The causes of noncommmunicable diseases (NCDs) are many and varied. Some are environmental, including indoor and outdoor air pollution. Some are genetic, such as for select cases of type one diabetes. Many more are the result of decisions people make and behaviours they engage in, including tobacco use or the harmful use of alcohol. Whatever the root, every year NCDs kill 8.9 million people across the WHO Southeast Asia Region, with 4.4 million succumbing to them prematurely. That is of deep concern.

A critical factor in the battle against NCDs, one of the Region’s Flagship Priorities, is the food systems people are part of. At the country, regional and global levels, food systems define the food environment, which consists of the physical, economic, policy and socio-cultural conditions that shape people’s dietary choices and nutritional status. In other words, food systems define the way in which risks associated with several NCDs – from diabetes to heart disease and hypertension to cancer – are mitigated or allowed to grow.

Member states across the Region recognise this: Each has now incorporated food environment-related policies in its National NCD Action Plan and is implementing high-impact legislation to drive transformative progress. In 2016, for example, Sri Lanka pioneered a ‘traffic light’ labelling system for all beverages sold in the country, creating a simple way for consumers to be made aware of the sugar contained in prepackaged drinks and make informed decisions to regulate their consumption. In the same year Maldives hiked taxes on energy and soft drinks by a massive 58% – the single greatest increase anywhere in the world.

India has meanwhile reduced the amount of trans-fats permissible in food products to 5%, while Thailand has passed legislation in line with the International Code of Marketing of Breast-Milk Substitutes. It is also working with industry to limit the salt content of a range of foods.

Though these and similar interventions are to be commended, further progress is needed to achieve the Region-wide target of a one-fourth reduction in premature NCD deaths by 2025 and a one-third reduction by 2030. As the Sustainable Development Goals outline, and as the UN Decade of Action on Nutrition emphasises, all countries have a unique opportunity to enhance multisectoral engagement to create more sustainable food systems that promote health.

A great place to start is by communicating effectively to increase health literacy and improve dietary habits. This requires health authorities to identify key problem areas where changes in consumption will have optimal impact on health outcomes, be that by decreasing salt intake, reducing the consumption of sugarsweetened beverages, cutting the intake of fatty foods, or simply promoting the benefits of a healthy diet. It also requires them to devise simple, comprehensible messaging that is culturally relevant, credible, actionable and accessible to all.

Member states should likewise consider new ways to engage food industries to public advantage. Governments have immense capacity, for example, to establish norms and standards for the nutrients food and beverages contain. They should ensure this capacity is put to full use. Importantly, at the same time as disseminating these norms and standards, it is vital they are enforced and are not merely seen as ‘opt in’ measures that can be adopted at will. Innovative measures to promote healthier street food should likewise be pursued.

Monitoring and evaluating efforts to adapt food systems should be a top priority. Clear indicators have been set in several areas to facilitate this, including the 2025 goals of achieving a 30% relative reduction in sodium intake, halting the rise of obesity and diabetes and reducing the prevalence of raised blood pressure by 25%. As part of this drive – and to gain a fuller picture of what is or isn’t working – countries should also measure the impact their broader agri-food systems are having on NCDs, at the same time as considering how they can accelerate progress towards each of their targets.

WHO remains committed to working with member states – alongside key partners at all levels – to consolidate member states’ many gains, including via innovative policies that empower individuals, communities and countries. Harnessing the food systems approach to tackle NCDs is not simply a matter of good policy. It is a matter of need.

The writer is Regional Director, WHO Southeast Asia

That three of the five states where assembly elections are on are straight BJP versus Congress battles has temporarily shifted national attention from the biggest conundrum in next year’s national polls – are opposition parties really in a position to meaningfully unite before elections and, should they win, really in a position to meaningfully govern.

Straight two way fights are crucial in the Lok Sabha, too, of course. Of the 543 parliamentary seats up for elections, 106 across 9 states (Madhya Pradesh, Chhattisgarh, Gujarat, Rajasthan, Uttarakhand, Goa, Himachal Pradesh, Arunachal Pradesh and Manipur) will be BJP versus Congress fights. BJP won a staggering 100 of these 106 seats in 2014, which was just over 35% of its total tally of 282.

So, for both BJP and Congress, stakes are huge in these bipolar contests. But stakes are obviously even bigger in the remaining 437 seats, which saw a variety of multipolar contests. Of these, BJP won an impressive 182.

Therefore, the basic math of 2019 general elections for the opposition is this: in how many of the 437 seats which saw multipolar contests in 2014 can opposition parties put up common candidates against BJP, and how many of those common candidates will actually be able to attract a disparate variety of anti-BJP votes.

Some have argued that since 69% of votes in 2014 were against BJP, which won a majority with 31%, and since BJP is bound to face some degree of anti-incumbency, opposition parties have plenty of margin of error while forming a ‘Defeat Narendra Modi’ alliance. That is, the quantum of anti-BJP votes nationally is big enough for opposition parties to not need a pan-India alliance, strategic working arrangements in key states may do the trick.

This sounds persuasive – till you put it to test on the ground. Let’s make one extremely reasonable assumption –Congress is not strong enough to be a natural leader of an anti-Modi coalition.

Let’s also ask whether Congress’s power position vis a vis other opposition parties will radically change if – a very big if – it wins MP, Chhattisgarh and Rajasthan? No. Because in many multipolar contest states, Congress is deemed to be among the weaker players. So, even three wins against BJP in straight assembly poll contests may not give Congress a lot of negotiation strength in the 437 Lok Sabha seats where bipolarity doesn’t apply.

Parenthetically, one should note that were Congress to win all three, BJP will suffer a big jolt. But we are not talking about BJP in this commentary.

Now, because Congress may not emerge as a natural leader of the opposition coalition, seat distribution negotiations between anti-BJP parties in key states will be brutally difficult. Regional parties don’t want to give up their regional bases of strength. Their first instinct is to secure their share in the regional vote pie, and in the absence of a natural leader, the first instinct will strongly act against the national oppositional requirement of making intelligent sacrifices.

Plus, there are powerful regional leaders whose personal calculations needn’t be best served by subsuming themselves to an opposition coalition. Uttar Pradesh’s Mayawati and Odisha’s Naveen Patnaik are good examples.

There’s also the issue we raised earlier: how many candidates representing a joint opposition will attract sizeable chunks of a myriad kind of anti-BJP votes. For example, even if SP and BSP form an alliance in UP, will SP and BSP vote blocs smoothly transfer to each other’s candidates, given the long and ugly history of local conflicts between Yadavs and Dalits?

Questions we have posited above are a small part of a fiendishly complicated set of problems that will confront anti-BJP parties as they try to stitch together coherent regional alliances. But even more complicated is the other question: should any species of an opposition alliance cobble together 272 seats or more in Lok Sabha, how will they govern.

Arun Jaitley, speaking last Saturday at the Economic Times Awards for Corporate Excellence, had described opposition parties’ anti-BJP efforts as a coalition of rivals. Jaitley was naturally speaking for his party. But his point can’t be dismissed by any objective person, even if he or she wants Modi out. Indeed, the problem with a coalition of rivals is even more acute if they somehow form a government.

When one party has a big chunk of seats, that party takes the most consequential cabinet berths, starting with the prime minister, and that PM’s word carries weight. But in a swirling soup of an alliance that’s likely to come to boil any time with the heat of ambition from some or all constituents, the process of choosing the PM and ministers for key portfolios will be, at best, highly and damagingly contentious. The end result will almost certainly be inherently unstable.

India of 2019 will be served terribly by such a governing arrangement. There are huge policy questions looming, and a cabinet full of battling regional satraps can be nobody’s idea of a team best suited for even minimally good governance.

Of course, it’s possible that a coalition with no centre of gravity and many centres of power will form a cohesive governing entity. But that’s like saying it’s possible that violent gau rakshaks will become secular and law abiding.