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Hunger: A global – and Indian – crisis

malnutrition 20948537 - poverty and hunger concept with a fork and knife on a broken asphalt road shaped as a dinner plate as a social problem of food shortage hardships caused by financial distress or natural disaster resulting in living poor on the streets as a health risk
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“There are people in the world so hungry, that God cannot appear to them except in the form of bread.” I used this quote from Mahatma Gandhi to preface an article published in 2017, focused on the crisis of hunger and malnutrition – one borne by India at virtually all levels of society and one borne globally. In the time since, the problem has far from retreated from view. 

This week, data was released in a United Nations (UN) report indicating that the lives of an estimated 8.9 percent of the world’s population are blighted by hunger – translating to almost 690 million people. This, the report said, is “up by ten million people in one year and by nearly sixty million in five years. The number of people affected by severe food insecurity, which is another measure that approximates hunger, shows a similar upward trend. In 2019, close to 750 million – or nearly one in ten people in the world – were exposed to severe levels of food insecurity.” 

To fight hunger has been an imperative and priority for a lengthy period of time. Yet the world is off track. “The world is making progress,” the report acknowledges – albeit with a significant caveat. It “is not on track to achieve the 2015 and 2030 targets for child stunting and low birthweight.” 

India is intimately acquainted with hunger. Last year, we reported on how “India has slipped on the International Food Policy Research Institute’s Global Hunger Index (GHI), ranking 102nd out of 117 countries. 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.” 

That report outlined that “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…in India, just 9.6 percent of all children between 6 and 23 months of age are fed a minimum acceptable diet.” 14.5 percent of India’s population were undernourished in the 2016-18 period. 

Hunger is an interrelated and complex issue, with environmental and sanitation concerns overlapping. Climate change is widely understood to be an exacerbative force for food insecurity. India is especially vulnerable to the effects of climate change and so its malnutrition crisis is poised to be hard-hit. Meanwhile, sanitation has long been a public health concern – one that the present administration has undertaken substantive measures to address through a number of programmes such as Swachh Bharat Abhiyan. Yet these are not issues that have faded from view – and going forward, how India grapples with the crisis of environmental disruption and enacting and preserving a robust sanitation system will be key in the fight against hunger. 

We are not on track. That is arguably the main takeaway of the report. Calling for zero hunger by 2030 is not a target we are likely to meet. In fact, the United Nations report states, “if recent trends continue, the number of people affected by hunger would surpass 840 million by 2030.” 

As with all public health crises, the COVID-19 pandemic poses only to worsen the situation. “A preliminary assessment suggests that the COVID-19 pandemic may add between 83 and 132 million people to the total number of undernourished in the world in 2020 depending on the economic growth scenario,” the report notes. This is an issue India feels deeply – many have expressed their fear that hunger would kill them, before COVID-19 ever has the chance to. 

Malnutrition is not to be understood through a singular lens. Obesity and overweight also influence malnutrition numbers – and India shoulders a considerable burden of obesity, including among young people. As I wrote for this publication last year, “together with China, India will be a chief driver of the explosion of childhood obesity by 2030, when 250 million children worldwide will be obese. In India, more than 27 million children will be obese by that year. This is compared to eleven million obese children at present. As such, by 2030, India will surpass the United States as the country with the second highest number of obese children.” More than 135 million Indians are affected by obesity. 

The data released by the UN speaks for itself and its lessons are clear: “countries will need a rebalancing of agricultural policies and incentives towards more nutrition-sensitive investment and policy actions all along the food supply chain to reduce food losses and enhance efficiencies at all stages. Nutrition-sensitive social protection policies will also be central for them to increase the purchasing power and affordability of healthy diets of the most vulnerable populations. Policies that more generally foster behavioural changes towards healthy diets will also be needed.” 

The benefits are manifold. Through investing in healthy diets and working to combat undernourishment, educational and economic potential are upped (in light of how conditions such as stunting can detrimentally affect cognitive development). Healthy eating can reduce the rate of noncommunicable, chronic diseases and – in turn, mitigate the cost to the healthcare system, the need for out-of-pocket expenditure (which is rife in India, driven significantly by NCDs) and the disability and premature mortality NCDs too often engender. Rethinking agriculture can have significant environmental benefits. And ending hunger will enable those who starve to maximise their potential.

The answer is not simplistic, as the report notes – be it in terms of economics, the environment, or public health. To address hunger, malnutrition and the copious number of byproducts of these public health issues will require seismic changes in direction. But such changes are within India’s power to effect – should it elect to trust the science, acknowledge the data, listen to the experts, and rethink its approach accordingly. Already, India has proven its willingness to combat hunger and obesity – the Eat Right India movement is a testament to this. Continuing and stepping up such efforts are vital. The alternative is so much worse. 

The full UN report can be accessed here.

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