India needs to be careful when it comes to agriculture-based nutrition as it opens the door for advocacy for transgenic food, said Jairam Ramesh, Union rural development minister, at the launch of the Lancet Series on Maternal and Child Nutrition. Ramesh was the chief guest at the programme on June 28 organised by The Lancet, one of the most prominent medical journals in the world. The Lancet series launched during the programme has mentioned agriculture, among other methods, as an intervention to tackle malnutrition.
Malnutrition not receding
Ramesh said that India has been through discussions related to GM food (for example, BT brinjal) and had found challenges on various fronts, including safety, toxicity and seed supply. He described malnutrition as a puzzle because it was not abating in spite of rapid growth and the other better health indicators that emerged in the process. Better indicators like education, water supply do not seem reflected in malnutrition, he said. The country has nutrition-specific intervention but does not have nutrition-sensitive intervention, which is required to deal with the challenges of malnutrition, he added.
The 2013 Lancet series outlines ten key nutrition-specific interventions. It claims that if these are scaled up to 90 per cent in 34 high nutrition-burden countries (including India), they could reduce the global prevalence of stunting and wasting by 20 per cent and 60 per cent respectively. These ten interventions include multiple micronutrient supplementation during pregnancy, calcium supplement to mothers at risk of low intake, maternal balanced energy protein supplementation as needed, universal salt iodisation, vitamin A and zinc supplementation for children, promotion of breastfeeding and complementary feeding, management of moderate and severe malnutrition.
Concerns over bias towards industry
Public health experts in the country have raised concerns about the fact that recommendations are biased towards industry profits. They say that the authors have conflict of interest especially as some of them have links with the powerful food industry.
Ramesh shared their concerns, and mentioned the two schemes that work to tackle malnutrition in India. He said that 93 million children have been targeted under Integrated Child Development Services (ICDS). Apart from this, 100 million children are being fed through the mid day meal programme.
The minister also added that people should not only look to binary solutions, like public and private programmes. There is another aspect, the community, which can play a significant role in the scene. He mentioned an example of Andhra Pradesh where self help groups (SHGs) are playing a significant role in the fight against malnutrition. These SHGs are providing home-made food to beneficiaries three times a day for a price of only Rs 10. The government gives them a grant of Rs 3 lakh, that too, only in the beginning. Scores of people have been benefitted from this, said Ramesh.
The programme had two sessions during which the Lancet series and its findings were discussed by Rajiv Tandon, coordinator of the Coalition for Sustainable Nutrition in India, Robert Black, chairperson, Department of Global Health, John Hopkins Bloomberg School of Public Health, Harold Alderman, senior research fellow, International Food Policy Research Institute (IFPRI), Venkatesh Mannar, president of Micronutrient Initative and Purnima Menon, senior research fellow, IFPRI. Other participants who discussed the malnutrition problem in India and the mitigation measures included K Srinath Reddy, president of Public Health Foundation of India (PHFI), Vandana Krishna, director general, Health and Nutrition Mission, Maharashtra government, Vinod Pal, head of department of paediatrics, All India Institute of Medical Sciences (AIIMS), and Shreeranjan, joint secretary, Union Ministry of Women and Child Development.
Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?
Maternal and child undernutrition and overweight in low-income and middle-income countries