This project is a comparative anthropology of conscience, ethics and human rights. Numerous international human rights documents formally declare their commitment to protect freedom of conscience. But, what is conscience and how do we know it when we see it? How do we distinguish it from self-interest or fanaticism? And what happens when the concept, often associated with a distinct Christian or liberal history, travels across cultural boundaries? The project will examine the cultural conditions under which claims to conscience are made possible, and the types of claims that are most persuasive when doing so. The project addresses these issues through the comparative analysis of three case studies: British pacifists, Sri Lankan activists, and Soviet dissidents. These case studies have been carefully chosen to provide globally significant, but contrasting examples of contests over the implications of claims to conscience. If claims of conscience are often associated with a specifically liberal and Christian tradition, mid-twentieth century Britain can be said to stand at the centre of that tradition. Sri Lanka represents a particularly fraught post-colonial South Asian counterpoint, wracked by nationalist violence, and influenced by ethical traditions associated with forms of Hinduism and Buddhism. Soviet Russia represents a further contrast, a totalitarian regime, where atheism was the dominant ethical language. Finally, the project will return specifically to international human rights institutions, examining the history of the category of conscience in the UN human rights system. This project will be ground breaking, employing novel methods and analytical insights, in order to producing the first comparative analysis of the cultural and political salience of claims of conscience. In doing so, the research aims to transform our understandings of the limits and potentials of attempts to protect freedom of conscience.

Cardiovascular diseases (CVD) have become the leading cause of mortality globally. In South Asia, high rates of CVD are observed at a younger age than in other countries causing a reduction in productive life years with severe economic consequences. High blood pressure (BP) confers the greatest attributable risk to death and disability associated with CVD. Our Wellcome Trust funded Control of Blood Pressure and Risk Attenuation (COBRA) trial (2004 to 2007) in Karachi, Pakistan, suggested the combined strategy of family based home health education (HHE) delivered by trained community health workers (CHW) plus care of individuals by trained private general practitioners (GP) to optimally manage hypertension had the most marked beneficial impact on BP compared to usual care, or single interventions. However, the COBRA intervention was designed for an urban South Asian setting, where private GPs cater to over 75% of the patients seeking care. Most of South Asia is still rural (73% Bangladesh, 64% Pakistan, 71% India, 85% Sri Lanka) where prevalence of hypertension is high and healthcare infrastructure and provider characteristics are very different compared to the urban setting. The COBRA trial did not evaluate effectiveness of strategies delivered using the public health infrastructure, or generalizability to the rural population in Pakistan. It is also not clear whether any benefit would extend to rural communities in other South Asian countries. In our ongoing COBRA-BPS feasibility study in Bangladesh, Pakistan, and Sri Lanka, we modified COBRA by developing a comprehensive "multicomponent intervention (MCI)" for effective delivery of hypertension care using the rural predominantly public primary care infrastructure. We also conducted extensive stakeholder consultation and received very favourable response for a full scale trial to evaluate MCI in 3 countries. We now propose a cluster randomised controlled trial (RCT) on 2550 adults with hypertension in 30 rural communities in Bangladesh, Pakistan and Sri Lanka, to evaluate a comprehensive MCI comprised of specifically comprised 1) home health education (HHE) by government community health workers (CHWs), 2) blood pressure (BP) monitoring and stepped-up referral to a trained general practitioner (GP) using a checklist, 3) trained public and private providers in management of hypertension and using a checklist, 4) designated hypertension triage counter and hypertension care coordinators in government clinics, 5) a financing model to compensate for additional health services including targeted subsidies. A total of 15 communities (5 in each country) will be randomised to MCI and 15 (5 in each country) to usual care in 3 countries. Individuals with hypertension will be followed for 2 years to assess whether MCI compared to usual care is more effective at lowering BP, and cost effective in terms of preventing CVD related disability and death. We will also interview stakeholders and conduct serial focus group discussions of patients on their experience with the strategy in relation to various components of MCI. If shown to be successful, our findings will be helpful in securing political commitment from stakeholders for up-scaling MCI strategies at the national level in these South Asian countries. The South-South collaboration and shared experiences will be very valuable in co-ordinating a regional action plan on NCDs with a focus on hypertension as an entry point. Our trial will provide direct evidence of the value of using comparable models and platforms for non-communicable disease management which would extend to other Asian countries with similar ethnic population and healthcare infrastructure.

In many distributed computing contexts, a need arises for two mutually-distrusting parties to undertake a joint calculation, often without the disclosure of the unprocessed data from one or both sides to the other. Sometimes a 'trusted third party' is used for this purpose - but immediately the verification of the trustworthiness of that party becomes a challenge. The cryptographic world has addressed this through the paradigm of secure multi-party computation - and the related problem of an untrusted processor through various schemes of homomorphic encryption. These are successful in many contexts, but imply certain overheads and complexities. We propose a different model, wherein the technologies of Trusted Computing are used to create an assured Trustworthy Remote Entity (TRE): this also enables us to develop duplex communications, which are seldom considered in the approaches described above. The main part of this project is devoted to developing and verifying a TRE-based solution for the substantial and far-reaching challenges of security and privacy in smart power grids: later in the project we consider the generalization of the approach to other similar problems, such as those in dynamic location-based road pricing. The 'big idea' is that the user can be signed up with a TRE, and have a high degree of confidence that their data (e.g. the information on how much electricity is being used right now) is not going to get in to the hands of someone who might use it against them (e.g. to work out when the home is unoccupied) - but the power company can also have from their side confidence that the data they receive is coming from one of their customers. If they need to reduce demand - in the extreme case by, say, remotely switching off somone's air conditioning unit fora time - they can send a signal back, confident that it will go to the right user, without knowing which customer that is. This approach can be generalised to many other situations: for example, the TRE could help to calculate a price for you to drive on a particular road at a particular time, without disclosing your movements to the transport authority. It could also pass back personalized (but anonymous) instructions on how to find a better route at the time.