Freedom or Folly?

The Madras High Court ruling risks erasing decades of progress against iodine deficiency, threatening India's children, productivity, and global public health leadership

- RAJAN SANKAR

In August 2025, the Madras High Court struck down the ban on the sale of non-iodised salt for direct human consumption, citing procedural lapses and the primacy of individual choice and commercial freedom. While the ruling appears to uphold personal liberty, it endangers one of India's most impactful public health achievements: universal salt iodisation (USI).

This decision risks reversing decades of progress in combating iodine deficiency disorders (IDD), particularly among the most vulnerable populations. As India stands at the forefront of global efforts to eliminate IDD, such a step backwards could not only undermine national health gains but also weaken the country's position as a leader in this critical public health domain.

India's fight against iodine deficiency began in 1962 with the National Goitre Control Programme, initially targeting specific high-prevalence areas. As evidence of widespread iodine deficiency across the country mounted, the programme evolved into the National Iodine Deficiency Disorders Control Programme (NIDDCP). By 1992, India mandated iodisation of all edible salt, a cost-effective measure that significantly reduced goitre prevalence and improved cognitive outcomes nationwide. This policy positioned India as a global leader in tackling IDD, with the country becoming one of the largest producers of iodised salt and achieving household coverage rates exceeding 90% in recent surveys.

The success of India's iodisation efforts must be viewed within the broader global context, where salt iodisation has emerged as one of the most remarkable public health achievements of the past three decades. According to the Iodine Global Network (IGN), a key international body dedicated to eliminating IDD, access to adequately iodised salt has surged dramatically since the early 1990s. In 1990, only about 20% of the global population had access to iodised salt. By 2022, this figure had risen to an impressive 88%.