Shifting away from dependence on the ‘Big Food’ industry to boost millet production and consumption, policies should emphasize integrating millets into government food schemes. Highlighting the limitations of Production Linked Incentives in realizing millets’ nutritional value, the suggestion is to encourage street food vendors and small-scale outlets to offer millet-based meals, particularly in rural markets.

                                                                                                                  Reshma Roshania

                                                                                          NCAER   (rroshania@ncaer.org) 

India is leading a compelling initiative to encourage the consumption of millets. By successfully advocating for the designation of 2023 as the International Year of Millets at the United Nations, India has established itself as the worldwide hub for the production, research, and innovation of these healthful grains.

Millets hold significant promise in addressing India’s concurrent nutritional challenges, including prevalent ‘hidden hunger’ and elevated cardio-metabolic diseases. Nevertheless, the current approaches to reintegrate millets as a staple in mainstream diets may be off course and face the risk of failure unless more careful and imaginative strategies are implemented promptly.

Misplaced focus in mainstreaming millets

The Ministry of Food Processing Industries’ Production Linked Incentive Scheme for Millet-Based goods (PLIS-MBP) is encouraging the “Big Food” industry to introduce millet-based goods through sales-based incentives in an effort to promote the consumption of millets. The program’s objective is to encourage the production of millet-based goods that are ready to eat and cook.

Food industry giants like Kellogg, Nestle India, Britannia, and Hindustan Unilever have joined on board and are creating a variety of packaged cookies, instant noodles, breakfast cereals, powdered drinks and savoury snacks that fall under the ultra-processed food category. Ultra-processed foods are made up of components that are extracted from whole foods using industrial processing techniques. To make the product more palatable and extend its shelf life, flavour enhancers, artificial colouring, stabilisers, and preservatives are typically added along with sugar, salt, and fat.

To encourage their use, ultra-processing millets is not the answer, though. It will actually be detrimental. There is little doubt about the findings: eating a diet high in processed foods raises the risk of obesity, heart disease, metabolic syndrome, depression, and early death (Pagliai et al. 2020). These dishes are becoming more and more well-liked in India across all socioeconomic classes, in both rural and urban settings. According to one research of teenagers in Delhi, ultra-processed meals can account for as much as 20% of a teen’s daily caloric consumption (Jain and Mathur 2020).

Furthermore, a lot of money is being invested in start-ups that are creating millet-based products. The Indian Institute of Millets Research’s Nutrihub incubator, in contrast to sales-based incentives, provides seed cash, training, mentorship, access to investor networks, and use of R&D facilities to “nutri-cereal” entrepreneurs during the idea and prototype stages. Numerous of these start-ups produce goods devoid of additives and artificial substances under the moniker “clean food.” Nevertheless, their prices are likewise exorbitant. It’s obvious that the formerly “poor man’s food” is now being promoted to the urban elite.

There is a difference between the so-called “People’s Movement,” which conjures up images of a fight for food sovereignty to give farmers more power and bring back the traditional millet, and the actual direction that this movement may take—that is, into the hands of Big Food and onto the tables of the wealthy.

A significant push from the Centre to integrate millets into the National Food Security Act’s pillars is absent from the plan. Although millets are frequently heralded as the “key” to resolving India’s food insecurity, particularly in light of the country’s unpredictable environment, they are by no means an essential part of the nation’s programmes for ensuring food security.

Making millets accessible for all

The strength of street food, which forms the foundation of Indian cuisine, must be acknowledged in the campaign for millets. Farmers are being pushed to grow more millet, while Big Food and start-ups are being encouraged to produce packaged items made from millet. The middle group, which consists of street vendors and small-scale food establishments, is severely lacking in representation. This group sources materials for producing fresh and minimally processed cuisine.

These entrepreneurs are able to provide millets to the general public in a more healthful manner. Think of dishes like bajra ladoos, ragi tikki chaat, and puffed jowar bhel. Is it possible for current incentive programmes to incorporate inventive suppliers and imaginative dhaba chefs in order to encourage reasonably priced and easily available millet-based products? The original ready-to-eat food was, after all, street food—minus the packaging and intellectual property.

It’s also critical to recognise and accommodate rural preferences. Since India is still 65% rural, millets must be both easily accessible and desired by the rural populace in order to genuinely become the staple meal they once were. Nonetheless, the majority of research on people’s knowledge, beliefs, and practises related to millets comes from urban India.

For example, a recent multi-city study discovered that the main justification for eating millets was the presence of a pre-existing medical condition, like diabetes (Kane-Potaka et al. 2021). Since non-communicable diseases are underdiagnosed in rural areas, such findings from the urban setting might not be very applicable there. Furthermore, millets are important in many rural areas since they are used as animal feed; therefore, before initiating awareness campaigns and “millet mahotsavs,” preferences should be investigated and understood in order to customise messaging.

Currently, PLIS-MBP criteria state that goods based on millet must include at least 15% millet in order for public money to be supported. This suggests that substances like sugar, hydrogenated fats, processed white flour, and additives could make up the other 85%. In spite of this, people are probably going to be sold these products as health foods. Examples of possibly mislabelled superfoods are products like Quinoa Puffs promoted as a diet snack or Oats Instant Noodles labelled as “nutrilicious”. Controlling Big Food labelling and advertising is essential to keeping millets from turning into a nutritional catastrophe.

It’s important to remember that rice and wheat became staples on our plates not because of massive marketing campaigns, celebrity endorsements, or international campaigns, but because of structural policies that guaranteed farmers’ profits and consumer affordability. Similar factors should direct millets’ path into general consumption in order to avoid potential problems in their marketing and promotion.

Further Reading

Jain, A and P Mathur (2020), “Intake of Ultra-processed Foods Among Adolescents from Low- and Middle-Income Families in Delhi”, Indian Pediatrics, 57(8):712-714.

Kane-Potaka, Joanna, et al. (2021), “Assessing Millets and Sorghum Consumption Behavior in Urban India: A Large-Scale Survey”, Frontiers in Sustainable Food Systems, 5(680777).

Pagliai, G, et al. (2021), “Consumption of ultra-processed foods and health status: a systematic review and meta-analysis”, British Journal of Nutrition, 125: 308-318.

This article first appeared in Hindu Business Line & I4I.

One of the greatest medical discoveries of the 20th century, antibiotics have saved countless lives by efficiently treating bacterial infections around the globe. However, the overuse and abuse of antibiotics have given rise to a formidable adversary, antibiotic resistance. This global health crisis threatens to undo decades of progress in healthcare, rendering once-treatable infections untreatable. Antibiotic resistance occurs when bacteria evolve and develop a resistant to the drugs designed to kill them. This alarming phenomenon is a global health threat, and raising social awareness about it is vital to combat this impending crisis effectively. This article intends to raise awareness of the serious problem of antibiotic overuse, its link to drug resistance, and the wide-ranging effects it has on people and society.     

By Dr Vikrant Kumar, AIIMS, New Delhi

The Rising Threat

Antibiotic resistance is a complex issue with far-reaching consequences. It arises primarily due to the excessive and inappropriate use of antibiotics in both human and animal healthcare. When antibiotics are overprescribed or taken improperly, bacteria can adapt and develop resistance, making these potentially life-saving medications useless. This phenomenon is not new, as bacteria have also naturally developed resistance mechanisms over millions of years. However, the accelerated pace of resistance due to human activity is alarming. Factors contributing to antibiotic resistance may include:

1. Overuse and abuse: Antibiotics are medications designed specifically to combat bacterial infections. They work by either killing bacteria or inhibiting their growth. Antibiotics are extremely effective when administered properly, but they have no effect on viral diseases like the flu or the common cold. This significant distinction is frequently missed, which contributes to the issue of antibiotic abuse.  Antibiotics are often prescribed unnecessarily for viral infections like the common cold, where they are ineffective.
2. Self-medication: Many people choose to self-diagnose and self-prescribe, buying antibiotics without seeking medical advice. This practice may lead to the misuse and ineffective use of antibiotics.
3. Incomplete treatment:Patients frequently stop taking their antibiotics once they start feeling better, failing to complete the entire course. This premature discontinuation can lead to antibiotic resistance, as it allows surviving bacteria to develop resistance mechanisms.
4. Overprescription:Due to patient pressure or a lack of conclusive diagnostic information, healthcare professionals occasionally prescribe antibiotics when they are not essential. This contributes to the overuse of antibiotics in clinical settings.
5. Agricultural Use: The widespread use of antibiotics in agriculture to support animal growth and fend off sickness in confined spaces has aided in the spread of resistant bacteria. The food chain can propagate these resistant strains to humans.
6. Global Travel: As people and goods move throughout the world, resistant bacteria can easily traverse international borders.  This means that resistance emerging in one part of the world can rapidly spread to others.

Consequences of Antibiotic Resistance

The consequences of antibiotic resistance are dire and far-reaching:

1. Increased Mortality: As antibiotic resistance spreads, the efficacy of current antibiotics declines. This is a serious challenge for contemporary medicine because it limits the options available for the treatment bacterial infections. Patients with antibiotic-resistant infections are at a higher risk of severe illness and death. Consequently, common infections like pneumonia, urinary tract infections, and tuberculosis are becoming harder to treat.
2. Rising Costs of Healthcare:Infections that are resistant to antibiotics cost healthcare systems a lot of money. Patients with resistant infections often require longer hospital stays, more extensive treatment regimens, and specialized care. These factors drive up healthcare costs, affecting not only patients and their families but also society as a whole. The inability to treat infections effectively prolongs hospital stays, increasing healthcare costs and the risk of hospital-acquired infections.
3. Economic Impact: The economic burden of antibiotic resistance is substantial, affecting healthcare systems, pharmaceutical industries, and agricultural practices. The higher expenses of treating antibiotic-resistant diseases burden healthcare systems and insurance companies, and rising costs restrict access to care for many people. Additionally, diseases caused by antibiotic-resistant bacteria result in the loss of productivity as individuals are unable to work and need lengthy sick leaves. Developing new antibiotics to combat resistance is also expensive and often financially unattractive for pharmaceutical companies, and thus, hindering innovation.

Global Implications

Antibiotic resistance is a global threat, impacting countries regardless of their level of development. Resistant bacteria can spread internationally, endangering public health worldwide. In addition, resistant infections can disrupt international trade and travel, affecting economies and creating public health crises.

Potential Solutions to the Crisis

Antibiotic resistance calls for a diversified strategy:

1. Stewardship systems:By putting antibiotic stewardship systems in place at healthcare facilities, it will be possible to make sure that antibiotics are only used as needed and in the right circumstances.
2. Raising Public Awareness:Education initiatives that stress the significance of finishing prescribed courses can enlighten the public about the proper use of antibiotics.
3. Reducing Agricultural Use:The spread of resistant bacteria can be controlled by enforcing stricter restrictions on the use of antibiotics in agriculture and encouraging alternative methods.
4. Research and Development:In order to tackle resistance, governments and pharmaceutical corporations must invest in the development of fresh antibiotics and cutting-edge therapies.
5. International Collaboration:International cooperation is essential for tracking the spread of resistance, exchanging information, and coordinating crisis containment and mitigation actions.

Conclusion

If not addressed, antibiotic resistance poses a serious risk to the public’s health and could have catastrophic effects. At every level, from individual accountability to international cooperation, immediate action is required. We may expect to maintain the effectiveness of antibiotics and secure our ability to fight bacterial infections by embracing appropriate antibiotic use, encouraging research, and putting in place efficient rules, ensuring a healthier future for everyone. The moment to take action is now as the clock is running out.