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Why iodine nutrition?

Iodine is a dietary element that is essential for the development and growth of the human body, especially the brain. Iodine deficiency has devastating and irreversible effects on brain development during the first trimester of pregnancy resulting in a reduced IQ of up to 13.5 points. This affects learning potential, school performance, limits opportunities and decreases productivity in later life. A simple intervention, providing iodine through salt for human (including table salt and salt used for industrial food production) and animal consumption is the easiest, most effective and least expensive way for complete prevention. 

What are the issues?

One of the main aims of the Universal SaIt Iodisation programme is to obtain national commitments from governments to address iodine nutrition by mandating iodisation of all edible salt, including table and food grade salt, as well as animal salt.

Currently, all but two countries, Russia and Ukraine, have national mandatory laws, legislations, decrees or programmes which have been formally adopted by the leaders of these nations. Out of 20 countries with mandatory laws, 15 have adopted these very recently in the last five years. Uzbekistan was the latest country to adopt the legislation in 2007. This is the backbone of the Iodine Deficiency Disorders elimination effort. Based on this, policies have been developed and inserted in a variety of ways such as food laws and nutrition policies.

The main challenge for governments, once adopted, is to implement and enforce mandatory legislation and ban all non-iodised salt from the market. Quite a few countries have most of their salt iodised, but often with insufficient iodine. Better quality assurance at production can alleviate this problem.

Sustainability is another area of concern. Once the goal is achieved and external donor support is reduced, there is a risk of sliding back. An effective national coordination mechanism with regular monitoring and public reporting, coupled with corrective actions is a mechanism that can prevent this. In 2008 further progress has been made in Armenia, Kazakhstan and Turkmenistan where governments have taken full responsibility of continued oversight of the achievements.

Facts & figures

The international arbitrarily determined level of adequately iodised salt is 15 iodine parts per million (ppm). Below are some on the latest available information from national surveys in 2008 and from the report Universal Salt Iodisation in CEE CIS during 2000 – 2009:

• In industrialised countries, around 60 to 80 per cent of the total salt intake is consumed with processed food (such as bread, meat, cheese and other dairy products), while the remaining salt intake hails from cooking and seasoning of home produced food with household salt.
• The regional average for use of iodised salt is 61 per cent (of which 51 per cent adequately iodised).
• 15 out of 22 countries have reached the international benchmark for success of 90 per cent.
• 51 per cent of household use of adequately iodised salt protects 54 per cent of all newborns from irreversible reduced intelligence.
• The annual number of babies born in households using adequately iodised salt has reached 2.96 million, which is 54 per cent of the total of 5.6 million annual new born babies in the CEE/CIS region. It is difficult to gather data for babies and under-two-year-olds as most surveys track urinary iodine in school children and pregnant women. If a mother is deficient, it is certain that her baby will be born deficient.
• In the scenario where all countries, except Russia and Ukraine, have reached the goal of at least 90 per cent coverage the regional average stagnates at 66 per cent.
• In the scenario where all countries, except Russia, have reached the goal of at least 90 per cent coverage the regional average stagnates at 71 per cent. Russia’s and Ukraine’s contribution to the regional average is significant because of the large population sizes in these countries. However, this also shows that the average does not reflect very well the progress in other countries.
• The CEE/CIS region is home to 15 large salt industries that produce the majority of salt that humans consume, directly as household salt or indirectly through the salt used in food industries.
• In Romania, Moldova, Ukraine and Russia, a bread bakery regulation from the Soviet times is frequently quoted to justify objections to the use of iodised salt in production. The underlying belief is that iodised salt would affect the organoleptic characteristics of bread. This has been dispelled by new studies.
• Iodised salt use in food industries especially in bread baking is common in Western countries such as Denmark, Germany, the Netherlands, Switzerland, Australia and New Zealand as well as Belarus and Kazakhstan.

What is UNICEF`s role?

UNICEF has strongly advocated for adoption of legislative frameworks and national laws to ensure a long-term and sustainable national mechanism. Adopting the goal to reach Universal Salt Iodisation became regional priority in 2001. UNICEF and partners are committed to eliminate iodine deficiency through the most cost-effective solution, universal salt iodisation, i.e. iodisation of all salt for human and animal consumption.

UNICEF aims to ensure Iodine Deficiency Disorder elimination in all countries, while a more focused approach is pursued in Russia and Ukraine through the new Gates-funded partnership with Global Alliance for Improved Nutrition.  Strong private-public-civic partnerships are the major reasons for exemplary progress.  Awareness raising activities at national and international levels (through media, events, goodwill ambassadors and face-to-face meetings) to engage government and industry partners remains important. 

For more information see www.unicef.org/ceecis or please contact:

UNICEF
Lely Djuhari
Regional Communication Specialist
Tel +41 792 04 44 82
Email:  MEDIACEECIS@UNICEF.ORG