LEAGUE TABLE: VITAMIN A SUPPLEMENTATION
For want of two capsules of high-dose vitamin A - at the cost of two cents a capsule - a child might die this year
from complications of measles or diarrhoea, among the most common childhood diseases. In fact, millions of
young lives may be lost in the next 12 months because of vitamin A deficiency, and each death could be easily
prevented.
Two potent capsules
The impact of vitamin A supplementation on reducing child mortality is comparable to — if not greater than — that of any single
immunization against a childhood disease. Long known as a cause of blindness, vitamin A deficiency (VAD) has increasingly
been recognized over the past decade as significantly heightening children's risk of dying from such common diseases as
measles and diarrhoea. In fact, in countries where VAD is a problem, ensuring that children receive adequate vitamin A can
reduce mortality by 23%.
Yet, while vitamin A supplementation ranks alongside immunization in protecting children's health, progress to ensure that
children receive its benefits remains uneven, as this league table shows. One way of tackling the problem is to ensure that
children with vitamin A deficiency receive a high-dose supplement twice a year.
Currently, there are 35 countries where over 80% of young children routinely receive at least one dose of vitamin A, and many
of these nations are likely to reach the goal of eliminating VAD by the year 2000. But present coverage is inadequate in 44
other countries. Of these, only 29 have plans to add vitamin A supplementation to National Immunization Days (NIDs) and
special campaigns in 1999.
Immunization is protecting 80% or more of children in many countries, a remarkable public health success. The challenge now
is to get vitamin A — through supplementation or food fortification — to the more than 55 million children in countries around the
globe who are suffering from vitamin A deficiency and who have not received any supplements.
One proven way of doing this is to build on measures and initiatives already in place. WHO and UNICEF recommend that
vitamin A supplementation be included in routine immunization activities and such events as NIDs in all countries where the
under-five mortality rate is greater than or equal to 70 per 1,000.
The progress made on vitamin A distribution, especially through NIDs, over
the past year has been striking. It is a success story that leads us to believe
that, with political will and public action, the goal set at the 1990 World
Summit for Children can be reached, if not by the year 2000, soon after.
WHAT THE TABLE RANKS
Progress in eliminating vitamin A deficiency
 |
 |
 |
| SUB-SAHARAN AFRICA |
MIDDLE EAST AND
NORTH AFRICA |
CENTRAL ASIA |
| Benin | 1 |
Iraq | 1 |
Afghanistan | 2 |
| Burkina Faso | 1 |
Oman | 1 |
Tajikstan | 3 |
| Cameroon | 1 |
Sudan | 1 |
Turkmenistan | 3 |
| Congo | 1 |
Yemen | 1 |
Armenia | 4 |
| Eritrea | 1 |
Iran | 2 |
Azerbaijan | 4 |
| Ethiopia | 1 |
Morocco | 2 |
Georgia | 4 |
| Ghana | 1 |
Egypt | 3 |
Kazakhstan | 4 |
| Guinea | 1 |
Algeria | 3 |
Kyrgyzstan | 4 |
| Liberia | 1 |
Israel | 4 |
Uzbekistan | 4 |
| Madagascar | 1 |
Jordan | 4 |
|
| Malawi | 1 |
Kuwait | 4 |
|
| Mali | 1 |
Lebanon | 4 |
|
| Mauritania | 1 |
Libya | 4 |
|
| Namibia | 1 |
Saudi Arabia | 4 |
|
| Niger | 1 |
Syria | 4 |
|
| Somalia | 1 |
Tunisia | 4 |
|
| Tanzania | 1 |
Turkey | 4 |
|
| Togo | 1 |
U. Arab Emirates | 4 |
|
| Uganda | 1 |
|
| Zambia | 1 |
|
| Angola | 2 |
|
| Burundi | 2 |
|
| Central African Rep. | 2 |
|
| Chad | 2 |
|
| Congo Dem. Rep. | 2 |
|
| Côte d'Ivoire | 2 |
|
| Guinea-Bissau | 2 |
|
| Kenya | 2 |
|
| Lesotho | 2 |
|
| Mozambique | 2 |
|
| Nigeria | 2 |
|
| Rwanda | 2 |
|
| Sierra Leone | 2 |
|
| Botswana | 3 |
|
| Gabon | 3 |
|
| Gambia | 3 |
|
| Mauritius | 3 |
|
| Senegal | 3 |
|
| South Africa | 3 |
|
| Zimbabwe | 3 |
|
 |
 |
 |
EAST/SOUTH ASIA
AND PACIFIC |
AMERICAS |
EUROPE |
| Bangladesh | 1 |
Mexico | 1 |
Albania | 4 |
| Bhuton | 1 |
Bolivia | 2 |
Austria | 4 |
| Cambodia | 1 |
Brazil | 2 |
Belarus | 4 |
| Lao PDR | 1 |
Dominican Rep. | 2 |
Belgium | 4 |
| Mongolia | 1 |
Ecuador | 2 |
Bosnia/Herzegovina | 4 |
| Myanmar | 1 |
El Salvador | 2 |
Bulgaria | 4 |
| Nepal | 1 |
Guatemala | 2 |
Croatia | 4 |
| Philippines | 1 |
Haiti | 2 |
Czech Rep. | 4 |
| Thailand | 1 |
Honduras | 2 |
Denmark | 4 |
| Viet Nam | 1 |
Nicaragua | 2 |
Estonia | 4 |
| China | 2 |
Peru | 2 |
Finland | 4 |
| India | 2 |
Colombia | 3 |
France | 4 |
| Pakistan | 2 |
Costa Rica | 3 |
Germany | 4 |
| Indonesia | 3 |
Argentina | 4 |
Greece | 4 |
| Papua New Guinea | 3 |
Canada | 4 |
Hungary | 4 |
| Sri Lanka | 3 |
Chile | 4 |
Ireland | 4 |
| Australia | 4 |
Cuba | 4 |
Italy | 4 |
| Japan | 4 |
Jamaica | 4 |
Latvia | 4 |
| Korea, Dem. | 4 |
Panama | 4 |
Lithuania | 4 |
| Korea, Rep. | 4 |
Paraguay | 4 |
Moldova, Rep. | 4 |
| Malaysia | 4 |
Trinidad/Tobago | 4 |
Netherlands | 4 |
| New Zealand | 4 |
United States | 4 |
Norway | 4 |
| Singapore | 4 |
Uruguay | 4 |
Poland | 4 |
|
Venezuela | 4 |
Portugal | 4 |
|
Romania | 4 |
|
Russian Fed. | 4 |
|
Slovakia | 4 |
|
Slovenia | 4 |
|
Spain | 4 |
|
Sweden | 4 |
|
Switzerland | 4 |
|
TFYR Macedonia | 4 |
|
Ukraine | 4 |
|
United Kingdom | 4 |
|
Yugoslavia | 4 |
Source: UNICEF, 1999.
| What the rankings mean |
|
1. Good coverage achieved. Vitamin A deficiency is a public health problem and/or high under-five mortality exists. Countries
have achieved high vitamin A supplementation coverage (over 80%) and are on track towards achieving the year 2000 goal of
eliminating vitamin A deficiency as a public health problem.
2. Need to fulfil commitments. Vitamin A deficiency is a public health problem and/or high under-five mortality exists. Present
coverage is inadequate, but these countries have made plans to add vitamin A to NIDs and special campaigns in 1999.
However, unless these countries follow through on these commitments, supplementation coverage would not be expected to
improve and the World Summit goal will not be achieved.
|
3. Major push needed. Vitamin A deficiency is a public health problem and/or high under-five mortality exists. Present
coverage is inadequate through routine systems. Vitamin A supplementation is not added to NIDs or other campaigns, nor
have any plans been made to do so. It is unlikely that the World Summit goal will be met in the near future in these countries.
4. No problem or no data. Vitamin A deficiency is either not a public health problem or no data exist to show it is a problem.
Furthermore, under-five mortality rate is low (less than 70 per 1,000). No large-scale action is being taken.
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