ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By Sobin George

Barriers to Establishing a Dedicated Public Health Cadre

The efforts to develop a public health cadre have not seen much progress in most of the Indian states, despite the recommendations of several committees appointed by the union government, and the 2022 guidelines issued for establishing them. This paper, by drawing on the views of experts in the field, examines the epistemic, structural, systemic, and administrative barriers to the establishment of such a cadre in the south Indian states. It notes that the dominance and perpetuation of biomedical view of health, poor understanding of what public health is, privatisation of healthcare, the vested interests of clinicians, consultancy firms, international funding institutions and the existing hierarchies and binaries within the system, act as major barriers to the establishment of the cadre. The paper suggests that the proposed public health management cadre needs a critical revisit in light of these impediments and concerns.

Reconciliations of Caste and Medical Power in Rural Public Health Services

Drawing from an ethnographic study conducted in a Karnataka village, the unfavourable differential treatments against Dalit patients in rural public health services are delineated. An analysis of medical interactions shows that as compared to non-Dalits, Dalit patients experienced more apathy, denial, and avoidance behaviours from service providers. Surprisingly, most Dalits did not attribute this to their caste, but to the flaws of the public health delivery system. Caste and allopathic medical practice are embedded in the rural public health delivery system, and both camouflage and normalise discrimination in paternalistic medical interactions. This sustains the favourable environment for caste-based discrimination in rural public health services even in places where Dalit consciousness is strong.

Is Drug Development in India Responsive to the Disease Burden?

Although the Indian pharmaceutical industry has played an important role in the development of generic medicines, it is not clear whether drug development, which is dominated by the private sector, is informed of the disease burden and public health priorities. An attempt is made to address this question by juxtaposing the therapeutic focus of the drugs approved for marketing and the new chemical entities in the pipeline with the disease burden across age groups.

Deregulation and the Fading Labour Agenda

The report of the International Commission for Labor Rights on the precarious workers in the automobile companies in Chennai reminds us of the inferior state of labour in Indian industry. While India is already in for a second round of labour law reforms, it is important to discuss the nature of the employment that the citizens are offered, often at the cost of their fundamental rights.