Advancing national sodium reduction policy under crisis: lessons from Ukraine

Issue/Problem

Excessive salt intake is a driver of noncommunicable diseases, contributing to cardiovascular disease, hypertension, and premature mortality. WHO recommends less than 5 g/day; however, intake in Ukraine reaches 12.6 g/day. The full-scale invasion of Ukraine by the Russian Federation has complicated the implementation of preventive health policies due to disrupted systems, resource constraints, and competing priorities.

Description of the problem

The WHO Ukraine, the Ministry of Health and national partners, implemented a sodium reduction initiative aligned with WHO Best Buys. Key components included: national policy dialogues engaging government, academia and industry; a nationwide behavior change campaign informed by focus group testing; promotion of voluntary product reformulation, particularly in high-consumption foods such as bread; and generation of evidence through a population-based knowledge, attitudes and practices (KAP) survey and the salt monitoring in bread project.

Results

The initiative established a coordinated multisectoral platform for sodium reduction in a complex emergency setting. Behavioral insights informed targeted messaging and campaign design, improving relevance for priority groups. Engagement with industry initiated reformulation discussions. The monitoring project and KAP survey provided a structured evidence base to guide communication strategies and policy prioritization. Policy dialogues strengthened alignment among stakeholders and reinforced sodium reduction as a national priority despite the ongoing war.

Lessons

Implementing sodium reduction policies in crisis requires integrating behavioral science, policy dialogue, and stakeholder engagement into a unified strategy. War conditions increase the importance of low-cost, high-impact interventions such as salt reduction. Ukraine’s experience shows that preventive policies can be advanced in fragile contexts through adaptive, evidence-informed approaches.

Key messages

• Ukraine demonstrates that sodium reduction policy can be advanced through coordinated multisectoral action, integrating behaviour change, reformulation and evidence generation into a unified strategy.

• Despite war-related disruptions, Ukraine shows that cost-effective NCD prevention measures such as salt reduction remain feasible and can be promoted through adaptive, evidence-informed approaches.