RESUMO
Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.
Assuntos
Análise Custo-Benefício , Deficiências Nutricionais , Saúde Global , Micronutrientes , Adulto , Criança , Deficiências Nutricionais/classificação , Deficiências Nutricionais/economia , Deficiências Nutricionais/prevenção & controle , Feminino , Humanos , Iodo/deficiência , Iodo/uso terapêutico , Ferro/uso terapêutico , Deficiências de Ferro , Masculino , Micronutrientes/deficiência , Micronutrientes/uso terapêutico , Fatores Sexuais , Zinco/deficiência , Zinco/uso terapêuticoRESUMO
Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view this effect as an impediment to sustained economic growth. Economic logic should be enfolded in public advocacy for increased investment in the prevention and control of IDA. This paper argues that integrated strategies are required, with each intervention clearly related to particular groups at risk, and benefits carefully calibrated with costs. Protecting women's lives through supplementation has the first call on public resources, but the most productive investments reduce population prevalence at least cost, and these lie with food-based approaches within the competence of the processed food and seed industries. The public and private sectors must embark on modernization of the food industry in developing countries and reorientation of the international agricultural research complex so that iron-enriched essential foods will be affordable and accessible to the poor, especially children. The costs of IDA, the availability of cost-effective strategies and the benefits of sustained iron nutrition improvement to individuals, families and nations are reviewed. The roles of iron supplementation, food fortification, plant breeding and biotechnology, both actual and imminent, are described. The paper concludes that a recast Green Revolution directed toward dietary quality may be the key to enhancing the learning and earning capacity of young people in the developing world.