{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:19:50Z","timestamp":1785687590459,"version":"3.56.0"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.10544.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000}}],"reference-count":0,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wellcome Trust","award":["200536\/Z\/16\/Z"],"award-info":[{"award-number":["200536\/Z\/16\/Z"]}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"\n Between 1948 and 1960, South India (Madras State) and Southeast Asia\u2014with an emphasis on Indonesia, the Philippines, and Burma\u2014 emerged as global centres for tuberculosis control. This article attempts to situate tuberculosis control of these two regions within the broader context of transnational health. It investigates the unique ways in which tuberculosis control in South India and Southeast Asia reflected the inner tensions between the notional magic bullet approach, which focuses on specific cures to root out the cause of the disease, and a more holistic approach that relates disease prevention to overall well-being of the population. The implementation of tuberculosis control programs across South India and Southeast Asia shed light on the nature of the postcolonial state sovereignty in public health. Across India, as in Southeast Asia, the state sovereignty appertaining to the implementation of health policy was fractured, as evident in the opposition to the\n Bacillus Calmette\u2013Gu\u00e9rin<\/ns4:italic>\n (BCG) vaccination. Based on a wide range of archival materials, this article situates tuberculosis control within the context of nationalist discourse and preventive medicine. In doing so, it adds not only to the historiography of tuberculosis in non-Western contexts, which has hitherto focused on India, Sri Lanka, or Africa but also to the relatively new field of Southeast Asian medical history.\n <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.10544.2","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T09:25:07Z","timestamp":1523957107000},"page":"4","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Tuberculosis control in postcolonial South India and Southeast Asia: Fractured sovereignties in international health, 1948-1960"],"prefix":"10.12688","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0294-0592","authenticated-orcid":false,"given":"Vivek","family":"Neelakantan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2018,4,17]]},"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T04:53:17Z","timestamp":1589863997000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,17]]},"references-count":0,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.10544.2","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r33003","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r32917","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r32919","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r32919","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r33003","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.15843.r32917","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,17]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.15843.r33003, Christian W. McMillen, Cocoran Department of History, University of Virginia, Charlottesville, VA, USA, 27 Apr 2018, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2#referee-response-33003","order":0,"name":"referee-response-33003","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.15843.r32917, Liping Bu, Department of History, Alma College, Alma, MI, USA, 25 Apr 2018, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2#referee-response-32917","order":1,"name":"referee-response-32917","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.15843.r32919, Susan Heydon, School of Pharmacy, University of Otago, Dunedin, New Zealand, 24 May 2018, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2#referee-response-32919","order":2,"name":"referee-response-32919","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.11362.r19309, George Dehner, Department of History, Wichita State University, Wichita, KS, USA, 13 Feb 2017, version 1, 4 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v1#referee-response-19309","order":3,"name":"referee-response-19309","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Vivek Neelakantan<\/b>; \nPosted: 11 Apr 2018<\/i>; \nGeorge Dehner, Comment 1<\/b>: The BCG example is problematic because US public health officials, British officials as well, were highly sceptical regarding the vaccine\u2019s effectiveness. Elaboration of the contested nature of the BCG vaccine would be appropriate.\nResponse: <\/b>Contested nature of the BCG vaccine expatiated on page 5, V. 2, in a separate paragraph.\nGeorge  Dehner, Comment 2:<\/b> \u201cThe author asserts that health programs became a component of nation-building; a point admirably demonstrated in the India discussion. However this high standard is not maintained in the examples of other states of South and Southeast Asia that comprise this study. For example, it would be useful to know more about the motivations of the 1956 pilot TB program in the Philippines:Who were the driving forces, the WHO or the US?Did the WHO have a role? It is not clear whether the program revolved around a BCG distribution system or was there some other system being pursued? In a similar fashion it is pertinent to know if the bureaucratic hassles faced by the WHO survey of TB in Burma were part of an assertion of Burmese government independence in matters of health or the result of disputes between central and local authorities? Fuller account of the case studies would help bolster the author\u2019s arguments.\u201d\nResponses<\/b>: I have expatiated on the Philippines\u2019 case study so that the narrative is not gravitated towards India. The pilot project in Ilocos Norte was implemented with technical assistance from the US. It did not exclusively on administering BCG vaccinations but relied on a three-pronged strategy, i.e. (a) administering tuberculin tests and vaccinating the detected negative reactors to the tuberculin test, (b) detecting the disease through radiography and (c) treating the infected individuals with isoniazid or streptomycin.  In the case of Burma, the bureaucratic hassles faced by SEARO officials in getting the tuberculosis  prevalence survey sanctioned was a part of the Burmese government\u2019s attempts to assert its sovereignty in health matters. This was a very helpful suggestion and I have incorporated it while narrating the Burmese experience of TB control during the 1950s.Additionally, in the case of Indonesia, I have also added on how TB shaped nationalist imagination and the consequent mobilisation mentality. For Burma, I have expatiated on how U Nu\u2019s Pyidawtha ideology shaped the Burmese approach to disease. In the Philippines, the nationalist rhetoric was less explicit although there was an added emphasis on the economic aspects of TB. I have also added a fresh account with respect to the inner tensions between magic bullet approach and a more holistic approach that linked health with nation building. Examples provided not only from India (original version) but also from Indonesia, and the Philippines. In the case of Burma, most of the inner tensions in public health could be teased out from a fuller use of \nSEARO Regional Director\u2019s Annual Reports<\/i> rather than the voice of local physicians.\nGeorge Dehner, Comment 3:<\/b> Expanding on the political aspects of TB control, and clarifying the unifying elements in their nationalist formation and tightening up the transitions between sections will go a long way in making the article more effective.\nResponse:<\/b> I have rewritten the conclusion. The underlining unifying feature of TB control in India and Southeast Asia (the three examples provided) is the notion of fractured sovereignties. I have spelt out the administrative fractures in great detail in the conclusion and to shore up the argument, have provided briefly how administrative fractures have impeded TB control to this day, with reference to WHO End TB strategy. I have also smoothed the transitions between sections so that the narrative is cohesive.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/2-4\/v2#referee-comment-3584","order":4,"name":"referee-comment-3584","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust [200536]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}