A country with strong aspirations to lead global economic growth cannot possibly achieve and sustain that if it loses 2-3% of its GDP to lower productivity, which is the long-term fallout of malnutrition.
A country in which 50% of its 113 million adolescent girls are anaemic cannot escape the fact that one child out of every three is underweight at birth (less than 2.5 kg), and most likely grows up to be stunted or wasted. A country where 42% of children under age 5 are malnourished cannot possibly convert its demographics into a social economic dividend or competitive advantage. A country where 285 million people sleep hungry every night cannot possibly create a productive and efficient workforce.
The country I am talking about is India, and we cannot hope to achieve enduring economic growth if the key indicators of human development – education, healthcare, nutrition, hygiene and sanitation – are not accessible to all, and improved to certain minimum acceptable standards.
The significance of addressing nutrition, in addition to assuaging hunger has emanated from several forums globally. In India, despite our poor indicators there is no determined and concerted effort to address the issue systemically. Based on the realisation that several countries in the world will not reach their MDGs without additional intervention, the SUN (Scaling up Nutrition) movement was created by the UN which currently has over 50 countries that are seriously pursuing multi-faceted nutrition specific and nutrition sensitive initiatives.
The path breaking work published in The Lancet in 2008, established the enduring and irreversible link between nutrition in the first 1000 days (from conception to 2nd birthday) and the physical growth and cognitive development of an individual. This was followed in 2013 by a deeper understanding and insights on nutrition which put the spotlight on adolescent girls. The 2011 Copenhagen Consensus isolated nutrition as the #1 issue to be tackled to generate the highest return on every dollar invested in it.
Several of these areas are gaining saliency, at least in conversation and hopefully in action on the ground as well – such as the Swachh Bharat program, which has the potential to directly impact the health and nutritional status of the country as a whole.
Further, the intergenerational cycle of poor health and nutrition is worsened by societal norms and conditions that discriminate against the girl child. If she is born underweight, she grows up to be an undernourished adolescent, is often married before age 18, experiences multiple pregnancies by the time she is 25, and is not healthy enough to produce healthy children or realise her own potential.
Only healthy mothers can produce a healthy nation, and so attention to nutrition for adolescent girls is of paramount importance. The need for good nutrition is based as much on good human development as it is on good economics.
The challenge of nutrition is multi-faceted, therefore the solution set needs to be multi-input as well. It needs initiatives that are both, nutrition-specific (adequate and correct calories, large-scale food fortification, deworming, etc.,) and nutrition-sensitive (potable drinking water, hygiene, sanitation, societal attitudes and norms etc).
In India, we need swift action in at least three areas:
Effectively addressing these three areas would need the coming together of government, civil society, non-profits and business – the last two play a critical role in deploying pilots to get proof-ofconcept, while the government plays the most critical role: scaling up concepts that work.
As an illustration, food companies can and must make a significant contribution through micronutrient fortification, which is a tried and trusted intervention, with the government mandating largescale fortification as part of our broad food standards. Similarly, healthcare companies must partner with the government to improve and standardize healthcare practices at primary health centers. Our final responsibility is to ensure effective running of the models we have in place – such as ICDS and midday meals, which reach 120 million children in primary schools.
However, the most difficult and fundamental shift will only occur when we foster a society that values gender equality, which in turn will ensure that girls are respected and cared for, so they can realise their potential. This involves changing deep-seated beliefs and mindsets, and a comprehensive approach that educates and informs just as it penalises undesirable behaviours.
Right now, it is critical that we take the responsibility, as individuals and corporates, to focus not just on economic indicators but human indicators as well. The voice of undernourished adolescent girls must be heard by those with the resources to make those lives valued and worth living.
I am grateful to Dasra for putting the limelight where it matters most, and for being a catalyst for positive action.