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May 11, 2006 • Volume 14 Number 17

Bert Garza

Extra Credit

Standards and norms are the argot of a college administrator, but in the "other" profession of Academic Vice President and Dean of Faculties Bert Garza, MD, they mean something else: the prospects for a child's well-being.

Garza is the chair of a major World Health Organization initiative that has devised a new set of standards to assess children's health and development, based on studies of some 8,000 youngsters in Brazil, Ghana, India, Norway, Oman and the USA.

Released late last month, the standards "provide evidence and guidance for the first time about how every child in the world should grow," according to a WHO press release, and "confirm that children born anywhere in the world and given the optimum start in life have the potential to develop to within the same range of height and weight."

The previous standard used for years - based on data from a limited sample of children from the USA - contained technological and biological drawbacks that made it less adequate to monitor the rapid and changing rate of early childhood growth, and failed to provide a sound basis for evaluation against international standards and norms, the WHO announcement said.

Individual differences aside, average growth patterns among children across large populations, regionally and globally, are remarkably similar, the report says: Children from India, Norway and Brazil all show similar growth patterns when provided healthy growth conditions in early life. Therefore, the WHO researchers say, differences in children's growth to age five are more influenced by nutrition, feeding practices, environment, and health care than genetics or ethnicity.

"The new standards are important for parents, health professionals, and other caregivers to assess the growth and development of children at the individual and population level," says Garza, who is director of the United Nations University Food and Nutrition Program.

For Garza, last month's report represents the "first installment" of the culmination of almost 15 years of work, involving continual travel to the six study sites and communicating with hundreds of individuals, as well as significant fundraising efforts to carry out "an expensive and complex study."

Although the report has attracted little attention thus far in the US, Garza says the rest of the world has perked up its ears.

"The current estimate is that approximately 100 countries are likely to consider adopting the new reference. For example, official review efforts have been begun in the UK and Brazil with many others likely to announce similar efforts in the next few weeks."

The potential benefits of the project, he adds, go beyond its immediate objectives: "It demonstrates well the type and quality of work that can be accomplished by the collaboration of multiple UN agencies and the public and private sectors."

For more on the WHO growth standards project, see www.who.int/childgrowth.

-Sean Smith

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