Salt Iodization: A Global Health Success Story

It is estimated that over 35 million babies are born each year without the protection that iodine offers the growing brain, and roughly 18 million are mentally impaired as a result.

We consume iodine in our foods. When plants and animal raised in areas with iodine-deficient soil, the diet for those people will be less healthy, resulting in populations suffering from iodine deficiency disorders (IDD).

In many middle to high income countries, the problem of iodine deficiency has largely been solved by adding iodine to salt, which then makes it into animal feed, breads, processed foods and salt shakers in homes around the world. Salt iodization is considered the most successful type of food fortification.

Salt is also being iodized in the middle to low income countries, with 70 per cent of households consuming iodized salt. Despite this affordable solution, iodine deficiency disorders continue to be a serious public health threat for more than 1 billion people.

Supporting efforts to achieve universal salt iodization is Nutrition International’s main strategy to help eliminate IDD. This means that all edible salt, for households, processed foods and animal salt, is adequately iodized based on how much the general population consumes.

Through support from the Government of Canada, Nutrition International has been working for more than a decade to speed up the pace and expand the adoption – or scale up – of universal salt iodization around the world. We want to see universal salt iodization because not only is it the ideal vehicle to deliver iodine, it is also an affordable and simple solution. Learn about our success in Pakistan.

Some of the barriers to salt iodization include:

  • Production-level constraints
  • Supply problems, including the procurement of potassium iodate (KI03)
  • Weak enforcement of regulations and policy
  • Inadequate demand on the part of consumers

Salt iodization has been hailed as a global health success story – over the past few decades global iodization rates have increased from 30 to 70 percent but there are still gaps in reaching the most vulnerable. Thirty-eight million newborns annually are born at risk of preventable but permanent brain damage every year because their mothers are iodine deficient.

In collaboration with governments in key countries, Nutrition International is leading iodization efforts by working with small, local salt producers in providing simple and easy iodization techniques to reach those households that are still not consuming iodized salt. We work with partners around the world to reach out to producers in the most critical areas to connect them with iodization resources. We support governments to design national iodine deficiency control programs, including legislation and monitoring,  and help them work succesfully with salt producers.

Nutrition International directly supports small-scale salt producers to not only ensure the salt they produce is adequately iodized but that they have the tools they need to work effectively. We provide equipment and training to help modernize the industry and iodize the salt. We encourage producers to form cooperatives to pool resources, improve production techniques, quality, packaging and marketing. We provide technical and logistical support to develop profitable business plans.

Local government are brought on board to create enabling environments, to help finance the cooperatives, and to monitor the iodization. We support government agencies to enforce the regulation of mandatory salt iodization. We are also helping the government evaluate salt iodization programs – including measuring the impact of salt iodization on levels of iodine within the population.

This economic development model delivers health benefits while supporting sustainable economic growth.

About 70% of all households in low to middle income countries now have access to iodized salt. With partners such as UNICEF, WFP, and the Iodine Global Network (IGN), and GAIN, governments, the private sector and donors, including support from the Government of Canada, Nutrition International has helped countries around the world to produce enough iodized salt to reach 386 million people.

  • In 2013, Nutrition International supported the iodization of close to 250,000 metric tonnes of salt in Africa, helping to protect more than 2 million newborns from iodine deficiency. We focus our salt iodization work in Senegal, as a regional hub for West Africa, Nigeria, Ethiopia and Kenya, which is a hub for East Africa.
  • In 2013, Nutrition International supported the production of an additional 1.2 million metric tonnes of iodized salt in Asia, helping to protect almost 7 million newborns from iodine deficiency.
  • We helped develop an innovative Global Positioning System (GPS) to locate small-scale salt producers in Senegal, Bangladesh and Pakistan, to link them with iodization resources.
  • Our work with the World Food Programme (WFP) focuses on local salt producers’ ability to iodize salt in countries where iodine deficiency rates are high.
  • Helping the Government of Pakistan and other governments to design a national iodine deficiency control programs.

Iodizing salt is considered one of the 20th century´s greatest global health initiatives. It delivers one of the most critical micronutrient for mental capacity, maternal and infant survival and human productivity.

So we asked ourselves this question: if adding iodine to salt works so well, what else can we add to salt that would improve global health? Double-fortified salt takes on two of the world’s leading micronutrient deficiencies by adding both iron and iodine.

While seemingly a simple idea, fortifying salt with more than one micronutrient is complex;  but the hope of boosting the health of an estimated two billion people suffering from iron-deficient anaemia is providing the motivation.

Double-fortified salt developed by Nutrition International and the University of Toronto is now reaching 3 million school children in Tamil Nadu every day through the mid-day meal scheme.