Cost-effective interventions that reduce human diseases and death from aflatoxin exposure are high priorities particularly for developing nations. A calcium montmorillonite clay, Nova- Sil™, when mixed at low inclusion rates with animal feeds can act as a selective enterosorbent for aflatoxins. NovaSil™ sequesters aflatoxins in the gastrointestinal tract and neutralizes their toxic effects by reducing the bioavailability of the toxins in the blood and other organs. These findings are especially significant for developing countries since clay-based strategies for managing aflatoxicosis would be practical, culturally acceptable, sustainable and unique in reducing external exposure and risk. When included in the diet of animals at levels up to 2.0% (w/w), NovaSil™ clay did not interfere with vitamin or micronutrient utilization. These results also support the hypothesis that NovaSil™ clay interventions in developing countries could have a major impact on health and well-being of susceptible humans who are highly and frequently exposed to these dietary toxins without compromising their nutritional status. Recent work has confirmed the relative safety of NovaSil™ in a long-term rodent study at and in a Phase I Adverse Events trial. No significant NovaSil™- related effects were observed in either study, and the conclusions were that NovaSil™ should be tested in a Phase II human trial in Ghana. A study population in Ghana has been identified that is exposed to high levels of dietary aflatoxins based on biomarkers in their blood and urine samples. This study will evaluate the consequences of NovaSil™ treatment on aflatoxin exposure over a 3-month period. In summary,enterosorption strategies, based on dietary NovaSil™ clay, hold great promise for the management of aflatoxins in highrisk human populations especially in developing countries. The remedy is novel, inexpensive and easily disseminated. © CAB International 2008.