An estimated 40 million people in India alone suffer from goitre. A large percentage of these are cretins, who are mentally or physically retarded. Far from being a "cosmetic" problem, goitre is a disease that retards health and productivity.
The endemic goitre belt in India stretches across the entire sub-Himalayan region from Jammu and Kashmir through Himachal Pradesh, Uttar Pradesh, Sikkim, all the way to Arunachal Pradesh. Recent surveys also show endemic pockets in Kerala, Andhra Pradesh, Madhya Pradesh, Maharashtra, Bihar and Gujarat.
The cause of goitre was identified long ago as iodine deficiency. Prevention and control of goitre through the distribution of iodised salt has been well-known, and goitre was eradicated in the developed countries several decades ago through the application of this technology. India's own National Goitre Control Programme languished after a promising start. It failed to make a significant impact in many areas due to administrative incompetence, lack of coordination between the various agencies involved, and commercial and vested interests.
The Goitre Control Programme, with its coverage limited to a few hyper-endemic sub-Himalayan states, is in dire need of improvement. It is naive to believe that by merely extending the salt iodation programme to cover the entire country, the problem will be solved. It is still necessary to ensure that the salt produced by numerous manufacturers is in fact iodated.