Iodine Global Network (IGN)

Iodized salt progress in Nepal threatened

Medical professionals are a mainstay of national coalitions for sustainable salt iodization, thus articles in general medical journals like The Lancet are important -- as is this "World Report" item about Nepal by Nayanah Siva. Siva summarizes the situation:

"Iodine deficiency disorders (IDDs) had been on the wane in Nepal, after several programmes from the country's Ministry of Health to tackle the lack of essential vitamins and minerals in the food chain. However, recent data suggest that the incidence of IDDs could be back on the increase. Nayanah Siva reports.

"Nepal has battled with iodine deficiency disorders (IDD) for decades, but over the years several programmes have been put in place by the country's Ministry of Health, and at one point the disorder had virtually been eliminated. However, recent data suggest that not only have IDDs not yet been fully eradicated, but also that previous progress might have even reversed.

"IDD is an important issue for maternal health, and in the 1980s UNICEF worked with the Nepalese Government to launch an emergency protection programme aiming to give iodine oil injections to young mothers, but the programme had limited success. In 1993, WHO initiated the global primary intervention strategy for IDD control by universal salt iodisation. Salt was chosen because it is widely available at low cost and can be consumed regularly throughout the year, according to WHO. Unfortunately, there is only one manufacturer of salt in Nepal, and there are issues with iodised salt not reaching the Nepalese people with its full initial iodine content because of poor storage conditions and the length of time it stays in transit. 'Putting [iodised salt] on the back of a yak and carrying it for 3 days can result in the loss of a proportion of iodine; it drops from something like 50 parts per million at source down to something like 15', said Brodie. Price is also an issue, with the difference of a rupee or two between iodised and non-iodised salt proving a disincentive to use iodised salt for the poorest populations. Consequently a third of households in Nepal are still using salt with low iodine content, according to UNICEF. There is clearly a lot of work still to be done if Nepal is to succeed in eliminating IDD."