Iron-fortified rice: Activists accuse Centre of covering up flaws in anaemia-combat plan

According to the fifth edition of the National Family Health Survey, 67% children in the age group of 6-59 months have anaemia

Non-governmental organisations on Monday accused the Centre of a “desperate attempt to cover up” the ills of a one-size-fits-all programme that seeks to reduce India’s anaemia burden by exposing people to iron-fortified rice without addressing the potential health risks to prevent the vulnerable from consuming such rice.

In the last two months, the Union Ministry of Women and Child Development, and the Ministry of Consumer Affairs, Food and Public Distribution asked the states to comply with a food safety notification in which the FSSAI advised people suffering from certain diseases either not to eat fortified rice or have it under medical supervision.

The Food Safety and Standards Authority of India (FSSAI) in August 2021 notified that every package of food fortified with iron should carry the following sentence: “People with thalassemia may take under medical supervision and persons with sickle cell anaemia are advised not to consume iron fortified food products."

“These circulars (by the two ministries) are a desperate attempt by the Centre to cover up an unscientific one-size-fits-all approach to anaemia in the country in response to irregularities in the government’s (iron) fortification programme,” the Right to Food Campaign and the Alliance for Holistic and Sustainable Agriculture said in a statement.

Read | Why are women and children in India becoming more anaemic?

Fortified rice is being distributed through different public distribution system (PDS) programmes. It is also used to prepare meals at anganwadi centres and midday meal schemes in many states.

"Since rice is distributed as a loose item in every PDS shop, the cautionary statement on the pack, even if it's there, bears little meaning. And there is no alternative (non-fortified rice) available in the shop,” activist Kavitha Kurugranti from ASHA told DH.

The Centre is scaling up the rice fortification programme in a big way as an answer to India’s large-scale anaemia prevalence, though a section of doctors raised questions on such a strategy.

According to the fifth edition of the National Family Health Survey, 67 per cent children in the age group of 6-59 months have anaemia (haemoglobin level less than 11 gm per decilitre). The situation worsened after the NFHS-4 when 59 per cent of kids were anaemic. In addition, 57 per cent women and 25 per cent men were found anaemic in NFHS-5.

The worrying part, Kurugranti said, was the absence of a screening system to check if the recipients of iron-fortified rice were having thalassemia, sickle cell anaemia or any other disease for which consumption of iron was not advisable, and not being able to provide an alternative to such individuals.

The people who depend on fair price shops (ration shops) are poor and do not have means to buy alternatives from the open market.

"In a situation where no choices were being given to the beneficiaries and worse, in a situation when many citizens with contra-indicated medical conditions didn’t even know that they were not supposed to consume iron-fortified rice, how would such circulars (asking the states to comply with FSSAI) help,” wondered the activists, releasing a set of documents they obtained using the Right to Information Act.