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In-spite of being the largest democracy in the world, Indian states are spending only around 1% of net state domestic product on public healthcare which is way lower than the world average. This low level of public healthcare spending resulted in a high out of pocket healthcare spending and poor health outcome in India. But democratically elected governments are responsible for spending significant amount of their budget on healthcare for the benefit of the masses. It is generally believed that, in a democracy, political competition drives the elected government to spend more on healthcare, education, infrastructure, etc. for the welfare of the citizens. This is especially true in developing countries, like India, where a significant section of population is poor. We empirically argue that intense political competition forces the incumbent government to spend more on public healthcare in order to win the election. Empirical analysis is done by creating a state level panel of 16 major Indian states, covering a span of two decades (1991–2011). • Political competition increases the public healthcare expenditure in India. • Higher level of electoral turnout compels government to spend more on healthcare. • Political Decentralization increases public healthcare expenditure in India. • Poor healthcare condition leads to high public healthcare spending. [ABSTRACT FROM AUTHOR]

Background & Aims: Treatment of inflammatory bowel disease would benefit from specific targeting of therapeutics to the intestine. We developed a strategy for localized delivery of the immunosuppressive cytokine interleukin (IL)-27, which is synthesized actively in situ by the food-grade bacterium Lactococcus lactis (LL-IL-27), and tested its ability to reduce colitis in mice. Methods: The 2 genes encoding mouse IL-27 were synthesized with optimal codon use for L lactis and joined with a linker; a signal sequence was added to allow for product secretion. The construct was introduced into L lactis. Colitis was induced via transfer of CD4+CD45RBhi T cells into Rag-/- mice to induce colitis; 7.5 weeks later, LL-IL-27 was administered to mice via gavage. Intestinal tissues were collected and analyzed. Results: LL-IL-27 administration protected mice from T-cell transfer–induced enterocolitis and death. LL-IL-27 reduced disease activity scores, pathology features of large and small bowel, and levels of inflammatory cytokines in colonic tissue. LL-IL-27 also reduced the numbers of CD4+ and IL-17+ T cells in gut-associated lymphoid tissue. The effects of LL-IL-27 required production of IL-10 by the transferred T cells. LL-IL-27 was more effective than either LL-IL-10 or systemic administration of recombinant IL-27 in reducing colitis in mice. LL-IL-27 also reduced colitis in mice after administration of dextran sodium sulfate. Conclusions: LL-IL-27 reduces colitis in mice by increasing the production of IL-10. Mucosal delivery of LL-IL-27 could be a more effective and safer therapy for inflammatory bowel disease. [Copyright &y& Elsevier]

Abstract: Coccidioides immitis is endemic in the soil of the desert Southwest. It causes a respiratory infection that is usually mild, but can last months and may disseminate beyond the lung. Disseminated infections can be fatal or require life-long therapy. Development of an effective vaccine may be a successful method of preventing serious disease. In this paper, we show that immunostimulatory-oligodeoxynucleotides (ISS-ODN) are an effective adjuvant for a recombinant coccidioidal protein known as antigen 2/proline rich antigen. Protective immunity induced by this ISS-ODN-based vaccine requires IL-12, interferon-γ and MHC Class II-restricted T-cells. Cytotoxic CD8 T-cells are not required. This study elucidates the mechanisms needed to elicit successful immunity against coccidioidomycosis, and holds promise for development of an effective coccidioidal vaccine against coccidioidomycosis. [Copyright &y& Elsevier]