On November 17, 2010, the Indian Journal of Medical Ethics Third National Bioethics Conference will start four days of discussions, debates and learning on governance in health care. This is a time to reflect on the NBCs. What have we learned from each conference? What do we aim to achieve at this November meeting and in other NBCs in the future?

In a comment on governance issues written for the journal, a philosopher and an economist outline the Health Impact Fund, a mechanism for incentives to develop new and affordable medicines, and discuss its ethical significance.

A microbiologist writes a scathing editorial on the fracas over the Lancet Infectious Diseases article on the “superbug”, pointing out that it focuses attention on the poor state of our public health system; on the ease with which scientific issues can be hijacked; and our squandering of one of the most precious discoveries of the 20th century, antibiotics.

A paper examines responses to the 2009 A H1N1 outbreak in India to identify ethical issues in pandemic planning.

In our dismay and outrage over the Delhi high court verdict, delivered after 26 long years, in the Bhopal gas case, we must not lose sight of the fact that the tragedy begins with the poor state of occupational health and safety in India. Further, the medical response was marked by confusion, scientific dishonesty and loyalty to employers rather than to the truth.

Two comments responding to an article on amendments in mental health legislation in India tease out the key controversies in the amendment process.

The current upsurge of the surrogacy trade in India points towards an unfettered commercialisation of assisted reproductive technology and thepractice of surrogacy. A paper analyses the Draft Assisted Reproductive Technology (Regulation) Bill and Rules, 2008, in the Indian socioeconomic context.

The Clinical Establishments Act was passed by the Lok Sabha in May and by the Rajya Sabha in August, 2010. A comment on doctors’ opposition to the legislation is followed by the thoughts of a former secretary of the Indian Medical Association, Mumbai..