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USAID. Universal Salt Iodization in the Russian Federation. Kerry Pelzman ANE/E&E PHN SOTA Meeting Washington, DC October 9, 2002. USAID. Iodine Deficiency Disorders. IDD remains the most common cause of preventable mental retardation -- even mild IDD IQ by 10-15%
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USAID Universal Salt Iodization in the Russian Federation Kerry Pelzman ANE/E&E PHN SOTA Meeting Washington, DC October 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 Global USI
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 Partnership • 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
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