Contemporary South Asia:

Entrepreneurial Solutions to Intractable Social and Economic Problems

Prof. Tarun Khanna (tkhanna@hbs.edu)

Harvard Business School, Morgan Hall 221
Course Coordinator

With
Prof. Rahul Mehrotra (mehrotra@gsd.harvard.edu)
Harvard Graduate School of Design, Gund Hall 312
Prof. Conor Walsh (walsh@seas.harvard.edu)
Harvard School of Engineering and Applied Sciences, Pierce Hall 328
Prof. Sue J. Goldie (sue_goldie@harvard.edu)
Harvard School of Public Health
Harvard Global Health Institute
Prof. Parimal G. Patil (ppatil@fas.harvard.edu)
Harvard Faculty of Arts and Sciences, 1 Bow St 311

Teaching Fellow: Gokul Madhavan (gmadhav@fas.harvard.edu)

Harvard Graduate School of Arts and Sciences
Curriculum Support: Dr. Cherie Ramirez (cramirez@hsph.harvard.edu)
Harvard Global Health Institute

Mondays and Wednesdays 3:305:00 pm

Sever Hall Rm 113 (Harvard Yard)

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Last Updated: August 12, 2014

I. OVERVIEW
Examples of Social and Economic Problems and Opportunities
When there is a severe shortage of doctors and surgeons and the state lacks the capacity to remedy this,
what entrepreneurial efforts can provide primary and tertiary medical care to an indigent, uneducated
population? When numerous social, economic, cultural, and religious constraints must be navigated, how
can families be motivated to demand quality healthcare? (How) Can technology help?
For populous, indigent locations, how can entrepreneurs across the state, civil society and private sector,
either unilaterally or in so-called public-private partnerships provide low cost housing at sufficient
scale?
How can entrepreneurs use the artsthink literary and music festivals, art auctions, movies, et ceterato
bridge societal divides?
Can one think creatively about tourism for example, heritage tourism or medical tourism to help
integrate countries into the worlds economic mainstream while also contributing to local economic and
societal development?
These are motivating examples of the kinds of problems and their solutions that will engage us in this course. This
is a pragmatically-oriented survey course focusing on several categories of social and economic problems faced
by the countries of South Asia, specifically in the realms of health, education, and the arts and humanities. The
primary objective of the course is to engage students in an inter-disciplinary and university-wide setting with the
current problems in South Asia, to prior attempts to address these problems and to immerse them in a hands-on
project-based attempt at their own candidate solutions.

II. ENROLLMENT ELIGIBILITY

The course is designed for undergraduates as well as graduate students from all parts of the University. The
course is listed in FAS, HBS, HKS, GSE, HSPH and HLS. Students from other schools and universities are
welcome to cross-register.
For undergraduates, this course satisfies the Societies of the World Gen. Ed. Requirement.

III. OVERALL STRUCTURE

The course is divided into an introductory module, followed by modules on each of urbanism, technology, health,
and the humanities, and ending with a concluding module.
The introductory section will explore how historical and contemporary choices have shaped the institutional
context of modern South Asia.
Each module will open with an overview lecture and then dive into case studies of organizations, companies,
non-profits, or regulatory interventions that have attempted to address some of the problems within that
category. Supplemental readings will be included.
The concluding module will summarize the main lessons drawn from the course and look towards the future.
In the lectures, we will review the available evidence on the incidence, causes, and consequences of the problems
in question. Through case studies we will examine real world, entrepreneurial attempts to provide solutions and

for each, will discuss whether and why the approach worked, how it could have been improved, and compare the
effort to other ambient successes and failures.
In addition to in-class discussions, there will be a weekly section (mandatory for undergraduates), for
explorations of selected readings and discussions of additional interesting cases. Each section will be run by a
knowledgeable graduate Teaching Fellow (TF). Section attendance is not mandatory for graduate students.
Section participation can help graduate student grades on the margin, but section non-attendance will have no
negative impact.
Lectures, case discussions, and sections will primarily draw on experiences from Bangladesh, India, and Pakistan,
but will also draw on material relevant to Afghanistan, Sri Lanka, and Myanmar.

HarvardX MOOC on Entrepreneurship and Healthcare in Emerging Economies

Part of this years course will overlap with a MOOC taught by Prof. Tarun Khanna and Prof. Sue Goldie at
HarvardX. This MOOC, SW47.1x Entrepreneurship and Healthcare in Emerging Economies, will begin
October 30, 2014. It is recommended (though not mandatory) that students also enroll for SW47.1x, as this will
allow them to connect online with other students across the world, who are also interested in entrepreneurship and
health in South Asia (and in other developing countries). Participation (or lack thereof) in SW47.1x will have no
impact on students grades in this course.

https://www.edx.org/course/harvardx/harvardx-sw47-1x-entrepreneurship-1966
IV. EXPECTATIONS AND REQUIREMENTS
The lectures and case studies are the core of the course, and are mandatory for all students. Beyond this,
course requirements are tailored separately to undergraduate and graduate students. The grade distribution
percentages below are only guidelines, and may be adjusted to benefit students.
For Graduate Students:
Lecture and case discussion attendance and participation, including responding to online polls and
participating in online discussions wherever appropriate. (25%)
Three 45 double-spaced-page papers, due immediately after the urbanism, technology, and health modules
respectively, analyzing a specific South Asian entrepreneurial intervention. (3 10%)
Four short responses (200300 words), due immediately before each session of the humanities module (4
2.5%)
A 2025 double-spaced-page final paper that presents the outline of a viable business plan targeting a specific
problem that can be tackled by an entrepreneurial intervention. (35%)
Successful project outlines from previous iterations of the course have included:
an academy dedicated to bringing creativity and liberal education into Pakistani high schools
a mobile-phone-based triage mechanism to allocate scarce medical resources in rural India
a funding mechanism for financing vocational education all over South Asia
While we dont expect students to launch their project this year, students with outstanding final projects who are
interested in moving forward with their ventures will have the opportunity to do so in the spring semester,
including doing so in some circumstances for course credit.
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For Undergraduate Students:

Lecture and case discussion attendance and participation, including responding to online polls and
participating in online discussions wherever appropriate. (10%)
Section attendance and participation. (15%)
Three 2 3 double-spaced-page papers, due immediately after the urbanism, technology, and health modules
respectively, analyzing a specific South Asian entrepreneurial intervention. (3 10%)

Four short responses (200300 words), due immediately before each session of the humanities
module (4 2.5%)

A 1520 double-spaced-page final paper. (35%)

Online participation
The success of this course depends on active participation by every student in class and online. An online forum
will be set up, and new information on current events relevant to the course will be posted there frequently by the
instructors and teaching staff. It is strongly recommended that students initiate and contribute to discussions on
the forum (including responding to other students postings). There will also be occasion to interface with the
activities of the Harvard South Asia Institute, which instructors will highlight during the course.
http://southasiainstitute.harvard.edu
Details on the final paper
Students are very strongly encouraged to work in teams on the final project outline. Successful teams have
typically been comprised of 34 students from multiple schools / faculties.
For undergraduates, the final paper offers an opportunity to synthesize material from across the course. While the
paper might take many forms, here are two specific types of papers that would be appropriate:
A detailed investigation of a particular intervention by a person or institution to tackle a specific complex
social problem in South Asia.
A well-structured candidate solution to a crisply-defined, particular manifestation of a complex socioeconomic problem in South Asia.
What matter the most are specificity of detail, sensitivity to context, and feasibility of solution.
In lieu of submitting a final paper, undergraduates may turn in a project outline just like graduate students. The
vast majority of undergraduates have chosen to do so in the previous iterations of this course.
There will be two optional evening sessions to go over final project business plans. Dates to be determined.
The final deliverable must be submitted no later than 23.59h on Wednesday December 10, 2014.

V. ADMINISTRATIVE DETAILS
Special Accommodations Request
Any student needing academic adjustments or accommodations is requested to present their letter from the
Accessible Education Office (AEO) and speak with the professor by the end of the second week of the term.
Failure to do so may result in the Course Head's inability to respond in a timely manner. All discussions will
remain confidential, although AEO may be consulted to discuss appropriate implementation.
Course Text
Khanna, Tarun. Billions of Entrepreneurs: How China and India Are Reshaping Their Futuresand Yours,
Harvard Business School Publishing (Boston, MA), 2007.
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(We will draw on several chapters of this narrative comparison of India with China, although overall only a very
tiny fraction of the readings are from this, or any other, single source. The intent of the book chapters is to orient
students towards a comparative way of thinking, anchored on one of the South Asian countries of interest to the
course, India. Although the bookstore will have copies available for sale, it is not mandatory to purchase the
book as it will be available to borrow from the libraries.)

Course Websites
For HBS students: Log in to Learning Hub for calendar updates and HBS Cases.
For undergraduates and non-HBS graduate students: http://isites.harvard.edu/icb/icb.do?keyword=k95698
Case Studies Packet (for non-HBS students): https://cb.hbsp.harvard.edu/cbmp/access/21135508
(Please use the above link to order your electronic packet of HBS case materials. You will be redirected to the
Harvard Business School Publishing website. There you should use your Harvard email address to create a login.
Once this has been completed, you will be able to purchase your case packet.)
Optional Text
Khanna, Tarun and Krishna G Palepu. Winning in Emerging Markets: A Roadmap for Strategy and Execution.
Harvard Business Press (Boston, MA), 2010.
(The early chapters of this book introduce a framework for thinking about entrepreneurial action. The rest of the
book is only tangentially applicable, so library reference may suffice.)

Contemporary South Asia: Entrepreneurial Solutions to Intractable Social and Economic Problems
Outline of Fall 2014 Sessions
Module I: Introduction (Tarun Khanna, HBS)
Sept. 3 Sept. 15, 2014
[1] Institutional Underpinnings of South Asia, Corruption & Institutional Failure in India (I-1)
[2] Fissures across South Asia and Entrepreneurial Attempts to address them (I-2)
[3] The Emergence of Soft Infrastructure: Unique Biometric IDs across India (I-3)
[4] Microfinance in South Asia (I-4)
Module II: Urbanism (Rahul Mehrotra, GSD)
Sept. 17 Sept 29, 2014
[5] Public Sanitation Provision (II-1)
[6] Urban Conservation of Monuments in Active Use (II-2)
[7] Public Private Partnerships for Preservation of World Heritage Sites (Case of the Taj Mahal) (II-3)
[8] Housing for Low Income Communities (II-4)
Paper due (2-3 pages for undergraduates, 4-5 pages for graduates) Sept. 29, 2014
Module III: Technology (Conor Walsh, SEAS)
Oct. 1 Oct. 20, 2014
[9] Experiments in Technology & Education, Khan Academy (III-1)
[10] Nanotechnologys Use to Democratize Healthcare Diagnostics(III-2)
[11] Simulation Exercise (III-3)
[12 & 13] Creating Low Cost, Smart Medical Devices for Low Income Countries Public Health Needs (III4 & III-5)
Paper due (2-3 pages for undergraduates, 4-5 pages for graduates) Oct. 20, 2014
Module IV: Health (Sue Goldie, HSPH)
[14] Health Realities in South Asia - A Multi-Sectoral Framework (IV-1)

Oct. 22 Nov. 5, 2014

[15] Public Health Delivery Communities to National Health Systems A Focus on Maternal and Child
Health (IV-2)
[16] Ensuring Quality When Considering Access and Why it Really Matters for India (IV-3)
[17] Intellectual Property Rights and Healthcare in South Asia, Case of Cipla (IV-4)
[18] Delivering Health Services at the Tertiary Care Level: Case of Narayan Health City (IV-5)
MOOC begins Oct. 30, 2014
Paper due (2-3 pages for undergraduates, 4-5 pages for graduates) Nov. 5, 2014
Module V: Humanities (Parimal Patil, FAS)
Nov. 10 Nov. 19, 2014
Four short responses due before each of the following sessions
[19] Introduction: The Third River (V-1)
[20] Outrage and Entrepreneurship: Textbook Controversies in South Asia (V-2)
[21] Cultural Agents in Service of Entrepreneurship , www.culturalagents.org (V-3)
[22] The Jaipur Literary Festival (V-4)
Module VI: Conclusion (Tarun Khanna, HBS)
Nov. 24 Dec. 3, 2014
[23] Entrepreneurial Initiatives in Food Security in India (with a comparison to China): The case of Amul
Dairy Cooperative (VI-1)
[24] BRAC of Bangladesh, the Worlds Biggest NGO (VI-2)
[25] The Kumbh Mela in 2013 (VI-3)
Final paper due Dec. 10, 2014
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Module I: Introduction
A multitude of institutionsof the state and otherwiseunderpin daily life across South Asia. These institutional
underpinnings are a function of the activity of entrepreneursin business, politics, and society writ largeand
they take time to emerge. To understand these underpinnings we must understand today's economics and politics,
but also the historical and cultural roots of the highly contoured and variegated environment in which today's
entrepreneurs must operate.
Corruption affords us one result of the context, and we begin the course by trying to understand the institutional
solutions to this problem. Corruption touches almost every nation's citizens at some time or anotheroften with
troubling frequencyregardless of ethnicity, creed, region or economic status. The phenomenon is hardly unique
to India (in terms of the region or the globe), but its seriousness and the place that it has earned within recent
national regional discourse make it a compelling point of entry into understanding the region, and the perspective
of the course on the region.
The next session studies schisms in the fabric of the region, be they social, political or economic. Think of factors
that prevent talented youth from getting a quality education or access to healthcare, think of the difficulties of
matching would-be employers and employees amidst lack of physical infrastructure, social barriers, and political
unrest. The states in the region have attempted to redress some of these barriers over the past decades, with
occasional successes, but plenty of room for improvement. We will introduce an analytic exercise, to run through
the term, to study the efforts of an entrepreneurial firm in Delhi, Aspiring Minds, to use technology to circumvent
barriers that prevent the disenfranchised from getting jobs. In the language of the course, Aspiring Minds is an
intermediary that is trying to fill a void in the institutional context of India.
The rest of the module will illustrate three sets of entrepreneurial efforts to repair the institutional fabric by
filling other such voids, and thereby spur economic development. Indias unique ID effort, to provide a
biometric, instantly verifiable ID to every Indian resident, is a breathtakingly ambitious effort, initiated by a
celebrity private-sector entrepreneur, embraced by the central government. For the first time, the state will be
able to know who its charges are, as a precursor to discharging its duties. Then we consider microfinance, in
Bangladesh and across the region, and ask about the pros and cons of for-profit and not-for-profit entrepreneurial
solutions to these problems. The sector, having enjoyed massive success, has come under political attack in both
Bangladesh and India in the past few years. Finally, if better information about residents, and easier access to
micro-loans, are part of the soft infrastructure that enables productive economic activity, the hard
infrastructure of the region is also glaringly inadequate (think roads, power plants, and the like). As an example,
we look at Roshan, an entrepreneurial effort to jumpstart access to mobile telephony in conflict-prone
Afghanistan.
Throughout the module (and the course), we must be mindful of how to evaluate the progress engendered by all
these foundational elements, the social and political bedrock and the infrastructural investments atop them. What
do crisp measures such as GDP tell us? What do more encompassing but harder-to-quantify notions such as the
Human Development Index (HDI), tell us?
The introductory module will be followed sequentially by modules on entrepreneurship in Urbanism, Technology,
Health, the Arts & the Humanities, and by a shorter Concluding module.

[1] Introduction Institutional Underpinnings of South Asia, Corruption & Institutional Failure in India
(I-1)
Prof. Tarun Khanna
Jorge Paulo Lemann Professor, Harvard Business School
Director, South Asia Institute
Readings
Bertrand, M., Djankov, S., Hanna, R., & Mullainathan, S. (2007). Obtaining a drivers license in India: An
experimental approach to studying corruption. The Quarterly Journal of Economics, 122(4), 16391676.
Khanna, Tarun. Palepu, Krishna, G. (2010). Winning in Emerging Markets: A RoadMap for Strategy and
Execution.
Please read Chapter 2 and the first part of Chapter 3 (through discussion of Table 3.1).
Martha Nussbaum, Creating Capabilities: The Human Development Approach, Belknap Press (2011), Chapter 3.
The capabilities approach is related to the Human Development Index (HDI)
http://hdr.undp.org/en/statistics/hdi/
If you have time, browse through summaries of the Human Development Report 201020th Anniversary
Edition: http://hdr.undp.org/en/reports/global/hdr2010/chapters/en/
Read one of these:
Ranjani Iyer Mohanty, Why the Arab Spring Hasn't Spread to Indiabut Should, The Atlantic, May
2011.
Steve Coll, Sporting Chance: Can a sex symbol and cricket legend run Pakistan? The New Yorker,
August 13 & 20, 2012
Optional Reading:
Pranab Mukherjee, Finance Minister, Black Money White Paper, May 2012
(Ministry of Finance, Department of Revenue, Central Board of Direct Taxes, New Delhi)
Discussion Questions:
1. In the article Obtaining a Drivers License in India: An Experimental Approach to Understanding
Corruption, the authors find no evidence of direct bribes, but instead a system of intermediary agents
who work with bureaucrats and are able to bend some rules more frequently and reliably than
others. What kinds of rules are these agents able to get bent on behalf of clients? What might this
suggest about potential strategies for reducing corruption of this kind?
2. What forms does corruption take in India? What are some practical solutions to mitigate corruption?
Think about any anti-corruption measures you have personally encountered. Were they successful? How
could they have been improved? (An example started in India that has spread to other countries is
ipaidabribe.com; Look at Imran Khans attempt to use charisma to start a political movement)
3. Khanna and Palepu provide a taxonomy of specialized intermediaries that facilitate the creation of new
enterprises. What is the relationship between what they term institutional voids and ambient corruption?
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4. Throughout the course, we will be concerned with whether our entrepreneurial initiatives engender
progress, and, if so, how can we measure it? There is a tension between using crisp measures, like GDP,
and more encompassing but less crisply defined measures, like the Human Development Index (HDI).
The latter is related to Martha Nussbaums Capabilities approach, which we shall refer to during other
sessions also, hence its inclusion during the introductory section of the course.
[2] Introduction Fissures Across South Asia and Entrepreneurial Attempts to Address Them (I-2)
Readings
Eck, Diana. India: A Sacred Geography. Harmony (March 27, 2012). (Chapters 1 & 2; pp. 1-55).
Ashutosh Varshney, Contested Meanings: India's National Identity, Hindu Nationalism, and the Politics of
Anxiety, Daedalus, Vol. 122, No. 3, Reconstructing Nations and States (Summer, 1993), pp. 227-261.
Read one of the following articles, on Naxalites in India, post-conflict Sri Lanka, or modern day Myanmar
(Burma):
Dipak K. Gupta, The Naxalites and the Maoist Movement in India: Birth, Demise, and Reincarnation,
Democracy and Security, 3:2, 2007, 157-188.
Robert D. Kaplan, Buddha's Savage Peace, The Atlantic, September, 2009.
Sebastian Strangio, Hope, Anxiety, and Life in a Changing Burma, The Atlantic, 2012.

Discussion Questions:
1. Eck writes about imaginative mapping in Hindu traditions. What is involved in this process? How does
it differ from a technical cartographic project (as undertaken by the British)?
2. In the beginning of Chapter Two Eck writes about India's practical everyday pluralism, and what
Jawaharlal Nehru called country's tremendous impress of oneness (Eck 45). How do these
characterizations reconcile with the kind of Hindu Nationalism Varshney writes about? How does Ecks
pluralism view coexist with Varshneys idea (page 245) that Secularism is a victim of its official
success?
3. What connections do you see between social schisms (including but not limited to the caste system), on
the one hand, and Khanna and Palepus idea of institutional voids that we discussed in the last session?
What do social schisms have to do with the generation of new enterprises and entrepreneurial action?
4. Think again of the connection between political fragmentation (reference readings on Naxalites, Sri Lanka
post-conflict, and the multiple ethnic communities in Myanmar (Burma), institutional voids, and the
formation of new enterprises.
5. Optional: The movie, Lagaan, is set in 1890 and gives a flavor of relationships between the British and
the Indians during the time of the British Raj. It also depicts the intermediary relationship that Indian
royalty had, choosing between representing the colonial rulers interests and those of its traditional
subjects. The British idea of divide-and-rule emerges through the sub-text and, as such, the movie is a
nice complement to the discussion of political fragmentation in this section as well as social
fragmentation in the prior session.

[3] Introduction - The Emergence of Soft Infrastructure: Unique Biometric IDs across India (I-3)
Readings
Case Study: Tarun Khanna and Anjali Raina, Aadhar and Unique ID, Harvard Business School, No 9-712-412.
Khanna, Tarun. Billions of Entrepreneurs: How China and India Are Reshaping Their Futuresand Yours,
Harvard Business School Publishing (Boston, MA), 2007. Chapter 3, Bias and Noise: Information Accessibility
in China and India.
ONLINE POLL 1
(Directions for participating in class polls will be distributed at beginning of the course. This case will also be
made available electronically to the world at large at the time of our discussion, so that we can learn from
responses-from-outside-class during our discussion.)
Choose one option for each question.
1. In what area will Aadhar/Unique ID have the biggest beneficial effect?
A Distribution of public sector goods (e.g. low price food grains)
B Delivery of government services (pensions, financial, getting a driving license, etc.)
C Facilitation of non-government ventures, commercial or otherwise
D Generalized societal transparency
E No significant benefits will be realized
2. Where will opposition, explicit or inadvertent, or other obstacles, come from in the next few years in the
Aadhar/UniqueID effort?
A Advocates of privacy laws mounting credible opposition
B Government bureaucrats undercutting particular initiatives
C Difficulty of maintaining internal momentum and excitement of startup effort
D Technological barriers to developing scale
E No meaningful opposition or obstacles will manifest themselves
Discussion Questions:

1. What could Nandan Nilekanis team have done differently in the past? What should they be thinking
about (differently) for the near future (one to two years)?

2. Soft infrastructure (e.g. institutions) can seem somewhat abstract, even nebulous, until they are absent.
What kinds of institutional voids does Aadhaar seek to fill?

3. Think about how the information environment in India, as characterized by Khanna in Bias and Noise is
likely to change as a result of every resident ultimately having a unique biometric ID that can be validated
in real-time.

4. In the context of the Capabilities approach, Nussbaum insists that government must actively support
peoples capabilities, not just fail to set up obstacles (Nussbaum 65).
How does this statement inform your previous assessment of the Government of Indias efforts to
launch Aadhar?
What policy implications does the capabilities approach have for the option of privatization of
traditional government services in the face of institutional failures, such as corruption?

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[4] Introduction Microfinance in South Asia (I-4)

Readings
Muhammad Yunus, Grameen Bank, 2006 Nobel Peace Prize Acceptance Speech
http://nobelprize.org/nobel_prizes/peace/laureates/2006/yunus-lecture-en.html
Is it fair to do business with the poor? [A transcript of the debate between Muhammad Yunus and Michael Chu
organized by the World Microfinance Forum Geneva, 12 October 2008.]
http://www.othercanon.org/uploads/Is%20it%20Fair%20to%20do%20business%20with%20the%20Poor.pdf
Michael J Sandel, What isnt for Sale? The Atlantic Monthly, April 2012
Microfinance in India: A Crisis at the Bottom of the Pyramid After, Legatum Ventures, May 2011.
(Focus on pp. 13 for an overview of the 2010 Andhra Pradesh Act and a summary of microfinance in India).
Indian Microfinance: Looking Beyond the AP Act and its Devastating Impact on the Poor, Legatum Ventures,
March 2012.
(There is [1] a brief overview as well as [2] a full length report and [3] a large format infographic.
Together this material provides an analysis of the AP Act's impact on the microfinance industry in Andhra
Pradesh, and beyond, 18 months after the AP government passed the bill.)
Optional Readings
Daryl Collins, Jonathan Morduch, Stuart Rutherford & Orlanda Ruthven: Portfolios of the Poor,
Princeton University Press, 2009.
Chapter 1. http://www.portfoliosofthepoor.com/book.asp
(Also consult the intriguing Household Stories that offer summary caselets at this site
http://www.portfoliosofthepoor.com/index.asp)
Beatriz Armandariz and Jonathan Morduch. The Economics of Microfinance, MIT Press.
Chapter 4, Group Lending. pp. 85199 (Focus on the non-technical parts of the description).
ONLINE POLL 2
(Directions for participating in class polls will be distributed at beginning of the course)
1. Do you feel that most of the efforts of the microfinance industry should be focused on the not-for-profit
variety or on the commercial variety?
Use a scale to respond, from A through E, with A indicating the bulk of microfinance should be not-forprofit, C indicating an equal split between for-profit and not-for-profit is best for the system, and E
indicating that the bulk should be on commercial microfinance.
2.

Consider the microfinance crisis in the Indian state of Andhra Pradesh. To which groups actions do you
attribute most of the reasons for the current problems? Pick one:
A. Microfinance companies
B. State organized self-help lending groups
C. Financial regulators, other civil society actors (e.g. press)
D. Borrowers
E. Other (please specify)

3.

On which group would you focus your primary efforts to find a way out of the crisis for the poor of
Andhra Pradesh. Pick one:
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A.
B.
C.
D.
E.
F.

Microfinance companies
State organized self-help lending groups
Financial regulators
Other civil society actors (e.g. press)
Borrowers
Other (please specify)

Discussion Questions:
1. Should access to minimal finance be for sale in Sandels terminology?
2. How does group lending work? What are the underlying ambient economic, social and political
conditions that you think are most conductive to the model working?
3. How do you think urban and rural microfinance should differ, if at all?

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Module II: Urbanism

Prof. Rahul Mehrotra
Professor and Chair - Department of Urban Planning and Design, Harvard Graduate School of Design
[5] Urbanism Public Sanitation Provision (II-1)
The introductory lecture will present a reading of urbanism developing in South Asian cities through a series of
observations from Mumbai. The lecture will also outline the relationships and roles of emerging actors and
agencies involved in the planning and decision making process in Mumbai.
One of the key emerging issues in the city is the acute lack of adequate sanitation facilities, which pose daunting
public health threats for both the poor and rich. In 1995 the World Bank floated the Mumbai Sewage Disposal
Project out of which the Alliance, led by the NGO SPARC in 2001 won the tender to build 211 toilets. The case
presented will focus on developing a new prototype for this series of interventions and exploring how design
could add value spatially as well as embed the sanitation infrastructure more appropriately into the community.
Readings
Mehrotra, Rahul (2008), 'Negotiating the Static and Kinetic Cities', in Andreas Huyssen (ed.), Other cities, other
worlds: urban imaginaries in a globalizing age (Durham: Duke University Press), pp. 205-221.
Appadurai, Arjun (2002), Deep Democracy: Urban Governmentality and the Horizon of Politics, in Public
Culture, Volume 14, Number 1, Winter 2002, (Article), (Durham: Duke University Press), pp. 21-47.
Correa, Charles (2002), The Questions, Hawkers and Pavements: 1968 to date in Bombay, The National
Commission on Urbanization in Housing and Urbanization, (London: Thames & Hudson), pp. 130 131.
Provoost, Michelle and Vanstiphout, Wouter, (2009), Facts on the Ground: Urbanism from Midroad to Ditch, in
Krieger and Saunders (eds.) Urban Design, (Minneapolis: University of Minnesota Press), pp 186200.
Discussion Questions:
1. How must urban designers and entrepreneurs adjust their conventional roles to fit the culture of
retroactive planning in Mumbai?
2. Discuss the idea of precedent-setting as described by Appadurai; how can formal institutions leverage
this while imagining and designing long term planning processes?
3. Urban governance in Mumbai has become a responsibility shared by the state government, municipality,
self-mobilized community groups and NGOs; at what level of intervention / in what type of projects is
this fragmented governance most effective?
4. How can design and entrepreneurship facilitate self-mobilization especially in areas of public health?

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[6] Urbanism Urban Conservation of Monuments in Active Use (II-2)

The historic Fort area in Mumbai till the mid-90s was largely neglected but also under threat because of three
main reasons firstly, the ideas of historicity, memory and nostalgia that were used to describe its significance
were out of sync with the culture that currently occupied the space. Second was a draconian rent control act which
froze rents across the city since the 1960s, thus providing no incentives for landlords to invest in the upkeep of
their buildings, and thirdly on account of the blanket building regulations which did not recognize the
particularities of this historic urban form.
The lecture will describe the process of introduction of urban conservation in Mumbai by a group of activists and
planners, its opportunities, and the challenges faced in implementing the legislation for preservation and
improvement of historical districts. The case will focus on the historical Fort area in Mumbai and in particular one
sub-district within this precinct. The case will also explore the questions and challenges of bridging the gap
between abstract policy and ground realities as well as the strategy of community participation through
constructing new significances that resonate more closely with contemporary conditions and aspirations.
Readings
Guzder, Cyrus (2004), Conservation Legislation in Mumbai Has it worked? And what next?, in Abha Narian
Lambah, Rahul Mehrotra (eds.), Conservation after Legislation: Issues for Mumbai (Mumbai: Urban Design
Research Institute), pp. 18 - 30
Orbasli, Aylin, (2004), Heritage Tourism and the City, in Abha Narian Lambah, Rahul Mehrotra (eds.),
Conservation after Legislation: Issues for Mumbai (Mumbai: Urban Design Research Institute), pp. 114 - 123
Tomlan, Michael A., (2004), More Carrots Financing Conservation, in Abha Narian Lambah, Rahul Mehrotra
(eds.), Conservation after Legislation: Issues for Mumbai (Mumbai: Urban Design Research Institute), pp. 94
103
Mehrotra, Rahul (2004), Constructing Cultural Significance: Looking at Bombays Historic Fort Area, in Future
Anterior, Volume 1, Number 2, Fall 2004, (Article), (New York : Historic Preservation Program, Graduate School
of Architecture, Planning, and Preservation, Columbia University), pp. 24 - 31
Kathpalia, Nayana, Lambah, Abha Narain (2004), Characteristics of a Heritage Precinct, Heritage buildings &
precincts, Mumbai: a conservation manual for owners & occupiers, (Mumbai: Urban Design Research Institute),
pp 18 33.
Discussion Questions:
1. What are the key challenges and concerns planners and conservationists should address while dealing
with monuments in active use, as is the case of South Asian cities?
2. In urban environments where resource allocation for health, sanitation and housing take top precedence,
how must governments and municipalities respond to demands of conservation, and safeguarding historic
memory through the built environment?

14

3. In your opinion, what are the features that constitute the cultural significance of a monument or precinct
at the scale of the city?
4. Based on the material presented in the lecture and essay by Orbasli, discuss the potential of heritage
tourism in Mumbai. What would the market be, and what entrepreneurial innovations could one employ
to augment this?
5. Tomlan discusses various mechanisms adopted in the US to promote heritage conservation. Which of
these (if any) can be adapted to the context of Mumbai, and what key ideas / components can be
leveraged to incentivize the private sector in Mumbai to invest in this process?
[7] Urbanism Public Private Partnerships for Preservation of World Heritage Sites (Case of the Taj
Mahal) (II-3)
The lecture will discuss the challenge of preservation within the plural landscapes in the South Asian context.
Monuments lie within the overlap not only of cultural and social but also religious significance.
The Archeological Survey of India, under the Ministry of culture is responsible for the overwhelming task of
archeological researches and protection of the cultural heritage of the nation. Often it is faced with its own lack of
intellectual and monetary capacity and is therefore unable to safeguard the integrity of each of the countrys
monuments. Recognizing this limitation, the government in 1996 established a National Culture Fund as an
institutional mechanism to facilitate public private partnerships for the preservation of these monuments.
The case discussed in this module will be of the preservation of the Taj Mahal. This case is an early example of a
public private partnership for the conservation of a World Heritage Site in India. In the lecture, the nature of the
MoU as well as the process that emanated from it will be presented.
Readings
Baig, Amita (2014), Everyones Taj Mahal, in Passage, Volume 1, March / April 2014, (Article), pp. 8
Tatas, ASI come together to conserve Taj, in Times of India, June 21, 2001, (Article), retrieved from:
http://timesofindia.indiatimes.com/india/Tatas-ASI-come-together-to-conserve-Taj/articleshow/361603754.cms
Not so Wonderful: Tata Group cannot continue with Taj Mahal Conservation collaborative Project, in India
Today, Heritage Archive, July 23, 2007, (Article), retrieved from: http://indiatoday.intoday.in/story/tata-groupsihcl-cannot-carry-on-with-the-taj-mahal-conservation-collaborative-project/1/155387.html
World Heritage Centre, The Criteria for Selection, UNESCO, World Heritage Convention, retrieved from:
http://whc.unesco.org/en/criteria/ (2013)
Koch, Ebba, (2010) Taj Mahal - Survey, Documentation (1995 2005) and Analysis Its Bearing on
Conservation, Krist, G., & Bayerov, T. (eds.), Heritage conservation and research in India: 60 years of IndoAustrian collaboration, (Wien: Bhlau), pp 47 - 56.

15

Additional references:
Taj Mahal, Agra: Site Management Plan, Taj Mahal Conservation Collaborative, (March 2003)
Ancient Monuments and Archeological Sites and Remains Rules, The Gazette of India, Part II, Section
3, sub section (ii), (New Delhi: Ministry of Scientific Research and Cultural Affairs), (1959), retrieved
from: Archeological Survey of India, http://asi.nic.in/asi_legislations.asp
Discussion Questions:
1. What might have been different in the design pf the MoU in this public private partnership that would
have committed both parties more strongly to the project?
2. In your opinion, is the World Heritage Site listing an advantage or disadvantage for the actual
conservation of this living monument?
3. What kinds of innovations could be employed to engage local stakeholders in the preservation of a World
Heritage site?
4. Is charging a different entrance fee for Indian nationals and foreign nationals a fair practice?
[8] Urbanism Housing for Low Income Communities (II-4)
Often housing that is supplied by the state takes on the form of mass housing configured as repetitive 3 to 4
storied blocks. Deployed very rapidly at a large scale, the compulsion is often to meet targets in a short period of
time as a perception to solve the problem. However more recently, incrementality is a widely adopted an
important strategy when designing especially for low income populations to accommodate space requirements
that fluctuate based on family size and composition. Furthermore, low cost housing is perceived only through
design, disconnected from both, broader ecological and also economic, social and cultural issues. The lecture will
examine this issue through different cases and focus in detail on two cases. The first a housing project in Navi
Mumbai by Charles Correa for CIDCO ( the City and Industrial Development corporation) and the second Hathi
Gaon project near Jaipur, India to house 100 elephant keepers (mahouts) and their families. Both projects
illustrate different ends of the spectrum in terms of housing and especially low cost housing. One the challenge of
large scale Incremental housing and the other where concerns of ecology ( natural, social , cultural and economic)
were integrated in the project.
Readings
1. Correa, Charles, (1985), Urbanization, The New Landscape: Urbanization in the Third World,
(Mumbai: Book Society of India), 9 - 30.
2. Correa, Charles, (1985), Equity, The New Landscape: Urbanization in the Third World, (Mumbai: Book
Society of India), 48 - 61
3. Patel S., d'Cruz C., and Burra, S. (2002), 'Beyond evictions in a global city: People-Mmanaged
Resettlement in Mumbai', Environment and Urbanization, 14 (1), 159-172.
4. Calott, Christopher (2004), Housing as a Form of Non-Formal Urbanism: Belapur Housing by Charles
Correa, Navi Mumbai, 1983 86 to the Present, in Extreme Urbanism, (Cambridge: Graduate School of
Design), pp 180 189
16

Discussion Questions:
1. Is low cost housing necessarily something the only the state should patronize, can public private
partnerships be employed to deliver these needs?
2. What is the role of an architect in a project like Hathi Gaon, where client intervention is minimal and the
beneficiaries do not have the capacity to organize themselves?
3. How can incrementality as a strategy open up new ways or possible methods to imagine low cost
housing?
4. What is your opinion of Correas argument that low cost housing is best configured in a low rise high
density form?
Additional references:
Shetty, Prasad, et al. (2007), 'Housing Typologies in Mumbai', in Collective Research Initiatives Trust
(CRIT)
(ed.),
(Mumbai:
Urban
Age
London
School
of
Economics),
http://downloads.lsecities.net/0_downloads/House_Types_in_Mumbai.pdf
Wakely, Patrick and Riley, Elizabeth, The Case for Incremental Housing, Cities Alliance Policy
Research and Working Papers, Series No. 1, 2011

17

Module III: Technology

Prof. Conor Walsh
Assistant Professor of Mechanical and Biomedical Engineering
Harvard School of Engineering & Applied Science
[9] Technology Experiments in Technology & Education, Khan Academy (III-1)
Prof. Tarun Khanna
Jorge Paulo Lemann Professor, Harvard Business School
Director, South Asia Institute
Technology is enabling a range of innovations that are transforming how education is structured at all levels of
academic institutionsfrom elementary and secondary schools to major universities, such as Stanford, MIT,
Harvard, and others across the country. Distance learning is becoming an increasingly present component of
education and is utilized in a wide range of ways, from supporting roles in individual classes to broad facilitation
of certificate and degree coursework. How much can we borrow from these technology experiments in the West
for our purposes in the South Asian context?
Readings
Thompson, C. How Khan Academy Is Changing the Rules of Education, Wired, July 15, 2011.
http://www.wired.com/magazine/2011/07/ff_khan/all/1
University 2.0 VIDEO: http://www.youtube.com/watch?v=SkneoNrfadk&feature=youtube_gdata_player
https://email.hbs.edu/owa/redir.aspx?C=4d25c7f481454ff2825b935672fa0275&URL=http%3A%2F%2Fwww.yo
utube.com%2Fwatch%3Fv%3DSkneoNrfadk%26feature%3Dyoutube_gdata_player
Explore Website Udacity: http://www.udacity.com/
http://www.udacity.com/
Guynn, J. Steve Jobs' virtual DNA to be fostered in Apple University, The Los Angeles Times, October 06,
2011.
http://articles.latimes.com/2011/oct/06/business/la-fi-apple-university-20111006
Kraemer, KL, Dedrick J, and Sharma P. One Laptop Per Child: Vision versus Reality, Communications of the
ACM (2009) 52(6): 6673.
http://pcic.merage.uci.edu/papers/2009/OneLaptop.pdf or
http://ezpprod1.hul.harvard.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=40217615&sit
e=ehost-live&scope=site
Chafkin, Max. Udacitys Sebastian Thrun, Godfather of Free Online Education, Changes Course,, Fast
Company magazine, December 2013 / January 2014. Available online from November 14, 2013.
http://www.fastcompany.com/3021473/udacity-sebastian-thrun-uphill-climb

Discussion Questions
1. How applicable is Sal Khans method of learning to South Asia? What is the role of the student, the
teacher, and the community-at-large in this method of learning?
18

2. How might Sal Khan engage with various aspects of the educational infrastructure in South Asia
(teachers, regulators, parents)? To what extent will his teams experiences with entities like LSAD be
relevant to South Asia?
3. Think also about the Udacity method, as well as about the Sugata Mitra TED talk suggestion (encountered
in the Education Module) that self-directed learning can occur amongst small groups of children and can
be even more effective with encouragement from the granny cloud. What do these readings
collectively suggest for the Khan Academys future potential in South Asia?
[10] Technology Nanotechnologys Use to Democratize Healthcare Diagnostics (III-2)
Dr. Anita Goel
Chairman, & Scientific Director of Nanobiosym
TBD - Visiting scientist and entrepreneur, Dr. Anita Goel, will be discussing nanotechnology and the way it is
changing the face of medicine for the developing world. Nanobiosym Health RADAR was awarded the Grand
Prize in the Nokia Sensing XCHALLENGE for their Gene-RADAR sensing technology. This allows for testing
the absence/presence of pathogens from a drop of body fluid as accurately as any diagnostic lab, without any need
for infrastructural overhead. Dr. Goel started Nanobiosym while she was a graduate student at Harvard.
[11] Technology Simulation Exercise (III-3)
Donal Holland
Fellow in Materials Science and Mechanical Engineering
Harvard School of Engineering & Applied Science
TBD Simulation exercise to discuss how new technologies are brought to market.
[12 & 13] Technology Creating Low Cost, Smart Medical Devices for Low Income Countries Public
Health Needs (III-4 & III-5)
Conor Walsh, Ph.D directs the Harvard Biodesign Lab which is focused on the design and evaluation of smart
medical devices to improve the minimally invasive diagnosis and treatment of disease through collaboration with
practicing clinicians.
Among his current research projects is the development of compact robots that operate inside medical imaging
machines to enable the highly accurate placement of biopsy needles and thermal ablation probes. With their
enhanced precision, these tools could help diagnose early-stage cancer by targeting much smaller tumors at an
earlier stage. He is also working with collaborators to develop wearable robotic devices that are soft and pliable,
unlike traditional exoskeletons that use rigid components.
Recently, in collaboration with the Harvard South Asian Initiative, he started a new program whose purpose is to
interact with local stakeholders (physicians and hospital administrators) in India with the goal of identifying
opportunities for innovation (by finding unmet medical needs) that can lead to new affordable medical
technologies. Four Harvard students are visiting the Narayana Hrudayalaya hospitals in Bangalore for 10 weeks
this summer where the students will interview patients, shadow physicians and spend time observing surgical
procedures to identify clinical needs. At the end of the summer, the team will share their findings and will seek to
build a long-term relationship whereby Harvard students continue to work on their project when they return.

19

Readings
Stephen B. Wilcox, Designing Usability into Medical Product, Chapter 5: User-Centered Medical Product
Development and the Problem of Egocentrisms, 2005 CRC Press LLC
Stephen B. Wilcox, Designing Usability into Medical Product, Chapter 6: Ethnographic Methods for New
Product Development, 2005 CRC Press LLC
The Good Enough Revolution: When Cheap and Simple Is Just Fine, WIRED magazine, 17.09
http://www.wired.com/gadgets/miscellaneous/magazine/17 09/ff_goodenough?currentPage=all

20

Module IV: Health

Prof. Sue J. Goldie
Roger Irving Lee Professor of Public Health, Harvard School of Public Health
Professor of Global Health and Social Medicine, Harvard Medical School
Director, Harvard Global Health Institute, Harvard University
Director, Center for Health Decision Science, Harvard School of Public Health
[14] Health Module Health Realities in South Asia - A Multi-Sectoral Framework (IV-1)
This session will provide the broad conceptual foundation for critically thinking about health in South Asia. A
carefully selected set of health challenges will be used in this first session to establish our conceptual framework,
and to illuminate important cross-cutting factors woven through the modules of the course. In the context of
country examples, we will identify and discuss categories of health conditions (and their growing complexities as
a consequence of globalization), influential social and political determinants (and their distribution and
dynamics), and a broad range of potential social responses (from health services delivery through communities
and national health systems, to institutional innovations to instruments of policy).
Readings
(2009). "What is health? The ability to adapt." The Lancet, 373(9666): 781. [1 Page]
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960456-6/fulltext
(Read executive summary) Human Development Report 2013. (2013). UNDP. 11-18. [10 Pages]
http://hdr.undp.org/en/reports/global/hdr2013/.
Jamison, D.T. (2006). Chapter 1: Investing in Health. Disease Control Priorities in Developing Countries (2nd
Edition). 1-11. Link. [11 Pages]
http://files.dcp2.org/pdf/DCP/DCP01.pdf.
(Skim) Marmot, M. (2012). Building of the global movement for health equity: from Santiago to Rio and
beyond. The Lancet, 379(9811), 181-8. Link. [8 Pages]
http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0140673611615067.
James, K.S. (2011). Indias Demographic Change: Opportunities and Challenges. Science, 333, 576-80. [5]
http://www.sciencemag.org.ezp-prod1.hul.harvard.edu/content/333/6042/576.long.
Sultan, F. Khan, A. (2013). Infectious diseases in Pakistan: a clear and present danger. The Lancet, 381(9884),
2138-2140. [3 Pages]
http://ac.els-cdn.com/S0140673613602482/1-s2.0-S0140673613602482-main.pdf?_tid=167cb022-118b-11e38ed4-00000aab0f02&acdnat=1377877662_b69826becd41591af0776c48111258ed.
(Optional) Frenk, J., Gmez-Dants, O., Chacn, F. (2010). Global Health in Transition. In Parker, R.,
Sommer, M., eds. Routledge Handbook of Global Public Health. New York: Routledge.
https://www.dropbox.com/s/vpsm4xgy6xqhgim/2010_Frenk_Global Health Transition_Routledge GP Health.pdf.
(Optional) Engelgau, MM., El-Saharty, S., Kudesia, P., Rajan, V., Rosenhouse, S., Okamoto, K. (2011).
Overview. Capitalizing on the Demographic Transition: Tackling Noncommunicable Disease in South Asia.
World Bank. 1-11. [12 Pages]
http://wwwwds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2011/08/17/000333038_20110817004056/Ren
dered/PDF/622600REPLACEM0blic00use0same0info0.pdf.

21

Discussion Questions:
1. Why have some countries made progress and not others? Compare the HDR scores in India, Pakistan,
Bangladesh, and Afghanistan with 2 or 3 health indices discussed in class (e.g. life expectancy at birth,
under 5 mortality, maternal mortality) using the 2013 Human Development Report
(http://hdr.undp.org/en/reports/global/hdr2013/). How does the aggregate HDR measure compare with
specific core health metrics? What do you notice about the trends for these countries?
2. In Nussbaums article on the Capabilities view, which we encountered earlier, what are the consequences
for economic development of inadequate attention to the state of health across countries in South Asia?

[15] Health Module Public Health Delivery Communities to National Health Systems A Focus on
Maternal and Child Health (IV-2)
Readings
Frenk J. (2010). Strengthening national health systems as the next step for global progress. PLoS Med,
7:e1000089. [3 Pages]
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000089.
Paul VK, Sachdev HS, Mavalankar D, Ramachandran P, Sankar MJ, Bhandari N, Sreenivas V, Sundararaman T,
Govil D, Osrin D, Kirkwood B. (2011). Reproductive health, and child health and nutrition in India: meeting the
challenge. The Lancet, 377: 33249. [18 Pages]
http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0140673610614924.
(Skim) Lim SS, Dandona L, Hoisington JA, James SL, Hogan MC, Gakidou E. (2010). Indias Janani Suraksha
Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. The
Lancet.375:2009-23. [15 Pages]
http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0140673610607441.
(Skim) Goldie SJ, Sweet S, Carvalho N, Natchu UCM, Hu D. (2010). Alternative strategies to reduce maternal
mortality in India: a cost-effectiveness analysis. PLoS Med. 7(4): e1000264. [17 Pages]
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000264.
Rao M, Rao KD, Kumar AK, Chatterjee M, Sundararaman T. (2011). Human resources for health in India. The
Lancet, 377(9765) 587-598. [11 Pages]
http://ac.els-cdn.com/S0140673610618880/1-s2.0-S0140673610618880-main.pdf?_tid=fa700e5c-1198-11e3920e-00000aacb362&acdnat=1377883628_1b775795c532c68b409158b68d4879dc.
This reading will also be relevant for Health Module 8 and 10.
Kumar, A.K.S., Chen, L.C., Choudhury, M., Ganju, S., Mahajan, V., Sinha, A., Sen, A. (2011). India Series:
Financing health care for all: challenges and opportunities. The Lancet. 377(9766), 668-79. [11 Pages]
http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0140673610618843.
This reading will also be relevant for Health Module 8 and 10.
From the papers below, choose either Pakistan or Afghanistan and briefly skim the papers:
Pakistan
Horton, R. (2013). Pakistan: health is an opportunity to be seized. The Lancet, 381(9884), 2147-2138. [2 Pages]
22

http://ac.els-cdn.com/S0140673613609460/1-s2.0-S0140673613609460-main.pdf?_tid=a12996c8-118a-11e3b91f-00000aacb35f&acdnat=1377877465_65b4a64d67f073ab551d250e351517ae
Sathar, Z. (2013). Family planning: a missing priority in Pakistan's health sector? The Lancet, 381(9884), 21402141. [2 Pages]
http://ac.els-cdn.com/S0140673613607631/1-s2.0-S0140673613607631-main.pdf?_tid=8000bac0-118b-11e38bc3-00000aab0f02&acdnat=1377877839_5633e742891e5351b5bcf8dbeb40f580
Nishtar S, Boerma T, Amjad S, Alam AY, Khalid F, ul Haq I, Mirza YA. (2013) Pakistan's health system:
performance and prospects after the 18th Constitutional Amendment. The Lancet, 381(9884), 2193-2206. [14]
http://ac.els-cdn.com/S0140673613600197/1-s2.0-S0140673613600197-main.pdf?_tid=3987a192-118d-11e3a472-00000aacb361&acdnat=1377878580_430c63ea14a6001809a0ab180023e5ea
Bhutta, Z. Hafeez, A. Rizvi, A. Ali, N. Khan, A. Ahmed, F. Bhutta, S. Hazir, T. Zaidi, A. Jafarey, S.N. (2013).
Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities. The Lancet,
381(9884), 2207-2218. [12 Pages]
http://ac.els-cdn.com/S0140673612619990/1-s2.0-S0140673612619990-main.pdf?_tid=973862ea-118d-11e39c1f-00000aab0f6c&acdnat=1377878737_804daaa8d0bc45264d20a74c4c227b92

Afghanistan (Optional)
Goldie SJ. (2012). Strengthening Afghanistans health system: challenges, progress, and opportunities.
Afghanistan Journal of Public Health. 1(1), 3-4. [2 Pages]
http://www.anpha.af/images/stories/afjph_volume_one_issue_one.pdf.
Edward A, Kumar B, Kakar F, Salehi AS, Burnham G, Peters DH. (2011). Configuring Balanced Scorecards for
Measuring Health System Performance: Evidence from 5 Years Evaluation in Afghanistan. PLoS Med, 8(7). [9]
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001066
Carvalho N, Salehi A, Goldie SJ. (2012). National and sub-national analysis of the health benefits and costeffectiveness of strategies to reduce maternal mortality in Afghanistan. Health Policy and Planning, 28(1), 6274. [13 Pages]
http://heapol.oxfordjournals.org.ezp-prod1.hul.harvard.edu/content/28/1/62.long.
Discussion Questions:
1. Think back to our first health introductory session [Introduction Health Realities in South Asia - A
Multi-Sectoral Framework (I-2)] in which we discussed a conceptual framework for thinking about
health broadly. How do the problems associated with the unfinished agenda of maternal mortality,
child mortality and under-nutrition fit into this conceptual framework?
2. Which social determinants will be most relevant for maternal and child health how variable will the
most influential determinants be across countries in South Asia?
3. What are the most effective ways (societal responses) to reduce morbidity and mortality in children
and women of reproductive age? What accounts for the different trajectories of success across South
Asia?

23

4. What unique challenges confront Pakistan? India? Afghanistan? How will they meet them? What
would you advise? Would your recommendations differ across countries? For example
Would you recommend investing in more research are there critical knowledge gaps? Would you
incentivize development of new technologies? Would you propose innovative delivery platforms?
Would you encourage entrepreneurial efforts outside the health sector? Would you focus on
strengthening the national health system? Would you promote social policy reform? Would you
advocate for resources from the global community (e.g., global norms and standards, human or
financial resources)?

[16] Health Module Ensuring Quality When Considering Access and Why it Really Matters for India
(IV-3)
Readings
Jha, A. (2012). Can quality be on Indias healthcare agenda? Should it be? The blog of Ashish Jha physician,
health policy researcher, and advocate for the notion that an ounce of data is worth a thousand pounds of opinion.
http://blogs.sph.harvard.edu/ashish-jha/can-quality-be-on-indias-healthcare-agenda-should-it-be/.
Berwick DM. (2002). A users manual for the IOMs Quality Chasm report. Health Affairs, 21(3): 80-90. [11]
http://content.healthaffairs.org.ezp-prod1.hul.harvard.edu/content/21/3/80.full.pdf+html.
Das J, Holla A, Das V, Mohanan M, Tabak D, and Chan B. (2012). In Urban and Rural India, A Standardized
Patient Study Showed low Levels of Provider Training and Huge Quality Gaps. Health Affairs, 31(12) 27742784. [11 Pages]
http://content.healthaffairs.org.ezp-prod1.hul.harvard.edu/content/31/12/2774.long.
Das, J. and Hammer, J. (2007). Location, Location, Location; Residence, Wealth, and The Quality of Medical
Care in Delhi India, Health Affairs, 26(3) w338-w351. [14 Pages]
http://content.healthaffairs.org.ezp-prod1.hul.harvard.edu/content/26/3/w338.long.
(Optional) Amin R, Shah NM, Becker S. (2010). Socioeconomic factors differentiating maternal and child
health-seeking behavior in rural Bangladesh: A cross-sectional analysis. Journal for Equity in Health, 9 (22) 112.
http://www.equityhealthj.com.ezp-prod1.hul.harvard.edu/content/9/1/9.

Discussion Questions:
1. What is the key distinction between access and quality and do you see them as complementary issues
or as competing issues in healthcare?
2. What role might the private sector play in improving access to high quality healthcare services in India,
and what role is it playing right now?
24

3. What is the role of the private sector in caring for the poor of India?
4. How might changes in information systems and technology affect access to reliable, high quality care,
especially for the poor, in India?
[17] Health Module Intellectual Property Rights and Healthcare in South Asia, Case of Cipla (IV-4)
Readings
Desphande, R., Sucher, S.J., Winig, L. (2011). Cipla. HBS Case No. 511-050.
Ministers of Foreign Affairs of Brazil, France, Indonesia, Norway, Senegal and Thailand. (2011). Why we need
a commission on global governance for health. The Lancet, 379(9825):1470-1. [2 pages]
http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0140673611618540.
(For a brief background account of how HIV treatment debates shaped global IP norms):
't Hoen E, Berger J, Calmy A, Moon S. (2011) "Driving a decade of change: HIV/AIDS, patents and access to
medicines for all." Journal of the International AIDS Society, 14(15). [12 Pages]
http://www.biomedcentral.com/1758-2652/14/15.
(For a brief analysis of the landmark Glivec Supreme Court decision in India earlier this year):
Kapczynski A. (2013). "Engineered in IndiaPatent law 2.0." New England Journal of Medicine, 369: 497-9. [3]
http://www.nejm.org/doi/full/10.1056/NEJMp1304400.
(For a good general overview comparing recent compulsory licenses on cancer drugsprimarily in Indiato the
experience with HIV, with implications for industry):
IMS Health. (2013). "White Paper: Securing IP and Access to Medicines: Is Oncology the next HIV?"
http://www.imsconsultinggroup.com/deployedfiles/consulting/Global/Content/Our Latest Thinking/Static
Files/IMSCG_Compulsory Licensing - Securing IP and Access to Medicine_March 20.pdf.
(Introducing recent debates on how to reform the global R&D system to address some of the access issues from
the start; provides a concise summary of the main recommendations of the CEWG report):
Rttingen JA, Chamas C, Goyal LC, Harb H, Lagrada L, Mayosi BM. (2012) "Securing the public good of health
research and development for developing countries." Bulletin of the World Health Organization, 90:398-400.
http://www.who.int/bulletin/volumes/90/5/12-105460/en/index.html.
(Optional) William W. Fisher & Talha Syed, Global Justice in Healthcare: Developing Drugs for the Developing
World. UC Davis Law Review, 40 (3).
(Optional) Prithwiraj Chowdhury and Tarun Khanna. The Anatomy of Intellectual Property Theft: The Case of
Chinese and Indian Herbal Patents. University of Pennsylvania and Harvard University Working Paper, August
2012.
Discussion Questions:
1.

What are the implications of India's domestic intellectual property policies and court decisions for
global health beyond India's borders? Conversely, how do international factors influence government
policies and the practices of firms and civil society groups in India?

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2.

What are the international and domestic factors that have shaped recent court and government
decisions in India relating to intellectual property and access to medicines? Why do you think these
decisions were made (by judges and government officials, respectively), and why now?

3.

What are the pros and cons -- from the perspective of health and economic development -- of India's
decision to join the WTO (and by extension, accept the TRIPS Agreement) in the 1990s? What are
the pros and cons, again from a health and economic development perspective, of the recent
compulsory licensing and Glivec cases?

4.

What alternatives might there be to existing national and international IP rules for incentivizing
pharmaceutical innovation? How feasible do you think these are?

[18] Health Module Delivering Health Services at the Tertiary Care Level, Case of Narayan Health City
(IV-5)
Readings
Tarun Khanna, Kasturi Rangan and Merlina Manocaran, Narayana Hrudayalaya Heart Hospital: Cardiac Care for
the Poor, Harvard Business School Case Study N9-505-078.
Video: Narayana Heart Hospital PART ONE (Pre-class viewing by students)
Atul Gawande. Big Med, Annals of Health Care, Restaurant chains have managed to combine quality control,
cost control, and innovation. Can health care? The New Yorker, August 13, 2012
The Good Enough Revolution: When Cheap and Simple Is Just Fine, WIRED magazine, 17.09.
http://www.wired.com/gadgets/miscellaneous/magazine/17-09/ff_goodenough?currentPage=all
Discussion Questions:
1. Would you describe Dr. Shettys heart hospital as successful? Explain why. How does Shettys approach
relate to the approaches discussed in the Wired article, The Good Enough Revolution, or in the New
Yorker article on restaurant chains?
2. If successful, what were the elements that made it successful? If not yet successful, what else should NH
be doing?
3. What are the limits to what Dr Shettys mission and model can achieve? Are there boundaries for the role
of private enterprise?
4. As Dr. Shetty continues to expand, do you think he should embrace as much as he can or leave anything
to the state? Think back to previous sessions in this module as you reflect on these last questions.
ONLINE POLL 3
(Directions for participating in class polls will be distributed at beginning of the course. This case will also be
made available electronically to the world at large at the time of our discussion,so that we can learn from
responses-from-outside-class during our discussion.)
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Choose one option for each question.

1. Should Dr. Shetty raise prices on the well-off to subsidize the poor more?
A. Raise prices on rich, treat more poor patients
B. Leave as status quo
C. Invest in further improvements to lower prices for all
2. Which of the following should Dr. Shetty pursue first?
A. Expansion into other tertiary health areas in the Bangalore facility
B. Creation of lower cost health tertiary health formats than even the existing hospital
C. Expansion of the proven heart care model around the world

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Module V: Humanities
Prof. Parimal G. Patil
Professor of Religion and Indian Philosophy
Chair, Department of South Asian Studies
[19] Humanities Introduction: The Third River (V-1)
Readings
Flexner, Abraham. The Usefulness of Useless Knowledge, Harpers, issue 179, June/November 1939, pp. 544552. Available online from the Harpers archive at
http://harpers.org/archive/1939/10/the-usefulness-of-useless-knowledge/
or
http://harpers.org.ezp-prod1.hul.harvard.edu/archive/1939/10/the-usefulness-of-useless-knowledge/

Nussbaum, Martha. Not For Profit: Why Democracy Needs the Humanities. The Public Square Book Series.
Princeton, N.J. : Princeton University Press. 2010.
Focus on Ch. 1 (pp. 111), Chs. 5-6 (pp. 79120).
Available online through Harvard Libraries:
http://ezpprod1.hul.harvard.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=321443&sit
e=ehost-live&scope=site
Pollock, Sheldon. Crisis in the Classics, Social Research Vol. 78 No .1, Spring 2011, pp. 21-48.
http://ezpprod1.hul.harvard.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=60449107&sit
e=ehost-live&scope=site
Cf. Sandel reading from the Introductory Module (http://www.theatlantic.com/magazine/archive/2012/04/whatisnt-for-sale/308902/) and Atul Gawandes Slow Ideas
(http://www.newyorker.com/reporting/2013/07/29/130729fa_fact_gawande?currentPage=all)
Discussion Questions: What kinds of problems are worth solving? Which ones take priority? What counts as a
problem? Should problems ever be created? How do you answer these questions?
Assignment: Class Forum Posting and/or Response. Identify a cultural problem that you feel is worth solving,
and propose a solution.

[20] Humanities Outrage and Entrepreneurship: Textbook Controversies in South Asia (V-2)
Readings
*Cf. w/ Eck and Varshney readings from the Introductory Module.
Topic 1:

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Golden, Daniel. New Battleground In Textbook Wars: Religion in History, Wall Street Journal, updated online
January 25, 2006.
http://online.wsj.com/news/articles/SB113815619665855532
Edits and decisions made by the California State Board of Education, pp. 93126 [Skim]
http://www.cde.ca.gov/be/ag/ag/documents/hssnotice022706a1.pdf
Thapar, Romila and Witzel, Michael. Creationism By Any Other Name. Outlook India, February 28, 2008.
http://www.outlookindia.com/article.aspx?230381
Malhotra, Rajiv and Jhunjhunwala, Vidhi. Academic Hinduphobia. Outlook India, February 10, 2008.
http://www.outlookindia.com/article.aspx?230142
Nayyar, A. H., and Salim, Ahmed. The Subtle Subversion: The State of Curricula and Textbooks in Pakistan.
Islamabad : Sustainable Development Policy Institute, 2005. (138 pages)
Book available in print at Harvard Depository : http://hollis.harvard.edu/?itemid=|library/m/aleph|010241032
You can place books on reserve by using the form found at: http://www.library.hbs.edu/hbs/forms/reserve/
Topic 2: (4) Commodification of Culture (see assignment); (5) Yoga (see assignment);
Discussion Questions (Based on Topic 1)
What is the epistemology of outrage? What does outrage reveal? Wherein lies its significance? Is it a problem? If
so, how would you address it in a particular case? Does outrage provide entrepreneurial opportunities?
Assignments (Based on Topic 2)
(1) South Asian culture continues to be commodified, in the sense that South Asian images, cultural/religious
practices, and motifs are used to market a range of products and also to spice up a variety of events,
performances, etc. Recently this has lead to outrage in segments of the South Asian community. Post at least one
example of such commodification to the course iSite, and comment on its appropriateness.
(2) Find and post what you take to be a good article on at least one of the controversies surrounding the practice
of yoga in the U.S. What are the issues generating these controversies. How would you address them?
[21] Humanities Cultural Agents in Service of Entrepreneurship, www.culturalagents.org (V-3)
Prof. Doris Sommer
Ira Jewell Williams, Jr. Professor of Romance Languages and Literatures and of African and African American
Studies
Guest Lecture
From www.culturalagents.org, Art is a force that drives innovation in everything from education, medicine,
science, law, political leadership, and business.
Prof. Sommers is the founder and faculty director of the Cultural Agents Initiative, which is a network of
academics, artists, educators, and organizations who develop recognition of the arts as resources for positive
change. It has resulted in a wide range of programs and efforts in the United States, Latin America, and further in
which the concept of cultural agencyusing the arts to spur creativity and entrepreneurship in education, politics,
society, and businesshas been instantiated in a variety of forms.

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Readings
TBA

[22] Humanities The Jaipur Literary Festival (V-4)

Prof. Tarun Khanna
Jorge Paulo Lemann Professor, Harvard Business School
Director, South Asia Institute
Readings
Jaipur Literature FestivalBeyond the Festival Template. (HBS Case N1-712-401)
Montenegro, Dolores. "The Problem with Literary Festivals". The New Statesman, published online 14 October
2013, 13:11. Link: http://www.newstatesman.com/books/2013/10/problem-literary-festivals
Ed. Ramanujan, A.K. Folktales from India: A Selection of Oral Tales from Twenty-two Languages. Pantheon
Books, New York: 1991. Introduction (pp. xiiixxxii), Tell It to the Walls (p. 3), What Happens When You
Really Listen (pp. 5556).
Kidd, D.C. and Castano, E. Reading Literary Fiction Improves Theory of Mind. Science, 18 October 2013. Vol.
342 no. 6156 pp. 377-380. DOI: 10.1126/science.1239918. Published Online October 3 2013 Link:
http://www.sciencemag.org/content/342/6156/377.full
Discussion Questions
1. What do you think is the value of literature? Given your views, what is the point of a literary festival? Do
such festivals solve or create any problems? If so, which ones?
Assignment
Class Forum Posting and/or Response to the above discussion questions.

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Module VI: Conclusion

In the concluding section, we will revisit two recurrent, if latent, themes from the prior modules. The first has to
do with transferability of entrepreneurial insights across geographic boundaries. We saw this within South Asia,
as with microfinance and community-based healthcare crossing from Bangladesh into India, Afghanistan, and
elsewhere. We also saw this with educational-technology innovations from the West assuming applicability in
South Asia. The second theme is that of the role of technology and its interaction with broader contextual factors,
how to make a given technology work within the context of the institutional voids that characterize a particular
geography.

[23] Conclusion - Entrepreneurial Initiatives in Food Security in India (with a comparison to China): The
Case of Amul Dairy Cooperative (VI-1)
We will focus on challenges facing Amul, the Gujarat-based milk cooperative that was responsible for anchoring
Indias so-called White Revolution (spread of quality affordable milk). If we have time, we may also consider
whether the Amul solution has anything to say to the current widespread problem of milk contamination in China.
(For that discussion, please peruse the compendium of news articles provided on the course iSite.) You can also
get a fairly wide-ranging overview of issues here, although as always Wikipedias details cannot be fully verified
or trusted at any particular moment.
http://en.wikipedia.org/wiki/2008_Chinese_milk_scandal &
http://en.wikipedia.org/wiki/Food_safety_incidents_in_China.

Readings
Rohit Deshpande, Tarun Khanna and Tanya Bijlani. Indias Amul: Keeping up with the Times. HBS Case No.
9-513-063
News articles on food contamination in China (please check iSite).
Finally, a short video http://www.youtube.com/watch?v=55hfOATypIA documents one entrepreneurial effort to
correct the problem in China.
Discussion Questions
1. How has the power of millions of farmers and their families, to quote founder Verghese Kurien, been
mobilized to build Amul over the past decades? What key events in Amuls history can you identify that
proved to be transformational in the development of the dairy sector in India?
2. Amul has played a catalytic role in transforming the dairy and food sector in India. Should it now
explicitly attempt to trigger a move towards technology-intensive large-scale dairy holdings seen in
developed countries, and thereby perhaps move away from its core of the small scale farmer?
3. How should Amul deal with the increased presence in India of multinationals like Nestle?
4. Can the power of collective action witnessed among Amuls farmers be leveraged to address at least part
of modern Chinas food security issues, as delineated in the articles on Chinas milk contamination
problem? Will this organizational insight from India travel to China, or is China better off banking on
alternatives (technology, stricter laws, more disclosure, et cetera)?

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[24] Conclusion BRAC of Bangladesh, the Worlds Biggest NGO (VI-2)

Readings
John A. Quelch and Nathalie Laidler, BRAC HBS Case No 504-012
Recommended Reading
Ian Smillie, Freedom from Want: The Remarkable Success Story of BRAC, the Global Grassroots Organization
Thats Winning the Fight Against Poverty, Kumarian Press, 2009.
[The book is 300 pages long, but the story is riveting and each chapter is quite short. Highly recommended to read
the beginning (until page 33) to get a sense for the origins of BRAC, as well as the concluding chapter (Chapter
21).]

Discussion Questions
1. What strategies and/or decisions seem to have contributed to this success?
2. What, if anything, would you differently as director of BRAC's Afghanistan branch?
3. What other services or programs would do you imagine could be useful in the context of Afghanistan?
4. Should BRAC contemplate an expansion into Myanmar as well, given the recent opening up of that
country, or is it a bridge too far at this juncture?
[25] Conclusion - The Kumbh Mela in 2013 (VI-3)
In our last class, we will consider humanitys largest gathering, the Kumbh Mela, a religious festival that occurs
once every 12 years. In 2013, it attracted 130 million people over 55 days, with a peak daily attendance of 30
million, to a so-called pop-up megacity near Allahabad. The temporary city was constructed in short order on the
river banks once the water of the rivers Ganges and Yamuna had receded, and subsequently dismantled, also in
short order. This unique setting allows us to consider multiple dimensions of entrepreneurship that have resonated
through our discussions: role of the state versus role of the private sector; context-sensitivity of entrepreneurial
initiative; the marriage of technology (represented by the ubiquitous mobile phone and by computing technology)
with centuries-old customs, etcetera.
We will use a newly written case study for class. The case study is informed by the efforts of a multidisciplinary
team of over 50 faculty, staff and student researchers from Harvard who traveled to the Kumbh for various
research projects. The Design school team studied the allocation of physical space to understand implications
both for rampant urbanism in fast-growing emerging markets and for temporary urban infrastructures needed in
refugee settings and in the wake of disasters; the public health and medical teams studied the dissemination of
disease in densely populated settings, and the ideal placement of triage and treatment facilities, and so on. The
main webpage for the trip and ongoing research materials is here: http://southasiainstitute.harvard.edu/kumbhmela/

Readings
Tarun Khanna and John Macomber, Kumbh Mela Indias Pop-up Mega City HBS Case No 713-463

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Discussion Questions:
1. Why was the 2013 Kumbh Mela successful? (For context, note that other large events, even those orders
of magnitude smaller than the Kumbh, are unsuccessful in India for the most part; large scale
infrastructural projects in other countries eg the Olympics, typically do not provide adequate return on
capital.) In answering this question, ask yourself what is your definition of success. Whose perspective
are you taking?
2. What was the role of different part of the government in orchestrating the Kumbh? How did this role
mesh with that of individual entrepreneurs (for-profit or otherwise, including non-governmental
organizations)? Should the private sector have played a greater or lesser role? How would you answer
the question about the relative roles of the state and the private sector in facilitating a large-scale
gathering in China?
3. To what extent are the factors that made the Kumbh successful applicable in other settings in India? In
other populous and fast-growing developing countries?
4. How can the next major Kumbh Mela, in 2025, be improved?

33