<p>Recently, the union cabinet approved the distribution of fortified rice to enhance nutrition among the country’s vulnerable populations. This will be done by adding micronutrients such as iron, folic acid, and vitamin B12.</p>.<p>With an outlay of Rs 17,082 crore for the next four years, the government claims that the programme will help reduce iron deficiency by 35%, resulting in savings in healthcare equivalent to Rs 49,800 crore in GDP terms. It is hailed as a valuable investment in improving the health of citizens, especially the marginalised.</p>.<p>The government claims that food fortification has been used globally as a safe and effective measure to address anemia and micronutrient malnutrition among vulnerable populations. As 65% of India’s population consumes rice as a staple food, it is claimed that it is the ideal vehicle to supply these micronutrients.</p>.<p>Rice fortification essentially means adding chemically produced micronutrients to the rice flour in a process called extrusion. These are converted into artificial grains that look similar to rice, with extra polishing. This fortified rice is then mixed with the rice to be distributed under the Public Distribution System (PDS).</p>.How healthy is health financing in India?.<p>Will this solve the problem of ‘hidden hunger’ and rampant malnutrition among the vulnerable population of women and children? The government has implemented this scheme on a pilot basis in select districts. However, there is no evidence from this pilot scheme to prove that it is effective in addressing malnutrition.</p>.<p>India has the second-highest sickle cell disease burden and the largest number of thalassemia cases in the world. In addition to this, <br>malaria and TB are widespread in the rural areas. Studies have shown that fortified rice will adversely impact patients suffering from these diseases.</p>.<p>Ironically, the government has addressed this issue by labeling the rice bags with warnings that those suffering from these diseases should not consume the fortified rice. These warnings are in English and printed on the gunny bags. However, the grains are not distributed in packets that contain the warnings. The entire population with access to PDS rice, including those who are suffering from the diseases, will end up consuming the rice.</p>.<p>Veena Shatrugna, former deputy director of the National Institute of Nutrition, warns that evidence supporting fortification is inconclusive and not adequate before major national policies are rolled out. Why is the government keen on rice fortification which is a technological solution to a problem that is caused by structural factors including a lack of access to food?</p>.<p><strong>Conflict of interest</strong></p>.<p>The most intriguing aspect of rice fortification is the dominance of national and international corporate interests in lobbying in favour of the policy.</p>.<p>FSSAI (Food Safety and Standards Authority of India) is the primary regulatory agency for setting standards for food items and food imports. Surprisingly, Food Fortification Resource Centre (FFRC) holds a seat within FSSAI, and has undue influence over funding and evaluation of the ongoing programme.</p>.<p>Alliance for Sustainable and Holistic Agriculture (ASHA), in its report, raises concerns about potential conflicts of interest in the decision-making on food fortification. FFRC members have affiliations with multinationals that promote food fortification and stand to benefit financially from mandatory food fortification. Most of the technology involved in the fortification has to be imported at high costs, paving the way for permanent dependence to solve the structural problem. It is naive to believe that these corporates are engaged in philanthropy to alleviate malnutrition.</p>.<p>In a tropical country like India, diverse diets that suit particular agro-ecological zones to tackle nutritional deficiency would be a more viable and acceptable public health investment option than centralised rice fortification that fails to meet the needs of a diverse population.</p>.<p>According to WHO, 77% of children in India aged six to 23 months lack diversity in their diet. It has called for a holistic approach to resolve this by adding eggs, legumes, nuts, fruits, and vegetables to the diet.</p>.<p>Malnutrition is the direct result of inequity in sharing resources, depriving the vulnerable population of a reasonable income to afford a diverse diet. Any amount of food fortification is bound to fail unless a fresh diet is made available to them.</p>.<p>Looking at the macro issues, our soils lack the micronutrients due to intensive use of chemical inputs and pesticides. Ironically, the culprits here are the food corporates who are now advising the union government to artificially fortify rice, pitching it as a solution to malnutrition.</p>.<p><em>(The writer is a farmer and Uttara Kannada-based environmentalist)</em></p>
<p>Recently, the union cabinet approved the distribution of fortified rice to enhance nutrition among the country’s vulnerable populations. This will be done by adding micronutrients such as iron, folic acid, and vitamin B12.</p>.<p>With an outlay of Rs 17,082 crore for the next four years, the government claims that the programme will help reduce iron deficiency by 35%, resulting in savings in healthcare equivalent to Rs 49,800 crore in GDP terms. It is hailed as a valuable investment in improving the health of citizens, especially the marginalised.</p>.<p>The government claims that food fortification has been used globally as a safe and effective measure to address anemia and micronutrient malnutrition among vulnerable populations. As 65% of India’s population consumes rice as a staple food, it is claimed that it is the ideal vehicle to supply these micronutrients.</p>.<p>Rice fortification essentially means adding chemically produced micronutrients to the rice flour in a process called extrusion. These are converted into artificial grains that look similar to rice, with extra polishing. This fortified rice is then mixed with the rice to be distributed under the Public Distribution System (PDS).</p>.How healthy is health financing in India?.<p>Will this solve the problem of ‘hidden hunger’ and rampant malnutrition among the vulnerable population of women and children? The government has implemented this scheme on a pilot basis in select districts. However, there is no evidence from this pilot scheme to prove that it is effective in addressing malnutrition.</p>.<p>India has the second-highest sickle cell disease burden and the largest number of thalassemia cases in the world. In addition to this, <br>malaria and TB are widespread in the rural areas. Studies have shown that fortified rice will adversely impact patients suffering from these diseases.</p>.<p>Ironically, the government has addressed this issue by labeling the rice bags with warnings that those suffering from these diseases should not consume the fortified rice. These warnings are in English and printed on the gunny bags. However, the grains are not distributed in packets that contain the warnings. The entire population with access to PDS rice, including those who are suffering from the diseases, will end up consuming the rice.</p>.<p>Veena Shatrugna, former deputy director of the National Institute of Nutrition, warns that evidence supporting fortification is inconclusive and not adequate before major national policies are rolled out. Why is the government keen on rice fortification which is a technological solution to a problem that is caused by structural factors including a lack of access to food?</p>.<p><strong>Conflict of interest</strong></p>.<p>The most intriguing aspect of rice fortification is the dominance of national and international corporate interests in lobbying in favour of the policy.</p>.<p>FSSAI (Food Safety and Standards Authority of India) is the primary regulatory agency for setting standards for food items and food imports. Surprisingly, Food Fortification Resource Centre (FFRC) holds a seat within FSSAI, and has undue influence over funding and evaluation of the ongoing programme.</p>.<p>Alliance for Sustainable and Holistic Agriculture (ASHA), in its report, raises concerns about potential conflicts of interest in the decision-making on food fortification. FFRC members have affiliations with multinationals that promote food fortification and stand to benefit financially from mandatory food fortification. Most of the technology involved in the fortification has to be imported at high costs, paving the way for permanent dependence to solve the structural problem. It is naive to believe that these corporates are engaged in philanthropy to alleviate malnutrition.</p>.<p>In a tropical country like India, diverse diets that suit particular agro-ecological zones to tackle nutritional deficiency would be a more viable and acceptable public health investment option than centralised rice fortification that fails to meet the needs of a diverse population.</p>.<p>According to WHO, 77% of children in India aged six to 23 months lack diversity in their diet. It has called for a holistic approach to resolve this by adding eggs, legumes, nuts, fruits, and vegetables to the diet.</p>.<p>Malnutrition is the direct result of inequity in sharing resources, depriving the vulnerable population of a reasonable income to afford a diverse diet. Any amount of food fortification is bound to fail unless a fresh diet is made available to them.</p>.<p>Looking at the macro issues, our soils lack the micronutrients due to intensive use of chemical inputs and pesticides. Ironically, the culprits here are the food corporates who are now advising the union government to artificially fortify rice, pitching it as a solution to malnutrition.</p>.<p><em>(The writer is a farmer and Uttara Kannada-based environmentalist)</em></p>
