Resilience of South Asian disabling conditions: a glimpse of lathyrism among comparative histories

Some disabling conditions in South Asia, such as lathyrism, iodine deficiency disorders (IDD), cataract, poliomyelitis, epilepsy and leprosy, have mechanisms and impairment effects that differ substantially. Yet they share socio-cultural features that have promoted their strong resilience in face of efforts to eliminate them as public health problems. For each condition a 'magic bullet' or much-improved technical fix has been applied, often with increasing vigour over decades. Successes are reported in some regions during some periods (so far as genuine data can be distinguished from data adjusted to fit externallyprescribed 'targets'). Yet the longer view is that 'vertical' applications of a seemingly effective fix are not enough, without concurrent broad and long-term measures for poverty alleviation, community health education, and local self-help. The widespread resurgence of malaria and tuberculosis warns that none of these diseases or conditions is beaten. None can be relegated to low-profile 'mopping up' work. The eradication of smallpox may have been seriously misleading.