By Global Network NTD Special Envoy Dr. Mirta Roses

Iron deficiency is the most prevalent nutritional disorder in the world. It affects millions of children and women, primarily in developing countries. According to the World Health Organization (WHO), over 30 percent of the global population is anemic, many because of iron deficiency. Among those in particularly vulnerable situations of poverty, the effects of iron deficiency and anemia are exacerbated by infections with neglected tropical diseases (NTDs) like soil-transmitted helminths (STHs, especially hookworm) and schistosomiasis (or snail fever). These NTDs cause blood loss, which leads to anemia and iron deficiency.

Iron deficiency anemia is known to complicate pregnancy, child birth, and early childhood growth and development. Approximately one-third of all pregnant women in developing countries are infected with hookworm, which contributes to iron deficiency anemia. Infection with genital schistosomiasis causes genital lesions, which have been associated with ectopic or tubal pregnancies, as well as increased risk of HIV infection. Addressing iron deficiency anemia needs to be a main component in all efforts to improve maternal, newborn, and child health (MNCH).

The great news is that there are cost-effective solutions available today that can dramatically lower the rates of iron deficiency and anemia and improve the lives of millions of children and their mothers. The WHO developed a comprehensive strategy to address iron deficiency and anemia, which focuses on three main lines of action:

• Increasing iron intake, by including iron-rich foods, food fortification and iron supplementation;
• Controlling infection through immunizations and control programs for malaria, hookworm, and schistosomiasis; and
• Improving nutritional status through vitamin B12, folate, and vitamin A supplements.

In the region of the Americas, the Pan American Health Organization (PAHO) has been addressing these issues for several years, particularly during Vaccination Weeks. Vaccination Weeks in the Americas (VWA) have contributed significantly to the reduction of morbidity and mortality in all age groups, particularly among children. Since the first VWA was celebrated in 2003, VWA have served as the perfect platform for delivering comprehensive solutions to improving child health. Deworming treatment, iron “sparks” and vitamin A supplements are commonly distributed along with vaccines that protect children against preventable diseases such as measles, rubella, yellow fever, diphtheria, tetanus, polio, and influenza. By facilitating people’s iron intake and distributing deworming medication along with vaccines during vaccination weeks, children and pregnant women in all regions of the world can receive protection against the threats of iron deficiency and anemia.

The potential of using this platform for distributing iron supplements and deworming medication is significant – PAHO estimates that over 400 million people in the Americas have been vaccinated through the VWA. Throughout the world, other regions are also taking advantage of this opportunity through the WHO Regional Offices: the European Region (EURO) began holding its Immunization Week in 2005, followed by the Eastern Mediterranean Region (EMRO) in 2010, the African Region (AFRO) and the Western Pacific Region (WPRO) in 2011, and finally, the South-East Asia Region (SEARO) in 2012. World Immunization Week is now a reality endorsed by the World Health Assembly to be celebrated every year around the third week of April. This major mobilization will carry other key interventions like deworming and iron supplements to every village.

The WHO program to jointly address iron deficiency and anemia is already being implemented in countries that have high levels of iron deficiency and anemia, malaria, and schistosomiasis and STH infections. It is our hope that through programs like this, along with the opportunities provided by vaccination weeks, the health burden caused by iron deficiency anemia will continue decreasing, so that mothers and children can have a real chance at growing healthy and thriving in life.

Dr. Mirta Roses Periago is an NTD Special Envoy for the Global Network and former Director of the Pan American Health Organization (PAHO).