With every second child stunted in the country, India is virtually a nutritional basket case. The country’s response to the nutritional crisis, however, evokes even greater dismay than its poor nutrition statistics. After decades of sponsoring an ineffective child nutrition programme, the Union government is on the verge of launching a National Food Security Bill (NFSB), which undermines India’s fight against malnutrition.
New findings published in a recent special issue of pre-eminent medical journal The Lancet show why India will suffer heavy damages unless our nutrition-related policies change course. In 2008, the first Lancet special series helped frame the global agenda on nutrition by pointing to key pathways and actionable evidence, identifying the first 1,000 days of life as the critical window of nutrition intervention. Five years after that landmark issue, the new issue provides fresh evidence to underscore the importance of tackling nutrition very early in life. The June Lancet series also highlights the changing nature of the malnutrition burden, and the heavy toll it imposes on the developing world.
With three-fourths of the world’s obese children in developing countries, growing obesity in these nations is fast turning into a major public health challenge, and one that could eventually be as serious as under-nutrition is today. Early stunting not only retards childhood development, but is also a major determinant of obesity-related disorders much later in life, The Lancet points out. Lifestyle changes in rapidly urbanizing economies such as India make them especially vulnerable to this double burden of malnutrition.
Malnutrition accounted for losses worth at least 8% of global gross domestic product (GDP) in the 20th century because of “direct productivity losses, losses via poorer cognition, and losses via reduced schooling”. Malnutrition will cost the world as much as 6% of GDP even in 2050 unless the progress against malnutrition quickens significantly. The costs will be significantly higher for high burden countries such as India.
Despite giant strides in reducing both hunger and poverty over the past two decades, India has struggled to rein in malnutrition. Three key factors explain this paradox. First, India’s lopsided food policy has made cereals widely available at the cost of other foods. The so-called Green Revolution focused on cereals and met the needs of a hungry nation, but the issue of nutrient deficiency remained unaddressed. Consumption figures reported by the National Sample Survey Office (NSSO) reflect this. Barely 1% of households reported hunger, and the average cereal consumption across income classes is roughly equal, according to NSSO. But many are unable to afford other nutrient-rich foods. Second, the low social status of women makes them ill-nourished and results in an extraordinarily high proportion of low birth weights, raising the risks of both childhood stunting and adult obesity. Third, open defecation and high population density create a perfect storm for infectious diseases to thrive, inhibiting children’s ability to absorb nutrients.
The evidence so far provides clear pointers for policy actions. We need a radical overhaul of our community outreach programmes to meet the needs of the very young, pay close attention to gender-friendly policies and women’s health, invest in preventive public health services such as clean water and sanitation, provide farm incentives to promote food diversity, and launch an effective nutrition education campaign to fight the burden of malnutrition. Instead of adopting such a multi-pronged approach, the Union government has chosen to walk the path of populism by introducing a flawed food security Bill.
NFSB, which assures subsidized cereals to a majority of Indians, is blind to the true nature of the country’s nutritional crisis, and will only reduce food diversity. According to The Lancet’s estimates, it will take $9.6 billion globally to fund effective anti-malnutrition efforts. But India alone will spend four times that amount annually on the food security Bill without getting any significant nutritional return. The only return from NFSB will be political.
Will NFSB help solve the true nature of India’s nutritional crisis? Tell us at email@example.com