Arpita Mukherjee, Professor, ICRIER and Latika Khatwani, Research Assistant, ICRIER explains why significant funding is the need of the hour to address vitamin D deficiencies
India is grappling with a growing public health challenge of micronutrient deficiencies, particularly Vitamin D deficiency, that quietly erodes the health and productivity of millions. The deficiency is linked to serious health consequences, including rickets in children, osteopenia, and osteoporosis in adults and weakened immunity. The data on the deficiency is alarming – 1 in 5 individuals are Vitamin D deficient, 46 per cent of children aged 0-10 years are prone to rickets, 1 in 2 Indians have osteopenia and 1 in 5 have osteoporosis. Addressing such deficiencies requires significant funding, and innovative models to tackle the issue holistically with lower costs.
The budget for the healthcare sector in India is much lower than the scale of the micronutrient deficiencies that the country is facing. In the recent Union Budget 2025–26, Rs 95,957.87 crores was allocated to the Ministry of Health and Family Welfare, which is only 1.97 per cent of the total Budget and approximately 0.27 per cent of the GDP. Although public health expenditure has grown over time, it remains well below the 2.5 per cent of GDP, the target set by the National Health Policy 2017. In this limited fiscal space, Rs 483.54 crore of the Ministry’s Budget goes to the tertiary care programmes like tobacco control and drug de-addiction, and there is limited budget to address micronutrient deficiencies.
One reason for limited budget is the lack of an estimation of the scale of the deficiencies. The ongoing Survey for Assessment of Markers of Population Health Activity, Diet and Anthropometry (SAMPADA), by Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN), is India’s first diet and biomarker survey, the results of which are expected in 2025. Such survey will help to understand the scale of the deficiency. These surveys cost over Rs 93 crores, includes 2.5 lakh participants, covers 36 states and UTs. The costs include cost of survey team, equipment, laboratory and testing equipment and infrastructure. Such surveys are conducted over a period of time (around 1 year) and at an interval of 5 years. Therefore, it is important to gather all health related information in one go to save costs and help in data-driven policy making.
Another, and may be a cheaper way of data collection is through routine testing of the population for deficiencies like Vitamin D, which can be clubbed with existing government programmes like Anaemia Mukt Bharat (AMB) campaign. AMB received Rs 805.91 crore in FY24-25 and with a little higher expense, mass testing for micronutrient deficiencies can be done. Delhi has already started testing for Vitamin D deficiency and other states may follow the same.
Delivering micronutrient fortified food through existing public distribution programmes is another cost-effective strategy to address the deficiency. The infrastructure for same already exists in India. Under Pradhan Mantri Garib Kalyan Anna Yojana, fortified rice containing iron, folic acid, and Vitamin B12 is distributed through the Public Distribution System (PDS)and Integrated Child Development Services (ICDS), which has an outlay of Rs 2.03 lakh crore in FY25–26. Vitamin D-fortified products can also be integrated into these delivery systems at minimal cost of Rs 0.02/l for milk and Rs 0.10/l for edible oil, to reach nearly 75 crore beneficiaries. The government can collaborate with organisations like GAIN to scale-up fortification efforts—building on past successes such as the significant reduction in anaemia achieved in Rajasthan through large scale fortification.
The WHO Model List of Essential Medicines includes both D2 and D3, but India’s NLEM includes only D3 (from animal sources) and not D2 (from plant sources), despite 30 per cent of the population being vegetarian. After including Vitamin D2 and D3 supplements in the NLEM, these can be distributed to the deficient patients through the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP); which has a budget allocation of Rs 29.34 crore in FY25–26. This may help to address the deficiency without much additional costs.
Community-level interventions targeting children and pregnant women are among the most cost-effective ways to address micronutrient deficiencies. ASHA and Anganwadi workers can play a key role in distributing Vitamin D supplements, offering nutrition counselling, and raising awareness about over-supplementation with proper training. According to an IFPRI (2020), Rs 1,019 crore was required for the distribution of micronutrient supplements such as Vitamin A, Iron, Folic Acid, and Zinc to children, pregnant and lactating women. Adding Vitamin D to this existing mix would require a marginal increase in budget, but will have a high success rate, if correctly implemented. Such programmes can be scaled up with multistakeholders partnership and funding from private companies and multinationals.
To complement the government budget and attract partnerships and funding, it is important to launch an awareness campaign like Vitamin D Kuposhan Mukt Bharat by partnering with organisations such as GAIN, NGOs, healthcare providers, and private pharmaceutical companies. This collaborative effort can mobilise resources, scale impact and build success stories across the country.
