Vol IX, Issue 1 Date of Publication: January 12, 2024
DOI: https://doi.org/10.20529/IJME.2023.064

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Mandatory fortification of rice in the public distribution system in India: An ethics perspective

Jananee Muralidharan
Shalini G Hegde
Santu Ghosh
Ankita Mondal
M C Arjun
Tinku Thomas
Sunita S Kurpad
Charles Davis
Harshpal S Sachdev
Anura V Kurpad
In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.

Copyright and license
©Indian Journal of Medical Ethics 2023: Open Access and Distributed under the Creative Commons license ( CC BY-NC-ND 4.0),
which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.

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