JAGRITI VOL. V, ISSUE 3, SEPTEMBER 2007.pdf
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IN THIS ISSUE
• 60th WHA
Resolution
• Partnership of
ICCIDD with BSG
• Rashtrapati BSG
Award
• USI in Srilanka
• In MemoriumFrancois Delange
Mandatory Reporting of Iodine Nutrition by Member States Reinforced
60th World Health Assembly Resolution
23 May 2007
SIXTIETH WORLD HEALTH ASSEMBLY
WHA60.21
23 May 2007
Agenda item 12.21
Sustaining the elimination of iodine
deficiency disorders
The Sixtieth World Health Assembly, Having noted with appreciation the report on sustaining the elimination of iodine deficiency disorders;
Noting that, although progress has been made by some Member States in the sustained elimination of iodine deficiency disorders in the
past two years, between one fourth and one third of the world's population still suffers from this micronutrient deficiency, most of them in
impoverished areas of the world;
Concerned that iodine deficiency can prevent the optimal development of children's brains, with possible consequent learning impairment
with subsequent social and economic consequences;
Recognizing that the fight against iodine deficiency contributes directly to many of the internationally agreed health-related goals including
those contained in the Millennium Declaration, including eradication of extreme poverty, reducing child mortality, improving maternal
health, achieving universal primary education, and promoting gender equality;
Applauding the support of international organizations, especially WHO, UNICEF, WFR bilateral development agencies and
nongovernmental and private partners, including Kiwanis International, the International Council for the Control of Iodine Deficiency
Disorders and the Global Network for Sustained Iodine Nutrition,
1.
URGES Member States:
(1) to redouble their efforts to reach those people not yet protected from iodine deficiency disorders and to sustain successful
programmes on a continuous basis;
(2) to implement the recommendation in resolution WHA58.24 to establish multidisciplinary national coalitions in order to
monitor the state of iodine nutrition every three years;
2.
REQUESTS the Director-General to continue to strengthen WHO's cooperation with other organizations in the United Nations system in
supporting Member States in fighting iodine deficiency and report on iodine status every three years in compliance with resolution
WHA58.24.
Eleventh plenary meeting, 23 May 2007
A60/VR/11
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ICCIDD Vision, Mission & Dedication
Tjyfa Hcig
VisiomTHe vision of ICCIDD is a world virtually free from Iodine Deficiency
'H^qH TPTcH Hcig
Disorders with national endeavors to maintain optimal iodine nutrition primarily
through consumption of iodised salt, which should be made easily available
and affordable for all people for all times.
May auspiciousness be unto all
May Peace be unto all
Moy fullness be unto all
May prosperity be unto all
Mission: The mission of ICCIDD is to provide a focused advocacy to
governments and development agencies, of a continued priority for iodine
nutrition, providing technical expertise in a multi disciplinary approach.
Editorial Board
Dr Chandrakant S Pandav
Chief Editor
Dr. Arijit Chokrabarty
Dedication: ICCIDD dedicates itself to programs fully supported at the
national level for permanent, sustained success and will work with all partners
and national entities towards that en I.
Managing Editor
Mr. Amit Shukla
Editorial
Patrons:
Shri Mohan Dharia
Chief Patron
Dear Colleagues,
Dr Kolyan Bagchi
Patron
Shri R V Pillai, IAS (retd.)
The 60th World Health Assembly unanimously passed a resolution reinforcing the call for
Patron
mandatory reporting on achievement of USI and elimination of IDD. As has been the practice,
the draft resolution was prepared by ICCIDD. The 60th session of the WHO Regional
Editorial Advisers:
Committee for South East Asia was held at Bhutan from 31 August to 3 September, 2007.
Dr Prabha Ramalingaswami
ICCIDD statement was circulated in this meeting.
Shri L M Jain, IAS (retd.)
Prof N K Ganguly
Sri Lanka has achieved Universal Salt Iodisation and is now ready for external evaluation. A
Prof M G Karmarkar
formal request for the same is awaited. Reports on current status of consumption of iodised salt
Shri S Sundaresan
in Nepal and Pakistan is reported.
Adv. Makarand Adkor
Shn Bejon Misra
ICCIDD is carrying out a nationwide survey of coverage of iodised salt in India in partnership
with the Bharat Scouts and Guides. A detailed methodology and the progress so far is reported
Editorial Assistants:
here.
Smt Sarajo Narayanan
Consumer Voice is a leading monthly magazine of consumer interest in India. The July, 2007
Shri Pritam Singh
Smt Shalini Chokrabarty
Circulation
Shri Pritam Singh
issue features an article on iodised salt in India, where 13 leading brands were tested. The full
feature is reproduced in this issue including the interview of Prof. M. G. Karmarkar, Senior
Advisor, ICCIDD.
The progress with coverage of adequately iodised salt is uneven. The World Health Assembly
resolution followed by the resolution in the Regional Committee will provide the required
Printed & Published by:
Dr Chandrakant S Pandav
on behalf of ICCIDD
Contact Address:
framework to consolidate and accelerate coverage of adequately iodised salt so as to move
closertowards sustainable elimination of IDD.
Room No 28, CCM Building,
Old OT Block, All India Institute of
Medical Sciences, New Delhi-29
Tel. 011-26588522
E-mail; cpandav@iqplusin.org
Website: www.iqplusin.org
Designed & Printed at
Sono Printers Pvt. Ltd.
F-86/1 Okhla Industrial Area, Ph-1
New Delhi-110020
Ph.-41616566, 26811313
Dr. Chandrakant S. Pandav
Regional Coordinator - SA Region
Mandatory Reporting of Bodine Nutrition by Member States Reinforced
60th World Health Assembly Resolution
23 May 2007
Canada then made short supporting statements. Iran spoke in the
he 60th World Health Assembly unanimously passed a
T
names of all Member States in its region, and Guinea spoke in the
resolution reinforcing the call for mandatory reporting on
name of all 47 African countries.The discussion on iodine lasted
achievement of USI and elimination of IDD.
22 minutes, and although there was likely additional country
The ICCIDD delegation to the 2007 WHA consisted of the Chair,
support among other Member States, they did not make additional
Gerard Burrow, the Executive Director, David Haxton, Jack Ling
statements in order to keep the session from becoming too long.
and the Regional Coordinator for Latin America, Eduardo Pretell,
However, despite the call of the 2005 WHA, it is clear a large
supported by UNICEF. They were able to convince the WHA to
repeat its call, first made in 2005 at the 58th WHA, for Member
number of Member States did not fully report or did not report at all
States to accelerate efforts to achieve IDD elimination and to
on the issue. Or, if they did, the information was included in a
larger document. To improve this, ICCIDD has offered its
report at three year intervals on their progress.
assistance to seek ways to improve on this process.
The resolution was adopted by acclamation. It was proposed by
the Government of Peru. Cosponsors were the Governments of
The report to the WHA contained in "WHO Sixtieth World Health
Argentina, Bhutan, Bolivia, Brazil, Chile, China, Cuba, Ecuador,
Assembly, Item 12.21, A60/28 dated 5 April, 'Progress reports on
El Salvador, Guatemala, Honduras, Indonesia, Islamic Republic of
technical and health matters'" is based on information available
Iran, Panama, Paraguay, Uruguay, Venezuela and Zimbabwe. It
and was prepared by the ICCIDD Secretariat.
was the first item to be discussed under the broad heading of
This document which is reproduced on the front page, can be
technical and health issues. Eduardo Pretell, representing Peru,
obtained on the WHO website (www.who.org) in the area relating
gave an excellent introduction that was well received. China and
to the WHA.
3
60th Session of the WHO Regional Committee for South-East Asia
Statement of the Regional Coordinator, ICCIDD - South Asia*
Thimphu, Bhutan, 31 August-3 September, 2007
M
ay I, on behalf of my colleagues in the International
3.
Promote gender equality and empower women:
Council for Control of Iodine Deficiency Disorders
Eliminating IDD in children reduces childcare burden for
(ICCIDD) first of all thank the Regional Director for
Women, frees up household resources and allows women
more time for income generating work.
extending the invitation to attend the 60th Regional Committee for
South-East Asia that is being held at Thimphu, Bhutan.
4.
Reduce child mortality: Control and Elimination of IDD
ICCIDD has been a regular participant in the Annual World Health
contributes to decreased rates of miscarriages, stillbirths,
Assembly (WHA), since 1994. The ICCIDD delegation to the 60th
and other pregnancy complications, as well as early
World Health Assembly held in May 2007 was able to convince the
neonatal deaths.
WHA to repeat its call, first made in 2005 at the 58th WHA, for
5.
Improve maternal health: Women as a result of their
Member States and I quote from the report,"
increased physiological requirements of iodine during
1,
pregnancy and lactation are more at risk of IDD.
URGES Member States:
(1)
Eliminating
to redouble their efforts to reach those people
yet
not
protected
from
women
will
diseases
reduce
and
other
rates
of
clinical
outcomes of IDD, thus improving the health status of
on a continuous basis;
women of reproductive age.
6.
Develop a global partnership for development: The
multidisciplinary
programs for sustainable elimination of iodine deficiency
national coalitions in order to monitor the state
ensure a strong partnership of public, private and civil
to
WHA58.24
establish
society at the global, regional, and country level.
of iodine nutrition every three years;
2.
in
thyroid
disorders and to sustain successful programmes
to implement the recommendation in resolution
(2)
IDD
miscarriages,
deficiency
iodine
REQUESTS
the
Director-Genera I
to
continue
The 2002
to
UN Special Session on
Children celebrated a
strengthen WHO's cooperation with other organizations
remarkable progress made towards the World Summit for Children
in the United Nations system in supporting Member States
goal of eliminating iodine deficiency disorders (IDD) the. world's
in fighting iodine deficiency and report on iodine status
leading cause of preventable mental and development problem.
resolution
Around the time of the World Summit for Children (1990), 20% of
every
three
years
in
compliance
with
households had access to iodine by using iodised salt. By the end
WHA58.24".
ICCIDD is the only organization, which focuses exclusively on the
of 2000, almost 70% of households globally consumed iodised
sustainable elimination of iodine deficiency disorders. ICCIDD has
salt, thus preventing more than 80 million newborns in the world
been providing over the last 22 years a wide array of expertise
annually from consequences of iodine deficiency. The Special
including medical,.nutritional, salt industry and technical aspects
Session also endorsed the goal "to achieve sustainable elimination
related to IDD. ICCIDD has also played pivotal role in policy
of iodine deficiency by 2005".
formulation by regular interactions with the elected representatives
However IDD remains a public health problem in over50 countries
and policy makers.
(Iodine Status Worldwide, WHO Global Database 2004). Iodine
Elimination of Iodine Deficiency Disorders will contribute to at least
nutrition is optimal in 43 countries. The number of countries with
iodine deficiency as a public health problem decreased from 110
six of the Millennium Development Goals:
1.
to 54 between 1993 and 2003. Nevertheless, in 54 countries
Eradicate extreme poverty and hunger: Eliminating
intellectual
located in all regions of the world, the iodine intake of the
potential, leading to higher earnings. In addition,-the
population is insufficient and iodine deficiency with its impact on
IDD
will
increase
learning
ability and
health and development is still a public health concern. In these
burden of diseases and pathologies related to IDD will be
eliminated
2.
thus
making
substantial
savings
countries, Universal Salt Iodisation (USI) needs to be strengthened
on
expenditure incurred thereof.
and fully implemented.
Achieve Universal Primary Education: Children will
Four countries in the South-East Asia Region of WHO (WHO-
learning
SEAR) have been able to achieve relatively high rates of coverage
capacity, leading to improved school performance and
of household use of iodised salt. There is a wealth of knowledge on
reduced drop out rates.
lessons learned on key issues with regards to sustainability. A lot of
have
improved
cognitive
development &
4
progress needs to be mode in the other priority countries of the
household coverage of iodized salt, but a sub-sample for titration
region, as well. Household coverage of adequately iodised salt is
is also required. Guidelines on how to draw a sub-sample for
95% in Bhutan (2001), while it is 90.1% in Sri Lanka (2005). The
titration are available. At production level titration is always
coverage with regard to the remaining countries are as follows:
required so as to have precise estimate of iodine. Information, thus
Maldives: 67% (2002); Nepal: 58% (2005); India: 57% (2005);
collected, should be linked with corrective decision making
Bangladesh: 51 % (2004-05); Timor-Leste: No recent survey data;
process. Monitoring is the backbone which tracks the success of
Thailand: 56% (> 30ppm)(2004); Myanmar: 86% (iodised salt),
the programme regularly
(2003); Indonesia: 73% (> 30 ppm), (2003); DPR Korea:
The review of the National programmes must be performed with
Information awaited.
more regularity than now is the case by analyzing both primary and
We need to continue to push the IDD/USI agenda collectively with
secondary data. It is relatively easier to have a review of the already
partners. Bhutan is the only country in the region that has
available data. It can be taken up as a first step. Subsequently
eliminated IDD. The introduction of cyclic monitoring as part of the
primary review of the programmes can be undertaken,
monitoring process for the first time in the world has worked to the
IDD affects quality of human resource development. These points
country's advantage. Sri Lanka is one more country that is doing
should now feature in international forums like South Asian
well in terms of IDD elimination. We understand that a request is
Association for Regional Cooperation (SAARC), Association of
independent external
South East Asian Nations (ASEAN) & United Nations Economic
being
processed
from
them for an
assessment.
and Social Commission for Asia and the Pacific (ESCAP).
The lessons learned from the more successful countries are:
This is not the time to rest. The effort should be more vigorous now.
1.
2.
3.
4.
Hold regular National Advocacy events to assure that ail
The problem of IDD is still largely perceived as equivalent to
actors in the field are informed, active and participating
"Goiter". People consider it a cosmetic problem and hence a low
Hold regular National and Sub National monitoring
priority issue. Focus should be more on the implications that iodine
activities and report them widely to demonstrate not only
deficiency has on the intelligence Quotient (IQ) of the child and the
progress but where problems are difficult
contribution of elimination of IDD to at least six of the Millenium
Maintain constant public information on the problems of
Development Goals (1. Eradicate extreme poverty and hunger; 2.
iodine deficiency and the dangers of absence of iodine
Achieve Universal Primary Education; 3. Promote gender equality
Sustain high level national political commitment across
and empower women; 4. Reduce child mortality; 5. Improve
maternal
the board
health;
6.
Develop
a
global
partnership
for
development). It is the quality of the human resources development
Experience has taught us that in the long history of IDD Elimination
that should be the focus. Therefore, there is a need to strengthen
Programs, wherever political commitment has waned off over a
the advocacy and make the people and policy makers aware of the
period of time, IDD once eliminated has resurfaced again. Rather
serious impact of iodine deficiency to the people. The focus of
than having a single sector dealing with the issue, it will be more
research should now be on to produce evidence on the quality of
pertinent to have a multisectorial approach where in all the
advocacy, monitoring and communication (AMC).
concerned agencies collaborate and produce an effective,
Bhutan is a success story. The challenge is to sustain the success.
efficient and sustained programme. Involvement of health,
Bhutan should be provided a platform to share the success with
education, industry & mines (dealing with salt & iodised salt)
other countries, not only in IDD and Nutrition fora but also in other
animal husbandry and Public Distribution System (PDS) should
fora where success story of any programme is being discussed.
bring tangible results.
What is needed is coming together of policy makers and scientific
Behavioral Change Communication (BCC) area needs emphasis.
fraternity
Communities are a valuable resource for advocating for Universal
together they can start an odyssey into future ably
supported by our partners of private sector, the iodised salt
Salt Iodisation (USI). Prevention of IDD is the single most important
cause of preventable mental handicap. Behavioral Change
producers towards a world devoid of IDD, and a healthy society,
Communication on Iodine Deficiency Disorders has lot to learn
thus, fulfilling the right of every child to optimal physical and
from development and implementation of BCC of polio, an
mental development.
important preventable cause of physical disability.
We know the answer to "What needs to be done?" We must now
Achieving success is one part of the goal. Regular monitoring
accelerate and share our efforts to find the answer to, "How is it to
should begin with focus on process of availability and accessibility
be done?" ICCIDD is committed to be a partner in terms of moving
of adequately iodised salt at household level. Rapid test kit is an
ahead with, "How it is to be done?"
important tool for advocacy. They can be used for assessing
*This statement was circulated in 60th session of WHO RC SEAR, at Thimpu, Bhutan
5
Sri Lanka Achieves Universal Salt Iodisation
By Mahinda Gunawardena
anka Salt Ltd., Hambantota and Puttalam Salt Ltd. are Sri
This disparity resulted in the high prevalence of IDD in Sri Lanka as
Lanka's main producers of salt accounting for the country's
nearly 80% of the salt entering the market for human consumption
annual demand of around 105,000 MT of salt. Recognising
was below the requisite iodisation standards.
L
the need for mitigating Iodine Deficiency Disorders (IDD), both the
Thus in early 2005, following to damages of salt infrastructure
salt industry and the Government of Sri Lanka were able to obtain
owing to the 2004 Tsunami, ICCIDD Sri Lanka in its endeavor to
the initial, limited assistance from UNICEF, whereby small capacity
find a long term solution to eliminate IDD, presented their case io
machines were made available for salt iodisation. This permitted
The Micronutrient Initiative. This resulted in Ml making available a
these two producers to iodise only 20% of their total production.
donor grant to the two main salt producers for the construction of
The balance was therefore given to the cottage industry sector as
two modern factories capable of iodising the entire production.
raw salt to be iodised and sold to consumers. This sector within the
A unique feature however, was the participation of cottage industry
poorer sections of the community represents the micro industry
sector, which was further strengthened by their becoming the
and generates both employment and sustains a large network of
marketeers of good quality factory iodised salt. Good example of
householdsand families.
partnership between International agency and a National NGO,
However their limited access to financial resources prevented them
between large producers and cottage industry - together all these
from making investments for quality machinery for iodisation as
constituents
well as ensuring quality control.
elimination of IDD in Sri Lanka.
can
accelerate
progress
The Lanka Salt Factory of 15 TPH Capacity was opened ceremonially by the Prime Minister of Sri Lanka,
Hon'ble Ratnasiri Wickramanayake on 25th May, 2007. On 17th June, 2007 the opening of Puttalam Salt
Factory was done ny Hon'ble Siripala De Silva, Minister of Healthcare & Nutrition
6
towards
sustainable
Universal Salt Iodisation in Nepal
"Not True to The Salt, STC Selling Unhygienic Salt"
n yet another example of why state run corporations are slowly
I
on the wane, it has been found that Salt Trading Corporation
(STC) Nepal, the partially state-run corporation that enjoys full
monopoly over the salt market in the country, has been selling
highly unhygienic salt to the general public, raising serious health
flouting the order selling and distribution of the salt is continuing
unabated.
The source also revealed that the decision to import this unhygienic
salt and consequent selling and distribution against the circular
concerns for its loyal consumers.
was made by the corporation's Finance and Commerce
Committee headed by Rajendra Man Sherchan, a member of
An investigation has finally revealed that the quality of the "Ayo
STC's management committee,
Noon" or packed iodized salt sent to the markets of 22 hilly districts
Minister for Industry, Commerce and Supplies Rajendra Mahato
of the country as part of the "Goiter Disease Eradication Project"
said the government would carry out a thorough investigation into
has been found to be of extremely low grade and unfit for
consumption.
this scam.
CEO Mahaseth had handed over the authority of taking important
A detailed chemical examination at the laboratory of the STC itself
decisions in the corporation to the 6-member sub-committee of
has found "inedible substances" in the salt, reports say quoting
the STC two years ago.
sources. The Ministry of Health and Population has also raised
objection on the quality of the salt.
The corporation has long been planning to enter into international
trade by opening its branch offices in a number of cities of India
From November last year STC has imported salt worth Rs 500
million from India, of which more than half, according to STC
sources, has been found to be unsuitable for human consumption.
Even though Parameshowar Mahaseth, former Chief Executive
Officer of the corporation had issued a circular to its regional
offices to stop any selling or distribution of the unhygienic salt, but
and China. The corporation is also said to be eyeing the Gulf
region to develop it as a major trading area for exporting
agriculture products there, [nepalnews.com ag July 31 07)
Http://www.nepalnews.com/archive/2007/jul/jul31 /newsO
9.php accessed on 6/8/07
PAKISTAN: Iodine Deficiency Affecting Children in Northwest
http://www.alertnet.org/thenews/newsdesk/IRIN/a72ad66ed9dc9872a060e4a5ab9z
fl .him
14 August 2007
odine deficiency is a major health problem in Pakistan.
Combating deeply rooted beliefs is hard, with many people
I
Allah Almighty has given us many natural wonders, including salt.
from it.
Why should we add man-made medication to it? If a child is ill or a
It is commonly believed iodine deficiency shows itself only as
woman suffers miscarriages, that is God's will," said cleric Abdul
goiter, but actually it can lead to slow mental development,
Hakim, based at a mosque close to Thandiani.
According to the Islamabad-based Network for Consumer
seemingly unconvinced by factual evidence.
Protection, around 50 million people across the country suffer
retardation, lethargy and reproductive problems,
including
miscarriages or still births among women," said Dr Faiza Zafar, a
However, gradually, the message regarding iodine has begun to
reac some families. "If this will help my son, I am willing to try it,"
physician based in Abbotabad. She diagnoses iodine deficiency
said Sumaira Khatoon, cautiously sniffing a handful of iodised salt
quite frequently among patients from all over the NWFR
brought from a corner-shop.
In 6.5 million people the problem of iodine deficiency is rated as
Goiter, iodised salt statistics
"severe", while in many parts of the NWFR where rain and rivers
wash iodine and other minerals out of the soil, up to 90 percent of
people outside major towns are said to suffer from some level of
According to the results of UNICEF-supported research conducted
by the Peshawar-based Research Centre of the Khyber Medical
College, in the Swat area of the NWFR the findings of which were
iodine deficiency.
published in 2003, 52 percent of boys and 45 percent of girls
Iodised table salt was introduced in Pakistan in 1994 and currently
aged 8-10, from a sample of 960 students, were found to suffer
the UN Children's Fund (UNICEF), which began importing
from goiter. While this marked a slight improvement over figures
potassium iodate into Pakistan around the same time, supplies
reported in past years, the incidence of the problem remained
provincial health departments.
high.
The rate, at US$2.50 per kilogram is low, and the cost of adding it
to salt ground at local mills is minimal.
According to the Network for the Sustained Elimination of Iodine
Deficiency, a network of major international organisations working
But a quite different problem has plagued the campaign to
globally against iodine deficiency, only 1 7 percent of Pakistan's
promote and popularise iodised salt. "Many people believe that
population uses iodised salt. This compares to over 70 percent in
this salt is a means of preventing reproduction and is being
neighbouring India, 93 percent in Nepal and 78 percent in
distributed as part of a Western conspiracy to stop the growth of the
Bangladesh.
Muslim population," said Dr Zafar.
International agency Micro-nutrients Initiative (Ml) has now taken
Zafar said: "Some patients refused to use the widely available
over responsibility for promoting iodised salt in the country and is
iodised salt because they were convinced it would reduce fertility."
working with the Health Ministry. Attempts are being made to
This belief, which exists not only in the NWFP but also in many parts
of
Pakistan's
populous
Punjab
Province,
is
similar
to
persuade rock-salt crushing factories to add the nutrient to its
products.
misconceptions surrounding the oral polio vaccine, and also
Wider marketing of iodised salt and indeed a battle against
fortified flour, the marketing of which has begun in some parts of
widespread malnutrition, which causes stunting among 38 percent
the country.
of Pakistani children, according to international findings, may help
However, Amjad Malik, a medical student who is working in
solve some of the issues millions of people face.
Abbotabad to combat iodine deficiency, said: "Such problems
But the struggle could be a long and difficult one, aid workers say.
have to be tackled and not allowed to stand in the way of people's
Many NWFP villages are cut off from major towns for months by
health."
snow and people tend to live in virtual isolation, unwilling to alter
This may be easier said than done though - especially in
age-old beliefs.
conservative areas of the NWFP where campaigns conducted by
Http://www.alertnet.org/thenews/newsdesl</IRIN/a72ad66
the government or non-governmental organisations (NGOs),
ed9dc9872a060e4a5ab920edl.htm
hold little weight and are often regarded with distrust.
Accessed on 14 August 2007
Partnership of ICCIDD with Bharat Scouts and Guides
Nationwide Survey of Iodised Salt
July - December 2007
artnerships enrich and strengthen programmes and enlarge
P
partnership needs to be strengthened and enlarged so that a
the reach in implementation. This is especially relevant in
nationally representative sample can be used for estimation of
situations where stakes are high and resources are limited. It
availability of iodized salt at retail and household levels.
has particular importance in the context of activities in the social
and development sector. A public health programme, such as
Current Study Period: July - December2007-Methodology
elimination of iodine deficiency disorders that has pointed
Mr. G.B.S. Sajwan who is the present Director was approached for
significance to the health and development of the nation's
revival of collaboration and to provide support to the project that
population, is one such example. ICCIDD is planning to span out
involves collecting information about iodised salt availability and
and enlarge the scope of this partnership with other groups
interested in the physical, mental and social well being of the
people.
pricing and its use from all the districts of the country. The Bharat
Scouts and Guides Headquarter at New Delhi was requested to
inform their State people for collection and dispatch of salt
samples to ICCIDD, C/o Centre for Community Medicine (CCM),
BSG was approached by ICCIDD to collect information about
All India Institute of Medical Sciences (AllMS), New Delhi and also
iodised salt in various parts of India. ICCIDD entered into a
to provide us the list of BSG State Chief Commissioner's addresses
partnership with BSG in 1997 when a formal letter was addressed
to facilitate personal contact. BSG State Chief Commissioners of
to the then Director of the BSG. Since then it has been a very
various states provided us the names of units under their
successful partnership.
jurisdiction, which would assist in collecting this information.
Objective
As per recommendation," we then contacted the specified unit.
To collect information about iodised salt availability, pricing and its
Jawahar Navodaya Vidyalayas
use in various states in India at district level.
Human Resource Development, Department of Education with
Previous Study Period: October 1997-June 1998
A national level salt sample collection and analysis by titration
which is under the Ministry of
their headquarters at Navodaya Vidyalaya Samiti, New Delhi also
extended their support in the project. The individual district
schools, who were interested to do the survey contacted us to
method and salt testing kit method for availability of iodized salt in
provide them the required material for the survey. Navodaya
India was previously done from October 1997 to June 1998. 80
NGOs from different States and 39 subunits of Bharat Scouts and
Vidyalayas are located all over the country including Lakshadweep
Guides participated in this study. 80 NGOs sent a total of 1539
The number of schools has now grown to 557 spread over 34
and Andaman & Nicobar Islands except the State of Tamil Nadu.
samples and 39 units from BSG sent 562 samples to the Delhi
States and Union Territories. Out of these 539 are functional.
office between the month of November 1997 and March 1998.
These schools have over 158,000 students on roll.
The reports indicate that about 58%-84% of the salt samples at
retail level contain adequate iodine. This time special efforts are
being made to contact the last time non-responders. This
There are total of around 600 districts in India. The number of
samples that can be handled by our laboratory at ICCIDD over a
period of 12 months besides the routine work will be 20,000.
Therefore, 40 samples per district were required to be collected.
received in ICCIDD laboratory will be quantitatively tested for
Hence, each district were sent the following:
1.
10 prepaid self-addressed envelopes (for sending back 4
3.
iodine content by the titration method.
Progress so far
. zip lock bags containing salt samples
2.
on IDD would also be sent to them by post. The salt samples
40 zip lock polythene bags for sending the salt sample
We have sent 40 letters across India to various States and Union
from the field site to ICCIDD laboratory, Delhi
Territories
One copy of English and Hindi brochure each, that
contains
information
buying
on
and . consuming
adequately iodised salt and usage of salt testing kit
requesting
Scouts
Bharat
and
Guides
State
Commissioners & Railway State Headquarters The progress so far
is enumerated in Table 1. Efforts are being made to contact more
and more schools through Jawahar Navodaya Vidyalaya Samiti
and Kendriya Vidyalaya Sangathan so as to reach the grass root
4.
One copy of English and Hindi instructions booklet
level ard get the desired information about iodised salt all over the
5.
One box of Salt Testing Kit (STK) which contains 20 STK to
count 7.
test the salt for presence or absence of iodine
The last date of collection of samples is 30th November, 2007.
Five Proformas to be filled by the volunteers
The time required for analysis of all the received salt samples in the
6.
The volunteers could also use the Salt Testing Kits to organize and
plan any community education activity. Booklets and pamphlets
ICCIDD laboratory would be 2 months. Report preparation will be
done in the month of February, 2008 followed by dissemination of
the results in March, 2008.
Bharat Scouts
& Guides
(units)
S.N
State
Navodaya
Vidyalaya
(districts)
2
19.
Lakshdweep
1
Arunachal Pradesh
16
20.
Madhya Pradesh
48
3.
Assam
26
21.
Maharashtra
31
4.
Andhra Pradesh
22
22.
Manipur
9
5.
Bihar
1
23.
Meghalaya
7
6.
Chhatisgarh
16
24.
Mizoram
8
7.
Chandigarh U.T.
1
25.
Nagaland
11
8.
Delhi
2
26.
Orissa
30
9.
Dadra and Nagar
1
27.
PondlcherryU.T.
4
10.
Daman and Diu
2
28.
Punjab
17
11.
Goa
2
29.
Rajasthan
32
12.
Gujarat
20
30.
Sikkim
4
13.
Haryana
19
31.
Tamil Nadu
14.
Himachal Pradesh
12
32.
Tripura
15.
Jammu & Kashmir
14
33.
Uttar Pradesh*
16.
Jharkhand
34.
Uttaranchal
13
17.
Karnataka
35.
West Bengal
25
S.N
State
Navodaya
Vidyalaya
(districts)
1.
Andaman & Nicobar
2.
18.
Kerala
27
14
Bharat Scouts
& Guides
(units)
2
2(40 schools)
*5 NGO Units
6
4
Rashtrapati Awards to Bharat Scouts & Guides
Dr. Chandrakant S. Pandav, B.S.G. Fellowship Awardee
he Rashtrapati Scout/Guide and Rover/Ranger Awards
pertaining to healthy environment and Nation building activities
function was held on 11 th July, 2007. The awards were
which were repeated enthusiastically by all present.
T
given away by the Hon'ble President of India H.E. Dr. A.RJ.
Dr. Chandrakant S. Pandav was awarded B.S.G. Fellowship in
Abdul Kalam at a grand function organised at the Ashoka hall of
recognition of his philanthropic gesture in support of the Bharat
the Rashtrapati Bhavan.
Scouts and Guides movement in India. Since Dr. Pandav was
In his address to the awardees and the guests, Dr. Kalam praised
unable 'to attend this function he was presented this fellowship
the Scouts and Guides for their discipline and commitment to work
during the National Executive meeting of the Bharat Scouts and
for taking the country forward. He also read out a set of promises
Guides at their headquarters in Delhi.
Left Dr. Chandrakant S. Pandav rccieving the Roshlrapoli Bharat Scouts and Guides Fellowship from Mr. Lail Jain, Notional commissioner of BSG.
Rightt: The President of India, H.E. Dr. A.RJ. Abdul Kalam interacting with the scouts and guides during the function
Iodised Salt Features in Leading Consumer Magazine
Consumer Voice Vol. VIII, Issue VII, July 2007
Courtesy Consumer Voice
The permission for reproducing the same has been taken from
onsumer voice is a monthly magazine of consumer
C
interest. The July issue of the magazine carried a full
feature on iodised salt in India. 13 local brands were
Consumer Voice.
For queries: Mr. Bejon Misra, Executive Director, Consumer
tested. Statement of Dr. M.G. Karmarkar, Senior Advisor ICCIDD
was also reported. In the next few pages we are reproducing all
that has been written in this issue relating to iodine and iodised
VOICE.
email: bejonmisra@hotmail.com, consumeralert@eth.net
salt.
12
The Salt of the Earth
Comparative Test
Courtesy Consumer Voice
alt is something we consume everyday. This white powder-
S
highest iodine content at 52.85 per cent ppm. To assess how much
like compound is an integral part of our lives and urban
iodine is lost from salt after cooking, vegetables were boiled for 0-
consumers don't even think twice before purchasing the
15 minutes and salt put in them.
same brand that they have been using for years. The only time that
iodine content was still consistent.
salt grabs attention is when one starts to suffer from hypertension
Highest iodine content
or heart trouble.
The boiled stuff showed that
Saffola: 52.85%; Tata Salt: 39.36%; Good Health: 39.03%
With the Government of India endorsing iodised salt as a panacea
for
Iodine
Deficiency
Disorders
(IDDs),
organised-sector
Lowest iodine content
manufacturers have had a clear lead in urban India promoting
Taja: No iodine content; Seema: 1.05%
their brand of salt as fortified with iodine, as 'vacuum evaporated',
How much salt?
lump-free, and everything else that advertising can highlight to set
branded salt apart. The Saffola brand for example, comes with a
catchline The heart of a healthy family'. There, however, is little
indication to show how consumption of Saffola salt actually
It is the sodium chloride content which determines how 'salty' salt
actually is. Standards specify that sodium chloride content should
be 96 per cent at least.
contributes to strengthening of the heart.
Brands with less than requisite sodium chloride content
If you are worried about iodine disappearing from salt during the
Saffola: 94.8%; Taja: 93.38%; Seema: 89.06%
process of cooking, you can put your worries to rest. Laboratory
Moisture
tests show that most of the salt brands tested retain an appreciable
amount of iodine even after cooking.
It is moisture that tends to cause lumps in salt during its 12 months
or so of shelf-life. That is why standards specify a maximum
Consumer VOICE tests of iodised salt had a mix of organized and
moisture limit of 6 per cent. While all brands (whether branded or
local-sector brands. The most surprising finding is that a local and
unorganised) had their moisture content well within maximum
little-known brand TOTA is among the top three in overall
permissible limits, brand 'Seema' had its moisture content very high
performance.
at 8.2 percent.
Fair amount of iodine
Salt brands are underweight
It was in 1973 that iodised salt standard were first laid down by the
Products being underweight is a common problem. The Weights
Bureau of Indian Standards. Minimum requirement for iodine
and Measures Act 1977 allows for some leeway-upto 1.5 per cent
content has been fixed at 15 ppm at consumer level and 30 ppm at
less quantity for salt packs upto 1 kg. Taja salt which has a
manufacturer level. Except for local brands like Seema and Taja,
proclaimed net weight of 1000 g actually weighed 947 g.
all brands conform to this national standard. Saffola has the
Salt costs a few rupees a kilo but is the most
widely used food product. Ever since iodine
began to be added to salt, there has been a tug
of water between big manufacturers and small
time salt producers for control of something
that is so basic to human food consumption
patterns. Consumer VOICE tests 13 brands of
iodised salt to find out which brand has how
much iodine and if brands that have been
priced at a premium are actually worth their
saltliterally. The good news is that cooking and
heating food does not diminish the iodine
content in salt significantly. Brand 'Nirma
Shudh' tops the overall performance, followed
by Shakti Bhog and a local brand Tota'
BRANDS TESTED
& THEIR RANKS
.
Nirma Shudh
Shakti Bhog
Tota
Ashirwad
Tata
Catch
Captain Cook
Good Health
Surya
Shudh
Saffola
Seema
Taja
1
2
3
4
5
6
7
8
9
10
11
12
13
Indian government has been focussing on what are known as
KEY FINDINGS
Iodine Deficiency Disorders (IDDs). Iodine supplementation in
India started with the Kangra Valley Study (in Himachal Pradesh) in
1956, since Kangra was identified as a region with high
1.
2.
3.
4.
Shakti Bhog and Good
Health are the only two
brands with ISI Mark.
Local brands have no iodine
value even though they
claim to be iodised.
prevalence of goitre and iodine deficiency. In a study carried out in
this population, three groups were asked to consume iodised salt,
iodated salt, and non-iodised salt, respectively. The group which
received iodised salt showed a decrease in the prevalence rate of
goitre from 38 per cent to 19 per cent over six years and to 8.5
Salt retains iodine value
even after food being
cooked for 10-15 minutes.
percent over 12 years. Similarly, the population which received
Taja salt 1 kg
underweight by 53 g.
contrast to the population that received unfortified salt in which the
pack
iodated salt showed decrease in goitre rates from 38 per cent to 15
per cent over 6 years and to 9.1 per cent over 12 years. This was in
goiter prevalence rate did not change. Iodine is said to be essential
for normal physical and mental growth. If there is lack of iodine
Insoluble matter
during pregnancy, a newborn's brain and body can become
Water insoluble matter denotes that matter in salt which does not
permanently retarded and stunted. In India, it is estimated that 200
dissolve in water. Such matter is mostly impurity. TATA Salt was
million people are at risk of IDDs, while the number of persons
found to be the finest with least insoluble matter in it. The expensive
suffering from goitre and other iodine deficiency disorders is about
brand Saffola and Taja, a local brand, had the most insoluble
70 million IDDs are generally related to goitre and thyroid
matterabove permissible limit. Saffola was also found to have
hormone. In the early 1960s, initial epidemiological evidence for
milky appearance when dissolved in water. This could be because
association of goitre and cretinism with iodine deficiency was
of certain minerals blended in it.
reported from Papua New Guinea. Globally, the prevalence rate
Does price have anything to do with quality?
of goitre in a community is considered a 'marker of IDD' in the
population understudy. It has been reported that, in general, if the
Edible salt typically costs around Rs 8 per kg. When brands like
total goitre prevalence rate in the community is more than 30 per
Saffola and Catch up their price and sell their product at twice the
cent, then cretinism is likely to be prevalent in that population
average price, one wonders what is it that sets them apart from the
Cretinism is a congenital disease due to absence or deficiency of
rest of the brands.
normal thyroid secretion, characterised by physical deformity,
After having tested 13 brands of edible salt according to relevant
dwarfism, and mental retardation, and often by goiter
national standards, Consumer VOICE did not find anything
Source: Relevance and importance of universal salt iodisation in
special with either Catch or Saffola that would put them head and
India, The National Medical Journal of India, Vol 10, No 6, 1997
shoulder above other brands. Catch probably prices itself in the
The Art of Living and Salt
premium segment because it has designed itself for use as table
salt that comes with attractive cylindrical packaging. Saffola may
be selling at a high price because it claims io be a fortified salt
brand.
In August 2006, spiritual guru Sri Sri Ravi Sankar's 'Art of Living'
launched a campaign against the imposition of iodised salt on
consumers. In its communication, Art of Living' said, "The
government banned the sale of natural common salt citing that the
How we test
addition of iodine to this everyday item appears be the most
The comparative testing of 13 brands of iodised salt was
effective way of combating deficiency. Our question is that when
conducted in an National Accreditation Board for Testing and
only estimated 2 per cent of India's population suffers from iodine
Calibration Laboratories (NABL) accredited lab during the second
quarter of 2007. The tests were conducted according to voluntary
deficiency, why compel the remaining 98 per cent to consume
iodised salt". Art of Living's' standpoint is that the ban on natural
BIS standard: IS 7224:1986 and relevant PEA rules 1955.
salt is direct blow to people's right choose. Today, it's salt; tomorrow
Iodine Deficiency Disorders
Iodised salt has acquired significance because of salt being the
most accepted carrier of iodine. For more than forty years now, the
it could be water any other food that we eat or drink. "How can we
justify the ban on common salt when more hazardous substances
such as alcohol and cigarettes are allowed to be sold with a mere
statutory warning?"
Comparative Test
Courtesy Consumer Voice
Brands
Weigh-
Nirma
Shoki
Parameters
’age
Shudh
Bhog
8
8
Toto
Ashirwod
Tata
Catch
Salt
Captain
Good
Cook
Health
Surya
Menu
Seama
Top
Saffola
(fortified)
Shudh
0/
/o
MRP Rs./kg.
5.5
8
9
16
9
9
9
7
4
7
16
Packing
4
3.5
3.5
2.5
3.5
3.5
4
3.5
35
3
3
2
2.5
3.5
Marking
6
4.61
4.61
5.07
4.61
4.61
3.69
4 61
5.07
4.61
4.61
3.23
4.15
4.15
Net Weight
3
3
3
2.7
3
1.4
3
3
3
3
1.8
2.7
0.8
3
Moisture
10
8.75
8.6
9
8.65
8.25
10
8.5
8.7
9
7.2
2
7.2
8.8
Chloride as
10
8.5
8.4
8
8.4
9
7.3
72
8.1
6.5
5
1.5
3.4
4.8
8
6
4.3
7
6.9
8
4.7
4.7
5.4
5.9
5.95
7
3
3.4 .
10
8.1
TO
7.1
8
8.85
7.6
7.3
8.1
4.6
1.6
0.4
0.8
3.9
Iodine Content
35
32.7
33.3
34.1
5
31.3
28.3
33.2 '
33.8
28.5
32.2
33.7
2.5
0
22
Particle Szie
4
4
4
4
4
4
4
4
4
4
4
4
4
4
Turbidity
6.
6
4
45
44
5.8
24
. 2.3
33
4.7
2.5
3.2
1.2
0.5
Whiteness
4
4
3.4
2
2.4
2.6
3
3.6
38
2.2
2.8
16
1.8
3.2 .
Overall Score’
100
89.16
87.11
860
2
85.16
84.31.
82.89
82.51
81 47
79.7
72.16
30.1.3
28.9
61.25
1
2
3
4
5
6
7
8
9 '
10
if
12
NoO
Water
Insoluble
Matter
Matter
Insoluble in
Water
Rating: Excellent>90*****z Very Good 71-90****, Good 51-70***, Average 31-50**, Poor<30*
The data presented is score obtained with respect to assigned weightage. It is based on the actual performance of tested brands.
Iodise Salt for an Entire Generation
Interview of Prof. M.G. Karmarkar, Senior Advisor, ICCIDD
Courtesy Consumer Voice
Consumer VOICE: Does iodised salt have
into a costly product. There are places in India where iodised salt is
®
any sideeffects? What about people who
have hyperthyroidism?
distribution system.
jy
MG
/
"
Karmarkar:
temporary
’
Hyper-thyroidism
phenomenon.
is
a
Excess
consumption of iodine through salt is not
being sold at a reasonable price of Rs 3-4 per kg through public
Consumer VOICE: What are the iodine deficiency endemic areas
in India?
MG Karmarkar: It is the hilly mountainous areas that lack in
possible as potassium iodate which is used to
iodine. Even the goats there are deficient in iodine. This means that
add iodine to salt is costly. On an average, we do not consume
iodine-deficiency cannot be met even by meat. We have found that
more than 3.6 kg of added common salt through food in a year, so
people in Kerala are iodine deficient even when there is common
the fears about consuming excess iodine are baseless.
perception that fish eaters do not need iodised salt. It was found
Consumer VOICE: What is the recommended dosage of iodine?
that their intake of iodine from fish is just about 30 micrograms as
How can one ensure that the right dosage reaches consumers and
against 150 required. We started work on iodine way back in 1956
not more?
when the Kangra valley project was initiated. Then Kangra was part
MG Karmarkar: Around 150 microgram of iodine is needed
everyday. Through our intake of 10 g of salt everyday, this need is
of Punjab and we found that giving of iodised salt to the population
forfive years obliterated the cases of goitre in the local population.
fulfilled. Once upon a time, TATA Salt used to put more than
Prof Madhu G Karmarkar is Senior Adviser, International
necessary amount of iodine in its product to avoid being snared by
Council for Control of Iodine Deficiency Disorders (ICCIDD).
PEA rules regarding the minimum iodine content of 30 ppm in salt
during manufacturing. This is because some amount of iodine is
lost after salt is manufactured due to transportation, packaging
etc.
Consumer VOICE: Many consumers and activist groups see
iodised salt as onslaught of promotion by a few big companies.
What is your opinion?
MG Karmarkar: When I was young, I don't remember there being
any salt advertising in the media. Branded salt began to be
promoted in a big way when TATA first started to manufacture salt.
They were also the ones to start making vacuum evaporated salt.
This was because they were in the business of manufacturing soda
ash. Since they had excess of sodium chloride and did not know
what to do with it, they got into the common salt business.
Iodisation of salt has increased the price of salt by only 10 paise
per kilogram. Some decades ago, salt and sugar were priced at
par. Now the cost of sugar has risen to 20 rupees per kg whereas
salt is still way cheap.
It is
also
not true that small-time manufacturers cannot
manufacture iodised salt. There have been drives where free
potassium iodate has been distributed to small manufacturers but
only 5-10 per cent of such manufacturers have the capacity to
make iodised salt as they do not have crusher facility and operate
chakkis instead. It is erroneous to think that iodised salt translates
Prof. Madhu G. Karmarkar has
spent a lifetime researching and
promoting iodine in food. His
experience of surveys done in all
Staes of India shows that almost all
states in India are iodine deficient.
Iodine can never be over
consumed and there is nothing like
an Multinational companies
conspiracy to take small time
manufacturers out of the salt
manufacturing chain, says the
man who has spearheaded the salt
iodisation campaign in India
Break the Salt Law Once More
By Surya Rao Maturu
Courtesy Consumer Voice
n November 2005, Ministry of Health &
TJ&wi J- ‘
I
Family Welfare, Government of India,
exempt the state from this legislation so far.
passed an ordinance banning distribution
Citizen groups can lobby with the Government of India to:
and sale (and consumption) of common non?
iodised
5
Maharashtra where a PIL has forced the state government to
salt.
Unfortunately,
it
appears,
looking at the background to this ban, that
vested interests are at work; the medical
health findings are not publicly debated and
verified. While iodised salt may be good for iodine-deficient areas;
the same may be harmful to the average consumer.
(I)
Have the non-iodised salt ordinance repealed.
(li)
Get adequate compensation for victims of iodised salt
consumption, from the Government of India.
Citizens can file RTI applications all over India to understand the
basis for the ordinance.
In 1859, the British passed a salt ordinance and in 1929 they took
Over the last 10 to 15 years, there has been a movement to
over the salt industry, banning salt production by local people.
promote iodised salt for everybody. The "expert opinions" of
From the 12th March to 6th April, 1930, Gandhi led his Dandi
doctors, nutritionists and even of some NGOs have been swayed
Yatra and defeated the then government by Salt Satyagraha 1930-
in favour of iodised salt. Some thirty crore Indians eat non-iodised
31. Let us do this once again in 2007.
salt. For them, a meal consists of rot ior rice, salt, onion,
Surya Rao Maturu
gur(jaggery) or pickle, and without dais, vegetables, and fruits.
Profiteering and governing laws have already denied gur and
onions to the poor. In future, they will have to forgo salt, as iodised
salt is beyond their meagre budget.
More than 50 crore Indians eat iodised salt. Against a requirement
of 5 million tonnes (MT) of iodised salt; 900 iodisation units have a
12 MT capacity. Manufacturers buy common, unrefined salt at Re
0.50 per kilogram, iodise it with KIO3-Potassium Iodate, a toxin,
at a cost of Re 0.10 per kg and the end user pays Rs. 6 to 8 for a
kilo of iodised salt. Total profits for this industry are more than Rs
1200 crore. Compulsory iodised salt will render a huge fraction of
the 2 million employed in the common salt unorganized industry
Iodised salt has its faithful
proponents in the health sector,
the Government of India and the
World Health Organisation. In the
face of the iodisation onslaught, a
few determined activists are
holding their ground demanding
that they be given the right to
choose between iodised and non
iodised salt. Is iodised salt a
necessity or an over rated health
concern? The debate rages...
jobless with no reemployment.
We have been buying and eating branded iodised salt for the last
45 years. We presumed it is "good" for our health. Yet known cases
of Hyper or Hypo Thyroid in earlier generations are unheard of.
After 50 years of iodised salt, we find an epidemic of Hyper and
Hypo-Thyroid disease all over India; almost on the scale of
diabetes! Over 80 per cent of these cases are that of women. A
100% salt-free diet is supposed to work wonders; especially
regarding high blood pressure which again is a major public
health disorder, now being witnessed even in the youth.
There is not a single question on iodised salt in the Parliament; nor
has there been any Public Interest Litigation (PIL), barring in
Surya Rao Maturu is an IIT-Kharagpur graduate and did MBA from IIM-Bangglore in 1979. He worked in the corporate
sector for 15 years before opting out to pursue his interests in organic farming, Appropriate Technologies, Alternate
Healing, Consumer Education and Networking with NGO's
17
In Memoriam: Francois Delange
Reproduced from IDD Newsletter Vol 5 Number 3
Basil Hetzel, Creswell Eastman, Claude Thilly
enthusiastic about the idea. A collaborative team was established
at the 1993 and 1994 meetings of the European Thyroid
Association, and led to ThyroMobil campaigns on five continents:
Europe,Asia, Africa, Latin America and Australia.The Thyro- Mobil
model was used for the standardized evaluation of iodine nutrition
in a total of 38,619 schoolchildren selected from 432 sites in 31
countries. For a detailed summary of the Thyro- Mobil program,
please see: Delange F et ak'The Story of the ThyroMobil' (Thyroid
International 1 /2007, Merck Serono).
In 1995, Frangois became ICCIDD Executive Director, following
Basil Hetzel. He led the important '7 Country Study in Africa' which
investigated salt iodization programs and the occurrence of iodine
induced hyperthyroidism, first reported from Zimbabwe in 1995.
He was Senior Editor of an authoritative report of the 1996
WHO/UNICEF/ ICCIDD meeting on this topic, which resulted in
more careful monitoring of salt iodine levels throughout Africa and
the world.
rancois Delange. died on 15th June 2007 in Brussels
F
following
cardiac. surgery.
His
death
was
a
shock
In 1997, Francois organized a meeting on IDD in Europe, in
experienced by the thyroid scientific community throughout
Munich, including a series of papers on thyroid cancer from
the world. Frangois was a founding member of ICCIDD and served
Eastern Europe following the Chernobyl disaster. Delange was
from 1986 as the first ICCIDD Regional Coordinator for Europe.
Senior Editor of the Report of the meeting that led to increased
He
was
an
outstanding
pediatrician
and
support from UNICEF and WHO for new IDD control programs in
thyroidologist,
particularly in the field of congenital hypothyroidism. He became
Eastern Europe. His colleague, Gregory Gerasimov (who was
Professor of Paediatrics at the Free University of Brussels.
Sub-regional Coordinator) played an important role in these
programs, with strong support from UNICEF.
He made a major contribution to iodine research in the
Democratic Republic of the Congo, as part of the Belgian group
Following the 1998 ICCIDD Board Meeting, Francois was
led by Dr Andre Ermans and Dr Jacques Dumont. Franqois was
responsible for the revised ICCIDD Global Action Plan (1999-
responsible for studies over a 10 year period on hypothyroid
2001), emphasizing sustainability of country programs by effective
(endemic) cretinism as seen on Idjwi Island on Kivu Lake (see
monitoring of both iodized salt and urine iodine levels.This
culminated in the 2001 ICCIDD/UNICEF/ WHO Handbook on
photograph on following page). His work attracted great interest
the ‘Assessment of Iodine Deficiency Disorders and Monitoring
and led to a visit to Idjwi Island by John Stanbury, a leading thyroid
their Elimination-A guide for program managers' in which he
expert.
played a major role. Beginning in 1996, Francois represented
As Regional Coordinator for Europe, he made extensive country
ICCIDD at the Sub-committee on Nutrition (SCN) of the UN
visits to establish cooperation with local scientists. In 1992, he
Agencies, to which he reported each year as Executive Director.
organized the ICCIDD Regional Meeting in Brussels on Iodine
In 2001, his magnificent contribution to ICCIDD was suddenly
Deficiency in Europe: A Continuing Concern'. He was Senior
interrupted by illness (severe acute pancreatitis), which led to his
Editor of the report that provided the first comprehensive review of
resignation. In due course he recovered and continued to produce
IDD status in European countries, including Eastern Europe.
important papers, focusing on pregnancy and infancy, for which he
In Germany, Merck KGaA had begun to use a mobile van with
was the- major ICCIDD scientific resource. He was a frequent
facilities for the determination of thyroid size (ultrasound) and
consultant for WHO, UNICEF, the International Atomic Energy
storage of urine samples for iodine determination. Francois was
Agency and Belgian Cooperation. It is ironic that, just a couple of
consulted with a view to its use throughout Europe, and he was
months ago, after more than 30 years of scientific work and
18
lobbying of the Belgian government, Francois was informed that
Francois spent most of his professional career in the department of
the government was ready to finally introduce legislation on iodine
Pediatrics at the University Hospital Saint Pierre, until he retired at
supplementation during pregnancy and lactation.
the age of 60, in 1995.This allowed him to pursue and develop his
In early 2007, the ICCIDD Board of Directors nominated Francois
for the newly established 'JT Dunn Distinguished Service Award' for
life long interest in IDD within ICCIDD.
Francois received many professional awards, including the ETA
exceptional service to ICCIDD and the elimination of IDD. This was
Merck prize in 1997, and authored or coauthored 12 books, 361
fitting recognition of his outstanding contribution and was much
publications including original articles, chapters of textbooks,
appreciated by him.The ICCIDD Executive Group decided to
monographs, and proceedings of international congresses. His
further honor him by, in the future, naming the scientific sessions
research activities began in 1960, and from the start, his interests
held by ICCIDD with the Regional Thyroid Associations the
were the clinical and experimental aspects of the physiopathology
'Francois Delange Scientific Symposia'.
of pediatric thyroid disorders. His main interest was the study of
Iodine Deficiency Disorders.
Among other honors, he received the Merck Prize (ETA) and
Doctorates (Honoris Causa) from the Charles University of Prague
Frangois was also a pioneer in the use of neonatal screening for
and Jagiellonian University of Cracow. His professional career,
compassionate commitment and dedicated service in the cause of
congenital hypothyroidism (CH). Under his leadership, systemic
using TSH determination as the prime target. He had to fight hard
overcoming IDD cannot be overestimated.
with his American colleagues who, at that time, advocated total T4
We salute him with admiration and gratitude and extend our deep
determination as the main target of screening for CH.
sympathy to his wife Nicole and other family members.
A great clinical scientist, and for his wisdom, courage, idealism,
Francois was born in 1935, studied medicine at the University of
scientific honesty, and witty sense of humor, Frangois will be deeply
Brussels and graduated with an MD in 1960. He became one of
missed by all those who knew him well, his many friends in Brussels
the few medical doctors to obtain double specialty recognition in
and around the world, and probably even his few enemies. We feel
(Pediatrics & Nuclear Medicine). His PhD thesis was
1981
screening for CH was initiated in Europe at the end of the 1970s,
honored to have been his lifelong friends.
completed in 1973.
Calamities Call for Iodised Salt Intake, Centre tells States
Economy Bureau Posted online:
10 August 2007
hiruvananthapuram, Aug 9: Calamity-hit States have been
where iodine shortage could be waiting round the corner.
T
advised to be on the alert for the outbreak of iodine-
Following the ravage of Dengue, Chikungunya and other viral
deficiency diseases. Both climatic volatility and unexpected
fevers, resistance to diseases is feared to be on a low point in South
natural calamities could deplete the natural iodine content in soil,
India this year.
especially in land-locked States, says a recent report by the Union
In children, iodine deficiency could cause mental retardation,
health ministry.
memory-loss and goitre. In pregnant women, it could manifest as
In a communique to all State governments and Union Territories,
miscarriages.
the ministry has alerted the possibility of outbreak of diseases like
A six-month long campaign will be launched through primary
goitre. This would call for preventive measures like ramping up the
health centres in various States, says the Union health ministry's
consumption of iodised salt.
directive.
Even States with long coastline like Kerala, Tamil Nadu and
Directorate of audio-visual publicity under l&B ministry has been
Andhra Pradesh are urged that they should not be caught napping.
asked
Although exposure to sea could improve the iodine content in soil,
to
supervise
awareness
programmes.
Seminars,
documentary shows, medical exhibitions and health-quiz for
the same States also have people living on inland hilly slopes,
students are planned around the iodine theme.
19
ABOUT BHARAT SCOUTS & GUIDES
The Bharat Scouts & Guides toda^ is the largest voluntary, non-political, secular,
uniformed organisation in the country, working in the field of character building of the
young boys and girls in grooming them into enlightened citizens with the spirit of
dedicated service to the community without any distinction of caste, creed and religion.
"Hamara Karam Ho Seva, Hamara Dhoram Ho Seva, Soda Iman Ho Seva"
- (Let Service be our Deed, Creed & Faith)
Dally consumption of Iodised salt
is a healthy habit
NGOs
Policy Makers
Publishing any material in IQ+ Jagriti does not necessarily mean ICCIDD's endorsement of the views expressed therein or the results quoted.
Materials for publication, subscription request, comments may be sent to: Dr. Chandrakant S Pandav, Room No 28, CCM Building,
Old OT Block, All India Institute of Medical Sciences, New Delhi 110029 E-mail: cpandav@iqplusin.org
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