Four things to end the silent crisis of malnutrition
About 60 million of India's young children - 40 per cent - will not reach their full potential because of malnutrition. Some will die before their fifth birthday. The rest will learn less in school and earn less in the job market. This is due to a toxic mix of poor feeding, inadequate health care, dirty water, and a lack of proper sanitation. Although interventions capable of reducing these numbers exist, unfortunately, their coverage is very patchy.
Malnutrition is a silent crisis. While the absence of glaringly obvious implications makes it a silent phenomenon, the sheer number of children affected by this condition has turned this into a crisis situation.
We have often been asked by policy makers, "What are the top three or four things to do to end malnutrition?"
Here is my answer:
#1. Develop a strategy: Not just a document that looks nice and is left on the shelf, but one that is thumbed through, dirtied with grimy fingerprints, written on, passed around, and updated on a regular basis. Nutrition improvement requires all sections of the society to be pulled together - and this needs a concrete plan of action.
#2. Commit to time-bound action: We need authorities and other non-governmental agencies to publicly commit to improving nutrition by a certain amount within a certain time frame. Make it uncomfortable to renege on this commitment. Collect data on nutrition outcomes and the coverage of nutrition programmes and publish this rapidly for the purpose of effective decision making and policy formulation.
#3. Empower people to be nutrition champions: Appoint people whose sole responsibility is to implement this strategy and deliver on the promise. Give them the authority to make different government departments work together. Embed such forces in the centre of economic policymaking.
#4. Build awareness: Be a champion for nutrition. Educate economists as to why this is important. Support and reward states that are doing great things in nutrition and others who want to make a difference. Be a leader in Asia and inspire the world in this fight against malnutrition. Let us talk of the "Indian nutrition miracle" in ten years' time.
Wouldn't I recommend breastfeeding, or vitamin A supplementation or improving agricultural productivity or reducing open defecation? All of these things (and more) are important. But each context needs a different emphasis. Besides this, it is important to note that the sequence of these depends on the nature of the nutrition problem, existing capacity, and political opportunities in a particular place.
The Global Nutrition Report (http://www.globalnutritionreport.org), launched in Delhi today, jointly by the Coalition for Food and Nutrition Security and IFPRI [International Food Policy Research Institute], estimates that for every rupee spent on scaling up nutrition interventions, 34 rupees are generated in terms of higher income. That is a phenomenal rate of return - much better than that achieved by any stock market the world over. Over 40,000 babies are born every day in India. Not investing enough in reducing malnutrition is like building 40,000 roads every day and letting 40 per cent of them crack, crumble, and subside. Economists would regard this as gross economic inefficiency.
Children have the right to good nutrition. Morally this is right. Economically it is vital.