Camp-Follower Too Long

The death of 20 children in Assam following the administration of vitamin A supplementation as part of a UNICEF-aided campaign throws open once again an old debate in public health policy. It exposes the dismal lack of coordination at various levels on issues and programmes which are vital to the health and lives of vulnerable populations. It is also an ironic pointer to the inertia in policy-making such that the state fails to reckon with the positive outcomes of socio- economic development, however small, over the decades.

The UNICEF-aided programme of administering prescribed doses of vitamin A to all children of a certain age-group has been in place since the 1970s. It has taken the form of a campaign to ostensibly capture all children quickly and repeatedly. The programme evolved as a result of studies which indicated that severe vitamin A deficiency existed among large enough numbers of children. A campaign effort, it was felt, would effect a change in the profile of children, preventing blindness and even death. But that was in 1970. Subsequently, there is widespread acceptance that even among the very poor serious vitamin A deficiency is small, to the extent of one in 300-400 children, and severe cases are even fewer. While this does not mean that there is a case for abandoning projects aimed at increasing the availability of food especially to small children, nutrition experts and public health paediatricians unanimously agree that a campaign approach is not the solution.