A Food Program That's Not About Food

What India's starving children don't need is more blind handouts. What they do need is real social change.

Last year, the New York Times splashed stark images of child malnutrition in India's hinterland across its front page. More recently, another front-page article in the Times reminded the world that India's hunger problem hasn't gone anywhere and told the story of how various social-safety-net programs have failed to help. As the article explains, India still faces endemic problems with chronic malnutrition and hunger -- rates of child nutrition here compare unfavorably with many countries in sub-Saharan Africa -- that government initiatives have failed to address.

The story of why hunger persists in India is long, sometimes depressing, and full of paradoxes, the central one of course being the fact that the country actually has a booming economy and robust food stocks. But really it's a story of poor planning, social exclusion, gender inequality, and above all, a government that's failing to translate new capital into broad prosperity for its people. Because of this, the various schemes for food distribution debated in the recent Times article, which are part of the conversation as India's long-delayed National Food Security Bill wends its way slowly through the political system, will likely do little to create a long-lasting solution to hunger in India. Any real effort will have to start with the country's social and governance problems, and include nutrition programs that pick their targets better.

India's nutrition programs have failed to provide what the most vulnerable members of its population need -- and the new bill under development isn't likely to do enough to address them either. We've known for a long time that the period beginning before a woman gives birth and ending around the second year of her child's life are the crucial years for addressing nutrition. Miss this window, and the battle is largely lost. India's programs are only now just starting to take this "window of opportunity" paradigm into account. But to actually translate a policy into action, reaching all children under 2 with everything that they need (breast-feeding, high-quality foods, immunizations and preventive health care, hygiene and sanitation, and above all, mothers who are healthy themselves), an approach is required that goes far beyond food distribution. 

Taking social exclusion, the evidence has consistently shown that marginalized social groups -- particularly lower castes, certain tribes, and some religious minorities -- have poorer access to social-safety-net services and are also more likely to be excluded from India's rapid economic growth. The stories from Madhya Pradesh portrayed in the Times this year and last year exemplify this social exclusion (as does Foreign Policy's recent story on the resource wars in the nearby provinces of Chhattisgarh and Jharkhand), as they describe the precarious conditions that exist for India's tribal populations, migrant laborers, and extreme poor.

In 2006, the Supreme Court of India asked the government to universalize projects such as the Integrated Child Development Services, the world's largest health, immunization, and nutrition program for young children. This has certainly helped expand services to excluded geographic areas and groups, but ensuring quality of service and reaching the more vulnerable children is still a challenge.

Gender is a problem as well. Research has shown that empowering women is one of the most effective ways to improve nutrition, especially for children. Studies by the International Food Policy Research Institute (IFPRI), where I work, have demonstrated that the low status of women contributes to hunger and malnutrition -- not just among the women themselves, but among their children too.

It's easy to see this process at work in India. South Asia, including India, is one of the worst places in the world to be a woman, especially a poor woman. Sex-selective abortion, female infanticide, low rates of female education, early marriage, domestic violence, and social exclusion of widows create misery across the life cycle. These gender imbalances lead directly to poor nutrition among women, as well as compromising their children's nutrition. Our research in Bangladesh, for example, shows that women who condone domestic violence have children who are more undernourished than those who do not condone violence.

When it comes to children, malnourished women are much more likely to give birth to a low-weight baby -- birth weight being an important predictor of child survival. Not surprisingly, one-third of babies born in India are born with low birth weight, compared with one-sixth in sub-Saharan Africa.

The extent to which women are allowed to control household spending also affects childhood nutrition. Numerous studies, including those by IFPRI, have shown that income or assets controlled by women are more likely to be spent on items that benefit children and themselves, such as food, clothing, and health care, than assets controlled by men.

As with social exclusion, gender inequality has been the target of a number of government and civil society programs. Sex-selective abortion, female infanticide, early marriage, and domestic violence are illegal -- though they still persist. Some states, including Madhya Pradesh, have conditional cash transfer programs aimed at families with girl children. These programs provide financial incentives to families to keep girls in school and delay marriage. Unfortunately, though, little is known about their impact. This is another problem: Well-intentioned investments are made, but without research into outcomes, little is known about how well they work and how they can be made to work better. 

Under the best of circumstances, though, reshaping social norms around gender and class could take a long time. Part of the impetus must come from the Indian media, which to their credit have taken an interest in pushing Indians to question the basic assumptions they grew up with. A long-running TV serial, Balika Vadhu (Child Bride), tackles issues of child marriage and ostracism of widows by showing the daily struggles and stories of a girl married as a child and another married early and widowed at age 16. The show is among the top 10 most-watched soap operas in India. In October 2009, Life Gulmohar Style, a 156-episode radio drama by the BBC World Service Trust aired on FM channels of All India Radio and Dhamaal Radio and took on issues of women's rights, including the question of dowry, in the modern world by portraying the lives of five young people, men and women; the BBC World Service Trust will conduct research on the social impact of the show later this year.

Finally, there's the role of good governance in addressing the crisis. As the recent Times story pointed out, vast resources are being lost to bad planning and corruption. The proposed National Food Security Bill aims to guarantee food security for all people in India, using means such as provision of subsidized food grains. However, it is currently caught up in acrimonious back-and-forth between the group of ministers who drafted its early version and critics who would like to see a more encompassing bill. In either case, it doesn't address any of the broader social problems that are really at the heart of the hunger problem in India.

That's a huge niche for government to fill, as a major report last year from the Institute of Development Studies pointed out, suggesting solutions to governance problems such as poor local-area service delivery, poor outreach to excluded groups, and the overall political economy of nutrition in India. There are ongoing experiments with some approaches to increase transparency and accountability: for example, leaning on local-level government or civil society groups to audit programs. Programs like the National Rural Employment Guarantee Scheme, which guarantees 100 days of hard-labor employment to poor rural families and sets a minimum wage rate for such labor, has offered ways to inform communities about their rights and address grievances. Such mechanisms should be tried out in nutrition programs as well.

All these efforts notwithstanding, government has a ways to go, both on the national and local levels -- and outside pressure can help. India's media has been, again, a key player in the fight. The Tracking Hunger campaign by the Hindustan Times has continued to portray different dimensions of the hunger and nutrition problem in India, while other papers have covered discussions surrounding the National Food Security Bill as it continues to be developed. But NGOs and research organizations need to continue to offer material to the media and civil society that puts pressure on Indian policymakers (such as IFPRI's India State Hunger Index), while also asking tough questions about how the current programs are functioning.

International donors and NGOs must work on investing in programs and research with a positive effect on women and marginalized classes and minorities. Nutrition, health, and anti-poverty programs must be designed so that they help women control family resources. Leaders at the G-8 and G-20 must force India to confront the role of social exclusion, gender inequality, and poor governance in malnutrition. Research institutions must make the effort to document the effectiveness and impact of ongoing efforts to address food security and nutrition, to report on people who are left out of such programs, and to tell the positive stories of those who implement successful programs in the face of these hurdles. 

India's hunger problem is not necessarily fatal. If the country can take some decisive action, reaching out to women and the poor and excluded and scaling up the social safety net in effective ways, it could make radical changes in a comparatively short time. Countries such Brazil, China, and Thailand have made huge leaps in nutrition in their countries, all in a short period of time. India can hardly afford to be left behind. 



Yes, America Is Exporting Terrorism

Why the latest WikiLeaks revelations matter.

Partly because the deadliest attack in the history of modern international terrorism was against the United States, Americans tend to see their own country as the center of the counterterrorist universe. It was a U.S. president who declared a "war on terror," led by the United States. Although U.S. officials have said a lot about international cooperation, the cooperation they have had in mind has been mostly a matter of the United States leading, pushing, or insisting, and other countries conforming or complying. The same U.S. president summarized his standard for other countries' counterterrorist performance with the phrase "either you are with us or you are with the terrorists" -- the "us" of course being the United States -- and the United States has shown a tendency to lord that standard over its foreign counterterrorist partners. The transition from George W. Bush to Barack Obama has softened these hard edges, but Americans still take a very U.S.-centric approach to the subject.

Some of the American exceptionalism on counterterrorism began even before the attacks of September 11, 2001. Legislation in the 1980s claimed extraterritorial jurisdiction for U.S. courts and U.S. law enforcement agencies regarding any terrorist act in which U.S. persons or interests were victims. Clearly, if every other state made a similar claim, the result would be legal chaos. Think about what the U.S. reaction would be if, say, France claimed jurisdiction over a terrorist crime that a U.S. citizen committed on American soil, in which a visiting Frenchman happened to be one of the casualties.

Because the overwhelming U.S. concern understandably has been with terrorism within the United States and above all terrorist acts -- like 9/11 -- perpetrated within the United States by foreigners, terrorism by U.S. citizens has been a jarring note that has not fit into most of the tunes Americans have been playing about fighting terrorism -- many of which, having to do with such things as no-fly lists for international flights, have focused specifically on keeping foreign terrorists out of the United States. Especially ill-fitting have been several cases over the last couple of years involving Americans traveling abroad to commit terrorism in other countries such as Pakistan and India, including terrorism against non-American targets. A noteworthy example is the surveillance that Pakistani-American David Headley performed in support of the gruesome attack by Lashkar-e-Taiba in Mumbai in November 2008, which killed at least 160 people.

The U.S. export of terrorism calls into question the high -- perhaps sometimes impossibly high -- standard to which Washington holds other governments in controlling what emanates from their territories. U.S. officials might not say "either you are with us or you are with the terrorists" anymore, but it still is considered not enough for governments to refrain from sponsoring or supporting terrorism. They are expected to do whatever it takes to prevent their citizens from committing terrorist acts abroad, with little American patience for excuses about how difficult it is to control borders or the activities of private individuals. To the extent this is the U.S. standard, the United States itself has failed it.

This and other apparent U.S. double standards in counterterrorism, looked at through the eyes of foreign governments, raise several problems that are nicely summarized in a document in the latest WikiLeaks disclosure: an assessment by the CIA's Red Cell, a unit with a license to perform "out-of-the-box" analysis about problems and trends that would not normally be the focus of the agency's everyday analytical work. The assessment points out that the export of terrorism from the United States might make foreign partners more inclined to push back -- and would give them a stronger case in pushing back -- on counterterrorist matters on which they find the asymmetrical U.S. approach most irritating. For example, a foreign government might insist on obtaining confidential information on U.S. citizens it suspects of supporting terrorism, or even call for the rendition of a U.S. citizen. If the United States were to balk, the foreign government could refuse to cooperate in the other direction the next time the United States called for information on, or rendition of, anyone in the foreign country. Who could blame the foreign government, given that international terrorists have now shown that they can come from the United States, and not just to it?

The Red Cell assessment notes that some pushing back already has occurred, probably spurred by annoyance over the asymmetry in how the United States handles renditions and information sharing. It cites the example of Italy issuing criminal warrants in 2005 for the arrest of U.S. officials involved in the abduction and rendering to Egypt of an Egyptian cleric. Again, think of the roles being reversed: It would be a subject of great outrage, to put it mildly, in the United States if Italian officers were found to have secretly abducted someone from U.S. soil and flown him out to be locked up in someone else's prison. The assessment correctly observes that the price of contretemps arising from such disagreements includes damage to bilateral relations as well as more specific damage to counterterrorist cooperation.

Obviously the first thing the United States should do to reduce the chance of such problems is to try hard to curb the export of terrorists and terrorism from its own territory. Chiefly this means focusing at least as much attention on detecting homegrown terrorists (regardless of whether any such terrorists seem likely to commit their lethal deeds in the United States or abroad) as the heavy attention now focused on keeping foreign terrorists out of the United States. There is no single technique involved -- just a lot of hard domestic intelligence work mostly by the FBI and its partners in local and state law enforcement agencies. The United States also could be more forthcoming in making two-way some of its border protection procedures (such as passport checks and provision of extensive passenger information) that tend to be one-way now.

Because stopping the export of terrorism probably will be as difficult for the United States to achieve completely as it is for other countries, the next thing it can do is to be a little more understanding when other countries, despite good-faith efforts, come up short too. More generally, it can try to view everything it does in the name of counterterrorism through its foreign partners' eyes and get rid of the double standards. And more generally still, it should understand that the United States is not really the center of the counterterrorist universe, that counterterrorism did not begin with 9/11, and that some foreign partners -- who had been confronting serious terrorist threats long before terrorism became a top security issue in the United States -- have at least as much to teach the United States on the subject as the other way around.

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