Forming National Coalitions for Sustained Elimination of Iodine Deficiency UNICEF/CDC Workshop to Strengthen Micronutrient Strategies Alma Ata, 28 March 2003

Content Introduction Why form a National Coalition? Who might be member? What might it do? How might it do those tasks? What are some suggested next steps?

Introduction Examples of failure after initial success include: –Guatemala –Countries of the former USSR –Bolivia etc The reason is that national vigilance declined, due to: –Low political concern, combined with –Diminished efforts by the salt industry, and –Failed insistence from consumers

How do we avoid repetition of such failures? 1.Sustained success depends on continued progress, 2.Continued progress depends on permanent supply of only iodized salt, and 3.Permanent supply of only iodized salt results from: Periodic political re-commitment, supported by Constant attention from the national leaderships, and Assurance of National Oversight Introduction (2)

Why form a National Coalition? 1. Despite assistance from foreign agencies, most of the investments in USI are from national resources 2. Government often represents the national responsibility, but history indicates that more than government oversight is required 3. Ignorance is the greatest obstacle to success

Reaching success in sustained national IDD elimination means that we should meet two related objectives: 1.Achieve the IDD elimination goal on time, (Reaching success), and 2.Assure steady progress of elimination efforts over time (Sustained success) Why form a National Coalition? (2)

Prime examples of ignorance include: –Political leaders Un-informed of the effects of iodine deficiency on the national economy –Consumers Not knowing of the damage of iodine deficiency on their children’s brain –Salt producers Not aware of their role in assuring iodine nutrition to the nation Why form a National Coalition? (3)

For reaching success, this ignorance must be overcome by comprehensive communication: –Periodically reaching key politicians, –Permanently reaching (future) consumers, and –Penetrating the salt productive industry as a principle Sustained success will depend on the success of inserting accurate information into the various learning channels Why form a National Coalition? (4)

Sustained success means that we must constantly assure quality and sufficiency: –Assured salt iodine quality, plus sufficient iodized salt supplies for all people at a fair price –Periodic renewal of high-level political commitment –Open, transparent and constant communication –Finance for training and other support activity budgets, combined with constant management attention –Permanent insertion into ongoing educational systems –Regular reminders about the value of iodine for animals –Professional measurement of human iodine nutrition, and –Regular monitoring, with periodic public reporting Why form a National Coalition? (5)

Who might be members? Suggestions include (No list is perfect for all situations) –Formal Government bodies –Judicial/legislative groups –Professional groups –Civic/civil society organizations –Scientific groups –Salt/Food industries –Communicators

High-level members are needed for assured oversight, decision making and direction Forming a National Coalition is a national responsibility, but Some initial support from agencies might help Government remains the ultimately responsible party for reaching the national goal Who might be members? (2)

What might it do? Press for meeting the goal by 2005 Press for achieving it through USI Press for norms and procedures to sustain the success Provide oversight to assure those objectives and share the resulting information widely Press for continuous public and other forms of education to assure permanent knowledge and acceptance Relate to international collaborators, such as the Network for Sustained Elimination of Iodine Deficiency

How might it proceed? Four essential groupings of issues must be addressed –Quality and sufficiency of the product National standards that producers can respect “Universal” really always means “all edible salt” –Permanence of the essential national components Fair and transparent application of the law Ongoing encompassing communication –Assured progress in iodine nutrition Continuous UIE information from pregnant women –Political, economic and human resource development

Suggested Next Steps Identify and encourage high-level leaders Remind them of the national commitment Advocate the concept that blending all the available national talent leads to success Call for a National Advocacy Event and Launch the National Coalition

Facts to Remember The central and essential issue is to protect fetal brains Permanent political commitment is needed Iodine deficiency is the underlying cause of IDD Universal Salt Iodization is the sustainable solution Unlike pills or injections, USI is not a quick fix Iodized salt is a product, not a public service The elimination goal is a beacon, not a finish The role of salt producers in USI is vital, yet Government remains the ultimate accountable party