November 2021

One of the most important parts of the work we do at IGN is to keep track of whether people around the world have adequate iodine in their diets.

We do this in a couple of ways. We continually monitor the use of adequately iodized salt, and we look at the iodine status of children and women of reproductive age, which is monitored through national surveys of urinary iodine concentration.

When countries around the world took on the challenge of iodizing salt to protect their populations from cognitive impairment, they were eager to monitor progress through national surveys, which gave them the good news that the global strategy to add iodine to salt has virtually eliminated iodine deficiency, and has been a huge public health success. But today, there are a couple of problems.

Firstly, we know there’s room for improvement, especially in countries where iodine status is adequate, but where inequalities exist between population sub-groups. Secondly, the data is getting old, and countries are often no longer willing to undertake costly and complex national surveys.

So what do we do? Nationally representative surveys are still the gold standard. But do we need to conduct them as frequently as before? And are there other options? As past programming strategies evolve to meet present-day challenges, a goal for us at IGN is to innovate, to find new ways of making programs sustainable.

The first step could be to collect data on the availability of iodized salt more systematically. After all, if iodized salt is widely available and used, we know that iodine status is likely to be reasonable or adequate, reducing the need for national surveys.

And on the production side, there’s potential to get a lot more information. We could check whether potassium iodate can be imported easily and sustainably. Perhaps we can collect information from industry which indicates whether salt continues to be adequately iodized and widely distributed to retailers. Ministries of Trade may track importation of iodized salt.

If information on production is positive, then would it be enough to collect information from several sentinel sites in a country to let us know whether things are still on track, rather than undertaking a costly and complex national survey? We believe this type of information collection could be cheaper, easier and quicker. And beyond this, what about the potential of new technology and use of social media?

Given the current lack of up-to-date information, and the continuing need to understand whether populations remain protected against deficiency disorders, we believe it’s time to review these new approaches. We’re working on it, so watch this space.