In Massachusetts, the state has recently taken the step of placing a low performing district outside of Boston into receivership, but the very unusual nature of this action shows how infrequently even chronically underperforming districts face substantive outside accountability.
Substantive gains in social accountability were also elusive as HIV scale-up did little to address deeply rooted information and power asymmetries in the wider facilities.
Just years earlier, in 2011, public outrage over endemic corruption prompted hundreds of thousands of Indians to take to the streets in peaceful protests demanding greater accountability, more reform and substantive legislation to combat graft.
Starting in 2011, hundreds of thousands of Indians took to the streets to participate in peaceful, Gandhian-style protests demanding increased accountability, more reform, and substantive legislation to combat graft.
If the risks associated with more intensive treatment are substantive, then setting low thresholds for accountability measures (such as A1C <7% or sBP <130 mmHg) may actually do more harm than good for many patients clearly an undesirable situation (30).
In this respect, substantive and long-term gains in social accountability – both in the ART clinics and beyond – were elusive.
It is not so much about the substantive issue of torture as it is about accountability, visibility, and candor in a democracy that is confronting a choice of evils.
I wholeheartedly support increased accountability, better police training, enhanced data collection, retooling the notion of community policing, and substantive civilian oversight.
