A micronutrient deficit

In her address to Parliament in June, President Pratibha Patil spoke of the enactment of a new law, the National Food Security Act. She said: “Every family below the poverty line in rural as well as urban areas will be entitled, by law, to 25kg of rice or wheat per month at Rs3 per kg.” Given that at least 440 million people in India still live on less than $1 a day, food security is a very important concern. Even more pressing, though, is nutritional security since that impacts our future, our children.
India has the unusual advantage of being one of the youngest countries in the world. In 2000, one-third of our population was under the age of 15 years and by 2020, the average Indian will be only 29 years old. This unique age structure provides us with a demographic dividend that distinguished scholars David Bloom and David Canning argue is conducive to economic growth. However, it will serve us well to remember Bloom and Canning’s caution that “both empirically and theoretically there is nothing automatic about the link from demographic change to economic growth. Age distribution changes merely create the potential for economic growth. Whether or not this potential is captured depends on the policy environment”.
Unfortunately, our policy environment in the area of child health is seriously lacking the initiative necessary to ensure that our children grow in a nutritionally sufficient environment. In children, maximal development of cognitive, social, emotional, physical/motor skills takes place during the years 0-6, and a lack of sufficient nutrition during these years can seriously impact basic skills. Impaired skills in childhood can stunt physical and mental development permanently, making for a young person who is unable to study and work at his or her best capacity. Insufficient nutrition is a combination of a macronutrient and a micronutrient deficit in the diet. Conceptually, the first refers to the total calories or more specifically the carbohydrates, fats and protein in the diet, while the second refers to the essential vitamins and minerals such as vitamin A, zinc and iron. Deficiencies in both can permanently stunt the height, brain development and immune functioning.
We have seen success stories in our battle against malnutrition when the government has shown a commitment to change. One such case is the Marathwada Initiative, launched in March 2002, in eight districts of Aurangabad division. The programme was implemented after 14 children under the age of 6 died from malnutrition in 2000-01 in the village of Bhadhali of Aurangabad district. The anti-malnourishment campaign relied on the infrastructure of the existing Integrated Child Development Services (ICDS) scheme and worked on training and motivating the staff on a regular basis. In just two years, the initiative resulted in the number of children with severe malnutrition going down by 62%. This showed that with no additional budgetary support or no additional staff recruitment by the government, significant change was possible. So the existing government framework can make a difference when local workable solutions are employed and the staff is trained and motivated.
The Copenhagen Consensus 2008, a list of solutions for global challenges created by a panel of leading international economists including five Nobel laureates, identified alleviating micronutrient malnutrition in developing countries as the best development investment. And according to the India Micronutrient National Investment Plan (IMNIP) for 2007-11, an additional investment of just Rs5.40 per capita per year can make the difference. Meanwhile, if we sit back and do nothing, the cost to our gross domestic product from micronutrient deficiencies will be Rs284 per capita, or 50 times more. So a combination of judicious government spending on micronutrient malnutrition while using the existing government framework as a platform could be the answer to removing malnutrition, a public health issue, and a serious threat to our nation’s future.
Sujata Kelkar Shetty was a postdoctoral fellow at the National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA. Comment at otherviews@livemint.com