GENEVA, January 18 (WHO) — More than 30% of the world's under-five-year-old children — about 192 million in all — are still malnourished and underweight, according to a World Health Organisation report.
More than two-thirds of those children live in Asia, especially southern Asia, 15% in Africa and 5% in Latin America.
Nevertheless, there has been a worldwide decrease since 1975 in the prevalence of protein-energy malnutrition, except for Africa, where the absolute number of malnourished children has increased with population growth.
Apart from the data on protein-energy malnutrition, the report reviews the situation concerning iodine, vitamin A and iron, which are all vital to human health.
Iodine deficiency disorders, the greatest worldwide cause of preventable brain damage in infants and young children, is currently a significant public health problem in 118 countries: 1571 million people live in iodine-deficient environments and are therefore at risk, while 655 million people actually have goitre.
Approximately half the global total of those affected by iodine deficiency disorder is found in Asia, but there are also 86 million affected by goitre in the African region. Even an estimated 11.4% of Europe's population is still affected.
Tangible progress in salt iodisation, the single most efficient long-term measure to prevent iodine deficiency disorder, is being made in many countries. Despite the magnitude of the problem, the WHO specialists anticipate that the disorder will be eliminated as a major public health problem by the year 2000.
More than a quarter of a million children are estimated to go blind every year due to a deficiency of vitamin A, and some 14 million currently exhibit signs of clinical xerophthalmia, ranging from dryness to severe ulceration. At least 50 million more children have deficient vitamin A body stores, which compromises their health and reduces their chances of survival.
The report stresses that improving the vitamin A status of deficient child populations six months to six years of age contributes significantly to decreasing the risk of mortality. Promoting exclusive breast-feeding for the first four to six months of life, and regular consumption of vitamin A-containing foods later, are the best strategies to improve vitamin A intake.
Iron deficiency in infants and young children is directly related to the massive problem of anaemia in women. Some 58% of pregnant women in developing countries are anaemic, with the result that infants are born with low birth weight and depleted iron stores. Iron deficiency in early childhood is associated with higher mortality and impairment of cognitive development.
A 1985 WHO global assessment of anaemia indicated that 51% of under-five-year-old children in developing countries were anaemic. Breast milk contains enough iron for infants up to four months of age. Artificial feeding and weaning diets, however, are often very low in iron, and the iron from vegetable sources is very poorly absorbed partly owing to inhibiting substances — such as tannic acid in tea or phytates in flour — or low levels of vitamin C in the diet.
An important section of the report shows how WHO member states, professional and other bodies, and consumer groups are encouraging and supporting breast-feeding.
Recent reports of large sums from public and private sources being spent, in well-meant solidarity, to provide breast milk substitutes for distribution through supplementary feeding programs in countries of central and eastern Europe contrast with the scarcity of resources to protect and promote breast-feeding in those same environments. Clear and practical policy guidance is called for in this connection, for uniform application by all governmental, intergovernmental and non-governmental authorities concerned.
Dr Fernando Antezana, the WHO's assistant director-general, sums up the situation this way: "In all environments, infants who are artificially fed are at greater risk than infants who are breast-fed".
As the report notes in conclusion, adequate diet is more crucial in infancy than at any other time of life because of the infant's high nutritional requirements in relation to body weight, and the influence of proper or faulty nutrition during the first months on future health and development.
The nutritional well-being of people is a precondition for the development of societies; it is all the more so where their most vulnerable member — infants and young children — are concerned. Governments will be unsuccessful in their efforts to accelerate economic development in any significant long-term sense until optimal child growth and development are ensured for the majority.