MPs set politics aside to learn a Gujarat lesson on tackling malnutrition

age is underweight, a statistic worse than that in sub-Saharan Africa — a group of eight MPs cutting across party lines and private citizens have formed a forum, Citizens Alliance on Malnutrition, to push the government for a national policy and action plan. They have met Prime Minister Manmohan Singh, UPA chairperson Sonia Gandhi and Opposition leader L K Advani.

Says BJP’s Shahnawaz Hussain: “This is one problem that concerns people across parties. That’s why we have come together as a forum cutting across party lines. We need to put it on the national agenda the same way we did with polio and HIV.” Pilot couldn’t agree more: “We are proud of our GDP growth and Sensex but do we realize that half our next generation will be mentally incapable of taking on challenges on empty stomachs if hunger is not dealt with now? What’s happening in Gujarat can make an effective difference elsewhere too.”

The MPs also visited tribal areas in several states, including Madhya Pradesh and Maharashtra, to assess government food schemes, including the mid-day meal plan and the Integrated Child Development Scheme. But it was Gujarat’s fortification plan that emerged as a “definite do-able.”

Said BJD’s Jay Panda, one of the alliance members: “We have begun to realize that the government can undertake certain things to help the situation. For example, fortification in Gujarat is a cheap and effective way of tackling hunger. These are things that need to be scaled up immediately.”

Fortification enables adding additional Vitamin A, D, iron and folic acid to food products — which lose these nutrients while milling, extracting or processing — so that without changing the quantity of food, the consumer can get micronutrients normally lacking in their daily diet. In Gujarat today, edible oil fortified with Vitamin A and D and wheat flour fortified with iron and folic acid is available both in the open market in the state as well as in government programmes like ICDS and mid-day meals.

Two years ago, the state government launched a public awareness programme on fortification with oil producers, refineries and packers along with the Roller Flour Millers’ Association and its member mills. “The fortification in Gujarat did not begin with government schemes or PDS but began with the open market as a public-private partnership,” said S K Nanda, principal secretary, Food, Civil Supplies and Consumer Affairs, Gujarat, while giving his presentation.

It was this success in markets that made the state initiate this programme for PDS and ICDS. As on July 2007, about 6.5 lakh tonnes of wheat flour has been fortified by various flour mills and sold in the open market. One of the studies on the impact assessment of the programme shows that of 602 children, pregnant and lactating mothers fed on fortified flour, 505 showed substantial increase in haemoglobin levels.

How does fortification help in solving malnutrition in children? “One reason why low birth weight prevalence continues to be high is the fact that national programs like ICDS focus on the child. The fact is that the damage is already done when the child is in the womb of an undernourished mother. It is important to break the inter-generational cycle of malnutrition,” said Nanda.

Other states are looking at Gujarat for leads. Haryana and Punjab have invited officials from Gujarat and held a meeting with their Roller Flour Mills Association. “It’s not difficult at all. There is no resistance from any quarter on this. We are working towards making it mandatory in these two states,” said Vinod Kapoor, whose mill has been voluntarily fortifying wheat since 1997 in Chandigarh.

So far, the only two Acts concerning food fortification are fortification of Vanaspati oil with Vitamin D passed in 1953 and fortification of salt with iodine in 2000.

The Central government has been working with Global Alliance for Improved Nutrition, GAIN, an international business alliance that works on nutrition on possibilities of legislation. The Ministry of Health says that it is not convinced on the merits of fortification as of now and is “seeking wider opinion on the issue”.