In these dismal times, there is a piece of good news for over three billion poor people around the world. An effective public private partnership is required to make it work but the methods are quite easy and low cost.
According to the World Health Organization and several other expert groups, it will prevent the loss of nearly one percentage point of GDP on average caused by health deficiencies.
The loss occurs because of low productivity and high health care costs associated with vitamin and mineral deficiencies in early childhood that stunt intelligence and physical energy. These cost over $250 billion a year worldwide in GDP losses.
The deficiencies of crucial micronutrient vitamins and minerals – including vitamin A, iodine, iron, zinc and folate are quite easy to remedy using good distribution systems and decent primary health care in rural areas and small towns.
The need is urgent. Vitamin A and zinc deficiencies alone kill over 1.1 million children worldwide every year while iron deficiency anaemia during pregnancy causes one-fifth of maternal deaths.
Vitamin A is necessary for sight and the immune system; iodine affects brain development; iron is essential for foetal health, learning and productivity; zinc fights diarrhoea and infections and promotes growth; folate is necessary for the production of new cells and the healthy early development of the spine, spinal cord, skull and brain.
The benefit to cost ratio of micronutrient support is unmatched by any other large-scale health or economic intervention. Several expert panels have ranked providing micronutrients as the best investment for accelerating socially equality and development.
The most common and widespread nutritional disorder is anaemia caused by iron-deficiency . Worldwide, nearly two billion people suffer from it. Some 18 million babies are born mentally impaired because of iodine deficiency in mothers and 150,000 babies are born with severe birth effects due to inadequate folate intake from mothers. About 350,000 children become blind due to vitamin A deficiency.
The good news is that cost-effective solutions are available and all it takes is to scale them up. Working together, governments, corporate donors, science and industry can make huge strides in reaching vulnerable populations. For politicians, this is a sensible way to deliver some tangible good in return for votes.
The evidence is overwhelming. Fortifying flour and other staple crops with vitamin A, folic acid, iron and zinc is very effective in reducing anaemia and birth defects. Salt iodization reduces goitre and improves cognitive development. In communities where iodine intake is sufficient, IQ can be on average 13 points higher than in iodine-deficient communities.
Providing young children with vitamin A supplement every six months reduces mortality by an average of 23%. Zinc supplements given with oral rehydration therapy can reduce the duration and severity of acute diarrhoea, which is a leading cause of death of children.
Maternal iodine deficiency is widely recognized as the greatest cause of preventable mental impairment in the world while the effects are life-long of iron-deficiency anaemia during infancy and the first years of life on cognitive performance .
A joint effort by governments and companies is required because the private sector is expert at distribution and governments have responsibility for primary health care. Other types of primary health care can be quite hard to install and supervise but a system to distribute pills and food supplements containing vitamins and minerals need not be an insurmountable challenge. Companies can also be held responsible for supplying unadulterated micronutrients.
The first 1,000 days – from conception until the age of two – are the most critical. It may be too late if deficiencies are not corrected during this period. Young children are likely to suffer vitamin and mineral deficiencies if exclusive breastfeeding is not practised during the first six months of life or if the solid foods introduced after that period are nutrient-poor.
This often happens in developing countries where mothers are too poor or weak to provide sufficiently nutritious breast milk or solid foods.
Taken together, micronutrient deficiencies lead to frequent infections in children, reduced ability to fight and survive disease, and impaired mental capacity. These risks remain serious as children grow and develop. They are poor learners and lose more school days due to illness.
In adults, vitamin and mineral deficiencies negatively affect physical energy and, therefore, productivity. Deficiencies during pregnancy threaten the health and lives of women and affect their unborn children.
There really is no need for people to suffer any more from these easily remedied afflictions. The results could change the world by improving the intelligence and energy of those marginalized currently by poverty.