ICCIDD leaders, in a letter published in the November 5 issue of The Lancet, reminded that iodine deficiency is not a problem confined to low-income nations; it has now been documented in the UK. ICCIDD board members Frits van der Haar and Gregory Gerasimov, former ICCIDD executive director and current Board member David P. Haxton and current ICCIDD executive director Michael Zimmermann added that the UK results paralleled the experience in Australia and New Zealand where IDD has re-emerged as a significant public health priority after long-presumed success in overcoming iodine deficiency.

In our view, prevention should not need to wait for more research. Global experience offers credible guidance: salt iodisation is safe, equitable, largely self-financing, and extremely cost effective.3 Medical advisory com- mittees in industrialised countries often advocate daily supplements for the most susceptible groups. In practice, however, supplementation strategies struggle to attain meaning- ful coverage and require a daunting combination of political will, efficient distribution, continuous communica- tion, and robust monitoring.4 Focusing these efforts on preventive salt iodisation is more cost effective and sustainable.