WHO Guideline Development: Effects and Safety of Vitamin A Supplementation in Populations

19-20 November, 2009, Geneva, Switzerland

Purpose and Justification

Vitamin A deficiency remains a significant public health problem with an estimated 190 million children and 19 million pregnant women affected globally³. Intensive efforts remain critically important to prevent and control vitamin A deficiency. Current WHO guidelines on vitamin A supplementation were published in 1997⁴ and 1998⁵. Since this time, knowledge has expanded. In 2000, WHO commissioned reviews of the scientific literature to examine the current state of knowledge concerning the use of vitamin A supplements to control vitamin A deficiency and convened a Technical Consultation on vitamin A supplementation in Yverdon-les-Bains, Switzerland, March 1-3, 2000. The objectives of the Consultation were to undertake a critical review of the safety and efficacy of vitamin A supplementation in order to provide WHO with guidance on the use of vitamin A supplementation as a public health measure to prevent and treat vitamin A deficiency. The reviews and conclusions of the Consultation were published in a special issue of the Food and Nutrition Bulletin in 2001⁶. Additional research has been conducted since 2001 and the official WHO guidelines on vitamin A supplementation need to be revised in a systematic manner using the current evidence⁷.

Steps of the New WHO Guideline Development Process

Outcomes

We expect to update only some of the most critical policy areas strictly following the procedures recently adopted by WHO. This work is expected to be completed in about 12 months time.

Participation in the Key External Experts and Stakeholders Panel

We are seeking approximately 80-100 Key External Experts and Stakeholders, including representatives from partner agencies, foundations, interest groups, content experts, methodologists, as well as those involved in implementation, monitoring, and evaluation of vitamin A supplementation programmes. This panel is expected to review and comment on the key questions, summary of evidence GRADE tables and draft recommendations through electronic communications.

If you would like to become a member of the Panel, or would like additional information about development of these WHO nutrition guidelines development, please send an email to micronutrients@who.int with your name and affiliation, and include "Vitamin A Guidelines" in the subject heading.

Financial Support

We would like to thank the following organizations for their financial support in the evidence-based guideline process: UNICEF, the Centers for Disease Control and Prevention (CDC)'s IMMPaCt program and the Micronutrient Initiative.

• Countdown to 2015: tracking intervention coverage for child survival. The Lancet 2006; 368:1067-1076.
• WHO/UNICEF Child Survival Survey-based indicators: Report of a UNICEF/WHO Meeting 17-18 June, 2004, New York.
• WHO. Global prevalence of vitamin A deficiency in populations at risk 1995-2005. Geneva, World Health Organization, 2009.
• WHO/UNICEF/IVACG. Vitamin A supplements: a guide to their use in the treatment and prevention of vitamin A deficiency and xerophthalmia - Second edition. Geneva, World Health Organization, 1997.
• WHO/MI. Safe vitamin A dosage during pregnancy and lactation. Geneva, World Health Organization, 1998.
• de Benoist B, Martines J, Goodman T. Special issue on vitamin A supplementation and the control of vitamin A deficiency. Food and Nutrition Bulletin, 22(3):2001.
• WHO. WHO handbook for guideline development. Geneva, World Health Organization, 2008. Full text.