◊ By Sudha Narasimhachar

Earlier this year, the FSSAI (Food Safety and Standards Authority of India) issued draft regulations on mandatory fortification of edible oil and milk with Vitamin A and D.

On Independence Day (August 15, 2021), India’s Prime Minister announced that fortified rice will be supplied through all major government schemes like PDS (Public Distribution System) and the mid-day meals programmes by 2024.

The government recently floated a 3-year centrally sponsored pilot scheme on rice fortification and supply via PDS in 15 districts across the country. Since April 2021, the government has already been distributing fortified rice through the mid-day meal scheme and ICDS (Integrated Child Development Services) programme, citing widespread nutritional deficiencies.

Fortification approaches are receiving support in the United Nations’ Food Systems Summit (UNFSS) processes too, including from India.

On August 28, 2021, a webinar was organised by ASHA (Alliance for Sustainable and Holistic Agriculture) to discuss the impact of mandatory food fortification policies.

EXCESSIVE INTAKE OF IRON CAN DO HARM

“Fortification is nothing new. The best example is that of iodised salt,” said Dr Veena Shatrugna, former Deputy Director, National Institute of Nutrition. But, she pointed out, that was done when iodine deficiency became a major public health concern because more than 40% of the children, mostly from the North eastern states, suffered from it and developed serious conditions like goitre.

Since reaching out to all the affected children was impractical, the Government of India decided to make it mandatory that all salt manufactured be iodised. Intake of excess iodine did not cause any major harm as excess iodine gets expelled as urine.

On the other hand, fortification of rice and wheat with iron, to tackle the increasing problem of anaemia, is neither safe nor apt, because intake of excess iron is harmful to health and leads to many complications such as diabetes and blood-related issues.

Iron gets deposited in unwanted parts of the body and hinders recovery from infections like tuberculosis and malaria, Dr Anura Kurpad, Professor, St John’s Research Institute, Bengaluru, informed those attending the webinar.

BALANCED DIET FOR POOR MORE USEFUL THAN FORTIFICATION FOR ALL

Anaemia is caused by many factors, not just deficiency of iron. Deficiency of minerals, vitamins, folic acid, etc, also contribute to anaemia. Supplying supplements to the target population like pregnant women and children of vulnerable sections of the society, as is already being done, is the best way forward, as they can be monitored based on individual and local conditions, opined the experts at the webinar.

Experts further believe, culturally evolved food habits based on geographical location, ethnic background, climate, etc, also have to be respected. Many tribal people eat ants, molluscs, bandicoots, shrimps, crabs, etc, which provide them with many nutrients like proteins and minerals.

Diversity of food is also very essential to get all the nutrients. “Just one or two cereals or oil fortified with iron cannot act as a magic bullet,” said Scientist and Conservationist and Founder of the rice seed banks, Basudha and Vrihi, Dr Debal Deb.

Kurpad said, “this is a situation when a cure becomes a malady,” because fortification of rice and wheat with iron is not the right solution. According to him, each community is different and a blanket solution such as mass food fortification cannot be applied because food habits are varied across different regions of India.

Furthermore, there are many natural ways of supplementing minerals and vitamins. For instance, pumpkin, sweet potato, mushrooms, eggs, banana, milk and milk products are good sources of vitamin A. Sunlight is a free source of vitamin D, available in abundance in India. Therefore, synthetic fortification is not required for all.

Dilnavaz Variava, Founder, The Sahayak Trust, spoke of the need to replicate her project of cultivating organic kitchen gardens in the Wardha district of Maharashtra, which has spread to Gujarat. These organic kitchen gardens, run at community levels in villages, have made a great impact in bringing down the level of malnutrition and anaemia among the populace in these regions, as fresh nutritious vegetables, fruits and certain food grains are grown in these gardens and consumed by the growers’ families, with the surplus produce being sold in markets.

MANDATORY FORTIFICATION COULD LEAD TO CARTELISATION BY CORPORATES, CLOSURE OF SMALL BUSINESSES

Dwijendra Nath Guru, an advocate for sustainable food systems, cited Europe as example, which also fortified salt with iodine to tackle iodine deficiency. However, it had strict regulations in place to ensure corporates do not market unsafe products under the garb of ‘public health’.

Guru alluded to a commercial agenda behind the Indian food fortification policy as being driven by 5 major multinational companies who manufacture the micronutrients to be used in mandatory fortification.

Dr Arun Gupta, M.D (Ped) and Convenor, Alliance Against Conflict of Interest, touched upon the term, “moral elasticity”. He believes the FSSAI cannot be burdened with the responsibility of food fortification because it does not have the knowledge and capacity to study the implications and hazards of the policy.

According to Gupta, there is a conflicting ulterior interest among the partners or co-partners of FSSAI, like the Bill & Melinda Gates Foundation, Tata Trusts, and corporates like Procter & Gamble, Heinz, Roche and BASF. He called for a robust legal framework to deal with these issues.

Dr Vandana Prasad, Founder Secretary, Public Health Resource Network, said nutrients are better absorbed from natural foods than from supplements. She believes poverty and caste discrimination are the main causes of malnutrition and anaemia and, therefore, must be addressed first.

According to her, a thorough cost-benefit analysis of the food fortification policy is also required because it is a threat to micro-economy. Many small players like the atta chakkis, oil mills and rice mills will go out of business if mandatory food fortification is executed and this will, in turn, create poverty, malnutrition and anaemia. “Don’t mix up food with supplements. Leave food alone,” implored Prasad.

Trade Analyst, Afsar Jafri, of GRAIN (Genetic Resources Action International), said mandatory food fortification could cause major economic damage. He reminded webinar attendees how the regulation for mandatory packaging of oil, issued after 1998’s dropsy epidemic, impacted hundreds of small oil mills.

Similarly, introduction of packaged atta led to thousands of small chakkis losing business. In Pakistan, Punjab, when pasteurisation of milk was made mandatory, thousands of small dairy farmers lost their businesses.

All this, because food fortification requires huge investments, large scale production, sophisticated laboratories and tedious packaging and distribution channels, which small players cannot afford and consequently, they are forced to shut.

The looming threat of cartelisation of multinational companies is especially glaring, according to Jafri.