Global Alliance for Improved Nutrition

Iodine deficiency is the leading preventable cause of intellectual and development disabilities in the world. Iodine is a vital micronutrient for mental and physical health, yet in many parts of the world, people do not have enough iodine in their normal diet. There is a simple, cost-effective solution: fortifying household salt with iodine. GAIN works with governments and producers to make this happen, helping to make millions of people healthier, smarter, and more productive. It takes an investment of just 15 to 50 cents for GAIN to help provide one additional person with access to adequately iodized salt through their lifetime.

Since 2008, GAIN’s Universal Salt Iodization program has supported 17 countries across Africa, Asia and Eastern Europe, including Afghanistan, Bangladesh, China, Egypt, Ethiopia, Ghana, India, Indonesia, Niger, Nigeria, Pakistan, Philippines, Senegal, and Tajikistan. These countries have high incidences of iodine deficiency, with 25 percent of households vulnerable to iodine deficiency disorders, including some 34 million newborns and infants each year. From 2008 to 2015, GAIN has helped protect an additional 466 million people against iodine deficiency. This includes an estimated 18.2 million pregnant and lactating women, leading to the protection of newborn cognitive health, as well as 113 million children aged 6 months to 15 years old who are no longer at risk of the debilitating effects of iodine deficiency. We are now in an unprecedented position: on the verge of being able to control iodine deficiency at a population level, in a sustainable way.

The Problem

Iodine Deficiency. More than 3.5 billion people today are malnourished--that’s roughly than half the world’s population. These people suffer from an array of preventable health problems because they lack access to vital micronutrients in their daily diet. Iodine is a micronutrient crucial for bone and brain development, including intelligence. However around 1.75 billion people--nearly a quarter of the world’s population--get too little iodine in their food. This leads to increased rates of miscarriage, stillbirth, and infant mortality, as well as cognitive and developmental problems, goiter, and hypothyroidism. Iodine deficiency is the leading preventable cause of intellectual and developmental disabilities in the world.

Much progress has already been made. The number of iodine deficient countries was reduced from 54 in 2003 to 32 in 2011. Yet despite many years of global Universal Salt Iodization (USI) efforts, about 25 percent of households in the developing world are still iodine deficient, many of them in areas that are the poorest and hardest to reach. New models are needed to ensure full and sustained coverage.

The Solution

Universal salt fortification. The good news is that fortifying salt with iodine is safe, relatively easy, has high returns on investment and is extremely inexpensive. Depending on the country and its level of support needed GAIN can begin, expand or sustain a salt iodization program to cover an individual over an entire year at an estimated 15 to 50 cents. Benefits include improved health, improved educability, lower health care costs, economic growth, and reduction of poverty.

Adding potassium iodate to household salt during the production process gives people access to adequate iodine in their diet. While most large salt producers do this routinely, many small and medium-sized producers in the developing world lack the means or knowledge to do so. GAIN supports governments and salt producers to help them to this in a sustained way.

How GAIN is different from other charities

GAIN’s mission is to create a world free of malnutrition. The organization works to build partnerships between governments, the private sector, and communities to design and implement effective and sustainable salt fortification programs. GAIN supports governments and salt producers in establishing and sustaining secure supplies of potassium iodate, improving iodization quality, effectively implementing salt quality laws and putting monitoring systems in place.

GAIN has been a major force in global universal salt iodization programs since 2008. GAIN emphasizes programming and outreach that prioritize underserved groups such as women, girls, and children.

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Why GAIN is effective

Global partnerships

GAIN’s flagship universal salt iodization program was established in partnership with UNICEF. GAIN also works with the Iodine Global Network (IGN) and the Micronutrient Initiative. Read more about GAIN’s partnership with the IGN here.

Proven impact

An example: GAIN’s work in Ethiopia led to the number of people receiving adequate iodine increasing from 5 percent to 43 percent between 2009 and 2011. By 2013, GAIN’s iodization program support helped increase the country’s iodized salt level to 95 percent.

Cost-effective

It takes an average investment of only between $0.15 and $0.50 for GAIN to be able to provide one additional person with access to adequately iodized salt throughout their lifetime. The cost per person is higher in countries that have low iodization coverage and populations that are difficult to reach, than in countries that are improving or just sustaining their salt iodization programs.

Economically beneficial

As well as improving health, USI programs have been shown to reduce poverty and boost economic growth: one study showed that a 1 percent decrease in malnutrition led to a 4 percent reduction in poverty, and the Copenhagen Consensus estimates that for each $1 donated, productivity increases by $30.

High Impact

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GAIN’s accountability and sustainability

GAIN is a recommended charity of The Life You Can Save. GiveWell lists GAIN as a standout charity, and the Stanford Social Innovation Review lists GAIN as a recommended charity.

GAIN has made its Framework for Transparency available on its website, along with its annual reports and financial statements. It regularly publishes its data with the International Aid Transparency Initiative (AITI).

GAIN uses existing local infrastructure, working with governments, nonprofits, and businesses to implement low-cost and effective salt iodization programs. GAIN ensures that supplies of potassium iodate are secured in the long-term and provides its expertise to ensure that programs continue after its direct involvement in the region has ended.

Frequently Asked Questions

Who are GAIN’s partners?

GAIN’s USI program was established in 2008 with a grant from the Bill and Melinda Gates Foundation for the GAIN-UNICEF USI Partnership Project, a 7-year program to improve iodine status in 14 countries, targeted by highest iodine deficiency rates. GAIN also has received limited funding for some of its USI work from bilateral aid organizations, such as IrishAid and USAID. In addition to UNICEF, GAIN works with the Iodine Global Network (IGN), the Micronutrient Initiative, national governments, salt industries, academia, and civil society on advancing salt iodization.

Is iodization cost-effective?

Yes. Iodization efforts are cheap to implement and economically beneficial to countries and local communities. A prime example is Switzerland, which eliminated iodine deficiency and its effects via universal salt iodization last century. Besides preventing iodine deficiency-related disease and suffering, the program cost of 0.7 million euros led to an estimated savings of 500 million euros.

What will my donation pay for?

GAIN estimates it has expanded access to adequately iodized salt across 14 countries for $0.20 per person, making this one of the most cost-effective poverty interventions there is. GAIN’s primary grant for universal salt iodization ended in 2015, so your donation is helping GAIN deepen its work to reach those who are still unable to access a sustainable supply of iodine in their diet.

What are some other examples of what GAIN has achieved?

Ghana: helped set up potassium iodate procurement and distribution system for medium and small-scale producers.
Ethiopia: provided initial fortificant and developed supply system to produce iodized salt for 55 million people.
India: helped develop/implement web-based information management system to improve government monitoring of salt supply.

Is my donation tax-deductible?

US donors can make tax-deductible gifts to support GAIN's USI work through GiveWell. Canadian donors can make tax-advantaged gifts through Charity Science. Swiss and German donors can give tax-deductibly via Giordano Bruno Stiftung.