India's gnawing pain

"This has not been a policy priority for this country for the last 40 years," said Victor M. Aguayo, chief of child nutrition and development at the United Nations Children's Fund office in New Delhi. "There was an underlying assumption that as soon as economic growth takes place, this will vanish. So let's focus on economic growth; let's focus on getting rich."

Instead, India's performance in combating child malnutrition has been worse than that of other countries with similar economic conditions. Close to half of all young children in India -- or a staggering 60 million -- are malnourished. Only Bangladesh and Nepal have a higher percentage of underweight children.

In a speech last year, Indian Prime Minister Manmohan Singh acknowledged the gravity of the situation, calling it a "national shame."

"We cannot deny that it is a crisis," said Loveleen Kacker, a senior official at the central Ministry for Women and Child Development. "Maybe we didn't treat it like a crisis earlier, which we should have. Then we would have taken corrective steps much earlier than now. And what we're thinking of doing now we should've started 10 years back."

The World Bank estimates that malnutrition and its negative effects on health and productivity cost India as much as 3% of GDP a year. Beyond the economic fallout is the damage to India's image and credibility as it tries to assert itself as an important player on the world stage.

"It's not nice to want to have an international role and then find that you're having to defend such an indefensible position," Kacker said.

Just why malnutrition remains such a stubborn problem here is due to a constellation of causes that tend to reinforce and aggravate each other, creating "the perfect storm of risk factors," as Aguayo put it.

At root is the abject poverty so pervasive in India, where one-third of the population of 1.1 billion squeaks by on less than $1 a day. Another third makes do with $2 a day.

That deprivation can stack the cards against a child before he or she is even born. Too many women here are underweight and undernourished themselves, the major reason why 30% of Indian babies enter the world weighing less than 5 1/2 pounds. Afterward, in the crucial first two years of life, many children are fed sugary water, animal milk, rice and other foods lacking the fat, protein and vitamins necessary for proper physical and mental growth.