Further, India in terms of hunger rankings has slipped from 95th rank in 2010 to 102nd in 2019. According to the report, Pakistan, the only country in South Asia region that had a ranking below India in previous indices, in the 2019 ranking, has come up to 94th place.
The 2019 GHI measured hunger in 117 countries where the assessment is most relevant and where data on all four component indicators are available. These indicators are proportion of underweight, and undernourished, mortality rate, stunted children under 5 years of age.
“Because of its large population, India’s GHI indicator values have an outsized impact on the indicator values for the region. India’s child wasting rate is extremely high at 20.8%—the highest wasting rate of any country in this report for which data or estimates were available," the report said.
“Its (India) child stunting rate, 37.9%, is also categorized as very high in terms of its public health significance. In India, just 9.6% of all children between 6 and 23 months of age are fed a minimum acceptable diet," it said.
The report also took note of open defecation in India as an impacting factor for health. It pointed out that as of 2015–2016, 90% of Indian households used an improved drinking water source while 39% of households had no sanitation facilities.
In 2014 the prime minister instituted the “Clean India" campaign to end open defecation and ensure that all households had latrines, the report said, adding, “Even with new latrine construction, how- ever, open defecation is still practiced. This situation jeopardizes the population’s health and consequently children’s growth and development as their ability to absorb nutrients is compromised."
In parallel, the Indian government authorities have strongly reacted to the report. “India’s population is equal to 193 countries. The criteria and parameter of the Global Hunger Index 2019 survey are not justified, e.g. how can we use the same parameters to evaluate Maldives and India? In the field of nutrition, the task is to do what is possible without forgetting to do what is necessary. PM Narendra Modi launched national nutrition mission," said Chandrakant S. Pandav, Member National Council for India Nutritional Challenges, POSHAN Abhiyan.
“This is the highest political commitment we can ever have in our country. Nutrition is an intergeneration issue and it is not like any other communicable disease. There can’t be any overnight changes in nutrition, but we are on the right track," he said.
Pandav though maintained that there is still a need for a more humane-cum-holistic approach and this can only be achieved by an active multi-sector approach, reinforced with a new set of national-level policies or guidelines around the usage of a community-based approach of addressing acute malnutrition in India.
"This way India will not only be able reverse its current status of having the highest number of children who are either too short for their age but not necessarily thin (stunted) or too thin for their height but not necessarily short (wasted) in the world, but also aid in the overall economic growth of the nation," said Pandav.
Public health experts have also said that India need some more time to tackle malnutrition and the efforts are going on.
“India’s portrayal in the GHI 2019 is certainly interesting because in my experience as a pediatrician for the past 30-40 years I have seen India conquering stunting, wasting and decreased infant mortality rate to some extent. There is obviously a need for more efforts, but India is a large country and it takes time to show results. I strongly believe stunting as a definite maker and marker of development," said Mrudula Phadke, Senior advisor, National Rural Health Mission (NRHM) and UNICEF.
“Prevention is important when it comes to improving maternal and child health outcomes, but we also need to focus on the existing burden of severe acute malnutrition (SAM) in the country, that has not changed in the last decade," said.
Phadke has also recommended to provide impetus on aspects such as compulsory breastfeeding, adequate complementary feeding, immunization practices, hidden hunger (micronutrients) among malnourished women which leads to babies being born with low birth weight (LBW) (for example, a single bout of diarrhea can push an LBW baby towards acute malnutrition), energy-dense nutritious food (necessary for recovery of SAM children), and access to clean water and sanitation (WASH) for families.
Highlighting that climate change affects the quality and safety of food, the GHI report said, it can lead to production of toxins on crops and worsen the nutritional value of cultivated food.
Citing an example, the report stated the climate change can reduce the concentrations of protein, zinc, and iron in crops. As a result, by 2050 an estimated additional 175 million people could be deficient in zinc and an additional 122 million people could experience protein deficiencies.
“Human actions have created a world in which it is becoming ever more difficult to adequately and sustainably feed and nourish the human population. Ever-rising emissions have pushed average global temperatures to 1°C above pre-industrial levels," the report said.
“Climate change is affecting the global food system in ways that increase the threats to those who currently already suffer from hunger and undernutrition," it said.
According to the report, 43 countries out of 117 countries have levels of hunger that remain serious. And, 4 countries Chad, Madagascar, Yemen, and Zambia suffer from hunger levels that are alarming and 1 country Central African Republic from a level that is extremely alarming.