Representatives from 9 CARMEN countries and experts in salt reduction from PAHO, US CDC, the UK, Australia, WHO Geneva, Inter American Heart Foundation, World Hypertension League, Health Canada gathered together in Miami, FL under the sponsorship of PAHO and PHAC. The countries and experts called for PAHO to establish a task force for and mandate to develop the evidence base for salt reduction, and to develop cost/benefit projections for review by national governments.
The group explored the existing salt reduction policies in CARMEN countries as well as in other WHO regions and countries around the world; and the next steps for a population-level dietary salt reduction in the Americas.
Document the policies and initiatives in the Americas Region aimed at reducing dietary salt to prevent and control chronic noncommunicable diseases (CNCDs), and to feature relevant experiences in CARMEN countries and in other countries and WHO Regions. Reach consensus on the Regional-, subregional- and national-level initiatives that can advance dietary salt reduction in the Americas and identify next steps for each.
• Participants gain a common understanding of the sodium sources and intake levels in countries of the Americas as well as any salt reduction policies and strategies that are emerging or in effect.
• Participants learn about salt reduction initiatives in countries outside the Americas and in other WHO Regions, and what interventions are proving effective.
• Participants reach a consensus on next steps, to include:
o Options for country-specific, sub-regional or regional actions appropriate to the Caribbean, Central and South American countries that will engage governments, civil society and private industry.
o Joint projects to advance the development of salt reduction policies and strategies within the CARMEN network.
o Resources needed to support next steps and potential sources to approach.
The meeting concluded with PAHO, the Public Health Agency of Canada (PHAC), and the country participants making a commitment to work on creating greater visibility of the issue, since salt is not only a problem for people with hypertensive disease but also a problem of the entire population; moreover, even a modest reduction in population salt intake results in a major improvement in public health.
It was agreed that dietary salt reduction is one of the most cost-effective public measures available, and one that is relatively feasible in collaboration with industry and governments. However, it is not well appreciated how huge a contribution salt makes to the burden of chronic noncommunicable diseases (CNCDs). It is important to educate both the public and policy-makers, as well as industry.
It was agreed to put the topic on the regional and subregional agendas, to look for national and regional advocates and champions, and to work on standardizing information. Information was also provided on opportunities for promotion through organization such as SLAN (the International Latin American Congress on Nutrition held in November 2009 in Chile) and such new actors as the Food and beverage Alliance formed by six largest food and beverage companies, which cover 80% of world market, and SALCA, the South American consumer association.
• Dietary salt is a very strategic issue for PAHO and its Member Countries. An active effort to reduce salt consumption should be made as part of the PAHO Regional Strategy on Chronic Disease Prevention and Control, and lessons should be learned from the Trans Fat Free Americas initiative.
• There should be follow-up with PAHO technical areas and PHAC on convening a Regional Task Force on Salt Reduction Policies, and on improving the assessment of the situation as part of developing a more detailed plan for 2009-2010, to include policy recommendations and targets.
• The country participants present and the CARMEN network should be considered as primary networks for distributing all materials related to salt, which should be translated into Spanish and Portuguese.
• Internal awareness should be raised on the importance of salt reduction policies, e.g. a technical discussion session within the PAHO Health Surveillance and Disease Management Area with online information-sharing via Elluminate.
• Specific issues and targets should be included within the objectives of the Partners' Forum