Could it be that the solution is not just about making more food available to our children, but ensuring that children at a young age are assured of the right vitamins and minerals (micronutrients) in their diet as well? At a prestigious conference in Copenhagen earlier this year, a panel of eight leading international economists, including five Nobel Prize winners and the Indian-born economist, Jagdish Bhagwati, was asked to study 10 challenges facing the world. It had to decide What would be the best way of advancing global welfare, particularly of developing countries, by an additional $75 billion spent over a four-year period.
The problems assessed ranged from expanding immunisation coverage to malaria prevention, HIV combination prevention, rural water supply to the Doha development agenda, peace-keeping in post-conflict situations and the increase and improvement of girls schools. The experts concluded that spending the money on providing micronutrient supplements for children specifically vitamin A, zinc, iron and iodine was the most effective option.
While the world accepts that malnutrition is a condition created not just by caloric shortages but also lack of essential micronutrients in the diet, Indian planners continue to waffle in addressing this specific issue. Though the figures show that 70 per cent of Indian children suffer from anaemia (iron deficiency) and over 50 per cent suffer from serious vitamin A deficiency. The National Nutrition Policy, which emphasises the fortification of micronutrients in food as one of the most cost-effective strategies in fighting malnutrition, has been in place for over a decade, but government nutrition schemes do not bother to adopt its recommendations.
While budgets for the Integrated Child Development Scheme (ICDS) and the MDM (Midday Meal) schemes have been raised substantially, thanks to the Supreme Court intervention, little thought has been given to the obvious aspect of ensuring that the food served to the kids is fortified with micronutrients even though the cost would be minimal compared to the total budget. Since the impact of malnutrition in under-three-year-olds is largely irreversible in terms of physical growth and compromised mental development, what we provide in the ICDS is of overwhelming importance.
The continued resistance to adopting a cheap and effective strategy for fighting child malnutrition stems largely from a closed mindset and intellectually dishonest propaganda. Any attempt to debate the issue is sought to be stymied by making the false claim that that the choice is between hot cooked meals and fortified packaged foods and biscuits. It is hardly a one-or-the-other solution. A problem so deep-rooted can be solved only by a multi-pronged strategy, not a one dimensional approach. Advocating micronutrient fortification is certainly not synonymous with pushing packaged food, as is made out by a well-entrenched group of NGOs. In fact, hot cooked meals, can be, and are being, fortified in several MDM and ICDS schemes. For instance, the Naandi Foundation provides hot, fortified meals in Andhra Pradesh, Madhya Pradesh and Rajasthan. Throughout West Bengal the kichri served in the ICDS is fortified. Opponents to a fortification strategy, including a key adviser to the Central government on child welfare, like to make the point that the best source of micronutrients is fresh food, such as lime and amla: so why add artificial micronutrients to hot cooked meals? The argument is simplistic.
Since the poor do not have the luxury of the best option, should they be denied access to a viable alternative?
Those who obstruct a well thought out fortification strategy are similarly intolerant of supplying complementary food for infants over six month in the ICDS. Promoters of breast-feeding practices view any suggestion to provide complementary food for infants as a conspiracy at the behest of multinational infant formula manufacturers. In actuality, most infant complementary food provided in the ICDS is manufactured by state-run public sector bodies and not private corporations or contractors. In their well-meaning zeal to promote breast feeding, these NGOs callously ignore the rights of over 50 per cent of Indian babies who are not fortunate enough to be breastfed and are being denied appropriate nutrition to compensate.