PVPF 2024

Interview with Professor K Srinath Reddy, Author “Pulse to Planet: The Long Lifeline of Human Health”

Discover insights on global health challenges & sustainable solutions in an interview with Prof. K Srinath Reddy, author of “Pulse to Planet: The Long Lifeline of Human Health” on Frontlist.
on Apr 04, 2024

Interview with Professor K Srinath Reddy, Author of “Pulse to Planet: The Long Lifeline of Human Health” | Frontlist

K. Srinath Reddy has lived in a multiverse of medicine, public health, sustainable development and public policy. Trained as a cardiologist and epidemiologist, he has been a passionate public health advocate at national and global levels. He was head of cardiology at the All India Institute of Medical Sciences, Delhi, before establishing the Public Health Foundation of India to create five Indian Institutes of Public Health. These are building broadband capacity in public health education, research, skill-building, policy development and programme implementation. After serving as the first Bernard Lown Visiting Professor of Global Cardiovascular Health at Harvard, he is presently an Adjunct Professor at Harvard, Emory, Pennsylvania and Sydney universities.

Reddy was President of World Heart Federation and is co-chair of the Health Thematic Group of the UN Sustainable Solutions Network. Author of 570 scientific papers and the book Make Health in India, he is an International Member of the US National Academy of Medicine and has served on several technical committees of the World Health Organization. He chaired the High Level Expert Group on Universal Health Coverage for India's Planning Commission and advises several Indian states on health policy.

Reddy received the WHO Director General's Award and Luther Terry Medal of the American Cancer Society for outstanding global leadership in tobacco control, besides the Queen Elizabeth Medal for Health Promotion and several honorary doctorates. The President of India conferred on him the prestigious civilian honour Padma Bhushan in 2005.

Frontlist: "Pulse to Planet" explores the intricate connection between human health and the well-being of our planet. What specific aspects of this relationship inspired you to write this book?

Professor Reddy: Over millennia, nature has fine-tuned our bodies to survive and thrive through a balanced interplay of many physiological systems that efficiently coordinate and regulate the functions of cells, tissues, and organs that contribute to our growth, longevity, and well-being ('homeostasis'). These systems also learn how to adapt to many external influences that challenge our bodies and minds so that we can remain healthy without undue perturbations of that internal balance ('allostasis'). This equilibrium is disturbed by many social, economic, environmental, and commercial influences. Environmental degradation is now becoming a significant threat to our health through a three-pronged assault of unrelenting climate change, many forms of pollution, and alarming biodiversity loss. Besides causing many diseases, climate change will also undermine nutrition security because of adverse impacts on agriculture and food systems. Even as we are witnessing many of these effects with increasing frequency all across the globe, we will also bear the responsibility for heaping irreparable harm on future generations who will be unfortunate victims of our follies. As a doctor, scientist, public health advocate, and parent, I believed it to be my responsibility to communicate these concerns to the public at large and especially to young people who must rally to protect their future.

Frontlist: You have been deeply involved in public health advocacy both nationally and globally. What are the key challenges you see in achieving universal health coverage, especially in low and middle-income countries?

Professor Reddy: Our vision for a healthy society cannot be realized if we do not ensure impactful action in three areas: (1) adequate health financing, especially government funding from tax revenues; (2) an efficient, equitable, empathetic, and economically viable health system which can efficiently deliver the wide range of health services needed to promote, protect, and restore health to all citizens across a long life course; and (3) concerted action on the many social, economic, environmental, and commercial determinants of health by aligning policies and programs in other sectors to public health objectives.

Much remains to be done in each of these areas across low and middle-income countries (LMICs). Unless adequate public financing is assured, countries cannot achieve UHC. Out-of-pocket spending should be lower than 20% of total health expenditure. Ideally, a ‘single-payer’ system should be created. The fee-for-service payment system must be replaced by a ‘capitation’ system or bundled package of all need-based services. Primary care has to be prioritized, as it is the strong foundational base of UHC. LMICs must design and deliver primary care services that are comprehensive (addressing many common health needs of the community), continuous (ensuring constancy of care as needed), combine acute and chronic care while being connected bidirectionally to higher levels of care which is more specialized and technologically advanced (secondary and tertiary care in hospitals). Some LMICs have advanced well in this direction, but others need to create the system architecture needed for UHC.

Health workforce shortages (in numbers and skills) exist at all levels of care and need to be addressed as a high priority. Many primary care services can be effectively delivered by technology-enabled non-physician healthcare providers who can be trained in a shorter time frame than specialist doctors.

Health extends beyond healthcare since many determinants of health occur outside conventional health. From control of air pollution to dealing with climate change, ensuring nutrition security through fit-for-purpose food systems, building liveable cities to water and energy security, good quality education to gender-sensitive social systems, and effective regulation of addictive substances - there is much that needs to happen in terms of multi-sectoral actions to advance population health. LMICs must implement their commitment to ‘health in all policies’. This calls for a combination of political will and professional skill.

Frontlist: Your book highlights the potential of science and technology to revolutionize public health. Can you share a few concrete examples of these advancements and how they might be implemented to improve health outcomes globally?

Professor Reddy: From simple innovations like the oral rehydration solution to treat diarrhea to vaccines that prevent many infectious diseases, science has contributed to saving millions of lives. Advances in diagnostics and therapeutics have transformed our ability to detect and treat deadly diseases like tuberculosis, heart diseases, diabetes, and several types of cancer. From imaging technologies that can look deep into our bodies to a sub-cellular level to assistive devices that enable persons with disabilities to be more functional and productive, technology has advanced health in many dimensions. Now, artificial intelligence is helping us to design drugs for neglected diseases. Even as we celebrate the amazing successes of science and technology, we must ensure that all of humanity benefits from their innovations and not get trapped in the profit nets of patent-protected proprietary science.

Another thought for all of us to ponder over - even as science and technology are now enabling us to perform life-saving surgeries on the hearts of unborn babies still in the mother’s womb, should we also not do more to protect the health of the many millions of children who will suffer the consequences of a damaged environment and distorted commercial priorities.

Frontlist: Climate change and environmental degradation pose significant threats to public health. How do you think we can integrate environmental sustainability into health policies/practices to mitigate these risks?

Professor Reddy: The healthcare sector not only suffers the consequences of a degraded environment, but it also contributes to climate change. About 5.3% of global greenhouse gas emissions are from healthcare. These come from the infrastructure and energy consumption (30%) and even more so from the supply chains (which contribute 70%). Investment in primary care and digital health technologies will reduce the need for energy-intensive hospital infrastructure and limit the need for people to commute long distances to obtain care. We also need to make health systems climate-resilient so that they can withstand damage and disruption by extreme weather events.

Frontlist: How can policymakers and healthcare professionals collaborate to address the complex interplay of factors influencing health outcomes, as highlighted in your book?

Professor Reddy: Policymakers need to be made much more aware of the health impact of social, economic, environmental, and commercial determinants so that they can frame policies and programs that enable and not erode health.

Healthcare professionals, by generating, marshaling, and presenting evidence. As trusted communicators, they can also educate the public who may then demand and support health-friendly public policies in many sectors.

Profiling the complex interplay of many factors which influence our health will turn attention away from siloed, reductionist, and piecemeal interventions. Such an understanding will help to advance multi-component, multi-sectoral interventions which will collectively uplift human health.

Frontlist: Looking ahead, what are some of the emerging trends or challenges in global health that you see as particularly important, and how does "Pulse to Planet" address these future considerations?

Professor Reddy: From pandemic threats to climate change and patent-restricted commercialization of science to the growing gulf of income inequality and conflict-driven erosion of social solidarity within and across countries, there are many emerging or expanding threats to human health. We need to mount a collective societal response, both as communities in a country and as populations across countries, to ensure that the many determinants of health are aligned in our favor - now and in the future.

Frontlist: With World Health Day approaching and global health facing numerous challenges, what message of hope or action do you want to leave with our readers inspired by the themes explored in "Pulse to Planet"?

Professor Reddy: Each human body is, in form and function, an exquisitely designed creation of nature. We need to ensure that we do not damage its structure and derail its function through thoughtless actions that disturb the balance which nature has created in both our internal and external environments. We can create a healthy society, for ourselves and future generations, by positively influencing the many determinants of human health.

Never before in human history have we been so clearly forewarned of the perils that await us if we follow the path to perdition. But also, never before in human history, have we been so forearmed with the knowledge and tools to alter that destiny. It is a challenge to human intellect and human enterprise, as to how best we use them to create healthy societies that can flourish on a healthy planet.