At the end of June, UNICEF published Sustainable elimination of iodine deficiency, a report on progress since the World Summit for Children of 1990 set the target to eliminate iodine-deficiency disorders worldwide. Iodine is essential for normal growth and development. According to WHO, in 2007, nearly 2 billion individuals had insufficient iodine intake, a third being of school age. Iodine deficiency can have serious consequences, causing abnormal neuronal development, mental retardation, congenital abnormalities, spontaneous abortion and miscarriage, congenital hypothyroidism, and infertility. Later in life, intellectual impairment reduces employment prospects and productivity. Thus iodine deficiency, as the single greatest preventable cause of mental retardation, is an important public-health problem.
Salt-iodisation is a simple cost-effective way of ensuring adequate iodine intake. 120 countries now have salt-iodisation programmes in place, with 34 achieving total salt-iodisation. A recent Lancet Comment discussed problems and solutions to date in Tibet. The number of households in the developing world that use iodised salt has risen from less than 20% in the early 1990s to 70% by 2000. This is a laudable public-health achievement, and success is reflected not only in the figures but also in the maturation of the programmes. Coalitions between international organisations, governments, donors, and salt producers, better education and monitoring, legally enforced political support, and shifts to domestic financing mean the interventions have longevity.
Whilst accomplishments cannot be denied, there is a long way to go. 38 million children are still born every year at risk because of iodine deficiency. There are large differences in the availability and consumption of iodised salt, and in legislation, between countries. Continued vigilance is needed to ensure the positive results seen so far are maintained, while novel approaches may be required in countries where the intake of iodised salt remains low or where improvement has plateaued. The UNICEF report is encouraging, but while there are still children at risk due to a preventable cause, there is no room for complacency.
Salt-iodisation is a simple cost-effective way of ensuring adequate iodine intake. 120 countries now have salt-iodisation programmes in place, with 34 achieving total salt-iodisation. A recent Lancet Comment discussed problems and solutions to date in Tibet. The number of households in the developing world that use iodised salt has risen from less than 20% in the early 1990s to 70% by 2000. This is a laudable public-health achievement, and success is reflected not only in the figures but also in the maturation of the programmes. Coalitions between international organisations, governments, donors, and salt producers, better education and monitoring, legally enforced political support, and shifts to domestic financing mean the interventions have longevity.
Whilst accomplishments cannot be denied, there is a long way to go. 38 million children are still born every year at risk because of iodine deficiency. There are large differences in the availability and consumption of iodised salt, and in legislation, between countries. Continued vigilance is needed to ensure the positive results seen so far are maintained, while novel approaches may be required in countries where the intake of iodised salt remains low or where improvement has plateaued. The UNICEF report is encouraging, but while there are still children at risk due to a preventable cause, there is no room for complacency.
The Lancet Volume 372, Issue 9633
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