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Micro, bio and packaged -- how India’s nutrition mix is being reshaped

By Rahul Goswami

Crop and food multinationals, ably assisted by government, are using the 'reduce hidden hunger' platform to push hunger-busting technologies that best suit them -- including biofortification of crops, the use of supplementation, and of commercial fortification of prepared and processed foods

In June 2011, the Ministry of Women and Child Development presented a 'situation analysis' to the Planning Commission's Working Group on Nutrition. Focusing on children, women and adolescent girls, the assessment was worse than grim. Preparing for the Twelfth Five-Year Plan, with the Eleventh drawing to a close, the assessment showed that India's women, girls and children benefit little from the so-called development gains of 55 years of planned development.

This is the view of the ministry, unfiltered by any political consideration, untreated by any development ideology:

  • Children: Every fifth child in the world lives in India; 22% of babies are born with a low birth weight; 50 out of 1,000 live births do not complete their first year of life; 42.5% of children in the 0-5 age-group are underweight; 79% of children in the 6-35 months age-group are anaemic.
  • Women: More than a third (36%) of women have a BMI (body mass index) below 18.5; among women who are thin, 44% are moderately or severely thin; 36% of women suffer from chronic energy deficiencies; 56.2% of women are anaemic; women suffer from a dual burden of malnutrition with nearly half of them being either too thin or overweight; the percentage of ever-married women in the 15-49 years age-group who are overweight or obese increased from 11% in NFHS-2 (National Family Health Survey) to 15% in NFHS-3.
  • Adolescent girls: In the 11-18 years age-group, there are approximately 83.2 million adolescent girls (about 16.7% of the country's female population); 33% of adolescent girls are undernourished; 56% of adolescent girls are anaemic; 30% of women gave their first births before they were 18 years old, contributing to a high maternal mortality rate and anaemia; the drop-out rate for adolescent girls (Classes I to X) is 63.5%; in the 15-19 age-group, almost half the total adolescent girls are undernourished.

Re-emphasised in mid-2011 but shunted into the background by misleading statements from the central government about the deceleration of food inflation, the impact of malnutrition and undernutrition on millions of Indians -- rural and urban poor, but also including sections of the urban middle class -- is still not treated as a continuing national emergency (see box 'The ICDS as 36 years of proof that PPP is not an answer').

The ICDS as 36 years of proof that PPP is not an answer

Services provided by the Integrated Child Development Services (ICDS) include supplementary nutrition, non-formal education, immunisation, health check-ups, referral services, and nutrition and health education. These are provided at anganwadis located within the village itself. The (woman) anganwadi worker is the key functionary who, with a helper, is responsible for the population of an average village (about 1,000 people).

The anganwadi worker surveys all the families in the community and identifies children younger than six and pregnant and lactating women. Eligible individuals are given supplementary feeding support for 300 days per year. On average, the daily supplement is expected to provide 500 calories and 12-15 gm of protein to children, and 600 calories and 18-20 gm of protein to pregnant or lactating women. Children who are severely malnourished are given an additional 300 calories and 8-10 gm of protein on the basis of medical advice. The anganwadi worker also monitors and plots the growth of children who attend the anganwadi by weighing them periodically and plotting the data on weight-for-age growth cards. Additionally, she is entrusted with the responsibility of nutrition and health education of women aged 15-45 years.

Launched in 1975, the programme has gradually increased from 33 projects to 7,073 projects in 2009, catering to about 87 million beneficiaries through a network of about 1 million anganwadis. The allocation of funds for the scheme has steadily increased from Rs 2,600 crore in the Eighth Five-Year Plan (1992-97) to Rs 44,000 crore in the Eleventh Five-Year Plan (2007-12).

According to an assessment of the ICDS, 'Reproductive Health, and Child Health and Nutrition in India: Meeting the Challenge' (in The Lancet, January 22, 2011), the programme has not been able to achieve the necessary results despite three decades of existence. The assessment noted that results of studies have shown little or no association between the presence of an ICDS centre and the nutritional status of children.

The focus on children younger than three years is inadequate, thus missing the critical window of opportunity to avert avoidable undernutrition -- a point often repeated especially by non-profit and civil society groups delivering midday meals. About 20% of children younger than six years live in areas that do not have an anganwadi centre (as the National Family Health Survey-3 has documented). Even in those areas that do, almost three-quarters of children did not receive any supplementary food from an anganwadi centre in the 12 months before the survey.

However, although the ICDS may not have succeeded in substantially reducing the burden of undernutrition, the presence of an anganwadi worker and a physical site for health and nutrition activities in villages and poor urban areas offers a great opportunity to improve nutritional status and provide healthcare services for mothers and children. -- RG

Rural RDA intake by decile classes

This chart plots the consumption of total cereals and total pulses (and pulses products) recorded by the NSS 61st Round (2004-05) from rural households. This set takes the rural average quantity of consumption of cereals and pulses per person for each class of monthly per capita expenditure (MPCE) (there are 12).

The 'y' (vertical) scale is pulses (gm/day) and the 'x' (horizontal) scale is cereals (gm/day). Each circle in the plot area represents an MPCE expenditure class in a state, scaled in size to represent consumption of cereals and pulses combined.

The dashed and dotted lines sectioning the plot show consumption percentage markers based on a recommended daily allowance (RDA) provided by the National Institute of Nutrition and adapted here as an average of male and female, for moderate and heavy activity. The RDA line markers are: 100% of total cereals -- 465 gm/day; 75% of total cereals -- 349 gm/day; 50% of total cereals -- 233 gm/day; 66% of total pulses -- 62 gm/day; and 33% of total pulses -- 31 gm/day.

In the quadrant that is less than 75% of the total cereals RDA and less than 33% of the total pulses RDA, the income categories represented are: Andhra Pradesh, 2; Assam, 1; Bihar, 1; Chhattisgarh, 1; Gujarat, 9; Haryana, 9; Himachal Pradesh, 4; Jammu and Kashmir, 2; Jharkhand, 1; Karnataka, 4; Kerala, 11; Madhya Pradesh, 1; Maharashtra, 5; Punjab, 10; Rajasthan, 1; Tamil Nadu, 4; Uttar Pradesh, 1; Uttarakhand, 3; and West Bengal, 1.

The background against which the Prime Minister's National Council on India's Nutrition Challenges was formed in 2008 has not changed (it has representation from more than a dozen ministries and its key recommendations include the creation of new institutional arrangements that are supposed to encourage different sectors to work together) (seeTable 1). Yet, like seed, whose public legacy in India of use, distribution, breeding and exchange is being reshaped and redirected to conform to the Green Revolution 2 model, so it is with nutrition.

Table 1: Nutrition, health, women and child development -- the government view

Target group Schemes Expansion
Pregnant and
lactating
mothers
ICDS, RCH-II, NRHM, JSY,
Indira Gandhi Matritva
Sahyog Yojana (IGMSY)
-- CMB Scheme
NRHM (2005-06),
JSY (2006-07),
ICDS (2008-09)
Children 0-3
years
ICDS, RCH-II, NRHM, ICPS,
Rajiv Gandhi National
Creche Scheme (RGNCS)
RGNCS (2005-06),
ICDS (2008-09)
Children 3-6
years
ICDS, RCH-II, NRHM, ICPS,
Rajiv Gandhi National
Creche Scheme, Total
Sanitation Campaign (TSC), National
Rural Drinking
Water Programme (NRDWP)
TSC (2008-09)
School-going
children
6-14 years
Midday meals scheme (MDM),
Sarva Shiksha Abhiyan
(SSA), ICPS
SSA (2002/2005-06),
MDM (2008-09)
Adolescent
girls
11-18 years
Rajiv Gandhi Scheme for
the Empowerment of
Adolescent Girls (RGSEAG),
Kishori Shakti Yojana,
Total Sanitation Campaign
(TSC), National Rural
Drinking Water Programme
(NRDWP), ICPS
NRDWP (2010), RGSEAG
(2010-11)
Adults MGNREGS, NRLM,
Skill Development Mission,
Women Welfare and Support
Programme, Adult Literacy
Programme, TPDS, AAY,
Old and Infirm Persons
Annapurna, Rashtriya
Krishi Vikas Yojana,
Food Security Mission,
Safe Drinking Water and
Sanitation Programmes,
National Horticulture
Mission, National Iodine
Deficiency Disorders
Control Programme (NIDDCP),
Nutrition Education and
Extension, Bharat Nirman,
Rashtriya Swasthya Bima
Yojana
NHM (2005-06), MGNREGS
(2005- 06), NRLM
(2010-11), NIDDCP (1992),
RSBY (2007),
Bharat Nirman (2005)

Source: Presentation (June 2011) to the Working Group on Nutrition, Planning Commission, by Ministry of Women and Child Development, Government of India

Now, like seed, it is agricultural biotechnology and privately directed crop research that determine cultivation options and food outcomes, and through them determine the nutritional choices and mix that hundreds of thousands of urban households take decisions about every day. This trend is supported by legislation which, on the one hand (as the Biotechnology Regulatory Authority of India, BRAI, does), destroys the idea and practice of traditional cultivators' cooperation on breeding, and on the other is converting India's National Agricultural Research System (NARS) into a science and technology provider that will ensure what the central government now calls demand-driven agriculture, and which is designed to encourage the depopulation of Indian agriculture and by so doing steadily erode the cultural and agro-ecological underpinnings of our traditional household food baskets and their nutritional diversity (see Table 2).

Table 2: Balanced diet for adults -- sedentary/moderate/heavy activity

Grams per day required by type of work
  Sedentary   Moderate   Heavy  

Food category

Man

Woman

Man

Woman

Man

Woman

Cereals and millets 375 270 450 330 600 480
Pulses 75 60 90 75 120 90
Milk and milk products (ml) 300 300 300 300 300 300
Roots and tubers 200 200 200 200 200 200
Green leafy vegetables 100 100 100 100 100 100
Other vegetables 200 200 200 200 200 200
Fruits 100 100 100 100 100 100
Sugar 20 20 30 30 55 45
Fat 25 20 30 25 40 30
             
Source: 'Dietary Guidelines For Indians, A Manual', National Institute of Nutrition (NIN), 2010

The concerned central ministries -- the Ministry of Agriculture, Ministry of Food Processing Industries, Ministry of Commerce -- have during much of the Eleventh Plan period laid the foundation for this transformation. They have, with the uncritical aid of the Indian Council of Agricultural Research (ICAR), adopted the sloganeering of the international agricultural research consortia that work closely with food and crop multinationals and which drive research agendas along the lines required by the global food and retail industry.

Thus it is that in India, these ministries and their supporters (in industry and also in allied ancillaries) repeat a mendacious manifesto of food conversion: that Indians suffer from 'hidden hunger' or micronutrient malnutrition; that they do not get enough micronutrients required to lead healthy productive lives from the foods they eat; that the diets of our poor usually consist of very high amounts of staple foods (cereals and pulses) but few micronutrient-rich foods such as fruits, vegetables, and animal and fish products; and finally that biofortified foods which have been bred to have higher amounts of micronutrients can provide these needed vitamins and minerals. Biofortification is a process of breeding higher levels of micronutrients (especially zinc, iron, and Vitamin A) directly into key staple foods using either conventional breeding methods or biotechnology.

It is now apparent that the Rashtriya Krishi Vikas Yojana (RKVY), the national flagship programme under which the bulk of agricultural research is being implemented, will be exploited to advance in the states the message that nutrition and health gaps can be bridged through new agricultural practices. This is already the argument developed by the International Food Policy Research Institute (IFPRI, the policy advocacy and analysis centre of the Consultative Group on International Agricultural Research, the CGIAR) in India. In fact, the RKVY matrix of sectors, years and states show that technology-specific thrusts have been provided at different times in the last three years to recipient states -- with no explanation available either from the central Ministry of Agriculture or the departments of agriculture of the receiving states as to the rationale for such interventions.

Thus the conditions have carefully been created for the introduction of the idea that biofortification of staple crops in India must accelerate and be intensified. The realisation of the claimed potential of biofortified crops is now one of the core subjects in the ministries of agriculture, of food processing industries and within the NARS. Hence the orchestrated exhortations from India's food industry and its collaborators, the Indian administration and its NARS -- that India must prioritise public research investment to ramp up the development of technologies and effective supply chains to increase the production and consumption of these nutrient-rich foods.

When that public research investment does not materialise -- as it has been prevented from doing in the Tenth and Eleventh Plan periods -- then the PPP advocates will strengthen their claim to both determining the course of the 'nutrition challenge' in India and simultaneously promise the delivery of the hunger-busting package of technologies. That is why the Britannia Nutrition Foundation has partnerships with the Global Alliance for Improved Nutrition (GAIN), the Clinton Global Initiative, the World Bank Institute, the UN World Food Programme and the Naandi Foundation (Hyderabad-based, which is already engaged in centralised kitchens that provide midday meals, and whose 'HUNGaMA Report' on child malnutrition was released in January 2012 by Prime Minister Manmohan Singh).

For members of the Indian Biscuit Manufacturers Association and of the Federation of Biscuit Manufacturers of India, the combined potential from (a) the 'agriculture for nutrition and health' mission, advanced by the international agri-research consortia, and (b) the evolving mandate to tackle 'hidden hunger' in India through packaged food formulas, is enormous.

The biscuit industry in India is already very large, estimated to be Rs 12,600 crore in 2010-11, and has grown at over 14% per year for the last three years (compared with an annual average agricultural growth rate of less than 4%, as the Planning Commission bemoans). The industry leaders are Parle Products, Britannia and ITC. They are being joined by multinationals including Kraft and Pepsico, Britain's United Biscuits, GlaxoSmithKline Consumer Healthcare and the French foods giant Danone.

For India's food industry, the intention is to use the 'reduce hidden hunger' platform provided by the central government and the agri-research system as part of a strategy that includes bringing about dietary diversification, the use of supplementation, and of commercial fortification of prepared and processed foods, also called 'ready-to-eat' or 'take-home rations' (see Table 3). Already, for the last three years, the registered 'mandis' (over 7,000) are being steadily linked to what is called the supply chain and thereby to the commodity markets. As this has happened, the cooperative legacy of agriculture in India has been slipping away. With it, nutritional independence is weakening, aided by the massive growth in retail foods in both urban and rural India.

Table 3:Recommended dietary allowances for Indians, including macronutrients and minerals

      Net energy   Visible fat Calcium Iron
Group Particulars Body wt (kg) kcal/day Protein gm/day gm/day mg/day mg/day
Man Sedentary work 60 2,320 60 25 600 17
Moderate work 2,730 30
Heavy work 3,490 40
Woman Sedentary work 55 1,900 55 20 600 21
Moderate work 2,230 25
Heavy work 2,850 30
Pregnant woman

.+350

82.2 30 1,200 35
Lactation 0-6 months

.+600

77.9 30 25
Lactation 6-12 months

.+520

70.2 30
Infants 0-6 months 5.4 92 kcal/kg/day 1.16 gm/kg/day - 500 .-
6-12 months 8.4 80 kcal/kg/day 1.69 gm/kg/day 19 - 46 mcg/kg/day
Children 1-3 years 12.9 1,060 16.7 27 600 9
4-6 years 18 1,350 20.1 25 13
7-9 years 25.1 1,690 29.5 30 16
Boys 10-12 years 34.3 2,190 39.9 35 800 21
Girls 10-12 years 35 2,010 40.4 35 27
Boys 13-15 years 47.6 2,750 54.3 45 32
Girls 13-15 years 46.6 2,330 51.9 40 27
Boys 16-17 years 55.4 3,020 61.5 50 28
Girls 16-17 years 52.1 2,440 55.5 35 26
               
Source: 'Dietary Guidelines For Indians, A Manual', National Institute of Nutrition (NIN), 2010  

Drafted by IFPRI and subscribed to by central planners and agricultural economists, there is now a call for a minimum of 15% of all RKVY and National Horticulture Mission (NHM) funds to be channelled towards the 'agriculture for health and nutrition' package of technologies. With state departments of agriculture being pressurised to fall into line, with extension systems being revived under corporate banners and with new public private partnership (PPP)-led funding, state governments are being told that they must integrate nutrition security concerns into their planning, implementation, and monitoring.

The ICAR network of research institutions, supported by the Department of Agricultural Research and Education and a raft of new 'agripreneur' schemes, is strenuously advocating that RKVY, NHM, and other platforms "create nutrition-sensitive value chains". In this transformation, we will see the establishment of public private partnerships that will be called 'accelerating development' and 'encouraging innovation'. The industrialisation of agriculture will proceed at the pace desired by the processed and packaged food industry and by food retail. India's food industry will increasingly move into the food and agricultural policy space once occupied by academia and research institutions, which will now abase themselves before the attractive private and 'foundation' funding sources available for narrowcast research agendas. Nutrition will relate not to a wholesome thali but to a negotiated RDA set by a market oligopoly assisted by turncoat technologists. If unchecked, this will be the nature of nutrition in India from the Twelfth Plan onwards.

(Rahul Goswami researches rural economies with a focus on agro-ecology. He is a consultant with the National Agricultural Innovation Project, Ministry of Agriculture, and is an examiner for UNESCO's Culture Sector, on intangible cultural heritage. He writes on issues concerning food and energy)

Infochange News & Features, July 2012