Society
He spared millions of people from a debilitating parasite
Guinea worm, once a disease that plagued millions, now affects fewer than 20 people worldwide—an incredible transformation driven by Jimmy Carter’s tireless advocacy.
“I’d like the last Guinea worm to die before I do,” former US president Jimmy Carter told reporters in 2015. While Carter’s passing on December 29, 2024, came before this goal was fully realized, his extraordinary efforts have brought the world to the brink of achieving the unimaginable. Guinea worm, once a disease that plagued millions, now affects fewer than 20 people worldwide—an incredible transformation driven by Carter’s tireless advocacy. His unwavering dedication has not only changed the course of public health but has also made complete eradication a realistic, imminent goal.
In the mid-1980s, former US president and Nobel Prize-winning peacemaker Jimmy Carter’s life and legacy took a turn toward global health when he witnessed the damage caused by Guinea worm disease in rural Ghana. It was an encounter that would shape not only his post-presidency but also the lives of millions of people in some of the world’s poorest regions. As he toured the villages, Carter was confronted by a sight that would forever remain etched in his memory: children and adults alike suffering from the parasitic worms that emerge painfully through the skin, often causing severe physical and emotional distress.
“Once you’ve seen a small child with a two- or three-foot-long live Guinea worm protruding from her body, right through her skin, you never forget it,” Carter reflected in later years (An Hour Before Daylight: A Personal Journey, 2001). His commitment to eradicating this disease would become one of the defining aspects of his post-presidential work.
Carter’s focus on Guinea worm disease and his contributions to global health remain a commendable testament to the role of science and leadership in solving complex public health challenges. Guinea worm disease, also called Dracunculiasis, was a significant health crisis, affecting millions of people annually. It was estimated that around 3.5 million cases of this debilitating disease occurred worldwide each year, primarily in rural communities where access to clean water was scarce. Guinea worm, transmitted through contaminated water, is a parasitic infection that involves the slow emergence of long worms from the skin, causing excruciating pain. The cycle of infection was perpetuated by the human tendency to seek relief by submerging affected body parts in water, inadvertently facilitating the worms’ reproduction.

In 1982, the former president and the former first lady Rosalynn Carter established the Carter Center, a non-profit organization dedicated to advancing human rights and improving public health worldwide. Just four years later, in 1986, the organization launched a determined initiative to eliminate Guinea worm disease. This initiative came at a critical moment when the World Health Organization (WHO) set its sights on eradicating the disease globally. The disease’s grip on affected regions demanded a multifaceted approach, and Carter’s leadership brought together political will, scientific expertise, and on-the-ground action to begin a comprehensive campaign against the parasitic threat, along with WHO.
The Carter Center’s strategy was simple yet revolutionary: improve access to clean water, educate communities about prevention, and mobilize local governments and international bodies to take action. One of the key interventions was the provision of filtration devices, called “poultices”, that helped people avoid ingesting copepods, the tiny fleas responsible for spreading the parasite. By ensuring that people had access to clean drinking water, Carter’s team was able to significantly reduce the cycle of infection, ultimately breaking the transmission chain of the parasite.

Carter’s ability to mobilize global resources and create lasting partnerships made Guinea worm disease one of the most successful examples of disease eradication in history. Under his guidance, the incidence of Guinea worm disease plummeted from 3.5 million cases in the 1980s to just 13 reported cases in 2022, according to the U.S. Centers for Disease Control and Prevention (CDC). The disease, which had once ravaged communities across parts of Africa and Asia, was now on the verge of becoming only the second human disease in history, after smallpox, to be fully eradicated.
Sharon Roy and Vitaliano Cama, scientists at the CDC who worked closely with the Carter Center, have consistently praised Carter’s leadership. “Carter’s bold vision, leadership, and ability to create political will for supporting Guinea worm eradication in affected countries were instrumental in this success,” Cama remarked (Carter Center, 2022). The fight against Guinea worm disease continues today, but the almost complete eradication of the parasite is a reflection of Carter’s unyielding dedication to improving the health of the world’s most vulnerable populations.
This extraordinary public health achievement is not just a victory for science, but a lasting mark to the power of compassionate leadership in advancing global health. Carter’s work with the Guinea worm eradication program is often cited as one of the most effective and far-reaching scientific interventions of the 20th century. His legacy demonstrates that when science is combined with moral vision and political resolve, great change is possible—even in the most challenging circumstances.
Jimmy Carter passed away on December 29, 2023, in Plains, Georgia, at the age of 99, after entering hospice care earlier in the year. His death marked the end of a remarkable life dedicated to public service, humanitarian causes, and advancing global health. Alongside his wife, Rosalynn Carter, who passed away in November 2023, Jimmy Carter left an indelible mark on global health, using his platform to better the lives of those in need.
The nearly eradicated Guinea worm disease stands as one of the greatest successes in the field of public health. As we pay tribute to the late president, it is clear that his scientific interventions and humanitarian work will continue to inspire efforts to combat disease, poverty, and suffering for generations to come. Through his vision and the ongoing work of the Carter Center, Jimmy Carter’s legacy in the world of science and global health will remain an enduring example of the positive impact one individual can have on the lives of millions.
Reference:
- Carter, Jimmy. An Hour Before Daylight: A Personal Journey. 2001.
- Vitaliano Cama and Sharon Roy, U.S. Centers for Disease Control and Prevention. “Global Guinea Worm Eradication Efforts and Achievements.” Carter Center, 2022.
(The article first appeared in the February 2025 edition of EdPublica magazine)
Health
How India’s Agrarian Crisis Is Making Nutritious Food Unaffordable
India’s agrarian crisis is reducing farmer incomes while making healthy diets increasingly expensive. Here’s why India’s food system needs urgent reform.
India’s agrarian crisis is shrinking farmer incomes while driving up the cost of healthy diets, exposing deep flaws in the country’s food system and nutrition security.
When the figures are carefully unpacked, one thing becomes unmistakable: Indian agriculture is passing through a deep and prolonged crisis. The sector is no longer a reliable source of income, and government support has not reached farmers in the measure needed to restore profitability. The farmer who, a few decades ago, owned his own soil is today gradually turning into a daily-wage labourer. Of a farming family’s total monthly earnings, barely one-third now comes directly from agriculture; the remaining share, nearly two-thirds, has to be made up through government or private jobs, wage labour, or small enterprises. In other words, farming alone is no longer enough to run a household.
How India’s Agrarian Crisis Is Making Nutritious Food Unaffordable
What is more worrying is that, even as the sector remains under pressure, the number of new entrants is rising rather than falling — and most are joining not as landowning farmers but as farm labourers. As landholdings are divided into smaller and smaller fragments, income from farming declines rapidly, forcing families to depend increasingly on non-agricultural sources to survive. This is reflected in suicide statistics too: of the total agricultural suicides recorded in 2023, the latest year for which the National Crime Records Bureau has released data, more than half — at least 56.5 per cent — were of farm labourers. This is not a sudden trend; it has been consistent for years. Of the 10,786 farm-sector suicides recorded that year, 4,690 were landowning farmers or cultivators, while 6,096 were farm labourers — that is, workers who own no land in their name, hold no crop insurance cover, and have no support to fall back on if the season fails. It is precisely this group of daily-wage workers that has today moved to the very centre of the agrarian crisis.
A survey by the National Bank for Agriculture and Rural Development (NABARD) paints a similarly stark picture: over the past five years, nearly 30 per cent of farming families reported crop losses caused by untimely rain, pest and disease attacks, cyclones or drought, and 12 per cent suffered unexpected drops in market prices. Faced with these shocks, families were left with only two options — exhaust their savings or borrow from moneylenders. The reality is so stark that, per NABARD’s All India Rural Financial Inclusion Survey (NAFIS) 2021-22, covering the five-year window from 2016-17 to 2021-22, the average farming household is left with a monthly surplus of just ₹1,951 after covering its expenses — and it is precisely out of this gap that the cycle of debt is born.
The average debt on a farming household stood at ₹91,231, marginally higher than the ₹89,074 average for non-farming households. The Parliamentary Standing Committee on Agriculture, Animal Husbandry and Food Processing has said the situation demands close monitoring and precisely targeted interventions, so that farmers can sustainably bear the burden of their debt while continuing to invest in agriculture. The committee stated that the department concerned must ensure farmers do not get trapped in an unbearable cycle of debt, and that the schemes designed for them actually deliver benefits on the ground.
And this crisis will not stop here. A powerful super El Niño is taking shape, and weather experts fear it may disrupt the coming monsoon. Farmers already entering the new season in loss, and under the weight of debt, have little capacity left to absorb another shock. In this new era of shifting climate, providing farmers with a coherent, far-sighted policy framework is not a lofty demand — it is the bare minimum.
The Rising Cost of Nutrition
The crisis in the fields echoes directly in urban kitchens, and today the sharpest edge of inflation is falling on the ordinary person’s plate. In India, a nutritious and balanced diet is becoming more expensive every year, moving further out of reach for crores of families. According to the UN’s latest report, The State of Food Security and Nutrition in the World 2026, the per capita cost of a healthy diet in India has risen by more than 48 per cent since 2017. The minimum cost of a daily balanced diet for an average Indian, which stood at $2.77 (PPP) in 2017, reached $4.11 in 2025 — a rise of roughly 34 per cent compared to 2021, when the figure for India stood at $3.07 (PPP). Purchasing power parity (PPP) does not depend on currency exchange rates alone; it also accounts for local prices of goods and services in a given country, and so more truly reflects the burden falling on an ordinary person’s pocket.
The average global per capita cost of a healthy diet has risen from $2.94 (PPP) in 2017 to $4.28 in 2025, an increase of nearly 46 per cent
This rise in prices hits poor and economically weaker families hardest, because the moment prices rise, it is nutrient-rich foods such as fruits, vegetables, milk and eggs that first begin disappearing from their plates. If a healthy diet continues to remain this expensive, the path to a balanced diet will become even harder for families already struggling with malnutrition. According to the definition set by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO), a diet can be called healthy only when it simultaneously provides the body with sufficient energy, essential nutrients, variety and balance — mere fullness of the stomach is not the criterion.

The global picture is not very different. The average global per capita cost of a healthy diet has risen from $2.94 (PPP) in 2017 to $4.28 in 2025, an increase of nearly 46 per cent. The situation among India’s South Asian neighbours is even more severe than India’s own. In Bhutan, this cost has reached $6.17, a rise of 49 per cent compared to 2017. In Bangladesh it stands at $4.59 with a 48.5 per cent rise, in Sri Lanka at $5.21 with a 35 per cent rise, in Pakistan at nearly $3.94 with roughly a 33 per cent rise, and in Nepal at $4.19 with a 26 per cent rise. In other words, India’s cost is higher than Pakistan’s but lower than Nepal’s, Bangladesh’s, Sri Lanka’s and Bhutan’s. Yet it must not be forgotten that in a country with as vast a population as India, even a small rise in cost can have a massive impact on the plates of millions upon crores of households.
There is, however, one reassuring point: the number of people worldwide unable to afford a healthy diet has declined from 297 crore (37.4 per cent) in 2021 to 269 crore (32.7 per cent) in 2025. Even so, nearly one in every three people in the world today still cannot afford the cost of nutritious food, and it is the African continent that is scorched worst in this regard, where 66.6 per cent of the population finds a healthy diet beyond reach.
It is also worth understanding exactly where the larger share of the cost goes. The greatest expense falls on fruits, vegetables, milk, eggs, meat and other fresh and animal-based foods, while grains such as rice and wheat remain comparatively cheap. It is precisely during the journey from farm to consumer — through processing, transport, storage, cold chains and wholesale distribution — that the bulk of the cost gets added. As much as 70 to 75 per cent of the total amount a consumer pays for their diet is spent purely within this middle chain. The result is that the farmer does not receive adequate reward for his labour, and the consumer too does not get produce at a fair price — both sides end up at a loss.
Taking the example of poor households in India, staple grains such as rice and wheat are easily available through government schemes or subsidised markets. But the prices of pulses, green vegetables, fruits and milk — the very foods that give the body real strength and immunity — have risen so much that they are slipping beyond the monthly budget of an ordinary family. The outcome is that even as malnutrition and anaemia persist in the country on one hand, the inability to afford nutritious food is growing on the other. This makes one thing entirely clear: merely supplying grain is not enough; the real test lies in delivering nutrient-rich components such as fruits, vegetables, pulses, milk and eggs to every plate at affordable rates. For this, irrigation, cold chains, research, food processing and the supply chain will all need to be strengthened, while also curbing the wastage of food.
The FAO has issued one more warning in its report: that tensions in the Strait of Hormuz and an effective El Niño persisting until the end of 2026 could together place additional strain on global food and fertiliser prices in the period ahead. According to the organisation’s Chief Economist, Máximo Torero Cullen, the real crisis facing the world is not a shortage of food but the rising cost of nutritious diets, and that boosting local production could bring this cost down significantly.
It must be kept in mind that if nutritious food keeps slipping beyond the reach of the ordinary person, the consequences will not remain confined to hunger alone — they will cast their shadow over children’s growth, women’s health, working capacity and the country’s overall economic productivity. This malnutrition will keep hollowing out bodies from within, generation after generation. Therefore, the goal before India can no longer remain limited merely to “food for all”; it must become “nutritious food for all.” Local production, a strengthened supply system and nutrition-centred policies have today become the greatest need of the hour.
The suicide of a farmer in the field and the vanishing nutrition from a child’s plate — these two events may appear separate on the surface, but their roots lie buried in the same systemic failure
Vanishing Diversity on Children’s Plates
It is said that the habits that take root on a child’s plate in early childhood go on to shape the direction of health for an entire lifetime. Yet today, essential components such as fruits, vegetables, pulses and dry fruits are gradually vanishing from the plates of crores of children across the world. This reality has come to light through an extensive study conducted by researchers at Tufts University and published in the journal BMJ Global Health. Analysing data from more than 1,200 dietary surveys conducted across 185 countries between 1990 and 2018, the study assessed the consumption, among children and adolescents from birth to nineteen years of age, of five plant-based food groups: fruits, non-starchy vegetables, starchy vegetables, pulses, and nuts and seeds. According to the researchers, these components are important not only for physical growth but equally for learning ability, mental agility and protection from many diseases later in life, and yet most children are eating far fewer fruits and vegetables than experts recommend.
The suicide of a farmer in the field and the vanishing nutrition from a child’s plate — these two events may appear separate on the surface, but their roots lie buried in the same systemic failure. The farmer does not get a fair return for his sweat, and the consumer does not get the nutrition he needs on his plate, and it is the chain standing between these two ends that keeps reaping the greatest profit. As long as this imbalance within the chain remains uncorrected, this cyclical curse will keep returning every year in a new form — sometimes in the shape of a farmer in the field, and sometimes in the shape of a malnourished child.
(The views and interpretations presented are those of the author and do not necessarily reflect the editorial position of EdPublica.)
Society
From Solar-Powered Clinics to Digital Public Infrastructure: Kerala’s Model for a Resilient Digital Health Ecosystem
Kerala’s combination of solar-powered clinics, digital health platforms and decentralised governance offers valuable lessons for building resilient Digital Public Infrastructure.
Digital Public Infrastructure (DPI) is changing how governments deliver healthcare, education and social services. Much of the global conversation focuses on large national systems, but Kerala offers a compelling sub-national example of how strong public health systems and hybrid energy solutions can support digital governance. In a state known for its social indicators, high literacy and decentralised administration, the pairing of solar-powered clinics with digital health platforms is emerging as a small but effective model for delivering robust public services.
Why Digital Public Infrastructure Needs Energy Resilience
Kerala’s healthcare system has long been considered among the best in India, regularly posting strong health statistics, with life expectancy above 75 years and near-universal literacy. The COVID-19 pandemic exposed a common weakness across many regions: the dependence of digital health systems on continuous power and network access. Telemedicine platforms, digital health records, vaccination databases and real-time surveillance systems all require reliable electricity and internet connectivity — infrastructure that remains patchy in Kerala’s rural and coastal regions, which are also vulnerable to power failures and severe weather.
Kerala has been piloting solar-powered primary health centres and community clinics in remote and disaster-prone areas, with mixed results. In Kadamakkudy panchayat in Ernakulam district, a solar-powered floating ambulance-cum-dispensary — billed at its 2025 launch as India’s first such service — was expected to serve more than 2,400 patients across the panchayat’s islands. It stopped running within months after developing engine and maintenance problems, a reminder that pilot ambition and long-term upkeep don’t always move at the same pace. Elsewhere, clinics have installed rooftop solar panels with battery storage to keep vaccine refrigeration, diagnostic equipment and digital health platforms running when the grid fails or during floods and cyclones, which have grown more frequent in recent years.
This energy transition is not only an environmental intervention; it is also an enabler of Digital Public Infrastructure. Kerala’s health system increasingly relies on digital platforms such as eHealth Kerala, which maintains electronic health records for millions of people, and telemedicine services that connect rural patients with specialists in metropolitan hospitals. For these systems to work, they need to remain operational at all times — solar power reduces the risk of interruption during emergencies, making services more accessible and reliable.
This matters in the wider South Asian context. Digital health initiatives are expanding rapidly across the region, but infrastructure gaps remain a major constraint: an estimated 12% of health-care facilities in South Asia have no electricity access at all, according to a 2023 WHO, World Bank, IRENA and SEforALL report. Kerala’s hybrid model is a useful counter-example, showing that energy resilience and digital governance need to be built together rather than treated as separate problems.
Kerala’s experience also illustrates the benefits of decentralised governance in building robust DPI ecosystems. Panchayats and municipalities — the state’s local self-government bodies — play a central role in implementing health and energy projects. This structure allows for context-specific solutions, such as solar systems in flood-prone coastal clinics or digital health kiosks in tribal communities, and it can adapt to local needs faster than more centralised approaches.
Kerala’s high literacy, combined with its emergence as India’s first fully digitally literate state under the Digi Keralam initiative, has created favourable conditions for the adoption of digital health tools. Citizens’ familiarity with digital public services has made it easier to scale electronic health records, telemedicine and other Digital Public Infrastructure. That digital readiness also has a direct bearing on disaster response: healthcare systems are often among the first services disrupted when floods or cyclones strike, making solar-powered clinics with battery backups and offline digital systems critical for maintaining care and public health surveillance when central grids and communication networks go down.

Kerala’s experience suggests that digital platforms alone cannot build Digital Public Infrastructure — they require a supporting ecosystem of physical infrastructure, particularly reliable, decentralised and sustainable energy systems. Hybrid solutions combining solar, grid power and backup storage offer one way to guarantee continuity of critical services. The implications extend beyond healthcare: solar-powered digital classrooms could support continuous learning in rural schools, and energy-efficient digital kiosks could widen access to welfare and financial services. In each case, energy infrastructure functions as the silent backbone of digital governance.
Many governments across South Asia are racing to roll out digital ID systems, financial platforms and e-governance tools, yet still struggle with basic infrastructure stability. Without dependable electricity and internet access, Digital Public Infrastructure risks becoming patchy and exclusionary. Kerala’s experience is a reminder to build resilience into digital systems from the outset, rather than retrofitting it later.
At the same time, the model is not without its flaws — Kadamakkudy’s stalled floating dispensary is a case in point. Large-scale solar infrastructure requires sustained investment, and hybrid systems need continuous local technical expertise to stay operational; without it, even flagship pilots can go dark within months of launch. Energy policy and digital governance frameworks are also often built in silos, and closing that gap will be necessary to scale the model beyond pilot projects.
Kerala’s solar-powered clinics point to a larger truth: digital transformation is not only about data and platforms, but also about energy, resilience and local governance. By combining renewable energy with Digital Public Infrastructure, the state is quietly building a more resilient and equitable model of public service delivery — one with real lessons, and real cautionary tales, for a region where millions of people still contend with power outages and limited internet access. The future of South Asia’s Digital Public Infrastructure may depend less on how fast governments digitise services, and more on how reliably — and durably — they power them.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the editorial position of EdPublica
Climate
Climate-Resilient Agriculture Must Move From Policy to Practice
Climate-resilient agriculture is emerging as a key policy priority in India as experts call for water conservation, crop diversification, and technology-driven farming to tackle growing climate risks.
Climate-resilient agriculture is gaining policy attention in India as experts advocate water conservation, crop diversification, and digital technologies to help farmers adapt to increasing climate risks and strengthen long-term food security.
As climate change continues to threaten agricultural productivity through erratic rainfall, rising temperatures and increasing water stress, experts have called for stronger evidence-based policies and investments in climate-resilient farming to safeguard India’s food security and rural livelihoods.
The discussion took place at a workshop organised by the Nation First Policy Research and Change Foundation (NFPRC) for Members of Parliament and State Legislators in New Delhi, where policymakers, agricultural scientists and researchers examined strategies to strengthen climate resilience across India’s farming sector.
“Our focus must be on evidence-based policymaking, climate-resilient governance, crop diversification, water conservation, irrigation and insurance coverage to strengthen India’s agricultural resilience,” Tarun Chugh, Member of Rajya Sabha and Chairperson of the NFPRC Foundation, said while inaugurating the workshop.

During a technical session, Praveen Kumar Singh, Agriculture Commissioner at the Ministry of Agriculture and Farmers Welfare, and Rajbir Singh, Deputy Director General at the Indian Council of Agricultural Research (ICAR), emphasised that adapting Indian agriculture will require region-specific crop diversification, wider adoption of millets, pulses, oilseeds and horticultural crops, along with investments in watershed development, rainwater harvesting, groundwater recharge and micro-irrigation.
Experts also highlighted the growing role of emerging technologies, including artificial intelligence, drones, Internet of Things (IoT) devices and digital supply chains, in improving weather forecasting, precision farming, irrigation management and crop insurance delivery. Speaking on agricultural innovation, Ramesh Chand, Distinguished Professor at the Indian Council for Research on International Economic Relations (ICRIER) and former Member of NITI Aayog, said technology, finance and governance must work together to build a more resilient agricultural system.
The workshop concluded with a call for closer collaboration between policymakers, scientific institutions and farming communities, underscoring that climate resilience will depend not only on technological innovation but also on translating research-backed policies into effective action at the farm level.
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