A study recently conducted by the Naandi Foundation
in India has found that 42 per cent of children under
five years of age were severely or moderately underweight
because of inadequate access to nutrition. The study
was based on a survey of the height and weight of
more than one lakh children across six states of the
country. To restate its central result: more than
two in every five children below five years of age
in this country do not get even the basic minimum
nutrition to survive or develop normally.
Releasing the report, the Prime Minister declared
this this was a ''national shame''. Nobody can disagree.
Child undernutrition of this magnitude after close
to 65 years of independent national development is
indeed a shame. And what is even more shameful is
that in the period over the last twenty years, when
India was reportedly ''shining'' because GDP growth
had risen significantly, this failure could not be
adequately addressed. Income growth accelerated, but
the decline in the level of malnutrition was unsatisfyingly
slow. That evidence has also forced the PM to recognise
that despite impressive growth in national product
in recent years, the level of malnutrition in the
country had remained unacceptably high.
Given the obsession with GDP growth of the UPA government,
this recognition that growth does not deliver even
basic nutrition is indeed positive. But for those
who have been observing the path of development India
has pursued, especially since the 1990s, such evidence
is by no means surprising. The evidence is common
knowledge, as are the policies that can help address
the problem.
There are many tendencies involved here that need
to be separated to correctly understand the predicament
the country faces. The first is of course the fundamental
problem that capitalist accumulation driven by the
search for profit never distributes justly the fruits
of whatever growth it delivers. The rich grow richer
but the poor tend to either lose out or gain only
marginally from the additions to national income.
Widespread malnutrition despite growth is one of the
consequences. That tendency is exaggerated when the
capitalism that we speak of emerges and develops in
an environment where social and structural backwardness
persists. Hence, rapid advances in human development,
be it in terms of reduction in poverty, elimination
of hunger and malnutrition or lessening of social
deprivation, are never seen.
Thus, it is not surprising to see that improvements
in social indicators and reduction in malnutrition
are not directly associated with GDP growth or the
level of GDP. Within India, for example, Sikkim reported
the lowest rates of child malnutrition, while richer
Madhya Pradesh had the highest. And, according to
one source, the percentage of under weight children
in Gujarat, one of India's richest and fast growing
state, marginally increased between 2001 and 2006
to touch as much as 47 per cent.
Similarly, for a range of reasons, there are substantial
differences in the improvement in social indicators
across countries. 28 out of 37 countries in poor Sub-Saharan
Africa have lower levels of per capita income than
India. Yet they are characterised by lower levels
of child malnutrition than India. The failure in India
to implement land reform and reduce asset concentration,
combined with the pernicious effects of caste-based
exclusion, has resulted in forms of extreme inequality
that ensure that large numbers remain nutritionally
deprived even as India's income grows.
The problem is not confined to children. As economist
A.K. Shiv Kumar notes: ''Birth weights of less than
2,500 grams are very closely associated with poor
growth not just in infancy but throughout childhood.
Estimates for India reveal that 20-30 per cent of
all babies are born with low birth weight, suggesting
that children begin to get malnourished in the womb.''
Malnutrition is being transferred from mother to child
as well.
Given such tendencies under capitalism, it has been
long accepted that governments in capitalist societies
must intervene to directly address malnutrition for
the social good. Well-fed and healthy children grow
over time into a healthy and productive workforce,
which contributes to national prosperity if they can
find jobs. Evidence shows that government action aimed
at reaching food to the poor, can substantially affect
the level of malnutrition, resulting in the observed
lack of correspondence between income levels and the
level of malnutrition across states and countries.
Such action would ensure access to food at affordable
prices as well as put purchasing power in the hands
those who are currently deprived of the ability to
buy food. What is best is a combination of: (i) a
universally accessible public distribution system
providing essential items at subsidised prices; and
(ii) a public works programme that ensures adequate
employment at a reasonable minimum wage for those
not absorbed by the capitalist growth trajectory.
On the surface, the UPA government appears on track
to meet these, having enacted the National Rural Employment
Guarantee Act and poised to enact the Food Security
Bill. But in practice, both in terms of the content
of the bills and in terms of implementation on the
ground, there is much to be desired. The NREGA is
handicapped by a poor wage structure that falls short
of even the minimum wage mandated in most states,
as well as by inadequate allocations and spending.
And the yet to be enacted Food Security Bill has been
so diluted that it is likely to exclude a substantial
section of the needy whose failure to access adequate
food is responsible for the 42 per cent malnutrition
among children.
The reason for this inadequacy in government action
is of course liberalisation and ''economic reform''.
Having provided huge direct and indirect tax concessions
to the rich as part of an effort to encourage and
promote private savings and investments, governments
at both the centre and in the states are strapped
for funds. In addition, all of them have been tied
down by the philosophy of liberalisation which opposes
deficit spending financed by borrowing. So either
deficits are consciously sought to be reduced (as
in the centre) or are kept down by law as in the states.
If tax revenues are not growing adequately and governments
cannot borrow, spending must be curbed. Experience
shows that when expenditures have to be trimmed, it
is capital expenditures and expenditures on social
security that are axed. One obvious casualty is spending
on schemes aimed at ensuring food security and rural
employment. In sum, by engineering a fiscal crunch
liberalisation militates against government policies
aimed at countering the adverse effects of capitalist
growth on hunger and nutrition. Growth benefits the
richest few per cent at the top, while leaving untouched
or even marginalising the majority.
But that is not all. The other casualty has been a
scheme specifically designed, among other things,
to reduce malnutrition among children. This is the
Integrated Child Development Scheme, or ICDS, which
was initiated in October 1975 in response to the evident
problems of persistent hunger and malnutrition especially
among children. Among the objectives of the scheme
is that of improving the nutritional and health status
of children in the age group 0-6 years. Since its
inception, the ICDS has grown to become the world's
largest early child development programme. The coverage
of the Scheme has expanded rapidly, especially in
recent years. Nevertheless, as is clear from the child
malnutrition figures quoted earlier, for a scheme
that has been in operation for three and a half decades,
the benefits are still far too limited.
The basic reason is that not enough resources have
been devoted to this scheme, to meet the huge requirement.
Quite simply, there are not enough anganwadis or anganwadi
workers to manage the scheme, and they do not have
adequate resources to meet all the nutritional requirements
of those pregnant and lactating mothers, infants and
small children who need them. The ICDS has been operating
on the underpaid labour of women in an undesirable
and unsustainable fashion. While small increases in
wages have been made, it still leaves them receiving
less than minimum wages! Further, the Supreme Court
has repeatedly instructed the government to make the
scheme universal to all habitations, but the small
or negligible increase in budgetary allocations to
the ICDS ensures that this will not happen in the
near future.
Put simply capitalist growth of the worst variety
fostered by neoliberalism and the consequent refusal
of the government to directly address the problem
explains the cause for ''national shame'' that the PM
speaks of. But even if he is finally reading and recognizing
the truth that has been staring everybody in the face,
he is unlikely to do very much about it. Given his
conviction, he would, of course, do little about looking
for alternatives to capitalism. What is more, those
same convictions would work against reversing the
neoliberal trajectory he has put the country on since
1991. In the event, he would find it impossible to
put even the shadow of a human face on India's inequalising
growth. The country, therefore, would have to live
in shame … till the UPA and similar governments are
replaced by one committed to a more people-centred
development trajectory.
