Sunil Sethi: Round the mulberry bush

AL FRESCO

Among the many matters of import that the Cabinet meets to thrash out in the national interest, this week it has once again been going round and round an old mulberry bush: what should little children be fed if the country is to stave off the blight, and the glaring international shame, of 46 per cent of its child population suffering from malnutrition in the age group of 0-5 years? On Thursday the Prime Minister approved doubling the outlay on supplementary nutrition, and an additional Rs 44,000 crore that will improve the lot of 16 crore children.

But members of the Cabinet fell about debating a well-worn issue: are hot cooked meals better than ready-to-eat meals, fortified with Vitamin A, iron and zinc, lack of which in pregnant mothers’ and infants’ diets is the chief cause of the hidden hunger that stalks the land? As with many other current debates—Mamata Banerjee versus Ratan Tata or Naresh Goyal versus Praful Patel—the rival arguments are presented as a clash of personalities, with the Planning Commission’s Montek Singh Ahluwalia favouring hot cooked meals and Women and Child Development Minister Renuka Chowdhury pushing food fortified with micronutrients. Several specious, and some facetious, strains have crept into the arguments, including the suggestion by one Planning Commission member that a bit of fresh food, like lime and amla, would do the trick.

But do the poor have the luxury of choosing the best option? If desperately-underfed mothers and their infants in Madhya Pradesh, Jharkhand and Bihar had access to fresh bananas and khichri everyday, why would programmes like the Integrated Children Development Scheme (ICDS), more than a quarter of a century old, be such a sensational failure in the poorest parts of the country? Why would malnutrition rates decline by a mere 1 per cent in the past five years in India as opposed to Bangladesh where they have fallen by 6 per cent in the same period?

Proponents of the two kinds of meal schemes overlook the simple fact that one type of food does not preclude the other: freshly cooked food fortified with micronutrients will do just fine, as has been demonstrated in several states; throughout West Bengal, for instance, the khichri served by ICDS is fortified. Yet the debate has got derailed on several grounds: the issue isn’t about types of food but about maternal and child health. Undernourished expectant mothers produce undernourished children; if the child is poorly fed till three, it will be physically and mentally stunted for life. Nearly a million children die each year from malnutrition but, curiously, the emphasis on adequate nutrition for mothers has been overshadowed in the hot vs fortified meals debate. Also caught in the quagmire are systems of food distribution: Can village panchayats ensure clear supply lines of balanced and hygienically prepared cooked meals? Or does the supply of fortified meals mean undue central control? There are examples of both systems being susceptible to misuse.

Equally curious is the fact that policymakers have detailed data of the worst-affected states, districts and village blocks before them, just the click of a mouse away. There are studies by NGOs, international agencies and state governments to show which schemes have worked best, where and why, and which are the darkest areas of disaster.

At a conference in Copenhagen this year, a panel of eight economists, including five Nobel Prize winners and the Indian-born Jagdish Bhagwati, were asked to study ten challenges that faced the world. The question posed was: What would be best way of advancing global welfare with an additional $75 billion spent over the next four years in the developing world? The experts concluded that the money would be best spent on providing micronutrient supplements for children to banish the spectre of malnutrition.

India, tragically, has no tangible answer nor targeted time frame, despite pouring in thousands of crores into schemes that go nowhere. It is going round and round the mulberry bush…