On April 18, 2018 the EUthyroid consortium released the Krakow Declaration on Iodine in response to the increasing concern about the deteriorating commitment of policymakers to address public health strategies against iodine deficiency disorders (IDD) in the European populations. Regulators and policymakers should harmonize obligatory Universal Salt Iodization to ensure free trade of fortified foodstuffs in Europe. Similarly, iodized animal feed requires regulatory approval to ensure free trade within the EU. National governments and public health authorities have to perform harmonized monitoring and evaluation of fortification programs at regular intervals to ensure optimal iodine supply to the population. Scientists, together with public health care workers, patient organizations, industry, and the public should support measures necessary to ensure that IDD prevention programs are sustainable, as appropriate within a rapidly changing environment and further social awareness of the issue. The declaration defines measures and responsibilities to optimize IDD prevention.