Why India needs a stronger iron-deficiency response in 2026

India has made consistent efforts to combat anemia since the 1970s, yet it remains one of the country’s most persistent and underestimated health challenges. As we move into the new year, strengthening our national response must become our priority. Today, an estimated 67.1% of children and 59.1% of adolescent girls in India are anemic, driven largely by poor nutritional intake across socioeconomic groups. Alarmingly, three in four Indian women still do not meet their daily iron requirements through food. These numbers point to a deep, systemic nutritional gap, one that can be addressed through better dietary habits, awareness and evidence-based supplementation.Much of this stems from poor recognition of early warning signs of iron deficiency; such as tiredness, headaches, low stamina. Iron deficiency affects the body in multiple aspects and emerging science indicates that chronic deficiency can alter cognitive and behavior function with some effects persisting even after treatment. Research indicates potentially long-term changes in brain function regulation involving the midbrain and hippocampal pathways, areas essential for memory, learning and emotional regulation. Women have monthly blood loss, pregnancy-related nutritional demands and postpartum changes that increase their risk significantly. Inadequate dietary iron along with social factors such as women eating less/ leftovers, add to the iron deficiency.The risks are even higher for pregnant women. Maternal anemia increases the risk of postpartum hemorrhage (excessive blood loss after delivery), infections, cardiovascular strain and prolonged postnatal fatigue. For infants, consequences include preterm birth, low birth weight, restricted growth and in severe cases, increased risk of early mortality. Therefore, it is essential to ensure iron sufficiency for safe pregnancies and healthier childhoods.Children and adolescent girls, are among the most vulnerable. Early life deficiency impairs cognition, weight gain, immunity and physical growth. It creates a cycle in which undernutrition leads to deficiency, which further reduces appetite, immunity, and deepens its impact over time.Another challenge is behavioural adherence. Many women discontinue iron supplementation due to side effects, misconceptions and compliance . Newer, more tolerable formulations make iron supplementation more sustainable. As India looks ahead to 2026, to reverse the country’s anemia burden requires a planned multi-layered approach:Place emphasis on awareness and nutrition literacy: India’s anemia challenge is rooted in multiple factors such as Iron deficiency, low Vitamin B12 and folate levels, dietary gaps and poor continuation of supplements Public awareness must therefore focus on how iron is consumed:Emphasis on preventive care: Preventive screening should become routine practice especially for women of reproductive age and adolescents. Comprehensive multi-micronutrient test including iron, B12, folate, ferritin and other markers help identify root causes early, enabling targeted, effective treatment. Once deficiencies are corrected, a preventive supplementation that is affordable and accessible, is crucial to prevent future deficiencies. To strengthen community and healthcare system: A robust nationwide response requires accessible screening services, improved counselling, follow-up and a consistent supply of high-quality nutritional supplements. Healthcare professionals, from physicians to frontline workers play a critical role to enable behaviour change, encouraging adherence and ensure women and girls remain iron-sufficient throughout their life stages.In conclusion, to combat anemia, we require a holistic and sustained effort at both the individual and national level. Addressing Iron deficiency treatment is not only medically a health imperative but also an economic one, as nutritional deficiencies reduce productivity and increase healthcare burden, ultimately impacting India’s GDP.India can move to a healthier, stronger and more productive community with the plan highlighted above especially for the women which will ultimately be an investment in stronger families, more resilient communities and a more prosperous nation.Dr Abhay A Bhave, Haematologist, Mumbai, Fellow in Haematology - Westmead Hospital Australia and CMC Vellore, Tamil Nadu, India