Achieving Universal Salt Iodisation (USI) in Pakistan: Challenges, Experiences and the Way Forward

This article aims to describe the history, progress, success and challenges of the Universal Salt Iodisation (USI) programme in Pakistan, which was launched in 1994. Revitalised in 2005 with financial assistance and technical, operational, logistic and commodity support from the Micronutrient Initiative (MI), it is now being implemented in 102 districts of Pakistan. With an increase in household utilisation of iodised salt from 17 per cent in 2001 to 69 per cent in 2011, severe iodine deficiency among women and school?aged children has decreased to 3 per cent and 2 per cent respectively. Strong government ownership and commitment, coupled with effective monitoring and supervision, have been the driving force of the USI Pakistan programme. These, combined with quality control measures, stringent regulatory and enforcement mechanisms, availability of fortificants in the open market and demand generation are the necessary requirements for programme sustainability.