India CSR interview with Dr. Nalini Saligram, Founder & CEO, Arogya World, an Ashoka Fellow
By Rusen Kumar
Arogya World is a global health non-profit organization working towards preventing non-communicable diseases (NCDs)—diabetes, heart disease, cancer and chronic lung diseases—through health education and lifestyle change. Since prevention is at the core of Arogya’s work, through its programs and advocacy efforts, they help people around the world lead healthier lives.
All programs at Arogya world are now ready for scaling up and investment from the corporate is invited and welcome. Collaborating with companies through CSR initiatives will aid the development of public healthcare and wellness in India. Dr. Nalini Saligram, Founder & CEO, Arogya World talked to Rusen Kumar, India CSR and shared how organisation is adding value to society and people.
Today we have Nalini Saligram, the head of Arogya World. Please introduce yourself, your organization, and your key area of intervention.
I am Nalini Saligram, founder, and CEO of Arogya World. I have a Ph.D. in Biochemistry from the Indian Institute of Science, Bangalore. I had the opportunity to work and live in various parts of the world in the pharma and healthcare industry. Leveraging my experience, I was determined to make a meaningful contribution to global health. This is how the Arogya World came into being. Founded 12 years ago, it is a global health non-profit that works on diabetes prevention through healthy living, with a PAN India operation. Our core objective is to facilitate sustainable development in national health, helping mobilize people to improve their health habits. We, at Arogya World, interact with experts from the healthcare and communications industry to help our programs reach the masses.
What inspired you to take up healthcare?
About 15 to 20 years ago I was a member of the Dean’s Council at Emory University, Atlanta– the School of Public Health. We were introduced to Dr. William Foege—the man who single-handedly conquered smallpox. Inspired by his journey, I decided to dedicate my life to public health. Having said that, routinely meeting with public health experts also keeps me going.
What was the reason for choosing Diabetes as your organization’s core focus?
Having lived with gestational Type 2 Diabetes and a family history of the disease, I wanted to be able to educate people unaware of lifestyle changes that can delay or prevent Diabetes, empowering them to take up healthy habits. Secondly— As a student of public and global health, several of my peers were working on Under-5 childhood mortality, women’s health, or HIV. Unlike them, I wanted to explore unconventional areas, using my background in both Science and Communications. I chose Diabetes as non-communicable diseases are one of the biggest challenges facing our nation. Through persuasion and science, I could effect a change in public behavior concerning health.
India is the world capital for Diabetes. What are the reasons behind the growing numbers of patients in the country?
The World Health Organization (WHO) categorizes Diabetes, heart disease, some cancers, and chronic lung diseases as non-communicable diseases (NCDs) as they are not communicable like infectious diseases. However, they are chronic in nature and affect every 2 out of 3 people. Non-Communicable diseases are the prime cause of death in India. The problem of NCDs is not limited to just rich countries. Middle and lower-income countries suffer greatly due to socio-economic factors like lack of access to healthcare, misinformation, and overpopulation.
The impact is felt severely by the poorest of the poor. Treatment and care for NCDs come at a great expense. Our study on 10,000 Indian women found that 25% of a lower-income family’s wealth is spent on treatment. The economic burden forces them to remain in poverty, negating any chance of improving their economic condition. This forces another generation into poverty. High cost/economic consequence is felt by families with lower income.
Indians are genetically predisposed to Diabetes. Research suggests that Indians can have Type-2 Diabetes as early as 30 years, two decades before the West! The issue is aggravated further in urban metros with 75% of the population either Diabetic or Pre-Diabetic.
Being demographically young, the median age here is 27 years. Leaving the issue unaddressed can mean a demographic disaster. Even children as young as 5 years old! 10% of our children and adolescents are pre-diabetic. Physical inactivity has exposed children and adolescents to the risk of early onset Diabetes. Another one of our studies revealed that Bangalore’s inactivity levels equal an alarming 65%.
Lifestyle is one of the biggest culprits behind India’s poor Diabetic health. Please elaborate on the factors that affect our lifestyles.
Rapid urbanization is responsible for the explosion of Communicable diseases. Consumption of fast food and tobacco are other major contributors. Smart marketing and attractive packaging lure children to eat at large fast-food chains. Busy lives force us to reach for processed, ready-to-eat food products instead of freshly cooked alternatives. But the good news is, despite being genetically predisposed, it is possible to prevent and curb genetic pressure with healthier lifestyle choices. According to the World Health Organization (WHO), 80% of diabetes and heart disease and 40% of cancers can be prevented with three lifestyle changes—eating right, adequate exercise, and avoiding tobacco.
Our ‘Doorstep Health Model’ follows the same ideology. We take prevention to people where they live, learn, and work. To children in schools, adults in their workplaces, and on social media. The model consists of sending participants healthy living reminders to eat right and exercise.
How can corporations join hands with healthcare, through CSR initiatives in creating awareness and helping take the right interventions?
The Corporate role is manifold. For example, employee health programs that focus on both; employees’ physical and mental health and extend the benefits to their families. The ‘Healthy Workplace’ program at Arogya World assesses and awards companies based on criteria encompassing physical and mental health. Additionally, leveraging Corporate Social responsibility (CSR) initiatives coupled with technology to improve adolescent health can include more people in the purview of leading healthy lives.
Mental health has emerged as the No.1 fallout from Covid. Corporations need to commit to the mental health and well-being of their employees and communities. Close links were observed between Covid and Diabetes now. People with underlying health issues like Diabetes were more susceptible to Covid and were more likely to succumb to the disease. To prevent the next pandemic, we need to prepare our bodies well. Companies can spearhead the effort not just for their employees but also for society at large. A collaboration of the private sector, the government, and civil society can work wonders for public health and welfare using a multi-stakeholder approach. Collaboration is key!
What are the key projects at Arogya World? Please elaborate on the key findings, outcomes, and impact.
In addition to the Doorstep Health model, we have four key projects at Arogya World—
‘Healthy Schools’: This program has reached 5,00,000 children so far. We interact with adolescent children, aged 11 to 14 years, and organize activities that teach children the basics of healthy living as a foundation before their lifestyle habits are set. Additionally, we provide them with reading materials to understand the concepts better.
An activity with 250,000 kids now showed a 15% improvement in both: awareness and health behaviors. Answers to awareness and behavior questions are tracked through scientific pre-post analysis, to evaluate an overall measure of health—available in multiple languages.
The results are validated by the Stanford Center for Asian Health Research and Education. Currently, we are reaching up to 2,00,000 children in extremely poor districts of West Bengal. So, we are optimistic about the potential to scale up opportunities for the ‘Healthy Schools’ program.
‘Healthy Workplace: This program recognizes companies for their investment in employee health. Our criteria are based on physical and mental health parameters. We assess companies’ employee health programs and award them basis effectiveness. So far, we have recognized about 170 companies. Government departments, public sector as well as private sector companies are included in the scope of this program.
‘M-Diabetes’: Our text message program is now adapted to voice messages as well as WhatsApp. Developed with Emory University, the program teaches people through text messages on their phones, available in multiple languages. The program is an effective way to leverage technology in public health intervention. 20% improvement has been observed across multiple health behaviors. In 2012-2013 the M-Diabetes was conducted with over 1 million people at Nokia. Our program has also been successful at the Aravind Eye Hospital and LV Prasad Eye Centre.
‘My Thali’: Using the National Institute of Nutrition guidelines, the My-Thali uses easy-to-understand graphics to indicate what should be eaten in proportional quantities. We also utilize social media to educate people on eating right and learning how to read food labels.
The program has reached 10.8 million people so far. A Nielson analysis revealed that over 1 million people had actively engaged with the My Thali program. In collaboration with the M S University of Baroda, we have arranged a program for adolescent girls in the villages of Gujarat, to measure the effectiveness of My Thali.
One of our recent efforts in Bangalore is called the ‘Arogya City’. The idea is to make Bangalore India’s first ‘Arogya city’. Similarly, we have conducted multi-stakeholder collaborations and pledges to improve the health of citizens in NCDs as well as mental health. Our 5 key programs are all measured in impact. We intend to show the effectiveness and scale-up opportunities of working with government healthcare machinery.
In what ways can companies partner with your programs?
Arogya World welcomes all corporate participation. Several opportunities in the Healthy Schools program are available in multiple states. Our current work includes a partnership with the Goa government, Bandar district, West Bengal, Bangalore, Karnataka, and Maharashtra. A multi-linguistic program helps us expand our activities across multiple states. We intend to collaborate with the government machinery, and corporates using technology to reach out to frontline workers to increase healthcare capacity. All programs at Arogya world are now ready for scaling up and investment from the corporate is invited and welcome. Collaborating with companies through CSR initiatives will aid the development of public healthcare and wellness in India.
(Rusen Kuma is the editor of India CSR)