Universal Vitamin A: The public‑health impact of large‑scale supplementation

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Keith West from Johns Hopkins University about the development and impact of universal vitamin A supplementation programs. Professor West traces the evolution from early clinical observations linking vitamin A deficiency to ocular manifestations and childhood blindness, to the pivotal studies in the 1980s by Alfred Sommer's team demonstrating its association with child mortality. He highlights the landmark Aceh trial (1983–1984), which showed a 34% reduction in preschool child mortality, followed by replication trials and meta-analyses across multiple countries demonstrating 23–30% mortality reduction. These findings supported large-scale implementation of twice-yearly supplementation programs in approximately 85 countries. The discussion also addresses ongoing questions around neonatal supplementation, noting regional differences in observed benefits. The episode underscores vitamin A supplementation as one of the most impactful global nutrition interventions, contributing to substantial reductions in child mortality worldwide.