Fun-filled articles!

Been reading a few articles that my uncle's been shuttling to me.

One of them was in this morning's opinion section of The Hindu: (http://www.hindu.com/2010/03/25/stories/2010032563771200.htm) by K.S. Jacob.
It's basic point is that India's public health should try to shake off the domination of international agencies and expertise, because it has enough nascent training and expertise to do a lot of its own independent thinking about public health. I feel like not every country can actually say this, cuz many are faced with either donor/internationally funded public health work, or no public health at all. It's cool that India actually has the resources and intellectual expertise to claim more public health autonomy. or at least for certain article-writers to want it to. I don't know if this is really a "stage of development", because I think this has been partially true since its independence. Britain invested more in India than many colonizers did elsewhere, and left somewhat of an institutional public health infrastructure for Indians to take over. During colonial times it was geared more towards protecting British health than the population at large, but its still a higher starting point than many others have had.
Also interestingly, this guy thinks the whole swine flu thing was hyped, with pharma happily reaping the benefits. Not sure I'm ready to jump on a "flu's overrated" bandwagon. Reading about spanish 1918 flu has scared the bejeezus out of me.

Also read an article in Economic & Political Weekly (Mar. 6 - 12) about strengthening Indian public health systems ["How Might India's Public Health Systems Be Strengthened? Lessons from Tamil Nadu" by Monica Das Gupta and other folk] I can't figure out how to link a pdf, but if you go to http://epw.in/epw/user/fullContent.jsp and search in Previous 4 issues for "Tamil Nadu", it should come up. or i can email the pdf.
They basically gripe about clinical health way overshadowing public health in budget and attention, and within public health, single-issue programmes like vaccination/eradication campaigns overshadowing less politically sexy interventions like clean water and sanitation. They say that the amalgamation of public health and medical specialists into mass under the ministry of health diminished career incentives for public health specialists and thus overall expertise in India. They also have a cool breakdown of central and state ministries of health, and how the former influences the latterses.
They have a surprising gender breakdown in public health roles, and talk about the glorification of women workers and the diminution of male workers, because women work on prioritized and glamorous maternal and child health , whereas males work on less sexy tasks, and have been unified under the body of "multipurpose workers." They advocate increasing the balance in prestige and funding. Interestingly, they don't try to contest the gender roles, and claim near the end that certain tasks are just too dangerous to be meant for women. I can imagine that in the US this would piss some ladies off, but I don't know India well enough to know how legit it is here. It seems like the lead author is female.
The domination of single-issue eradication-style interventions is super interesting, and as also criticized a bit in the Hindu article. I'm still not sure where I stand on this, other than some vague generalizations about there needing to be more balance. Atul Gawande touches a little on this in Better in the chapter on polio eradicators. He doesn't really have much to say about it either, though, he's more impressed at the eradicators' vigilance and attention to detail. Which I agree, is totally cool. Although according to the Hindu article, its doomed to fail without water and sanitation efforts as polio has feco-oral transmission, and according to this article, a lot of polio vaccinations have failed because kids are too malnourished to actually absorb the vaccine. So, more balance?

Also from the same issue of Economic & Political Weekly (Mar. 6-12), there's an article about price controls in Indian pharmaceuticals. ["Prices of New Pharmaceuticals in India: A Cross Section Study" by Ravinder Jha]. India's pharmaceutical industry is going through crazy changes, because India' now recognizes product patents. Before 2005, Indian pharma more or less ignored international product patents, and produced generic versions of a bunch of drugs developed in the US and europe. These were mad cheap, and India supplied a lot to other developing countries. After joining the WTO in 1994(5?) though, it had to consent to recognizing product patents by 2005, and so now everything's different. This was something that tickled my fancy for most of my undergrad years.
Anyway, price monitoring and control was phased out in the pre-2005 era under the argument that generic competition would eliminate the need for controls. This article looks at price-drop patterns before 2005 for various drugs, and finds that price controls were more necessary for drugs whose therapeutic advantage was high, because they had high initial prices and fewer competitors of a similar therapeutic value. It then says that post-2005, when intramolecular competition (different companies producing the same drug) disappears because of product patents, this effect will be heightened, and the need for price controls will definitely be higher for drugs of high therapeutic value. Their economic analysis might be interesting, but I'm too ignorant to understand it.
Also, they reference a random book by Sudip Chaudhuri that I picked it at a book fair in downtown Dehradun when I was last in India in 2006. This irrationally excites me.

Okay back to reading harry potter.