This article is written by Manya Dudeja, from the University School of Law and Legal Studies, Guru Gobind Singh Indraprastha University. It deals with the evil of hidden hunger that dooms India and also covers the various legal provisions in place to tackle this menace.

Introduction

Malnutrition, as the word suggests is mal or bad nutrition, and India, unfortunately, has fallen victim to it. According to the World Health Organization (WHO), malnutrition refers to the deficiencies, excesses, or imbalances in a person’s intake of energy or nutrients. On the face of it, India appears to have successfully encountered the problems related to food in India by preventing famines. However, improvement in the nutritional status of people has not kept pace with the country’s success in other sectors. Why has India failed to combat the hidden hunger? Why are the people of India being denied a right as basic as the right to nutritious food and why, even after 73 years of independence, India is still stuck at the elementary problem of providing healthy food to its population? It is because of this failure on the part of stakeholders that the law has to take upon itself, the burden to monitor and regulate the distribution of healthy and nutritious food. 

Sustainable Development Goal 2 aims at zero hunger and at ending all forms of malnutrition. India has been involved in various efforts to achieve this goal through various programs and schemes of the government of India to end hunger by 2030. 

The relevance of law in ensuring nutrition for all

1. The law has to interfere in cases of the scarcity of food to ensure legislation dealing with this right is available. 
2. The laws to maintain the quality of food and to prevent adulteration would be significant to ensure that people do not just consume food, but nutritious food.
3. A child derives nutrients from his/her mother and this makes prenatal and post-natal care of the mother important, along with legislation to promote breastfeeding.
4. Another indirect link is the duty to maintain a child which would include the duty to provide him/her with adequate nutrition for healthy growth. 

Right to Health

Living a life, free of malnutrition and full of good health is a part of the Right to Health which is included in Part IV of the Indian Constitution under the Directive Principles of State Policy.

Right to Food: A fundamental right

The National Human Rights Commission (NHRC) has recognised the importance of the right to food and has taken a stand in favour of including it as a part of Article 21 of the Constitution of India which guarantees the fundamental right to life and personal liberty. The Commission thinks that the right to food is vital to living a life with dignity. For the effective realisation of this right, Article 21 must be read along with Article 39 (a) and Article 47 which are the Directive Principles of State Policies (DPSP), and put down the obligations of the State with respect to this right. 

• Under Article 39(a), the State provides the citizens of India the right to have an adequate means of livelihood.
• Article 47 puts the burden on the State to improve public health by raising the level of nutrition and standard of living of the people. This would be one of the primary duties of the State. The State would also try and prohibit intoxicants that are injurious to health, except for medical purposes. 

The right to food can therefore be enforced as a fundamental right under Article 32 of the Constitution of India.

The Commission was saddened to find out that even when the granaries of the Food Corporation of India (FCI) are flooded with grains, it has been found that people living under poverty and hunger are suffering from prolonged malnutrition. Further, due to malnutrition, their bodies do not develop the immunity to fight off and resist diseases like malaria and diarrhea and often end up dying because of them. The right to food should have a broader meaning and should include food with appropriate nutritional levels so that the right does not just remain a theoretical concept but provides relief to the people in distress. 

• In People’s Union for Civil Liberties v. Union of India & Others (PUCL), the Supreme Court recognised that the right to food is a human right. It also put down a basic nutritional floor for the millions of impoverished people in India. The Supreme Court through this landmark judgment has also rearranged specific government food schemes and has recognised them as legal entitlements. 

Direct policy measures

National nutrition strategy

The NITI Ayog released the National Nutrition Strategy, 2017 to address the effects of malnutrition across generations. The Strategy was released after the National Health Policy of 2017 which highlighted the negative impact of malnutrition on the productivity levels of the population as well as its effect on mortality rates. The Strategy proposes the following to address the issue of malnutrition in India:

• The Strategy aims to reduce all forms of malnutrition in the country by the year 2030, the focal point of the Strategy would be the most vulnerable and critical age groups. It would also make an effort to achieve the nutrition and health goals mentioned in the Sustainable Development Goals.
• The Strategy would also like to launch a National Nutrition Mission on the lines of the National Health Mission. This would integrate nutrition-related provisions cutting across sectors like women and child development, health, sanitation, drinking water, rural development, food, and public distribution, etc. 
• The approach followed by the Strategy to achieve its objectives would be, decentralisation. This would promote ease of making decisions at the state and district level. Strengthening Panchayati Raj institutions and urban local bodies to take nutrition-related decisions would encourage local innovation and accountability of nutrition outcomes. 
• To improve healthcare and nutrition, the Strategy has proposed to initiate certain interventions, These would include:

1. Promoting the practice of breastfeeding infants for the initial six months after birth.
2. Universal accessibility of infant and young childcare, which would include the Integrated Child Development Scheme (ICDS) and crèches. 
3.  Better care and management of the children who are severely undernourished and sick. 
4. Vitamin A supplements shall be provided to children between the age groups of nine months to five years, twice a year.
5. Deworming and micronutrient supplements shall be provided to children, twice a year. 

• Adequate measures should be taken to improve maternal care and nutrition:

1. The mother should be provided with nutrients to supplement during pregnancy and the lactation period.
2. Mothers should also be provided with support through health and nutrition counselling. 
3. Anemia should be screened and the mothers should be made to consume iodised salt.
4. Postnatal care should be provided along with the facility of institutional childbirth and lactation management. 

• The Strategy also proposes reforms in governance. They are as follows:

1. Converging the implementation plans made by state and district administration with respect to the Integrated Child Development Scheme (ICDS), National Health Mission (NHM), and Swachh Bharat. 
2. There should be a focus on the most undernourished and malnourished communities in the districts as they would be more vulnerable.
3. The service delivery mechanisms should be developed by looking at the impact and evidence. 

POSHAN Abhiyan

It was in 2018, on the occasion of Women’s Day that an Overarching Scheme for Holistic Nourishment was introduced under the POSHAN Abhiyan. The agenda to achieve a malnutrition free India would be possible by the success of the following schemes:

• Integrated Child Development Scheme (ICDS): This program has been operating in India since the year 1975. It includes schooling, immunization, check-up, and health care services for children below six years of age and their mothers.
• Mid-day Meal Scheme: This scheme has been in effect since 1995. Under this, children are provided with a nutritious meal in their schools (applicable for government schools). This addresses the nutrition needs of children. Activists have been demanding the inclusion of eggs in the meal as a quick source of protein to keep the children healthy.
• National Health Mission: The program was initially launched in the year 2013 to meet the health needs of 18 states which were identified to have weak public health indicators. However, later the mission was extended to the whole of India.
• Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG): This scheme is also known as SABLA. It was launched in the year 2011. This scheme aimed to improve the nutrition status of adolescent girls i.e. girls in the age group of 11-18 years.
• Indira Gandhi Matritva Sahyog Yojna: This scheme was introduced in the year 2010. It aimed to incentivise improved health and nutrition for lactating and pregnant mothers. The scheme also tried to educate mothers about the nutritional benefits of breastfeeding for their newborn children. 
• There are many other schemes as well which have increased the nutrition levels as one of their objectives:

• Targeted Public Distribution System (click here)
• National Horticulture Mission (click here)
• National Food Security Mission (click here)
• Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) (click here)
• Swachh Bharat Abhiyan (click here)
• National Rural Drinking Water Program (click here)

Under this scheme, Anganwadis would be utilised to provide services to the districts with the highest malnutrition. It would be implemented by the Ministry of Women and Child Development as a ‘People’s Movement’ or a ‘Jan Andolan’ to create awareness around the issue. 

National Food Security Act, 2013

The aim of this Act is to fulfill the objective of providing food and nutritional security to the people of India. This would be ensured by empowering people with a legal right with some prerogatives for certain groups and provide them with a chance to live a dignified life. 

People covered under the poorest of the poor or the Antyodaya Anna Yojana (AAY) category are provided 35 kg of food grain per family per month to meet their food and nutrition requirements. While other priority groups would be entitled to 5 kg of food grain. It would be the duty of the Central Government to identify and allocate grains to the deserving people who are most in need of food security. The Act also addresses the nutritional needs of mothers and children by providing them with meals according to prescribed nutritional norms.

Indirect policy measures

• Increasing the production of food grains to ensure food security.
• By working on improving the dietary pattern of the population by promoting the production and increasing the availability of nutritionally rich food items.
• Working on increasing the purchasing power of the poor and reducing their vulnerability so that they are able to afford a healthy, nutrition-rich diet.
• Expanding and enhancing the public distribution system.
• Increasing nutrition knowledge through school curriculum etc. 
• Monitor and prevent the adulteration of food.
• Initiate better community participation in nutrition surveillance. 

Conclusion

Living in the 21st century, in a time where AI and technology are dominating their way into the world, India still struggles to nurture a healthy population. It is facing a paradox between increasing GDP and high malnutrition and starvation-related morbidity. 14 percent of India’s population is estimated to be under-nourished. According to the Global Hunger Index 2020, India ranks 94 out of 107 countries.

While making India malnutrition-free would be difficult, it would not be impossible. The on-going programs need to be improved and work has to be done on their effective implementation to make sure that they are able to reach the deprived. While target-oriented legislations have to be put in place to keep a check on the plethora of schemes, the judiciary needs to be an active participant in the discourse to achieve nutritional justice for the people. All stakeholders should come together and pledge to put in their best efforts in making India free of the evil of malnutrition. Civil Society Organisations should use public policy to solve problems of malnutrition and the hidden hunger in India. 

References

• 37 JILI (1995) 261 Right to Nutrition

• Narayan J, John D, Ramadas N. Malnutrition in India: status and government initiatives. J Public Health Policy. 2019 Mar;40(1):126-141. doi: 10.1057/s41271-018-0149-5. PMID: 30353132.

• Mishra C P. Malnutrition-free India: Dream or reality. Indian J Public Health [serial online] 2017 [cited 2021 Mar 3];61:155-62. Available from: https://www.ijph.in/text.asp?2017/61/3/155/214814

• https://www.un.org/sustainabledevelopment/hunger/

• https://nhrc.nic.in/press-release/right-food-fundamental-right

• https://www.prsindia.org/theprsblog/malnutrition-india-national-nutrition-strategy-explained

• https://swachhindia.ndtv.com/malnutrition-in-india-has-this-decade-laid-down-a-blueprint-for-a-malnutrition-free-india-40644/

• https://www.prsindia.org/media/articles-by-prs-team/all-you-wanted-to-know-about-the-food-security-bill-2953

• https://www.thehindu.com/news/national/all-you-want-to-know-about-malnutrition-in-india/article28233890.ece

• https://www.latestlaws.com/did-you-know/right-to-health-all-you-want-to-know-about-malnutrition-in-india/

• https://www.orfonline.org/research/preventing-hunger-and-malnutrition-in-india/
• https://www.corteidh.or.cr/tablas/r24372.pdf

LawSikho has created a telegram group for exchanging legal knowledge, referrals and various opportunities. You can click on this link and join: