- Better data, smarter treatment plans and more realistic targets are needed to tackle anaemia, which affects nearly two billion people worldwide and remains a major obstacle to global health goals
Singapore, 11 September 2025—Duke-NUS Medical School, working with an international team of experts, has contributed to a new evidence-based plan to tackle anaemia—a condition affecting nearly two billion people worldwide and a persistent obstacle to achieving global health goals.
Published in The Lancet Haematology, the study sets out expert consensus on the causes of anaemia, identifies major data and knowledge gaps and recommends the most cost-effective strategies for reducing its global prevalence.
Anaemia develops when the body lacks enough healthy red blood cells to carry oxygen. Iron deficiency is the leading cause, though other nutrient shortages, chronic diseases and infections such as malaria and hookworm play a role depending on local conditions. Despite its scale, anaemia often receives less attention than other health threats, even though it undermines maternal health, child survival and economic growth.
In 2015, the United Nations set a target of halving anaemia in women of childbearing age by 2030. Nearly a decade on, most countries remain far from this goal. The study shows why: in many low- and middle-income countries, recommended interventions are either unavailable, too costly or underused.
Assistant Professor Robin Blythe, from the Duke-NUS Medical School’s Health Systems & Services Research Programme, who led the economic modelling component of the study, said:
“A one-size-fits-all approach to anaemia does not work. Countries face very different challenges, from poverty and infectious diseases to food shortages. These realities are often overlooked in global health targets. We need goals that are ambitious yet realistic—and tailored to each country’s needs and resources.”
The team estimated how much progress each country could realistically achieve by 2030 using currently recommended measures such as staple food fortification, iron supplementation, and preventive malaria treatment in pregnancy. They used country-specific data, including anaemia prevalence, health system capacity and how much each country can cost-effectively afford to spend on public health. Their analysis shows the global Sustainable Development Goal (SDG) target of 50 percent reduction is not feasible with current tools and funding.
The study reveals sharp contrast between countries. Singapore, for example, could achieve a 25 per cent reduction among women of reproductive age—slightly above the global average but still only half of the SDG target. With an anaemia prevalence of 18.4 per cent among women of reproductive age, Singapore’s strong health system, high antenatal care coverage and ability to implement fortification programmes put it in a strong position to make meaningful gains.
Most anaemia cases in Singapore are mild (17 per cent), with only 1.4 per cent moderate cases and virtually no severe ones. The country’s ability to pay for public health programmes, its high coverage of antenatal care, at 81 per cent for iron supplementation, and its ability to implement food fortification programs put it in a strong position to reduce anaemia further.
“Singapore has the capacity to make real progress,” said Asst Prof Blythe. “By focusing on fortifying staple foods with iron and improving the uptake of supplements during antenatal care, the country can achieve real reductions in anaemia while using resources efficiently. Unlike in malaria-endemic regions, preventive malaria treatments are not relevant in Singapore, so investments should go where the impact will be greatest.”
By contrast, Indonesia is projected to achieve only a 9 per cent reduction due to constrained healthcare spending, while Malaysia could reach 28 per cent reduction. These variations underscore the need for country-specific goals rather than uniform global targets, ensuring public health resources are directed where they can make the most difference.
Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, said:
“This study shows that solving major health challenges requires collaboration across disciplines and borders. By setting realistic targets based on local conditions and investing in proven programmes, countries can accelerate progress and improve health for billions. These recommendations point to a more practical, evidence-driven path forward.”
The study also called for better data systems to track anaemia and its causes. While many surveys measure how common anaemia is, few gather information about its specific causes in each population. This makes it hard to plan effective responses. A global anaemia database and expanded health surveys would help close this data gap and improve decision-making.
Asst Prof Blythe emphasised that setting more realistic targets is not about giving up on ambition. “When targets are set too high and countries fail to meet them, it can create frustration and even discourage continued efforts. Our approach provides a clear, data-driven way to set targets that reflect what each country can realistically achieve with current tools. This way, we can still drive progress while being honest about what is possible.”
The authors are now sharing their findings with the World Health Organisation, with the hope that future health and nutrition targets will adopt a similar country-specific, evidence-based approach. With stronger data, better funding strategies and smarter policies, countries can make meaningful progress in reducing anaemia and improving public health.
Country-specific targets for reducing anaemia in women of reproductive age by 2030 based on each nation’s health challenges, resources and what currently recommended interventions can cost-effectively achieve. // Source: Cost-effective targets for anaemia reduction in 191 countries: a modelling study. Lancet Haematol. 2025 Aug 20