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The great nutrition challenge

The challenge is that different forms of malnutrition — stunting, wasting, overweight, anaemia, low birth weight — exist in almost all populations.

Written by Purnima Menon , Lawrence Haddad |
Updated: October 13, 2015 12:03:48 am
malnutrition-759 Any problem that affects one in three individuals on this planet is a grand problem. It is hard to deny that.

The Global Hunger Index 2015 that was released on Monday as well as the Global Nutrition Report (GNR) 2015, which was released in September, present an updated set of findings on the state of malnutrition and hunger across the globe. The aims of both these reports are many, but perhaps the most important one is putting the critical data together on the scale of the global problem and helping nations see where they sit on this grand problem of malnutrition. And a grand problem it is. Any problem that affects one in three individuals on this planet is a grand problem. It is hard to deny that.

The challenge is that different forms of malnutrition — stunting, wasting, overweight, anaemia, low birth weight — exist in almost all populations.

Sadly, this is not a grand problem with insignificant consequences. Malnutrition affects men, women and children. Poor nutrition in early life, often invisible to most, shows up in the daily travails of adults in later life — lower work productivity, higher diabetes, greater risk of heart disease, high blood pressure. Nutrition also affects the wealth of nations; the costs of poor nutrition are numerous, but on a positive note, the returns to investment in nutrition
are impressive. For every rupee spent on effective nutrition programmes, Rs16 can come back through improved productivity in the labour force. Talk about impressive rates of return on investment.

Many things can be done to unblock this grand problem, including clear leadership, smarter and more financing, and diverse actions to attack the problem from many angles. But first, one must confront the problem. And this is what worries us most about India today: A potential denial of the problem, seen primarily in that findings from new nutrition surveys are not triggering commitments and action at the scale necessary. Notwithstanding a data drought since 2005-06, in the last one year, three new sets of nutrition surveys were released — the District-level Household Surveys (DLHS-4), covering some states; the Rapid Survey on Children (RSOC), covering the entire country and all states; the Annual Health Survey’s nutrition add-on survey, the Clinical, Anthropometric and Biochemical (CAB) assessment.

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As each new survey gives us a new set of numbers to wrap our heads around, there are still too few voices of leadership across India calling the nutrition problem out as something critical to keep an eye on, to not forget, to build accountability for.

In July 2014, the finance minister noted, in his budget speech, that a “Nutrition Mission” was necessary to tackle this problem. Despite an official announcement to initiate this from the ministry of women and child development in September 2014, there has since been no action. In fact, less than a month ago, the expenditure and finance committee rejected the ministry’s financial proposal for a nutrition mission. Despite the 2014 budget pronouncement, 2015 also brought drastic budgetary cuts for Central government spending on nutrition and health schemes. And the prime minister’s speech at the Global Call to Action Summit 2015, in late August, did not even mention nutrition.

Although examples of state-level leadership are emerging, we believe that national policy commitments and national target-setting are critical to clarifying and emphasising policy priorities. In the current national scenario, one is left feeling confused about policy intent on a challenge that affects so many.


What is needed now? The GNR has several “calls to action” for diverse actors in the global and national nutrition landscape. We think, for India, it is imperative to first focus on the one to “strengthen national accountability on nutrition targets”. Indian political and bureaucratic leadership must fully acknowledge the great nutrition challenge that lies ahead and urgently set national and state nutrition targets that line up with the World Health Assembly global targets. Once targets are set, dialogue must open up on smarter spending (are the right things being done with available budgets?); increased spending (is adequate financing available for nutrition?); and implementing cross-cutting actions (are we doing enough to address the various drivers of poor nutrition?).

But first, India needs to recognise the problem, and through that, move to a greater sense of accountability for the challenges that lie ahead.

The writers are senior research fellows at the International Food Policy Research Institute

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First published on: 13-10-2015 at 12:03:45 am
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