Sustainable Elimination of Iodine Deficiency (Disorders): Perspective for Central & Eastern Europe and Central Asia on “ Realizing USI” ARNOLD TIMMER, UNICEF REGIONAL OFFICE April 2004

Realizing USI Phases: 1.Building commitment among partners, creating alliances, USI legislation development 2.Increasing iodized salt supply (production/import) and supporting activities 3.Fine-tuning of the programme, assessing impact, focus on sustainability

The Market Production of IS Enforcement of Laws Government Legislation The Black Market Uniodized Salt The Household Iodized Salt : From the Law to the Table Adequate iodine nutrition

Programme Cycle ASSESSMENT of the problem & means for resolution ANALYSIS of the cause of the problem ACTION Based on the analysis & available resources ASSESSMENT of the problem & means for resolution ANALYSIS of the cause of the problem ACTION Based on the analysis & available resources

Action Components Communication and Advocacy Interventions Monitoring and Evaluation Management, Training, Technical support, Capacity development

The Main Components of a National Iodine Nutrition Programme Communications High-level Advocacy Mobilization Consumer Education Salt Iodization Production & Quality Assurance Packaging & labeling Marketing Retailing Pricing Monitoring Legislation/Regulation Standards & Inspection Manufacturing Practice Impact Assessments Reporting IDD Slide courtesy of Emory University

Production Quality Assurance Awareness raising Coverage Monitoring Legislation Regulations Laboratory Impact Advocacy Policy Management Universal Salt Iodization

Role of Communication Difficult to convince behavior Different scenarios: –legislation (+) enforcement (+) –legislation (+) enforcement (-) –legislation (-) enforcement (-) Purpose short term is to increase immediate use: –Mass media campaign –Package and shops Purpose long term is to sustain basic level of awareness: –Curriculum in schools –Package

The Market Production of IS Enforcement of Laws Government Legislation The Black Market Uniodized Salt The Household Iodized Salt : From the Law to the Table Supportive Environment Advocacy for USI legislation  Creation of IDD coalitions and monitoring bodies  Engagement of IS producers in advocacy and IS agenda Increasing ImmediateUse  IS marketing to consumers  Branding and packaging with IS producers  Point of sale promotion Adequate iodine nutrition Ensuring Sustained Use  IS promotion by medical professionals  IDD education and IS promotion in schools and civil society groups  Engaging private sector salt production in marketing

Universal Salt Iodization Program Management Policy/Advocacy Ensuring Adequate Supply Ensuring Awareness and Use Production/Importation Quality assurance Packaging/labeling Legislation/Regulation Price Awareness Logo/ product recognition Behavior change Coverage Monitoring Impact Assessment