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Should India deal with nutrition governance as Brazil did?

Jul 07, 2014

Currently almost half the children in India are malnourished, which negatively impacts their productivity throughout their life, writes Arun Gupta.

Arun Gupta

New Delhi: During NDA rule a National Nutrition Mission was set up in 2003. During UPA rule, in 2008, the Prime Ministers Council on India’ Nutrition Challenges was established. Nutrition governance has been dealt in India this way. I being part of both, feel that this has rather been under-utilized and neglected way of dealing with nutrition at the highest level because of reasons that I talk about below.

In spite of the fact that many a programmes and policies have been put in place, India faces shame when it comes to malnutrition data in children year after year. But there is hope that the BJP generates now with its manifesto that promises:

“One of our main targets will be to eradicate the curse of malnutrition. We will do so by revamping existing programmes and launching a multi-pronged war against malnutrition across the nation, especially in the under-developed areas, with the help of State Governments. All resources will be provided to achieve this goal.”

Nutrition must become a high level priority and primary concern if India has to take advantage of its demographic dividend. Currently almost half the children in the country are malnourished, which negatively impacts their productivity throughout their life.

Brazil has shown that success can be worked out if concerted action is taken. In the past twenty years, Brazil reduced average malnutrition rate by 50%. They took inter-sectoral action in health, education, nutrition and sanitation areas. They linked it to the income increase through the real elevation of the minimum wage and cash transfer programmes.

Brazil’s significant point was also through elimination of formulated products out of official eating programs and ensured that the business sector was not a partner in this drive weather food or cash programmes.  This lesson is important because most of times it is the sticking point in India because of the vested interest of food/nutrition industry.  Industry and it’s front organizations indulge creating all sorts of “partnerships”, “stakeholder dialogues”, “working together” and “creating alliances” as industry wants to stay as close to policy as possible.

Further to sustain and maintain this work Brazil put in place leadership in nutrition at the highest level. There are two main bodies that operate as coordinating mechanisms – the National Council on Food and Nutrition Security, called  CONSEA, and the Chamber for Nutrition Security (CAISAN), which is an inter-ministerial group.

If India would like to make its Prime Minister’s Council on India’s Nutritional Challenges functional, it would need to legally mandate the existing structures, and provide an executive and technical team with it.  An Inter-ministerial council on nutrition again by law needs to be set up with coordinating mechanisms. Similar structures could be set up at State level.  This could lead to revamping of the current nutrition infrastructure.

CONSEA is a legally mandated advisory body that reports to the President, where it is housed. It has special powers, and has more than 50 members, especially from civil society, and is responsible for proposing and formulating public policies to guarantee the human right to healthy and adequate food, regularly monitors and mobilizes action, and recommends to the President what comes out of its conferences. Some of the key recommendations include strengthening State capacity to regulate, restrict acquisition of land by foreigners, intervene at WTO to revise the trade policy, promote family farming, etc. Similar councils operate at state and municipal levels.  At national level the CONSEA collaborates with CAISAN to get its decisions implemented. CONSEA has a staff of 13, and annual budget is about 400,000 US$, its Chair is appointed by the President.

CAISAN, a government body linked to the Chief of Staff’s Office of the Minister of Social Development and Fight Against Hunger, is made up from senior officials from many government ministries, ranging from social development to foreign relations. It is responsible for implementing the national nutrition policy, CONSEA's agreements and suggestions. CAISAN is also responsible for monitoring the implementation. It coordinates 17 ministries.

Both bodies have as a reference the deliberations and recommendations of the National Conferences on Food and Nutrition Security, which are held every four years and are responsible for setting the direction, identifying priorities and developing and monitoring the National Plan of Food Security, based on inputs by state, district and municipal conferences, which nominate delegates to the National Conferences. These interventions have resulted in improved social and nutritional indicators, including the decline in poverty percentage and reduction in child malnutrition.

Poor convergence between two key ministries, lack of decision-making capacity, and inadequate operational as well strategic capacity of the national system to deal with nutrition are some of the fundamental flaws in India’s nutrition governance system.

These has been reiterated time and again but have not been addressed. Some leadership action need to taken at the highest level to drive this change and sustain.

Perhaps, India needs to change the direction. Brazil has given the example.

For a start, the Prime Minister could take an empowered delegation to interact with the Brazilian CONSEA during the upcoming BRICS summit in July. This could provide important lessons on nutrition governance to the country. The action is likely to give dividends at all levels, people and political, global and regional. Given India’s challenge to improve growth and economy in the coming decades, it is imperative that India’s youth are enabled to develop to their full potential, something that is not possible with the current levels of malnutrition. The time to act is NOW.

Dr. Arun Gupta is pediatrician  and public health activist working as regional coordinator of the International Baby Food Action Network(IBFAN) Asia, he has been a member of the PM’s Council on India’s Nutrition Challenges.

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