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The Preamble and the Directive Principles of India’s Constitution provide for state intervention for assuring every citizen’s health and well-being. Yet India has wide disparities and inequalities in the standard of living, with two-thirds of the people without access to tap water and a clean toilet, a third malnourished, over a million children dying before reaching the age of five, and millions dying due to communicable diseases that are treatable at an incredibly low cost. Despite insuring schemes, every year over 60 million are impoverished due to the high cost of care. This is due to abysmal spending on health, weak governance, and poor leadership. Clearly, India has failed to forge a political system founded on the principle of a social contract where ensuring universal access to fundamental public goods—clean air, safe water, sanitation, hygiene, nutritious food and basic healthcare, and security against health-expenditure shocks—is visualized as its primary obligation, not an option. In deeply stratified societies like ours where gender, caste, religion, and residence create barriers that cannot be overcome by individual effort, the negotiating presence of a strong and assertive state becomes necessary. This book discusses the evolution of India’s health policy, followed by a comprehensive discussion on financing and governance in health, and contains two stories about India’s struggle to reverse the HIV/AIDS epidemic and revitalizing the primary healthcare system in rural areas under the National Rural Health Mission (NRHM). Finally, it assesses what the future focus should be. It is based on the author’s understanding of the health sector acquired over two decades of engagement in various capacities.

This book explores contemporary South African culture as a test case for the achievement of democracy by constitutional means in the wake of prolonged and violent conflict, and addresses ethical issues normally approached from within the discourses of law, the social sciences, and health sciences, through narrative analysis. It draws from and juxtaposes narratives of profoundly different kinds to make its point: fictional narratives, such as the work of Nobel laureate J. M. Coetzee; public testimony, such as that of the Truth and Reconciliation Commission, and Jacob Zuma's (the former Deputy President's) 2006 trial on charges of rape; and personal testimony, drawn from interviews undertaken by the author over the past ten years in South Africa. These narratives are analysed in order to demonstrate the different ways in which they illuminate the cultural ‘state of the nation’: ways that elude descriptions of South African subjects undertaken from within discourses which have a historical tendency to ignore cultural dimensions of lived experience and their material particularity. The implications of these lived experiences of culture are underlined by the book's focus on the violation of human rights as comprising practices that are simultaneously discursive and material. Cases of such violations, all drawn from the South African context, include humans' use of non-human animals as instruments of violence against other humans; the constructed marginalisation and vulnerability of women and children; and the practice of stigma in the context of the HIV/AIDS epidemic.