India: No bread, lots of beer

Hindustan Times, April 30, 2013

Prime Minister Manmohan Singh has aptly described the persistence of mass undernutrition in India as a “national shame†. What is even more shameful, however, is the passivity of the government — and of the country — towards this humanitarian emergency. The passivity begins with a reluctance to face the facts. The first step towards more effective nutrition policies in India is regular monitoring of the nutrition status of the population, and particularly that of children.

However, no comprehensive nutrition survey has taken place in India since 2005-6, when the third National Family Health Survey (NFHS-3) was conducted. The findings of NFHS-3, including the absence of any significant progress since NFHS-2, conducted seven years earlier, were truly alarming.

Reaction? Discontinue the surveys! It is only under public pressure that plans for a follow-up survey were made, and the results of NFHS-4 are not expected to be available until 2015 at the earliest — a full 10 years after the NFHS-3 wake-up call.

Meanwhile, India’s much poorer neighbours — Bangladesh and Nepal — are conducting regular health and nutrition surveys, and keeping much better track of the state of their children.

In both countries, there is evidence of sustained improvement in nutrition-related indicators, such as the heights and weights of children, or the body mass index of adults. Similar evidence is yet to emerge in India.

The contrast with Bangladesh is particularly helpful in bringing out India’s resounding failure to implement simple public health measures that can have a major impact on the nutrition of children.

Just to cite a few statistics (from NFHS-3 and its equivalent in Bangladesh), 82% of children in Bangladesh are fully immunised, 88% get vitamin A supplements, 89% are breastfed within an hour of birth, and 85% are treated with oral rehydration therapy when they have diarrhoea.

The corresponding figures for Indian children are below 50% in each case, and as low as 25% for vitamin A supplementation. Similarly, the proportion of the population practising open defecation (a major cause of undernutrition and ill-health) is around half in India, but less than 10% in Bangladesh.

The National Food Security Bill is an opportunity to shed this long-standing apathy towards the nutrition emergency in India. The Bill has some serious shortcomings and is, at best, a fraction of what needs to be done. And yet, with suitable amendments, it could make a big difference.

Potential contributions of the Bill include an improved framework for the Public Distribution System, permanent legal entitlements to nutritious food for all Indian children, and — last but not least — the principle of universal maternity entitlements.

The actual impact of the Bill is likely to depend a great deal on how it is implemented on the ground, but nevertheless, an improved Bill would be a valuable foothold for practical change.

It is, thus, very important for proposed amendments of the Bill to be tabled and debated in Parliament as soon as possible.
The government’s priorities, however, seem to lie elsewhere. The food ministry, for one, seems to be doing its best to ensure that the Bill does not see the light of day.

The food minister has been making countless announcements in the last few months about the imminent tabling of a revised Bill in Parliament. Yet he never quite seems to be able to get his act together, so to speak.

In the last week of the first part of the Budget Session, the government had a real opportunity to move ahead as the Parliament was, for once, functioning — at least part time. But the food ministry, for mysterious reasons, decided not to table the revised Bill until the last day of the session, and due to disruptions that day (related to the country’s policy on Sri Lanka), even that did not happen.

As Parliament reconvenes for the second part of the budget session, the food Bill seems to be off the radar. The attitude of opposition parties is not particularly helpful either.

They claim to be supporting the Bill, but they are not willing to suspend their disruptive histrionics even for an hour so that the revised Bill can at least be tabled in Parliament.

In between the tantrums, our honourable members of Parliament continue to enjoy highly subsidised food at the Lok Sabha canteen, no doubt intensifying the other side of the country’s “double burden of malnutrition†— obesity. Earlier this week, some of us tried to raise these issues with Members of Parliament.

We went from door to door in their fancy residential quarters, but found that most of them were out of town. Perhaps they were having a holiday while their colleagues disrupted Parliament on their behalf, until it is their turn.

Meanwhile, food stocks continue to accumulate beyond reason. As the rabi harvest begins, the godowns of the Food Corporation of India are already bursting at the seams.

Food stocks are expected to reach an unprecedented 90 million tonnes or so by early July, much of it stored in primitive conditions or just lying in the open.

The government is desperately looking for ‘economical’ ways of disposing of the excess stocks: subsidised exports, open market sales, liquor manufacturing — anything but distribution to the poor. If they don’t have bread, let them drink beer?

Jean Drèze is visiting professor, Department of Economics, Allahabad University