects in several countries and has been used operationally by China to eliminate lymphatic filariasis. The successful use of iodized salt to eliminate iodine-deficiency disorders is encouraging; similarly, fortified salt could be used as a vehicle to eliminate lymphatic filariasis. Despite the potential programmatic advantages of fortifying salt with DEC instead of undertaking mass administration of tablets, DEC-fortified salt remains an underutilized intervention. We discuss the reasons for this and suggest settings in which the use of DEC-fortified salt should be considered. [ABSTRACT FROM AUTHOR]