Skip to main content

Rice fortification: Govt of India 'covering up' its one-size-fits-all approach to anaemia

By Dr Vandana Prasad, Kavitha Kuruganti 

An RTI response by the Ministry of Women and Child Development reveals knee-jerk and self-protecting measures in the form of a few circulars issued by the Ministry of Food and Public Distribution as well as the Ministry of Women and Child Development with regard to fortified rice being distributed in the country under government schemes.
These circulars, which are a desperate attempt by the Government of India, to cover up on an unscientific one-size-fits-all approach to anaemia in the country, are apparently in response to grave irregularities in the government’s fortification programme highlighted by Alliance for Sustainable and Holistic Agriculture (ASHA) and the Right to Food Campaign (RTFC).
The Government of India has started scaling up its rice fortification intervention even before the so-called pilots were completed, or evaluation lessons culled out, ignoring numerous scientific, holistic and community-controlled approaches to tackling malnutrition. Reports of fact-finding visits to various districts in Jharkhand and Chhattisgarh have been put out by these collective platforms in the months of April and May 2022, that highlight grave issues.
The two citizens’ alliances have been raising concerns over public health and other impacts from the Government of India’s baseless, massively-scaled up programme of fortified rice distribution in schemes such as PDS, ICDS, PMGKAY and MDMS/POSHAN, making fortified rice inescapable for the poor who rely on these programmes for their food.
A major health concern raised was on risks to citizens for whom iron is strictly contra-indicated, such as those with thalassemia and sickle cell disease (SCD). The FSSAI (Fortification of Foods) Regulations 2018 recognize this risk and seek to warn patients about the dangers of consuming such iron-fortified rice.
The risk is not just to these patients, as scientific evidence shows. Iron-fortified foods are contra-indicated for other conditions too, including acute infections, acute malnourishment, certain stages of malaria and tuberculosis, or even diabetes.
Ignoring the existing body of evidence, and widely-practised medical approach of avoiding iron for such medical conditions, the Government of India embarked on an ill-conceived and ambitious plan to feed iron-fortified rice to citizens, to tackle anaemia.
Such a one-size-fits-all reductionist solution to anaemia ignores numerous conditions specific to our country, and in fact showcases the disconnect between policy-making and actual situation of the poor.
What is shocking is that the Government of India, under pressure from the evidence showcased by ASHA and RTFC, is now escaping its responsibility by simply issuing circulars to state governments, asking them to “comply”.
On 27th May 2022, the Department of Food and Public Distribution, GoI issued a letter to Departments of Food and Civil Supplies and FCI to request compliance to FSSAI’s statutory regulations, drawing the recipients’ attention to Regulation 7 (which mandates a warning label for SCA and Thalassemia patients).
An email is issued by the same Department on July 13th 2022 asking for dissemination of notification dated 27/8/2021 on Food Safety and Standards (Fortification of Foods) First Amendment Regulations 2021 issued by FSSAI.
It says, “All States/UTs and FCI were requested therein to bring it to the notice of all concerned and ensure strict compliance” of the FSSAI notification “while distributing fortified rice under TPDS, ICDS, PM-POSHAN schemes and in other welfare schemes. This may be displayed at the Fair Price Shops appropriately along with the posters/banners about fortified rice”.
The Ministry of Women and Child Development followed this up with their own letter to all state governments, on 1st August 2022.
RTFC and ASHA said in a statement:
“It is irresponsible of the Union Government to thrust the reckless scheme of rice fortification onto state governments, but force them to bear the consequences of the same including statutory compliances. 
"State governments have been expressing helplessness in the face of GoI’s aggressive push of fortified rice in conversations with civil society groups, that too not from the Health Ministry but unreasonably by the Ministry of Food and Public Distribution.”
While this is so, the problem only gets compounded further now. Poor, unaware citizens in different parts of India will now be subjected to two different messages being put out at the fair price shops (while it is unclear what babies and children in schools are supposed to do with the new compliance-related circulars) – one that is promotional, and one that displays a statutory regulation.
Government is behaving irresponsibly towards citizens who are at risk from its fortified rice programmes
In a situation where no choices are being given to the beneficiaries and worse, in a situation when many citizens with contra-indicated medical conditions do not even know (unscreened/undiagnosed/unaware) that they are not supposed to consume iron-fortified rice, how are such circulars going to help?
RTFC and ASHA in the statement added:
“This is irresponsible behaviour from the Government of India, where they think their responsibility ends by such Circulars. What about choices for beneficiaries? What about the fact that many patients have not been screened and diagnosed? What about the fact that such labelling compliance will not help in a situation where fortified rice is being given in loose form, or cooked form?
“What about the fact that for many poor for whom such rice is contra-indicated, the government food schemes are their lifeline? What will happen to the entitlements of these people under National Food Security Act?”

When ASHA and RTFC conducted fact finding visits to Jharkhand and Chhattisgarh -- both states with high disease burden of SCD and Thalassemia -- to observe whether any steps had been taken to screen and protect such patients, they found that no steps had been taken apart from some lackadaisical compliance at times to the FSSAI labeling regulation, on gunny bags that reach dealer shops.
Since the rice is given in lose form in PDS and cooked form in school/ICDS meals programmes, and since many of the patients are illiterate, there was no way for patients to read labels. Moreover, most were undiagnosed since no screening was being done.
Such unsuspecting patients were given no warning and were being forced to consume iron-fortified rice as they were poor and couldn’t buy non-fortified rice from the market, said ASHA and RTFC.
India has one of the highest disease burdens of thalassemia globally with almost 3.9 crore carriers, as well as the largest number of children with β-thalassemia in the world. India also has highest prevalence of Sickle Cell Disease in South Asia, with some 2 crore estimated carriers.
India has been ranked the country with the second highest numbers of predicted SCD births. All such patients are at risk along with several others who are contra-indicated – such as those with Malaria and Tuberculosis, said ASHA and RTFC.

Comments

TRENDING

'Enough evidence' in Indian tradition to support legal basis for same-sex marriage

By Iyce Malhotra, Joseph Mathai, Sandeep Chachra*  The ongoing hearing in the Supreme Court on same-sex marriage provides space for much-needed conversations on issues that have hitherto remained “invisible” or engaged with patriarchal locker room humour. We must recognize that people with diverse sexualities and complex gender identities have faced discrimination, stigma and decades of oppression. Their issues have mainly remained buried in dominant social discourse, and many view them with deep insecurities.

Savarkar 'criminally betrayed' Netaji and his INA by siding with the British rulers

By Shamsul Islam* RSS-BJP rulers of India have been trying to show off as great fans of Netaji. But Indians must know what role ideological parents of today's RSS/BJP played against Netaji and Indian National Army (INA). The Hindu Mahasabha and RSS which always had prominent lawyers on their rolls made no attempt to defend the INA accused at Red Fort trials.

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Victim of communal violence, Christians in Manipur want Church leadership to speak up

By Fr Cedric Prakash SJ*  The first eleven days of May 2023 have, in many ways, been a defining period of Indian history! Plenty has happened in a rapid-fire stream of events. Ironically, each one of them are indicators of how crimes and the criminalisation of society has become the ‘new norm’; these include, the May Day rallies with a focus on the four labour codes which are patently against the rights of workers; the U S Commission on International Religious Freedom (USCIRF) released its Annual Report on 1 May stating that conditions for religious freedom in India “continued to worsen in 2022”; the continued protest by the Indian women wrestlers at Jantar Mantar for the expulsion of the chief of the Indian Wrestlers Federation on very serious allegations; the Elections in Karnataka on 10 May (with communalism and corruption as the mainstay); the release of the fake, derogative and insensitive film ‘The Kerala Story’; the release of World Free Press Index on 3 May which places India

Delhi HC rules in favour of retired Air Force officer 'overcharged' for Covid treatment

By Rosamma Thomas*  In a decision of May 22, 2023, the Delhi High Court ruled in favour of petitioner Group Captain Suresh Khanna who was under treatment at CK Birla Hospital, Gurugram, between April 28 and May 5, 2021, for a period of eight days, for Covid-19 pneumonia. The petitioner had to pay Rs 3,55,286 as treatment costs, but the Ex-Servicemen Contributory Health Scheme (ECHS) only reimbursed him for Rs 1,83,748, on the basis of government-approved rates. 

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

Unlike other revolutionaries, Hindutva icon wrote 5 mercy petitions to British masters

By Shamsul Islam*  The Hindutva icon VD Savarkar of the RSS-BJP rulers of India submitted not one, two,or three but five mercy petitions to the British masters! Savarkarites argue: “There are no evidences to prove that Savarkar collaborated with the British for his release from jail. In fact, his appeal for release was a ruse. He was well aware of the political developments outside and wanted to be part of it. So he kept requesting for his release. But the British authorities did not trust him a bit” (YD Phadke, ‘A complex Hero’, "The Indian Expres"s, August 31, 2004)

India joining US sponsored trade pillar to hurt Indian farmers, 'promote' GM seeds, food

Counterview Desk  As many as 32 civil society organisations (CSOs), in a letter to Union Commerce Minister Piyush Goyal on the Indo-Pacific Economic Framework (IPEF) and India joining the trade pillar, have said that its provisions will allow the US to ensure a more favourable regulatory regime “for enhancing its exports of genetically modified (GM) seeds and GM food”, underlining, it will “significantly hurt the livelihoods of Indian farmers.”

Polygamy in India "down" in 45 yrs: Muslims' from 5.7 to 2.55%, Hindus' 5.8 to 1.77%, "common" in SCs, STs

By Rajiv Shah Amidst All India Muslim Personal Law Board (AIMPLB) justifying polygamy, saying it “meets social and moral needs and the provision for it stems from concern and sympathy for women”, facts suggest the the practice is down from 5.7 per cent of Muslim families in 1961 to 2.55 per cent in 2006.

Modi govt 'wholly untrustworthy' on Covid data, censored criticism on pandemic: Lancet

By Rajiv Shah   One of the world’s most prestigious health journals, brought out from England, has sharply criticised the Narendra Modi government for being “wholly untrustworthy on Covid-19 health data”, stating, the “official government figures place deaths at more than 530 000, while WHO excess death estimates for 2020 and 2021 are near 4·7 million.”