Elimination of Iodine Deficiency in Lithuania: Comments for policy-making Frits van der Haar Associate Professor International Health Emory University School of Public Health Atlanta, Georgia, U.S.A.
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Elimination of Iodine Deficiency in Lithuania:
Comments for policy-making Frits van der Haar Associate Professor International Health Emory University School of Public Health Atlanta, Georgia, U.S.A.
Changes of nutrition policy are influenced by:
• Nutrition needs in the population • Available information, technology
and resources
• Food Industry concerns • Public Health views • Opinions among Gatekeepers • Attitudes among Decision-makers
IDD: What significance?
• Iodine Deficiency causes diminished
educability, productivity and earnings from:
– Brain damage in newborns (up to 15%
IQ loss for life), and
– Apathy in adolescents and adults • Pregnancy wastage, infant mortality • Higher health care cost among elderly
Effects are not trivial for the nation
On the other hand: Correction is do-able and OK!
Universal Salt Iodization is
• Safe • Simple • Economical • Equitable • Self-financed
“Salt iodization: The most elegant among all nutrition solutions”
The “do-ability” of Salt Iodization
• Science is known and available • Technology is established • > 50 years Experience worldwide • associated Costs are minimal • The practice is self-financing
Salt industry leaders of Lithuania are ready to assist
What may be some reasons to worry?
• Progressing requires Partnership • Questions about cost-benefits • Clinical side-effects may arise • Success doesn’t occur overnight
Development is a social process, and always risks running into obstacles
Partnerships ..
Enhancing Alliances Public Sector Private Sector Increasing the Capacity for Problem Solving Civic Sector Opening the channels of communication .. are hard work
What if they get “too much”?
• Technical answer is Quality Assurance of salt supplies: People can’t eat too much iodine from using iodized salt • Political answer is to establish national policy on a balanced trade-off between benefits and risks among different groups
Cost-benefit is an over-arching consideration
• The public investment is minimal • Salt iodization pays itself • Modern health care of thyroid
patients is in place and effective
• Population benefits accumulate
Returns will “last a lifetime”
Good policy provides guidance and protection Group Government Producers Consumers Responsibility Apply the law equitably and educate the public Deliver and promote only iodized salt Accept and consume only iodized salt Right Insist on protecting the population by sufficient, good quality iodized salt Insist on fair and equal treatment of all actors in the salt industry Insist on permanent national oversight to ensure nation’s success