Window on Eurasia: 50 Percent of Uzbeks Suffer from Iodine Deficiency Diseases

Paul Goble

Baku, March 17 – Nearly 50 percent of the population of Uzbekistan, some 12 million people, currently suffer from iodine deficiency diseases, including mental retardation, because Tashkent, despite help from UNICEF and the Asian Development Bank, has not iodized all the salt sold in that Central Asian republic.
The Uzbek government launched a program to iodize salt there more than 10 years ago, and in May 2007, President Islam Karimov issued a decree ordering that the program be completed. But now, almost a year later, Fergana.ru reported last year, Uzbekistan still has not achieved that goal and many Uzbeks are suffering as a result
(www.ferghana.ru/article.php?id=5627&PHPSESSID=a427077a9490dc5fbb8340c10df06169n).
This public health problem is one that has affected almost all the post-Soviet states. The Soviet government started iodizing salt in the 1950s, but its program began to collapse in the late 1970s. When the USSR fell apart, iodized salt largely disappeared
(http://lnweb18.worldbank.org/eca/eca.nsf/Attachments/ECAPOV+Chapter+8/$File/chapter8.pdf).
In some cases, as in the Russian Federation, the primary cause was that the plants producing iodine solutions for adding to salt were located beyond its borders, and the distribution system simply collapsed, with this public health issue seldom attracting the attention it deserved (http://www.unicef.org/ceecis/reallives_1345.html)
A few succeeded in opening iodine producing plants or purchasing iodine additives abroad. Russian began iodizing most of its domestic salt in the late 1990s, and the percentage of iodized salt in Kazakhstan went from 29 percent in 1999 to 94 percent in 2006 (http://www.nytimes.com/2006/12/16/health/16iodine.html?_r=1&oref=slogin).
But many, like Uzbekistan, have not made much progress, and their people are suffering. In addition to the obvious limitations of cost, accessibility, and government attention, Fergana.ru pointed out, that Central Asian country suffers from three particular problems that make achieving a breakthrough very difficult.
First, the number of producers (81), distributors, and points of sale of salt is so large that it may simply be beyond the capacity of the Uzbek government to check to see whether salt labeled as containing iodine in fact does. A recent check of more than a dozen stores in two rayons of one oblast found no iodized salt available.
Second, many of the companies that do iodize salt do so incorrectly, leaving the salt with an unpleasant taste or appearance and thus causing many people who have been told that they should use iodized salt to decide against doing so, whatever its health benefits.
And third, Uzbekistan has had problems developing relations with foreign suppliers – it produces no iodine solution itself – to purchase the six tons of iodine it needs each year. Its ties with a Chilean firm fell through, and the Uzbeks have been unhappy with iodine produced in Ukraine.
Now, Uzbekistan plans to purchase what it needs from the Untied States, but the price and who is to pay it may beproblems. The total annual cost would be approximately 250,000 US dollars, of which UNICEF has committed itself to pay 59,000 US dollars. And Tashkent would like someone else to pick up more of the tab.
But if Uzbekistan producers pass on this cost to consumers, many of the latter may seek to purchase cheaper non-iodized salt, and consequently, in the absence of a serious government effort to enforce universal iodization in that country, more Uzbeks will suffer from iodine deficiency and iodine deficiency diseases in the years ahead.