HIV-AIDS INDUSTRY.pdf
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SCIENTIFIC GENOCIDE
ECONOMIC DISASTER
CIVIL UNREST
' Gita Diwan Verma
Anju Singh
Dr. Ute Schumann
- 3X-.S"
In the '70s JACK was working on small training programs in rural areas with funds
from International charitable donors. We soon realized that these kinds of resources
were grossly inadequate for any meaningful development. This led us to explore
possibilities of bilateral and multi-lateral funding. In this process we found that donor
agencies had their own policy agendas and pre-packaged programs which they
were routing .through a handful of consultants operating out of plush offices in big
cities. The lure of money as well as the illusion of consultations led NGOs to believe
that donors were actually supporting people's programs which would eventually
translate into development. We also realized that the high visibility of the NGOs did
command respect in society, but they had no real following among people. We saw
this kind of donor agency pnd NGO cooperation as a dead-end in developmental
activism and pulled out of it.
Around this time HIV/AIDS became the focus internationally. We were also working
on this crisis and were initially swept away by concepts of “foreign disease", “testing"
and “high-risk groups”. However, within three years we realized these actions were
not contributing to HIV prevention and we were on the wrong track. But we were
unable to raise our voice on this issue since people were unwilling to even talk about
AIDS, leave alone discuss any criticism of AIDS interventions. It was only in '95-96
that we were able to confront donor agencies with our questions. And then a strange
thing happened. We were threatened and systematically discredited in the NGO
sector. Internationally recognized experts working on donor programs who
supported JACK'S stand were branded traitors, maligned, mistreated and dismissed
from their jobs on flimsy grounds. This panic reaction convinced us that there was a
larger conspiracy behind the HIV prevention program.
In the effort to get to the bottom of this conspiracy, we found many startling things.
For instance, unofficial drag trials on pregnant women had been going on in India
since the late '80s. What disturbed us most was the criminal silence being
maintained by India's scientific community.
At that point we decided to close our routine activities and concentrate on
understanding the full gamut of issues relating to HIV at policy level. This, it turned
out, was like opening up a Pandora’s box and has taken us several years.
Many people have shared JACK’S concerns. A few have directly supported our effort
to find out the truth about AIDS, often at great personal and professional cost. We
salute these people.
This booklet Is a first attempt to draw attention to some of the most serious
Issues surrounding HIV/AIDS in India. Due to the necessity of limiting the size
of the Initial booklet and, at the same time providing an overview, we have had
to present the issues in a compressed manner, although each one of them
could have merited a book
Purushothaman Mulloli, August 15, 1999
Contents
World overview
Indian scene
Misguided measures
“High Risk Groups": Creating new untouchables9
Blood Banks: Did a PIL mislead Supreme Court for private interest?
Testing: Policy for World Bank loan alone9
Prevention in health workers: “Prevent HIV through PEP treatment," says NACO!
Vertical transmission UNICEF, women NGOs “rescue" newborns from HIV?
STD control: Cross connection with HIV9
Errant strategy
Real objectives?
Draft Policy": New mechanism for colonization
HIV/AIDS
World Overview
AIDS was first diagnosed in the US in the early '80s. But many still look to Africa for
its origin, blaming African monkeys and African sexual practices The West - through
international donors - labeled Africa the epicenter of the AIDS epidemic. For the
West, Africans and Asians are the "high risk group" (as tribals, truck drivers, sex
workers, etc are "high-risk groups" within these countries).
In the West HIV estimates have declined. In the US official statistics show that the
number of HIV positive persons had not increased from 1 million since testing began
and experts say the figure has now come down to between 6 - 800,000. In UK also
the official estimate of 23,000 HfV positive cases nationwide is about a half or a third
of eariier estimates. In Russia 30,000 were earlier estimated to be HIV positives, but
later only 66 were found to be so!
But in Africa the "estimated” HIV positive total has risen to 20 million - seemingly
in direct proportion with the increasing international donor activity in the HIV/AIDS
sector with the entire action shifting from the West to Africa. Even as the reported
AIDS cases in Africa number only 129,000 (half the US figure), many damaging
claims about AIDS continue to be made by a multitude of western research projects
and by government and non-govemment organizations. Amongst the most publicized
of these were stories relating to whole villages identified as “dying from AIDS" in
Kagera district of northern Tanzania and to hordes of “AIDS orphans". Less publicized
were the facts that two years later in ‘most affected' villages only 5 to 13% of the
people tested HIV positive or that the “orphans" were children left with grandparents
in polygamous cultures and had nothing to do with AIDS!! But the damage hasalready been done - and is only now being understood. The 'New African’ magazine,
which circulates across the continent, says "alarmist and exaggerated" forecasts
made by western experts, supported by the WHO, have done immeasurable
harm to African confidence and the way Africans are seen abroad and has called
for an international inquiry to establish the truth about AIDS.
Since in most African countries. HIV tests are too expensive for general use, AIDS is
diagnosed through guidelines laid down by the World Health Organization and known
as the 'Bangui clinical case definition'. To qualify for AIDS someone must have a
combination of symptoms like weight loss, persistent diarrhoea and fever for a month
and a dry cough. The trouble with such symptomatic HIV diagnosis is that many of
these symptoms are indistinguishable from symptoms of old, established diseases
like TB and malaria. Nor is the kind of testing being carried out in Africa free from the
danger of exaggerated results. According to Dr. Harvey Baily, "Some of these tests
are so non-specific that 80 to 90% of the positives are false positives. ... The
inevitable outcome is that the figures for numbers of HIV infections in Africa will
become wildly exaggerated and feed into a very deadly self-fulfilling prophecy "
Today Africans with symptoms of almost 20 old and established diseases that have
come to be identified with HIV are refusing to seek medical help for old disease
due to the fear of being labeled as an AIDS easel At the same time, as noted by
the minister of health and child welfare in Zimbabwe, WHO and the 'AIDS industry’
had fostered a damaging epidemic of ‘HIV-itis’ in Africa, which is distracting money,
attention and personnel from known problems like malaria, TB, STDs and safe
motherhood. Likewise in Uganda, in 1992 the total budget for malaria treatment and
control was less than $ 57,000, yet foreign funding for AIDS was over S 6 million.
Under the circumstances, Africa is witnessing resurgence of old and curable diseases
like and malaria and TB, which are beginning to assume the proportions of a public
health hazard - a clear signal of the disruption of health care systems by HIV
interventions. Furthermore, as people die on the streets - not from HIV/AIDS, but
from curable diseases - governments are unable to respond, as theyare completely
dependent on and controlled by donors who came in with funds for controlling
opportunistic diseases but drew the health system into the HIV prevention program.
Africa has everybody - from the World Bank, the churches, the Red Cross, the
UNDP, African Medical Research Foundation... About 17 organizations in Kagera
alone are doing something for AIDS. The numerous AIDS agencies that have
flourished in much of Central Africa have also brought “development”, turning small
neglected towns into towns full of Land Rovers and Toyotas. The day the epidemic
goes away, a lot of "development" is going to go away! Many who have seen ground
realities say it is easy to ‘do good' in Africa as it is so disorganized that the one who
is doing good is also the one reporting the good he is doing! So Africa is a good
market and experimental ground for many organizations, a perfect field for fake
charity which benefits the benefactors.
Meanwhile, the immense international funds available for HIV and AIDS work remain
an incentive for exaggerated statistics. Indeed, many of the horror stories in Africa
came into existence due to the funds they brought. Political factors have also played
a part in the scramble for funds. For instance, when Kenya lost $300 m desperately
needed foreign currency in 1991, due to an attempt by industrialized worid to force
political and economic reforms, the Health Minister made a crisis announcement
showing AIDS figures spiraling out of control and horror stories of AIDS deaths. This
was internationally recognized as an attempt to win back donor sympathy and funds.
Many African countries are now facing mounting debts. There are cases where
merely the annual interest payment on borrowings for HIV prevention add up to more
than twice the total annual health budget of the country!
Thus in Africa the HIV prevention program driven by the AIDS industry through
international donors has made for a medical crisis and social disarray of tragic
proportions in just about a decade.
AIDS industry achieves
ANARCHY in AFRICA
in less than a decade1
HIV/AIDS
Indian scene
After labeling Africa "the epicenter of AIDS', international donors have labeled India
"the world’s AIDS Capital”. And they have lent their support for AIDS prevention
and control in India through the application of their “African model" - the same one
that has placed Africa in the midst of a medical crisis and social disarray of tragic
proportions. Unlike other activities in India that are planned, driven and controlled by
certain donor countries, the HIV/AIDS program cuts across everything. It is a health
issue that is also a social issue, an overarching concern that concerns everyone, a
potential entry point into any issue or community. This makes it the best possible
case study for an insight into the machinations of certain donor countries.
To say that HIV/AIDS prevention is both a manifestation of and a mechanism for
control by foreign donor sounds far-fetched. This is only if we view colonization in
terms of cannons and Robert Clive. Today we are far away from agrarian and
industrial societies and well into market economies. Soon there will be no nations,
only markets. Now colonization is about exploitation and control in a market context,
not about cannons and Robert Clive in an industrial state. Its instruments are as
insidious as the process itself. One instrument is taming the system via the
bureaucracy. Another is institutionalizing activism (in the form of “NGOs") so it too can
be tamed. A third is the instrument of the “draft policy" drawn up through the
bureaucracy after consultations with NGOs. Such policies need not see the inside of
Parliament and can therefore circumvent the democratic process. And they carry no
accountability leaving open possibilities for "adjusting" interventions to serve various
agendas with the complicity and cooperation of the bureaucracy and the NGO sector.
The donor controlled HIV/AIDS program in India is a clear manifestation of these
processes of insidious colonization.
•
A number of measures for prevention and control of HIV/AIDS are in place as a
result of the combined efforts of- multi-lateral and bilateral-donors and the
governmental and non-governmental systems through which they operate. These
include targeted interventions for high-risk groups, banning of professional blood
donors, testing, PEP treatment, STD control, sexual health projects, reproductive
and chjld health (RCH) projects, TB, leprosy, vertical transmission programs, etc.
But by now it has becbme abundantly clear that these measures are
contributing virtually nothing to the prevention or control of HIV/AIDS.
•
This is not about poor implementation, insufficient coverage, inadequate
resources or any of the usual reasons for ineffective interventions. This is about
the completely misguided nature of interventions. HIV/AIDS has no cure. We only
have some idea how it spreads. It can affect any one. The purpose of any
prevention and control measure must be - indeed, can be - merely to build
awareness and empower people to take informed decisions on their own
behavior to protect themselves. Nothing else in the name of HIV/AIDS prevention
has any scientific basis or moral sanctity. In this context, a closer look (in the
following pages) at current measures makes it obvious that these measures
cannot contribute significantly to prevention and control of HIV/AIDS.
It would be naive to assume that in funding for so long an obviously ineffective and
futile HIV/AIDS program certain donor countries are acting out of innocent ignorance.
It is far more plausible that what seems a misguided strategy from the perspective of
HIV/AIDS prevention is actually a successful effort in using HIV/AIDS as a
mechanism for colonization of the most populated (lucrative?) country, by the AIDS
industry.
•
HIV/AIDS prevention measures may have failed to achieve their stated
objectives. But they have succeeded in fostering an irrational fear psychosis,
unethical medical practices (such as abandoning patients testing positive),
irresponsible institutional behavior, violation of individual rights by forced testing,
marginalisation of “high-risk groups", manipulation of public health concerns by
market and vested interests, etc. It is very clear that these measures have had
far-reaching disruptive impacts on our healthcare system as well as our
social and democratic fabric and the resultant chaos has left us vulnerable
to all sorts of machinations.
•
Donors control not only HIV/AIDS prevention measures but also research and
statistics on HIV/AIDS. It is therefore child's play for them to tailor research
conclusions and manipulate statistics to exploit this chaotic situation to the fullest.
There'have been several instances of dubious identification of high-risk groups
and HIV/AIDS affected regions to serve other ends. There has even been an
instance of the NACO lying to the parliament to protect donor interests! It is
becoming clear that HIV/AIDS “studies” and "statistics" are being effectively
used to manipulate opportunities for donor activity using HIV/AIDS as an
entry point.
On the whole, in the name of HIV/AIDS prevention, some utterly ineffective and highly
disruptive measures are being taken - not only at great public expense but also at the
cost of urgently needed effective measures for HIV/AIDS. It is becoming increasingly
evident that HIV/AIDS prevention and control is less about HIV/AIDS prevention and
more about control of societies The gainers from this strategy are readily identifiable
in the form of large pharmaceutical interests, researchers and other market forces
that control certain foreign donors.
Whatever is happening in the name of HIV/AIDS threatens the sovereignty - even
identity - of nations like ours, a threat that needs to recognized and addressed
now, urgently. It is imperative that processes that have for long circumvented
democracy be made accountable and find their rightful place on the nation's political
agenda. In this context, the following sections first look at the misguided measures
currently in place for HIV/AIDS prevention and control and questions their validity and
then put forth some thoughts about the real objectives of this errant strategy.
AFRICA is under control...
INDIA looks good1 *Lets go SET THEM!! I
Misguided Measures
“High Risk Groups”:
Creating new untouchables?
The notion of "High Risk Groups” (HRGs) for HIV/AIDS is a central construct of the
public health strategy being promoted by donor agencies through “targeted
Interventions”, "highway clinics", "coastal area projects”, “reproductive and child
health projects", "sexual health projects", etc. Over the years various “classes" of
people - commercial sex workers, truck drivers, street children, etc. - have come to
be labeled HRGs for HIV/AIDS. And most of what is being done in the matter of
prevention and control of HIV/AIDS is in the form of targeted interventions for these
HRGs.
Some targeted interventions are taking shape and others are said to have “effectively"
worked, such as the well-known Sonagachi initiative launched in 1992 in one of the
oldest and largest red light areas of Calcutta. By 1996 the Sonagachi initiative had
earned the status of an “effective approach" meriting nation-wide replication. Even as
donors are standing up and cheering Sonagachi there are several questions that cast
doubt on the efficacy of the HRG approach that is claimed to have succeeded there:
•
Are manipulated statistics on increased use of condoms, decline in STDs and no
increase in HIV infection over a 4-year period in a localized red light area
sufficient for identifying an “effective approach" for HIV/AIDS in India?
•
Does the fact that, notwithstanding the Sonagachi success, Calcutta did record
the highest increase in HIV/AIDS cases not suggest that the targeted intervention
was not really an effective approach for HIV/AIDS?
•
What is the basis for the assumption of rampant Indian male promiscuity or
prostitute-like behavior amongst the Indian populace that is implicit in the
suggestion that this “model" be replicated in other parts of the country?
There is also the matter of how HRGs are actually being addressed. Staying with the
example of commercial sex workers, it is well known that very large percentages of
these in major cities are mobile and do not operate out of identifiable “red light areas".
In Delhi only 4000 of the city’s estimated one lakh prostitutes are found in GB Road.
Even complete “condomization" of this 4% of the HRG is likely to achieve little beyond
glamorizing selected NGOs, as evident from official claims of 50% of the CSWs in GB
Road being HIV positive 1
The fact is that the HRG construct cannot possibly do much for prevention of
HIV/AIDS inasmuch as it is a flawed approach that focuses on identifying "high
risk groups” rather than building awareness on "high risk behavior”.
Further, a closer look at the basis of identifying HRGs clearly shows that it is highly
suspect and tantamount to a scientific fraud on the people (Box-1).
In other words, most of the population is being excluded from the purview of
substantive HIV/AIDS prevention and control measures which are only being targeted
at a dubiously identified priority group Clearly there is no way such a strategy can
achieve any significant success in preventing HIV/AIDS.
Box-1: Identifying HRGs - A "scientific" fraud: Kerala Experience
The British Government's ODA (Overseas Development Administration, now DfID)
launched in April 1996 a project on targeted interventions in Kerala. It listed tribals,
street children and sex workers among HRGs and said this was based on NACO'S
studies in 65 cities, including-3 in Kerala. When asked for the study. ODA said it was
confidential. Nor was the study available with Kerala Government.
•
Surely a Gol report meant to help in prevention of AIDS and generated at huge
public expense could not be confidential.
•
Surely a foreign donor can not keep material relating to people's health
confidential from the very people concerned.
But still it was only after approaching Kerala High Court and after 14 months of effort
that 3 portions of a patchy report could be obtained. It turned out that the 65-city HRG
study was only a 36-city study, in which only 21 city-reports had been completed. The
study does not mention tribals at all and nowhere does it mention prevalence of HIV
in the other groups listed as High-Risk Groups. In fact, Kerala has no identified street
children and sex workers are also not a visible group.
•
Surely un-identified and invisible groups can't be labeled high-risk.
»
Surely, if they are, there must be a hidden agenda
Meanwhile, the HRG construct has had three significant damaging effects:
•
First, it has misled public in respect of perceptions of risk. People are lulled into
the belief that if they do not belong to or associate with HRGs they are not at risk.
•
Second, the medical profession - in an appalling display of ignorance and
"quack" like behavior - has come to consider the HRG label a “symptom" of
HIV/AIDS. This was obvious from the remarks in a recent television program of
no less than Head of Microbiology of Rohtak Medical College that a truck driver
admitted with a number of problems was "clinically diagnosed" as having AIDS.
•
Thirdly, since HIV is an infection with extreme social stigma attached to it,
labeling groups of people as HRGs leads to their marginalisation - even
ostracism and can be viewed as being undemocratic, subversive, discriminatory
and a violation of individuals’ rights.
All this raises a number of questions.
•
Why are certain donor countries Interested In Interventions In, say, tribals
in Kerala In the name of HIV/AIDS? Could such communities really be seriously
at risk? Or is there a hidden agenda?
•
Why are NGOs content to be Implementing unscientifically Identified and
formulated HRG projects? After all aren't they the ones usually most concerned
about resource crunches and flaws .in approaches? Then why are they running
(for foreign donors) HIV projects like highway clinics, coastal area projects, red
light area projects and, ofcourse, projects in tribal areas? Are donors and NGOs
acting out of ignorance? Or are they collaborating on some hidden agenda?
A bureaucrat and a truck-driver (both frequently travelling men)
/?•
went to a Doctor for oral thrush.
?
Ji The bureaucrat got an antibiotic.
‘'tE?
...The truck driver was sent for HIV TEST si
Misguided Measures
Blood banks
Did a P!L mislead Supreme Court for private interest?
In January 1996 the Supreme Court passed a landmark judgement on blood banks in
the wake of a public interest litigation. This judgement speaks of, among other things,
total elimination of professional donors on account of the risk of spreading HIV and
establishing a National Blood Transfusion Council (NBTC) for modernizing blood
banks and ensuring availability of adequate and safe blood. The NBTC was created.
But it was the National AIDS Control Organization (flush with World Bank loans) that,
in the name of implementing the Supreme Court's directives, went on a spending
spree. It installed imported equipment worth Rs.250 crores in 40 blood banks across
the country in a bid to improve their capacity. In Delhi, for instance, the blood storage
and processing capacity was upgraded to 2.4 million (24 lakh) units even though the
annual requirement in Delhi is of the order of o.4 million (4 lakh) units.
Also, to date the blood bank reforms have not led to any improvement in collection. In
fact collection has reduced. This raises a number of fundamental questions about the
blood bank reform process:
•
Why is it that the NBTC has remained quite inactive, spending till 1998 a meager
1.5 crores - and that too mainly on administration and seminars? Who then is
going to ensure that all blood collected is screened for HIV?
•
What made for the recent “problem of plenty" when blood banks turned away
voluntary donors during the Kargil incident on account of “inadequate storage”
even after NACO had equipped 40 blood banks with very expensive facilities for
upgrading capacity and quality? Was this equipment inappropriate? Or is it just
lying unused out of administrative inefficiency? Who is ensuring that public
investments made in the name of HIV/AIDS prevention through enough safe
blood supply are not being wasted?
•
Why have blood bank reforms been taken over by NACO, which has no expertise
in the sector? Why are blood bank reforms being implemented in the name of
HIV/AIDS control? Is blood safety not required for other diseases like Hepatitis
B? How does banning professional donors help that?
It is obvious that the current process of blood bank reforms is doing little for
prevention and control of HIV/AIDS. It must .be appreciated that blood-banking
reforms can contribute to this only to the-extent of ensuring blood safety. And this can
only be done by ensuring’that all blood collected is screened for HIV/AIDS through
processes recommended for transfusion safety. Banning a group of donors does
nothing to ensure transfusion safety.
What it is achieving is some far-reaching detrimental impacts on blood banking:
o
Firstly, since professional donors contribute anything between a third to half of
blood reserves (which are half of the blood required), banning them has far
reaching implications for blood availability - and blood imports. An idea can be
had from the fact that the value of imports of blood products has increased from
25 lakhs in 1993 to an estimated 2000 crores for the current year, with
international experts placing the figure closer to 3000 crores!
Secondly, banning of professional donors has created a mindset in which
“Indian" blood banks are beginning to be perceived by general public as being
unsafe. Indeed, no less than the report of the Parliamentary Standing Committee
on Dreaded Diseases (1998) actually says, “Blood Banks are places from which
infected blood is donated and transfused" (para-3.4). Such a mindset is likely to
further increase costly imports of blood products.
In effect, therefore, the Public Interest Litigation on blood bank reforms appears to
have served foreign private market interests rather than achieve anything whatsoever
by way of improvements in blood banking.
In the context of the above, and since blood banking reforms were initiated by a
Supreme Court judgement, one needs to examine a bit further how these reforms.
especially the ban on professional donors, came to be suggested.
•
The Supreme Court judgement was based on a study on blood banks. The study
- known as the Ferguson Study - which is claimed to have been commissioned
by the Health Ministry to a firm of Chartered Accountants - was aggressively
projected as the Blood Banking Bible, something that experts swear by without
even seeing.
The Ferguson study strongly recommends banning of professional donors. But it
does so on the basis of flimsy and scientifically absurd data. The study fails to
scientifically prove that professional donors are in any way a risk to the blood
banking process on account of HIV.
•
Data collected by the government over the two years period (within which the
Supreme Court judgement had directed that professional donors be banned)
clearly shows that, of professional donors, replacement donors and voluntary
donors, professional donors, in fact, are the lowest risk group for HIV and
voluntary donors the highest!
Since the study on which the Supreme Court judgement is said to be based contains
nothing to suggest banning professional blood donors, one wonders how this
recommendation crept into the judgement. Is it that the Supreme Court took note
of the recommendations of the study without a detailed perusal of the study
report? Or was the Supreme Court deliberately misled?
It is noteworthy that the Parliamentary Standing Committee states with respect toprofessional donors (para 2.12) that they “have a very objectionable kind of lifestyle"
and that they “keep on donating blood once in fifteen days and once they get money
they immediately go to a red light area"! Why is the Parliament making such
absurd statements? In fact, why is it making any statements about professional
donors since there is already a three-year-old Supreme Court judgement in the
matter? Could it be that this completely absurd and unfounded perception is
being reinforced at the highest levels to serve some hidden agenda?
We've banned professional donors due to HIV risk...
If we can discourage all the other donors by insisting
on announcing their HIV test results .. then .
... we can import ALL our blood requirement!
9
c
I.-I
■
Misguided Measures
Testing:
Policy for securing World Bank loan alone?
Based on international policies NACO's national policy also has clear guidelines
against mandatory testing and states that testing for HIV/AIDS should only happen
by consent, in confidentiality and with adequate counseling.
But this policy is being blatantly violated at the instance of NACO! These violations
have been happening for some time now in both private and public hospitals (Box-2).
In Delhi they are to happen even in observation homes (Box-3). And the Health
Minister's recent announcement regarding blood donors has not only endorsed these
violations, but has also paved the way for similar violations at a national scale.
Box-2: “Enforced" testing in private and public healthcare sector
HIV tests of surgery patients and pregnant women have been going on for some time
all over the country at private hospitals, nursing homes and ante-natal clinics as well
as public hospitals including AllMS. These are prescribed as routine tests, with total
disregard for confidentiality, consent, and counseling. Inquiries a"t major testing labs in
Delhi, Bombay, Calcutta, Bangalore, Madras and other cities have revealed this is
already an accepted norm in, especially, the private health sector. While not strictly
“mandatory" such testing is not far from this given the nature of the doctor-patient
relationship is such that a patient has no choice in the matter of prescribed tests.
Box-3: Mandatory testing by Delhi Government
In January 1999 Delhi's Social Welfare Minister announced the decision to test
destitute women and children housed in government observation homes for HIV.
When it was pointed out that there is no such treatment available, hence there is no
justification for the decision, the minister made another statement saying she will be
"curing them through yoga"'. She also said that mandatory testing is only “being done
for HIV not AIDS?'. In a reply to our letter she further said that the proposed HIV
testing was not compulsory but “a sort of voluntary adaptation"'. The situation has
been further compounded by the Delhi health minister who, while pleading ignorance
of his colleague's decision, has publicly come out in support of mandatory testing,
saying that the center should allow the implementation of mandatory tests. This is a
situation where ignorant, irrational and illegal decisions are being taken. What makes
it more serious is that these decisions have the added danger of becoming
established practice having been taken by the government institutions themselves.
NACO s stand on violations of its policy is as appalling as the violations themselves.
Regarding private clinics, NACO is of the view that the HIV testing in them is not
mandatory and. in any case, these are not under its control. Regarding Delhi
governments decision to conduct mandatory tests in its observation homes for
destitute women and children, NACO (while admitting that these were a violation of
the national policy) expressed no authority other than 'b^ing hopeful' that the Delhi
Government would not pursue such a. course. Regarding the health minister's
,s,,®*®ment' NAC0 ls satisfied he has also announced that he will be consulting the
WHO in this regard.
Testing can do nothing for HIV/AIDS prevention. Those testing positive cannot
be cured, rendered non-infectious or quarantined. For those testing negative
there is no guarantee they will not acquire the infection In future. For these
obvious reasons the national policy does not include mandatory testing in the
HIV/AIDS program. For other reasons, including high expenses (at the cost of other
urgently needed healthcare interventions) and social implications (including
infringement of individual rights), it is explicitly excluded.
But not only is testing is going on, it is fast becoming the most visible HIV/AIDS
intervention, raising several questions:
•
Why are doctors in both private and public healthcare systems prescribing
HIV tests? Are they using HIV tests as a measure for protecting themselves by
turning away patients testing positive? If this is so should they not be considered
guilty of unethical behavior? And more importantly what happened to millions of
dollars worth of awareness building on universal protection amongst healthcare
workers?
.
Why are politicians recommending HIV testing at the risk of making them
established practice? Are they, like the state minister in Delhi, acting out of
ignorant beliefs such as that HIV can be cured through yoga? In which case,
should they be allowed to take decisions on any crucial matter relating to public
health? And, of course, whatever became of all the awareness training? Or are
they, including the union health minister, unaware of the national policy? Or are
they no longer representing people but some hidden agenda?
•
Is NACO really unable to ensure implementation of the National Policy? Is
there really no mechanism for it to seek compliance from either private sector or
state or union government? Why should the union minister be consulting WHO
and not NACO? In short, what is the role of NACO besides collaborating with
donors on all manners of dubious research?
•
Or is it that NACO is unwilling to ensure implementation of the national
policy? Is it driven by some hidden agenda to lend its support to HIV testing
(and to human rights and national policy violations that this entails)?
•
What are the NGOs - who should be crying foul at these human rights
violations - doing? Why are they not objecting? In fact, why are they through
their STD clinics in coastal area projects, highway projects, red light area projects
and even tribal area (!) projects participating in blood testing? Do the strings
attached to the foreign funds for their projects tie their hands or does the color of
foreign money blind their perception of their role?
These questions need to be answered, as HIV testing is becoming an industry that
professionals are being used to feed. Promotion of HIV testing is creating a captive
market for introducing (questionable and dangerous) drug trials. And by allowing the
situation to get out of its hands, NACO is paving the way for a society subjugated in
the name of HIV/AIDS by market forces and other vested interests.
-T
If we test EVERYONE ...
our HIV estimates can exceed Africa's...
And World Bank can shift to India!!
M i s g u i ded Measures_______ ______ _—---------------------------------- -
Prevention in health workers.
“Prevent HIV through PEP treatment", says NACO!
Nowhere in the world has AZT o7 any other drug been projected as either curative or
preventive HIV drug. But NACO is projecting AZT as ‘preventive therapy'. It is
recommending practically along with a prescription, AZT drugs, in the guise of Post
Exposure Prophylaxis (PEP) treatment for Health Workers exposed to needle stick
injuries. This treatment, they say, is already being provided in government hospitals.
NACO cites as the basis for this guideline a US government study that claims that
starting this treatment within hours of accidental needle stick exposure to HIV can
decrease the chances of becoming infected by 79%. What they do not mention is that
this carries the assumption that 100 out of 100 exposures to the virus through needle
stick injuries would result in HIV infection. But the fact is that possibility of contracting
the virus this way is miniscule, and in all likelihood the 79% in whom HIV infection is
said to have been prevented, would not have contracted the virus in any case ('PEP'
or not). Also, there is no way any study can conform that a potential infection has
been averted by AZT treatment started within ‘a few hours’ of exposure since there is
a ‘window period' of a few months after infection, when the virus cannot be detected.
Box-4: AZT - No ordinary drug
Arthur Ashe died because he was t.aking huge doses of AZT, while Magic Johnson,
who discontinued AZT treatment, has resumed his basketball career. AZT is no
ordinary drug; it is a cocktail of anti HIV drugs, recommended for HIV positive people.
Initially hailed as a miraculous breakthrough in AIDS medication, the therapy
temporarily seemed to work. AIDS patients who were administered these drugs
showed improvement for a few months till the virus, which is able to mutate at a very
high rate, developed a resistant strain. Since then various combinations of these
drugs have been tried, and in all cases the virus is able to come up with a multi
resistant strain of itself. At best AZT has been shown to delay the onset of AIDS and
even that is directly linked to drug compliance. Once you start AZT therapy, you have
to take the drugs every few hours, every day, every week, every month, for years,
without missing a single dose. What makes this difficult is that it involves taking 15 to
20 pills every day, and night, no matter where you are or what you are doing. One
you must have with a quart of water, another after a full meal, for some you wait till
your stomach is empty. You have to be prepared to plan you whole day according to
the pill schedules. If you miss a few doses or take the wrong drug at the wrong time
(which is highly probable given the confusing drug schedules) the virus becomes
resistant to the therapy and the viral load is not only back to pre-therapy levels, it is
now resistant to all other drugs. It is feared that this resistant strain might spread and
cause an outbreak of untreatable AIDS. Besides debatable medical benefits, AZT is
known to cause severe side effects - some even life threatening. AZT is a form of
chemotherapy and chemotherapy ravages the immune system. To top it all is the
®x rem®'y hlgh costs of treatment. Costing about 18000$xa year and more for every
drug added to the therapy. All these factors make AZT one of the most controversial
rugs in the west, with people preferring to defer treatment and wait for better options
So all one is achieving through PEP treatment is
(a) making healthy people start expensive and unsafe AZT treatment (see Box-4)
even before confirming they have been infected, and
(b) diverting attention from universal precautions.
Health workers don’t need PEP. They simply need to follow the basic Universal
Precautions to avoid getting infected. The fact that NACO is recommending PEP
treatment as a guideline for standard precautions in health care settings even as AZT
drugs are being shunned throughout tho west raises a number of questions:
.
Are healthcare workers really expected to take PEP treatment for all needle
stick injuries?
Do they not know that PEP treatment would mean subjecting themselves to all
kinds of dangerous side effects, enormous expense and future implications of
multi-drug resistance?
.
Are healthcare workers not likely to want to first confirm if they need PEP
treatment?
Since for this they would need to know the HIV status of the patient, is not the
NACO, by recommending PEP treatment, implicitly supporting HIV testing of
patients in the interest of health care workers and against its own policy and all
public health rationale?
•
Is NACO not implying that universal precautions are inadequate for
HIV/AIDS?
Is this not adding to the AIDS scare within the medical community? And is this
not, therefore, resulting in irrational and unethical practices like testing or
abandoning suspected HIV patients?
o
Given that AZT is not an accepted preventive drug why Is NACO
recommending PEP treatment? Does not NACO realize that this can only
cause confusion and unreasonable fear in the medical community? By projecting
AZT as a preventive drug, isn't NACO misleading the people in matters relating
to their health?
•
Why are NGOs putting alarming findings of unscientific studies on
precautions in public hospitals In the media?
Will not the recent report in the HT about alleged high levels of HIV infection
amongst doctors in public hospitals in Bombay based on this dubious study
create a baseless fear? Will this not divert attention from Universal precautions to
untested PEP treatment and similar knee-jerk reactions?
These questions need to be answered urgently as NACO has put us on our way to
becoming the biggest guinea pig farm for HIV drug trials, to benefit treatments .that
are ultimately in the control of western pharmaceutical companies.
Misguided Measures
Vertical transmission:
UNICEF, women NGOs “rescue” newborns from HIV?
1998 end and early 1999 saw three developments with a bearing on transmission of
HIV from mother to child (vertical transmission) in India:
•
NACO announced that AZT drugs would be administered to pregnant women.
This is to be done through UNICEF's mother and child health programs and has
officially commenced in six centers.
•
The Parliamentary Standing Committee Report on Dreaded Diseases was
tabled. The last paragraph reads:
“The Committee decides that our country should contribute its own might, for
1t may so happen that the research conducted in India may ultimately lead to
success."
•
US government announced the decision to “stop recruiting pregnant women" for
administration of AZT drugs.
To understand the full importance of these developments one needs to understand
that administering AZT drugs to pregnant women is not something starting now - as
suggested by NACO or the Parliamentary Committee report. It is something that
has been going on from the beginning of the ‘90s as part of unofficial drug
trialsl Thousands of pregnant women in India have already been administered
deadly AZT cocktail drugs. Several hundreds of them have already suffered
devastating side effects of AZT (refer Box-4) and several hundreds of children have
already been born with birth defects as a result of AZT (Box-5).
Unofficial drug trials on pregnant women in India have been going on at the instance
of foreign research institutes in collaboration with some of the most respected private
and public sector health institutions in the country, with NRI researchers and experts
serving as the conduit. From the early '90s onwards a number of “experts" on HIV
have been created and projected through the media to a medically gullible public that
believes anything that the “Doctor says"! Faith in the doctor, combined with the fear
surrounding HIV, led people to believe that “expert doctors" recommending AZT were
not just saviors as far as HIV was concerned but noble men making a noble effort to
bring fruits of western scientific achievements to India even as the inertia-ridden
government was doing nothing. Through early and mid ‘90s the media continued to
report experts on AZT. Especially in 1997 there -was a veritable media blitz of
statements by international and Indian experts at various seminars and workshops
highlighting the success of AZT treatment in various parts of the world and expressing
concern over non-availability of AZT drugs in India. Thus it was that by 1998 AZT
drugs had gained acceptability in the minds of people. The Parliamentary standing
Committee wanted to know why the government was not doing anything to make AZT
drugs readily available. And there was already a Rs.3000 crore market in India for
AZT drugs manufactured in the west!
Now that UNICEF has lent its impeccable credentials to AZT and the Parliament has
expressed concern over government's lethargy in using AZT drugs, this market
seems poised to grow.
Box-5: What AZT can do for pregnant women and children
Particularly alarming side effects of AZT treatment of pregnant women are
spontaneous and induced abortions. A study carried out in Asia reports these
effects in 16% of the pregnant women administered AZT. Equally alarming is the high
incidence of birth defects among surviving children. The Asian study revealed
horrifying birth defects in babies born to women who took AZT while pregnant,
including babies born with holes in their chests, malformed hearts, abnormally small
brain, progressive blindness, misplaced ears, extra digits, etc. AZT has been
pronounced to be downright harmful when taken by children. In fact, HIV positive
children who take AZT die faster than children who don’t. There is a 30% chance of
an HIV positive mother passing on the virus to her child. It is claimed AZT can bring
down the risk of transmission to 7%. In view of the hazards that AZT poses to the
healths even survival, of the child, the risk of administering AZT should be weighed
against the likelihood of the child developing AIDS. Put simply, from the fetal
viewpoint the risk of Intervention needs to be less than the risk of transmission.
And there Is no scientific basis to suggest that this Is the easel
'The convergence between UNICEF's intentions and the pharmaceutical companies’
interests is no coincidence. It is well known that the UN is facing a severe resource
crunch following the failure of member countries to contribute funds and has solicited
contributions from the private sector. UNICEF and UNAIDS are both heavily funded
by pharmaceutical companies. The survival and sustainability of UN organizations
has thus become inextricably linked with the interests of their “holding companies’! By
taking on the task of administering AZT drugs to pregnant women, knowing fully well
their damaging effects on both mother and child, UNICEF has made it clear that it is
no longer dedicated to the service of the needy, but rather to the service of those that
can fund its own survival.
All this raises some other serious questions:
•
Who decides that pregnant women in India may be administered dubious
drugs?
Who permitted this? Omwhat basis? Who is* accountable for disastrous side
effects on the mothers? And for deformities in children? Is the Indian government
responsible for the survival of UNICEF or of Indian mothers and children?
•
And what Is the role of all the “gender-sensitive” womens’ organizations
who will be implementators (and beneficiaries) of this UNICEF endeavor?
Why are they not protesting against - instead of participating in - such a
program? Is it because no foreign funding is available for such a protest? Is it
because they see their role of serving people as a poor second to their own need
for staying in business?
AZT will be
terrible for
THEIR HEALTH
t
P
NO AZT will be
terrible for
YOUR survival!
Misguided Measures_________________
STD control:
Cross-connection with HIV?
NACO recently launched a ‘pilot project’, named innocently enough “Family Health
Awareness Week". The purpose of this program is to control the spread of HIV by
controlling Reproductive Tract and Sexually Transmitted Infections (RTI/STI). The
methodology consists of identifying all cases of RTI/STI in the rural population of
these districts and treating them, so that HIV can be prevented. Since it is not
possible to ask people to get themselves tested for STD, they are to be coaxed to do
so by projecting testing as a general health check up.
Several selected NGOs are also operating STD clinics under various projects in
coastal areas, on highways, in red light areas and even in tribal areas throughout the
country where blood tests are being done at will.
Justifications being offered for conducting' an STD contrdl campaign in the name of
HIV/AIDS prevention merit closer scrutiny and seem rather dubious (Box-6).
Box-6: NACO’s pilot prolect for STD control: Dubious justifications
In India 90% of HIV transmission is said to be through heterosexual activity
What of NACO’s own figures tfiat say that at worst 74.15% and at best 46% of HIV
transmission is through heterosexual activity? Does this not epitomize the dramatic
and misleading way in which statistics can be used to scare the public?
STD infections increase the chances of transmission of the HIV virus
What is the basis of this? Can the higher prevalence of HIV among STD patients
correctly be interpreted to mean STD causes HIV rather than merely that a certain
type of behavior is leading to both STD and HIV infections?
.Studies show that Tanzania has been able to control HIV by controlling STD.
What of latest studies from Uganda, which have proved that treatment of STDs has
no effect on the risk of transmission of the AIDS virus? Or are lessons from
international research to be selectively applied to serve other interests?
This targets “low risk" rural populations which have not been covered so far
But then why is the same methodology that is used for prostitutes being applied to
villagers who are, generally speaking, neither aware of STDs or HIV nor a
promiscuous lot? Will not projecting HIV as an STD, to a rural population who have
not been exposed to any other awareness campaign, Serve to enhance the stigma
and fear associated with HIV? Will it not, instead of encouraging villagers to come out
and seek counseling, drive potential HIV cases underground?
Moreover, it is not easy to diagnose particular STDs and STD clinics tend to
circumvent this problem by symptomatically prescribing broad-spectrum anti- biotic
drugs for treatment. These drugs, besides their harmful .effects on mis-diagnosed
patients, have no effect on HIV infections, which cannot be cured by drugs.
The proposed modalities of NACO's pilot project also raise a number of questions:
•
Is it right to test people without their consent and without their knowledge?
•
Is it right to go ahead and test people without working out mechanisms for
guaranteeing confidentiality?
•
Is it right to go ahead and test people without first installing mechanisms for
awareness and counseling?
Obviously, NACO's pilot project violates its own policy against testing in spirit, if not in
letter. It does seem that the Government has found a novel way of bypassing the
prohibition of mandatory testing for HIV - that of testing people by fooling them into
getting themselves tested for STDs!
NACO’s STD project and the STD clinics being operated by various NGOs also
appear to disregard all past experience with the handling of stigmatized diseases like
leprosy and TB. Despite widespread awareness regarding this - a benefit that highly
stigmatized STDs do not enjoy - experience has shown us that no one likes to be
seen coming to such facilities.
Given the highly dubious justifications, the pathetically inadequate modalities and the
ridiculously low possible impact - not to speak of past experience that tells us that
clinics for stigmatized diseases are bound to be poorly used - what is really expected
of these STD control measures?
•
Why is NACO carrying out an STD control project in villages in the name of
HIV control? Why is it deliberately misleading people with manipulated statistics
and selectively projected international research findings to justify its project? Why
is it interested in promoting the use of broad-spectrum antibiotics for STD
treatment even though these have no effect on HIV?
•
Why are NGOs operating STD clinics in all kinds of places including tribal
areas? Do they real believe these are needed or will work? Or are these a
means to some other hidden end that just happens to need a lot of blood tests?
These questions need to be answered because all manners of testing are being
carried out in the name of HIV/AIDS prevention and control which, without the
“official" knowledge of our country, seem to be serving research and experimental
work elsewhere.
f
India has another World Bank loan for HIV.
What can we make them buy now?
After
-q
condoms, testing kits, blood equipment, AZT...
broad-spectrum antibiotics for STDs: JT
Errant Strategy
ReaE objectives?
i'- — .rrrt ...■
__ ____ _______ ..
_____ li.
It is clear that measures currently in’place are not doing much for HIV/AIDS
prevention and control. Nor can they do much on account of their flawed rationale and
inadequate scientific basis. Instead, they are making for far-reaching disruptive
impacts in healthcare as well as society. That foreign donors (with their vast
“international experience"),1 key NGOs (with their “alternative” perspectives) and so
many bureaucrats (trained by IAS academies and groomed by mid-career training in
foreign lands) have all missed the fact that these measures are most misguided is not
possible. Or so one hopes, since the alternative implies that the country's - in fact the
world's - developmentis in the hands of an extremely asinine assemblage of partners
who are unable to individually or collectively see the obvious! Rejecting that alarming
alternative, one tends to assume that foreign donors, NGOs and bureaucrats do
see that current HIV/AIDS prevention measures are misguided. The question
that follows is why are they abetting, endorsing and promoting such wasteful,
ineffective and disruptive measures. The answer lies in what these measures are
really achieving (since they are not achieving stated objectives). Some of these
“achievements” are outlined here. All these clearly cater to the multi-billion dollar
thriving AIDS industry.
Creating an "HIV/AIDS scare”
The most obvious “achievement" of HIV/AIDS prevention and control measures has
been to create an “AIDS scare”, as borne out by media reports such as the following:
«
In a. village in Kerala when a whole family committed suicide out of fear of
ostracism when the head of the family found he was infected with HIV.
o
Ina village in Bengal the village priest's family was thrown out of the village when
it was found out that their son, a casual laborer in Bombay, was HIV positive.
o
In Tamil Nadu, within a week of UNAIDS declaring it as a “successful state" a
suspected case of HIV was burnt alive in the street.
o
In Haryana, an entire village was ostracized when medical community, without
benefit of recommended tests, declared a villager to be suffering from AIDS.
o
In AllMS - India's premier medical institute -recently an “HIV suspect” was
denied treatment. He died. And his HIV tests turned out to be negative.
Current measures are contributing directly to an AIDS scare in many ways. The highrisk group construct has fuelfed the AIDS scare through a vicious cycle of fear
rejection-fear among groups labeled HRGs, driving potential cases underground. The
banning of professional donors has created an AIDS scare in the blood-banking
system and public at large is wary of both using and donating to blood banks. Testing
for HIV has frightened not.only those targeted for testing but also everyone else as it
implicitly exaggerates the scale of AIDS. Promotion of Post Exposure Prophylaxis
(PEP) treatment has scared healthcare workers (who are beginning to- avoid “HIV
suspect” patients) as well as general public (who is becoming scared to visit a
hospital for fear of becoming infected). Current measures have indirectly contributed
to an AIDS scare by diverting attention from counseling and awareness building that
could have promoted more rational perspectives. The fear psychosis that has been
created has made for a situation in which anything can be done in the name of
HIV/AIDS prevention without being questioned by the public at large.
Creating chaos in the health care system
A related “achievement" of current measures for HIV/AIDS prevention is the
weakening of the healthcare system. This has been effected in two broad ways.
Firstly, economics of healthcare systems have been completely distorted. High costs
have been built in either directly (such as through large scale expensive testing) or
indirectly (such as by banning professional blood donors, which increases import
requirements). These are bound to increase dependency on aid, besides being at the
cost of implementation of. say, measures for hospital infection control procedure that
could have prevented more infectious diseases like hepatitis 'B'. Secondly, through
creating an AIDS scare, inadequately handling awareness building and coming up
with knee-jerk over-reactions in the form of recommending PEP treatment, the
HIV/AIDS program has fostered irrational and unethical behavior in the medical
community. There are growing numbers of instances of insistence on HIV testing,
denial of treatment to patients suspected of having HIV and even all manners of
“clinical diagnosis” of HIV. The medical community seems to want to distance itself
from the disease. A resource starved healthcare system manned by a medical
community that would rather stay clear of HIV/AIDS can hardly be expected to
constructively intervene (interfere?) in HIV/AIDS prevention and control, leaving
the field clear for certain donor countries to manipulate.
Medicalisation and research
Creating an AIDS scare and chaos in the healthcare system of the country, of course,
are not ends in themselves. They merely create the setting in which more tangible
objectives can be realized. So far the most obvious evidence of such a tangible real
objective is medicalisation. In the name of preventing and controlling a disease that
cannot be prevented or cured by drugs, a large market for broad-spectrum STD
drugs, controversial AZT drugs for PEP treatment for healthcare workers and for
pregnant women and expensive testing kits has already been created. Boldly
disregarding the national policy on AIDS control certain donor countries - in
connivance with flACO, NGOs and highly respected medical institutions - are
using the HIV/AIDS prevention program to reduce us to hapless subjects on
which to dump (at lowered prices) all sorts of unnecessary drugs. A second “real
objective" is to facilitate research and drug trials. Again violating with impunity the
national policy on testing, donors controlling the HIV/AIDS program have succeeded
in opening up the floodgates for rampant "testing" in the name of HIV/AIDS prevention
and control. Private clinics, public hospitals, government agencies and politicians are
all endorsing and promoting testing and NACO seems unable or unwilling to stop
them. Even respectable organizations like the UNICEF (through its mother and child
programs) have been roped into this exercise. All this is happening even though there
is no basis whatsoever to view testing as a prevention measure or, say, to consider
tribals a high-risk group for HIV/AIDS. For about a decade now we have been
evolving into one of the largest research laboratories and a guinea pig farm for
experimenting with dubious drugs. Obviously, this is not happening without the
knowledge - even connivance - of concerned authorities.
HIV industry — driving disease control programs that are
Errant Strategy
Draft Policy: New mechanism for colonization!
Mechanisms of colonization via the bureaucracy and NGOs
It is evident from the foregoing that the HIV/AIDS prevention and control program is
being used not for preventing or controlling HIV/AIDS but for exploiting and controlling
the nation to serve the interests of foreign donors in the emergent market economy
context. It was stated at the beginning of this note that this is what colonization in a
contemporary context is about. It was also stated that the instruments of this insidious
process of colonization are a tamed bureaucracy, a tamed NGO sector (dominated by
women led NGOs) and the artifice of the draft policy.
The modus operandi of foreign donors has evolved into a fairly standard procedure.
•
It begins with identifying (or creating) and supporting (with funds and, more
significantly, consultant inputs) a “suitable" NGO to “work on" a certain issue.
Often these “NGOs" are not voluntary agencies, but arms of large corporate
houses or management consultancy firms or just friends and relatives of
bureaucrats!. The specific objectives of the task vary but the agenda is to draw
attention to the “need for policy".
•
Once this “need" is brought into public consciousness, a “suitable" bureaucrat is
fixed. This is typically a “shishya" of one of the “gurukuls" abroad where
bureaucrats routinely attend all manners of “training" who is now in a position of
strength in the administration. So effective are these "gurukuls" that it is seldom
necessary for the “gurus" to participate in the process beyond briefing stages.
•
The "shishya” then rounds up something in the nature of a chapter of an "alumni
association" by way of a handful of state secretaries who have been to the same
"gurukul" in younger days and a draft policy is written up.
•
A bunch of “suitable" NGOs/firms is then rounded up for a series of "regional
consultations" at which the draft policy is “widely endorsed". The Planning
Commission in due course of time reprints it under its aegis
•
Often a political figure - if necessary, even the Prime Minister - is invited to
inaugurate one or more of these consultations or give a speech in a specially
arranged forum. In certain matters of great concern the endorsement of the draft
policy by a larger political cross-section may be arranged. This is done not
through the democratic mechanism of a parliamentary vote, but our British legacy
of a “parliamentary committee" advised, of course, by the same "experts" from
the tamed bureaucracy and NGO sectors.
The draft policy for HIV. like all other draft policies on which our country is running,
went through the above process. But unlike other draft policies, the HIV draft policy
has the distinction of having been released during election time by the Prime Minister
and having been permitted to be declared as government policy by the Election
Commission. This procedure of announcing a policy is unprecedented in the
history of independent India. And the policy itself, allowing as it does the kind of
things discussed so far in this note, is tantamount to gifting away the sovereignty
of the nation to foreign donors working for market forces It is, therefore,
obvious that we have already been colonized.
Thus it has come about that foreign donors are replicating the African model of HIV
prevention and control in India and have, thereby, firmly pushed us on the same path
to a scientifically created genocide and civil unrest. Unfortunately, all our own
democratic institutions are party to this. The Parliament of India is appreciated
worldwide as a symbol of the maturity of the electorate of the world's largest
democracy. Sadly, parliamentarians have repeatedly betrayed the trust placed in
them by the people. The Parliamentary Standing Committee's 73,d Report oh
Dreaded Diseases shows once again how parliamentarians can let down the nation
through their blissful ignorance. The Supreme Court which has a history of delivering
social justice and commands immense respect and credibility amongst the Indian
masses and the international community has also come under a cloud on account of
the consequences of its judgement on blood bank reforms. But, in the ultimate
analysis, and above all, it is the National AIDS Control Organization (NACO)
that is squarely to blame for the betrayal of the nation in the name of HIV.
The responsibility for HIV prevention and control in India - along with millions of
dollars of World Bank loans - were vested in NACO. But NACO it has become
reduced to a being an arm of foreign donors serving market forces. This was
recognized by no less than the Parliamentary Standing Committee, which states:
“The Committee has learned that the various international agencies are implementing
various programs in different parts of the country for tracking the problem of
HIV/AIDS. In this connection the Committee is.constrained to note that NACO is not
involved in the implementation of all projects in all parts of the country." NACO
seems to be guilty of nothing short of treason. Nothing short of a criminal trial
against NACO will redress this betrayal of the nation.
Things have come to this because the powers that be believe we do not deserve
better and we believe that things cannot change. But it is our right and our duty that
things change. We must shake off the indifference and inertia that has become our
tradition and act to protect our interest and make those who are charged by the
constitution to protect our interest do their job. It is imperative that HIV/AIDS no
longer be viewed merely as a medical issue, health issue, socio-economic
issue or even developmental issue. It must be seen for what it is - an urgent
political issue. If it is not handled as such now we are doomed to economic
disaster and national disintegration.
GURUKUL
U.K.
4
Find many more like-minded
bureaucrats and others...
like yourself...
We have great plans for
development in India.
- our development of course!
HIV/AIDS is one of the greatest crises being faced by mankind today. History tells us
that whenever there has been a crisis there have also been those who have exploited
the crisis. HIV/AIDS is no exception to this historic truism. The self-serving HlV/AIDS
Industry is very industriously exploiting the global HIV/AIDS crisis.
It thrives on chaos — where fear becomes the central creed, irrational behavior
becomes the norm, knee-jerk reactions pass off as policy and strategy - and
anything goes, no questions asked.
It systematically undermines systems - systems of public healthcare, systems of
governance, systems of society,'systems vital for functioning, even, sorvival of a
people - so that anarchy can make way for total exploitation.
It is the most unconventional and deadliest form of warfare - where not a missile is
fired, not a soldier is killed, not a border is changed, not a building is destroyed - but
enduring subjugation is achieved.
While AIDS can kill individuals, the HIV/AIDS industry destroys society and
nationhood - not by any obvious manner of biological death but by insidious and
persistent cultural, social, economic and political annihilation. Thus the HIV/AIDS
industry has emerged as the most effective ever instrument of colonization,
compromising the survival of nations to the sustenance of vested, market interests.
Africa is already showing the consequences of avowing the HIV/AIDS industry to
prevail. And we are hurtling with inevitability on the> same path to economic disaster,
civil unrest and national disintegration.
While much is being said about the deadly AIDS, little is being said of the equally - if
not more - deadly HIV/AIDS Industry.
This booklet is intended to draw attention to this little known, scarcely acknowledged
and barely understood deadly dimension of the HIV/AIDS scenario, so that HIV/AIDS
is no longer seen as just as health or medical issue, but as a socio-political issue.
It is intended to provoke Indians into shedding off their inertia and heeding the
.warning signs so that whatever is needed can be done to get the nation off this
doomed course.of colonization in the name of HIV/AIDS prevention and control.
Joint
JACK
Action Council
Kannur
Dr. Zainuddin Colony - P.O.Chowa, Kannur - 670006, Ph:502230, 503535
For information / material, contact C-38 Anand Niketan, N. Delhi-21, Ph:6115488
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