Nothian is a small village on the outskirts of Islamabad. The village, composed of 400-500 households, is undistinguished from the surrounding villages in all respects expect one: wide spread prevalence of goiter among mainly female participation. The first thing that comes forcefully into view when you enter the village is the ugly sight of young girls carrying visible protuberance on their necks. You get a sense of all village womenfolk suffering from goiter as you get into the heart of the village.

From old to young, the common thread of having goiter in common binds them in a single woe. On some women the size of goiter is as small as apricot while on other as big as a melon. School teachers of the village tell of low school achievement among children. Nothian illustrates all milestones in the spectrum of maladies that has come to be known as Iodine deficnciey disorder. There is widespread prevalence of both visible and invisible signs of iodine deficiency: goiter and low IQ among children.

More importantly, Nothian also belies the generally-held belief of iodine defincicy being primarily the problem of hilly areas like Chitral and Gilgit. Nothian shows that problem of iodine deficiency knows no geographical boundaries. It affects all regions (villages next to Nothian are also known to show up IDD cases). One also comes across one of the biggest reasons of Iodine deficiency disorder -- non-use of iodized salt. Neither of the shops in village sells iodized salt nor a majority of village folk aware of the advantages of using iodized salt. More alarmingly, those who used iodized salt in the past were dissuaded from using it on the ground of iodized salt promoted as part of imported agenda of family planning.

In a nutshell, Nothain is a microcosm of what ails IDD policy and perceptions. And Nothian is hardly an exception. The same picture obtains all across Pakistan.

Iodine is one of the micronutrients that are needed by human body over a period of time to perform its most vital functions. All we need in terms of intake of iodine is a spoon of Iodine. But this spoonful of iodine is spread over our life cycle, with small amount ingested on a daily basis. One of the tested ways to improve idoine's sustained intake is through salt. This has proven to be a success in the rest of the world, yet in Pakistan iodized salt use has been decreasing over the years.

This is evidenced in the dismal figure of only 17 percent of people using iodized salt despite 52 percent of the population being aware of the health benefits of its use. While the iodized salt intake has been going up in the rest of the world and in South Asia, Pakistan has registered a downward trend. This has serious implications for public health in Pakistan. According to nutritional survey 2001-2002, the prevalence of goiter among women stood at 21 percent and among school children 6.7 percent. The urinary iodine test revealed a more worrying figure of about 36.5 percent of mothers and 23 percent of pre-school children suffering from iodine deficiency.

Though goiter is the most visible manifestation of iodine deficiency, mental impairment is the most invisible result of iodine deficiency which consigns a whole generation to a life of mental retardation. In Pakistan, an estimated 2.1 million children are born each year with severe intellectual impairment caused by iodine deficiency in pregnancy. This is compounded by the prevalence of goiter among 4.3 percent of children in urban and 8, 2 in rural areas.

This poses an enormous public health challenge. The most common way to prevent this alarmingly widespread problem is the promotion of universal salt iodization and legislation to ensure mandatory iodization of salt. In countries where USI was adopted and implemented the iodized salt uptake has shot up. China, India, and Iran have seen the use of iodized salt intake going up to 95 percent, 70 percent, and 95 percent respectively. This shows Pakistan in poor light as compared to its neighbours like Bangladesh where iodized salt uptake is 78 percent. In Pakistan, the ministry of health is leading the charge on USI in Pakistan.

USI campaign worldwide has been fortified with an array of legislative measures to ensure mandatory use of iodized salt. In African subcontinent, 32 out of 43 countries have legislation to ensure mandatory use of iodized salt. In Pakistan the Ministry of health drafted bill called Iodine deficiency control disorder bill 2009 is toeing and froing in a ping pong game between different bureaucratic departments, with the Cabinet division withholding its assent to the passage of the bill on an absurd technicality.

This delay is aggravating an already worsening public health emergency which consigns more than 2 million children to a life of mental retardation in a single year. Beyond these bureaucratic tangles, there are encouraging stirrings from across the board parliamentarians on IDD legislation issue. Lately a sizeable number of parliamentarians are evincing great interest in the issue. Political ownership of IDD legislation was initiated by mohtarma Benazir Bhutto when she gave full backing to USI. Sherry Rehman gave her full support to IDD legislation.

These are encouraging signs for public health professionals, policy makers and consumers alike. Only by joined up action of government, civil society, parliamentarian and ministry of health and UN bodies and media can we get any closer to the goal of making Pakistan a model country where the scourge of IDD is removed for ever. Whereas the rest of the world has achieved its salt iodization goals, Pakistan still lags behind despite massive investment poured into salt iodization programmers. We need to act quickly. Luxury of time is something we cannot afford given the urgency of the situation.

Terence Taylor carries with him enormous experience of working with various institutions of international repute in diverse fields. Presently the founding President of the International Council for Life Sciences (ICLS) Taylor was previously Vice-President, Global Health and Security at the Nuclear Threat Initiative (NTI). Before that he acted as President and Executive Director of International Institute for Strategic Studies (IISS).

Taylor developed a keen interest in international security policy matters as a UK government official (both military and diplomatic) and for the United Nations both in the field and at UN Headquarters. His experience is related to both military field operations and development and implementation of policies in relation to arms control and non-proliferation treaties for both conventional and weapons of mass destruction.

He has also conducted consultancies for private companies on defence industry matters, political risk assessment, and studies of private biotechnology industry, particularly in relation to bio-safety and bio-security. He is a member of the US Institute of Medicine's Standing Forum on Microbial Threats. He began his career as an officer in the British Army and went to many parts of the world, including UN peacekeeping missions. He was involved in investigations of Soviet Union Biological Programme besides working as a weapons inspector with the UN in Iraq. While he was in Islamabad recently at a conference, TNS found the opportunity to sit with him for an interview. Excerpts follow:

The News on Sunday: Being a military man how did you get hooked on to the world of science?

Terence Taylor: I did my degree in politics and economics. The army decided that I should become a scientist. I am more involved in the application of science and basic research.

TNS: A huge amount of money is being spent on the development of weapons of mass destruction. Pakistan and India are doing the same at the cost of education and health. How do you respond to this?

TT: You have to look it at the global level. I see less money being spent on weapons of mass destruction. But I see certain regions you have put your finger on, such as South Asia where more money is being spent on weapons, nuclear weapons. It is not just nuclear weapons but all delivery means including missiles and combat aircrafts, etc. Governments have to take decisions about national security. As a human being, I would like nuclear weapons to be removed. But it has to be done very carefully because my starting point is security, not about the weapons themselves. You will not eliminate the weapons unless you solve the security concerns.

I strongly believe that the key to progress is through confidence building. You can't criticise nuclear weapons because the establishment says it needs them. Pakistan is a threat if you are in Delhi. If you are in Islamabad they would say the other way around. There has been a huge reduction in the number of nuclear weapons, massive reduction. It only happened because of fundamental political changes, particularly in the Soviet Union. There is still mistrust between the US and Russia and that is why nuclear weapons can't be eliminated. I think the same is true for India and Pakistan. We have to look forward, not backwards.

We have to build confidence and trust in each other, between Islamabad and New Delhi. But that has to be done first. Then I would be able to say nuclear weapons are unethical and extra-legal in terms of law. You can have confidence building measures about exchanging data. There has to be real progress in talks between India and Pakistan on the security situation. I don't think that any side outside of South Asia can help in these matters. It is not just India and Pakistan; China is there. That is a complex situation.

TNS: More and more countries are clamouring to join the nuclear club; how can we prevent that from happening?

TT: There are fewer nuclear weapon states now than there were ever before. Argentina and Brazil wanted to have nuclear programme but they have given up. In fact, they have nuclear freeze. Kazakhstan and South Africa had nuclear weapons. They have given them up. And more countries have given up nuclear weapons. When I look back in history I see hope. I see fewer nuclear weapon states in future. I see weapons being dismantled. I mentioned South Africa; they actually had few nuclear warheads and they dismantled them. Argentina and Brazil did not have useable weapons but they had their nuclear programme. Ukraine had nuclear weapons but after the collapse of the Soviet Union they gave up nuclear weapons. You know what was driving the other countries is driving Iran and North Korea; that is their security concerns. North Korea has nothing else in terms of leverage in the international community. So, something else has to happen. The level of tension has to be reduced. I don't see politicians in the West and the East think alike. But we have to do hard zero security, hard security. If we don't solve issues we can't get rid of nuclear weapons.

TNS: Don't you think scientists of India and Pakistan can work to bring peace in the region?

TT: Absolutely, scientific community can help do it. Scientists should be motivated in both countries. I think there should be a sensible and rational approach in both countries. Scientists need to communicate with the public and the press with these issues. But that should be done in a rational way, in a way that leads to discussion. Yes, we have to improve security. I mean let us emphasise for a movement. If security problems remain, there could be other kinds of weapons. So, the fundamental problems like Kashmir should be resolved. Scientists do play a role which is not always positive. I don't think President Obama's message has been fully appreciated. He said, "They would like to move towards a nuclear free world." I think it is an educational issue. I think scientists need to understand international relations and social issues and also social scientists need to understand scientific issues. I don't want to unduly criticise my friends in the press but sometimes the popular press exaggerates things and the truth gets extorted. They need help from scientists to explain the things they are reporting in a rational and balanced way.

TNS: There is apprehension that weapons of mass destruction might land in the hands of terrorists or religious extremists.

TT: It is a matter of great concern. A historical example is of the Japanese group. They did use chemical weapons in a subway. It was quite clear that they were working on biological weapons very unsuccessfully. Now technology is very different and fifty years from now technology would be even more different. Inside the US anthrax was used although it affected only 4-5 people but it caused a great deal of disruption.

TNS: Some people say you can make a weapon of mass destruction in a garage.

TT: It is more difficult at the moment or you have to be really determined. There are many examples. There is a Moroccan experience where there was an attempt to use biological weapons by extremists but, fortunately, it was forestalled by the Moroccan security agencies. It is not a fantasy that extremists might try to do it again. We can't always be lucky. We need this awareness. There are some simple things that can be done to make biological weapons. It may not kill thousands but it is bad enough. It is for the psychological impact.

In recent years, there has been massive media coverage of militancy in Pakistan's tribal areas with little or no attention paid to understand the local socio-political dynamics and the nature of people and their real problems.

A comprehension of these dynamics is critical to know how various factors have contributed to the problem of extremism and terrorism there. The reason behind paying less attention to the socio-political problems in FATA in the media is that most of the writers and commentators are not locals of the area, hence unable to understand the true context.

There is a need to understand the people of FATA, their problems and issues and how these are connected to the problem of extremism and terrorism. In this regard, an attempt can be made to understand the grievances of the inhabitants of FATA.

The foremost grievance of the inhabitants of FATA is lack of economic opportunities to earn a decent living. They argue that in an area where industries are non-existent and agriculture is limited, the government should have extended every help to create job opportunities besides helping them making their lands arable. In the opinion of residents of FATA, government's help was and is the only way to alleviate mass poverty. According to different Pakistani government estimates, the prevalence rate of poverty in FATA is more than 70 percent, earning less than two US dollars a day which equals around 166 Pakistani rupees.

Another important grievance of the people of FATA is regarding the existing obsolescent physical infrastructure of their area and lack of government support to provide them basic amenities of life, like well-equipped hospitals, clean drinking water, roads etc.

According to Multiple Indicators Cluster Survey (FATA 2007) conducted by Planning and Development Department, FATA Secretariat, with technical assistance from United Nations Children's Fund (UNICEF) and World Food Programme (WFP), "A number of projects were started under successive FATA Annual Development Programmes (ADPs), however, meagre financial allocations coupled with increased development cost have resulted in huge throw-forward liabilities. FATA ADP has throw-forward liabilities of more than Rs40 billion. With current level of funding by the Federal Government it would take at least four years to complete the ongoing projects of the FATA ADP. Thus, it leads to poor visibility and impact of the development interventions. Even with increased allocation since year 2002, the per capita government funded development investment in FATA (Rs905/-or US$ 11.30) stands very low against the national per capita government funded development investment (Rs2044/-or US$ 25.55)."

The role of Malik and the Political Agent has also been a grievance for a large section of the people of tribal areas because they argue that justice in such a system is hard to attain, particularly for the poor. The grievances of the ordinary tribesman or tribeswoman are quite genuine. Successive governments, by design or default, kept FATA backward. British colonial rulers kept FATA a buffer zone between British India and Czarist Russia and subsequently between British India and Soviet Union (1917-1947).

The Pakistani establishment continued with the policy of the British. In pursuing a myopic policy, the decision-makers glossed over the realities in FATA and how they could endanger the stability of the whole Pakistan in future. But as time passed and society changed in FATA this policy backfired. The disenchantment with the state and sympathy for groups like Taliban has simultaneously increased due to state failure to provide the basic amenities to tribesmen.

Militants in FATA or their masterminds have tried to exploit the sentiments and genuine grievances of the population, particularly about the decadent governance and justice system and dominance of tribal chieftains. "So, posing to provide a system of justice in which there would be speedy trials and the rich and the poor would get justice and establishing Qazi Courts in some parts of FATA which decided cases in no time, Taliban got the support of a large part of population," says Shakoor Safi, who hails from FATA and is a researcher at the University of Peshawar.

The enforcement of shariah may not be the main concern of residents of FATA but it has been their great desire. So, the Taliban got widespread support from the people by making people believe at the outset that their movement's main aim was the enforcement of shariah in the area. Though most of the grievances of the local people and those of the Taliban insurgents are not the same but the latter have very shrewdly used the complaints of the people to create space in FATA.

In this situation, there has hardly been an effort by the government to address the genuine grievances of the tribesmen. The grievances have multiplied as the outcome of Taliban activities and military offensive.

The federal government has spent almost nothing in Mohmand and FATA out of the more than $10 billion it received from the US after 9/11. According to Munir Orakzai, the head of FATA parliamentarians group, "Pakistan government has spent not even a single dollar in FATA after 9/11, notwithstanding the big claims of the government to the contrary."

So, without addressing the genuine grievances of the tribal people and that too on a war-footing, one cannot and should not expect elimination of extremists and terrorists from the area. The security may get back physical control of the areas like South Waziristan but, ultimately, this would not serve any purpose unless the standard of life of the inhabitants of FATA is improved.