Sustaining the Elimination of Iodine Deficiency in the Americas

Statement by Mr. Kul C. Gautam
 Deputy Executive Director
United Nations Children’s Fund (UNICEF)
Miami, March 10, 2002

I feel so happy to be addressing all of you here, at this meeting on sustaining the elimination of iodine deficiency in the Americas.

As I look at this audience, I do not see here a gathering of salt producers, but a gathering of the world’s great brain protectors and promoters of child development.  As someone coming from UNICEF, whose raison d’être is promoting child survival, development and protection, I feel in perfect company-a society of like-minded people.

In a historical context, the business of producing, distributing, selling and taxing salt has been a source of great historical events-of revolutions, and wars, construction of huge infrastructural projects and protection of the health and well-being of millions-even billions of people.

I have just been reading this wonderful book: Salt-A World History, by Mark Kurlansky, which I’m sure many of you have read.  It gives one the impression that the human civilisation has been revolving around salt.

The great Greek poet Homer called salt a “divine substance”.  Plato described it as especially dear to the gods.  Mahatma Gandhi started a salt march that eventually led to the overthrow of the British Empire, not just in India, but also beyond.

This book recounts in graphic detail how some of the greatest public works in history, including the building of the Great Wall of China, and the Erie Canal, were funded through salt revenues.  Rights of governments to tax and control salt were apparently one of the key elements leading to the American Revolution and the Civil War.

Right here today, we are gathered to talk about another ongoing revolution attributable to salt.  This is the story, curiously rather inadequately told in this book, of the revolution in the protection of human brains as a result of salt iodization.

Today, more than 90 million newborns in the world are protected from a significant loss in learning ability because of the tremendous progress made in salt iodization, in which many of you here have been the great pioneers and entrepreneurs.

Only a decade ago, less than 20 per cent of the world’s households were using iodized salt.  Today, that figure stands at 70 per cent worldwide, and over 80 per cent in Latin America and the Caribbean.

We at UNICEF feel proud to have joined you in the salt industry in this massive effort which was given a strong political push at the time of the World Summit for Children in 1990.

Of all the many promises that were made to the children of the world by the largest gathering of world leaders in history in 1990 at the World Summit, the goal of reducing iodine deficiency has been one of the most successful.

And your presence and collaboration here during these two days will mean that millions more children born in the region will be protected against brain damage and losses in learning ability.

Even mild iodine deficiency can lead to a loss of 10-13 IQ points, with tremendous consequences for the economic and social development of nations and communities.   Our task therefore is truly one of building the intellectual foundation for human development.

You salt producers here today are part of a global fraternity, a partnership of public, private and civil society.

What we have learned from the incredible achievement of the past decade in salt iodization is that we must work together in partnership.  That no single government, organization or leader working alone can hope to address the immense and changing needs of children.  Progress requires new and dynamic alliances across every sector of society.

This meeting is a sterling example of how these new alliances can work.  It shows how this partnership among the salt producers who iodize the salt, governments, the scientific community and the United Nations system has been a key to global progress for children.

The United Nations Secretary-General, Kofi Annan, recognized the importance of this partnership a few weeks ago at the World Economic Forum in New York.  The Secretary-General praised the work of the world’s salt manufacturers.  He challenged all those at the Forum to think of ways in which their industry could help mobilize technology and science to tackle the interlocking crises of hunger, disease, environmental degradation and conflict that are hampering global progress.

My colleague Juan Aguilar will speak to you more about this particular region.  Of course the Americas are far ahead of other regions in salt iodization. Latest estimates show that over 80% of households in the region consume adequately iodized salt.

In 12 countries, virtually every household consumes iodized salt and many of these countries are preparing to evaluate the success of their programmes.  Countries in Central America such as Guatemala, El Salvador, and Honduras, were the pioneers, and Ecuador and Bolivia were early success stories.  The whole region of the Americas is now the most technologically advanced in the world on salt iodization.

This region has been a shining example of success, but we cannot become complacent in these achievements.  Rather, we must ensure that this investment in the social and economic potential of the region, is sustained.

Not so long ago, in 1996, the Government of Bolivia celebrated its success towards achieving universal salt iodisation.  It was believed that conditions existed for sustained iodine nutrition for Bolivians.

However, a national survey conducted in 2000 confirmed a precipitious decline in iodized salt coverage to 63% from previously high levels.   Similar stories can be told for Guatemala, which has also witnessed fluctuations in salt iodisation during the past 50 years.

The danger of losing ground once more – a danger that has sadly become apparent in other regions – highlights the importance of vigilance.

As we look to the future, I see for all of us five key challenges and opportunities.

First, of course, is to sustain the achievements made to date.  Indeed, the focus of this meeting is to see what the salt industry can do to sustain the high levels of salt iodization that we see in the Americas.  Over these two days, I understand, you will discuss many ways to do this.

Second is to ensure that the remaining 20 per cent of the population that is still deprived of iodized salt is reached and protected.  This is of great importance because these last 20 per cent of children and people are among the most vulnerable and deprived in many societies.

Third, this wonderful vehicle of salt that reaches every household of the world, should be utilized as a vehicle for other important micronutrients and additives where feasible.  For example, we understand that already in Mexico and the Caribbean, successful efforts have been made to add fluoride in the salt to reduce dental caries.  Working with the World Health Organization and other competent authorities, we need to explore how we can go to scale with this initiative.

Perhaps the time has come for us to explore if salt could also be an appropriate vehicle for fortification with iron which is the single largest cause of micronutrient malnutrition among children and women in the world.   We have in this audience Dr. Venkatesh Mannar of the Micronutrient Initiative and other experts who might tell us of the feasibility of this proposition.

Today, table salt is iodized on a massive scale, but that is not yet the case with salt used in food production and processing.  We might wish to consider how we can expand the use of iodized salt in the food industry.

A fourth challenge and opportunity: many of you as salt producers are also great entrepreneurs who may have interest in the production of other commodities that can be fortified with micronutrients.  Your business skills, your outreach to decision makers and leaders of societies, should be used to promote fortification with other commodities such as iron and folate fortification of flour, or vitamin fortification of sugar.  The list goes on.

The potential of food fortification is so great and so well recognized now that we have a number of global initiatives ongoing or in the offing to promote it.  There is the good work of the Micronutrient Initiative.   We are now about to establish a global alliance for improved nutrition (GAIN) which is expected to be launched at the UN Special Session on Children two months from now.

Fifth, and most importantly, I would especially like to urge you, in your deliberations, to work towards, and advocate for the setting up of multi-sectoral coalitions or “National Watches” composed of all the national lead entities involved.  Government ministries of industry and health, the salt industry, scientific groups, and civil society-all can ensure that salt iodization is sustained.

These “National Watches” would permanently oversee that high-quality iodized salt is produced.  That only iodized salt is sold in all markets. That political commitment to ending iodine deficiency is periodically renewed, and that the public remains aware of the dangers of iodine deficiency and the need to consume only iodized salt.

As we did in 1990, the issue of salt iodization and micronutrient malnutrition will be brought to the attention of the highest leaders of the world, in May of this year, when a United Nations General Assembly Special Session on Children will be convened.  It will review progress for children since 1990, and we hope secure the highest level of political commitment for a new decade of action for children, including ending the hidden hunger of micronutrient malnutrition that has silently ravaged millions of children for millennia.

In our experience, one path to success and sustainability is a well-educated consumer who demands iodized salt.  This has been seen in countries like El Salvador, where consumers educated about the value of iodised salt demanded the sale of iodized salt, reject the non-iodized products.

Another key to success is committed donors who are focused on this issue.  In Latin America and the Caribbean, many thanks must go to alliances with the Belgium Government, the Micronutrient Initiative, and the Kiwanis Club, who are pooling forces with salt producers to make a difference.

And finally, the key is the salt industry – all of you – to make the commitment required to realise sustainable change.  You – every one of you – should be applauded for the social responsibility you have shown, your solidarity with women and children to protect them for once and for all from iodine deficiency disorders.

I want you to know that UNICEF is here to help you in any way we can. For UNICEF, ensuring adequate iodine nutrition is part of ensuring that children receive the right start in life and are able to develop to their full potential.  With the right start, we know that children will go on to learn better in school and become more productive citizens.

Together, and in partnership with others, let us ensure that no child, ever again, has to enter life with lowered learning ability, or worse mental damage, because of iodine deficiency.

Thank you, and I wish you every success with this important meeting.