This demonstrates how effectively the international nutrition community can pull together when institutions provide leadership to fulfill internationally agreed-upon mandates. These very significant accomplishments were achieved under the leadership of WHO, in collaboration with many other organizations and individuals. Moreover, the evidence on efficacy in specific segments of the population (e.g., pregnant women) has been established. This has led to definitive evidence of efficacy for vitamin A, iron/folate, and mixtures containing these nutrients ( 1). Decades of research and dialogue about codifying the evidence for the biological efficacy of a number of nutrients have led to improving child growth and preventing illness and death. Without a strong evidence-based foundation, we cannot expect interventions, no matter how well organized and conducted, to achieve the goals of improved nutrition. There is an urgent need to elaborate these frameworks at national and program levels not only for program efficacy studies but also for the broader research agenda to support and improve the science of delivering adequate nutrition to those who need it most.Ī successful dialogue to translate nutritional science knowledge into improving nutrition in populations is based on an initial agreement that interventions to improve nutrition in populations show evidence of biological efficacy. Research on program efficacy is expanding, but there is a lack of adequate frameworks to facilitate the process of harmonizing concepts and vocabulary, which is essential for communication among scientists, policy planners, and program implementers.
DEVTA NOVEL PART 25 TRIAL
This article discusses the differences between biological and program efficacy, and why elucidating the fidelity of delivery along the program impact pathways is essential for implementing a program efficacy trial and for assessing its internal and external validity. This requires analysis of the major policy instruments for delivery and well-designed program delivery studies that examine the flow of a nutrient through a program impact pathway. The challenge now is to develop implementation (delivery) science knowledge and achieve a similar consensus on efficacy criteria for the delivery of these nutrients by public health and other organizations. This knowledge rests on decades of methodologic research development and, more recently, on codification of methods to compile and interpret results across studies. The biological efficacy of nutritional supplements to complement usual diets in poor populations is well established.