CHICAGO, Illinois — From fruits and vegetables to meats and cheeses, most foods meet the desire to get a healthy amount of Vitamin A. But in sub-Saharan Africa, that desire has proven hard to fulfill. Being the most food insecure region in the world in 2017, regular access to necessary vitamins and minerals is already a problem for many. However, a number of cheap and well-known interventions could prevent deficiencies of Vitamin A in sub-Saharan Africa.
Access to Vitamin A in Sub-Saharan Africa
Vitamin A deficiencies in sub-Saharan Africa present a specific challenge due to the harm the condition does to children. Across the world, more than 100 million children are affected by vitamin A deficiency. The issue causes over 1 million deaths every year. Case rates are highest in the sub-Saharan Africa region, with 48% of children being affected there.
The symptoms of a vitamin A deficiency range from mild inconveniences to chronic conditions. Though it is one of many vitamins necessary for proper human health, a deficiency of vitamin A presents distinct harm to the world’s most vulnerable.
One example of the harm a deficiency of vitamin A in sub-Saharan Africa presents is in the harm it does to sight. Across the world, people experiencing vitamin A deficiencies will begin to experience dry eyes and other vision problems. For half a million children every year, this dryness will eventually lead to complete blindness, according to the American Academy of Ophthalmology (AAO). This can have an immediate impact on children’s education. In sub-Saharan Africa, special schools for those with vision impairments are difficult to access and many mainstream schools lack the necessary capacity to provide the proper support.
Vitamin A deficiencies can also weaken maternal health. Its occurrence has been associated with increased levels of anemia which increase maternal mortality rates. Low maternal vitamin A levels also may lead to offspring suffering from physical conditions such as insulin resistance to mental conditions such as schizophrenia.
The consequences of this demonstrate themselves in the region’s high infant and maternal mortality, accounting for 38% and two-thirds of global deaths in these categories, respectively.
The Cassava Conundrum
Though access to food overall is front and center to deficiencies of vitamin A in sub-Saharan Africa, the type of food commonly eaten also plays a role. For instance, cassava, a starchy, calorie-dense fruit that hundreds of millions of people commonly eat in the region provides a lot of energy, but not much in the way of vitamins and minerals.
To counter this, scientists from the University of Nebraska-Lincoln have been adding provitamin A-beta carotene to cassava. Not only does this increase vitamin A capacity, but it also can lengthen the shelf life of cassava, potentially improving food access. The scientists applied this approach to other crops such as potatoes.
Supplementation with Helen Keller International
While the enriched cassava method is new, not all solutions are so recent. One effective solution practiced by many organizations for years now has been biannual, high-dose vitamin A supplementation in children under five. This could reduce childhood mortality by up to 12%. Despite this being a relatively cheap solution, many children are still lacking it. For instance, according to data from 2018, only 64% of children that needed supplements received it.
One organization working to counter these disparities is Helen Keller International (HKI). Since the 1970s, HKI has been helping governments, international bodies and local organizations coordinate vitamin A dispersion programs.
HKI has proven to be effective at implementing successful operations such as one that began in Senegal in 2013. Originally, just a small-scale pilot program, by 2019 it had every district in the country providing supplements for 100% of children between 6 and 11 months old and 72% between 12 and 59 months old.
Inadequate access to vitamin A in sub-Saharan Africa still contributes to and creates numerous health problems for those in the region. Solutions are here, however, and they are cheap too. Supplementation is estimated to cost just $1.23 to deliver a dose. Recent scientific gains, along with the steady push of organizations such as HKI, have led to major improvements since 2000, UNICEF reports.
– Joey Harris
Photo: Wikimedia Commons