One of the greatest public health success stories is also one of the least known. It started with a beautifully simple innovation: putting iodine into table salt. Salt is regularly consumed around the world by rich and poor alike, and so by fortifying salt with iodine, most people’s daily iodine needs could be met at a negligible cost with no change in behavior. In the 1990s, 113 countries were classified as iodine-deficient; that number is now 20. The impact of Universal Salt Iodization (USI) on human capital development is staggering when one considers that iodine deficiency is the most common cause of preventable mental retardation worldwide and that it can reduce IQ scores by an average of 13.5 points. The global scale-up of USI inspired the establishment of new institutions in the early 2000s to extend the success of USI into the fortification of edible oils and cereals such as wheat, maize, and rice to address other micronutrient deficiencies in low- and middle-income countries. With that amplification, the global infrastructure for reaching nutritionally vulnerable groups in developing countries with fortified foods was born.
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