Food or Water for India's Children--Does it Have to be a Choice?

India will likely surpass China as the earth's most population nation by 2030, according to the latest UN Population Division projections. India has a higher fertility rate than China (almost one child per woman more), but this is partially offset by the much higher rate of infant and childhood mortality in India than in China. The high death rates are broadly indicative of poor health among the children who remain alive. One aspect of poor health is malnutrition and this week's Economist reports on a new politically-motivated scheme to get cheap food into the hands of more of India's residents. 

The scheme aims to reach 800m of India’s 1.2 billion people, giving each a monthly dole of 5 kilos of rice or wheat, at a nominal price. That makes it the world’s biggest serving of subsidised food.

But, is this the best way for India to spend its money if improved health is really the objective?

It would be better to deal with pitifully bad nutrition than plain hunger. Walk around any north Indian village where grain seems adequate, and stick-thin people offer evidence of how few nutrients are being absorbed. Roughly half of all children under five are malnourished. Save the Children, a British charity, said in June that over 60m children, aged five or younger, are stunted. The consequences can be grim: damage to young brains, a reduced capacity to learn, even death.

Yet helping children requires more than a supply of base calories. A lack of protein or vitamins in diet, dirty water, neglect of girls, lack of education on hygiene and ill-nourished mothers who get pregnant too often: all contribute to the problem. Arvind Virmani, a prominent economist, argues that cleaning up water supplies, especially by building sewage systems, would do far more good against malnutrition than doling out more grain. Just a simple hand-washing campaign could be of huge help.

On the face of it, you can hardly argue with the notion of getting hot lunches to children who would otherwise not have one, but a more well-rounded and potentially even less costly set of other health policies initiatives should also be on the table when billions of dollars are going to spent, as will be the case with the proposed food program.