A for India: Bill Gates impressed by nation’s focus on eliminating malnutrition

India is more focused on solving the problem of malnutrition than any other country, feels Microsoft co-founder and billionaire philanthropist Bill Gates. He has also said that he would give India an ‘A’ score for this focus.

Speaking to the Press Trust of India in the United States on the occasion of the launch of the Gates Foundation’s Goalkeepers Report 2024, he said, “Well, India, for its income level, acknowledges that some of these nutritional indicators are weaker than it would like. That kind of frankness and focus on it, I think is very impressive.”

About India’s strategy, he said, “It’s using the public feeding system and the Midday Meal System to try and get fortified foods out… I would give India an ‘A’ for focus on the problem.”

The Gates Foundation’s Goalkeepers Report is an annual document that tracks progress on the United Nations Sustainable Development Goals (SDGs). The Foundation is one of the biggest funding agencies in the global efforts to bring down malnutrition.

Gates said that the understanding of malnutrition had improved a lot. “Part of that’s been understanding the complex system in your gut, which involves a lot of bacteria. It’s called the microbiome. But what we’ve seen is that if you’re missing certain vitamins or if you’re missing protein, some kids, their gut gets inflamed, so they can’t absorb the food they’re eating, and they simply don’t grow.”

One of the tragedies of malnutrition was measuring how much a child lost in terms of their physical and mental capabilities because of malnutrition at a young age, he said. “We haven’t had a very good measure of that. We’re getting better at that,” he said.

Solving malnutrition or even just reducing it had two major benefits, he said. One was that a well-nourished child was “far less likely, twice as less likely”, to die from diseases like diarrhoea or pneumonia during their early years. Another was that eliminating or reducing malnutrition could combat the deficit in those early years that could affect development even in later years.

Explaining why preventing malnutrition in the early years was so important to growth in the later years, Gates said, “…If you don’t have full brain development at an early age or full height and strength development, when you’re older, it doesn’t matter if you eat enough; you don’t grow those extra inches, gain that strength, or have your brain develop.” Therefore, malnutrition in the early years can mean a lifelong deficit.

For a nation like India, solving the malnutrition problem would bring significant economic rewards, said Gates.

“India is a great example where, if we can reduce malnutrition, it literally helps drive meaningful economic growth,” said the co-chair and Board Member of the Gates Foundation.

“[India] is the place where [there are] these new approaches, like the probiotic where we have the trials going on,” he said.

The Indian private sector, said Gates, was investing in methods that would bring down the cost of treating anaemia with a one-time infusion.

“And as we see the success of the interventions, that will clearly indicate that in Africa, which has an even more challenging malnutrition problem than India does, what should be the priority in those countries,” he said.

In the next five years, a lot would be learnt in India that would provide information for other programmes globally, Gates said.

About philanthropy in India, he said that it was great to see the increasing number of philanthropists, including people in the tech sector.

“We’re involved in sharing ideas and really encouraging and celebrating that some of that philanthropy, both individual and corporate, does go against health and malnutrition specifically. We have good partners,” said Gates.

He added, “If you go back 10 years ago, [Indian philanthropists] would have been more limited, like the Tata Trusts and Nandan Nilekani. But now, with additional success and encouragement, it’s gotten to be quite a bit broader.”

In response to a question, Gates said that the period from 2000 to 2019 was a miracle period. “And it’s the result of a lot of things, but the biggest is what we did to get new vaccines out to all the world’s children,” he said.

India played a very big role in the global vaccination drive, said Gates, as the majority of new vaccines for Rotavirus, pneumococcus etc were made in India.

“We’ve worked with those partners to get not only the [vaccine production] volumes up, but also to get the cost down. That’s allowed GAVI to provide the vaccines basically for free to developing countries,” said Gates.

GAVI is an international organisation created in 2000 to improve access to new and underused vaccines for children living in the world’s poorest countries.

Gates said that during the pandemic, many countries that had been borrowing money reduced their spending on health. “Fortunately for India, that’s not as much the case. The external debts are not gigantic. You haven’t had that kind of squeeze,” he said.

India was self-reliant when it came to scaling things up in a very, very big way, he said. “If we can take the latest innovations, including in these nutrition areas, there’s every reason to think [that] India can continue the health improvement, including reducing maternal death and childhood death,” said Gates.