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Insights from the The Lancet Haematology Commission At Kilifi Hospital, Kenya, two mothers, Fatuma and Halima, shared the strain of caring for children hospitalised with severe anaemia. Both children received blood transfusions, but the mothers recalled not being given a clear explanation of what anaemia was. The emotional toll included tears, worry, and the constant stress of budgeting for food, transport, and hospital visits (Mutua & Atkinson, 2025). Their voices echo those of millions of families worldwide, including in India, where anaemia silently shapes futures. It is not just a clinical diagnosis, but an emotional, financial, and social burden falling most heavily on women and children. The Global Picture: Ambitious Goals vs Stark Realities Anaemia affects an estimated 1.9 billion people worldwide, primarily children, adolescent girls, and women of reproductive age. Yet, most countries remain off track to achieve the World Health Assembly and Sustainable Development Goal target of reducing anaemia prevalence by 50% by 2030 (Atkinson et al., 2025).  According to the recently published Lancet Haematology Commission, current global targets are unrealistic; health-economic modelling suggests a more feasible reduction of 12–22% by 2030 (Blythe et al., 2025). The World Health Organisation (WHO) and UNICEF have established the Anaemia Action Alliance (2021) and, in 2023, launched a Comprehensive Framework for Action. Yet measurable progress remains limited, with only 18 countries showing improvement (Rogers et al., 2025). Climate change is intensifying anaemia by lowering crop nutrient content, disrupting health systems, and driving disease risks. A study from Sub-Saharan Africa shows how even a 1°C rise is linked to a 13.8% increase in childhood anaemia (Fanzo & Carducci, 2025). The poorest, least able to adapt, bear the greatest burden, making nutrition central to climate resilience. India at the Epicentre India bears one of the highest burdens across all age groups. NFHS-5 shows more than half of women and two-thirds of children are anaemic, underscoring the scale of the challenge. To address this, Anaemia Mukt Bharat (AMB) was launched in 2018 as a paradigm shift, adopting a lifecycle, health-system approach. Anaemia Mukt Bharat incorporated the National Centre for Excellence and Advanced Research on Anaemia Control (NCEAR-A) at AIIMS as its technical hub. The centre leads research, training, digital innovation, and advocacy through strong partnerships. Future success depends on decentralised district-level implementation, sustained political commitment, and next-generation champions to ensure long-term impact. (Yadav, 2025) Why Fortification is India’s Best Bet Anaemia reduction strategies must balance effectiveness with affordability, especially in a country as large as India. A costing study (Oliver et al., 2025) estimated the per-person unit costs of six WHO-recommended interventions for women of reproductive age across 193 countries. The key finding was that “in most countries, food fortification and deworming were the lowest cost interventions, with population-weighted average costs of less than US$1 per person per year.” For India, this means fortification is not only cost-effective but also scalable, reaching millions through existing food systems without requiring radical infrastructure changes. Building on USAID’s Lessons: Why Sustained Commitment Matters Since 1961, USAID has shaped global nutrition through pioneering efforts in food fortification, vitamin A supplementation, and salt iodisation, contributing to reductions in anaemia and child mortality. It helped establish indicators, supported large-scale surveys, and fostered partnerships with WHO, UNICEF, and governments worldwide. Its closure in 2025 marked a major setback, risking the loss of decades of technical expertise and fragile program gains (Dary & Peniston, 2025). The lesson is clear: sustainable progress in anaemia control depends on long-term, consistent investment without which even the most effective strategies risk unravelling. Towards an Anaemia-Free Future Anaemia is the quiet thief of strength and dreams, draining lives in silence. Fortification stands out as one of the most cost-effective and scalable solutions. What is needed now is collective will, smart investment, and integrated action to ensure that no woman, child, or community continues to carry this burden. Fortify Health is working to turn this vision into reality by enabling access to wheat flour fortification by partnering with open-market millers and governments, so that every meal can carry the quiet power to fight anaemia and safeguard futures. References
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