What it takes to nourish India

Empowering locals, diversified food sources, and global trade can help address India’s nutrition crisis

The theme of this year’s National Nutrition Week is “healthy diets going affordable for all”. As healthcare professionals, it is important for us to reflect on the challenges of this theme so that access to a healthy and affordable diet becomes the cornerstone of India’s progress. A range of micro, small, and wide measures are needed to tackle the problem of nutrition in the Indian context. For the world to get an affordable diet and a healthy life, it is imperative for Indians to get adequate nutrition.

Various factors, such as disruptions in supply chains, the Ukraine war, the pandemic, and erratic climate conditions, have resulted in a rise in global inflation. India is experiencing the driest August, which has spiralled food inflation to above 11%. The ‘State of Food Security and Nutrition in the World’ (SOFI) 2023 says that 74% of Indians can’t afford a healthy diet.

We cannot deny that, in an increasingly globalised world, albeit before the pandemic and the war, Indian agro-business has borne the brunt of the global turmoil. But the issue is much more complex than that. India’s abysmal nutrition statistics in recent years are also because of our inability to provide the fruits of growth to a large section of the populace, which cannot afford even two basic meals a day. No wonder 80 crore people are dependent on the grains given by the government under the Food Security Act.

The solutions to providing affordable meals to so many people are not easy. India now has an almost digitalized foodgrain transfer system for its people under the Food Security Act, but each state has its own set of issues. One of the reasons for not identifying actual beneficiaries is the pending census in the wake of the pandemic and political interference. Ordinarily, the 2021 Census would have led to an upward revision in the population covered by the PDS, but the census has been indefinitely delayed. The estimates for 2020 (Jean Drèze, Meghana Mungikar, and Reetika Khera) suggest that roughly 10 crore people are excluded on account of the same.

India alone accounts for more than one-third of the world’s severely food-insecure population. Around 35.5% of children under the age of five are stunted, and 19.3% of children are wasted. Of the children between the formative ages of 6 and 23 months, 89% do not receive a ‘minimum acceptable diet’ (NFHS-5).

The Integrated Child Development Scheme (ICDS), now known as Saksham Anganwadi and POSHAN 2.0, is allocated Rs 20,554 crore in FY’24—that’s a meagre increase of 1% over the revised estimates of FY 23. Similarly, the Pradhan Mantri Poshan Shakti Nirman (the mid-day meal scheme) saw a drop in the budgetary allocation to Rs 11,600 crore in
FY ’24 from Rs 12,800 crore in FY ’23 (RE). This makes the present government’s intent to tackle undernutrition and absolute hunger questionable.

What are the solutions? First, India needs a microlevel approach. The National Food Security Act, 2013, has prescribed the role for local authorities—panchayats and urban local bodies (ULBs)—in the implementation of the scheme, but on the ground, our local bodies do not have the capacity or the wherewithal to implement it. For them to be empowered, the state governments must devolve their power for greater decentralisation.

Second, India needs to be much more open to globalised trade. Our agricultural exports must increase and compete in the global market. For instance, India is the largest producer of milk, but our dairy farmers have little access to the global milk market. An integrated approach will also help enhance the quality and standards of India’s produce and put healthier food on tables. A lot of structural issues need to be addressed before we open ourselves more to the global market.

Third, we need better-quality food, even for our population. There have been experiments in providing fortified rice to the poor, but we have done it without adequate credible independent studies, which advise on the contrary. A better solution is to move towards millets and local produce. A decentralised approach, providing local produce to the beneficiaries and diversifying the foodgrains depending on the state, is the need of the hour.

I feel that in the coming years, the issues of nutrition should be at the centre of our mainstream discourse.

(The writer is a doctor and a public health policy expert)