In ‘Micronutrient Supplements for Child Survival’, a Best Practice Paper for the Copenhagen Consensus Center, Sue Horton et al. outline ways to make vitamin A coverage universal. Although it is often assumed that the children not reached by vitamin A supplementation live in remote areas, Horton et al. find that many live in or around big cities such as Nairobi and Delhi which have a weak urban health infrastructure.
They find that a Bangladeshi program provides a good model for how to achieve universal coverage. In this program, community groups and volunteers focused on reaching families with children who had not received supplements. Horton et al. also argue that there is a missed opportunity in many developing countries to provide vitamin A to pregnant and recent mothers. They recommend that when newborn children receive their first immunization, mothers should also receive vitamin A supplements.
Horton et al. point out that only a very small number of countries have launched zinc policy initiatives or pilot programs. And there are no large-scale, comprehensive programs anywhere.
They outline the work that is required – including policy advocacy, technical assistance, capacity building, and additional financing – to support the international scale-up of zinc supplementation.
Horton et al. estimated the cost of delivering vitamin A and zinc supplements by region. The costs are very low, and vary based on personnel costs. The estimated per-child cost of increasing Vitamin A supplementation to 80-90% of the population of South Asia, Sub-Saharan Africa and East Asia is $2.40, while the estimated cost of achieving 40% Zinc coverage in the same regions is just $1.00 per child.
It is possible to put a monetary value on the benefits of increased vitamin A and zinc supplementation. The Copenhagen Consensus Center research shows that the benefits are very large. For treatment of pre-school aged children, each dollar spent on these initiatives results in around $17 of benefits. In the worst-affected countries, the benefits of supplementation with vitamin A and zinc can be up to 100 times higher than the costs.
Where to Find Out More
The Copenhagen Consensus research that this section draws from:
Micronutrient Supplements for Child Survival (Vitamin A and Zinc): Best Practice Paper
Sue Horton, France Begin, Alison Greig and Anand Lakshman.
Hunger and Malnutrition: Copenhagen Consensus 2008 Challenge Paper
Sue Horton, H. Alderman, J.A. Rivera
Hunger and Malnutrition Chapter
in Global Crises, Global Solutions, second edition
Edited by Bjorn Lomborg
The Expert Panel's joint explanation for their rankings is available for download here. The Expert Panel's individual rankings and further elaboration can be found in the book, Global Crises, Global Solutions, second edition.