Anaemia in South Asia: A looming crisis threatening women’s health and economy
Anaemia is one of the deadliest but least experienced health hazards in the south of Asia. In the mid-2025, it is estimated that almost 259 million adolescent girls and women in the region will be anaemic, almost half of the population. It is estimated that without any serious policy shift, another 18 million cases are likely to appear by the year 2030.
The severity of this disorder is beyond clinical concern. The direct impact of anaemia is on the educational performance, productivity in the workforce, maternal health and long term economic development. Structural vulnerabilities are further enabled in a region that was already in the grip of inequality and poverty through the continued increase in anaemia.
Causes and Consequences of Anaemia
Nutritional and Biological Factors
The anaemia in the whole of South Asia is mainly caused by iron deficiency, which is based on low content of iron and inefficient absorption of iron in a diet. Phytate-rich diets low in bioavailable sources of iron are prevalent, particularly in low-income families; meat and fortified foods are among the most important bioavailable sources of iron.
Adding to these is other micronutrient deficiencies including that of folate and vitamin B12, endemic parasitic infections and chronic diseases. Women in the reproductive age are more vulnerable due to loss of menstrual blood, early pregnancies, and inappropriate spacing of the births.
Social Determinants and Healthcare Access
In addition to biology, anaemia is conditioned by deeply rooted social disparity. They also follow gender conventions that women and girls eat the least and last thus preventing access to quality food. Poor health services particularly in the rural regions subject many of them to lack screening, supplementation or treatment.
Although there are massive campaigns, non-usage of iron and folic acid tablets is rampant because of side effects, irregular availability or lack of knowledge. The organizations that support maternal and adolescent health often are not well coordinated and do not focus on populations that are at the greatest risk.
Economic Burden and Productivity Losses
There are huge economic costs of anaemia. Low physical and mental abilities among the women in the working age reduce the income in the households and the productivity in the country. UNICEF and WHO claim that South Asia annually loses a value of about 32.5 billion US dollars because of healthcare expenses and lost employee productivity linked to anaemia.
These losses are not even distributed. Families headed by anaemic women have greater chances of experiencing a pattern of malnutrition, low income, and low schooling, which amounts to a generational passage of condition.
Regional Response: Colombo’s Coordinated Push
The 2025 Colombo Conference
The Nourishing South Asia conference held on July 9-11, 2025 in Colombo brought together government, health ministry, academic and international organization representatives of the countries of South Asia. This forum focused on anaemia among adolescent girls and women and it also focused on multisectoral solutions.
SAARC, WHO and UNICEF sponsored this occasion, which was concluded with a regional statement and creation of the South Asia Anaemia Academic Alliance. This body intends to disseminate findings, observe the interventions, and develop evidence-based plans dependent on the socio-economic regions.
National Commitments and Scientific Direction
The Prime Minister of Sri Lanka, Dr. Harini Amarasuriya, revealed the plan to intensify community-based actions and nutrition support, especially in the areas with a high level of anaemia. Her administration pledged to increase the services offered in maternal health programs, as well as making the micronutrient supplementations available in the rural clinics.
Other countries, Bangladesh, India, Nepal among them paid particular attention to the question of improving the staple food basic diets, rice, wheat and salt with iron and other essential nutrients. Scholars contend that food fortification is scalable in terms of impact on programs in low income populations where there is little dietary diversity.
Systemic Barriers to Progress
Strained Healthcare Systems
Many South Asian countries struggle with underfunded public health systems. Diagnostic facilities are poor at distant parts and the process of follow-up of anaemia is irregular. When supplements are issued there is almost no data on compliance or effects.
Health workers are usually ill-trained and not motivated to take part in the implementation of health programs. The issue with most frontline interventions is that they get implemented in silos that break no connections with sanitation, education or agricultural services.
Entrenched Gender Inequality
The norms of culture restrict women to resources and control over health choices. Young women are likely to drop out of school because of marriage/motherhood responsibilities and are therefore not exposed to health education and services.
Patriarchal household arrangements majoring on male nutrition and education places women in a more vulnerable position, of being exposed to anaemia and its complications. To solve the issue of anaemia in women, it is necessary that these norms in anaemia are challenged and women should be economically and socially empowered.
Poverty and Food Insecurity
Anaemia grows where healthy food is either very rare or where it is too expensive. The urban slums as well as the rural areas have problems of lack of iron-rich food in the staple diets. Further cutting of food diversity has occurred in Bangladesh, Pakistan and northern India due to inflation and climate causes of crop failures in 2024-25.
Efforts to combat anaemia must also address food systems and market access. Programs focused only on supplementation or clinical care will fall short without parallel improvements in food security and income.
The Economic Case for Intervention
Combating anaemia is a short- and long-term economically beneficial activity. Women who are healthier are productive with higher earnings and likely to engage in formal employment. There is improved prenatal care and early nutrition which makes their children have better educational achievements and low healthcare expenses expended in future.
There is high returns of investment in anaemia reduction. Fortification projects, such as the ones, present a case of $27 being gained per $1 dollar spent. The WHO estimates that between 25 and 50 percent of deaths among women due to anaemia can be prevented by increasing maternal nutrition services.
Expert Perspectives and Regional Leadership
Sanjay Wijesekera, UNICEF’s Regional Director for South Asia, stated that anaemia
“Is a warning sign that systems are failing women and girls at every level—from diet and education to healthcare and protection.”
He called for urgent collaboration across sectors to address the crisis.
Dr. Gaurav Dixit, a haematologist and researcher, emphasized the complexity of anaemia, noting that
“it is not just a medical issue but a developmental challenge.”
He pointed to the need for accurate data collection and culturally sensitive delivery models.
Building Momentum Through the South Asia Anaemia Academic Alliance
The newly launched South Asia Anaemia Academic Alliance aims to fill research and data gaps, standardize measurement tools, and evaluate the effectiveness of interventions. It will also work with national ministries to tailor strategies for diverse populations, from urban adolescents to rural tribal women.
One of the alliance’s goals is to develop a digital surveillance system that tracks anaemia prevalence in real time, improving responsiveness and accountability. This tool will be piloted in Nepal and India later this year.
Global Commitments and Lagging Targets
Over 50 percent of the world anaemia among women in reproductive ages transpires in South Asia. Although they are the focus of the 2030 Global Nutrition Targets of the WHO, there has been no improvement. Only in Maldives and Bhutan, there is a chance to achieve goals of reduction in 2025.
In this respect, the Colombo conference focused on the need of being aligned with the global aims, though there is a likelihood that regional specificity matters the most. Warnings were sounded by the speakers that unless there is a course correction, then the global anaemia reduction target, which aims to reduce anaemia by half by 2030, will not be achieved, which comes at the expense of health equity and economic progress.
Will South Asia Act in Time?
There is no doubt that it is imperative in health, economic and moral terms to control anaemia. However, improvement will not rely on statements and conferences. It needs the transformation of the food systems, reformation of health delivery, addressing gender inequality, and mobilizing of general and the personal resources.
The following two years were fateful. With seriousness on part of the countries on promises made in Colombo being effected, there may be a lot on the way to reducing the burden of anaemia and uplifting millions of lives. However, in case the dynamics stall, the 18 million anaemic girls and women that were expected as result of momentum may turn out to be a nightmare.
With this growing crisis in South Asia, the question which needs to be answered is whether the leaders will convert this urgency into action or anaemia will continue to be a silent plague, in which potential is wasted and further development of the region is slowed down another generation!
