Anaemia burden — iron alone is no solution

India’s anaemia burden is not in doubt. The fifth National Family Health Survey (NFHS-5) found that more than half of women and about two-thirds of young children are anaemic. In this context, double-fortified salt (DFS) — fortified with iodine and iron — is often proposed as a potentially transformative solution. However, the case for DFS rests on convenience: everyone consumes salt, so why not add iron to it? But convenience is not efficacy, and a policy that asks the country to continue consuming salt to deliver iron deserves closer scrutiny.

Iron fortification of salt is a vehicle that cuts against public health. Indians consume, by most estimates, roughly twice the five grams of salt a day recommended by the World Health Organization (WHO). About one in three adults has hypertension, and India’s own non-communicable disease (NCD) action plan commits to a 30% relative reduction in salt intake.