A response by Veena Shatrugna and Dr Sylvia Karpagam.
Firstly, Biocon Foundation claims to have started giving spirulina to children from “2012 even before the government embarked on the ‘project’,” according to this article in the Times of India. This means that for three years, from 2012 to 2015, Biocon has issued spirulina to children even before the Food Safety and Standards Authority of India’s approval in 2015.
These children are from the anganwadi and Biocon cannot directly access children and issue them nutraceuticals under the banner of the Department of Women and Child Development. If the department has approved Biocon issuing spirulina to children with severe acute malnutrition even before it has passed any safety standards, it becomes equally culpable and criminally liable for allowing this product to be issued.
If Biocon Foundation has indeed chosen to address malnutrition, then there are adequate guidelines for their ready reference that should have encouraged them to feed children locally produced foods and eggs. In any event, corporates have been clearly instructed to stay away from provision of food to children by a Supreme Court order in 2014 (PUCL vs Union Government) as commercial interests have always taken precedence over the nutritional requirements of children, particularly those from the the most marginalised sections.
If CSR is indeed the agenda, it is ironic that the Department of Women and Child Development has to then set aside Rs 3.6 crores for spirulina.
Malnutrition is represented in terms of standard-deviation classification, not in absolute numbers, so it is clear that Biocon does not understand elementary principles of nutrition. In their note on the Balaspandana programme, Biocon claims that: “According to a 2013 Lancet series on Maternal and Child Nutrition, increasing intake of protein, vitamin and minerals through nutrition supplements is an evidence based direct intervention which has an unusually high benefit-cost ratio”.
The Lancet statement is valid only when children have access to adequate food (calories). It is known that children from these areas of Karnataka had been starving and had a massive calorie deficiency, resulting in severe acute malnutrition (a deficit of approximately 400-600 calories). In this situation it is a mockery of sorts to provide vitamins and minerals on a hungry stomach, because no amount of vitamins and minerals work if there is no food – that is, energy. The tragedy is that spirulina, which could make matters worse, was distributed.
In fact, in many of the anganwadis visited by us, severely malnourished children have not been given eggs for several months and not even the basic foods, under the pretext of not having the requisite supplies and facilities to make the meals. In effect, children are being given spirulina granules as the only supplement, without even a single meal from the anganwadi.
The claim by the corporate that “the successful intervention and improvement in the malnutrition status among children aged under five in the last four years by Biocon Foundation has resulted in a tremendous decline in the number of severe acute malnutrition children in the region” has no basis and amounts to undue misrepresentation to ensure that this product is marketed at a large scale by a corporate entity.
Even in the best-case scenarios, children shift from severe acute malnutrition to moderate malnutrition (that is, from a -2 standard deviation to a -3 standard deviation). We were given to understand that no baseline information was collected. In any case, the data is not in the public domain and has not been peer reviewed. The nature of the claim that using spirulina reduces malnutrition too has not been substantiated.
The statement that spirulina is approved and recommended by WHO to governments across the world to combat malnutrition is a fraudulent claim and not backed by any WHO statement. In fact, this so-called endorsement has been prominently displayed on all the boxes of spirulina issued to children and has the Karnataka government’s logo on it to give it official sanction. This amounts to fraud and may be taken up by the authorities concerned.
Lastly, the health camps that in place after the Justice NK Patil issued recommendations in response to a public interest litigation in Karnataka have stopped functioning and in many children have in fact not had regular health check ups.
Veena Shatrugna is the former deputy director of National Insitute of Nutrition. Dr Sylvia Karpagam is public health consultant based in Bengaluru.
We welcome your comments at firstname.lastname@example.org.