With A Pinch Of Doubt

Iodine & Iron

• Iodised salt came to India in the late 1950s
• Today, 80 per cent of India uses iodised salt, which has reduced the incidence of goitre
• Fortifying salt with both iodine and iron can help fight another widespread condition—anaemia
• Double fortified salt, or DFS, could prove to be a game-changer in the fight against malnutrition
• But if the fight against anaemia is to succeed the government has to ensure that more than just a few big salt-makers get the technology for making DFS

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The idea is workable. In fact, the success against goitre after iodisation of table salt was made compulsory builds the case for fighting anaemia by making double fortification compulsory too. But experts and voluntary groups are vexed by what is making the idea unworkable: the government has chosen too narrow a channel to introduce DFS to a population as big as India’s. The fortification technology that the Centre has endorsed, developed by the National Institute of Nutrition (NIN), Hyderabad, is being shared only with the few big manufacturers who have signed mous with the institute.

Tata Chemicals, the first to launch DFS in the market, has priced it Rs 20 per kilo. “We have turned our focus to help consumers fight iron deficiency by offering an affordable, organic way of dealing with it,” said R. Mukundan, the managing director of Tata Chemicals, speaking at the product launch. It does not take an ideology to see profit behind piety. What is clear even from a practical standpoint is this: unless the technology reaches India’s numerous small- and medium-scale salt-makers and competition drives the price down, DFS will not rid itself of the irony of not reaching those who need it most. “It’s great that India has finally got DFS in, but it remains to be seen if it makes its way down to rural areas and small towns, where people who really need it live,” says M.G. Venkatesh Mannar, president of Micronutrient Initiative, a Canada-based group promoting DFS.

Iron is a tricky nutrient. It isn’t readily absorbed in supplemental forms. In double fortification, there are complications arising from reaction between the two supplements. To overcome them, food scientists in the private and voluntary sectors have developed various formulations, besides technologies such as microencapsulation of the iron component. Mannar’s NGO is seeking government approval for its own formulation, citing triumphs in Sri Lanka, Bangladesh and mid-day meal programmes in Andhra Pradesh. The way to boost availability of DFS is to test and approve more formulations and also take NIN’s formulation to more salt-makers. Eventually, double fortification could be made compulsory.

Instead, the government plans to take DFS to all through its own programmes. It says Tata’s salt would soon be made available through the Integrated Child Development Scheme (ICDS) and school mid-day meals. Distribution through the leaky pds is also being considered. To be fair, ICDS and mid-day meals are among the government’s few big successes in the health sector. But experts call for a broader front. The latest National Family Health Survey (NFHS-3) found 25 per cent of men, 55 per cent of women and 70-80 per cent of children anaemic—alarming enough for the prime minister’s office to have pushed DFS, choosing salt over flour or bread as the vehicle for supplementary iron. It will take a little more push—and perhaps a reworking of strategy—to make sure everyone gets the right sort of salt.