A Judicial Ruling that is Salt in the Wound: Why Mandatory Iodisation of Salt Must Continue
The Madras High Court’s order to lift the ban on the sale of non-iodised salt was not based on scientific evidence but on a procedural flaw: the expert committee that informed the regulation was deemed not inclusive enough of dissenting voices. The court’s remedy — dismantling a life-saving public health shield to fix a process issue — is a perilous overcorrection
In August 2025, a ruling by the Madurai Bench of the Madras High Court quashed the national regulation mandating the iodisation of all salt for human consumption, jeopardising one of India’s greatest public health victories. The court’s decision was not based on scientific counter-evidence but on a procedural flaw: the expert committee that informed the regulation was deemed not inclusive enough of dissenting voices. While the principle of inclusive debate in policymaking is sound, the court’s remedy — dismantling a life-saving public health shield to fix a process issue — is a perilous overcorrection. If this judgment stands, it risks reversing six decades of progress against Iodine Deficiency Disorders (IDD) and compromising the cognitive potential of future generations.
The silent threat of iodine deficiency
The stakes could not be higher. Iodine is an essential micronutrient, indispensable for the production of thyroid hormones that regulate metabolism and, most critically, orchestrate brain development in the foetus and young child. A lack of iodine is the world’s single most important preventable cause of brain damage. The consequences, collectively known as Iodine Deficiency Disorders, range from goitre and hypothyroidism to stillbirths and congenital abnormalities. The most insidious impact, however, is on intelligence. Children born in iodine-deficient regions suffer an average IQ loss of up to 13.5 points compared to their peers in iodine-sufficient areas.
This is not a localised problem. Due to the geological makeup of the subcontinent, Indian soil is naturally deficient in iodine, meaning the food grown on it cannot provide the required daily intake. Consequently, the entire population is at inherent risk, making a population-wide intervention not just beneficial, but essential. Universal Salt Iodisation (USI) is the globally recognised solution — a safe, cost-effective, and equitable strategy.
India’s approach is firmly in line with a powerful global consensus. Salt iodisation is not an experimental strategy; it is a proven public health cornerstone, hailed by the World Health Organization (WHO), UNICEF, and other development partners as one of history’s most successful public health measures. More than 170 countries have adopted salt iodisation programmes to protect their populations. Crucially, over 130 of these nations have implemented mandatory legislation, recognising that a voluntary approach is insufficient to guarantee equitable protection. This widespread international practice is built on decades of strong scientific evidence, confirming universal salt iodisation as the most efficient and effective method for eliminating iodine deficiency on a national scale.
A homegrown, evidence-based triumph
India’s Universal Salt Iodisation programme is a model of evidence-based public health, built over 60 years on a foundation of Indian science. The journey began with the pioneering Kangra Valley study (1956-1972), which provided the definitive local evidence that iodised salt was the solution to endemic goitre. This led to the National Goitre Control Programme in 1962, which evolved into the National Iodine Deficiency Disorders Control Programme (NIDDCP) as the full spectrum of the deficiency became understood.
Recognising the universal nature of the threat, India adopted a policy of mandatory iodisation for all edible salt in 1992. The results have been a resounding success. Today, over 93% of Indian households consume iodised salt, a figure confirmed by the National Family Health Survey (NFHS-5, 2019-2021). This achievement has protected millions of children from preventable cognitive impairment and stands as a pillar of the nation’s human development strategy.
The unmistakable lesson of history
The most compelling case against the court’s ruling comes from India’s own recent past. Between 2000 and 2004, the central government lifted the ban on non-iodised salt, opting for a voluntary system in the name of consumer choice. The outcome was a public health catastrophe. National household coverage of iodised salt plummeted from over 50% to just 30%. The impact was even more devastating in populous states like Uttar Pradesh and Bihar, where coverage fell to 18% and 17%, respectively. This “natural experiment” proved that the poorest and least-informed households were disproportionately harmed, as cheaper, non-iodised salt flooded the market. The government, acknowledging the unfolding crisis, wisely reinstated the ban in 2005, and coverage levels quickly began to recover. This history provides an irrefutable, data-driven lesson: India’s high iodised salt coverage is not a self-sustaining habit but a fragile achievement maintained by a necessary regulatory framework. To ignore this lesson is to wilfully repeat a disastrous mistake.
Equity, not just choice: Iodised salt as a merit good
The debate is often incorrectly framed as a conflict between public health and individual liberty. A more accurate lens is the economic concept of a “merit good” — a product that is beneficial for society but which individuals tend to under-consume if left to a free market. This happens because of an “information failure”; the benefits are not immediately visible or are underestimated by the consumer. Iodised salt is a classic merit good. Its primary benefit — protecting the brain of an unborn child — is invisible and long-term. A consumer making a split-second decision in a shop is unlikely to weigh a small price difference against the potential IQ points of a future child.
In this context, arguing for “consumer choice” is effectively arguing for the right to make an uninformed decision that causes irreversible harm to the most vulnerable. Mandatory iodisation is therefore a policy of equity. It ensures that every citizen, regardless of income, location, or education, receives a fundamental health protection, much like regulations for clean water or vaccinations. This is not an infringement on liberty; it is the fulfilment of the state’s duty to protect the right of every child to reach their full potential.
The path forward: Protect progress, perfect process
The High Court’s judgment, while flawed in its remedy, offers a chance to reaffirm India’s commitment to science-led policy. The way forward is twofold. First, the Ministry of Health and Family Welfare must immediately appeal to the Supreme Court and seek a stay on the order. This is critical to prevent a rapid decline in iodised salt coverage and protect the population from immediate harm.
Second, the government should embrace the court’s directive to improve the policy-making process by constituting a new, transparent, and inclusive expert committee. This body should include a wide range of stakeholders, from nutrition scientists and economists to representatives from the salt industry, including small-scale producers whose concerns about cost and logistics are valid and must be addressed.
However, the committee’s mandate must be to review and strengthen the implementation of the Universal Salt Iodisation programme — improving quality control, supporting small producers, and enhancing monitoring —not to re-litigate the settled science on the necessity of iodine. While this deliberative process unfolds, the national mandate for Universal Salt Iodisation must remain in force. The cognitive future of India’s children is non-negotiable. We can and must perfect our processes without demolishing the protections they provide. To do otherwise would be to sacrifice a proven public health triumph on the altar of procedural purism.
