Dear all: I want to make a clear statement on the fact that I consider certain ideas ignorant and not necessarily people. I have held many ideas which I have realized with more insight were misguided or even ignorant. With deeper reflection, those ideas have been revised or abandoned. The specific "idea" that I find ignorant is that a single intervention can conquer all the health problems in developing area of the world. In this regard, I do find that the Bill Gates foundation follows that pattern of looking at one "magic bullet" intervention in isolation, rather than the combination of interventions that would improve the health situation. Just as you cannot simply implement a water and sanitation intervention and eliminate all disease transmission because malaria is transmitted via blood and insect, HIV via body fluids including blood, and measles is transmitted via droplet spread --- you cannot conquer all the world's health problems with a multivitamin supplement either. So, the substitution of ONE "magic bullet" intervention for another "SINGLE" long-term intervention that does not address a huge chunk of transmissions routes is the idea that I find ignorant. Nevertheless, while you are building a gardening program in an area that has so much drought and environmental degradation that even the goats are vitamin A deficient, you can enable many more children to survive until that gardening program, along with programs to assist women to develop acceptable, palatable recipes for those new foods, and to ensure that the kids, not the men are eating some of those foods. Even though I am definitely on the side of food being the answer and have never taken a nutritional supplement myself, not even as a child --- there are circumstances I've seen specific supplements stave off death long enough to arrive at a longer term solution. If there are simply no green plants available to eat, you will not find a source of beta-carotene to convert to retinol. Furthermore, human milk remains a good source of retinol and beta- carotene even in deficient conditions and can mitigate the effects of deficiency during the first six months of exclusive breastfeeding. Like the New York Times Sunday magazine article that exposed the problems caused by the "Nutrification of Foods" that has led some in search of the "magic nutrient' that will cause them to live forever or be slim or beautiful or the "bad food" that if were eliminated from the diet would produce the same result ---- it is clear that you must look at the bigger picture of interactions. The effects of single nutrients cannot be really evaluated in isolation from food and meals and even the overall health of the person eating those foods. The "magic bullet" bullet approach to evaluating interventions in developing areas of the world have resulted in a competitive process for funding rather than a process of looking far more carefully about which interventions truly complement each other and result in synergistic improvements in health. What is not as commonly known even in nutrition circles is that there is a branch of epidemiology that goes well beyond a linear approach and this branch validates much of what careful observers can often detect before the number crunchers --- and that is looking at effect modification. Personally, I think the qualitative observational approach discovers these relationships far faster than the quantitative approach. I also have problems with the "dumping" of "surplus" foods during famine situations because these do not resolve the long term problems. Yet, in the face of many who are dying, I would not deny food to those who need it. I would work harder to put into place those programs that would prevent the famines from ocurring and more locally available resources for emergency conditions that cannot always be anticipated. Some topics such as immunizations and abortion are topics about which some of us have such deeply held convictions based on our personal experiences and beliefs that we may never agree. What we CAN agree about is that breastfeeding is a central intervention to a huge array of unnecessary health problems in developed and developing countries alike. It is a sad state of affairs that breastfeeding has BECOME an intervention and not the norm. When we have less than two of five infants younger than six months who are exclusively breastfed --- and slightly more than one out of five infants younger than six months who are exclusively breastfed in the areas of the world with the highest infant mortality rates --- and the lack of breastfeeding increases many infectious and chronic diseases --- and the lack of breastfeeding contributes to environmental degradation in many ways --- and the lack of breastfeeding contributes to psychological detachment as well --- we really have a global crisis that deserves constant attention. Best, Susan Burger *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. 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