Is grain fortification the only way to meet India’s nutritional challenge?

Relevance: Article throws a light on pros and cons of food fortification

Synopsis: As the Centre presses ahead with its plan to distribute fortified rice through the public distribution system, in order to fight chronic anaemia and malnutrition, critics have raised questions on the strategy.

Context

In a recent reply in Parliament, the Centre has said it is running a pilot scheme to fortify rice and distribute it through the PDS for a period of three years starting 2019-20, with a total outlay of Rs 174.64 crore. The Central government is funding 90% of the scheme for the north-eastern and hilly states, and 75% for the rest of India. The pilot focuses on 15 districts across 15 states, preferably one district per domain.

Note: As we have already covered food fortification and its associated points in our 7PM initiative so we are covering only additional new points here. Please go through the following article first.

Some are against while some are supportive of this strategy. Let us see both sides of the argument.

Against food fortification

• Ignores the role of a balanced diet: The program of fortification ignores the central role of a balanced and diverse diet in addressing a variety of nutritional problems of India. Also, the new nutrient recommendations of the Indian Council of Medical Research and National Institute of Nutrition (NIN) show that a diverse natural diet is adequate to meet the normal micronutrient needs of the population.
• Avoidable expenditure: Fortification of only the rice delivered through the social safety networks will cost the public exchequer about Rs 2,600 crore annually. This, in the backdrop of the already ongoing public health initiatives of iron supplementation, represents an avoidable and wasteful expenditure with no palpable benefits.
• Misdiagnosis of the scale of the prevalence of anaemia: On the prevalence of chronic anaemia, which has been elaborated as one of the main reason for the fortification programme, experts have said that it is magnified because of the use of inappropriate haemoglobin cut-offs to diagnose the malady in children and pregnant women. This creates an ongoing perception of stagnant or worsening anaemia prevalence. However, it does not reflect the true nutritional status of a population.

For Food fortification

The United Nations World Food Programme (WFP), in a cross-country mapping of the rice fortification programme done in Bangladesh, Bhutan, India and Sri Lanka, found that it is possible to improve the diet of millions of vulnerable people with fortified rice.

Suggestions

UNWFP, in a report released a few months back, suggested three key interventions by the national governments to make the programme a real success.

1. Operationalization of fortified rice distribution channels to reach groups that can benefit most from the consumption of the grain is key to providing necessary incentives for production and supply in the initial phase.
2. Public-private sector collaboration: Fortification programmes are most successful when driven by partnerships and trust between the public- and private-sector actors, with a final public health objective. Multi-sectoral collaboration between various ministries–agriculture, education and health in particular–as well as with academia and local and international NGOs helps create an enabling environment for rice fortification, with each stakeholder contributing their individual expertise and sphere of influence.
3. Incentives to pvt sector: Finally, it said that the private sector should be provided with adequate incentives to build robust supply chains of fortified rice.

Thus, though there is ample evidence on the benefits of fortification to meet nutritional challenges, whether it is the only way available is a million-dollar question which policy makers and experts need to explore.

Terms to know

• UNWFP