For all that has been achieved in the fight against iodine deficiency around the world, there still exist areas and countries whose populations are vulnerable and are experiencing the lifelong effects of iodine deficiency.
The impact of iodine deficiency is not limited to just those individuals who are afflicted; it also has adverse effects on entire communities and their economies. The mean IQ of a deficient community can drop by 10-15 IQ points leading to decreased educability and work productivity and contributing to impaired social and economic development. If iodine intake can be increased, there is often a dramatic improvement seen in the IQ of the population.
One such country is Papua New Guinea, a country of over 8 million people in the southwest Pacific, north of Australia. Papua New Guinea is known for its geographic diversity, volcanoes, beaches and coral reefs. The mountainous, inaccessible terrain, partly responsible for its cultural and linguistic diversity, has left pockets of remote communities vulnerable to severe iodine deficiency. Part of the demographic fabric that makes Papua New Guinea so unique and culturally diverse can also present challenges in iodization programming. Implementing programs in a country with over 800 languages, where only about 15% of the population lives in urban centres, can present logistical challenges that must be addressed for the adequate delivery and monitoring of universal salt iodization. 
A strategy of fortifying food grade salt with iodine has been globally successful in increasing iodine intake and significantly reducing the prevalence of iodine deficiency. The strategy has also been successful in much of Papua New Guinea. However, national and localized surveys of children and women have identified pockets of iodine deficiency in Papua New Guinea due to an unusual situation of remote communities not having access to commercial salt. Thus, they do not benefit from iodization and are iodine deficient.
IGN is supporting UNICEF and the PNG National Department of Health to distribute iodized oil capsules, vitamin A and deworming medication in some of these remote communities as an emergency measure to improve the iodine supply and reduce vitamin A deficiency and the loss of nutrients through worm infestation. At the same time, IGN is working with national stakeholders to explore opportunities for long-term, strategic initiatives to improve access to commercial salt in remote communities or identify alternative vehicles for iodization to improve iodine nutrition.
Fortunately, there are not many areas in the world that are still experiencing the consequences of iodine deficiency due to the success of salt iodization. Having championed and supported the establishment of salt iodization throughout the world, IGN is working to ensure existing salt iodization programmes are effective and sustainable and to address poor reach of salt iodization in unique situations, such as PNG. IGN’s ultimate goal remains to eliminate iodine deficiency and to provide every child with a chance to thrive through sustainable initiatives that increase iodine intake.
The findings outlined in this blog were drawn from:
Emily Schmidt, Hanifa Namusoke, Victor J. Temple, Karen Codling, Christiane Rudert, Brian Holtemeyer, and Todd Benson. Access to iodized salt in four areas of rural Papua New Guinea. IFPRI – Papua New Guinea (2019).
Goris JM, Temple VJ, Sumbis J, Zomerdjk N, Codling K. Iodine status of non-pregnant women and availability of food vehicles for fortification with iodine in a remote community in Gulf province, Papua New Guinea. PLoS ONE (2019) 14 (11): e0224229. doi.org/10.1371/journal.pone.0224229
Simbu survey on household availability and awareness of iodized salt, and use of salt condiments, flavourings, and fortification vehicles for iron: Health Education to eradicate iodine deficiency in Simbu Province, PNG. University of Papua New Guinea – Report by Simbu Medical Students Association (2018).