Hunger, Malnutrition And The GHI Debate: Why India’s Nutrition Crisis Cannot Be Wished Away

Every day, an estimated 25,000 people worldwide—more than 10,000 of them children—die as a result of inadequate access to food. India, despite being one of the world’s leading food producers, accounts for the largest number of undernourished people, estimated at 194.6 million.

Although the country has recorded significant economic growth over the past two decades, food insecurity and malnutrition remain serious public health challenges. As India seeks to confront these persistent issues, it continues to face formidable obstacles in meeting Sustainable Development Goal 2, which commits nations to ending hunger by 2030.

The Global Hunger Index (GHI), developed by the International Food Policy Research Institute, is a key tool for assessing and tracking hunger at both national and subnational levels, drawing on a composite of multiple indicators.

The Government of India, in a recent Parliamentary answer, rejected the Global Hunger Index’s assessment of the country, terming it a flawed measure of hunger that does not reflect the country’s true position. India was ranked 102 out of 123 countries, in what the GHI says has sufficient data to calculate the scores. 

With a score of 25.8 in the 2025 Global Hunger Index, India has a level of hunger that is serious. In a detailed query section, GHI’s website has explained how their shortlisted indicators function.

‘Undernourishment’ is defined as the share of the population whose caloric intake is insufficient; ‘child stunting’ is the share of children under the age of five who have low height for their age, reflecting chronic under-nutrition. ‘Child wasting’ is when the share of children under the age of five has low weight for their height, reflecting acute under-nutrition; and lastly ‘child mortality’: the share of children who die before their fifth birthday, reflecting in part the fatal mix of inadequate nutrition and unhealthy environments.

However, the government argues that three of the index’s four indicators are linked to child health and nutrition outcomes and cannot be used to assess the prevalence of hunger in the overall population. It added that the only indicator directly related to hunger, the prevalence of undernourishment, suffers from serious methodological and data limitations.

GHI stated that India’s 2025 score is an improvement from its 2016 score of 29.3, and 2000 and 2008 scores of 38.1 and 34.6, respectively, considered alarming and serious. 

However, India's child wasting rate, at 18.7 per cent, is the second highest in the report; its child stunting rate is 32.9 per cent; its prevalence of undernourishment is 12.0 per cent; and its under-five mortality rate is 2.8 per cent.

Experts contend that the government’s position on the Global Hunger Index is fragile, and that its argument—that indicators focused largely on children cannot be extrapolated to measure hunger in the overall population—has significant limitations of its own.

Even though the Indian government disagrees with how the Global Hunger Index is calculated, we cannot deny the existence of hunger and poor nutrition in India, said Dr Asna Urooj, a Professor of Food science and Nutrition at the University of Mysore. “Many children are underweight or not growing properly. The Indian government's NFHS data confirms this.” 

As per the Indian government, stunting and wasting are not measures of hunger, but outcomes of multiple complex factors including sanitation, environmental conditions, disease burden, maternal health, genetics, and food utilisation. Similarly ‘Under Five Mortality Rate’, is influenced by a wide set of determinants such as access to health care, immunisation coverage, sanitation and hygiene, safe drinking water, and overall socio-economic conditions.

The government stated that the methodology adopted by GHI is ‘flawed’ and it cannot be taken to reflect hunger in the overall population.

However, Urooj adds that today, most countries across the world, including India, use the globally accepted WHO-Multicentre Growth Reference Study (MGRS) growth standards for the purposes of measurement as well as for evaluating progress on these metrics.

MGRS, which was conducted between 1997 – 2003 and enrolled children from Brazil, Ghana, India, Norway, Oman, and the United States, demonstrated that all economically advantaged children who were breastfed as infants grow similarly when they are not exposed to adverse nutritional environments. “A single set of growth charts can be used to judge growth in any child, regardless of race or ethnicity,” says Urooj.

Urooj explains that there is strong evidence that shows that healthy children worldwide grow similarly according to the World Health Organization Child Growth Standards when they live in healthy environments, no matter their race, ethnicity, or nationality.  She adds that these standards are designed precisely to allow meaningful comparisons across countries making them a widely accepted benchmark in assessing child nutrition and growth outcomes globally. 

“The term hunger evokes a certain emotionality which I would actually argue against,” said Vandana Prasad, a public health professional with over two decades of experience in the field.

“I think the government mostly has a problem with the fact that it's being called hunger which is maybe perhaps an over-interpretation of the findings in the sense that hunger is slightly different from malnutrition,” she adds.

The sensation of not feeling hungry does not mean that one is not malnourished, notes Prasad. The terms are not synonymous and technically should be used slightly more carefully. However, the interchangeability doesn't mean that we should not be concerned as a government and as a country about the current rates of malnutrition in very many different ways, she adds.

Anaemia, obesity, over-nutrition or stunting as metrics tell us plenty about the overall situation, nutrition and development. “It is not just food, these indicators are so powerful that they basically indicate an entire socio-economic status,” said Prasad. 

The government in its answer claimed that nutrition goes beyond mere eating of food; it requires proper digestion, absorption, and metabolism of nutrients. Furthermore, it mentions various initiatives under the Ministry of Health and Family Welfare and Ministries of Women & Child Development, working alongside Anganwadi Centres and keeping tracks on ‘Poshan Tracker’. As of October, 2025, Poshan Tracker had at least 8 crore beneficiaries. 

While the government states that Poshan Tracker data shows improvement in malnutrition indicators in children across the country, GHI does not acknowledge the aforesaid data since it is not included in the UNICEF-WHO-World Bank Joint Malnutrition Estimates Joint Data Set Including Survey Estimates and/or the WHO Global Database on Child Nutrition.

“The GHI uses the same data sources for all countries to calculate the respective country scores. This ensures that all the rates used have been produced using comparable methodologies,” the website mentions.

Child undernutrition in India goes hand in hand with the poor nutritional status of mothers, GHI mentions. The child wasting rate in India is highest at birth and then consistently declines to the age of three, at which point it becomes fairly steady. 

This pattern suggests an intergenerational pattern of under-nutrition where the factors driving India’s high child wasting rate are mothers’ insufficient weight gain during pregnancy and low birth weight among infants. This underscores the need for attention to gender inequalities, maternal health and nutrition, and infant feeding.

There needs to be more investment in maternal health and nutrition, improvements in public hygiene, said economist Reetika Khera. “Economic growth, rising GDP ought to make resources available for the government to invest in programmes like the ICDS or PMMVY,” she said, adding that in the Indian case, governments tend to starve these programmes for resources.

Urooj stated that a limitation of GHI is the upward bias it induces because of using proxy indicators involving undernutrition and under-5 mortality. This is because while hunger leads to undernutrition, hunger alone is not the only reason for undernutrition or mortality. Nevertheless, India, despite its economic growth, faces alarming disparities in hunger levels across its districts.

A study examined the spatial distribution of hunger across 692 Indian districts revealed high spatial disparity, with 90 districts identified as hunger hotspots. Factors such as the Multidimensional Poverty Index, lack of education, and inadequate sanitation were significant contributors to higher hunger levels. These findings emphasise the multidimensional nature of hunger and highlight the need for district-specific interventions addressing socio-economic inequalities and improving nutrition to effectively combat hunger in India.

Beyond the debate of hunger, malnutrition and the relevance of GHI, Prasad mentions that what needs to be acknowledged is the state of socio-economic development, inequity, and difficulty accessing decent food.

“Nutrition has a lot to do with food but it is not only true with food. It's also to do with healthcare, poverty, gender and every one working in public health nutrition actually understands that,” she says, adding that it is trivial and not meaningful to be quibbling on very narrow things. “I think broadly we all as a country should be very concerned about the state of nutrition in our country.”