ICCIDD STRATEGIC PLAN

ICCIDD….STRATEGIC WORK PLAN….REACHING THE GOAL

THE VISION OF ICCIDD IS A WORLD VIRTUALLY FREE FROM IODINE DEFICIENCY DISORDERS WITH NATIONAL ENDEAVORS IN EACH COUNTRY TO MAINTAIN OPTIMAL IODINE NUTRITION, PRIMARILY THROUGH UNIVERSAL CONSUMPTION OF IODIZED SALT.

THE MISSION OF ICCIDD IS TO ADVOCATE TO GOVERNMENTS, CITIZENS, AND DEVELOPMENT AGENCIES A PRIORITY COMMITMENT TO IODINE NUTRITION THROUGH A MULTIDISCIPLINARY APPROACH INVOLVING ALL RELEVANT PARTNERS.

ICCIDD BELIEVES THAT COUNTRY PROGRAMS MUST BE FULLY SUPPORTED NATIONALLY FOR SUSTAINED SUCCESS, AND WILL WORK WITH ALL PARTNERS AND NATIONAL ENTITIES TOWARDS THAT END.

ICCIDD BELIEVES THAT IT IS THE COMBINED, MUTUALLY SUPPORTIVE EFFORT OF ALL RELEVANT PARTNERS THAT WILL ACHIEVE USI, REACH SUSTAINABLE LEVELS OF IODINE NUTRITION, AND PERMANENTLY ELIMINATE THIS ANCIENT SCOURGE. ICCIDD IS THEREFORE COMPLETELY COMMITTED TO AN APPROACH OF PARTNERSHIP WITH ALL STAKEHOLDERS.

BASIS OF THE WORK PLAN

The work plan of ICCIDD is based on the identified needs in national endeavors as revealed by annual reports from Governments and Agencies on the progress toward USI (Universal Salt Iodization) and Sustained Iodine Nutrition. ICCIDD reviews the reports, including those from WHO and UNICEF and the Global Network as well as the reports from its unique network of Regional Coordinators. The Board of Directors decides on priority lines of action at its annual meeting and sets targets and policies for the organization in the ensuring period.

The Constitution is the legal base; the Board is the Governing Body; the Executive Committee chaired by the Chair of the Board acts for the Board between the annual Board sessions; the Committee Chairs report to the Chair of the Board or the Executive Director depending upon the function; RCs report to the Executive Director

Following the Board policies, the Executive Director prepares the work plan for approval of the Board at its annual session. The Executive Committee then provides guidance for its execution including the annual appeals for resources needed to meet the demands. These resources come from (a) grants, some annual others multiyear, from bilateral development agencies (b) specific grants (such as from UNICEF for evaluations, assessments and country overviews); (c) WHO, for studies and research activities and (d) foundations, industry and others.

ICCIDD offers the scientific and technical services to support the global effort to achieve USI and virtual elimination of IDD. It is committed to USI and believes that the production, marketing, and consumption of iodized salt are critical to the solution to the problem; ICCIDD thus works with the salt industry and food processing industry in every country within the context of national programs. Government ministries provide the policy guidance and oversight required. Development agencies support national investment and capital requirements.

The Board has set the following general guidelines for priority action by ICCIDD in the next two years:

- Continual collaboration with UNICEF and WHO in supporting national endeavors to achieve the USI and Optimal Iodine Nutrition Goals set by the UN at the UN Special General Assembly on Children and the UN Millennium Development Goals.

- Continual support to and active participation in the Global Network on Sustained Iodine Nutrition and full acceptance of the responsibility to be lead agency in national evaluations and assessments under existing guidelines

- Expanded liaison and collaboration with national authorities on iodine nutrition programs and improved working relationships with UNICEF and WHO at country level

- Increased emphasis on geographic priorities in Asia and in Africa where the most challenging large problems remain

- Increased emphasis on advocacy and communication work that stresses the challenge of preventing invisible brain damage to infants, especially in utero and up to three years, replacing the traditional concerns with visible goiter and cretinism.

- Increased emphasis on women of child bearing age and improving maternal health and reproductive health as a major public health demand, a priority which requires additional applied research.

- Improved and increased liaison and collaboration between the salt and food industries and the public health and public education sectors, private and civic sectors.

PROPOSED ACTIVITIES

ICCIDD is not a "funding agency" nor does it desire to become one. It sees its main roles as described above and to accomplish them, it advocates action by UNICEF, WHO, MI, Salt Industry, Governments and others towards the goal of sustained IDD elimination. This requires a careful mix of strategic lines of action:

1. Regular discussions with UNICEF, WHO, MI and others at national level and at regional level

2. Regular and frequent consultations with national authorities including health professionals and productivity councils and regulatory bodies

3. Regular review of progress reports from national sources so as to identify difficulties and indicate tentative lines of action; or publish results for knowledge sharing and promotion';

4. Aggressive promotion of national assessments under the aegis of the Network; i.e., four kinds of national reviews (a) in those countries facing difficult obstacles to progress (b) in those countries where progress while good seems stalled (c) in those countries where household access is good and the national authorities desire confirmation that sustained levels are achievable and (d) specific requests for identified technical, operational, policy or practical problem solving.

5. New ways of looking at USI and Optimal Iodine Nutrition to assure that maternal health and reproductive health remain priority attention issues.

6. Creation of alliances and partnerships, especially at the national level.

The first three items above require modest administrative and human resources. The latter two require resources from development agencies for multiyear commitments. At the moment, Canadian CIDA is supporting on priority the ICCIDD initiatives and national support in Africa (while continuing core support); AUSAID is supporting activities and priorities in South and East Asia (while continuing core support); the Netherlands Government is asked to support ventures in maternal and reproductive health on priority (with modest support to core activities); and UNICEF is asked to support activities related to the NEWSLETTER and to National Assessments and Overviews).

WHO

ICCIDD will continue to be represented at the WHO World Health Assembly annually and occasionally at the WHO Executive Board. It will maintain regular contact with the Nutrition Unit at WHO Headquarters and the Regional Coordinators will attend Regional Committee Meetings where IDD is suggested to be an annual reporting item for monitoring progress and measuring success. In addition, the RCs of ICCIDD will be in direct contact with the WHO CRs.

- The Chair will determine who will represent ICCIDD at each of the above meetings. A report is expected following attendance at each. The report should indicate what happened and what results were obtained.

ACHIEVEMENTS EXPECTED: At minimum, continued priority interest of the agency in elimination of IDD. Improved collaboration on scientific investigations and information sharing. (See below). Inclusion on the agenda annually at each Regional Committee of WHO an item requiring States Members to report on progress. Improved communications between WHO CRs the Regional Directors with ICCIDD Regional Coordinators and Officers.

UNICEF

ICCIDD will attend the Regular Session of the UNICEF Executive Board and will meet with Senior Officials of the Fund and with Regional Directors to identify roles for ICCIDD in national programming of resources by UNICEF. It is desirable that UNICEF encourages discussion of iodine nutrition at the various Regional Management Team meetings in the regions and that ICCIDD RCs be invited to collaborate. In addition, in two regions each year, ICCIDD will make extra efforts to work on program development with the UNICEF Regional and Country Office Representatives and teams.

The Chair will determine who will represent ICCIDD at each of the above activities. A report is expected following attendance at each with specifics indicating progress toward the objectives.

ACHIEVEMENTS EXPECTED: Agreement to a grant for undertaking assessments with and via the Global Network. Reviews of 15 (see below) national programs supported by UNICEF. Renewed senior management priority attention to iodine nutrition and achievement of the UN Goal. Improved working relationships in two regions in 2004 and two in 2005 (West Africa and East Africa; South Asia and Central Asia). More regular referral to ICCIDD by Regional Directors of specific problems in national undertakings in IDD elimination. Attendance at and support to 2 Regional Management Teams per year. More attention in UNICEF country programming to the role of iodine nutrition (and other vitamin and mineral demands) in improved maternal health and improved reproductive health. Continued support to the NEWSLETTER.

GLOBAL NETWORK

ICCIDD will continue to play a leadership role in the Global Network on Sustained Iodine Nutrition, collaborating with all Board Member Organizations on advocacy, policy formulation, technical exchanges and national assessments. The Board has accepted the offer of MI to have a secretariat as a staff position in MI Ottawa. ICCIDD is proposing to UNICEF that ICCIDD enter into an agreement that would provide UNICEF with additional outside technical and program analysis support especially related to application of resources from a grant from the Gates Foundation; and, to support assessments in a number of countries at various levels of progress toward USI and Sustain Iodine Nutrition. This will work jointly with the secretariat in MI on these activities.

ACHIEVEMENTS EXPECTED. Upon successful determination of the grant from UNICEF for assessments and overviews, ICCIDD will propose teams for acceptance by the Network Chair for assessments and reviews in 20 countries over the next two years. (See below). ICCIDD will report to the Governments and Agencies on these assessments and reviews and to the Network Board. The ICCIDD NEWSLETTER will feature activities of the Network. ICCIDD will take a leadership role in creating and supporting National Coalitions for Iodine Nutrition in all countries, but in the next two years will focus on 20 countries (see below) and work in cooperation with Network Board Member affiliates and GAIN in so doing.

ADVOCACY

ICCIDD will continue its global advocacy. This will be achieved through improved and expanded circulation of the NEWSLETTER; continued support to the concept of Regional Meetings to measure progress on USI and Sustained Iodine Nutrition (as in Beijing in 2003 and Lima in 2004); continued publication by its members of scientific information; accelerated action alone and with allies in the formation of national coalitions and other alliances for iodine nutrition. ICCIDD will continue to reach out to other international non governmental organizations with interests in the same field and seek to create working alliances at national level with them. Priority opportunities are: World Girl Scouts and Guides; World Boy Scouts and Guides; World Federation for Mental Health; Inter-Parliamentary Union. This means, as well, that ICCIDD will work with the UN SCN on matters of mutual interest and attempt to influence other regional and subregional efforts in public health and public nutrition (see below)

ACHIEVEMENTS EXPECTED. The NEWSLETTER will continue and 8 issues will be published in the two year period. The Editor will publish an Index for mass distribution and reference. The monthly "Update" will be maintained and the mailing list expanded. Collaboration with Scout and Guide movements will expand from three countries to ten. A Network sponsored meeting on Sustained Iodine Nutrition will be held in Dakar, Senegal, in September 2004 sponsored and ICCIDD will pay a leading role. RCS will attend WHO Regional Committee Sessions and review progress toward USI and Sustained Iodine Nutrition. A plan for a Spanish language edition of NEWSLETTER will be prepared. The celebration of "IDD Day" will be held in more countries. More specifics are in the Regional discussions below. The NEWSLETTER will feature supporting evidence of the need for iodine supplementation during pregnancy.

Executive Committee

The Executive Committee will continue to 'meet' electronically rather than expend limited resources on travel. The Chair will communicate with the RCS and others at least quarterly. The Program Group of the Committee will review national efforts and reports and suggest lines of action to the Chair and others for consideration. The Treasurer will issue quarterly financial reports and statements of condition. The Executive Committee will report electronically to the Board following each meeting. Executive travel will be under the supervision of the Chair. The Executive Committee will undertake a search for an Executive Director and after review propose action to the Board I

AFRICA

1. West Africa

NATIONAL IODINE NUTRITION EFFORTS

POOR PROGRESS is reported from Burkina Faso, Ivory Coast, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mauritania, Niger, Senegal, and Sierra Leone. ICCIDD cannot address all of these simultaneously, but on priority, will propose to UNICEF, WHO and the Network.

ACHIEVEMENTS EXPECTED: Two assessments completed. All governments contacted at least once. Communications with UNICEF and WHO Reps in all countries sustained. Collaboration with UNICEF in national dialogues on VMD information. Verify what the National Coalitions do in light of minimal reporting indicated in at least 5 countries. Verify national median UIC Ghana, Gabon, Guinea, Senegal and Sierra Leone. Verify status of stand alone budget in each country. A special mission to Ghana to continue discussions with Ministries other than Health. Reported on each activity to the Chair and the Board.

STALLED PROGRESS seems evident in Cameroon, Mauritania and ICCIDD will communicate with national leaders, WHO and UNICEF to determine exact status and seek ways to assist forward motion. In addition, ICCIDD will recommend that an Assessment be made of the lessons learned in Cameroon. Reports on UIC are needed from CAR, Chad, Congo, DRC, Ivory Coast, Guinea, Senegal, and Sierra Leone. National Coalitions will be formed in CAR Congo, and DRC. National Political and Financial Commitment will be verified.

ACHIEVEMENTS EXPECTED. Improved communications with WHO and UNICEF. Improved information on which to base advice and plans for technical assistance. Assessments completed in Cameroon, DRC and Senegal. Formation of 3 National Coalitions. Confirmed national political commitment in all countries. Active participation with UNICEF in national dialogues on VMD in at least 4 countries. Reports on each activity to the Chair and the Board. Promote celebration of IDD Day in each country.

GOOD PROGRESS by trends in iodized salt production / import is reported in Congo, DRC, Mali, Nigeria and Togo. Some of these might benefit from a national review.

ACHIEVEMENTS EXPECTED. National reviews/ assessments in all countries. Reports to Chair and Board on each activity.

SPECIAL REQUESTS

The RC will press UNICEF and WHO for positive consideration of investments in laboratories in for Nigeria, Gabon, and Rwanda for 2004 - 2005.

RELATIONS WITH WHO:

Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health.

ACHIEVEMENTS EXPECTED. Attendance at WHO Regional Meeting. Discussion with all delegations on progress toward USI and Sustain Iodine Nutrition. WHO to encourage mandatory reporting annually. Studies completed satisfactorily. Reports issues on each activity.

RELATIONS WITH UNICEF:

The RC will communicate directly with each UNICEF Country Representative and with the Regional Director. In reviewing ICCIDD activities, actual or planned, the RC will work with the UNICEF Rep and other agency representatives to assure full coordination. The RC will seek to be a participant in country reviews of programs, especially those calling for investments in public health and public nutrition. In undertaking all the above activities, the RC will seek mutual support to them from the UNICEF Representative. Attendance at Regional Management Team meetings is desirable. The RC will seek copies of all reviews and national reports on iodine nutrition and offer commentary to the Representative as appropriate. In dealing with individual requests from national entities including the Government, the RC will assure ICCIDD that every effort to incorporate the needs into the UNICEF country program has been made before forwarding the request to the Chair. In discussion with UNICEF Representatives, arrange for collaboration and support to national dialogues on the VMD Report and to national leadership review of the DAR.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 5 countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 12 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 4 joint field visits. Participation and review of the VMD and DAR in at least ten countries.

RELATIONS WITH GLOBAL NETWORK. The composition of the Network Board is such that it is not likely that each Organization Member will have a constituent or subsidiary in each country. To the degree that each is present; the ICCIDD will endeavor to assure full participation in the National Coalition and share information freely. In addition, ICCIDD will encourage national managers to approach WHO and UNICEF Representatives to seek reviews, assessments and monitoring missions via the established Guidelines. ICCIDD will collaborate fully with the Network Chair and the RD of UNICEF in preparing and executing the Regional Meeting on Sustained Iodine Nutrition to be held in Senegal in September 2004.

ACHIEVEMENTS EXPECTED. Successful completion of 3 assessments, reviews, or monitoring missions as per above with full participation of ICCIDD. Successful creation and stimulation of at least 4 National Coalitions in the same number of countries. Successful planning and execution of the Senegal Meeting.

RELATIONS WITH OTHER REGIONAL BODIES and OTHER AGENCIES:

It is expected that ICCIDD and the West African Health Organization will enter into a Memorandum of Understanding on mutual support to agree upon objectives for advocacy to each State Member of the WAHO. WAHO would elevate the priority for nutrition in general and iodine nutrition in particular.

ACHIEVEMENTS EXPECTED. AN MOU approved by the Chair to be signed during the year.

MICRONUTRIENT INITIATIVES has recently expanded its attention to countries and programs in West Africa. ICCIDD will seek to collaborate to the fullest regarding efforts to achieve USI and virtual elimination of IDD.

SPECIAL NOTE. No division of labor or responsibility is made in this paper regarding the tasks of the RC and those of the Sub Coordinators; this is a responsibility of the incumbents

2. EAST AND SOUITHERN AFRICA

NATIONAL IODINE NUTRITION EFFORTS

POOR PROGRESS is noted in Ethiopia and Somalia. Regarding Somalia it seems not much can be done at this stage. Ethiopia requires an entire new look. ICCIDD will press for a discussion nationally with all the leaders and with all the foreign aid donors in an effort to re commit the political leaders to (a) import iodized salt to assure full protection of the population (b) while it reviews ways and means to assure adequate and well financed iodized salt from domestic production.

ACHIEVEMENTS EXPECTED. A joint mission visit to Ethiopia is indicated. A draft revised plan of action by end of October 2004. An approach to the Network Board for commitment of resources to undertake the necessary reviews and program planning. Improved direct communications between ICCIDD RC and development agencies and national authorities.

STALLED PROGRESS seems evident in Angola, Botswana, Lesotho, Madagascar, Malawi, Namibia, South Africa, Swaziland, Tanzania, Zambia, and perhaps Zimbabwe. Each case is different; some are dependent upon imports; some more than others; some not at all. RC will communicate directly with the UNICEF Representative in each country to obtain recent reports and analyses and comment on them. From these will come suggestions for action within the purview of ICCIDD. RC will encourage UNICEF and WHO country Representatives to press for official requests to undertake reviews, assessments and monitoring missions in as many countries as possible. RC will also communicate with Reps in each country to encourage formation of National Coalitions. RC will communicate with UNICEF Rep to offer collaboration with national dialogues on the VMD Report and the discussions on the National DARs in each case.

ACHIEVEMENTS EXPECTED: Improved and more regular communications with each country Rep of WHO and UNICEF. Improved ability to review program documentation and offer pertinent assistance and collaboration. At least 5 national reviews, assessments, monitoring missions (Angola, Botswana, Malawi, South Africa, Zambia. At least 5 national dialogues on VMD and DAR utility (Angola, Botswana, Malawi, Tanzania, and Zambia). At least 5 new National Coalitions to be up and running.

GOOD PROGRESS IS NOTED in Burundi, Comoros, Eritrea, Kenya, Rwanda, and Uganda. However, in some no information is available to indicate active National Coalitions (Burundi, Kenya,). There is little evidence that USI and IDD Elimination are priorities in other than the MOH. In cooperation with the Network the RC will encourage the UNICEF and WHO Representatives to seek requests for assessment, reviews or monitoring missions. The RC will collaborate with the UNICEF Rep in the National Dialogues associated with the VMD Report and the country DARs.

ACHIEVEMENT EXPECTED. At least two national coalitions demonstrably in operation. Communications improvement with and to all UNICEF Reps and WHO Reps. Communications with Government leaders to seek national collaboration with education, agriculture and other sect ors. Assessments, monitoring missions and/or reviews completed in at least three countries. Promote celebration of IDD Day in each country.

RELATIONS WITH WHO:

RELATIONS WITH UNICEF:

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 4 countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 4 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 3 countries.

RELATIONS WITH GLOBAL NETWORK. The composition of the Network Board is such that it is not likely that each Organization Member will have a constituent or subsidiary in each country. To the degree that each is present, the ICCIDD will endeavor to assure full participation in the National Coalition and share information freely. In addition, ICCIDD will encourage national managers to approach WHO and UNICEF Representatives to seek reviews, assessments and monitoring missions via the established Guidelines.

ACHIEVEMENTS EXPECTED. Successful completion of all assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 5 National Coalitions in the same number of countries.

RELATIONS WITH OTHER REGIONAL BODIES and OTHER AGENCIES.

Commonwealth Regional Health Community Secretariat (CRHCS). Regular meetings of this body cover topics of interest to ICCIDD. It is important that ICCIDD continue to attempt to influence the Secretariat on issues related to iodine. However, more than mere attendance and satellite meetings are needed. The Secretariat might be encouraged to seek a working arrangement with ICCIDD to provide appropriate technical and advisory assistance as needed.

Micronutrient Initiatives is active in this Region. The RC will keep in communication with the Regional Director of MI and will seek to work in mutually supportive ways on matters of concern to national efforts on iodine nutrition.

ACHIEVEMENTS EXPECTED. Improved and more regular communications and exchanges of essential documentation and ideas. Perhaps a MOU with the Commonwealth Secretariat. More continuous and mutually beneficial working arrangements with MI

III MEDITERRANEAN AND MIDDLE EAST. (*)

NATIONAL IODINE NUTRITION EFFORTS

POOR PROGRESS is being made in Iraq (but see below), Sudan, Syria, and limited information exists regarding Saudi Arabia, Qatar, Kuwait and UAE. ICCIDDD will seek discussions with national Leaders and with UNICEF Representatives in each country to agree on challenges to be met. In the case of Iraq, UNICEF recently approved resources to reach 85% of household access to iodized salt by early 2005. In addition, ICCIDD will encourage UNICEF and WHO to press for governments' requests for assessments, or reviews, or monitoring missions in Morocco, Syria, and Yemen at a minimum. The RC will approach the UNICEF Representative in each country to offer collaboration regarding national dialogues on the VMD and the country DARS.

ACHIEVEMENTS EXPECTED. Close review of progress in Iraq. At least three Network Sponsored Assessment and Review Missions. At least 5 national dialogues assisted. Reports on each activity. Improved communications with UNICEF and WHO and national authorities.

STALLED PROGRESS seems evident in, Sudan, Iraq and Palestine, Yemen, Egypt and Morocco and the RC will seek discussions with Government and UNICEF to confirm information and make suggestions.

ACHIEVEMENTS EXPECTED. Progress report from Egypt, Yemen and Morocco. Participation in a national dialogue on the VMD Report and the DAR. Improved communications with national authorities and UNICEF and WHO.

GOOD PROGRESS is reported from Algeria, Iran, Jordan, Lebanon, Libya, Oman and Tunisia and the RC will seek discussions with government leaders and UNICEF to determine the value of assessments, reviews or monitoring missions to assist the authorities to reach the UN Goal.

ACHIEVEMENTS EXPECTED. Review, assessment or monitoring missions completed in at least three countries and reports filed. (An assessment of Iran is being processed). Improved communications with the national authorities in each country, with UNICEF and WHO Representatives. Participation in at least three National Dialogues on the VMD Report and the DARS. Reports filed on each activity.

SPECIAL REQUESTS

There is a growing demand for websites and improved data bases. ICCIDD will endeavor to seek financial and technical support for these in a number of countries. These will improve national monitoring and oversight and contribute to technical exchanges between countries.

RELATIONS WITH WHO:

Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda annually to be proposed. The 2004 Meeting has an agenda item and country reports are expected. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health. Since this is a sub region, appropriate liaison with the RC is needed.

RELATIONS WITH UNICEF:

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 5 countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 5 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 2 joint field visits. Participation and review of the VMD and DAR in at least 3 countries.

ACHIEVEMENTS EXPECTED. Successful completion of 2 assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 3 National Coalitions in the same number of countries.

RELATIONS WITH OTHER REGIONAL BODIES and OTHER AGENCIES

(*) It needs to be noted that this region for ICCIDD is not congruent with either a WHO or UNICEF region and is so labeled for convenience of reference only. While much of the information comes from the RCs excellent reports, a good bit is based on information available through UNICEF, personal correspondence, and the Network. Thus, Afghanistan and Pakistan, in the WHO Region, are reported on below since the resources for the activities are flowing from UNICEF.

III. SOUTH ASIA

NATIONAL IODINE NUTRITION EFFORTS

POOR PROGRESS is reported from Pakistan and Afghanistan. Joint communications of ICCIDD and UNICEF and WHO to the authorities may open opportunities to action. UNICEF in Afghanistan is currently assisting in upgrading of salt production sites and facilities. The recent VMD Report and National DARS will be used to seek renewed political attention. In any case, the requests should be to 'update' the Salt Situation Analysis in each country.

ACHIEVEMENTS EXPECTED: Improved facilities in Afghanistan should provide increased production of iodized salt. Renewed national commitment in Pakistan. Request from Pakistan for review and programming planning assistance under purview of the Network. Reports issued on each activity.

STALLED PROGRESS is evident in India, Bangladesh, Nepal, and Maldives. RC will communicate directly with the UNICEF Representative in each country to obtain recent reports and analyses and comment on them. From these will come suggestions for action within the purview of ICCIDD. RC will encourage UNICEF and WHO country Representatives to press for official requests to undertake reviews, assessments and monitoring missions in as many countries as possible. RC will also communicate with Reps in each country to encourage formation of National Coalitions. RC will communicate with UNICEF Rep to offer collaboration with national dialogues on the VMD Report and the discussions on the National DARs in each case.

ACHIEVEMENTS EXPECTED: Recent salt situation studies to be reviewed by producers and traders for action. Joint approaches by ICCIDD with MI, UNICEF, WHO to discuss the VMD Reports and the DARS and seek renewed political commitment and involvement. National and sub national coalitions formed in at least two countries. Assessment, review or monitoring missions via the Network system in at least India, Bangladesh and Nepal. Improved communications between ICCIDD and UNICEF and WHO. Reports issued on each activity.

GOOD PROGRESS is evident in Bhutan, Sri Lanka. The recent VMD Report and the DARS offer an opportunity to continue high level discussions to assure sustained optimal iodine nutrition.

ACHIEVEMENTS EXPECTED. National dialogues completed in two countries. Sustained USI levels continue. Lessons learned reviewed and published and shared. Reports issued on each activity.

RELATIONS WITH WHO: Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health.

RELATIONS WITH UNICEF: The RC will communicate directly with each UNICEF Country Representative and with the Regional Director. In reviewing ICCIDD activities, actual or planned, the RC will work with the UNICEF Rep and other agency representatives to assure full coordination. The RC will seek to be a participant in country reviews of programs, especially those calling for investments in public health and public nutrition. In undertaking all the above activities, the RC will seek mutual support to them from the UNICEF Representative. Attendance at Regional Management Team meetings is desirable. The RC will seek copies of all reviews and national reports on iodine nutrition and offer commentary to the Representative as appropriate. In dealing with individual requests from national entities including the Government, the RC will assure ICCIDD that every effort to incorporate the needs into the UNICEF country program has been made before forwarding the request to the Chair. In discussion with UNICEF Representatives, arrange for collaboration and support to national dialogues on the VMD Report and to national leadership review of the DAR.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 4countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 3 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 3 countries.

ACHIEVEMENTS EXPECTED. Successful completion of 4 assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 4 National Coalitions in the same number of countries.

IV. THE AMERICAS

NATIONAL IODINE NUTRITION ACTIVITIES

POOR PROGRESS is reported in Dominican Republic, Haiti and Guatemala. Each situation is different, but in general the effort to USI is not advancing. Reports issued for the Lima Sustain Iodine Nutrition Meeting indicate a need for a program review and realignment in Dominican Republic with renewed political commitment; a new approach in Haiti with renewed political commitment; and application of recommendations from recent reviews in Guatemala. Collaboration with the UNICEF Representative on dialogues related to the VMD and the DARs is indicated. Communications with the UNICEF RD, Representatives and the CRs of WHO is indicated. National Coalitions are needed.

ACHIEVEMENTS EXPECTED: Improved communications directly with Representatives of Agencies. A program and political commitment review in Dominican Republic and Haiti. Renewed pressure to achieve USI in Guatemala by revised current stalled strategies. (3 Network efforts). Collaboration with UNICEF on dialogues regarding VMD. National Coalitions created in 3 countries.

STALLED PROGRESS is indicated in Bolivia by the report to the Lima Meeting. Communication with the UNICEF Representative and others to apply the lessons learned and the recommendations made by a Network Consultant to re invigorate the program. National Coalition invigorated and with multi sectoral and multi professional collaboration.

ACHIEVEMENTS EXPECTED: National effort revitalized. Communications with UNICEF and WHO improved and consolidated. USI achieved in 2005. Collaboration with the UNICEF Representative on national dialogue related to VMD and DAR. National Coalition invigorated.

GOOD PROGRESS IN Argentina, Belize, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, El Salvador, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Venezuela in the reports to the Lima Meeting. However, some special needs are indicated in some places: In Mexico, Venezuela, and Peru (at minimum) improved relations with salt corporations may be needed. National monitoring facilities in government need confirmed financial support. Quality Assurance of the product is always needed. The VMD reports and DARS need wider distribution.

ACHIEVEMENTS EXPECTED. Special efforts to reach out to salt producers and traders in Mexico, Ecuador, Venezuela and Peru. Collaboration with UNICEF on dialogues related to the VMD and DARS in 6 countries. Collaboration with MCH and reproductive health study in all countries. Communications with UNICEF and WHO improved and sustained. Lessons learned reviewed and published and shared. Reports issued on each activity.

In relation to all the above, the reports filed for the Lima Meeting will be reviewed and direct commentary on each provided to Governments and Agencies nationally with specific recommendations for consideration in each case.

RELATIONS WITH WHO: Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed as already endorsed by Peru. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health.

In discussions in NY with the RD, it seems assured that MNM will be an item on the RMT in September and a major discussion on next steps in Iodine Nutrition is contemplated.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 4countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 3 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year in addition to the RMT in Panama in September. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 3 countries.

ACHIEVEMENTS EXPECTED. Successful completion of 4 assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 8 National Coalitions in the same number of countries.

V. ASIA PACIFIC

NATIONAL IODINE NUTRITION ACTIVITES

POOR PROGRESS is reported in Cambodia and Fiji. The reports to the Beijing Conference reflect a need to reconsider planning and strategies. The VMD Reports and the DARS offer an opportunity to reopen national high level discussions on the issues and re commit political and other resources to make the efforts less dependent upon foreign aid. A Network sponsored program review and analysis for Cambodia seems indicated. UNICEF with USAID and Kiwanis support has provided nearly US$1 million so far and AUSAID has been supportive.

ACHIEVEMENTS EXPECTED. Review in Cambodia. Communications with the UNICEF Regional Office and UNICEF Rep improved and solidified. National Dialogue of the VMD and DARS in both countries.

STALLED PROGRESS seems evident in Indonesia, Laos, Myanmar, Philippines, and Timor. Recent views suggest follow-up on recommendations and proposed altered actions. Mongolia has many studies on viability of domestic production, but little progress reported on national investment. Philippines reporting improved market reach of iodized salt, but reaching the goal seems remote. Reports to Beijing meeting merit follow up by ICCIDD and other Network partners. The VMD Report and national DARS offer opportunities to renew national dialogues on policy and commitment.

ACHIEVEMENTS EXPECTED. Communications with UNICEF Regional Office and Country Representatives on follow up to national reviewed and to reports to Beijing Meeting concerning Laos, Myanmar, Myanmar, Philippines, Timor and Vietnam. Improved regular communications with WHO and UNICEF Country Representatives. Increased access and opportunity to comment on national proposals. At minimum, 4 proposals for Network sponsored reviews, assessments, or monitoring missions. Reports prepared on each activity.

GOOD PROGRESS is reported from Thailand and Vietnam. Follow-up with recent Network sponsored review of Thailand effort. Continued collaboration with special effort on USI in Tibet by the RC and team from Australia.

ACHIEVEMENTS EXPECTED. Encourage Government to seek assessments, reviews or monitoring missions in at least three provinces. Prepare plan to seek Government partnership on special studies to learn from experiences in China on a range of activities. Reports prepared on each activity.

In relation to all the above, the reports filed for the Beijing Meeting will be reviewed and direct commentary on each provided to Governments and Agencies nationally with specific recommendations for consideration in each case.

RELATIONS WITH WHO: Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed as already supported in principle by GPRC. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 5 countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 4 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 4 countries.

ACHIEVEMENTS EXPECTED. Successful completion of 5 assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 6 National Coalitions in the same number of countries.

VI. CHINA AND EAST ASIA

NATIONAL IODINE NUTRITION ACTIVITES

GOOD PROGRESS is reported in China. However, that said, there are significant challenges in many provinces and elements of the massive national endeavor. Follow up of the Being Conference report from China and Mongolia is indicated. ICCIDD has an almost continuous presence in the country by virtual of the RC and because of the work for UNICEF by the Chair.

ACHIEVEMENTS EXPECTED. Review in some Provinces. Communications with the UNICEF Regional Office and UNICEF Rep improved and solidified. National Dialogue of the VMD and DARS in both countries.

STALLED PROGRESS seems evident in Mongolia. Mongolia has received results of many studies on viability of domestic production, but little progress reported on national investment. Reports to Beijing meeting merit follow up by ICCIDD and other Network partners. The VMD Report and national DAR offer opportunities to renew national dialogues on policy and commitment. No contact has been made with the DPRK.

ACHIEVEMENTS EXPECTED. Communications with UNICEF Regional Office and Country Representatives on follow up to national reviewed and to reports to Beijing Meeting concerning China and Mongolia. Improved regular communications with WHO and UNICEF Country Representatives. Increased access and opportunity to comment on national proposals. At minimum, 2 proposals for Network sponsored reviews, assessments, or monitoring missions. Reports prepared on each activity. An initial contact with the DPRK is planned.

RELATIONS WITH WHO: Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed as already supported in principle by GPRC. Communications with each CR of WHO on above issues. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in 2 countries (see above). All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 2 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 2 countries.

ACHIEVEMENTS EXPECTED. Successful completion of 2 assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of a National Coalition in Mongolia.

VII EUROPE AND CENTRAL ASIA*

NATIONAL IODINE NUTRITION ACTIVITIES

POOR PROGRESS seems the norm for Albania, Greece, Portugal and Spain in Western Europe: Ukraine in Eastern Europe. Some of these have requested reviews and ICCIDD with UNICEF has responded. Spain undertook a national workshop last year with good results. Salt associations in Ukraine and Russia have held a number of meetings. The VMD and the DARS give new opportunity to national dialogues to renew political commitment and public private collaboration especially in countries of Eastern Europe and Central Asia.

ACHIEVEMENTS EXPECTED. Renewed communications with each WHO CR and UNICEF Representative (and the Regional Offices) to seek ways more closely to work together to address the national policy issues. Each Regional Coordinator will undertake the communications to RDs and Reps in UNICEF with corresponding national responsibilities. See below re approaches to the EU and issues related to standardization of iodized salt. Reports filed on each activity.

STALLED PROGRESS seems evident in Russia, Belarus, Moldova, Kyrgyzstan, Tajikistan Uzbekistan in Eastern Europe and Romania, Hungary, Turkey, France, and Belgium, in Western Europe. Renewed approaches via various channels seems indicated. Communications with national leadership with UNICEF and WHO collaboration seems indicated. The VMD Report gives an opportunity to look at the issues anew.

ACHIEVEMENTS EXPECTED See below re approaches to the EU and issues related to standardization of iodized salt and better informed public opinion. Network sponsored reviews, assessments, or monitoring missions in at least 3 countries in Eastern Europe. Participation in at least 2 national dialogues on the VMD report and political commitment in each Region.

GOOD PROGRESS is reported in Armenia, Georgia, Turkmenistan, Azerbaijan, and a number of countries in Western and Central Europe. The VMD report opens opportunities for improved collaboration with UNICEF and WHO in national dialogues on the issues. Communication between ICCIDD, UNICEF and WHO to be stimulated. Baltic States seem more interested to implement effective legislation.

ACHIEVEMENTS EXPECTED. Reviews, assessments, or monitoring missions in three countries. Plans are well advanced for a review in Turkmenistan. Improved communications between ICCIDD and UNICEF and WHO Country Representatives. Participation in national dialogues on the VMD and the DArs in at least 4 countries.

RELATIONS WITH WHO:

Communications with the Regional Director on major policy issues and regarding participation in WHO Regional Committee on IDD. Special Item on Agenda to be proposed for annual reporting on Iodine Nutrition. Collaboration with WHO on studies pertinent to the goals of virtual elimination. Collaboration with Science Committee and others in research and applied technology regarding MCH and reproductive health. Collaboration with WHO and other Network Board Members on plans for approaching the EU regarding standardization and for creation of improved public understanding of the issues in a number of countries.

RELATIONS WITH UNICEF:

The RCS will communicate directly with each UNICEF Country Representative or National Committee and the two Regional Directors. In reviewing ICCIDD activities, actual or planned, the RCS will work with the UNICEF Rep and other agency representatives to assure full coordination. The RC will seek to be a participant in country reviews of programs, especially those calling for investments in public health and public nutrition. In undertaking all the above activities, the RCS will seek from the UNICEF Representative. Attendance at Regional Management Team meetings is desirable. The RCS will seek copies of all reviews and national reports on iodine nutrition and offer commentary to the Representative as appropriate. In dealing with individual requests from national entities including the Government, the RCS will assure ICCIDD that every effort to incorporate the needs into the UNICEF country program has been made before forwarding the request to the Chair. In discussion with UNICEF Representatives, arrange for collaboration and support to national dialogues on the VMD Report and to national leadership review of the DAR.

ACHIEVEMENTS EXPECTED. Assessments designed and completed in countries indicated. All Representatives of UNICEF alert to presence of ICCIDD and ability to collaborate. At least 6 country program reports reviewed and comments offered. At least one meeting with the RD and staff per year. At least 3 joint field visits. Participation and review of the VMD and DAR in at least 4 countries. A Regional Meeting on Progress toward the Goal will be held in Istanbul in September.

RELATIONS WITH GLOBAL NETWORK. The composition of the Network Board is such that it is not likely that each Organization Member will have a constituent or subsidiary in each country. To the degree that each is present; the ICCIDD will endeavor to assure full participation in the National Coalition and share information freely. In addition, ICCIDD will encourage national managers to approach WHO and UNICEF Representatives to seek reviews, assessments and monitoring missions via the established Guidelines. ICCIDD will collaborate with lead organizations in the Global Network on current proposals to approach the EU and to increase public awareness of need for optimal iodine nutrition diet.

ACHIEVEMENTS EXPECTED. Successful completion of assessments, reviews, mission as per above with full participation of ICCIDD. Successful creation and stimulation of at least 8 National Coalitions in the same number of countries.

(*)For purposes of this paper, countries in Europe are grouped into two regions: Eastern Europe and Central Asia and Western/Central Europe."

COMMITTEE ACTIVITIES

COMMUNICATIONS

Plans. At as many as possible international and regional forums, advocacy of the importance of communication to strengthen and maintain the political will/policy support and public education that aims at fostering the behavioral norm of using iodized salt; strengthen the communication component of ICCIDD's home site by combining the IDD communication website at Tulane University with the ICCIDD home site.

Achievements expected: More country programs include communication inputs as an integral part of the national program, greater purposeful and professionally executed communication activities at the country level to keep a sharp focus on programs against iodine deficiency and to create demand for the use of iodized salt to fight iodine deficiency; gradual phasing out the Tulane website.

DEVELOPMENT.

PLANS. As approved by the Board to draft and submit proposals for long term financial support to Canadian CIDA, the Netherlands Foreign Aid, and UNICEF to accomplish this work plan. Approaches to WHO will be made on specific issues.

ACHIEVEMENTS EXPECTED: Successful negotiations with all donors. Program proposals fully financed. Reports submitted to donors and to the Board.

LIAISON

PLANS. Continue liaison with UNICEF senior leadership, attendance at Board Sessions relative to our work, and discussions with Regional Directors to improve field collaboration. Continue to reach out to other organizations for collaborative support : Girl Guides and Scouts; Boy Guides and Scouts; World Federation of Mental Health Associations; Interparliamentary Union; the Global Network on Sustained Iodine Nutrition. Two joint visits to regions with the RCs (East Africa and West Africa; perhaps Asia).

ACHIEVEMENTS EXPECTED : Successful advocacy with UNICEF. Improvements in relations with other non governmental organizations. Favorable consideration of iodine nutrition on the agenda of meetings of the IPU. Successful field missions. Successful work with national assessments, evaluations and monitoring mission planning and deployment.

SALT

The Salt Issues Committee is dedicated to building in the salt industry an understanding of the importance of iodine nutrition, the role of salt iodization in overcoming IDD and the partnership role for salt producers in national coalitions and to expand the active support to national coalitions by the salt industry.

PLANS: Survey Regional Coordinators to provide the names and contact information for salt producers and any salt industry associations in their regions. Create a salt industry database. Survey that database for producer perspectives on the progress and prospects for salt iodization and to identify their needs in a more comprehensive manner. Analyze survey results and share the analysis with Regional Coordinators. Maintain a list of available salt industry consultants to support technology transfer, capacity-building and program assessments. Identify policy recommendations to enable increased and effective salt industry partnership in overcoming IDD. Promote to the salt industry the importance of their role in national coalitions to achieve iodine nutrition.

ACHIEVEMENTS EXPECTED: The RC survey will be distributed in July, 2004 with a request to be returned by September 15. The producer/salt association survey will be distributed by October 1 with receipt requested for November The salt industry consultants list is available now. Once the database is prepared, notice and encouragement for participation in national coalitions will be done upon receipt of information from Regional Coordinators about the formation of such coalitions.

DPH

GREENSBORO

JUNE 2004/1