Lattars
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Whither Public Health
Lattars Curiously, the union health secretary (now a member of PHFI’s board) – after placing the socially irrelevant reproductive and child health II (RCH II) at the core of the national rural health mission (NRHM) – is reported to have pontificated, “public health practitioners need to understand the social, economic and environmental determinants of health” (The Indian Express, March 20, 2006). He does not appear to know that India was the first country to use social science studies in its national programmes: successfully in the national tuberculosis programme, and unsuccessfully when American demography shaped the family welfare programme. The Indian Express also reported that finances for the “autonomous” PHFI are to come from US financial donors and Indian industrial houses. The working draft, marked confidential but circulated to US institutions, proposes a chain of institutions to raise an army of public health experts, led by the head of the US ASPH, to train doctors, managers, analysts, demographers, epidemiologists, and community health workers. AIDS and dengue fever are the “challenge of public health”, and the root causes are “shortage of professionals, small-scale and questionable quality of current schools of public health, and absence of high quality public health research agency”. The empowered financing committee has passed the proposal and the Foundation proposes to pay scales higher than the government institutes! Thus, while primary health centres are being curtailed to “save” money under NRHM, the Bill Gates Foundation has the freedom to push resources where it wants in the name of collaboration among selected “stakeholders”. The idea of new AIIMS-like institutes is not new. What is new is the thought that the country cannot either mobilise its own intellectual resources to define public health needs and develop the required curricula, or (Continued on p 2036) (Rs) Six One Two Three months year years years Institutions – 1250 2300 3300 Individuals 500 935 1750 2500 Concessional Rates Teachers/Researchers – 685 – 1800 Students – 450 – – Concessional rates are available only in India. To avail of concessional rates, certificate from relevant institution is essential. Remittance by money order/bank draft preferred. Please add Rs 35 to outstation cheques towards bank collection charges. Institutions – 1500 – 4150 Individuals – 1250 – 3500 (US $) Air Mail Surface Mail Institutions 1yr 2yrs 3yrs 1yr 2yrs 3yrs Sri Lanka, Pakistan and Bangladesh 80 150 200 65 120 175 Other countries 150 275 375 90 170 240 Individuals Sri Lanka, Pakistan and Bangladesh 50 90 125 30 50 75 Other countries 100 175 240 65 120 170 All remittances to: Economic and Political Weekly Hitkari House, 284 Shahid Bhagatsingh Road,
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Director : S L Shetty Economic and Political Weekly May 20, 2006 rejuvenate the over 200 medical colleges and their preventive and social medicine (PSM) departments. It is difficult to see humour in a situation that evokes only sadness. It is even more disconcerting to believe that those trained by India’s premier institutions will have no hesitation in joining consultancy firms to serve private capital for professed enrichment of Indian public health, and be willing to forgo what is vital for the country’s intellectual independence. In the 21st century, when linking up with the rest of the world with confidence and on our own terms is possible, a publicprivate partnership is quietly smuggled in to accommodate a political mentor. Why is India unable to define its public health needs and invite the best minds and proven practices from all over the world? Why are consultancy firms with no experience of public health, like McKinsey, given contracts to run public health projects and learn on the job when it collaterally damages the services by focusing on AIDS alone? Are we under the illusion that this is an altruistic step on the part of the donors? The PHFI seems to be important to both the American and the Indian governments, one needing the markets, the other more resources to increase middle class consumption patterns. In the process, what is being neatly avoided is that public health is not just the amalgamation of social sciences, health management, and epidemiology, but the integration of their perspectives. Consequently, the vision of a public health that is inclusive as well as comprehensive may get further postponed. Unless the islands of excellence deal with the new epidemics (farmer suicides, hunger, violence against the poor, their shattered homes and livelihoods, falling food availability, and disappearing little girls), and reach out to the existing medical colleges and their PSM departments that train important components of human resources in public health, there can be no revival of the same. IMRANA QADEER New Delhi Here are some guidelines fortake up to six to eight months fromthe address, day-time phone numbers andauthors who wish to make date of acceptance to appear in the email address. submissions to the journal. EPW. Every effort will, however, be made (The email address of writers in the Special to ensure early publication. Papers with Article, Commentary and Discussion immediate relevance for policy would be sections will be published at the end ofEPW welcomes original research papers in considered for early publication. Please the article.) any of the social sciences. note that this is a matter of editorial * Authors are requested to prepare their * Articles must be no more than 8,000 judgment. soft copy versions in text formats. PDF versions are not accepted by the EPW. Authors are encouraged to use UK Englishprocessed. EPW invites short contributions to the spellings (Writers using MS Word or this along with the submitted paper. poses challenges in processing. Readers of EPW are encouraged to send comments and suggestions (300-400 words) * Graphs and charts prepared in MS * All submissions will be acknowledged Office (Word/Excel) or equivalent software immediately on receipt with a reference on published articles to the Letters column. number. Quoting the reference numberare preferable to material prepared in All letters should have the writer’s full name in inquiries will help. jpeg or other formats. and postal address. * EPW posts all published articles on its web processing of the papers we receive. * Every effort is taken to complete early site and may reproduce them on CDs. Since we receive more than 35 articles Address for communication: EPW encourages researchers to comment every week and adequate time has to be Economic and Political Weekly, on Special Articles. Submissions should be provided for internal reading and external Hitkari House, 1,000 to 2,000 words. refereeing. It can take up to four 284 Shahid Bhagatsingh Road,
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