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Emerging biotechnologies from fields such as synthetic biology and industrial biotechnology raise challenges for governance. In response, public funders have developed new approaches to govern these technologies before decisions are locked in and products emerge onto the market. Over a decade of experience with these nascent forms of governance, such as Responsible Re- search and Innovation (RRI), shows their value but also the limitations, particularly when im- plemented without consideration of day-to-day working conditions, sector specific distinctions and institutional structures shaping research in the biological sciences. Drawing on three workshops with members of the ERA CoBioTech funding programme, we show how a new approach, grounded in the idea of human capabilities, can help to integrate the skills, knowledge and institutional conditions needed to enact upstream governance in the design of future funding programmes. We identify the goals researchers associated with RRI in the life sciences, outline five sets of capabilities that enable researchers, managers and adminis- trators to practise responsible research and innovation, and unearth a corresponding set of re- sources that these capabilities depend upon. Funders that learn to design programmes to max- imise and expand the five capability sets are likely to enable more substantive forms of upstream governance than before.

This article traces the history of India’s first tertiary cancer hospital, Tata Memorial Hospital (TMH). TMH was originally conceived in 1932 as a philanthropic project by the Tatas, an elite Parsi business family in Bombay. The founding of TMH represented a form of philanthro-capitalism which both enabled the Tatas to foster a communal acceptance for big businesses in Bombay and provide the Tatas with the opportunity to place stakes in the emerging nuclear research economy seen as essential to the scientific nationalist sentiment of the post-colonial state. In doing this, the everyday activities of TMH placed a heavy emphasis on nuclear research. In a time when radium for the treatment of cancer was still seen as ‘quackery’ in much of the world, the philanthro-capitalist investment and the interest in nuclear research by the post-colonial state provided an environment where radium medicine was able to be validated. The validation of radiotherapy at TMH influenced how other cancer hospitals in India developed and also provided significant resources for cancer research in early-mid twentieth century India. Ultimately, this article identifies ways in which cancer comes to be seen as relevant in the global south and raises questions on the relationship between local and global actors in setting health priorities.

BackgroundTranscatheter edge-to-edge mitral valve repair (TMVr) improves symptoms and survival for patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and severe secondary mitral regurgitation despite guideline-recommended medical therapy (GRMT). Whether TMVr is cost-effective from a UK National Health Service (NHS) perspective is unknown.MethodsWe used patient-level data from the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial to perform a cost-effectiveness analysis of TMVr +GRMT versus GRMT alone from an NHS perspective. Costs for the TMVr procedure were based on standard English tariffs and device costs. Subsequent costs were estimated based on data acquired during the trial. Health utilities were estimated using the Short-Form 6-Dimension Health Survey.ResultsCosts for the index procedural hospitalisation were £18 781, of which £16 218 were for the TMVr device. Over 2-year follow-up, TMVr reduced subsequent costs compared with GRMT (£10 944 vs £14 932, p=0.006), driven mainly by reductions in heart failure hospitalisations; nonetheless, total 2-year costs remained higher with TMVr (£29 165 vs £14 932, pConclusionsFor patients with HFrEF and severe secondary mitral regurgitation similar to those enrolled in COAPT, TMVr increases life expectancy and quality-adjusted life expectancy compared with GRMT at an ICER that represents good value from an NHS perspective.

An urban Telecommunications Center could offer much to the city of the future. First, it would be a media facilities center, offering materials, classes, and studios for the production of programs. Because it would have a professional staff, the Center would also be a source of expertise to the community. Another function of the Center would be to coordinate and combine community resources to serve the varied needs of the community. Looking further into the future, other functions that the urban Telecommunications Center might be performing 10 years from now could be controlling traffic patterns, providing a two-way-video system for interpersonal communication, and supplying a myriad of other public functions. If these Centers are to function as the coordinators of the future electronic culture, we will have to acquire new skills and understandings to deal with advances in technology. It is hoped that the Telecommunications Center will become a place of art as well as information, so that knowledge can be conveyed efficiently, but with humanity, grace, and humor as well. (SH)

Summary box In March 2021, Khan et al published a commentary titled ‘Decolonising global health in 2021: a roadmap to move from rhetoric to reform’ in BMJ Global Health .1 To our knowledge, under the decolonising global health umbrella, this is the first publication to make explicit how to move from theory to practice. However, we express concern over the prescriptive nature of this commentary, namely in its call for ‘metrics,’ ‘checklists,’ and a ‘map’—unironically all tactics that have been and are used by colonisers to assert violence. In this commentary, we directly respond to Khan et al and join the larger discussion on what it may mean for decolonising global health to move from theory to practice. First, we address the definition of decolonisation in decolonial thought, followed by the definition used by Khan et al . Second, we critically deconstruct the suggested “roadmap,” and conclude that these “reforms” will not realise the definition of decolonisation. Finally, we suggest conceptual frameworks that may be better suited to think through decolonisation in the global health industry. We recognise that the decolonisation of the global health industry can take different forms. …