Hunger and Malnutrition ‘Emergency’
India may be one of the world’s fastest growing economies, but its hunger levels are amongst the worst in the world. Very recently, the Global Hunger Index (GHI) 2024 has been released. It says that the level of hunger in India is ‘serious’ and ranks India 105th among 127 countries for which the ranking was done (high income countries are not ranked). GHI-2024 suggests that India’s undernourished population this year would effectively rank as the seventh most populous country in the world — with roughly the population of Brazil, a staggering 200 million people.[1]
Every year when the GHI report is released, the Modi Government has disputed its findings, claiming that the GHI is a flawed indicator and that it is a conspiracy to malign the country and derail the government’s Viksit Bharat agenda. As we have discussed in Chapter 3, it has even come up with manufactured data to claim that the the nutritional status of the Indian population is improving.
Probably no government in the world disputes the data and methodology of such reputed international organisations so much as India does. Commenting on the Modi Government’s denial of ‘bad news’, The Economist recently wrote: “Denial is the first, and often the only, response of India’s government to bad news.” It goes on to give some examples of how the Modi Government has responded to ‘bad news’:
“Last year the Global Hunger Index, a measure of undernutrition, ranked India 111th out of 125 countries. The government said it had ‘serious methodological issues’. India ranks 176th of 180 countries on an environmental index. ‘Unscientific methods’. What about the World Bank’s human capital index, which measures health and education? ‘Major methodological weaknesses’. The World Press Freedom Index? ‘Methodology which is questionable’. The Freedom in the World Index, Democracy Index and indices? ‘Serious problems with the methodology’. Sometimes the government does not even like its own data. In 2019 it withheld the release of unflattering consumption numbers, promising fresh ones with ‘a refinement in the survey methodology’.”[2]
Let’s leave aside the Modi Government’s false protestations, and go back to the issue of the country’s appalling hunger levels.
Hunger has debilitating physical and mental effects on the human body.[3] Apart from its effects on the individual, for society as a whole too, the prevalence of widespread hunger has enormous economic costs. How can hundreds of millions of Indians become productive members of society unless they are given the conditions needed to develop their inherent capacities, and obviously, the most basic of these is food?
India is also at the epicentre of a global stunting crisis, due to child malnutrition. According to recently released data from the National Family Health Survey–5 of 2019–21, 36 percent of children under the age of five are stunted (low height for age, indicating chronic malnutrition), and 32 percent are underweight (low weight for age, indicating both chronic and acute malnutrition).
Under /mal-nutrition severely stunts intellectual, emotional and physical growth. Studies also show that the effect of malnutrition is most acute in the age group from 0 to 3 and this cannot be mitigated in one’s adult life; in other words, both body growth and brain development are permanently adversely affected.
Clearly, for a country facing such a hunger and malnutrition crisis, this should be THE MOST IMPORTANT crisis facing its policy planners, and they need to urgently address it.
Budget 2024–25: Nutrition Schemes
In this chapter, we examine the Modi Government’s budgetary allocations for the various schemes meant to address the nutrition requirements of the people.
i) Food Subsidy
This is the most important programme in the country to tackle hunger and malnutrition. Under this, the government provides essential rations to the poor at subsidised rates through the public distribution system (PDS). This food subsidy programme is mandated under the National Food Security Act (NFSA), passed by the Parliament in 2013.
In a country with such mind-boggling levels of hunger and malnutrition, the NFSA provides very inadequate relief, but nevertheless it is a bare minimum lifeline for the poor. Amazingly, the Modi Government has been seeking do away with the National Food Security Act (NFSA) and eliminate spending on food subsidy ever since it came to power in 2014–15. In its very first year in office, it set up the High Level Committee (HLC) on ‘Reorienting the Role and Restructuring of the Food Corporation of India’, headed by the BJP leader Shanta Kumar. The recommendations of the committee include:
- reducing public sector grain stocks;
- replacing public procurement of grains with cash transfers to farmers;
- deferring implementation of the NFSA;
- drastically reducing the percentage of the population to be covered under the NFSA; and
- steeply hiking the issue prices of foodgrains.[4]
In accordance with these recommendations, during its first six years in power (2014–15 A to 2020–21 BE), till before the pandemic struck in 2020, the Modi Government’s food subsidy budget as a percentage of budget outlay continuously declined. The decline was so steep that allocation under this head in 2020–21 BE (Rs. 1.16 lakh crore) was less than the allocation in 2014–15 A (Rs. 1.18 lakh crore) in nominal terms. As a percentage of budget outlay, it had fallen by half (from 7.1 percent to 3.8 percent) (see Chart 12.1)! Instead of strengthening the PDS, the Modi Government was more interested in exporting foodgrains to earn foreign exchange, so much so that our country had become the world’s biggest rice exporter[5] — in a country that accounts for one-third of the severely food-insecure population in the world.[6]
Then, during the first year of the pandemic (2020), due to the widespread distress caused by its callous handling of the pandemic, the government was forced to increase its food subsidy budget and provide free rations to the people. The budget papers reveal that the government’s food subsidy budget (2020–21 A) increased by more than 4 times to Rs. 5.41 lakh crore, as compared to the budgeted Rs. 1.16 lakh crore.
Since then, the government has been claiming that the economy has rebounded and we have emerged as the fastest growing economy among the G20 economies. It is also claiming a dramatic decline in poverty levels in the country. So, it has once again started reducing its food subsidy budget. The food subsidy budget this year (Rs. 2.05 lakh crore) is marginally less than the revised estimates of last year (Rs. 2.12 lakh crore). As a percentage of budget outlay, it has come down to 4.3 percent, which is 73 percent less than the peak reached in 2020–21 A (15.4 percent); it is even less than the allocation made in 2014–15 A (7.1 percent), by 40 percent (Chart 12.1).
Chart 12.1: Food Subsidy Budget, FY15–FY25 (Rs. lakh crore)
As the Shanta Kumar Committee recommendations make clear, in the medium term, the Modi Government is planning to end procurement of foodgrains and eliminate the public distribution system, and replace it by cash transfers to the poor, which can then be suitably wound down to further reduce the food subsidy bill (just like has happened for cooking gas). That was one of the aims of the three farm bills that the farmers so resolutely fought against, forcing the government to withdraw the bills. Considering the anti-poor anti-farmer nature of the Modi Government, it should soon come up with a new trick to further reduce its food subsidy bill.
ii) Nutrition Schemes Aimed at Pregnant Women and Children
The previous governments had put in place several relatively smaller nutrition schemes oriented towards pregnant women and children. While the funding for them was inadequate, at least they attempted to address the problem. We discuss budget allocations for the 3 most important schemes below.
a) Anganwadi Services
It is a programme aimed at providing health, education and supplementary nutrition to mothers and children below 6 years of age. This scheme is implemented by the Ministry for Women and Child Development.
In his first budget speech of 2014, Finance Minister Arun Jaitley had stated that “a national programme in Mission Mode is urgently required to halt the deteriorating malnutrition situation in India, as present interventions are not adequate.” He promised to put in place a “comprehensive strategy” within six months. More than a decade has passed since this promise was made. The Modi Government has yet to come out with any such strategy. In fact, the word ‘malnutrition’ has disappeared from the Finance Minister’s diction. The most important of the Centre’s nutrition schemes to address malnutrition among women and children is Anganwadi services. The Modi Government has drastically reduced the budgetary allocation for this scheme.
During the first seven Modi Budgets (2014–15 to 2020–21), the allocation for Anganwadi services was cut in real terms by a huge 33 percent (see Table 12.1).[7] This huge reduction was made, despite a damning Niti Aayog report of 2015 that stated:
- 41 percent of the Anganwadis have inadequate space;
- 71 percent are not visited by doctors;
- 31 percent have no nutritional supplementation for malnourished children; and
- 52 percent have bad hygienic conditions.[8]
In 2021–22, the Modi Government resorted to its typical smoke-and-mirrors routine to fudge the allocation for this scheme by clubbing it with two other schemes — Poshan Abhiyan and Scheme for Adolescent Girls. They were together renamed as ‘Saksham Anganwadi & POSHAN 2.0’.
Comparing like with like, the budget for the pompously named ‘Saksham Anganwadi and POSHAN 2.0’ in 2024–25 BE is marginally less than last year’s revised estimate in nominal terms; which means that the cut is much more in real terms. As compared to the combined allocation for its 3 constituent schemes in 2014–15 A (see Table 12.1), the budget for Saksham Anganwadi & POSHAN 2.0 this year (2024–25 BE) has fallen in real terms by a huge 32 percent![9]
Table 12.1: Allocation for Anganwadi Services, and Saksham Anganwadi & POSHAN 2.0,
FY15–FY25 (Rs. crore) [10]
| 2014–15 A (1) | 2020–21A (2) | Increase, 2 over 1, % (CAGR) | 2023–24 RE | 2024–25 BE (3) | Increase, 3 over 1, % (CAGR) | |
| Anganwadi Services (Core ICDS) (4) | 16,552 | 15,784 | –33% | |||
| Poshan Abhiyan (National Nutrition Mission) (5) | 152 | 408 | ||||
| Scheme for Adolescent Girls (6) | 622 | 41 | ||||
| Saksham Anganwadi and POSHAN 2.0 [= 4+5+6] | 17,326* | 16,233* | 21,523 | 21,200 | 2% |
* Saksham Anganwadi and Poshan 2.0 was not in existence for these years.
This reduction in the most important nutrition scheme for our pregnant women and children, has taken place amidst a nutrition emergency. We repeat data from NFHS–5 of 2019–21 given above for emphasis:
- 36 percent of children under the age of five are stunted (indicating chronic or long-term malnutrition);
- 57 percent of women suffer from anaemia.
This only means that our ruling regime is totally insensitive towards the 5 crore children in the country who are malnourished and the more than two crore pregnant women and lactating mothers, majority of whom are suffering from anaemia. It also means that the Anganwadi workers who are being paid a pittance will continue to work at their very low wages.
b) Pradhan Mantri Matru Vandana Yojana
This scheme was earlier known as the Indira Gandhi Matritva Sahyog Yojana, or IGMSY. It was launched by the UPA-2 government in October 2010 on a pilot basis in 53 districts. The National Food Security Act (NFSA) passed by the Parliament just before the Lok Sabha elections in 2014 made it incumbent upon the incoming government to extend this scheme to all over the country. Under this scheme, an allowance of Rs. 6,000 is to be given to all pregnant women and lactating mothers (PWLM), to partially compensate them for wage-loss so that women can take adequate rest before and after delivery. This is especially important for women in the unorganised sector, who make up 90 percent of the country’s female workforce. Fear of losing wages often forces women in the informal sector to work through pregnancy and immediately thereafter, to the detriment of their own health and the health of their babies, who require at least 6 months of regular breastfeeding. This scheme also comes under the Ministry for Women and Child Development.
Despite this scheme being mandated by a Parliamentary law, the BJP refused to extend this scheme to all over the country for 3 years. Activists and academics mounted pressure on the government to implement the maternity entitlements, as they were much needed to tackle the huge maternal health crisis gripping the country: according to the WHO, in 2016, India accounted for 17 percent of all childbirth deaths in the world, with nearly 5 women dying every hour in India due to pregnancy and delivery related complications.[11]
Prime Minister Modi finally announced the implementation of these entitlements in his address to the nation on 31 December 2016. But as is his wont, he repackaged the programme and proudly presented it as a new scheme, the Pradhan Mantri Matru Vandana Yojana (PMMVY). The new scheme reduced the financial support given to PWLM during the first pregnancy to Rs. 5,000, from the Rs. 6,000 stipulated in the NFSA.[12] It also limited the benefit to first live birth, again contradicting the NFSA which granted this financial support to all PWLM. (In 2022, the scheme was revised and now offered the allowance to a second child, if the infant is a girl. The aim is to discourage female foeticide.)
Following the PM’s announcement, FM Arun Jaitley announced an enhanced allocation for PMMVY in his 2017 budget.
It is a very insensitive government in power. It found a way to reduce the allocation for pregnant women, one of the most high-risk groups in society who need utmost care. The FM introduced conditionalities such as institutional delivery and full vaccination for women to be eligible for this financial assistance. These conditionalities actually end up excluding 60 percent of the country’s women, because they don’t deliver in hospitals, and/or are unable to vaccinate their children. But they are the ones who need these maternity benefits the most, as they include women from the poorest sections of the population, belong to Dalit and Adivasi communities, and live in the remotest areas of the country. They are unable to deliver in hospitals or vaccinate their children, because of the terrible state of government health services in the country.[13] Instead of focussing on improving facilities in government hospitals, and making hospitals more accessible for the poor (by improving ambulance facilities), the suit-boot sarkar’s FM/PM put the blame on the victims of our dismal public health system, and barred them from receiving maternity benefits!
Because these conditionalities excluded a majority of women from this scheme, the FM saw no reason to allocate enough funds to cover all the eligible PWLM in the country. For the first year (2017–18), he allocated only Rs. 2,700 crore (and spent only Rs. 2,084 crore), whereas a budget outlay of Rs. 3,870 crore was needed to provide the assistance of Rs. 5,000 promised under PMMVY to all the estimated 129 lakh mothers who were eligible for receiving assistance under the scheme.[14] In 2018–19, the number of eligible women increased to 130.9 lakh and in 2019–20 to 132.7 lakh.[15] But as we can see from Chart 12.2, the FM reduced the budget allocation, and actual spending was even lesser. Consequently, according to an estimate by Accountability Initiative, only 35 percent of the eligible PWLM had been covered under the scheme as of 2 January 2020. The money is paid out in 3 instalments to each beneficiary; only 44 percent of the women had received all three instalments.[16]
To fudge the insufficient allocation being made under the scheme, in 2021–22, the FM merged PMMVY with six other women empowerment schemes under a new head Samarthya. In the subsequent budgets, the FM again reshuffled the umbrella schemes, to include some more schemes under Samarthya. But all these schemes have very tiny budgets; we estimate that around 93 percent of the total budget for Samarthya is spent on PMMVY. Based on this assumption, we have plotted the budget for PMMVY in Chart 12.2 (for those years where this figure is not available). As we can see from the chart, in no year has the budget allocation crossed the 2017–18 BE allocation of Rs. 2,700 crore. And except for the year 2019–20 A, actual spending has remained way below the budget estimate!
Chart 12.2: Allocation for PMMVY, FY18–FY25 (Rs. crore)
For 2023–24, the figure for PMMVY A is revised estimates; actuals will only be available next year.
We have assumed that the budget estimate and actual spending for PMMVY constitutes 93 percent of the total budget for ‘Samarthya’ for the years where separate budget for PMMVY is not available. These years are marked in square icons in blue.
This only means that an overwhelming number of PWLM continue to be denied their maternity entitlements under one excuse or the other. According to a press release of the Ministry of Women and Child Development, as of 15 July 2022, a total of 257.6 lakh women had been given maternity benefits during the five-year period 2017–18 to 2021–22 and up to 15 July 2022 in the financial year 2022–23, or roughly 50 lakh women per year.[17] This figure is way below the total estimated number of pregnant women and lactating mothers in the country. A budget brief by Accountability Initiative estimated that total number of eligible PWLM in 2022 was 198 lakh — implying that only a quarter of them were receiving the promised financial assistance![18]
The payment is made in 2 instalments; an RTI response by the Ministry of Women and Child Welfare admits that of the limited number of women receiving financial assistance under PMMVY, 29 percent had not received their full payment.
The above mentioned budget brief by Accountability Initiative estimates that in FY 2022–23, the total budget allocation required to cover only the first live birth was Rs. 8,204 crore. The budget allocation was less than a third (Rs. 2,438 crore), and money actually spent was less than a quarter of this amount (Rs. 1,995 crore).
A financial assistance of Rs. 5,000 to pregnant women and lactating mothers is actually a very inadequate sum. The total budget outlay for covering all PWLM works out to only Rs. 8,200 crore, which is a tiny sum for a country like India — which has the world’s third largest number of billionaires. Yet our PM and FM do not see it fit to allocate this small amount for our mothers. What a shame!
c) Mid-day Meal Scheme
This is another important nutrition programme to combat the huge malnutrition levels among children in the country; an additional objective is to improve school enrolment and child attendance in schools. Allocation for this comes under the Ministry of Education. A footnote to the budget document of the Department of School Education and Literacy says that this scheme “is one of the foremost rights based Centrally Sponsored Schemes under the National Food Security Act, 2013 (NFSA).” This scheme has also been renamed after our PM. Earlier called the National Programme of Mid-Day Meals in Schools, it has now been rechristened ‘Pradhan Mantri Poshan Shakti Nirman’ or PM-Poshan.
But it is only hollow theatrics. The Modi Government is not willing to allocate a decent amount for providing one nutritious meal a day to our children, despite the fact that more than one-third of our children under five — about 4.7 crore souls — suffer from stunting. The budget papers show that the amount spent under this scheme last year (2023–24 RE) was less than the actual amount spent during Modi’s first year in power (2014–15). On paper, the allocation this year (2024–25 BE) has been hiked by 25 percent over last year’s RE, but it is actually less than the amount spent in 2022–23. Even assuming that the full allocation this year is spent, it amounts to a cumulative annual increase (CAGR) of only 1.71 percent over the actual spending in 2014–15 (Table 12.2), implying a reduction in real terms of 32 percent.[19]
Table 12.2: Allocation for Mid-Day Meal Scheme, FY15–FY25 (Rs. crore)
| 2014–15 A (1) | 2022–23 A | 2023–24 RE | 2024–25 BE (2) | Increase, 2 over 1, % (CAGR) | |
| PM-Poshan (Mid-day Meal Scheme) | 10,523 | 12,681 | 10,000 | 12,467 | 1.71% |
iii) Total: Nutrition Schemes
Adding up the allocation for all the 3 important nutrition schemes discussed above — Saksham Anganwadi and Poshan 2.0, Samarthya and PM-Poshan (Mid-day Meals Scheme) — the total allocation is (21,200 + 2,341 + 12,467 =) Rs. 36,008 crore in 2024–25 BE. This is just 0.75 percent of the total Union Budget outlay!
Such is the commitment of the Modi Government to improving the nutritional status of our people, especially our women and children.
Notes
1. “Abject Failure: On India’s Global Hunger Index Ranking”, 17 October 2024, https://www.thehindu.com.
2. “India Cannot Fix its Problems if it Pretends They Do Not Exist”, 8 August 2024, https://www.economist.com.
3. See, for instance: “The Physical, Mental, and Social Effects of Hunger”, 9 February 2023, Published online by Cambridge University Press, https://www.cambridge.org.
4. “Modi’s Farm Produce Act was Authored 30 Years Ago, in Washington D.C.”, RUPE, Mumbai, 17 January 2021, https://janataweekly.org.
5. Chris Lyddon, ‘Focus on India’, World Grain, January 12, 2017, http://www.world-grain.com.
6. See Chapter 3.
7. CAGR. Our calculation, assuming an average inflation rate of 6 percent.
8. Sourindra Mohan Ghosh, Imrana Qadeer, “An Inadequate and Misdirected Health Budget”, 8 February 2017, https://thewire.in.
9. CAGR. Our calculation, assuming an average inflation rate of 6 percent.
10. Our calculation.
11. “5 Women in India Die Every Hour During Childbirth: WHO”, 16 July 2016, https://indianexpress.com.
12. The government announced that the remaining cash incentive of up to Rs. 1,000 would be given under a separate scheme called the Janani Suraksha Yojana so that on an “average” women get a total sum of Rs. 6,000, as stipulated under the NFSA.
13. Maya Palit, “So Glad You Mentioned Pregnant Women, PM-ji. How About We Tell You What We Know About These Schemes?” 4 January 2017, http://theladiesfinger.com.
14. The number of beneficiaries (129 lakh) is an estimate made by Accountability Initiative (see: Budget Briefs: PMMVY–JSY–2020–21, https://accountabilityindia.in.) The calculation of Rs. 3,870 crore has been done by us assuming a Centre–State cost sharing of 60:40.
15. Budget Briefs: PMMVY-JSY-2020–21, ibid.
16. Ibid.
17. Enrolments under PMMVY, Ministry of Women and Child Development, 29 July 2022, https://pib.gov.in.
18. Avani Kapur et al., Budget-Briefs: PMMVY–JSY–2023–24, https://accountabilityindia.in.
19. CAGR, calculated assuming an average annual inflation rate of 6 percent.
(Neeraj Jain is a social–political activist with an activist group called Lokayat in Pune, and is also the Associate Editor of Janata Weekly, a weekly print magazine and blog published from Mumbai. He is the author of several books, including ‘Globalisation or Recolonisation?’ and ‘Education Under Globalisation: Burial of the Constitutional Dream’.)