04 Fiedler (jl/d)

Vitamin A deficiency is the most important cause of childhood blindness in lower and middle income countries, and contributes significantly to morbidity and mortality from common childhood infections. Beaton and colleagues’ metaanalysis of randomized community-based trials in eight countries concluded that vitamin A supplementation resulted in a 23% reduction in the mortality rates of children between the ages of 6 months and 5 years (Beaton et al. 1992). Vitamin A supplementation programmes are not only highly effective in reducing mortality and morbidity, but in countries in which vitamin A deficiency constitutes a public health problem, these programmes appear to be among the most cost-effective public health interventions available. The World Bank’s analysis of 47 health interventions found only one to be more cost-effective than vitamin A supplementation. On the basis of this analysis, the World Bank has endorsed vitamin A supplementation as a public health programme priority.