Despite steep challenges, including frequent natural disasters, poverty rates, and the COVID-19 pandemic, Bangladesh has defied the odds to make progress in its development goals. It bucked the global recession during the pandemic year, with 5.1% GDP growth in 2020 – the highest growth rate in South Asia. The country has also made significant headway in reducing infant mortality rates and increasing life expectancy.

Now, Bangladesh is taking another step to improve national health outcomes, with the 'Iodised Salt Bill' currently in front of the parliament. This is not just a piece of legislation; it is a real commitment to human development.

Iodine is an essential micronutrient, especially critical during foetal development and in the first few years of a child's life. Iodine deficiency can result in lifelong cognitive disability and impairment, goitre and even death. Every year, approximately 16.2 million babies are born in developing countries without adequate iodine and nearly one billion people globally remain at risk of iodine deficiency.

Salt iodisation has been one of the world's most successful public health campaigns in recent decades and is the most effective way to combat iodine deficiency. It is also one of the most cost-effective interventions, costing less than US$ 0.05 per capita per year. As of 2020, 108 of 139 low-and-middle-income countries have legislation on universal salt iodisation.

Bangladesh has done a remarkable job in bringing down once-epidemic levels of goitre and thyroid disease. In the mid-1990s, 47% of the population suffered from goitre. Today, that number is well below 6%. Yet only 57.6% of households use adequately iodised salt, meaning that about 68 million households consume inadequately iodised salt, leaving them vulnerable to iodine deficiency disorders.

This new law seeks to close this gap and improve the availability of adequately iodised salt. The 'Iodised Salt Bill', when enacted, mandates that all edible salts, including salt used for livestock and the production of processed food items for human consumption, be iodised at 30-50 parts per million. It brings in clear and standardised guidelines for salt production, stocking, import and marketing, and mandates registration of manufacturers sellers and importers. The new law also increases penalties for violations.

Akhil Ranjan Tarafdar, the project director of the Control of Iodine Deficiency Disorders (CIDD) project, is confident the new legislation will increase adequately iodised salt coverage to 100%. The CIDD project has been instrumental in reducing iodine deficiency in the country. For the last 15 years, Nutrition International has been working with the government, salt producers and citizens to improve salt iodisation in Bangladesh. From providing technical support to salt processors and the Bangladesh Small and Cottage Industries Corporation (BSCIC), upgrading laboratories, supporting the maintenance of iodisation plants, introducing new technology, and training CIDD project officials, Nutrition International is proud to have contributed to national salt iodisation efforts. This bill is the culmination of Nutrition International's long-standing partnership with the government of Bangladesh.

Nutrition International has been at the forefront of cost-effective, scalable nutrition interventions globally and is a champion of universal salt iodisation. Nutrition International has supported efforts for universal salt iodisation, as well as vitamin A supplementation, rice fortification, behaviour change interventions, and improving the affordability of nutritious foods in Bangladesh. Nutrition International delivers targeted interventions for women, girls and children – and works with them – to ensure they have the nutrition they need to thrive.

Saiqa Siraj is the Country Director of Nutrition International, Bangladesh. E-mail: ssiraj@nutritionintl.org

Tomoko Nishimoto is the Regional Director of Nutrition International, Asia. E-mail: tnishimoto@nutritionintl.org