Abstract
Fortification of food-grade (edible) salt with iodine is recommended as a safe, cost-effective and sustainable strategy for the prevention of iodine-deficiency disorders. The present paper examines the legislative framework for salt iodization in Asian countries. We reviewed salt iodization legislation in thirty-six countries in Asia and the Pacific. We obtained copies of existing and draft legislation for salt iodization from UNICEF country offices and the WHO's Global Database of Implementation of Nutrition Actions. We compiled legislation details by country and report on commonalities and gaps using a standardized form. The association between type of legislation and availability of iodized salt in households was assessed. We identified twenty-one countries with existing salt iodization legislation, of which eighteen were mandatory. A further nine countries have draft legislation. The majority of countries with draft and existing legislation used a mandatory standard or technical regulation for iodized salt under their Food Act/Law. The remainder have developed a 'stand-alone' Law/Act. Available national surveys indicate that the proportion of households consuming adequately iodized salt was lowest in countries with no, draft or voluntary legislation, and highest in those where the legislation was based on mandatory regulations under Food Acts/Laws. Legislation for salt iodization, particularly mandatory legislation under the national food law, facilitates universal salt iodization. However, additional important factors for implementation of salt iodization and maintenance of achievements include the salt industry's structure and capacity to adequately fortify, and official commitment and capacity to enforce national legislation.
Highlights
The present paper reports on findings of a review undertaken among Asian and Pacific Island countries* on their salt iodization legislation and its impact on universal salt iodization (USI) programme achievements
Legislation was voluntary in Brunei and Singapore where a standard for iodized salt is available but it does not apply to all salt
The current review found that most countries in the Asia and Pacific regions have mandatory salt iodization legislation
Summary
We collected and reviewed draft and existing legislation, relevant programme documentation and policy papers on salt iodization from thirty-six countries in Asia. English translations of the abovementioned documents were obtained from UNICEF country offices in the countries listed in Table 1 in 2012 and updates were requested in 2015/16. An additional search was conducted of the WHO-hosted Global Database of Implementation of Nutrition Actions (GINA) and through WHO regional offices. Implementation details given in the legislation or supporting documents, such as coordination and enforcement authority, labelling/packaging requirements, internal and external regulatory monitoring requirements, and penalties, were reviewed. Basic information on the current status of the countries’ salt iodization programmes and household consumption of iodized salt data was sought from global WHO, UNICEF and IGN databases and country programme documents
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