FAO.org

Ted Greiner

Food-based approaches to combating vitamin A deficiency continue to be largely ignored by governments and donors. This may be partly because the way of viewing them has largely been informed by the community which supports supplementation. Food-based approaches may be perceived as competitive or distracting and are thus slandered, for example claiming they are unproven or even ineffective. To the contrary, it is the supplementation approach that fails to improve vitamin A status and is even lacking in proof of impact on young child mortality in real life settings. A wide variety of common and indigenous foods are proven effective in improving vitamin A status even in short-term trials. Food based approaches are complex to implement and to evaluate and take timeto mature and exert impact. But unlike supplementation, they reach all members of the community, are safe for pregnant women, have no side effects, are sustainable, and confer a wide range of benefits in addition to improving vitamin A status. Food-based approaches are also often portrayed as being expensive, but this is only true from a “donor-centric” way of viewing costs. From the point of view of host countries, communities and families who grow vitamin A rich foods, the economic benefits are likely to outweigh the costs. The 1992 ICN called for the elimination of vitamin A deficiency. The urgency of this call may have provided an excuse for the rapid implementation of supplementation programs in over 100 countries while very few have implemented national foodbased approaches. It is thus important that ICN 2 instead call for the replacement of supplementation programs with sustainable food-based approaches. It should call on countries to assign responsibility and funding to specific individuals or organizations who are then given benchmarks and are held accountable to meet them. Donors could greatly assist by funding simple dietary assessment and other components of national plans for making this shift.