Shifting goals

New Delhi, Oct. 22: An international non-government organisation has submitted a plan to the government to improve the delivery of iron, vitamins and other micronutrients to children and tackle India’s “hidden hunger”.

The India Micronutrient Investment Plan for 2007-2011 of Micronutrient Initiative — a Canada-based organisation which is trying to eliminate vitamin and mineral deficiencies — calls for nationwide use of candies loaded with iron and vitamins and other supplements to help India reach goals that had been originally set for the tenth five year plan.

But health experts have cautioned that supplements will only be a short-term solution. In the long term, the experts said, India will have to find ways to get its public to change eating habits — supplementing lunch and dinner staples of wheat and rice with traditional, more nutritious cereals, and increasing the consumption of fruits and vegetables.

While the green revolution and economic growth have helped India largely overcome its hunger problem, vitamin and mineral deficiencies persist as “hidden hunger” and contribute to high mortality, disability and brain damage, said Luc Laviolette, the regional director of Micronutrient Initiative.

The organisation has now proposed a Rs 587-crore plan to combat micronutrient malnutrition by strengthening existing programmes to deliver iron, vitamin A, iodine, and zinc through multiple routes.

The tenth plan goals remained unachieved because of “lack of recognition of the criticality of the problem and of what simple interventions can achieve”, said T.S.R. Subramanian, former cabinet secretary, now chairperson of Micronutrient Initiative.

The Initiative has pointed out that the additional investment, which amounts to Rs 5.40 per capita per year, is 50 times lower than the per capita yearly loss to the GDP resulting from micronutrient deficiencies.

The tenth plan had recognised the need to shift goals from food security to nutrition security and had envisaged eliminating vitamin A deficiency and reducing anaemia among children. Yet, according to Micronutrient Initiative officials, three out of four children in the country have anaemia and half of India’s children under five do not receive appropriate amounts of vitamin A supplements.

Laviolette said studies suggest that 300,000 deaths are precipitated by vitamin A deficiency in India, while zinc deficiency contributes to stunted growth in a large number of children.

The NGO has also estimated that 150,000 birth defects each year could be prevented by adding folic acid to staple foods.

“There are well-proven solutions to each of these problems,” Laviolette said.

The Micronutrient Initiative plan calls for steps such as greater coordination among government departments, regular tracking of progress and the creation of greater public awareness to strengthen the delivery of micronutrients.

Candies with iron, vitamins, and folic acid, for three to five-year-olds, and small sachets containing vitamin A, vitamin C, iron and folic acid for children below two years of age have been successfully tried out in Bengal, Gujarat, Bihar, Andhra Pradesh and Uttar Pradesh. One study showed that nutricandies can improve the nutrition status of children within 12 weeks.

But experts cautioned that nutritional supplementation will need to be accompanied by dietary diversification and behaviour change. Nutrition today does not get adequate attention from doctors, said Samir Chaudhuri, director of the Child In Need Institute in West Bengal. “We also need behaviour change at the home level.”