According to the Indian Council of Medical Research and the National Institute of Nutrition (ICMR-NIN), no study has been conducted to ascertain the impact of chemically fortified food. Activists have pointed to investments in diversifying the food basket, rather than impose industrial interventions in the absence of conclusive evidences.
The government is planning to cover 291 aspirational and heavy burden districts under the rice fortification programme by March 2023, said Sudhanshu Pandey, Secretary Department of Food & Public Distribution. Briefing the media, Pandey said that 90 lakh metric tonnes of fortified rice has already been produced in the country so far. The year’s total requirement is 175 lakh metric tonnes under the second phase of ‘distribution of Fortified Rice through Public Distribution System (PDS)’ that began in April 2022.
The first phase of the programme covered the Integrated Child Development Services (ICDS) and PM POSHAN across the country and about 17 lakh metric tonnes of fortified rice was distributed by March 2022. More than 90 districts in 16 states have so far procured around 2.58 lakh metric tonnes of fortified rice for distribution under the public distribution scheme he said.
The secretary also said that independent concurrent evaluation to assess the outcomes and the impact of the rice fortification programmes would be carried out by the Development Monitoring and Evaluation Office (DMEO) under NITI Aayog while steering committee in the states too will monitor the implementation of the programme.
Civil society campaigners….
However, campaigners connected with the right to food campaign say that the fortified rice programme is not based on sound science.
Dr Veena Shatrugna, a former deputy director of the National Institute of Nutrition says that “The fortification project is not formulated from a sound medical science point of view. Any one food item cannot provide all nutrients in adequate amounts. Solutions to anaemia, hunger and malnutrition can only be resolved by introducing diverse foods like several cereals, pulses, fruits, vegetables and even animal foods into the diet rather than looking for a one bullet solution like fortification,”
The activists have pointed to investments in diversifying the food basket, rather than impose industrial interventions in the absence of conclusive evidences.
Responding to a query using the right to information law from Greenpeace India, the Ministry of Consumer Affairs, Food and Public Distribution failed to provide any specific survey or data when asked the scientific basis for the pilot project of rice fortification. The Ministry mentioned that the National Family Health Survey- 4 (NFHS-4) survey was the basis of approvals for the centrally sponsored pilot scheme on ‘Fortification of Rice and its Distribution under Public Distribution System’ for a period of three years beginning in 2019-20. It maintained, “Third-party evaluation of the ongoing pilot scheme is due in the third year i.e. in 2021-2022.” This third party evaluation has not been done yet, the activists say.
Yet another response received to a RTI question to the Indian Council of Medical Research, National Institute of Nutrition (ICMR-NIN) mentioned that no study had been conducted to ascertain the impact of chemically fortified food.
Interestingly ICMR said that it did conduct a double blind randomized controlled study in government primary school children (5-11 years age group) on chemically fortified rice served as part of their mid-day meal. But their findings showed, “iron fortified rice has a similar effect as mid-day meal on improvement in anaemia.”
Activists say that this clearly raises doubts on the government’s assumptions that fortified rice could be helpful in eradicating anaemia. It also means that if mid-day meal schemes are improvised, added with diversity and effectively implemented they can be a boost in the fight against malnutrition and anaemia, they say.
Kapil Yadav of the Centre for Community Medicine at All India Institute of Medical Sciences (AIIMS) also made a presentation on ‘Staple Food Fortification as a Complementary Strategy to Address Micronutrient Vulnerability’.
He said that food fortification is a cost-effective complementary strategy to address multiple micronutrient deficiency. Yadav stressed that only 0.01 per cent of population may face health risk due to consumption of fortified rice, particularly those ailing with Thalassemia Major. He emphasised that fortified rice helps preventing cretinism, goiter, IIH (Thyrotoxicosis), brain damage, improvement in foetal and neonatal health and improvement in productivity of the population. The benefits of rice-fortification intervention far outweigh the risks involved, he argued.
Globally, more than two billion people have multiple micronutrient deficiencies and 1.6 billion people have anaemia. Over 50 per cent have iron deficiency and 260,100 pregnancies every year are affected by neural tube defects (NTDs) and the multiple micronutrient deficiencies are an important cause of mortality, morbidity, impaired human development, he said.
Yadav’s arguments for fortified rice were complemented by Siddharth Waghulkar of the World Food Programme who offered evidences from various Indian studies.