(1839–1910) Medical history in Japan - Wellcome Trust

examples of community mobilisation principlesthat have supported the elimination ofcongenital syphilis. WHO has developed a rangeof tools to support countries in this work.The challenges for policy in tacklingsocioeconomic inequalities in maternal healthcareaccess in India was the subject of the presentationby Professor Rama Baru of the Centre of SocialMedicine and Community Health at JawaharlalNehru University, New Delhi. She arguedthat commercialisation of health services hasaccentuated inequities and contributed to thepersistence of poverty. Health services’ planningand regulation must be in tandem, and there is aneed for intersectoral coordination and greaterconvergence between health services and povertyreduction strategies. Her co-presenter, Dr RituSadana of the WHO Department of HealthSystems Financing, gave one WHO perspective.In a wide-ranging global review, she lookedin particular at health system constraints onachieving the related Millennium DevelopmentGoals and drew on evidence from the report of theCommission on Social Determinants of Health.Controversies and myths have surroundedvaccination, particularly child immunisation,since its early days. In her presentation, Dr HelenBedford of the Centre for Paediatric Epidemiologyand Biostatistics at the UCL Institute of ChildHealth, London, discussed these controversies,focusing mainly on the UK immunisationprogramme to consider how approaches shouldbe targeted to maximise vaccine uptake based onthe best available evidence. The real challenge is todevelop a better understanding of public concernsabout vaccines and to build and sustain trustwith the public, using rigorous evidence of safetyand efficacy. Dr Thomas Cherian, of the WHOExpanded Programme on Immunization, gave aglobal immunisation overview. He spoke of theDecade of Vaccines initiative (2011–2020) and itsgoal of extending the full benefits of immunisationto all people, on the principle that access tosafe and effective vaccines is a human right.In the final seminar, the attention switchedto reproductive rights. Dr Gayle Davis of theUniversity of Edinburgh presented a nationalperspective on reproductive rights, using researchfrom Scotland since 1950. Dr Adrienne Germain,President of the International Women’s HealthCoalition, reviewed commitments made at theUN International Conference on Population andDevelopment and the contributions of women’shealth and rights activists over the past 25 years.The programme for the second halfof the 2011 series include sessions onfood security, environmental health,asbestos pollution, environmental lawand torture as a public health issue.The Politics ofSanitation in IndiaNew publicationThe new work from SusanE Chaplin, The Politics ofSanitation in India: Cities,services and the state, examines how theenvironmental problems confrontingIndian cities arose and how theyhave forced millions of people tolive in illegal settlements lackingadequate sanitation and other basicurban services. This occurred for twokey reasons. The first is the legacyof the colonial city characterisedby inequitable access to sanitation services, a failure tomanage urban growth and the proliferation of slums, andthe inadequate funding of urban governments. The secondis the nature of the postcolonial state, which – insteadof being an instrument for socioeconomic change – hasbeen dominated by coalitions of interests accommodatedby the use of public funds to provide private goods.The result is that the middle class has been ableto monopolise what sanitation services the state hasprovided because the urban poor, despite their politicalparticipation, have not been able to exert sufficientpressure to force governments to effectively implementpolicies designed to improve their living conditions. As aconsequence, public health and environmental policieshave frequently become exercises in crisis interventioninstead of being preventative measures that benefit thehealth and wellbeing of the whole urban population.These issues are explored by studying the history ofcolonial and post-independence urban development andmanagement in Ahmedabad, Chennai, Delhi, Kolkata andMumbai and analysing why these cities have failed to provideequitable access to sanitation services for all residents.Contact for Europe:Alan BallFox/MelisendeG8 Allen HouseThe Maltings, Station RoadSawbridgeworthHerts CM21 9JX, UKE melisende@btinternet.comContact for rest of the world:Orient Blackswan Private Limited3-6-752 HimayatnagarHyderabad 500 029Andhra PradeshIndiaE info@orientblackswan.comwww.orientblackswan.comThomson Prentice is former managing editor of the WHO WorldHealth Report and has helped organise the Global Health Historiesseminars since their inception. He is a freelance editor and writerbased near Geneva (E thomsonprentice@wanadoo.fr).22 | Wellcome HISTORY