Let us take our fight against mass malnutrition to its logical conclusion

Rajeev R Malnutrition is a widespread global health issue characterized by an imbalance in the intake of essential nutrients, leading to adverse effects on an individual’s physical and mental well-being. It manifests in various forms, including undernutrition, overnutrition and micronutrient deficiencies. Undernutrition, marked by insufficient calorie and protein intake, is a major concern in many developing regions. It leads to stunted growth, weakened immune systems and even mortality, especially among children.

Conversely, overnutrition, often linked to excessive consumption of calorie-dense but nutrient-poor foods, contributes to a rise in obesity and diet-related chronic diseases in both developed and developing countries. Micronutrient deficiencies such as vitamin and mineral shortages can have long-term health consequences, affecting cognitive development, immune function, and overall vitality. Addressing malnutrition requires a multifaceted approach encompassing improved access to nutritious foods, education on balanced diets and healthcare interventions to combat its various forms and ensure a healthier, more equitable future for all.

As per the Global Hunger Index-2022 report, the prevalence of undernourishment in our population stands at 16.3 per cent; child stunting 35.5 per cent; child wasting 19.3 per cent and child mortality rate is 3.3 per cent. It is said that the value of ‘prevalence of undernourishment in the population’ is flawed as it is based on an opinion poll conducted on a very small sample size and does not take into account the series of measures taken by the Union Government to ensure food security in the country.

Data on nutritional indicators in the country are captured periodically under the National Family Health Survey (NFHS) conducted by the Ministry of Health and Family Welfare. As per the recent NFHS-5 (2019-21) report, the nutrition indicators for children under five years have improved as compared with NFHS-4 (2015-16). Stunting has reduced from 38.4 per cent to 35.5 per cent. Wasting has reduced from 21 per cent to 19.3 per cent and underweight prevalence has reduced from 35.8 per cent to 32.1 per cent.

The Food and Agriculture Organization (FAO) estimates that around 842 million people – 12 per cent of the global population – are unable to meet their basic dietary requirements, around half of them living in G20 countries. Food production will need to increase by 60 per cent to feed a world population expected to exceed nine billion by 2050, which has rapidly changing consumption patterns. Important causes of food insecurity are poverty, rural underdevelopment, unemployment and household incomes that are too low to ensure adequate access to food. It is estimated that three quarters of the world’s poor live in rural areas of developing countries. Improving productivity, enhancing incomes, and diversifying sources of revenue - including by developing the rural non-farm food system economy are the key components of addressing poverty, food and nutrition challenges. Global economic growth is also impeded because one in eight people are too hungry to work productively.

Malnutrition and non-communicable diseases have high costs in lost gross domestic product (GDP) and higher budget outlays, with productivity losses from child malnutrition estimated at more than 10 per cent of lifetime earnings. An increasing number of developing countries, including G20 members, have a double burden of over and under-nutrition. Obesity rates have nearly doubled since 1980 and the number of overweight people in the world has already overtaken the number of people without enough to eat. Health problems related to excess weight impose substantial economic burdens on individuals, families and communities. G20 countries are well placed to drive the innovations needed to help the world sustainably grow much more food while lowering inputs and reducing pressure on land and water. Nutrition-sensitive agricultural growth has enormous potential to improve human productivity and economic growth.

The Centre rolled out Pradhan Mantri Garib Kalyan Ann Yojana (PMGKAY) that is benefitting over 80 crore poor and poorest of poor. The integrated scheme aims at strengthening the provisions of National Food Security Act, 2013 in terms of accessibility, affordability and availability of foodgrains for the poor.

The Central government will spend more than Rs. two lakh crore in 2023 as food subsidy under NFSA and other welfare schemes, to remove the financial burden of the poor and the poorest of the poor. It is laudable to ensure that no one starves in our country.

Union Minister of Health and Family Welfare Dr Harsh Vardhan recently stated that of the 135-crore people inhabiting India “196 million are victims of chronic hunger while another 180 million suffer from obesity. 47 million children have stunted growth while another 25 million are wasted. 500 million are deficient in micronutrients and 100 million suffer from food-borne diseases.”

The million-dollar question is from where to start? Since a lot is already being done to address the problem of malnutrition and the fact the number of malnourished is quite high, we need to focus on our affected children from one-year-old till they attain the age of 16. As they are from weaker sections of our society, our approach to address their malnutrition should go beyond the boundaries of the Mid-Day Meal Scheme.

It is strongly recommended that malnourished children aged up to three should be the responsibility of Anganwadi volunteers and thereafter area primary and secondary schools where they should be enrolled mandatorily and called to schools for tutorial classes during holidays where they would be served delicious and nutritious food under the extended Mid-Day Meal Scheme. It will help us not only to monitor their health closely but also ensures their basic education. The task is certainly gargantuan but not impossible. Education and health, we all agree, are the most painful victims of poverty, and without education and health we can neither aspire for peace, social bonhomie nor sustainable long-term inclusive development. We are left with only 23 years when to celebrate a centenary since independence. The grand occasion should be a different one, a one where our children are much healthier than their counterparts in other developed countries. Scaling the heights of development and military strength without empowering masses with quality education and good health will be nothing but a pyrrhic victory. Therefore, our focus on ensuring the last mile development should encompass the poor and poorest among them. They must be provided with fishes but at the same time they need to be taught how to catch a fish for which our approach should be inclusive, marked by responsibility and transparency.

(The writer is a senior journalist, columnist and author. The views expressed are strictly his personal)