India’s food bill will not provide the security it claimsBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3194 (Published 08 May 2012) Cite this as: BMJ 2012;344:e3194
- Veena S Rao, adviser, Karnataka Nutrition Mission, Department of Health and Family Welfare, Government of Karnataka, Ananda Rao Circle, Bangalore 560009, India
The International Food Policy Research Institute terms India’s position in the global hunger index “alarming”—67th in 2011 compared with 65th in previous years, indicating worsening food and nutritional insecurity.1 This index measures hunger using three combined, equally weighted, indicators: the proportion of people who are calorie deficient, the proportion of people who are underweight, and the mortality rate among children under 5.
About a third of India’s adult population has low body mass index, suggesting they are calorie deficient; 43% of children below 5 are underweight and 48% stunted; and the under 5 mortality rate is 74 per 1000 live births (two fifths of which is directly related to malnutrition).2 As alarming are the 30% of babies born with low birth weight; the 47% of adolescent girls underweight3; and the prevalence of anaemia of 56%, 57%, and 75% in girls, women, and children, respectively.4
Successive governments in the past decade have promised food and nutritional security but could not reform the ailing governmental public distribution system, which provides subsidised grain to poor families—because of leakages and corruption it covers only 42% of the target group.5
In December 2011 the current government introduced the National Food Security Bill6—it does not meet expectations. The bill states that its purpose is “providing food and nutritional security through the life cycle approach.” The bill disregards accepted definitions of “food security”7 and “nutritional security.”8 It defines “food security” as “the supply of the entitled quantity of foodgrains” (7 kg of rice, wheat, or coarse grain a month) and meals provided under existing programmes—for example, snacks for children younger than 6 years, and school lunch programmes—and newly proposed meal programmes for destitute, homeless, and starving people. The universally accepted definition of food security by the Food and Agriculture Organization of the United Nations is “permanent access for all to food, nutritionally adapted in quantity and quality, and culturally acceptable, for a healthy and active life.”7 8 The bill subsumes existing food programmes but does not indicate any mechanisms for implementation. At best, the bill can be seen as a hunger or starvation prevention bill. Although 7 kg of grain a month can provide relief against chronic hunger or starvation, it cannot provide food or nutritional security. It translates into 234 g of grain a person a day (about 650 calories), without necessary protein, micronutrients, and vitamins, compared to an average recommended daily allowance of 2400 calories.
Despite its claim, the bill does not adopt a so called life cycle approach. It does not cover the nutritional needs of adolescent girls—a critical link in a life cycle approach. The new entitlement for pregnant and lactating women is welcome, but children out of school, the most vulnerable of adolescents, are left out.
Confusion persists about the nature of so called entitlements. In law “entitlement” means a benefit that can be gained or abridged with due process, whereas a “right” is fundamental. Section 3 feebly attempts to present the entitlement of 7 kg of grain a person as a right. Until the confusion is clarified, mechanisms for enforcement and redress remain unclear.
The bill’s greatest deficiency is its inability to define its target group, which is termed “priority and general households”; this responsibility is passed to state governments. The use of a force majeure clause in a piece of social legislation is unprecedented: it is precisely in times of war and natural disaster that such a bill must be implemented with even greater vigour. The bill unrealistically prescribes that starvation be monitored by state government systems, but in rural India chronic or seasonal starvation can only be tackled through surveillance and workers in the field.
It is a primary responsibility of government to prevent hunger and starvation, and providing free or subsidised food is a solution. In addition, food and nutritional security requires a conducive environment created through awareness and information initiatives in the community that educate about maintaining healthy diets and adequate nutrition within household budgets, about safe drinking water, and about hygienic sanitation. Private sector participation is also required to make low cost food available in the markets.
Even in its present form, the bill is a welcome initiative to tackle the chronic hunger and starvation that affect large parts of arid and tribal regions of India, provided that efficient delivery systems are created, which the bill does not explicitly cover. In no way can it be called a bill for food and nutrition security, however. This kind of security requires an innovative national strategy that covers all ages and contains essential interventions beyond those in the bill, including the nutritional care of adolescent girls and the provision of protein and micronutrients. And it must include mechanisms for delivery.
The bill has not yet become law and is generally opposed, even by those in the government. The Indian government must consult with the states, devise a strategy, reach consensus on cost sharing, establish quantifiable objectives, set responsibility and monitoring mechanisms, and show political will to achieve the objectives.
Cite this as: BMJ 2012;344:e3194
Competing interests: The author has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work.
Provenance and peer review: Not commissioned; not externally peer reviewed.