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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

The head of scientific work at the World Health Organization reflects on the agency’s challenges and achievements as it navigates the COVID pandemic. The head of scientific work at the World Health Organization reflects on the agency’s challenges and achievements as it navigates the COVID pandemic.

Paediatrician and clinical scientist Soumya Swaminathan is best known for her groundbreaking research on tuberculosis (TB). Last year, much to her surprise, she was appointed Director General of the Indian Council of Medical Research (ICMR) and Secretary of the Department of Health Research (Ministry of Health and Family Welfare) of the Government of India. Swaminathan is only the second woman to lead the ICMR, which was established in 1911, and the only woman to currently head any government science agency in India.

Feminist discourses on the \"New Indian Woman\" focus on the woman's body as a surface upon which modernity is inscribed. Sexual transgression has been the only lens through which the New Woman has been usually studied and analyzed until now, thus offering a superficial definition of modernity by women being defined only by the corporeal. This is problematic not only because it offers a reductionist view of modernity but also \"constructs a boundary around the notion of modern womanhood that excludes woman whose bodily autonomy has been compromised, for example through sexual assault\" (Daya, \"Embodying Modernity\" 97). This paper will study two novels, Kishwar Desai's Witness the Night (2010) and Kalpana Swaminathan's I Never Knew It Was You (2012), closely analyzing the women sleuths as portrayed in these texts: Simran Singh in the former, Lalli and Sita in the latter. The paper will move beyond the existing discourses on the New Indian woman and demonstrate how the New Woman in these narratives of detection is transgressive in contesting dominant ideals of femininity. The aim will be to understand how these women detectives contest and challenge patriarchal hegemonies through their behavior and how their acts of detection also are essential acts of rebellion against a largely misogynistic system. Swaminathan's Lalli and Sita and Desai's Simran can be seen as a reflection of the uninhibited, independent, professional, twenty-first century Indian woman. The paper seeks to reconstruct the figure of the New Indian woman through the representations of these women fighting crimes against women in modern-day India, enacting their autonomy and rebellion in the process by deftly taking on the role of a detective, traditionally a profession for men. The aim will also be to discuss how these works provide a space for creating new roles for women, while also illustrating a wide spectrum of women's experiences. Lastly, the paper will explore these works in the context of India's economic growth and how they affect and are affected by India's publishing industry.

Arguably, no living person has done more than M. S. Swaminathan to improve the lives of the poor and the marginalized. His monumental contributions to India's Green Revolution are documented elsewhere. In this paper, I focus sharply on two little-chronicled bodies of his work: (1) the IRRI Cambodia programme which guided and supported that conflict-affected country to achieve rice self-sufficiency and exporter status; and (2) the United Nations Hunger Task Force which fundamentally changed global thinking about hunger and food security by going beyond productivity improvement to include nutrition, social safety nets, natural resource management, and an enabling policy environment. Both cases illustrate the power of international collaboration and a commitment to inclusive and sustainable development. The Sustainable Development Goals will carry these principles forward for humanity as an enduring legacy of Swaminathan's vision and life achievement.

By combining scientific excellence with social involvement, M. S. Swaminathan has put himself in the tradition of the great agricultural researchers such as Von Liebich, Vavilov, De Vries, Haber and his friend and colleague Norman Borlaug that have defeated the Spectre of Malthus. His ability to use his knowledge and insights to find solutions for complex social problems made him one of the founding fathers of the Green Revolution. And one of the first that saw the drawbacks of the extensive use of water, fertilizer and pesticides that came along with it. He became a staunch advocate for the Evergreen Revolution towards an eco-friendly, resource-poor, sustainable agriculture that is based on science and technology and aims for nutrition security for all. Challenged with the perspective of feeding 9 or 10 billion people with sufficient and nutritious food and producing enough raw materials for the developing bio-based economy we have to keep on learning by doing research and combining its results with the experience of farmers and others. Yet there seems to be a lack of belief – at least in Europe – in human learning; a general distrust in science, which might lead to paralysis in agricultural development. Hence the biggest challenge is to bridge the gap between the sciences and society and to engage society in the development of science to meet the challenges of tomorrow.

M. S. Swaminathan is a central figure in the history of the Green Revolution and of the World Food Prize. This article recounts his association with Norman E. Borlaug, his recognition as the first World Food Prize Laureate in 1987 for his breakthrough achievement in improving the quantity, quality and availability of food in India and countries around the world, and his role as 'Dean' of the World Food Prize Laureates. Swaminathan has been a guiding light in shaping and participating in the core activities and milestone events of the World Food Prize, including its annual Borlaug Dialogue international symposium on cutting edge themes in agriculture and food production/food security; Global Youth Institute and Borlaug-Ruan International Internship programme for high school students; and as Chair of the Laureate selection committee.

Este artículo aborda la difícil inclusión de las artes que surgen de los márgenes de la modernidad en un ámbito aparentemente envolvente como la contemporaneidad. La coexistencia en el tiempo no parece suficiente para considerar ciertas artes, como las artesanías o las artes tribales, como parte indisoluble del espacio del “arte contemporáneo”. Desde la crítica a este planteamiento, el artista indio Jagdish Swaminathan desarrolló una línea teórica aplicada sobre el proyecto del Bhārat Bhavan en Bhopal, del cual se establece aquí una revisión crítica guiada por el concepto de contemporaneidad. El planteamiento de este artículo defiende al Bhārat Bhavan como un proyecto innovador en el contexto internacional de los años 80, pero de calado limitado por las vicisitudes históricas a las que se vio sometido.