Ethiopia Launches Fortified Salt to Prevent Birth Defects Nationwide

The Government of Ethiopia, through its Ministries of Health, Industry, and Trade and Regional Integration, has launched a nationwide programme to introduce double-fortified salt containing iodine and folic acid. The initiative was developed in collaboration with the Ethiopian Public Health Institute (EPHI) and Nutrition International, with technical support from the University of California-Davis and the University of Toronto, and financial backing from the Gates Foundation. The programme aims to reduce neural tube defects (NTDs) and improve maternal and newborn health. “By introducing double-fortified salt across Ethiopia, we can protect families, strengthen communities, and give every child the healthiest possible start in life,” said Dr. Mekdes Daba, Minister of Health. Ethiopia reports 80 cases of NTDs per 10,000 live births, more than three times the African average. These defects, including spina bifida and anencephaly, are largely caused by insufficient folate during early pregnancy and can result in neonatal deaths or lifelong disabilities, imposing significant emotional and financial burdens on families. The double-fortified salt builds on the country’s universal salt iodization programme, which already reaches more than 90 percent of households. Recent clinical trials have shown that DFS-IoFA rapidly increases folate levels among women aged 15-49, lowering the risks of NTDs, stillbirths, and low birthweight. Industrial pilot testing at Green Star Trading PLC in Hawassa confirmed that both iodine and folic acid remain stable for over ten months under local heat and humidity, with more than 94 percent of nutrients retained from factory to household and no detectable change in taste or smell. “Double-fortified salt provides a practical, daily intervention to prevent birth defects,” said Tiringo Kinfegabriel, Country Director for Nutrition International. Production can be scaled through Ethiopia’s 14 central iodization facilities with minimal equipment upgrades and short-term training. Domestic quality control will be supported by EPHI’s national reference laboratory, and rapid folic acid testing kits are expected to be rolled out across all regions in 2026. The programme is expected to deliver both health and economic benefits, including reduced healthcare costs and improved productivity. The additional cost of production is estimated at US $0.01 per capita per year. Both the Project Advisory Committee and the Food Fortification Steering Committee endorsed the intervention in November 2025, recommending its immediate adoption as a mandatory national standard. “Ethiopia has made significant progress in reducing iodine deficiency, and DFS-IoFA is the next step in safeguarding maternal and child health,” said Dr. Mesay Hailu, Director General of EPHI. The launch formalizes a national roadmap for mandatory fortification, aligning with Ethiopia’s National Food and Nutrition Policy, the Seqota Declaration, and the UN Sustainable Development Goals.