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Ottawa, CANADA – A new three-year project designed to kickstart the development and introduction of double-fortified salt with both iodine and folic acid (DFS-IoFA) into the Ethiopian marketplace has officially launched. Supported by a grant from the Bill & Melinda Gates Foundation, Nutrition International is collaborating with the Government of Ethiopia through the Ethiopian Public Health Institute, the Ethiopian Food and Drug Administration, and the Ministries of Health, Industry and Trade, as well as the University of Toronto, the University of California at Davis, and the International Federation for Spina Bifida and Hydrocephalus to develop, test and bring the product to market.

“This nutrition innovation is an important step forward on the path to eliminating micronutrient deficiencies in Ethiopia,” said Joel Spicer, President and CEO of Nutrition International. “Double-fortified salt has the potential to be an effective, sustainable, at-scale solution for reaching people with nutrients that are essential for their health. Preventing iodine deficiency disorders and neural tube defects in a single solution will be life-changing for mothers and their babies in particular, resulting in positive, long-term impacts on health, education and human capital.”

Ensuring that women have adequate folic acid intake before conception improves their nutritional status and reduces the risk of folate-deficiency anaemia, and can dramatically reduce the number of births affected by neural tube defects (NTDs) and significantly contribute to reducing neonatal and child mortality. NTDs are largely caused by maternal folate insufficiency in the first 28 days of pregnancy. The most common forms of these defects include spina bifida and anencephaly, which can result in early neonatal deaths, or long-term disabilities. The burden of care often falls on mothers or female caregivers, and results in financial distress and psychological pain and stigma – for the families and the affected child.

The Government of Ethiopia has committed to reducing the prevalence of NTDs in the country, which is more than eight times higher than other African nations. Few people in Ethiopia regularly eat enough foods that are rich in folate or vitamin B and, across the country, between 60-100% of women are folate insufficient – varying widely by region – resulting in a higher risk of pregnancy impacted by NTDs.

Iodized salt is one of the greatest public health achievements of the 20th century, helping to dramatically decrease global rates of iodine deficiency disorders (IDDs), including mental impairments and goitre. The Government of Ethiopia has mandated salt iodization since 2011 and adequately iodized salt currently reaches more than 90% of the population, reducing the prevalence of IDDs. This project will support the eventual move to replace all iodized salt in the country with DFS-IoFA.

Double-fortified salt with iodine and folic acid was developed in a laboratory setting at the University of Toronto more than 20 years ago, with support from Nutrition International. This project will will support the production of this formulation in Ethiopia using the same Central Iodization Facilities that were created to iodize salt mechanically – and test its acceptability and biological effect in the country’s population, engaging government institutions and salt producers in Ethiopia, and sharing findings with international organizations and other relevant stakeholders. The project will generate the evidence that consumption of DFS-IoFA can effectively improve folate status, to provide the information that will support decision-makers in formulating policy and regulations around its introduction and use, and the strategy to bring the product to market.

Nutrition International has been working in Ethiopia since 2005 and has been supporting the government’s salt iodization program for more than a decade.