A new report by the House Select Committee on Hunger has documented a dramatic connection between vitamin A deficiency and childhood deaths from malnutrition and infections in developing countries. Some 40,000 people, most of them children under the age of 5, die from these causes each day. Between 5 million and 10 million children develop night blindness each year, with a quarter of a million children going blind each year in Asia alone.
These estimates were given the committee by Dr. Alfred Sommer, director of the International Center for Epidemiologic and Preventive Ophthalmology at Johns Hopkins University. He said that the number of children who have vitamin A deficiencies but do not demonstrate these most obvious symptoms probably reaches 20 million in Asia, Africa and Latin America.
Sommer cited a study done in Indonesia on 4,000 children over an 18-month period between 1977 and 1978. The study, he said, "demonstrated that those children with very early, mild eye changes died at four to 12 times the rate of otherwise identical children who did not have early eye changes."
"Evaluation of the survivors," he added, "showed that the reason for increased mortality among children with eye signs of vitamin A deficiency was probably increased risks of respiratory disease and diarrhea."
Vitamin A, Sommer explained, apparently is necessary for healthy mucus membranes, which line the urinary, respiratory and gastrointestinal tracts that are the major areas in which bacteria enter the body. Children who do not get enough vitamin A become more susceptible to infectious bacteria. He estimated that 20 to 35 percent of childhood deaths in the world may be connected to vitamin A deficiency.
Dr. John Costello of Helen Keller International told the committee that investigators at the feeding camps for the victims of the Ethiopian famine found up to 10 percent of the children suffered from nutritional blindness, among the highest rates ever recorded. Helen Keller International got 5 million doses of vitamin A from Hoffman-LaRoche pharmaceutical company, and three other companies packaged the doses into capsules and bottles for emergency distribution in Sudan and Ethiopia.
The select committee reported that among the most effective treatments for vitamin A deficiency were capsules containing 200,000 international units of the vitamin -- capsules called "golden bullets" -- that can be taken and stored in the liver for up to six months. The capsules are given to children aged 1 through 5.
"During eight years of capsule distribution in Bangladesh, the prevalence of blindness in children up to age 6 was reduced from 27 per 10,000 to less than 4 per 10,000," the report noted. A study of 420 villages in Indonesia found that the death rates among children who got the supplements was 23 percent lower than those who did not.
Good results have been obtained by fortifying commonly consumed foods, much as margarine is fortified with vitamin A in the United States In Costa Rica, vitamin A deficiency was found in 32.5 percent of children in 1966. In 1978, three years after its sugar was fortified with vitamin A, only 2.3 percent of the children had a vitamin A deficiency. A sugar fortification program in Guatemala cost 7 cents per child in 1976.
Another approach, promoted by the United Nations and the Agency for International Development, has focused on promoting the production of vitamin A, rich vegetables in home and school gardens. AID, according to the House select committee, has allocated only $4.6 million to vitamin A projects between 1975 and 1984, although its congressional funding for nutritional programs in 1985 was increased by $10 million. Its budget request for health and nutritional programs for next year, however, is $100 million below this year's, and only $575,000 has been requested for vitamin A projects in the Office of Nutrition's budget.
Rep. Mickey Leland, (D-Tex.), who chairs the Select Committee on Hunger, wants the United States to make a $30 million long-term commitment to support international efforts to prevent vitamin A deficiency.
Ever since World War II and the Marshall Plan, foreign aid has been a principal weapon in the arsenal of democracy. Now, perhaps more than ever in recent years, it makes sense to attack the poverty and despair that are the festering grounds for tyranny and terrorism.
Helen Keller International estimates that it costs $1 a year to get vitamin A capsules to a child. Diet fortification programs cost pennies per child. Money spent on preventing widespread blindness and death would alleviate misery, and the world might be a little bit safer.