Health Minister Yael German – while unwilling to change her recent decision to cancel the nationwide requirement of municipalities and towns to fluoridate their drinking water since only a small percentage of the population needs it – is willing to consider fortification of foods to improve public health.

In a personal interview on Sunday with The Jerusalem Post, the former mayor of Herzliya said she had a more positive view of adding nutrients to food than to tap water.

When it was suggested that vitamin D be added to all milk and white cheeses (at present, the important vitamin is added only to one-percent-fat milk), iodine be added to salt and folic acid to flour, German said she would speak to ministry director- general Prof. Ronni Gamzu and other experts about it.

Leading public health experts note that vitamin D helps prevent many diseases, ranging from various types of cancer and heart disease to diabetes and osteoporosis.

Iodized salt is widely used around the world to prevent types of mental retardation and promote the biosynthesis of thyroxine and triiodothyronine hormones by the thyroid gland.

Folic acid deficiency is a major cause of neural tube disorders that lead to retardation, death and low birth weight in fetuses and a wide variety of other problems in children and adults.

The Palestinian Authority has for some time fortified salt with iodine and flour with folic acid, but until now the ministry in Jerusalem has not done so.

The minister said she was well aware that health promotion and disease prevention were urgently needed because health systems around the world will go bankrupt from trying to treat an aging population for all chronic disease.

As for the idea that enforcement of no-smoking laws be transferred from the municipalities – which throughout the country last year handed out only 2,500 fines despite the estimated millions of annual violations – to a private company, German said she thought privatization of enforcement, with part of the proceeds going to the ministry to finance health promotion and education, was a good idea, but she worried about legal problems that could make it impossible for inspectors who do not work for the government to hand out fines. However, she agreed to look into the issue.

German said that decades of tap water fluoridation is “wasteful because only about 2 percent of fresh water is actually drunk by residents.”

She maintained that there are better ways of delivering fluoride – which has been proven to protect and preserve the dental health of children – than through the water supply, and stated that “thyroid disease” and other diseases could result from exposing the whole population to fluoride.

German’s cancellation of mandatory fluoridation aroused much opposition by public health experts both outside and within her ministry.

“It may be that it was a mistake to do it for 30 years,” she said.

Asked about the raging controversy on whether private medical services (Sharap) should be allowed in government and Clalit Health Services hospitals, German said she had a “neutral view and open mind” about it and wanted to hear the recommendations of a public committee on the subject that she recently appointed.

Regarding the possibility of allowing physicians’ assistants and nurse practitioners to receive licenses in Israel to ease the severe manpower shortage of both doctors and nurses, German said she thought paramedics could be trained more to help in emergency medicine in the hospitals.

But when she heard that Gamzu had recently voiced positive opinions about these medical personnel, the minister said she would speak to him.

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