WHO has termed salt reduction a 'Best Buy' for NCD prevention. Critically evaluate the feasibility of behaviour-change-based public health interventions in India.

WHO caps safe intake at under 5 g salt (2 g sodium) per day and estimates a return of at least US$12 for every US$1 invested in sodium reduction — hence the "Best Buy" label [1]. Yet cost-effectiveness on paper is not the same as feasibility in Indian kitchens.

The case for feasibility

• Salt is a household behaviour, not an industry problem: in Tamil Nadu roughly 88% of salt intake comes from home cooking, so reformulation alone cannot work — persuasion is the only available lever [2].
• Delivery infrastructure already exists: NP-NCD with population-based screening of all persons aged 30+ through Ayushman Bharat Health and Wellness Centres puts a counsellor, a BP cuff and medicines at one point [3].
• Scale of payoff: excess sodium was linked to about 1.7 million deaths globally in 2023; a population-wide shift reaches crores never diagnosed [1].
• A technological shortcut: WHO's January 2025 guideline on lower-sodium salt substitutes offers a taste-neutral swap needing no daily willpower [4].

Why optimism must be qualified

• The global record is poor: the world is off-track on the 30% sodium-reduction target, with only about 5% of member states covered by mandatory, comprehensive policies — advisory models have underperformed [5].
• Salt is added by taste in crores of kitchens; there is no recipe to regulate, gains are invisible and delayed, and evaluation fails without a baseline dietary survey.
• The substitute is conditional, excluding children, pregnant women and those with impaired potassium excretion — difficult where a family eats from one pot [4].
• Iodine trade-off: less salt means less iodine unless fortification levels are raised alongside [6].

Salt reduction is a genuine Best Buy, but its weakest form is unaided persuasion. Counselling should therefore be anchored to enforceable levers — quiet salt ceilings in state-run kitchens, front-of-pack warnings, iodised substitutes and repeat dietary surveys — so the healthier choice becomes the default rather than a daily act of discipline, advancing SDG 3.4 on premature NCD mortality.