Where the underfed don’t know they are

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Malnourishment in India is an old worry. But is it worsening? In global comparison, yes, going by the country’s slide on the Global Hunger Index (GHI), put together by a couple of international agencies and released last week. Of the 117 countries listed, India is at No. 102 this year, down from No. 95 in 2010, and ranked below both Pakistan at No. 94 and Bangladesh at No. 88. Countries with far slower economic growth, like Mozambique and Niger, also fare better than India now. On the various parameters that go into the GHI, we have not done all that appallingly on the proportion of children who are too short for their age, and of those who die before their fifth birthday. But this year’s GHI findings on children who weigh too little for their height are particularly grim. This fraction, at over one-fifth, has reportedly worsened over the past half decade or so. All such surveys offer estimates that can, at best, only produce an approximate snapshot of reality. Yet, it’s clear that too many Indians are underfed than our collective conscience should allow. India has pledged to make the country “malnutrition-free” by 2022 under the National Nutrition Mission. On current trends, that goal will likely be missed.

How can the problem be addressed? One initiative after another has been launched by the Centre over the years. For example, the Integrated Child Development Scheme of 1975 aimed nutrition supplements and immunization shots at children up to the age of three years (besides expectant mothers), while also trying to generate higher awareness about health and nutrition. In 2013, we had the Food Security Bill, which was designed to assure cheap food to target groups such as pregnant women, lactating mothers and children under 14, as also the destitute, homeless and disaster-struck. Under this scheme, rice was made available at 3 per kg, wheat at 2 per kg, and coarse grains at 1 per kg. The government has the funds. The latest budget pegged its food subsidy bill for 2019-20 at 1.84 trillion, up 7.5% over the previous year. As of now, the Food Corporation of India granaries are reported to be overflowing with surplus stocks. So much so that India is reported to have donated some foodgrain to Afghanistan and Yemen as aid. Despite all this, domestic hunger continues to haunt us. Is there a better way to ensure the poor are adequately nourished?

Rather than plain lack of food, the problem may lie in inappropriate nutrition. Nobel laureates Abhijit Banerjee and Esther Duflo posit as much in their book, Poor Economics. A general reduction in extreme poverty has meant that starvation per se is no longer as insidious a threat as it used to be, they say, but people fall into a poverty trap on account of the poor quality of nutrition, not quantity. What people eat matters more than how much. Unaware of what’s good for them, the poor tend to go by their taste buds rather than what’s truly calorific and rich in micronutrients. Instead of piling their plates high or loading them with extra calories, we need to nudge them towards qualitatively superior food. Since diets are slow to change, food technology may need to enrich what they already consume. Salt infused with both iron and iodine is one such experiment. Other ideas could be tested. Of course, diets differ, influenced as they are by non-economic factors, which means trials in specific places need not be scalable nationwide. But still, we do need to rethink how we quell hunger.



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