The semantics of hunger

An important dimension of the ongoing discourse on the Global Hunger Index 2022 (GHI 2022) has been the appropriateness of the term ‘hunger’. The Press Information Bureau (PIB) release (October 15, 2022) put out a strong rejection of the index as “an erroneous measure of hunger” as it was “based on mainly indicators relating to health indicators of children is neither scientific nor rational”. Seasoned commentators have argued that hunger and nutrition are “two different things” and that “sensational use of the word hunger is abhorrent”.

The GHI reasons that its ‘hunger’ scores are calculated based on a formula that combines four indicators – undernourishment, child stunting, child wasting and child mortality -- that together capture the multidimensional nature of hunger. Further, taken together, these component indicators reflect deficiencies in calories as well as in micronutrients. Though India ranks 107 out of 121 countries, the GHI score has improved from 38.8 in 2000 to 29.1 in 2022.

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What does SDG say about hunger and indicators?

The Sustainable Development Goals (SDGs) were mandated by a United National General Assembly Resolution called the 2030 Agenda. SDG Goal 2 seeks to end hunger, achieve food security, improved nutrition and promote sustainable agriculture. SDG Goal 2 uses the following as the measure: “the number of people who suffer from hunger – as measured by the prevalence of undernourishment”.

Specifically, Indicator 2.1.1 measures the prevalence of undernourishment which is considered as “the share of the population with a caloric intake which is insufficient to meet minimum requirements for a healthy life”. Further, the goal for this indicator is to “end hunger by 2030 -- eliminating undernourishment for all”.

The NITI Aayog SDG Index also tracks Zero Hunger. The 2020-21 score was 47, up from 35 in the previous year. The score of 47 puts this Goal in the ‘Aspirant’ category (0-49). The target for the percentage of children under five years who are stunted is six, and the 200-21 national score was 34.7. Nine states scored above the national average: Haryana, Chhattisgarh, Jharkhand, Rajasthan, Uttar Pradesh, Gujarat, Madhya Pradesh, Meghalaya and Bihar.

At an overall score of 66 (100 is the maximum score on the NITI Aayog scale), India is in the front-runner category. The global Sustainable Development Report, 2022 noted that progress in 10 of the goals were similar to those in 2021, including Goals 2 (ending hunger), 3 (good health and well-being) and 6 (clean water and sanitation).

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Why does ‘hidden hunger’ continue to be acceptable, though hunger is not?

The scientific, technical and policy communities have for long used “hidden hunger” as an advocacy tool to draw attention to inadequate intake and absorption of vitamins and minerals (zinc, iodine and iron) that are too low to sustain good health and development. This terminology is used as it is less obvious than regular hunger but has significant nutritional consequences.

The term is very widely used as the obverse is considered obvious, that the consequences, and more importantly, the imagery of ‘hunger’ is traditionally marked by stunted children with swollen, distended abdomen (Kwashiorkor, malnutrition characterised by severe protein deficiency) or an emaciated appearance (Marasmus, severe malnutrition with visible wasting of fat and muscle).

India’s undernutrition, particularly in the severe category, has reduced consistently over the years and ‘hunger’ is hardly now associated with such imagery. Some researchers have also sought to reason that the indicator of hunger (getting two square meals a day throughout the year) used by the National Sample Survey Office (NSSO) underestimates it when compared to the Comprehensive Nutrition Survey (CNS). Others have applied the ‘synthetic panel approach’ to analyse food security transitions and have underscored the issue of chronic food insecure households.

In the decade of 1990s, the global community was focused on tackling hunger, as well as micronutrient deficiencies, in the lower income nations. Over the next two decades, as severe forms of malnutrition rapidly declined, the focus shifted to the challenges of ‘double burden’ – tackling undernutrition as well as rising obesity and non-communicable diseases. Micronutrient deficiencies remain inordinately high, though the National Family Health Survey figures on the prevalence of anaemia are a relevant example.

The South Asian enigma

Nutrition and child health researchers are familiar with the ‘South Asian enigma’ that captures the phenomenon of impressive economic growth and reduced poverty, not translating into intuitive or expected improvements in nutritional outcomes. A wide range of causes has been proposed, from sanitation to maternal undernutrition.

Among other important reasons, infant and young child feeding (IYCF) or complementary feeding indicators - specifically, adequacy and minimum dietary diversity - are important factors as undernutrition sets in during this phase. Its determinants are complex and span across the household,
community and governance factors.

The other under-recognised contemporary issue is the ‘food budget squeeze’. Scholars of this thesis point to the growing divergence in the relationship between poverty and hunger in India. This phenomenon points to the rising share of expenditure on essential non-food items, including education, healthcare, energy, transportation and communication. The point is not that central and state governments are not doing enough to mitigate hunger and improve food security but that strengthening other social sector investments may have collateral benefits in this domain too.

(Rajib Dasgupta is Chairperson at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi)

Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.