Promoting Corporate-Driven Fortification As The Route To Address Iron-Deficiency Is Ill-Advised

Admitting that one of the major drawbacks of artificial fortification is nutrient bioavailability, IRRI advocates improving rice grain quality through natural breeding programmes

Several years back, when genetically-modified Golden Rice was the industry buzzword and was being promoted as a solution for impaired vision with some advocating its use to enrich plants as a means to curb immune system dysfunction in children, I happened to be in a conversation with the acclaimed agricultural scientist and the World Food Prize Laureate Dr. M. S. Swaminathan.

I asked Dr. Swaminathan as to what he thought of Golden Rice, which the multi-billion-dollar GM industry claimed incorporates beta-carotene, a precursor to Vitamin A, to address this deficiency in children. Industry spokespersons had gone to town saying that the GM rice strain could help save the lives of one lakh children every year. It was only the fears being expressed by activists that was coming in the way for correcting the vision-deficiency in children, the industry had said.

The Philippine’s Court of Appeals had finally banned growing Golden Rice in that country in May 2024.

I wish to return to the discussion I was having with Dr. Swaminathan, who passed away in September 2023. In any case it is important to know what the distinguished agricultural scientist had to say about the efficacy of the controversial GM rice variety.

If I remember correctly, the scientist-administrator had replied somewhat like this: “The bigger question about fortified crops is the absorption and utilization of the essential nutrients by the human body. The tragedy is that for those for whom Golden Rice is targeted at do not have adequate body fat to assimilate and absorb the nutrients.”

Instead of these quick fixes, and similar short-cuts that may not eventually lead to nutrition security as expected (in the long run), the efforts should be to meet the nutrient requirement from diversified crops, including pulses and millets, to address under-nutrition or what is popularly called as ‘hidden hunger’.

It is in this context that I found the 2024 working paper by Economic Advisory Council to Prime Minister (EAC-PM) very meaningful. It very clearly brings out that diverse diets are much better at addressing malnutrition, including anaemia, than fortification.

The working paper ‘Changes in India’s Food Consumption and Policy Implications’, which uses data from the Household Consumption Expenditure Survey 2022-23 NFHS 5 (2019-21) found something that was perhaps missed out at the time when fortification was being rolled out. It found that ‘irrespective of consumption of fortified cereals, anaemia prevalence was higher in states with lower diversity of iron-rich foods among both children and women’.

These assumptions are in contrast with the findings of the numerous international studies that had built policy emphasis on fortification as the way forward. This is exactly what happens when policy makers are clear about the efficacy of a programme that is to be rolled out, and numerous studies are included to justify the need.

For instance, it is interesting to find out that out of the 18 studies on the impact of rice fortification on anaemia, only four were from India. ‘The results are too ambiguous,’ the working paper observed.

This implies that large-scale fortification of food staples like rice, oil and salt may not be desirable. Since the human body does not readily absorb the fortified nutrients, I thought the EAC-PM should have categorically called for the fortification programme to be withdrawn. Perhaps not to upset the ongoing policy initiative, the working paper refrained from saying so in as many words.

What surprised me was after detailing out all ambiguities, the study concluded “rice fortification can help address anaemia in settings where rice is the staple food.”

To begin with, let’s first look first at rice fortification programme. Although the Food, Civil Supplies and Consumer Affairs Department of the Government of Haryana says ‘rice fortification involves the addition of micronutrients to rice post-harvest to restore the micro-nutrients lost during processing and to enhance the level of vitamins and minerals by adding other vitamins and minerals not originally present in rice’, fortification is carried out in two steps.

Not getting into technical details, Haryana’s tryst with rice fortification, for instance, is in tune with the objectives laid out on in the Rs. 17,000 crore rice fortification scheme.

Although the EAC-PM paper thinks that rice fortification has a role in areas where rice is a staple, the International Rice Research Institute (IRRI) based in Manila, does not even think that fortification has a role in areas where paddy is widely grown. A paper ‘Why Rice Grain Quality and Nutrition is More Important Than Artificial Fortification For Achieving Nutritional Security’ (Sept. 23, 2024) says: “Many nutrients added during fortification are not as bioavailable as those naturally present in food. For example, iron added through fortification may be poorly absorbed due to the presence of compounds in rice, such as phytates, which inhibit iron absorption.”

Admitting that one of the major drawbacks of artificial fortification is nutrient bioavailability, IRRI advocates improving rice grain quality through natural breeding programmes. It therefore calls for opting for plant breeding approach that ‘creates a virtuous cycle where better nutrition, economic development and agricultural sustainability reinforce each other.’

If iron being added artificially to rice does not help the vulnerable communities, as it is not bioavailable, I don’t see any reason in promoting fortification as the route to address iron-deficiency. Knowing the limitations and yet continuing with a programme that does not deliver the anticipated benefits, is certainly a waste of resources. It is therefore important to rethink on the viability of fortification that is being carried out.

The problem is that fortification is a corporate-driven initiative and the policy makers often lack the courage to point its weaknesses, even if these are clearly visible.

It is in this connection that I admire the EAC-PM for pointing out the inherent deficiencies in the fortification programme, but I only wish it had picked up the courage to dispel the ambiguities and call for its roll back.

(The author is a noted food policy analyst and an expert on issues related to the agriculture sector. He writes on food, agriculture and hunger)