Former WHO Scientist Advocates for Nutrition-Focused PDS Overhaul
In a compelling address at the third edition of the Dr. S S Badrinath Endowment Oration in Chennai, former World Health Organisation chief scientist Dr. Soumya Swaminathan emphasized the urgent need for India to transition from illness treatment to prevention by addressing critical nutrition gaps through public distribution system (PDS) reforms.
From Calorie-Focused to Nutrition-Balanced Systems
Speaking under the theme "Well-being as a way of life" at Sankara Nethralaya on Tuesday, Dr. Swaminathan acknowledged that India has largely succeeded in preventing starvation through the PDS. However, she pointed out that the current system prioritizes calorie provision over balanced nutrition, creating significant health challenges.
"We are filling our stomachs with calories, but we are not nourishing our bodies with adequate protein and micronutrients," she stated, highlighting how protein-rich foods like pulses, fruits, vegetables, eggs, and milk remain relatively expensive, disproportionately burdening economically disadvantaged populations.
Nutrition Deficiencies Driving Non-Communicable Disease Epidemic
Dr. Swaminathan issued a stark warning about the health consequences of poor nutrition, noting that inadequate diets are fueling a rapid increase in non-communicable diseases across India. She revealed alarming statistics showing diabetes prevalence has doubled from 11% in 2011 to 22% in 2025, with a substantial portion of the population now classified as pre-diabetic.
The nutrition expert connected dietary deficiencies directly to rising rates of:
- Diabetes
- Obesity
- Hypertension
Climate Change and Environmental Health Emergencies
Beyond nutrition, Dr. Swaminathan identified climate change and biodiversity loss as emerging public health crises requiring immediate attention. She emphasized that ecosystem damage increases disease risks and noted that several planetary tipping points have already been crossed.
Rising temperatures are creating multiple health impacts:
- Accelerating the aging process
- Increasing cardiovascular strain
- Reducing work capacity among outdoor laborers
She further explained that air pollution compounds these risks, with fine particulate matter PM2.5 entering the bloodstream and affecting multiple organs, thereby elevating the likelihood of cardiovascular disease, diabetes, and neurological disorders.
Healthcare Financing and International Models
Dr. Swaminathan addressed India's healthcare financing challenges, noting that out-of-pocket spending still accounts for approximately 48% of healthcare costs, often pushing families into financial distress. She contrasted this with public health spending that remains around 1% of GDP, significantly below levels in neighboring countries like Thailand and Sri Lanka.
Citing Thailand's successful 30 baht universal healthcare scheme as a model, she emphasized that political will to prioritize primary care over large tertiary hospitals can substantially reduce costs while improving health outcomes. This approach, she argued, demonstrates how systemic reforms can create more sustainable and effective healthcare systems.
The former WHO scientist's comprehensive analysis underscores the interconnected nature of nutrition, environmental health, and healthcare policy, presenting a compelling case for holistic reforms to address India's growing public health challenges.
