Control and prevention of micronutrient malnutrition.

The importance of micronutrient deficiencies to child survival and to the health and development of nations is universally recognized. Over two billion people, or more than one in three individuals, are at risk of iron, vitamin A and iodine deficiencies. More than 13 million people suffer night blindness or total blindness due to vitamin A deficiency; severe iron deficiency accounts for one in five maternal deaths and one-third of all young children are anaemic; iodine deficiency affects 50 million children and is the greatest single preventable cause of intellectual impairment, as well as a major cause of lost potential and productivity. The World Summit for Children acknowledged that the elimination of the various forms of micronutrient malnutrition would constitute a significant contribution to social, economic and public health development. At the FAO/WHO International Conference on Nutrition held in Rome in 1992, the governments and the non-Governmental Organizations from virtually all nations, together with the international development community, made the elimination of iodine deficiency disorders and vitamin A deficiency important goals to be achieved by the end of the decade, along with a substantial reduction in the levels of iron deficiency anaemia. The United States Agency for International Development established the Opportunities for Micronutrient Interventions in 1993 to help countries achieve these goals by institutionalizing micronutrient activities into other sectoral policies, projects and strategies internationally. An important factor in the recent perceived higher priority for multisectoral micronutrient interventions is the cost-effectiveness of such interventions. The World Bank estimates that a deficiency of vitamin A, iron and iodine could waste up to 5% of the gross domestic product (GDP) of a country, while addressing them effectively would cost only 0.3% of GDP. The three main complementary approaches to controlling and preventing micronutrient malnutrition include food-based strategies such as fortification and diet-based approaches including gardening; supplementation; and related public health interventions.