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India is on the brink of a major public health crisis as Vitamin D deficiency—affecting a large portion of the population—continues to be overlooked, according to a new expert report released on Monday.
Amid growing evidence of a nationwide deficiency, the Indian Council for Research on International Economic Relations (ICRIER) has called for urgent policy reforms to improve the affordability and accessibility of Vitamin D testing and supplements.
Titled “Roadmap to Address Vitamin D Deficiency in India,” the report refers to the condition as a “silent epidemic” and urges coordinated, multi-sectoral action involving policymakers, healthcare providers and food regulators.
The report is based on a meta-analysis conducted by researchers from ICRIER and the ANVKA Foundation and was prepared by a high-level working group comprising experts from premier medical and research institutions—including AIIMS, ICMR-NIN, and PGIMER. It outlines a comprehensive strategy to address the crisis, which is linked to bone disorders, weakened immunity, cardiovascular diseases, diabetes, and heightened vulnerability to respiratory infections.
“Vitamin D deficiency is a silent epidemic affecting millions, yet it remains largely overlooked. Its impact goes beyond weak bones—it weakens immunity, raises the risk of chronic diseases, and places a heavy financial burden on families and the healthcare system. Tackling this crisis requires a united effort from policymakers, healthcare professionals, industry leaders, and society as a whole,” said Dr Aashish Chaudhry, Managing Director, Aakash Healthcare and co-author of the study.
“Through fortified nutrition, awareness campaigns, and proactive health strategies, we can build a ‘Vitamin D Kuposhan Mukt Bharat.’ This is not just a public health mission but a vital step towards a healthier, stronger, and more productive India as we move toward Viksit Bharat 2047,” he added.
One in five Indians suffers from this deficiency, with India’s eastern region showing particularly high levels—reaching up to 38.81%. The issue is especially worrying among adolescents, newborns, and the elderly. Women across all age groups are more vulnerable than men, and the prevalence is notably higher in urban areas compared to rural ones.
Despite its widespread reach, Vitamin D deficiency remains largely unmonitored and is not sufficiently addressed through India’s national health programmes.
Key factors contribute to deficiency
Lifestyle & Environment: High pollution levels block UVB rays needed for natural Vitamin D production. Limited outdoor activity, urban crowding, and work-from-home habits reduce sun exposure.
Dietary Gaps & High Costs: Vitamin D-rich foods like eggs, fish, and fortified dairy remain unaffordable for many. Traditional diets and widespread lactose intolerance worsen low intake, with only 8–14% of Indians meeting the recommended dairy consumption.
Skin Tone & Cultural Norms: Darker skin tones, which require 3–6 times more sun exposure to produce Vitamin D, combined with widespread sunscreen use and body-covering clothing, hinder absorption.
Affordability Barriers: Testing costs often exceed ₹1,500, and supplements are priced between ₹48–130 for 10 tablets, making them unaffordable for many. An 18% GST on supplements further limits access.
Obesity and Chronic Illnesses: Obesity interferes with the metabolism of Vitamin D, while rising metabolic disorders worsen the deficiency.
Policy Gaps: There is currently no national programme targeting this crisis. Food fortification is voluntary, and Vitamin D is missing from key schemes like mid-day meals in most states.
ICRIER warned that the long-term health effects—ranging from bone-related ailments to lower immunity—could place a major strain on India’s public healthcare system and reduce productivity across the workforce.
“India needs a roadmap similar to its iodised salt success—mandatory fortification, subsidies, and awareness campaigns. Voluntary steps won’t curb this crisis. Without swift action, the country risks a rise in preventable illnesses, placing more pressure on an already overstretched healthcare system,” said Deepak Mishra, Director & Chief Executive (ICRIER).
To improve diagnosis, the think tank recommended standardised testing protocols across public and private healthcare facilities, addressing existing inconsistencies in test quality and access.
“This analysis is a wake-up call. The report aims to highlight the urgent need for coordinated action against Vitamin D deficiency,” said Dr Arpita Mukherjee, Professor (ICRIER). “By addressing policy gaps, funding research, and implementing large-scale interventions, India can work towards the UN Sustainable Development Goals of eliminating malnutrition and ensuring good health by 2030. Without data-driven interventions, India’s SDG goals on health and malnutrition will remain out of reach.”
ICRIER’s recommendations come at a critical time, as India’s healthcare spending remains tight. The report points out that preventive steps—such as improved nutrition—could offer a practical and cost-effective way to avoid long-term health and economic challenges.
A call to reframe the crisis
“Vitamin D deficiency is not just a clinical issue—it’s a public health emergency hiding in plain sight,” the report said. The expert group has urged policymakers to reframe the issue as one of national concern and shift the focus from curative interventions to preventive, community-based solutions.
One of the key recommendations is the immediate initiation of a national-level awareness campaign to educate the public about the causes and consequences of vitamin D deficiency. The panel also recommends revisiting India’s Recommended Dietary Allowances (RDA) for vitamin D, which it says are outdated and significantly lower than global benchmarks.
The paradox of sunshine
India, despite being a tropical country with abundant sunlight, remains one of the most vitamin D-deficient populations globally. The report attributes this paradox to lifestyle changes, urbanisation, pollution, darker skin pigmentation and a lack of awareness about safe sun exposure.
“People are either not stepping into the sun or are actively avoiding it due to concerns about tanning or heat,” said one of the experts involved in the report. “Moreover, women and children, especially in urban areas, are particularly vulnerable due to clothing practices and indoor lifestyles”
The report also highlighted a growing body of evidence linking low vitamin D levels with adverse pregnancy outcomes, stunted child growth, compromised immunity and even mental health issues—further highlighting the urgency for intervention.
Policy inertia and fragmented efforts
Despite the overwhelming evidence, the report criticises the lack of a coordinated national strategy. “Efforts to address vitamin D deficiency in India have been fragmented, sporadic, and mostly clinical,” it notes, adding that the issue has not received the kind of institutional focus that problems like iron or iodine deficiency have in the past.
The working group has recommended the integration of vitamin D supplementation into key national programs such as the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) initiative, Integrated Child Development Services (ICDS) and school health programs under the Ayushman Bharat scheme.
A systematic screening and supplementation plan for pregnant women, lactating mothers, and children has also been proposed. “Vitamin D should be made an essential part of antenatal care, just like folic acid or iron,” the report notes.
Fortification and food-based solutions
To address the population-level deficiency sustainably, the panel has strongly recommended mandatory fortification of commonly consumed foods like milk, edible oils, and flour with vitamin D. Although the Food Safety and Standards Authority of India (FSSAI) has issued fortification guidelines, the roadmap points out that implementation remains weak, voluntary, and inconsistent.
“India needs to move from voluntary to mandatory fortification for vitamin D, especially in staple foods consumed by all segments of the population,” the report says. It also calls on the FSSAI to update and enforce labeling norms and ensure the bioavailability of fortified products.
The roadmap emphasizes that food-based solutions should be complemented by regular supplementation in vulnerable groups. However, it cautions against unregulated over-the-counter use of vitamin D, noting the risk of hypervitaminosis and toxicity.
Research gaps and lack of data
A major barrier to policy formulation has been the absence of comprehensive national data on vitamin D levels across different populations. The report recommends that the Ministry of Health and Family Welfare in collaboration with ICMR and other research bodies should start a nationwide surveillance and study to map the prevalence of deficiency and assess the impact of interventions.
It also calls for India-specific clinical guidelines for diagnosing, treating and monitoring vitamin D deficiency in both public and private healthcare settings.
A call to action
The expert panel has outlined a multi-pronged approach that includes policy reforms, regulatory strengthening, clinical protocols, community awareness, and targeted research. Among the key recommendations are:
*Revising national RDA and upper intake levels for vitamin D
*Including vitamin D status in national health surveys
*Strengthening inter-ministerial convergence on nutrition policy
*Making vitamin D supplementation free and universally accessible for high-risk groups
*Promoting outdoor physical activity, especially in schools and urban planning
The report called for the government to adopt vitamin D deficiency as a national priority under the broader framework of preventive healthcare and nutrition security. “India has the science, institutions, and public health infrastructure. What it needs now is the political will and administrative alignment to act decisively,” it said.
With non-communicable diseases on the rise and immunity-related concerns brought to the forefront by the COVID-19 pandemic, experts believe that addressing vitamin D deficiency could serve as a low-cost, high-impact intervention to improve the overall health of the population.