Can Biofortified Crops Reduce Malnutrition in Bihar?

It is ironic and unfortunate that while India aims to become a $5 trillion economy by 2025, more than a hundred children died in less than a month due to acute encephalitis syndrome (AES) in Bihar’s Muzaffarpur district (Tripathi and Pandey 2019). The state government initially claimed that toxins found in litchi fruits caused the disease. However, the causes were later found to be more complex (Kaur 2019). While there is no consensus on what triggered the outbreak of AES, or even the cause of the deaths, one thing is clear: there was a high prevalence of malnutrition among the children who suffered. Seventy percent of the victims were under the age of five years and came from rural and poor backgrounds (Ganapathy 2019). A preliminary survey by central and state authorities found that among the 289 families surveyed in Bihar’s Muzaffarpur district affected by the outbreak, 280 were below the poverty line (Kumar 2019a). Residents of Harivanshpur village in Muzzaffarpur protested against the government’s inaction by blocking the highway that connects Vaishali and Muzaffarpur. Parents of the children who died because of AES were among the protestors (Kumar 2019b). 
Across the state, it is alarming to note that nearly half of the population below the age of five is not receiving proper nutrition. In rural Bihar, the National Family Health Survey-4 found that 49.3% of children below five years of age were stunted, nearly 21% were wasting, and 45% were underweight (IIPS 2017). Stunted and underweight children represent the proportion of children who suffer from chronic and acute undernutrition (Saha 2019). In 2015, India committed to take steps for achieving the United Nation’s 17 Sustainable Development Goals, the second goal explicitly focusing on ending hunger, and achieving improved nutrition and food security (RIS 2017).  Despite achieving higher production levels and greater self-sufficiency of food grains, India continues to have a poor record on food and nutrition security (UN 2017). According to the Global Hunger Index (GHI) 2018, India ranks 103 out of 119 countries (Hindu 2019). The deaths of children in Bihar are a reminder of how far India is from the goal of eradicating hunger and achieving improved food security by 2030.
In the last 50 years, agricultural research has focused primarily on calorically dense crops. The prices of nutrient-rich non-staple foods have increased steadily because of high demand and relatively low supply (Bouis et al 2011). This makes it harder for low-income groups to afford nutritious non-staple foods. While no single intervention will alleviate the complex issue of food security, one intervention that can be effective is the use of biofortified staple cereals. We will detail the benefits of biofortified crops and present a strategy through which Bihar’s food security can be improved using biofortified cereals. Our research relied on an examination of existing distribution networks operating under food security welfare schemes and meetings and group discussions with agricultural scientists and representatives of farmers’ groups, government agencies, the seed industry, and non-governmental organisations (NGOs). 

Addressing Malnutrition

Biofortification describes a process where the nutritional quality of food crops are enhanced using specific agronomic practices, conventional plant breeding, or modern biotechnology. While conventional fortification aims to increase nutrient levels in foods at the time of processing, biofortification aims to do so during the plant growth phase. Biofortification projects can be designed and implemented based on context-specific deficiencies in minerals and vitamins that groups of people might be experiencing. For example, Stein et al (2007) argued that Indians lose about 2.8 million disability-adjusted life years (DALYs) every year due to deficiency in zinc.[1] Biofortification of rice and wheat with zinc has the potential to reduce this number by 20%–51%, redeeming between 1.4–0.6 million DALYs per year. Stein et al (2007) also argue that zinc biofortification is cost-effective in comparison to other micronutrient interventions. 
Stakeholders must ensure that technology and infrastructure are in place and that seeds are accessible to farmers to aid them to grow biofortified crops. State agriculture universities, with the support of institutions like International Food Policy Research Institute and HarvestPlus, are in the process of developing or finding suitable varieties. They are close to releasing biofortified varieties. Early notification and certification of biofortified varieties can facilitate availability. NGO representatives who were consulted for this research claimed that the quality of the produce and the yields for biofortified cereals were better than popular hybrid varieties used in Gaya and Muzaffarpur in Bihar. Biofortified cereals available in the market are relatively expensive and thus remain inaccessible to poor and marginalised people. 

Government Networks and Schemes

To ensure that biofortified cereals are accessible to nutrition-deficient groups, the government can use multiple networks of procurement and delivery. About 81% of households in Bihar have already been identified as priority households to get subsidised cereals under the National Food Security Act, 2013 (Drèze et al 2015). Distribution of biofortified cereals through this well-oiled public distribution system will ensure that the fortified cereals reach nutrition-deficient groups at a subsidised price. In addition, farmers will be supported since their produce will be purchased at the minimum support price.  The Bihar State Food and Civil Supplies Corporation makes cereals and other essential commodities available to specific groups through 4,500 fair price shops. 
By incorporating the use of biofortified crops in two welfare schemes, malnutrition levels in children can be reduced. This is important given that children are particularly vulnerable to malnutrition, morbidity, resultant disability, and mortality (Ade et al 2010; Kurian and Suri 2019). As of 2017, under the Integrated Child Development Scheme (ICDS), 80,211 anganwadi centres in Bihar seek to offer a supplementary nutrition programme to over 79 lakh beneficiaries covered under the supplementary nutrition program (Government of Bihar 2017). The scheme includes providing rations and hot-cooked meals. The nutrient intake of recipients can be increased if biofortified cereals are included in the ICDS. The Mid-Day Meal scheme has a broad reach in schools across Bihar as well. As of 2019, it was running in 70,238 schools across the state, and covered more than one crore children. This scheme can be used to address general nutritional deficiencies in students as well as addressing deficiencies at the block and district level. 
The existing “Decentralized Procurement Scheme” (DCP), for example, requires food grains to be procured and distributed by state governments themselves. The government argues that this scheme offers a more efficient alternative to a centralised system (Ministry of Consumer Affairs, Food and Public Distribution 2015). Thus, agencies such as the National Agricultural Cooperative Marketing Federation of India and the Tribal Cooperative Marketing Development Federation of India under the DCP can procure biofortified cereals effectively and ensure they reach intended recipients. 
The deaths of over a hundred children because of AES underscores the impact poverty and malnutrition has on low-income groups. If nutrient-rich food reaches these groups, the prevalence of malnutrition can be reduced. Incorporation of biofortified cereals in government welfare schemes at the level of procurement, distribution, and delivery can address the challenges of price and physical inaccessibility. National and international agencies and universities are already conducting research and implementing projects on biofortification. Committed efforts to reduce malnutrition are required to prevent an outbreak similar to the one that took place in Bihar in 2019.