Countries are scored by the GHI between zero and 100, with India scoring 30.3 – worse than the score for the South Asia region as a whole, which the GHI puts at 29.3. India fares poorly compared to many of its south Asian neighbours, falling behind Sri Lanka (ranked 66th); Nepal (ranked 73rd); Bangladesh (ranked 88th); and Pakistan (ranked 94th). Per the rankings, India has a ‘serious’ degree of hunger based on its score.
“Because of its large population, India’s GHI indicator values have an outsized impact on the indicator values for the region,” the report notes. Concerning hunger indicators, “India’s child wasting rate is extremely high at 20.8 percent—the highest wasting rate of any country in this report for which data or estimates were available. Its child stunting rate, 37.9 percent, is also categorized as very high in terms of its public health significant…in India, just 9.6 percent of all children between 6 and 23 months of age are fed a minimum acceptable diet.” In the 2016-18 period, 14.5 percent of India’s population were undernourished.
The report also highlights poor sanitation, with 39 percent of Indian households lacking access to sanitation services. The Modi government’s Swachh Bharat Abhiyan, which marked its fifth anniversary at the beginning of this month, is mentioned in the report as a programme towards improving sanitation indicators for the nation such as reducing rates of open defecation.
As previously reported by Health Issues India, under Swachh Bharat, “100,753,274 household toilets have been built. 699 of India’s 731 districts are open-defecation free, covering 599,963 open-defecation free villages. 35 states and union territories are open-defecation free.” However, the label of open-defecation free does not mean that the practice is eradicated entirely. As the report notes, “even with new latrine construction, however, open defecation is still practiced. This situation jeopardizes the population’s health and consequently children’s growth and development as their ability to absorb nutrients is compromised.”
“Nutritional status is compromised where people are exposed to high levels of infection due to unsafe and insufficient water supply and inadequate sanitation,” notes the World Health Organization (WHO). “In secondary malnutrition, people suffering from diarrhoea will not benefit fully from food because frequent stools prevents adequate absorption of nutrients. Moreover, those who are already experiencing protein-energy malnutrition are more susceptible to, and less able to recover from, infectious diseases.”
In the case of diarrhoea, the condition is the biggest killer of children under five worldwide and the second most common cause of infectious disease outbreaks in India. Steps such as proper handwashing practices and vaccination against conditions which cause diarrhoea such as rotavirus can alleviate rates of the condition and improve the nutritional status of India’s children.
However, it cannot go overlooked that improving sanitation will comprise a major tenet of efforts to tackle malnutrition. While the Government has made significant progress, there is more to be done. Ensuring adequate water supply to homes and latrines, enforcement of sanitation protocols in facilities such as hospitals and schools, behavioural change efforts to end open defecation among practitioners, and improving waste management in the country are among the steps needed to effect broader improvements to India’s sanitation indicators and, consequently, its nutritional status.
Another major issue flagged by the report is climate change. “Since the early 1990s, the number of extreme weather-related disasters has doubled, reducing the yields of major crops and contributing to food price hikes and income losses,” the report reads. “These disasters have disproportionately harmed low-income people and their access to food. Looking ahead, climate models project higher average temperatures in most land and ocean regions, hot extremes in most inhabited regions, and heavy precipitation and an increasing probability of drought in some areas—all additional challenges for reducing hunger.
“Ending hunger and undernutrition in a changing climate demands large-scale action to address the inequities exacerbated by climate change while minimizing environmental changes that could prove catastrophic to human life. It requires us to better prepare for and respond to disasters, support resilience and adaptation among the most vulnerable groups and regions, address global inequalities, mitigate climate change without compromising food and nutrition security, make financing for climate action fair and effective, and radically transform food systems.”
India’s climate woes are projected to worsen in the coming years, with increasingly inclement weather events including heatwaves, droughts, flooding, and erratic monsoon rains, among others. “Climate change affects social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter,” the WHO said earlier this year as it urged nations to act on the health effects of climate change. UN Secretary-General Antonio Guterres has warned of seven million deaths due to climate change without action.
“Climate justice is a transformative concept,” wrote Mary Robinson, the Adjunct Professor of Climate Justice at Trinity College Dublin and former UN High Commissioner for Human Rights, in a linked Comment with the report. “It insists on a shift from a discourse on greenhouse gases and melting icecaps into a civil rights movement with the people and communities most vulnerable to climate impacts at its heart. It gives us a practical, grounded avenue through which our outrage can be channeled into action. Ensuring access to nutritious food is central to this pursuit of climate justice.”
Prime Minister Narendra Modi has affirmed India’s commitment to tackling climate change, pledging to Guterres that his government will act and emphasising the importance of transitioning to renewable, clean energy infrastructure. The connection between climate change and malnutrition is fresh impetus for the country to honour these commitments.
India has much to lose to malnourishment. Two-thirds of child deaths in India can be attributed to malnutrition. The country loses US$46 billion to malnourishment. While the country has witnessed reductions in its number of malnourished people in recent years, it is clear that malnutrition still incurs a significant toll. Without concerted, targeted action, taking the findings of reports such as the GHI into account, its toll on the development indicators of the country will only get worse.
“It will take humanity’s ingenuity, dedication, and perseverance to ensure that we collectively achieve Zero Hunger while tackling the unprecedented challenge of climate change,” the report concludes. Going forward, will India exhibit the ingenuity, dedication, and perseverance the GHI demands?
The Global Hunger Index can be accessed here.