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Americans come together to fight diseases. For over 100 years, they have asked their neighbors to contribute to disease campaigns and supported health policies that target one disease at a time. Common Enemies asks why disease campaigns are the battles Americans can agree to fight, why some diseases attract more attention than others, and how fighting one disease at a time changes how Americans distribute charitable dollars, prioritize policies, and promote health. Drawing on the first comprehensive data on thousands of organizations targeting hundreds of diseases over decades, the author shows that disease campaigns proliferate due to the perception of health as a universal goal, the appeal of narrowly targeted campaigns, and the strategic avoidance of controversy. They funnel vast sums of money and attention to a few favored diseases, and they prioritize awareness campaigns and medical research over preventing disease and ensuring access to healthcare. It’s easy to imagine more efficient ways to promote collective well-being. Yet the same forces that limit the potential of individual disease campaigns to improve health also stimulate the vast outpouring of money and attention. Rather than displacing attention to other problems, disease campaigns build up the capacity to address them.

What distinguishes this book from the current literature is its analysis of malnutrition and its meticulous exploration of dietary transition, poverty nutrition traps and links between multiple anthropometric failures among children and their vulnerability to infectious diseases. It also explores the abysmal performance of the Public Distribution System and critiques its conversion into a universal food subsidy, investigates the links between affluence, obesity and non-communicable diseases (NCDs), and explores the health policy challenge of a ‘double burden of disease’: high communicable disease mortality and a growing burden of NCD mortality. It is puzzling that calorie intake has declined, despite rapid economic growth. An explanation is developed that encompasses the influences of food prices, growing affluence, urbanization, lifestyle changes and less strenuous activity levels. Dietary diversification had a role in lowering calorie intake. New light is shed on poverty nutrition traps that limit the ability of the undernourished to engage in productive and remunerative employment. Child malnutrition has remained stubbornly high. As simultaneous anthropometric failures among children (for example, wasting, stunting, and being underweight) are closely related to infectious diseases, a composite indicator of malnutrition, its variations and links to infectious diseases are analysed. Amelioration of child malnutrition through women’s empowerment is emphasised. As an epidemiological transition is underway—higher deaths from chronic degenerative non-communicable diseases (NCDs) than from communicable diseases—key contributory factors are aging, affluence, and being overweight/obese. Health policy choices are, however, confounded by the irreversibility of growing affluence, lifestyle changes and urbanization. Although controversial, a universal food subsidy was legislated recently as the National Food Security Act (NFSA). The critique rests on huge leakages that will magnify under NFSA and aggravate fiscal deficit without a drastic overhaul of the PDS. A distillation of lessons from policies pursued elsewhere and various initiatives in India is given. The vision that emerges is unavoidably incomplete in some respects, but illuminates successes and failures in designing and implementing policies.

Equity and Access attempts to unravel the complex narrative of why inequities in the health sector are growing and access to basic health care is worsening, and the underlying forces that contribute to this situation. It draws attention to the way globalization has influenced India’s development trajectory as health care issues have assumed significant socio-economic and political significance in contemporary India. The volume explains how state and market forces have progressively heightened the iniquitous health care system and the process through which substantial burden of meeting health care needs has fallen on the individual households. Twenty-eight scholars comprising social scientists, medical experts, public health experts, policy makers, health activists, legal experts, and gender specialists have delved into the politics of access for different classes, castes, gender, and other categories to contribute to a new field of ‘health care studies’ in this volume. Adopting an interdisciplinary approach within a broader political-economy framework, the volume is useful for understanding power relations within social groups and complex organizational systems.

Steeped in archaic and narrow colonial attitudes towards people of ‘unsound mind’, the discourse on mental health in India, as also the public apparatus dealing with it, are rigid, exclusionary and deeply gender insensitive. Interrogating the ways in which we understand and deal with mental health disabilities, this volume unravels the voices of women trapped in the predominantly skewed discourse of mental ill-health as ‘madness’, within the sciences, legal systems, policies, and the media. The chapters focus on the state of mental health of Indian women, with respect to social attitudes, cultural barriers, treatment, policies, safeguards, or lack thereof. The chapters ask fundamental questions: Is ‘mental illness’ a social, medical, legal, penal, historical, personal construct? Is mental disorder a disability? Do people living with a mental ailment have a ‘memory’, or the ‘insight’ to tell their own stories? In dealing with these questions, it seeks to provide a perspective on how women suffering from mental illness, view themselves and their surroundings in India.

The current “obesity epidemic” has been at the top of the national and, increasingly, global public agenda for the last decade—the subject of extensive and intensive concern, scrutiny, and corrective efforts from various quarters. In the United States, much of this attention is predicated on the “official” account of obesity—that it is a matter of personal responsibility, specifically to the end of monitoring and ensuring appropriate caloric balance. However, even though it continues to have cultural presumption, that account does not resonate with the populace, which may explain why efforts of redress have been notoriously ineffective. In this book, the author places obesity in cultural, political, and economic context. She argues that the failure of the official “story” of obesity mirrors broader cultural tensions and anxieties that similarly have failed to account for lived experience. Alternative narratives of obesity have thus surfaced in an attempt to address that breach by invoking the concept of authenticity in various ways. The author chronicles the most prominent of those competing stories, examining and evaluating each in relation to the cultural backdrop against which they are drawn.

Scholars have been debating the ethics of what is now called human gene editing for more than 60 years. This innovative book examines the historical debate and finds that it is set up as a slippery slope, with the ethically consensual acts of human gene editing at the top and the Brave New World or Gattaca at the dystopian bottom. More importantly, what stops the debate from slipping down the slope into unacceptable acts are agreed upon limits, which this book describes as barriers on the slope. The book describes what makes weak and strong barriers, and it shows how the first barriers were built on the slope. The first barrier was between modifying the existing human body (upslope of the barrier and acceptable) and modifying the species (downslope of the barrier and unacceptable). The second was between modifying to combat disease (upslope) and modifying to enhance a person’s abilities (downslope). The book shows how these barriers were weakened and finally knocked over, potentially allowing people to engage in any human gene editing they desired. The book then turns to describing barriers that could be built on the slope and also shows that many commonly advocated barriers are unstable. The debate about human gene editing, as well as many other debates in bioethics, would be greatly improved if participants would consider the insights of this book and only create defensible barriers.

India has expressed its commitment to ensuringa healthy, educated, skilled, and employed population through a large number of policies and programmes. Additionally, legislative measures in the area of sexual and reproductive health, youth and gender issues have highlighted the nation’s commitment to addressing reproductive rights, as well as the rights of women and young people. Progress has been made: Almost all children are in school, life expectancy has increased, gender disparities in schooling and life expectancy have narrowed, maternal and infant mortality have declined, more and more couples have exercised their right to bear only the children they want, and HIV rates have fallen. At the same time, there remain many areas in which progress has been uneven, and which, if not addressed soon, will affect people’s wellbeing and violate their rights. This volume synthesizes available evidence pertaining to the current situation and progress made in improving the health and population situation and realizing rights of women, men and the young, and obstacles that may have impeded progress, and outlines priority areas for action.

Poverty was the predominant paradigm within which science policy was constructed in the late colonial, nationalist, and post-independence eras of India. Whether as critics of its poverty or as architects of measures for its poverty eradication, India’s commentators called on a broad framework of ‘science’ to both diagnose and treat poverty. Yet, when we think of science in India today, this earlier priority of poverty eradication is hard to find. Poverty eradication as a goal in itself seems to have fallen off India’s scientific agenda. What accounts for this? Has the problem of poverty in India been solved? Or has it become an inconvenient subject alongside the new narratives that frame India as a site of remarkable economic growth? Seeking answers to these questions, the essays in this volume take a distinctive approach to the politics of health in modern India. Insisting that the commodification of health and medicine is fundamentally about economies of bodies, yet irreducible to conventional economic frameworks, the essays pursue the questions of who wins and who loses in India’s health economies. As this problematic transcends traditional disciplinary boundaries, the essays cut across studies of development and demography, research laboratories, and the rural and urban poor, combining the methodologies of anthropologists, sociologists, health economists, science studies and public health scholars, and historians.

Health and medicine have interested demographers and public health experts more than social scientists in India. Foundational questions on the meaning and experience of health and on the role of medicine, are glossed over as health and medicine are taken for granted and not opened up as objects for enquiry. How do we distinguish between health and ill-health, given the experience of disease and its detection is deeply embedded in social settings? How do we distinguish something as purely health problem from a problem of life or, a misfortune? Does the medical establishment increasingly define life-style problems as ‘diseases’ and medicate them? Social sciences try to answer such ‘health experience’ related questions by probing several situations and experiences to draw insights in a comparative perspective. On the role of medicine, people from different walks of life, the patient, the physician, the healthcare administrator, and pharmacologist, to name a few, use different standards to assess effectiveness of therapy. How do we understand the efficacy and effectiveness of cure when there are several competing standpoints? What is the impact of privatisation and corporatisation of medicine on health? This book discusses many of these foundational questions. International scholarship on the sociology of health and medicine defines itself only in relation to allopathy / biomedicine and is yet to grapple with the theoretical implications of other contemporary theories of body and disease suggested by the continuity Asian or African systems of medicine. This book introduces medical pluralism into the heart of social theory of health and medicine.