President Obama’s visit there has put India in the spotlight and among the things of which to take note is the surging scourge of Type 2 diabetes among India’s 1.15 billion people. Outpacing the incidence of Australia, and nearly double the rate of incidence in England, India is hot on the tail of America’s 12 percent diabetes rate, with 7.1 percent of the population now suffering from an illness generally associated with wealthy societies. And that is the cruel irony of India’s predicament.
As the Indian economy has grown, tens of millions of people have moved from poverty to working class, and even into the middle class. The problem? That move brought with it dietary changes which are literally killing Indians by the hundreds of thousands and causing millions more to suffer with diabetes.
Physicians suggest that many Indians are biologically programmed for poverty. According to many scientists, their bodies have adapted to being underfed and overworked. From the time they are nursed by their already malnourished mothers, the infants of Indian poverty are conditioned to deal with need. If they are fortunate enough to achieve lives in which they have more food, it may actually overwhelm their bodies.
When that programming combines with urbanization in which farm jobs are replaced with more office jobs, and in which long walks for potable water are replaced with the twist of a faucet, many adult Indians end up with diabetes. This seemingly cruel irony could be interpreted in two very different ways.

One response would be to see the situation as confirmation of the notion that some people really are programmed for poverty – that wealth building in classically impoverished communities is as foolhardy as nation building around the world. Most Indians, the argument would go, are simply meant to be poor. Their biology betrays any significant effort to change a thousands-year-old norm, and it is dangerous to move in that direction. That’s one way to interpret the data, but not the only one.
Instead of seeing Indians as programmed for poverty, we could recall that for Indians, as for all of us, with increased access and opportunity, comes increased responsibility. The problem is not that Indians are getting wealthier and better fed, as much as it is that the new foods which they choose to eat are not the right ones for people in transition from poverty to affluence. It’s actually not so different from how America found itself on a similar upward spiral with diabetes.
It’s not that people are programmed for poverty, it’s that all of us – Indians, Americans, etc. – have gained more access to more choices in the last fifty years than in all of the previous 500 years. We don’t need to give up that access, but we do need to take responsibility for the choices which come with it. We need an ethic of emerging affluence to allow our bodies to cope with an inherited biology of poverty.
From the beginning of time, according to virtually every tradition I know, people are given choices. The issue is never simply what we are programmed for, or who we are destined to become, even in karmic traditions. The issue is how human beings take responsibility for those things over which they do have control.
The rise of India’s economy has brought, and will surely continue to bring, many unforeseen consequences. The response ought not to be how to go backward. It should be to ask at each stage of new development, at each moment in which people have access to new opportunity, what new responsibilities are also emerging. If we think the answer is ‘none’, we need to look harder.
Neither Indians nor Americans, nor anyone else for that matter, need to suffer from diabetes at the rates we currently do. Nor do we need to give up the comforts and conveniences of modern life. We simply need to address the obligations which come with them.