Governments Need to Play a Bigger Role in the Fight Against Climate and Health Crisis

At COP 29 in Baku, Azerbaijan, the World Health Organization (WHO) highlighted the critical link between climate change and public health, stressing that climate action is both an environmental priority and a pressing health requirement. WHO pointed out that rising temperatures, air pollution, and extreme weather events drive up non-communicable disease (NCDs) rates.

What were once diseases of the developed world — obesity and diabetes, are now increasingly reported in South Asia. For instance, childhood obesity rates in India have skyrocketed. In 2022, an estimated 12.5 million children aged between 5 to 19 years were considered overweight, a huge jump from 0.4 million in 1990, according to a global study published in The Lancet. Similar trends are visible across other countries in South Asia, such as Pakistan, Bangladesh, and Sri Lanka, where rising rates of childhood obesity are setting the scene for early-onset diabetes and heart disease.

Obesity among children and teens is caused by various factors which include maternal obesity, greater use of formula feeding than breastfeeding, consumption of sugary beverages and fast food, and inadequate physical activity. Policies and initiatives by governments have been sorely lacking in their response to these issues so far.

The rising rates of obesity and diabetes don’t just reflect health concerns; they are a manifestation of deep societal problems: growing inequality, increasing urbanisation, and environmental degradation. Over a quarter of the world’s population lives in South Asia which is among the regions witnessing the highest growth in non-communicable diseases. Such cases are symptomatic of deeper structural issues pushing the region’s most vulnerable populations, particularly children, towards poor health outcomes.

A crucial element contributing to this health crisis is the shift in living patterns. Urbanisation has altered eating patterns, lifestyles, and even climates. Traditional meals cooked at home are being steadily replaced by processed and ready-to-eat, high-calorie foods. Fast food, soft drinks, and a culture of frequent snacking is becoming increasingly prevalent, especially in cities. Children, who are frequently exposed to suggestive advertisements and brand campaigns have proven to be the most vulnerable. To make matters worse, the rise in screen times and a consequent fall in physical activity only adds to the problem, creating an enabling environment for obesity among children.

Nevertheless, the causes are more deep-rooted than that. There is an economic disparity that undercuts the health development of populations. For most of the low-income earners living in urban slums or the countryside, healthy foods are not affordable. Instead, they resort to cheap and simple foods that are easily available, which merely satisfy hunger but are devoid of any meaningful nutrition. Children raised in such conditions are prone to gaining excessive weight.

Education has a huge impact on this issue. Many people in rural and poor areas lack adequate knowledge about eating right or the long-term risks of unhealthy food choices. Parents often think that giving their children high amounts of filling, high-calorie food is sufficient for their nutritional needs. School curriculums in these areas often lack matter on health and nutrition, perpetuating the cycle of poor health.

Gender is another contributing factor. In many parts of South Asia, girls are often unable to participate in sports or physical activities because of cultural norms. Combined with poor dietary choices, this makes girls more likely to become overweight. This can lead to health problems down the road, such as complications during pregnancy, which affects their children as well.

To make matters worse, South Asia’s healthcare system is not at all prepared to cope with this growing burden. Public health services are usually underfunded and inaccessible, particularly in rural areas.  Meanwhile, in urban areas, healthcare services usually concentrate on treating advanced diseases rather than prevention. Early interventions are sporadic, and most cases of childhood obesity and diabetes remain undiagnosed until they reach a critical condition, resulting in more invasive treatments.

Climate change is worsening this health crisis. South Asia is one of the most climate-vulnerable places on the planet. Environmental degradation is making it harder to ensure food security. The occurrence of extreme weather events, irregular rainfall, and increased temperature have made agricultural production unstable, with food shortages forcing families to consume less healthy, calorie-dense alternatives.

Additionally, climate change is leading to a decline in outdoor physical activities, particularly in cities. Heatwaves, pollution, and a shortage of safe green spaces are among the reasons why children are more likely to be confined indoors, further leading to sedentary lifestyles.

Given these concerns, individuals or families cannot be expected to navigate this crisis alone. Governments have to step up and respond with a holistic and coordinated plan of action.

Implementing school-based nutrition initiatives is crucial for promoting healthy-eating habits among students at an early age. In India, the midday meal program has been successful in providing free lunches to numerous children as a positive initial step. However, expanding the program to include more nutritious and balanced meals aimed at preventing obesity could significantly transform the impact of this effort. Nutrition education should be a key focus area to empower schools to shape healthy lifestyles among students from an early age.

Promoting healthy eating habits and adequate physical activity levels among the population at large requires extensive public awareness initiatives to be implemented by authorities at a national level tailored to specific cultural contexts within different communities. In rural regions, targeted campaigns should highlight the advantages of consuming traditional foods. For urban populations, the focus could be directed towards minimizing screen time and promoting regular physical activities.

Research increasingly indicates that key risk factors contributing to obesity in later life are established within the first 1,000 days — from birth to age two. Maternal influences during pregnancy, breastfeeding practices, and early dietary habits are critical areas for targeted medical and public health interventions aimed at reducing childhood obesity and diabetes. Prenatal, antenatal, and postnatal care services must prioritize these aspects. Furthermore, evidence suggests a connection between early-life undernutrition and a heightened risk of developing overweight or obesity in later years.

Efforts to improve healthcare systems should focus on training healthcare professionals to identify signs of obesity and diabetes. Government investments in this area are vital. Regular health screenings at schools could enable timely interventions to prevent conditions from worsening.

Environmental factors must also be addressed. Governments should prioritize climate-resilient agriculture to ensure that nutritious food remains accessible, even in the face of environmental shocks. In urban areas, creating more public spaces, parks, and pedestrian-friendly infrastructure can promote active lifestyles and reduce sedentary behaviour.

The rise of obesity and diabetes among South Asia’s youth is a stark reflection of the region’s growing inequality and environmental challenges. This is not merely a health issue—it is a societal one. Without immediate, decisive action, the consequences will reverberate for generations, putting millions of lives at risk and overwhelming already fragile healthcare systems. Governments must act now to prevent a future where poor health is the norm for South Asia’s future generations. The time for prevention, education, and equitable access to healthcare is now.

Urvashi Prasad – Former Director, Office of the Vice Chairman, NITI Aayog (India), and UK Alumni Ambassador for SDG 10 with the British Council.

Dheeraj Batra – Co-Founder of Obesity Innovation Lab and Board Member at Johnson & Johnson GPH Innovation Advisory Board.