This was published as a Guest Editorial in the Journal of Human Lactation 9:214-215, 1993. I was responding to an editorial in a previous issue by Lydia Furman (Breastfeeding and full-time employment: does the baby lose out? JHL 9:1-2, 1993.)

Click here to open the pdf file.

IMAGE: Greeting card from the Philippines, painting by Tam Austria

 

 

After doing so much work with the SIDA/UNICEF universal vitamin A capsule distribution program in Bangadesh, as well as the food-based Worldview International Foundation project, I came to a startling realization. SIDA had asked me to talk with both government stakeholder and other potential donors about their opinions on vitamin A control programs. Eerily, both said the same thing: “There are so many other priorities; at least we have the capsules to fall back on.” But despite huge efforts by UNICEF, VAC was reaching too low a proportion of the young child population (usually about half) to have a public health impact (it has to reach at least about 2/3 to do that).

Meanwhile, for what SIDA had spent on the VAC program over a decade, WIF’s approach could have made substantial, sustainable improvements in the diet in several high prevalence districts. (See the WIF evaluation here.)

I realized that VAC distribution created a “policy block” that actually allowed government and donors off the hook so that there was no chance of them struggling to find complementary or better approaches.

This talk was well received, but came too late historically. Soon afterwards, Canadian CIDA decided to purchase huge quantities of VAC and they have flooded the developing countries ever since. Soon an effort was made to no longer refer to supplementation as a “short-term” solution; it was supposedly here to stay.

We’ll see.

Click here to download this brief abstract from the IVACG meeting of 1993 in pdf format.

Image from http://www.acdi-cida.gc.ca