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Universal Salt Iodization in the Russian Federation: Combating Iodine Deficiency Disorders

This report details the significant public health issue of iodine deficiency disorders (IDD) in the Russian Federation, highlighting IDD as a leading preventable cause of mental retardation and other severe health outcomes. Although historic efforts successfully eliminated IDD in the USSR from 1950 to 1980, these initiatives have declined since the dissolution in 1991. The USAID Universal Salt Iodization program aims to reinstate widespread iodization of salt, addressing the needs of over 2 billion people globally at risk of IDD. Advocacy and regulatory frameworks are crucial for sustainable success.

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Universal Salt Iodization in the Russian Federation: Combating Iodine Deficiency Disorders

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  1. USAID Universal Salt Iodization in the Russian Federation Kerry Pelzman ANE/E&E PHN SOTA Meeting Washington, DC October 9, 2002

  2. 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

  3. 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

  4. USAID Global USI

  5. Infants Born Annually Unprotected from IDD

  6. 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

  7. 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)

  8. 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

  9. 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

  10. USAID USI Program Elements • Advocacy: Political & Industry Commitment • National Legislation & Regulatory Framework • Production Capacity & Quality Control • Marketing & Consumer Demand Creation • Monitoring: Impact & Sustainability

  11. 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

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