Research to address the challenge of malnutrition and anaemia in the Andean Region

The Academy of Medical Sciences, in collaboration with the Academia Nacional de Medicina del Perú and the Academia Nacional de Ciencias held a policy workshop on nutrition and anaemia in the Andean region on 20-21 January 2020. 

A livestream of the Day Two plenary session of this workshop is available HERE: 

Low and middle income countries (LMICs) account for 89% of all anaemia-related disability. However, despite several interventions, the number of people diagnosed as anaemic rose from 25% of the world’s population between 1993-2005 to 27% by 2013. In Africa 37% of children aged between 6-14 years are anaemic largely due to malnutrition and parasitic infections. Despite a high prevalence of anaemia also in Latin America there is little understanding of the main cause in this region.

A particular consideration regarding anaemia should be given to the Andean region. The Andean region constitutes a complex geographical area with coast, mountain and jungle and includes different countries whose capitals or important cities are located in highland settings, as Quito (Ecuador), Bogota (Colombia), San Jose (Costa Rica), Mexico DF (Mexico) among others. In Peru and Bolivia, a high proportion of the whole population lives over 3000m altitude.

Anaemia persists in the Andean region despite governmental effort to reduce the burden. Worryingly, anaemia rates have not decreased since the early 2010’s. Children living at high altitude are at a particular risk of anaemia. In Bolivia for example, despite iron supplementation over an 18-year period, the prevalence of anaemia on the whole remained unchanged whereas it increased in children living at high altitude. Iron deficiency appears to explain only a small proportion of childhood anaemia and there is an urgent need to better understand its other causes to develop appropriate and effective interventions.

Many research questions and knowledge gaps remain to be addressed to understand the complex association/interaction between malnutrition, anaemia and high altitude. As evidence mounts that iron supplementation may be counterproductive, we should tread carefully in recommending a supplementation in children diagnosed with anaemia despite a lack of stunting and clinical signs of anaemia. As we now better understand anaemia it may be time to update the way anaemia is diagnosed using direct iron status marker measurements instead of indirect markers such as haemoglobin. However, research is needed to understand how feasible it is to use new measures to solve the current anaemia problem. More research is needed to establish the main cause of anaemia in the Andean region in order to tackle the problem effectively.

The main objective of this workshop is to establish an understanding and research priorities of nutrition and anaemia in the Andean region and consider the role that research can play in improving this in the region. The workshop will take a particular focus on the impact of altitude on the prevalence of anaemia. In addition, the workshop will provide a platform for countries to share knowledge of what hasn’t worked and of successful approaches, which have led to an improvement. To achieve this, our aims are as follows:

• Bring together evidence from all countries in the Andean region on the current state of play on nutrition and anaemia.
• Identify country/region specific and shared research challenges and barriers to managing the issues identified.
• Provide a platform for different countries and sectors to share their research experiences, challenges and successes to allow countries to learn from one another.
• Agree on a list of research priorities and solutions to overcome the identified barriers, which can be addressed on a regional level.

Following the workshop, a written report will be produced and disseminated to UK and stakeholders within the region with identified next steps to help reduce rates of anaemia and malnutrition in the Andean region. 

Click here to find out more about our previous GCRF workshops.

This workshop is funded by the Global Challenges Research Fund that aims to support cutting-edge research that addresses the challenges faced by developing countries. Visit our GCRF webpage to read more about the fund. 

The organisation of this workshop is being overseen by a steering committee based in both the UK and Andean region. The steering committee members are:

Co-chairs

• Dr Gustavo F. Gonzales, Universidad Peruana Cayetano Heredia, Peru
• Professor Lucilla Poston FMedSci, King College London, UK

Members

• Dr Roberto Accinelli, Director High Altitude Research Institute, Peru
• Dr Andrew Armitage, University of Oxford, UK 
• Dr Cynthia Beall, Case Western Reserve University, USA
• Professor Dino Giussani, University of Cambridge, UK
• Dr Cynthia Gonzales-Castañeda, Universidad Peruana Cayetano Heredia, Peru
• Dr Claudio Lanata, National Academy of Medicine, Peru
• Dr Sophie Moore, King College London, UK
• Cinthya Vásquez-Velasquez, National Academy of Science, Peru