European Union

Credit: UNDP

By Michelle Muschett and Sabina Alkire
NEW YORK, Aug 27 2025 (IPS)

The development trajectory of Latin America and the Caribbean is going through a period of unprecedented vulnerability and uncertainty. The significant achievements of past decades, as well as the possibility of continuing to make progress, are under threat from the impact of growing geopolitical tensions, unresolved structural challenges, and an increase in crises of various kinds—environmental, political, health, technological, and social.

These challenges intertwine and reinforce each other, magnifying their impact and overwhelming the response capacity of institutions. Against this backdrop, a fundamental question arises: how can we protect the gains made in human development while continuing to move forward in this new reality?

The answer lies in the very essence of the concept of human development. Since its formulation by the authors of the first UNDP Human Development Report in 1990, economists Amartya Sen and Mahbub ul Haq, the focus of this concept has been on expanding people’s capabilities so that we can lead lives we value and find meaningful.

It is not just about income or material goods, but about health, education, participation, freedom, and dignity. But human development is not static and can suffer setbacks. To safeguard its progress in the face of recurring shocks and to continue expanding capabilities, it is essential to embed resilience as an unconditional requirement.

Beyond mere endurance

In the context of human development, resilience is not limited to enduring or withstanding sudden impacts, nor to restoring a previous state. It is the capacity and agency of human beings to live valuable lives in such a way that they can prevent or mitigate the impact of crises both in their own lives and those of their communities and, if necessary, recreate valuable lives and continue to thrive.

It means that people and communities can reorganize, adapt, and move forward, even—and especially—in the midst of adversity. A system is resilient not because it is immune to shocks, but because it knows how to respond effectively, learn from experience, and emerge stronger.

Just as a house is resilient if, even with modest materials, it withstands an earthquake, protects its inhabitants, and allows life to continue, a health system is resilient if, in the face of a pandemic and despite its limitations, it reorganizes resources, mobilizes staff, welcomes volunteers, requests and absorbs external aid, provides psychological support, recognizes collective effort, and leaves behind strengthened capacities for facing future emergencies.

The key is not to avoid all damage—that would be impossible—but to respond with purpose and to strengthen the system based on experience. In short, resilience is not improvised; it is built.

Agency, capabilities, and human security

Resilient human development rests on three fundamental pillars: capabilities, human security, and agency. Capabilities are the real opportunities people have to live a life they value: being healthy, learning, participating, working with dignity. Human security protects that essential core against persistent or sudden threats such as hunger, violence, natural disasters, or disease.

Agency, meanwhile, is the ability to act according to one’s own values. It is not only about feeling included and being able to choose, but about actively influencing one’s own life and environment: organizing, participating in public life, imagining alternatives even in the midst of crisis.

When people live in contexts of limited freedoms or insecurity—marked, for example, by violence, precariousness, or exclusion—their agency tends to weaken. We may withdraw, lose trust in others, become demobilized, or adopt extreme positions.

This is why a resilient vision of development cannot be limited to the material: it must also strengthen interpersonal trust and the sense of belonging—the emotional, relational, and civic fabric that allows us to act, decide, and rebuild.

An urgent approach for Latin America and the Caribbean

The need to incorporate resilience into human development is particularly pressing in Latin America and the Caribbean. Without a resilient perspective, each crisis can mean significant development losses.

Conversely, if development agents and actors integrate resilience into their management and actions, it is possible to prepare better collectively, minimize damage, and transform systems based on each experience.

From a public management perspective, this means, for example, that public policies anticipate risk contexts—such as designing and implementing education systems that can also function in emergencies; social protection systems that expand households’ capacity to cope with crises and that have pre-established mechanisms to extend benefits to those affected; or care systems that facilitate reintegration into the labor market.

It also means ensuring community support networks and mutual aid mechanisms and, above all, strengthening institutions and individual and collective capacities to anticipate, decide, act, and adapt.

Prioritizing the essential, even with scarce resources

Resilience in public policy requires investment, planning, and consensus around a long-term vision. But it does not always entail large budgetary efforts, even in fiscally constrained contexts. The key is to innovate and prioritize what is essential: identifying which capabilities must be protected at all costs, which services must be maintained even in times of crisis, and which bonds must be strengthened before they break. Innovation is not only technological—it is also social, institutional, and territorial. The region is already applying tools with great potential for scalability and impact to transform realities, expand capabilities, and create opportunities where there was once exclusion, such as innovative applications of the Multidimensional Poverty Index (MPI) or inclusive financing instruments with local impact.

The resilience approach from a human development perspective means prioritizing strategically, making evidence-based decisions, and avoiding improvisation to ensure local impact and agency. Furthermore, by explicitly incorporating prevention, preparedness, and recovery into the development agenda and public budgets, the future costs of crises can be significantly reduced.

A compass of hope for uncertain times

Resilient human development protects and adapts the classic concept of human development to today’s challenges. It combines the transformative vision of development with the precaution of human security and the recognition of people as agents of their own destiny, even in the face of adversity.

In a world with fewer certainties, resilience is an ethical, practical, and hopeful compass. For Latin America and the Caribbean, it is also an opportunity—not to resign ourselves to permanent risk, but to turn each challenge into a springboard for more just and cohesive societies.

The future is not written; we build it together. Collective resilience must be at the heart of our responses: it is key to driving economic growth and shared prosperity; to fostering innovative financing and public policies that make it possible to prevent, mitigate, and rebuild lives after a crisis; and to broadening the sense of belonging, increasing human agency and security. Only through collaboration and collective action can we build valuable, dignified, and resilient development and life paths for all people.

Michelle Muschett is Regional Director, UNDP, Latin America and the Caribbean; Sabina Alkire is Director of the Oxford Poverty and Human Development Initiative (OPHI) at the University of Oxford

This blog is based on findings from the Regional Human Development Report 2025, “Under Pressure: Recalibrating the Future of Development in Latin America and the Caribbean” (coming soon).

IPS UN Bureau

 

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A patient being checked for BP at Mann PHC. Credit: Rina Mukherji/IPS

By Rina Mukherji
MANN, India, Aug 26 2025 (IPS)

Generally thought to be diseases of the wealthier classes, non-communicable diseases (NCDs) like hypertension and diabetes are on the rise among India’s underprivileged working classes in semi-urban and rural sprawls.

Take the case of Mohan Ahire. A middle-aged gardener in Pune, Mohan never realized that the heaviness in his head was a symptom of hypertension. Last summer, a mid-morning visit to the market saw him fall unconscious on return. Upon regaining consciousness, his wife and sons discovered the paralysis on the right side of his body, leading doctors to diagnose it as a stroke.

Bahinabai Gaekwad, a 56-year-old sweeper in Mann village, was at work when she suddenly collapsed and died. Doctors from the Primary Health Centre (PHC) next door found that she had been suffering from undiagnosed hypertension for a long time. The ailment ultimately led to a fatal cardiac arrest.

The worst problem is that most patients from underprivileged sections are not aware of their health condition.

Praful Mahato, a migrant laborer from Balasore in Odisha, who is currently employed in a dhaba (roadside eatery) in Mann, a fast-industrializing rural outpost of Pune city, had been suffering from heaviness and dizzy spells for some time. But he attributed his symptons to long hours at work and resulting fatigue. A chance visit to a medical camp confirmed high blood pressure and diabetes. Since the last four months, medication has controlled his blood pressure and brought down his sugar level.

Jagdish Mondol, in his 50s, did not realize he had hypertension and diabetes until he needed to undergo a hernia operation at a government hospital in Bhadrak, Odisha. This was despite blurred vision and difficulty in walking. Thankfully, the operation got him to wake up to his health condition. Regular medication has now improved his blood pressure and sugar level.

Fortunately, some patients may seek help on their own. Lalita Parshuram Jadhav, a 40-year-old migrant construction worker from Yavatmal, is one such. “Since the last two years, I have been experiencing pain in my legs; it became quite acute over the past year,” she tells IPS. A medical check-up confirmed hypertension and high sugar levels.

India’s Hypertension and Diabetes Epidemic

The cases cited above exemplify the rising burden of India’s non-communicable disease (NCD) of Hypertension and Diabetes. Ranked among the top ten NCDs responsible for untimely deaths worldwide, these two diseases are interlinked. This means those with hypertension are also vulnerable to developing prediabetes and diabetes.

According to the World Health Organization (WHO), an estimated 1.28 billion adults in the 30-79 age group suffer from hypertension, with two-thirds of them living in low- and middle-income countries. Yet, only 21 percent of those affected have their hypertension under control, while around 46 percent of these remain unaware of their condition and remain undiagnosed and untreated.

Diabetes, notably, can be of two varieties. Type 1 Diabetes is a congenital condition, while Type 2 diabetes is a lifestyle disease that develops later in life. South Asians, Pacific Islanders, and Native Americans have a significantly higher risk of developing the disorder.

The International Diabetes Federation (IDF) recorded a dramatic increase in the number of people affected by Type 2 Diabetes globally since the 1990s, and since 2000, the rise has been dramatic. In India, there are an estimated 77 million people above the age of 18 years suffering from diabetes (type 2), while nearly 25 million are prediabetic (at a higher risk of developing diabetes in the future). Yet, more than 50 percent of these are unaware of their diabetic status.

In India, the prevalence of Diabetes rose from 7.1 percent in 2009 to 8.9 percent in 2019. Meanwhile, 25.2 million adults are estimated to have Impaired Glucose Tolerance (IGT), a prediabetic condition that is estimated to increase to 35.7 million in the year 2045. It is also estimated that approximately 43.9 million people suffering from diabetes remain undiagnosed and untreated in India, posing a major public health risk.

It is a matter of concern that most deaths from these diseases occur in the 30- to 70-year-old age group, posing a major economic loss.

In Mann, doctors at primary health centers (PHCs) are battling this scourge, with hypertension affecting around 28 percent of the population and 12 percent being diabetic. The scenario is similar to that at Mullaheera, in rural Haryana, located just outside the national capital region of Delhi.

Dr. Sona Deshmukh, from the People-to-People Foundation, which is collaborating with the Government of India on its Viksit Bharat @2047 initiative and the in-charge for the Pranaa Project, tells me, “Diabetes is common among the older population, but hypertension is rising among the youth.”

Dangers Posed by Hypertension and Diabetes

The problem with both Hypertension and Diabetes is socio-cultural, with most people viewing these diseases as benign. Yet, ignoring them can lead to paralytic strokes and ultimately, death.

Characterized by headaches, blurred vision, nosebleeds, buzzing in the ears, and chest pain,  uncontrolled and untreated hypertension can lead to—

• chest pain (also termed angina);
• heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen.
• heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs; and
• sudden death due to irregular heartbeat.

This is because excessive blood pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can result in the complications listed above, besides bursting or blocking arteries that supply blood and oxygen to the brain, causing a stroke. It can also cause kidney damage, resulting in kidney failure.

In the case of Diabetes, the body is unable to either produce or use insulin effectively. While individuals with Type I diabetes have a congenital condition wherein the insulin-producing cells in the pancreas are attacked and destroyed, patients with Type II diabetes—which is a preventable lifestyle-related disease—either do not produce enough insulin or are unable to use insulin effectively for the body’s needs. Uncontrolled diabetes can lead to blindness and organ failures that affect the kidneys, heart, and nerves, ultimately leading to diabetic strokes and death.

Reasons Behind the Spurt

So, what are the reasons behind the spurt? Government Medical Officers Dr. Mayadevi Gujar and Dr. Vaishali Patil say, “The transition of many rural outposts into semi-urban industrialized zones has brought in lifestyle changes. Locals, who once partook of healthy home-cooked millets or cereals, now eat cheap, oily snacks from wayside kiosks cooked in reused palm oil. With more disposable income, workers lean towards sugary soft drinks and fast food, making them prone to diabetes. Addictions like tobacco and alcohol are on the rise. Tobacco-chewing remains common to both men and women in rural India.”

Additionally, with climate change affecting agricultural incomes in rural India, the younger generation is stressed with employment issues. These make a potent recipe for hypertension and diabetes.

Dr. Sundeep Salvi, a noted specialist in cardiovascular diseases, who heads the Pulmocare Research and Education (PURE) Foundation and has chaired the respiratory group for the Global Burden of Disease Study, adds, “Unlike in the past, people eat and sleep late, watch late-night television, drink endless cups of tea and coffee, and work late hours. Skipping meals is common, with little time for exercise. Sleep deprivation is a fallout of this. Stress and inadequate sleep are a deadly combination, feeding hypertension and diabetes.”

Salvi calls for hydration and good nutrition to stave off hypertension and diabetes. “Excess tea and coffee are harmful. Caffeine-present in tea and coffee-is a diuretic; it prevents hydration. A dehydrated constitution results in hypertension and diabetes, which, in turn, cause heart disease, stroke, kidney diseases, and eventually, death.”

He also views air pollution as a major risk.

“By air pollution, I am referring to both indoor and outdoor pollution. In rural areas, the burning of crop waste causes outdoor pollution. But indoor pollution in rural homes and urban slums is 5–10 times greater than outdoor pollution. High levels of particulate matter contribute to 20 percent of the global burden of diabetes, as well as hypertension.

Diabetologist and Director of the Diabetes Unit at Pune’s KEM Hospital Prof. Chittaranjan Yajnik, who has been working on this issue for over two decades, has an interesting take on the matter based on his findings.

Yajnik sees a direct correlation between vulnerability to diabetes and poor intrauterine growth.

“Poor intrauterine growth reflects in poor organ growth, especially of the infra-diaphragmatic organs (liver, pancreas, kidneys, and legs), reducing their capacity to perform adequately in later years. Such individuals, when faced with overnutrition and calories later in life, end up with prediabetes and diabetes.”

Yajnik’s research found that two-thirds of prediabetic girls and a third of the prediabetic boys were underweight at birth.

“These findings are suggestive of a ‘dual teratogenesis’ concept, which envisages a combination of undernutrition and overnutrition over a life course due to rapid socio-economic and nutritional transition…” This means intrauterine programming of diabetes needs to be supported in growth-retarded babies since metabolic abnormalities develop very early in life.

Yajnik certainly has a point, since anemia in expectant mothers and low birthweight babies is a major problem all over India. The National Family Health Surveys conducted over the years by the Government have shown a persistently high prevalence of fetal growth restriction in Indian babies. This phenomenon is linked to low birth weight in newborns, which is as high as 18.24 percent, according to the latest data.

The Solution

Recently, the Ministry of Health and Family Welfare (MOHFW) of the Government of India has implemented several schemes nationwide at the primary health level, starting with nutrition, medical care, and immunization for pregnant mothers while ensuring institutional delivery. Offspring are also extended comprehensive help for the 4 D’s (defects at birth, diseases, deficiencies, and developmental delays), immunization, supplementary nutrition, and WASH interventions. These continue through adolescence to prepare a healthy population for reproductive age.

Meanwhile, weekly wellness sessions have been introduced all over India. Deshmukh adds, “Regular screenings for hypertension and diabetes are done every few months for early detection and follow-up. Counselling sessions encourage people to adopt healthier lifestyles, while Yoga is being popularized through events like the International Yoga Day.”

These initiatives, one hopes, will arrest the epidemic.

IPS UN Bureau Report

 

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