1. Anemia: A Severe, Yet Neglected Public Health Problem 2002 AFR SOTA Meeting Wednesday, June 12

2. Magnitude of the Problem > 2 billion people worldwide, mostly women & children > 50% of pregnant/postpartum women & young children, esp 6-24 mo of age Lack of national/subnational representative data -- HemoCue/DHS

3. Consequences of Anemia Maternal Mortality LBW, preterm delivery Resistance to infection Psychomotor & cognitive development School performance Physical work capacity

4. Complex Etiology Deficiencies of iron, folate, vitamin A, B6, & B12 Malaria Hookworm Chronic infection, esp HIV/AIDS Relative Contributions Depend on Age, Diet, & Geography

5. INTERVENTIONS Supplementation: Most AFR countries have policies for antenatal iron/folic acid supplementation -- should be extended through 3 mo postpartum (e.g. DPT1,2,3) Coverage/use remains low *quality & supply of supplements *health worker counselling & provision -- facilities & CBD *social marketing & private sector demand

6. INTERVENTIONS Fortification : Conventional Biofortification Home-based (“sprinkles”) Other dietary interventions (e.g. animal foods, iron pots, fermentation, & changing intake of promoters & inhibitors of absorption have limited potential to be taken to scale

7. INTERVENTIONS Public Health Services: Malaria Control & Treatment Hygiene & Anthelmintics Family Planning, including OCPs w/ iron

8. A USAID Priority? #1 Addresses Public Health Need #2 Contributes to Economic Growth & Poverty Reduction in Line with Millenium Challenge #3 USAID Comparative Advantage in All Program Areas