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A very hungry nation
All that talk about growth and high-table membership means little to India's huge population of malnourished children and anaemic women.
Independent India's greatest failing must be its inability to feed its people. With 42 per cent of all children malnourished, 56 per cent of women anaemic, and the country ranked 65th out of 84 countries on the Global Hunger Index, the report card of the state on nutrition must have an F.
Most disturbing is the fact that things have got worse over time. In the first half of the last decade, the number of undernourished persons in India decreased by around 13 million, but the second half witnessed a reversal with the number of undernourished increasing substantially, according to the M S Swaminathan Research Foundation's 2008 report on the 'State of Food Insecurity in Rural India'. The report says, "This turn of events has occurred due to several factors such as fall in food grain output, increasing levels of unemployment, the impact of deflationary macroeconomic policies on the agricultural and rural economy and the influence these factors have had in decreasing the purchasing power of the poor in India."
Nutrition, according to Swaminathan, is the availability of food in the market, adequate purchasing power to access it, and the power of the body to absorb the food. Availability of food begins with agricultural productivity, which has come down with declining state investment. As a result, the per capita daily availability of cereals in India has declined to its 1957 levels, as a look at the provisional figures for 2008 in the 2009-10 Economic Survey shows. The daily availability of cereals per capita has dropped to its 1973 level. The limited gains of the Green Revolution appear to have been wiped out.
Foodgrain reaches the poor through a network of subsidised grain outlets, the Public Distribution System (PDS), which moved to a "targeted" system in 1997. The government's expenditure on food subsidies as a percentage of GDP, too, declined before rising again.
To be eligible for subsidised foodgrain and kerosene, a household must qualify as "Antyodaya" (poorest of the poor), Below Poverty Line (BPL) or Above Poverty Line (APL) according to income criteria set by state governments. The size of the subsidy decreases from Antyodaya to APL. And while Antyodaya and BPL families have a fixed entitlement, APL families do not. Two other major nutritionrelated schemes are the Integrated Child Development Services and the Mid Day Meal Scheme, both major advances on nutritional policy of the past, but seriously hamstrung by staff shortages. The ICDS is still a significant distance from being universal: the National Family Health Survey III (2005-6 ) notes that while 72 per cent of the sample was covered by anganwadis, only one in four had received supplementary food from them.
The reach of the PDS varies from state to state. While Tamil Nadu is the only state with a universal PDS, Kerala has a well-functioning system and Chhattisgarh has recently reformed and thus expanded its coverage.
In most of India, the PDS is isn't working well. In its 2005 'Performance Evaluation of the Targeted PDS' report, the Planning Commission noted: "The implementation of TPDS is plagued by targeting errors, prevalence of ghost cards and unidentified households", "only about 57 per cent of BPL households are covered by it" and "only about 42 per cent of subsidised grains issued from the Central Pool reaches the target".
Such widespread exclusion and misdirection has led to calls for disbanding the PDS. The latest Economic Survey suggested that the PDS system be disbanded and the state move towards a food coupon system, leaving the poor to buy directly from the market.
However, simultaneously, the UPA is working towards a National Food Security Act, following from the promise made by President Pratibha Patil in her first speech after UPA 2's return to power. Meanwhile, UPA chairperson Sonia Gandhi's reconstituted National Advisory Council is recommending that a universal PDS be first rolled out in India's 150 poorest districts and then in the rest of the country, with an entitlement of 35 kg of foodgrain per household per month at Rs 3 per kg. Simultaneously, an ongoing PIL being heard in the Supreme Court (PUCL Rajasthan vs Union of India and others ) is pushing for the right to food to be recognised as a fundamental right.
Nobel prize-winning economist Amartya Sen has said access to resources was restricted by "earning handicaps" and "conversion handicaps". In the case of nutrition, earning handicaps for the poor arise from the lower educational levels and limited employment opportunities. In addition, caste, physical disabilities, geographical distance and illiteracy may all work as factors handicapping them from converting their income into nutrition.
A combination of the two "handicaps" has meant that food consumption in India has been steadily declining. According to the 61st round of the National Sample Survey, the average daily intake of calories has dropped from 2, 153 kcal to 2, 047 kcal from 1993-94 to 2004-05 for rural India, and from 2, 071 to 2, 020 kcal in urban areas.
Finally, there's the need for clean drinking water and adequate sanitation to ensure nutrition is absorbed into the body. Over half of India is still forced to defecate in the open, according to WHO and Unicef's 2010 report. However, India has made significant progress towards expanding access to safe drinking water, and 88 per cent of India gets water from "improved" sources, says the report.
On paper, the state seems not to have withdrawn from its role in ensuring people have access to enough nutrition, but by allowing its schemes to be overrun by misdirection and corruption, excluding the most needy, it has allowed the chorus calling for the government to give up on nutrition to swell. The NAC and the Economic Survey are clearly speaking in two different voices. "The Economic Survey is a wishlist drafted by technocrats, while the NAC's mandate comes from the leader of the party that got the maximum votes, and civil society activists who work on the ground, and any suggestions by the NAC will be debated by the country's Parliament, " insists an NAC member who did not wish to be named. But whose will be done? Wait and watch.
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