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India's National Mental Health Program (NMHP) was initiated in 1982 with objectives of promoting community participation and accessible mental health services. A key component involves Central government calculation and funding for psycho-tropic medication. Based on clinical ethnography of a community psychiatry program in north India, this paper traces the biosocial journey of psycho-tropic pills from the Centre to the Periphery. As the pill journeys from the Ministry of Health to the clinic, its symbolic meaning transforms from an emphasis on accessibility and participation to administration of 'treatment'. At its final destination of delivery in the rural health centre, the pill becomes central to professional monologues on compliance that mute the voices of patients and families. Additionally, popular perceptions of government medication as weak and unreliable create an ambivalent public attitude towards psychiatric services. Instead of embodying participation and access, the pill achieves the opposite: silencing community voices, re-enforcing existing barriers to care, and relying on pharmacological solutions for psycho-social problems. The symbolic inscription of NMHP policies on the pill fail because these are contested by more powerful meanings generated from local social and cultural contexts. The authors argue this understanding is critical for development of training and policy that can more effectively address local mental health concerns in rural India. The paper concludes with an outline of potential areas and approaches to interrogate well meaning mental health programs that alienate the very people it is meant to serve.

The experience of five Indian nongovernment organizations (NGOs) suggest the emergence of a new paradigm of scalling up, in which NGOs become catalysts of policy innovations and social capital, creators of programmatic knowledge that can be spun off and integrated into government and market institutions, and builders of vibrant and diverse civil societies. We detail the mechanisms by which NGO impact can be scaled up without drastically increasing the size of the organization. (DSE/DÜI)

Not Available ; Sustainability of fish production as well as livelihood generation from reservoirs depends on the appropriate management measures. The present study aims to generate data on fish diversity and fisheries of the Kotwal reservoir, Morena, Madhya Pradesh, India and suggests probable remedial measures to make the production sustainable. 29 species of fishes belong to 21 genera, 11 families and 7 orders have been recorded from the Kotwal reservoir. The largest representation was recorded for Cypriniformes order with 1 family, 9 genera and 15 species. Seasonal variation in fish production was very distinct as the production was 30-35% higherin summer months compared to winter months (500-600 kg/Ha). The fish composition includes two species (Ompok bimaculatus and Wallago attu), which included as Near Threatened (NT) category in IUCN list. The study depicted various craft and gears, which were in use for catching fish in the reservoir. Besides, the study elucidated the packaging and marketing process of the fish catch. A note on various governmental programs and schemes in uplifting the fisheries and the socio-economic status of fishermen associated with this reservoir have been documented as a baseline data for the further studies ; Not Available

<i>Objective:</i> A better understanding of human genetic variation is important in assessing disease epidemiology and phenotypic variation, and may be critical in evaluating genetic aspects of common genetic diseases, such as schizophrenia, bipolar disease and Parkinson's. These diseases are particularly difficult to investigate as there are few peripheral markers, and although a genetic aetiology has long been suspected, robust findings have been hard to establish. <i>Methods:</i> Variations in alleles at 13 tri-nucleotide gene loci expressed in the brain and implicated in several neurodegenerative diseases, as well as certain other loci, were examined in the Indian population for comparison with other major ethnic groups. <i>Results and Conclusion:</i> In the Indian population, the distribution of alleles at the Machado-Joseph disease locus was similar to the Western European pattern of distribution. Analysis of haplotypes at the locus for Huntington's disease suggested multiple origins, and possible effects of population admixture because of the recent history of the country. At other alleles of neuropsychiatric interest (dopamine receptor, serotonin receptor, serotonin transporter, alcohol dehydrogenase), allele frequencies in the Indian population differed from other populations. Interspecies comparison suggests a gradual expansion in repeat size, with the exception of the <i>Clock</i> gene, which displays a contraction of CAG repeat numbers. World-wide differences in disease phenotypes need to be explored, and an appreciation of their genetic basis may provide a window of opportunity for improving our knowledge of the underlying genetic mechanisms.

Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the 'attack' to the 'consolidation' and 'maintenance' phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent.

The field of Global Mental Health (GMH) aims to address the global burden of mental illness by focusing on closing the "treatment gap" faced by many low- and middle-income countries (LMICs). To increase access to services, GMH prioritizes "scaling up" mental health services, primarily advocating for the export of Western centred and developed biomedical and psychosocial "evidence-based" approaches to the Global South. While this emphasis on scalability has resulted in the increased availability of mental health services in some LMICs, there have been few critical discussions of this strategy. This commentary critically appraises the scalability of GMH by questioning the validity and sustainability of its approach. We argue that the current approach emphasizes the development of mental health services and interventions in "silos," focusing on the treatment of mental illnesses at the exclusion of a holistic and contextualized approach to people's needs. We also question the opportunities that the current approach to GMH offers for the growth of mental health programmes of local NGOs and investigate the potential pitfalls that scalability may have on NGOs' impact and ability to innovate. This commentary argues that any "scaling up" of mental health services must place sustainability at the core of its mission by favouring the growth and development of local solutions and wider forms of support that prioritize social inclusion and long-lasting mental health recovery.

Frontmatter -- Contents -- Acknowledgments -- 1. Introduction: Why "Against Health"? -- Part I : What Is Health, Anyway? -- 2. What Is Health and How Do You Get It? -- 3 Risky Bigness: On Obesity, Eating, and the Ambiguity of "Health" -- 4 Against Global Health? Arbitrating Science, Non-Science, and Nonsense through Health -- Part II : Seeing Health through Morality -- 5 The Social Immorality of Health in the Gene Age: Race, Disability, and Inequality -- 6. Fat Panic and the New Morality -- 7 Against Breastfeeding (Sometimes) -- Part III : Making Health and Disease -- 8 Pharmaceutical Propaganda -- 9 The Strangely Passive-Aggressive History of Passive-Aggressive Personality Disorder -- 10 Obsession: Against Mental Health -- 11 Atomic Health, or How The Bomb Altered American Notions of Death -- Part IV : Pleasure and Pain after Health -- 12 How Much Sex Is Healthy? The Pleasures of Asexuality -- 13 Be Prepared -- 14 In the Name of Pain -- 15 Conclusion: What Next? -- About the Contributors -- Index