Perhaps the one positive aspect to an otherwise grim story of chronic hunger in India is the more frequent public acknowledgement of this sorry state of affairs. The latest monthly progress report of the Integrated Child Development Services (ICDS) for Maharashtra says some 25 per cent of children below six years in Mumbai are severely malnourished. In January, Prime Minister Manmohan Singh described the prevalence of child undernourishment as a national shame when releasing the Hunger and Malnutrition Report 2011. India's extremely low global ranking on quality of life indices used to be met with a smug denial until some years ago. That has slowly given way to an acknowledgement that the impressive growth of purchasing power among the upwardly mobile classes has remained anything but socially inclusive. The government's draft food security bill has rightly been criticised for failing to codify universal entitlements to food. But a policy of huge procurement of grains — with its attendant wastage — would sooner rather than later be unsustainable when hunger remains a mass phenomenon. A particularly disturbing aspect of the ICDS figures on Mumbai is that the city's north east suburb, notorious for its abysmally poor public health, maternal and child care services, is continuing on a downward spiral. This is the region that recorded an infant mortality rate twice the State average in 2009, as per the human development report for Greater Mumbai. The State government has now decided to set up an urban malnutrition mission, an idea worth replicating elsewhere.
Research has established that chronic maternal undernourishment leads to fetal deprivation, underweight babies and the greater proneness of children and adults to illnesses. The susceptibility to cardiovascular diseases in later life when nutritional deprivations occur in the womb is of particular concern in India. The obvious lesson here is that comprehensive interventions which enhance the agency of women would bring all round benefits for the entire population. There is also a strong case to extend the midday meal scheme to the 0-6 age group, given the very positive impact it has had on children of school going age. After all, a lack of early intervention adversely impacts learning and developmental outcomes. Concerted efforts in the 1990s saw an increase in school enrolments and retention rates and a modest decline in the prevalence of child labour. These culminated in the enactment of the law on the right to basic education. A sustained intervention in relation to malnutrition and attendant morbidity should not be beyond our reach.