The Health Ministry is advancing a plan to subsidize gluten-free foods for celiac sufferers, because their high price imposes a heavy burden on people living with the disease.
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The plan, which has the backing of Health Minister Yaakov Litzman, has yet to be budgeted and will have to pass the hurdle of the Finance Ministry. The Health Ministry puts the annual cost of the subsidy at 90 million shekels ($23.3 million), while the estimate by the National Nutritional Security Council is higher — 120 million shekels.
Celiac disease is a sensitivity to the gluten found in wheat, barley, rye, spelt and oats that causes an autoimmune response in which the body attacks its own tissues, first and foremost in the small intestine. It has a genetic basis and thus tends to run in families.
An estimated one of every 157 people in Israel suffer from celiac disease, but a document by the nutritional security council says that its prevalence is underestimated because of cases that are asymptomatic and a lack of awareness regarding symptoms that need checking. It estimates that there are between 48,000 and 76,000 potential sufferers, more than 15,000 of them children and teens.
There is no remedy or medical treatment for the condition. The only thing that prevents the onset of symptoms is a strict gluten-free diet. This requires avoiding any food that contains even a trace of gluten.
Over the years the market has responded with a wide variety of gluten-free products, but these items are on average three times more expensive than their regular counterparts. An study by the Taub Center in 2014 found that while the average monthly outlay on bread and grain products like pasta was 100 shekels per capita, for those needing gluten-free products it averaged 300 shekels per capita.
An interministerial committee headed by Prof. Itamar Grotto, the Health Ministry’s director of public health services, submitted its recommendations on a subsidy last year. It called for a payment to be made available directly to the celiac patients to be used solely for the purchase of gluten-free products, which would require a dedicated distribution and supervision infrastructure. The committee recommended outsourcing this process to a company or organization that would run a type of “buyers’ club” for celiac sufferers.
The committee also recommended steps that would encourage local manufacturers to make gluten-free products, as well as reductions on customs duties on imported products and the elimination of the individual subsidies granted through local welfare authorities.
Subsidies for medical foods aimed at certain classes of patients exist through the health basket. These foods, which are evaluated annually by the health basket committee, are defined as medicines; they are manufactured by pharmaceutical companies and sold in pharmacies, not off the shelf in supermarkets. Gluten-free products are categorized differently. But the nutritional security council believes that “Supplying gluten-free food to celiac sufferers is like giving medicine and it should be included in the health basket, in view of the disease’s obvious clinical symptoms.”