Inter Press Service - November 5, 2002
Ranjit Devraj

The 'Maharaja of Microsoft' is scheduled to begin Monday a four-day tour of several Indian cities and promote development of an anti-AIDS vaccine in an initiative funded primarily by the Bill and Melinda Gates Foundation.

The foundation, which has a staggering 24 billion dollar corpus, counts the World Bank and several western countries among other donors.

Last year, the Gates' foundation issued a 100 million U.S. dollar challenge grant to the U.K-based International AIDS Vaccine Initiative (IAVI), which has signed an agreement with the Indian government to develop the vaccine in this country.

In interviews to Indian publications ahead of his tour, Gates declared that, as with his software company Microsoft, the key to his foundation was the large number of smart people that have come into it and formed "partnerships".

Although the stated motive of the HIV/AIDS initiative is laudable, health and human rights groups have raised ethical questions regarding conduct of vaccine trials in India, a country with a poor record for public accountability when it comes to clinical trials and actual use of medicines, contraceptives and vaccines.

"There is no word yet on what kind of compensation would be paid to volunteers should the vaccine trigger off AIDS in them," said Amit Sengupta, a leader of the Jan Swasthya Abhiyan or People's Health Movement, an umbrella group for hundreds of major non-governmental organisations (NGOs) in the country.

Said Purushottaman Mulloli, spokesman for the Joint Action Council (JAC), which speaks for several human rights organisations: "It is easy to induce people to accept medicines and vaccines in this country where half the population is illiterate and chronically poor. Many have the attitude that any medicine is better than nothing at all."

Mulloli is among activists that are planning to campaign against the HIV/AIDS vaccine trials during Gates' visit here.

They say what has aroused suspicion is the involvement of America's sleuthing agency, Central Intelligence Agency (CIA), in identifying India along with Russia and China as countries that pose international threats by spreading the AIDS epidemic.

A study conducted for the CIA recently said that by 2010, these three countries, together with Nigeria and Ethiopia, will outstrip the epidemic in sub-Saharan Africa and exceed worst-case scenarios unless drastic measures such as vaccination are resorted to.

According to the report, publicised in several Indian newspapers in October, the number of people with AIDS in these five countries will grow to an estimated 50 million to 75 million people, or far higher than other projections.

Titled 'The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, India and China', the report has already been handed over to the concerned governments.

"Why should the CIA be involved in public health matters and even arrange for selective leaks from classified documents?" Mulloli asked.

The CIA report also projects that the current number of people with HIV is between 5 and 8 million people, twice the figures shown by the Indian government's own 'Sentinel Surveillance System'. That shows a stable infection rate of between 3.5 and four million people over the last four years.

Mulloli said there appeared to be a clear link between Gates' visit and the release of the CIA report with its exaggerated and unsubstantiated projections, which suggest that India will have between 20 and 25 million people with HIV by the end of the decade.

Activists say that in the wake of India's decade-old economic liberalisation, several well-funded public health initiatives have come with doubtful motives while ignoring an array of basic but pressing problems that seem to receive scant attention.

For example, says Mira Shiva of the Voluntary Health Association of India (VHAI), the number of deaths and level of morbidity that result from viral hepatitis is far greater than HIV.

Gates' foundation, however, recently made a 25 million dollar grant to the government of southern Andhra Pradesh state to help introduce Hepatitis B vaccine and strengthen infant immunisation programmes.

But there are grounds for scepticism and suspicion, activists say. Last month, SAMA, a voluntary group that specialises in women's health issues, blew the whistle on government hospitals dispensing injectable contraceptives under population programmes in violation of a Supreme Court ban.

SAMA carried out detailed follow-up studies on 52 women who had been given the drugs only to find out that all of them, except two, were forced to discontinue them because of severe side effects that they were never warned of by doctors at government hospitals in the national capital.

The revelations only the latest episode in a two-decade-old, see-saw battle between voluntary groups and the health ministry.

The ministry has come under intense pressure from transnational corporations to introduce injectables like Net En and Depo Provera into the health care system without adequate trials and ignoring poor infrastructure.

"Pharmaceutical lobbies, international funding agencies and development banks that have made population control a condition for loans and grants are now having an increasing role in family welfare and population programmes in countries like India," said researcher C Sathymala, who leads SAMA and is respected internationally for her research on injectable contraceptives.

India's lax laws that allow unauthorised or unethical use of drugs and vaccines on unsuspecting populations was demonstrated by the administration of unapproved cancer drugs on patients at the Regional Cancer Centre in southern Kerala state last year.

Given such a history, officials at the IAVI have taken elaborate care to announce that trials for the proposed HIV/ADS vaccine would be conducted with utmost regard for transparency and ethical issues. (END/IPS/AP/HE/HD/RDR/JS/02)

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