Sustainable elimination of iodine deficiency disorders by 2005

The challenge

Iodine deficiency is the world’s single greatest cause of preventable mental retardation. It is especially damaging during the early stages of pregnancy and in early childhood. In their most severe form, iodine deficiency disorders (IDD) include cretinism, stillbirth and miscarriage, and increase infant mortality. Even mild deficiency can cause a significant loss of learning ability – about 13.5 intelligence quotient points at population level – as well as other symptoms such as goiter, an abnormal enlargement of the thyroid gland. In addition to adversely affecting the rights of children, iodine deficiency results in a loss of economic productivity and slows progress towards achievement of the Millennium Development Goals. The good news is that it is easily preventable.
 
A diet low in iodine is the main cause of iodine deficiency. It usually occurs among populations living in areas where the soil has been depleted of iodine because of flooding, heavy rainfall or glaciation. If soil is deficient in iodine, so are the plants grown in it, including the grains and vegetables that people and animals consume. 
 
There are almost no countries in the world where iodine deficiency has not been a public health problem. About 41 million newborns in developing countries every year remain unprotected from the lifelong consequences of brain damage associated with iodine deficiency disorders¹. This shortcoming affects a child’s ability to learn, and later in life, to earn, thereby preventing children, communities and nations from fulfilling their potential.

International support for the elimination of iodine deficiency dates from the World Summit for Children in 1990. As part of the Summit’s Plan of Action, world leaders agreed to a goal of elimination of iodine deficiency. This commitment led to the development of an informal global partnership, the Network for Sustained Elimination of Iodine Deficiency, which included United Nations and donor agencies, members of the scientific community, non-governmental organizations and the salt industry.
 
Since 1994 the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended universal salt iodization (USI)² as a safe, cost-effective and sustainable strategy to ensure sufficient intake of iodine by all individuals.

Before the mid-1990s, the onus to iodize salt was only on countries that were recognized as having a public health problem, as indicated by surveys finding significant levels of cretinism and goiter. In 1994, UNICEF and WHO called on all countries to iodize salt regardless of whether they had a documented IDD problem. This allowed a far greater acceleration of efforts over the next decade. The pledge was renewed at the United Nations General Assembly Special Session on Children in 2002. In their action plan, ‘A World Fit for Children’, 190 high-level national representatives reinforced the need to continue efforts towards sustained elimination of iodine deficiency by 2005. Universal salt iodization is the recommended strategy.

1.  ‘Iodine deficiency disorders’ refers to all of the ill effects of iodine deficiency in a population that can be prevented by ensuring an adequate intake of iodine.    

2.  Universal salt iodization indicated by at least 90 per cent of households consume adequately iodized salt.