In a move that will prevent millions of children from developing goitre, mental retardation, and stunted growth, collectively called the iodine deficiency disorders (IDD), the Central Government has announced the re-imposition of the ban on the sale of non-iodised salt from August 15. With this, India will join a group of about 90 countries that do not allow the sale of non-iodised salt. The decision comes after the retrograde step taken by the predecessor government to lift the ban on the sale of non-iodised salt in 2000, which ironically was the target year set by the World Health Organisation to eliminate iodine deficiency as a public health problem around the world. The problem is no longer restricted to the `Himalayan endemic belt.’ India is one of the major iodine deficiency endemic countries; of the 283 districts surveyed for IDD, it was endemic in 247. Lifting the ban had led to a further drop in the consumption of iodised salt — and a concomitant increase in the number of people suffering from iodine deficiency disorders in many States.
A recent survey done in Tamil Nadu, Kerala and Madhya Pradesh by the Indian Coalition for Control of Iodine Deficiency Disorders offers some interesting insights. While the proportion of households consuming adequately iodised salt in Kerala was found to be nearly 50 per cent as against 18 per cent in Tamil Nadu, health benefits were not the decisive criterion for a majority of such households. Consumers in Kerala were not convinced of the health benefits of iodised salt and nearly half of those surveyed were ignorant of its advantages. Only a small percentage was aware of its benefits in Tamil Nadu. That nearly half the respondents in Bihar were not aware of the kind of salt they consumed exemplifies the problem. The imperative need is to increase awareness among consumers. Another issue that demands immediate attention is pricing. Since price is a major factor in buying decisions, making iodised salt less expensive and using the public distribution system will go a long way in widening its reach among the more vulnerable socio-economic groups. The government should ensure that crystal salt is also adequately iodised. Educating consumers on proper storage practices is also necessary. At the same time, there is a compelling need to enforce good manufacturing practices and quality adherence during transport and storage. Although nearly all the samples examined at the household level in Kerala contained some element of iodine, only about 50 per cent of households was found to consume adequately iodised salt. Similar trends have been seen in Tamil Nadu and Madhya Pradesh. It is time governments in India realised that legislation without serious enforcement and compliance serves little purpose, as shown by the performance of States where the ban on the sale of non-iodised salt exists.