Opinion: Anemia — a new beacon for global development

What if tackling one single development issue could save the world billions of dollars annually? What if action on it could unlock the potential of millions of women and children, prevent intergenerational cycles of poverty, and build resilience to shocks and crises? And what if the path to preventing that condition was proven, cost-effective, and scalable? Wouldn’t it make sense for global leaders to use every resource available to address it — because it is both a practical and moral imperative?

Anemia is that issue. Though largely invisible, the scale and scope of anemia touches every corner of the planet: nearly one-quarter of the world’s population is affected.

Anemia’s significant effect on productivity also makes it an economic crisis. Iron-deficiency anemia alone drags down the global economy with a staggering loss of almost 1% of global gross domestic product annually. But most of all, the disproportionate impacts of anemia on women and girls is propelling a gender equality crisis. According to calculations based on World Health Organization available data, anemia is afflicting twice as many women as men.

Off track to meet anemia targets

In 2012, world leaders recognized that addressing anemia was a critical prerequisite for ending extreme poverty. They saw that it was a bellwether for overall progress toward the 2030 Agenda for Sustainable Development and for advancing health, education, productivity, food systems, and resilience results, and ending intergenerational cycles of poverty. They knew that it was not solely a nutrition issue, but an economic issue, a health issue, and fundamentally, a critical pillar for achieving gender equality. As such, the World Health Assembly made a commitment in 2012 to cut rates in half in women by 2025.

Since then, however, anemia rates have stagnated and, in some cases, even increased. Not only are we off track to meet the 50% reduction target, but we are likely to see even more cases today than when it was set — particularly in the face of cascading global health, economic, and food crises.

This lack of progress is an outrage that demands answers for all women and children. How did we fall so far behind, and what must we do to get back on track? It should compel us to come together across sectors and nations to find solutions, increase investment, and drive progress. Transforming anemia reduction should become a new beacon for collective global development efforts.

A new global development agenda

Leaders at national, regional, and global levels agree that a new action agenda for tackling anemia is urgently needed.   

First, we must radically transform our approach to addressing anemia reduction. What causes anemia is highly country and context-specific. About half of the anemia burden is caused by iron deficiency, but we must also address the factors that cause the other 50%, including other nutritional deficiencies, malaria infections, parasitic diseases, gynecological and obstetric conditions, genetic red blood cell disorders, and chronic diseases. To better understand and address the multiple and diverse anemia causes and risk factors, stakeholders need to understand the drivers of anemia in their context and the most cost-effective suite of interventions to address those causes.

Second, anemia is also both a cause and consequence of gender inequality, and anemia reduction policies, plans, and programs need to reflect that. Thus, we must make anemia programs work better for women, adolescent girls, and children by addressing gender-biased social norms, such as inequitable intrahousehold food allocation, and other barriers to preventing and treating anemia. All too often, when being designed, anemia reduction interventions do not consider the daily individual realities, pressures, needs, and vulnerabilities. Even worse, few programs are specifically designed with the needs of adolescent girls in mind. Women and girls deserve and should demand that programs adequately meet their needs and with high-quality services.

Finally, country and regional leaders recognize the importance of anemia reduction agenda and need support to drive anemia agendas. We must learn from country experiences, support and uplift regional expertise, and work alongside national governments delivering these vital services. Together, we must galvanize political commitment and usher in a new era of national anemia action plans that reflect their unique country contexts, financed by a blend of domestic and international resources, and implemented at scale via national and subnational health platforms and new food systems and gender-targeted approaches.

Reducing the global burden of anemia must become our shared goal as a development community. Ominously, our lack of progress over the past decades is a stark indicator and reflection of our lack of overall development progress on global poverty, health inequity, and gender equality. We must recognize that there is no offramp from the present cycle of crises without improving and safeguarding the health and resilience of millions of vulnerable communities.

That is why the Anaemia Action Alliance, under World Health Organization and UNICEF’s leadership, is coming together with a transformative agenda to mobilize global leaders, experts, and advocates worldwide from across diverse sectors to accelerate and coordinate multisectoral actions on anemia.

The same leaders must adopt anemia as a maker and marker of their own development objectives — whether it is health, gender, poverty, education, resilience, or hunger — and commit to working together in powerful new ways.  

We must once again make anemia a beacon for our global development efforts and this time we must see it through. Future generations simply cannot afford further decades of inaction.