Distribution of iron fortified rice through government schemes as a “silver bullet” to curb anaemia must stop in States such as Jharkhand which have large tribal populations that suffer from sickle-cell anaemia, thalassemia, and tuberculosis, warn activists. For such people, an overload of iron can create adverse health issues, they say.

In a fact-finding exercise, the activists discovered that neither field functionaries nor beneficiaries had been educated about the potential harms, and there were no warning labels despite the food regulator’s rules on fortified foods.

According to a report prepared jointly by the Alliance for Sustainable and Holistic Agriculture (ASHA-Kisan Swaraj) and the Right To Food Campaign, Jharkhand, where fortified rice is being distributed under Central government-funded schemes such as the public distribution system (PDS); PM-Poshan (erstwhile mid-day meal scheme) at schools; and Integrated Child Development Services (ICDS or anganwadi services), consent is not being obtained from beneficiaries.

PDS dealers and frontline workers too have not been informed beforehand about the potential harmful effects of fortified rice.

The fact-finding team discovered that among the beneficiaries who received fortified rice in the State were also patients diagnosed with thalassemia, sickle cell disease, and tuberculosis, and there may be many more who have been not diagnosed yet.

Thalassemia, sickle cell anaemia and malaria are conditions where there is already excess iron in the body, whereas TB patients are unable to absorb iron. Consumption of iron-fortified foods among patients of these diseases can reduce immunity and functionality of organs.

Jharkhand is an endemic zone of sickle cell disorder and thalassemia, with a prevalence of 8%-10%, which is twice the national average. Jharkhand is also an endemic zone for malaria — in 2020, the State ranked third in the country in malaria deaths.

“The right to informed choices about one’s food is a basic right. The right to know what one is consuming is also a basic right. In the case of rice fortification, it is seen that no prior informed consent was ever sought from the recipients,” notes the report.

“There is a need for precision because no nutrient taken in excess will do you good. Universal fortification is not the answer for nutrition deficiencies,” said Dr. Anura Kurpad, Professor, St. John’s Medical College and Hospital, Bengaluru.

Our code of editorial values