Global Health in Conflict Understanding Opposition to Vitamin A Supplementation in India

Johns Hopkins University School of Medicine, Baltimore, MD 21205-2113, USA.
American Journal of Public Health (Impact Factor: 4.55). 05/2012; 102(7):1286-97. DOI: 10.2105/AJPH.2012.300759
Source: PubMed


Vitamin A supplementation is a public health intervention that clinical trials have suggested can significantly improve child survival in the developing world. Yet, prominent scientists in India have questioned its scientific validity, opposed its implementation, and accused its advocates of corruption and greed. It is ironic that these opponents were among the pioneers of populationwide vitamin A supplementation for ocular health. Historically, complex interests have shaped vitamin A supplementation resistance in India. Local social and nutritional revolutions and shifting international paradigms of global health have played a role. Other resistance movements in Indian history, such as those in response to campaigns for bacillus Calmette-Guérin and novel vaccines, have been structured around similar themes. Public health resistance is shaped by the cultural and political context in which it develops. Armed with knowledge of the history of a region and patterns of past resistance, public health practitioners can better understand how to negotiate global health conflicts.

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    ABSTRACT: I read Wallace's article(1) with interest. Although it was a good article, Wallace missed the most salient argument in support of the antisupplemental side: half of Indian children have stunted growth because of macro-level undernutrition that is inclusive of total calorie intake and a host of micronutrients-a problem that India has made no substantial progress in addressing. Vitamin A is important but it is only one aspect, and in many ways a symptom, of a much bigger nutritional issue. Vitamin A does not directly stunt children's growth. Addressing Vitamin A as a single issue with a spot solution is not necessarily the best use of resources. (Am J Public Health. Published online ahead of print September 20, 2012: e1. doi:10.2105/AJPH.2012.301011).
    American Journal of Public Health 09/2012; 102(11):e3. DOI:10.2105/AJPH.2012.301011 · 4.55 Impact Factor