Despite the fact that programs began detecting neonates with congenital hypothyroidism (CH) over 40 years ago, at present only 30 % of the world birth population (approximately 127 million) undergoes screening for this disorder. The estimated cost of detection by screening, $15,400 compares with a lifetime expense of $1,296,000 in developed countries. The annual cost of the 30,000 CH cases not identified and treated early is approximately $40 billion dollars. Increasing the coverage of newborn screening worldwide remains a significant public health challenge.