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Picture this: a young child in a remote village in sub-Saharan Africa receives not one, but two life-saving interventions that enables them to grow, earn, learn and lead. The first, a vaccine, a powerful tool in public health that protects an individual from infectious illnesses and diseases. The other, a dose of vitamin A, one of the most cost-effective methods to improve child survival. When combined, these interventions are more than a sum of their parts, they become a powerful force for child health – and Nutrition International is leading the charge.

Vitamin A deficiency (VAD) increases the risk of child morbidity and mortality and is a significant public health concern in more than half of all countries worldwide. Supplementing children aged 6-59 months with two doses of vitamin A per year strengthens immunity, protects against blindness and has been shown to prevent at least 12% of child deaths caused by common childhood illnesses such as measles, malaria, diarrhoea and respiratory infections. With each vitamin A capsule costing only two cents to manufacture, improving a child’s chance of survival through VAS is one of the most economical and successful population-level nutrition interventions.

Vaccines are crucial for protecting children’s health. A child is considered fully immunized if they receive all of the World Health Organization (WHO) recommended childhood vaccines by the age of 12 months. However, in populations plagued by high child mortality and VAD, vitamin A supplementation (VAS) and vaccines work more efficiently when delivered together. To be fully protected, children must receive both interventions, which are often administered together through existing health infrastructures or through campaigns, such as national immunization days.

In combination, VAS and vaccines complement each other to provide a more comprehensive approach to improving child health and survival. While vaccines protect against specific diseases, VAS helps to strengthen the immune system overall, making vaccines more effective. VAS also helps to reduce the severity of illness and complications associated with infectious diseases.

The COVID-19 pandemic has put millions of children in the most vulnerable contexts at risk of missing a critical dose of vitamin A. In 2020, countries with the greatest need for VAS also reported the lowest coverage. Specifically, countries with under-five morality rates of over 60 per 1,000 reported a 46% coverage drop between 2019 and 2020. To address this, Nutrition International, with support from the Government of Canada, launched an 18-month VAS emergency response project in Africa. Through this project, Nutrition International has been working to strengthen health systems in 18 countries by integrating VAS with other essential child survival services including immunization, nutrition screening and deworming. These efforts are aimed at optimizing the delivery platforms to ensure that coverage did not drop due to COVID-19. As a result, an estimated 167 million children under five received two doses of vitamin A in 2021.

Additionally, in response to countries expressing a need for technical support, Nutrition International convened a regional technical meeting in Senegal in January 2023. The meeting aimed to increase understanding of the most effective approaches to integrating VAS into primary healthcare systems in Africa, ensuring high coverage and high-quality delivery of VAS through routine delivery.

As the world continues to grapple with the global pandemic, protecting the health of children from preventable illnesses has never been more paramount.  Measles and polio are two potentially deadly infectious diseases that have been effectively controlled through immunization. In low- and middle-income countries, these life-saving vaccines are frequently administered through routine delivery or campaigns conducted over a period of days or weeks that target all eligible children, regardless of their vaccination status. In such situations, high-dose VAS has been proven to reduce the chances of complications and mortality from measles by up to 50 percent and it remains a cornerstone of the WHO’s best practices for the treatment of a child already diagnosed with the disease. Combining VAS with vaccines enhances efficacy, curtails the outbreak’s spread and is a cost-effective approach that increases the likelihood of reaching children who may miss out on either intervention if delivered separately, ensuring they are fully protected against diseases and malnutrition.

As a global leader in vitamin A for more than 30 years, Nutrition International is committed to continue working closely with ministries of health to integrate VAS into routine healthcare systems to reach those at risk who need it most. Good nutrition is critical for building a strong and resilient immune system, which is essential for vaccines to work effectively. A well-nourished population is better equipped to withstand pandemics, where the ability to fight off infections and recover quickly is paramount. Through global collaboration with other organizations, Nutrition International is dedicated to providing every child with the chance to not just survive, but to achieve their full potential.

Learn more about Nutrition International’s vitamin A program.