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Vitamin A deficiency affects some 127 million preschool children globally, putting them at increased risk of sickness and death. But supplementation is cost-effective and has proven potential to reduce the yearly number of preventable child deaths. This report tracks the progress of supplementation programming following 10 years of global advocacy. It is a 'scorecard' for countries and the international community on progress in scaling up one of the most effective child survival interventions available - a prerequisite for achieving MDG 4.