Short Summary
High salt consumption contributes to poor cardiovascular health. Worldwide, cardiovascular diseases are the leading cause of death and are among the top ten contributors to years lived with disabilities.
There is good evidence that reducing the amount of sodium people consume in their diets can reduce the risk of cardiovascular problems. Therefore, several countries have successfully reduced the sodium intake of their population, for example by setting sodium limits, which led to the food industry reformulating certain high-salt products.
We think that an organization advocating and assisting in implementing these policies could cost-effectively improve the health of millions.
The Problem
Sodium (usually consumed as table salt) is a silent killer. Each year, diets high in salt contribute to millions of deaths due to cardiovascular disease. The burden of cardiovascular diseases related to sodium consumption is expected to grow due to dietary changes, aging populations, and lifestyle changes.
The Solution
What’s the proposed solution?
Limiting salt consumption levels is regarded as a cost-effective way to reduce the burden of cardiovascular diseases at a population level. We recommend that a new nonprofit organization should focus on advocating for sodium policies and assisting food producers to reformulate their products in line with safe limits. We think interventions of this type are promising because they affect the choices available to consumers and, as such, do not rely on individual behavioral changes to reach a large scale.
A new nonprofit organization could combine advocacy and technical assistance to lead the State and food producers to cooperate and reduce the level of sodium in popular high-salt foods. Complementary interventions, such as front-of-pack labeling and fiscal approaches, may support these goals.
What is the evidence for and why do we trust this solution?
This is a high-risk, high-reward intervention. We estimate that nonprofits have successfully led to food reformulation, direct policy change and correct implementation in around ten percent of their advocacy attempts. It may take multiple attempts and careful targeting for a new organization to achieve change. Yet given the cost-effectiveness of this intervention, this low-success scenario is still worth pursuing.
Overall, there is evidence of a reduction in sodium intake due to reformulation, based on primarily observational longitudinal studies documenting the reduction of sodium consumption following reformulation interventions. This is not very high-quality evidence but it is in line with expectations for an evidence base of policy in this space. Experts largely agreed with our conclusions.
The Impact
Our speculative cost-effectiveness model and other CEAs in the literature suggest that sodium advocacy is highly cost-effective. Our modeling suggests that in Indonesia, this intervention may avert 866 DALYs for every USD 1,000 spent (about $1 per DALY). In Georgia, it may avert 13.8 DALYs for every USD 1,000 spent (about $72 per DALY).
Overall, we believe this is an idea worth recommending for incubation. We are excited by the potential leverage that policy work can have and the possibility of a charity that could have a huge outsized impact on people’s lives and health and address a growing global problem.
Who is best suited to do this?
Ideal founders of this charity should be comfortable with high levels of uncertainty given the high risk and high reward nature of this intervention.
Given the advocacy-heavy nature of this work, strong stakeholder management skills or experience in government advocacy would be a valuable asset.
We believe having relevant public health background would also be helpful.
