The international nutrition system is broken. Leadership is absent, resources are too few, capacity is fragile and emergency response systems are fragmentary. New governance arrangements are urgently needed. An agency, donor, or political leader needs to step up to this challenge. There is a fabulous opportunity right now for someone to do so. But who?

—Richard Horton in the introduction to the five-part series on maternal and child undernutrition, The Lancet, January 17, 2008

It may be worthwhile for the finance minister to look at the recent Lancet series on maternal and child undernutrition before he allocates money to the Integrated Child Development Scheme (ICDS), the only government programme in the country that is designed to cater to the nutritional requirements of children under six. In the Lancet study — a global, scientific report by a team of public health scientists — he may not find a single fact that he has not heard from experts in India. And herein lies a sad tale.

Among the 20 countries where four-fifths of all undernourished children live, India is home to the largest number. The country is a perfect example of the trend pointed out in the study: nutrition slipping through the gaps even as the portfolio of interventions increases. The last round of the National Family Health Survey (NFHS 3) shows that malnutrition has reduced by just one per cent (from 47 per cent to 46 per cent) in the last eight years. This just means every second child under six years of age is underweight, a statistic worse than that in sub-Saharan Africa.

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