UNDER THE MICROSCOPE Dr. Raymund W. Lo This is the ultimate in paradoxes: an archipelago with the third longest coastline in the world having to import of all things— salt! Imagine being surrounded by tons of saltwater and loads of sunshine year-round, and the Philippines has to import 93 percent of its salt requirements? Back in 1990, we imported a measly 15 percent of our salt requirements, mainly Morton Salt (the classic blue cylinder with the girl in a ponytail carrying an umbrella in one hand while trailing salt from the container she’s holding in the other hand), which was probably the only iodized salt available in the country then. Then in 1995, RA 8172 was enacted prohibiting the use of non-iodized salt. Its intention was good: To eliminate iodine deficiency in the population. Is it coincidental that the drastic drop in salt supply coincided with the so-called ASIN (Act for Salt Iodization Nationwide) law? Philippine Chamber of Agriculture and Food Inc. (Pcafi) President Danilo Fausto said so, laying the blame squarely on the Department of Trade and Industry (DTI), which was required to provide the machine to incorporate iodine into salt being produced but did not do, so resulting in the death of the salt industry. Faced with heavy penalties but without the means to iodize the salt they were producing, many salt producers stopped production. The ramifications of the law continue into other areas. Coconut trees need to be fertilized with salt to be most productive. The requirement for salt, which need not be iodized, is at least 300,000 metric tons of salt for the 350 million trees in the country. In the food export industry, many countries refuse entry of food with iodized salt, since these are additives, and natural salt is preferred. This is another lost-income opportunity. The pharmaceutical industry is likewise impacted, especially the producers of intravenous fluids. Sodium chloride, or salt to the layman, is a main ingredient of IV fluids. In fact, the human body fluids contain mainly salt. Is it only the DTI that dropped the ball here? No. In the Implementing Rules and Regulations (IRR) of the ASIN law, the DOH was designated as the head agency tasked to coordinate with the Department of Science and Technology, along with the Technology and Livelihood Resource Center (TLRC), to train on salt-iodization technology and quality assurance. The DOH was required to set and enforce standards for food-grade iodized salt and to monitor compliance by the food-grade salt manufacturers through the Bureau of Food and Drugs (BFAD). The list goes on. The Cooperative Development Authority (CDA) shall assist small and subsistence salt producers to organize into cooperatives. The Department of Environment and Natural Resources (DENR) shall identify suitable land areas for salt works or farms. The Bureau of Customs shall monitor salt importation. What’s apparent is the wide-ranging reach of government in the law’s implementation. However, as with many, if not all laws, not enough budget is allotted for the many activities and materials required for full IRR implementation. Thus, they have been very strict in monitoring iodization of salt by producers but neglected to assist them in their capacity building for iodization of their product. Perfect recipe for failure! The use of industrial salt must have been forgotten in the rush to implement the law, leading to lack of salt for industrial and agricultural use. Apparently as well, when the law was formulated, there did not seem to be proper consultation with technical experts and involved stakeholders such as coconut farmers and processed food exporters. What happened was the law was rushed into implementation without proper safeguards, budgetary requirements, and understanding of the real intent, which was to reduce iodine deficiency as a public health problem. We can cite many other laws that went awry in implementation, but that will take many columns. But did the law at least achieve its main aim? In the succeeding years, there was a general improvement in iodine levels among schoolchildren, pregnant and lactating women, and the elderly, that is, until 2013, when levels were observed to have dropped to deficient status among these groups, except schoolchildren. (Perlas et al. Journal of Endocrinology and Metabolism vol.7 no.3, June 2017). That was in a study. On the ground however, the picture is even less rosy. In surgical pathology practice, it is still not uncommon to encounter large thyroid specimens indicative of iodine deficiency. That sadly indicates that we still have a long way to go in reducing iodine deficiency. It is not as simple as mandating putting iodine in salt. Yet, while trying to reduce one problem, iodine deficiency, it produced a radical unintended consequence, a salt shortage. The impending massive importation of salt will have ill effects on foreign currency reserves and national debt. This is aside from its adverse impact on agriculture, food, and pharmaceutical industries. Hardly a good bargain!