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Call for separate Kutch state ups before elections
The call to form a separate Kutch state has upped in the lead up to the forthcoming Lok Sabha elections in Gujarat.
The Kutch has 24% of the land in Gujarat but the state government hasn't kept its promise to provide even the stated share of Narmada waters. It uses only 7% of waters drawn from partially built reservoir, wasting 93% to the sea, say the Narmada Bachao Andolan (NBA) activists.
The Kutch Rajya Sankalp Samiti (KRSS) states the cultural differences and geographical distance of Kutch from the Gujarat's state capital of Gandhinagar of about 400 km as one of the key reasons for Kutch being neglected for development, which presses the call for a separate Kutch state.
Advocates of a separate Kutch state report that the Kutch district pays taxes to the tune of over Rs 600 crore to the Gujarat state government which in turns only spends Rs 200 crore on Kutch.
Also the autonomous development board under Article 371(2) of the Constitution which was promised in 1960 could never come into existence due to lack of political will.
According to the royal family of Kutch, at the time of integration of the princely state with India in 1947, the accession was done on the condition that Kutch would retain the status of a separate state. It enjoyed this status till 1960, when a separate state of Gujarat was carved out of Maharashtra and Kutch was merged with it.
"Kutchis have rightly approached the Supreme Court against the unjustifiably small share. It's what we had anticipated – both the people in the Narmada valley and in Kutch, at two extremes, would be deprived by the 'power'ful central Gujarat. Its high time Sardar Sarovar had a re-look at, not only from the perspective of the displaced, but also the drought affected, yet cheated, 'planned beneficiaries', upholding their right to distributive justice" says NBA activists.
Will pictorial warnings on tobacco products get postponed again?
The Group of Ministers (GoM) on tobacco warnings is meeting on 8 April 2009 and further dilution or delay to pictorial health warnings on tobacco products is expected. This is a great concern before the nation when the implementation on pictorial warnings is long due now and the deadline is very close (31 May 2009).
This meeting is scheduled at the time when in the previous month General Election 2009 for Lok Sabha were announced and the Election Commission of India has passed the model code of conduct to ensure that no impression is given or created by any political party to influence the electorate in their favour. Hence, any kind of politically motivated decision resulting out of this meeting at this crucial hour is the violation of the this model code of conduct.
Also, considering the Honourable Health Minister, Dr. Anbumani Ramadoss has resigned; convening such a meeting by the GoM will certainly have no one representing the concerns of public health and can result into giving likeminded outputs. The non-representation of the health sector in this decisive meeting will lead to biased decisions and favours to the tobacco industry.
According to Monika Arora, Director Health Related Information Dissemination Amongst Youth (HRIDAY), "The GoM in its earlier 8 meetings has either delayed or diluted the effective pictorial health warnings notified by Ministry of Health and Family Welfare (MoHFW) in July 2006. The implementation of current mild warnings is continuously being delayed due to GoM’s intervention. This is a breach of right to information about the health hazards of the consumption of a deadly product."
Further, the issue of implementation of Packaging and Labeling rules 2008 is subjudice before our Supreme Court. This case was filed before the apex court seeing the lack of executive will to implement the said rules. Therefore, further interference in the implementation of the rules by GoM would lead to legislative interference when the said matter is pending.
According to Bhavna Mukhopadhyay, Senior Director, Voluntary Health Association of India (VHAI), "Any decision emerging out of the GoM meeting tomorrow that is likely to delay or dilute the existing rules will be a serious violation of the election code of conduct as it will gift windfall benefits to the tobacco industry and political gains to certain members of the GoM, who have lakhs of tobacco workers in their constituencies".
Whereas, the Cigarette and Other Tobacco Products Act 2003 (COTPA 2003) and Global tobacco control treaty signed and ratified by India, the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) mandates that all tobacco products, including bidis, must display effective pictorial health warnings.
Also, a survey conducted in four Indian States by Healis Sekhsaria Institute for Public Health and VHAI reports 98% of public supporting the pack warnings and 99% supporting government action to strengthen health warnings requiring them to be large and including pictures of all tobacco products. At this juncture, any of the Government’s decision in further deferring the pack warnings will not only dishonor its international commitment and people’s will but also undermines the health of its 1 billion citizens.
According to Dr. Prakash C Gupta, Director, Healis Sekhsaria Institute for Public Health, "Pictorial warnings on tobacco products are intended to increase consumer knowledge of the deadly health effects of tobacco consumption, to encourage cessation and to discourage uptake. In India they also break the linguistic and cultural barrier, in addition to informing the illiterate population (a large proportion of this segment smokes bidis) about the harmful effects of tobacco use."
The issue of pictorial warnings has time and again affected the people working in public health as the persistent delay in enforcing the law to display pictorial warnings on tobacco products has resulted in no forward movement. It is ironical that the very same Government that has vehemently supported the guidelines on Article 11 of the FCTC (pack warnings) for the global community at the third Conference of Parties (COP-3) meeting in November 2008 in South Africa is delaying its implementation on different pretexts on its own home turf.
Before going to the 3rd Conference of Parties (COP3) to the FCTC, the Indian Ministry of Health and Family Welfare had revealed before the Central Information Commission that tobacco industry is putting "pressure" to relax the tobacco control policies (source: The Hindu, 14 November 2008).
The Preamble of the global tobacco treaty, indicates that Parties “need to be alert to any efforts by the tobacco industry to undermine or subvert tobacco control efforts and the need to be informed of activities of the tobacco industry that have a negative impact on tobacco control efforts”. Further, Article 5.3 of the FCTC requires that “in setting and implementing their public health policies with respect to tobacco control, Parties should act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with the national law.”
Hope GoM members are listening!
Right to health is not for the majority of UP residents: SR Darapuri
Right to health is not for the majority of UP residents: SR Darapuri
"Every citizen should have access to healthcare, regardless of caste, religion, gender, age or socio-economic status" said retd IG Police SR Darapuri, who is the Lok Rajniti Manch (People's Politics Front) candidate for the prestigious Lok Sabha constituency of Lucknow.
Three-quarters of households in Uttar Pradesh (UP) are in rural areas, according to the National Family Health Survey (NFHS-3) data. However health systems catering to the healthcare needs of people in rural UP are grossly sub-optimal, says Darapuri. The living conditions in rural UP and urban slums exacerbate the vulnerabilities of poor to preventable diseases and causes of death. “The right to health is a basic human right” asserted Darapuri.
For instance, only 29 percent of people in UP live in pucca houses (NFHS-3 data). Sixty-seven percent of households have no toilet facilities (NFHS-3) however in rural UP the situation is more grim with more than four-fifths of rural households (84%) having no toilet facilities.
To top it all, only 9 percent of households in UP have water piped into their dwelling (NFHS-3), which is ironical as access to safe drinking water is alarmingly low in UP. Only 5 percent of households treat their drinking water to make it potable. The prevalence of water-borne diseases therefore is seething high, says Darapuri.
The social, economic, and sexual vulnerability of women - particularly young women and girls - harms their health and increases their risk to contract a range of infectious diseases. Gender inequalities prevent many women from being able to protect themselves. Millions of women lack the social and economic power to take optimal care of their health. According to NFHS-3 data, the median age at first marriage is 16.2 years among women in UP. More than half (59%) of women age 20-24 years got married before the legal minimum age of 18 years. Among young women age 15-19 years in UP, 14 percent have already begun childbearing, lower than the national average (16%). “It is not surprising that maternal mortality rates and infant mortality rates are one of the highest” says Darapuri.
Access to nutritious diet and awareness about nutrition are also grossly inadequate in UP, which compromises the immunity of undernourished individuals, particularly posing life-threatening risk to children below 5 years of age.
Providing quality healthcare to all, is the non-negotiable responsibility of the government - and ensuring that the living conditions of the citizens, particularly women, young girls and children, are optimal and doesn’t threaten their normal healthy well-being, is also a fundamental duty the state is entrusted with, believes Dr Sandeep Pandey, Ramon Magsaysay Awardee (2002) and member of National Presidium, Lok Rajniti Manch (People's Politics Front).
World Health Day: Make hospitals safe in emergencies
The World Health Day (7 April 2009) focuses on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disast
ers - treating injuries, preventing illnesses and caring for people's health needs. They are cornerstones for primary health care in communities – meeting everyday needs, such as safe childbirth services, immunizations and chronic disease care that must continue in emergencies. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences.
This year, the World Health Organization (WHO) and international partners are underscoring the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need. They are also urging health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care.
Particularly in low and middle-income countries, the heavily burdened health systems with raging epidemics and limited health facilities and trained healthcare workers, often fuel the debate between strengthen health systems and single-disease vertical interventions. However the role of strong and robust health systems, which are well funded, resourced and have adequate skilled human resource to provide services to all those who need it, is certainly a vision that the world is striving to achieve.
Even in developed countries like USA, data reveals on how access to healthcare remains a privilege and is often beyond the reach of the most underserved communities.
The paradigm shift will occur when communities that seek healthcare services, are treated with dignity as equal partners along with healthcare workers in improving health systems. It is honestly not only a clinical or medical issue. The genuine partnership between healthcare workers and communities based on equity, dignity and respect, will certainly radically improve the quality and accessibility of healthcare services.
Cause with a 'Wild' Twist
The cause for animal rights that is finding expression at the Prince of Wales Zoological Gardens in Lucknow is one of a kind. Contrary to the hohallah that animal rights activists create aka the dharnas and demonstrations for the caged critters making a case for their right to freedom worldwide, in the city of nawabs the movement that is gaining grounds is by the people for the animals and that too silently!
The focus is more on improving the quality of life of the animals in confinement instead, and city folks are going all out to do their best. More of a community initiative denizens are doing their bit by adopting zoo animals and sponsoring their upkeep. Such a move has helped take the financial burden off the zoo authorities who have been struggling to make ends meets when it came to maintenance and upkeep of inmates.
Says Renu Singh, Director Lucknow Zoo, who came up with the ingenious schemes to get the community involved in doing their bit for the,"Adoptions of our animals has breathed new life into the zoo. Since we no longer are we facing a cash crunch the extra funds that we have have been put into improving the overall ambiance.The footfalls have increased and zoo has become a must visit place and quite popular with city people. When we began inviting sponsors to adopt the zoo animals I was not sure what the response would be, but I was pleasantly surprised at the requests that began coming by corporates and individuals wanting to take on the responsibility of care and upkeep of the animals. The scheme has been so successful that the total revenue raised by such adoptions are touching almost Rs 39,66,729/- ever since it began 2 years ago. Now we have a waiting list of individuals wanting to adopt the animal of their choice. Seeing such enthusiasm we have also opened up the gardens and parks up for sponsorship."
Confirms Seema Singh, Senior Manager Marketing United Bank of India,"Our bank decided to adopt Jason the Chimpanzee and a golden monkey. We were also keen to adopt Nikita, the female chimpanzee but someone else beat us to it. Nevertheless we are going through the list of animals at the zoo and will pick an animal soon to adopt with the left over funds we have."
On the other hand a retd colonel in the Indian Army who adopted Nikita the chimpanzee feels, "As citizens it is our duty to help share the responsibility of taking care of any living creature that cannot fend for themselves. These animals would have been able to survive in wild on their own but in captivity they are totally dependent on us and should not be allowed to suffer on account of lack of funds."
Adds AC Hari DGM, Oriental Bank Of India who has adopted two tigers,"As the annual maintenance of the tigers of Rs 1,60,000 was well within our budget we decided to adopt them. The aim is just to make the life of these animals better in captivity, tigers are disappearing from the wild so this gives us a chance to do something for them so that their numbers increase in captivity."
With most corporate firms allocating a budget for social causes the adopting animals at the zoo has become quite a hit with the them
Says a senior manager of a petroleum products industry in the city who prefers to remain anonymous,"The budget is already allocated for social causes every year but adoption and upkeep of zoo animals seemed the perfect way of doing our bit. And to be honest its a two way approach when we put up our board with the company name on it it helps us get publicity as well. All our branches plan to utilise their social budget in such causes."
But while the corporates and city folks are living up to their social responsibility the Zoo authorities too are not far behind in coming up with innovative ideas to attract attention to the zoo and its critters.
Birthday bashes for the Cheetahs, Chimpanzees, deers and Giraffes, naming ceremonies for the Pelican chicks, Valentines day celebrations for the tigers and Zebras etc all are events that the Lucknow Zoo regularly organises to pull in the crowds to promote the adoption schemes for the animals.
On the other hand so enthusiastic is the staff here in organising such events that the Director of the Zoo refers to the two Cheetah cubs she hand reared as her own daughters, "The Cheetah cubs Suheli and Sharda brought to Lucknow Zoo from Dudhwa National Park only eight days old when some rangers found them abandoned by their mother. Having hand reared them I refer to them as my own daughters. They are a year old now and I have just celebrated their birthday on January 18 and very soon they too will be up for adoption."
In addition Singh has also made extra efforts to acquire rare and endangered species for her zoo which have also become quite a crowd puller,"A white civet cat has just been placed at our nocturnal house. No zoo in the country has this animal but we got it when it was being smuggled out of the state by poachers who were nabbed by the Special Task Force. I got in touch with STF and requested them to place the animal with us which they did." Another animal she is trying hard to get now is the man eater tiger which has been terrorising various districts of UP, he too will be up for adoption!
But will want to adopt a man eater? "Everyone of course," she chuckles "The controversy that surrounds the tiger has already turned him into a celebrity. So the requests are going to be pouring in to adopt him and save him from getting killed."
Truly a cause for animal rights this!
Anjali Singh - Citizen News Service (CNS)
(The author is a senior journalist and Director of Saaksham Foundation. Email: saakshamforchildrights@gmail.com)
[Top photo caption: Director Zoo Renu Singh with two leopard cubs rescued from Dudhwa National Park. She hand reared the cub and now they are up for adoption.]
Health of Women is Indeed Our Precious Wealth
7 April 2009
Health of Women is Indeed Our Precious Wealth
On this year's World Health Day, let us focus on addressing issues that can improve health status of women. A wide array of socio-economic, cultural and gender-based inequalities continue to aggravate risk for women.
The latest effort in this direction was a symposium on ‘nutrition in women’ held in New Delhi . Its main aim was to draw attention to the very pertinent observations of a ‘Multi Centric Study on Nutrition in Women’, conducted jointly by the Department of Science and Technology (DST) of Government of India and the Diabetes Foundation of India (DFI), and ably coordinated by All India Institute of Medical Sciences (AIIMS), Delhi . The symposium was followed by a consensus conference on ‘Indian Diets for Prevention of Obesity and Related Disorders’.
It is high time we took a serious note of the health disorders in women arising due to age old dietary habits, coupled with changing life styles and static mindsets. It is indeed a congratulatory effort on the part of DST to conduct a country wide, 3 year long multi centric study (2005 – 2008) on nutrition related non communicable diseases in women over 35 years of age. The objective of the study was to prepare a health/nutrition profile for women by (i) identifying the problems related to non communicable diseases like diabetes, hypertension, obesity and high cholesterol, (ii) developing region specific and cost effective strategies for primary prevention and management of these diseases.
The study, the first of its kind, was conducted in 9 sites, which included rural as well as urban areas, and covered all the four regions of the country (north, south, east and west). 4621 willing, women respondents in the age group of 35 to 70 years were targetted for this study. Out of these, 2008 women were from urban areas and 2613 from the rural segment. Some startling revelations, (albeit expected) regarding women’s health were made on the basis of the information gleaned and clinical tests conducted during the course of the study. It was found that
(i) The overall prevalence of obesity/overweight was 64% in urban women and 36% in rural women.
(ii) About 14.5% of the urban women suffered from diabetes, as compared to 14.5% of their rural sisters.
(iii) Hypertension was strikingly high, with about 50% of the urban women and 33% of the rural women suffering from it.
(iv) High cholesterol levels were more predominant in urban women (25%) as compared to rural women (13%).
(v) Prevalence of anemia was as high as 80% in rural areas and somewhat better (25%) in urban regions.
Of course, there were a lot of regional variations/imbalances, with the women folk of Ballabhgarh (a rural site in Haryana) being overall healthier than others and the respondents from the urban site of Kochi coming at the bottom of the ladder.
More importantly, 96% of the urban women and 76% of the rural women were found to suffer from at least one cardiovascular risk factor.
One major contributory factor for this poor health scenario could be the sedentary life style of 48% of the urban and 44% of the rural womenfolk, coupled with a faulty and imbalanced diet.
Another important point brought out by this study was that tobacco consumption was very high at 41% amongst rural women and 21% in urban areas.
The message conveyed by the study is very clear. There is a heavy burden of Multi Risk Factors of metabolic syndrome leading to non communicable disorders amongst the middle aged and elderly women in the urban as well as rural areas. The high prevalence of obesity, hypertension, diabetes and high cholesterol levels in these women calls for sincere and cost effective interventions.
Till now, very little attention has been paid by the health agencies on prevention of these diseases in this segment of the Indian population. As it is, a woman’s health has always been of little consequence in our society. She is traditionally supposed to be the last to have a meal in the family and the first to neglect her health in the zeal to keep others fit and fine. This gender disparity is more pronounced in women who are above 35 years of age. They are taken more for granted by the family (their reproductive functions being almost over by then) and also by themselves (as health and well being of their children is of greater priority to them). Coupled with this, are the immense physiological changes which they undergo during this period of life.
So it becomes imperative that women be specifically targeted with health education and be motivated to practice healthy dietary and life style habits.
According to experts, intake of Trans fatty acids, coming from hydrogenated fat, should be avoided almost completely. Mustard oil, taken along with safflower/sunflower/soybean oil, seems to be the safest amongst all other available cooking medium (though not one of the existing cooking oils is ideal). But Dr Anoop Misra, of Fortis Hospital , cautioned that one should not consume more than half kilogram of oil in a month.
There is also an urgent need for the food industry to label the contents of the nutrients in their packaged products, especially that for Trans Fatty Acids. Canada was the first country in the world to make this mandatory, followed by USA . India needs to do the same. Dr.Vinita Sharma, Advisor to DST, strongly advocated the revival of ‘Indira Aahar Yojana’, which was once initiated (and, perhaps, later abandoned) by late Dr. Sukhatme, in Pune. It entailed the marketing of simple and healthy lunch packs and snacks for the benefit of consumers. This need is strongly felt for all segments of society, wherein we have healthy food products available in the market to counteract the fast food syndrome. In fact, DST is trying to initiate the marketing of tasty and wholesome food products in attractive packaging to woo the overburdened working women of today, whose health problems are compounded by irregular and/or long working hours. In fact, some housewives can start a business venture by supplying ‘wholesome tiffins’ to working women at their work place.
The employers should also accept their social responsibility in providing balanced meals in the office canteens as also some affordable means of physical activity at the work place.
On this World Health Day, let all ye women resolve to start taking good care of their bodies (and souls) and do not leave either of them in the hands of the men folk. Let us carry forward the movement initiated by DST and DFI for meaningful prevention of non communicable disorders, by timely nutrition related interventions, which are based on region specific food items, targeted at both, balanced nutrition and improving the status of health of women of all strata of society and of all ages.
The author writes extensively in English and Hindi media. She serves as Editor of Citizen News Service (CNS).
Published in
Ghana News, Accra, Ghana
Citizen News Service (CNS)
Bihar Times, Patna, Bihar
Pakistan News, Pakistan
Thai Indian News, Bangkok, Thailand
Medical News, Australia
The Liberian Times, Liberia
Two Circles.net
World News Network (WN)
Asian Tribune, Thailand/ Sri Lanka
Acquire Health
Op-Ed News (OEN), USA
News Trust, USA
Mangalorean Times, Mangalore, Karnataka
Media for Freedom, Kathmandu, Nepal
Zimbabwe Guardian, Harare, Zimbabwe
Northern Voices, Chandigarh and Himachal Pradesh
Darjeeling Times, Darjeeling, West Bengal
The wages of protest
Arundhati Dhuru & Dr Sandeep Pandey
[Published in THE HINDU, 5 April 2009]
While the RTI Act and the audit provisions of NREGA enable ordinary people to demand accountability from governments, it doesn’t always work like that on the ground. There have been several cases recently in U.P., where the demand for rights by workers has been met with violence…
The political ruling class has decided to deal with the demands being raised by workers for their legal rights strongly.
The advent of the Right to Information (RTI) Act and the National Rural Employment Guarantee Act (NREGA) were a breakthrough in Indian democracy. They provided the openings in a system which was opaque, insensitive and impersonal to the common citizens of this country. The ruling elite which was not prepared to be answerable to people at all had to relent. They realised that, after all, they are functioning in a democracy which is created in the name of the people. People began asking questions under the RTI Act and started conducting social audits under NREGA, which were revolutionary ideas given the kind of system we have inherited from the British and given the mindset bureaucracy develops when it is entrenched in this system. People did achieve success using the RTI and the social audit provision and a definite empowerment was taking place.
However, it looks as if it’s been decided that enough is enough. People could be allowed the luxury of only so much transparency and accountability. They could not transgress the limit beyond which the unquestioned supremacy of the ruling elites stood to be challenged. The initial fear in their minds towards these pro-people laws has vanished and now they are dealing with people demanding their basic rights under these Acts with vengeance. They have decided to quell every voice which raises questions about their highhandedness with utmost contempt and violence if necessary. The administrative machinery, which is supposed to be responsible for implementing these laws, is being used by the people’s representatives with impunity.
Plenty of discrepancies
In the Dumri Village Panchayat of Kasya Block of Kushinagar district of U.P., what started as an investigation into the discrepancies in Below Poverty Line survey, on a complaint made by some villagers, turned into a full fledged investigation into bungling in development funds which came through the Panchayat. Discrepancies were observed by an Assistant Commissioner in the Rural Development Department in the housing schemes for poor as well as NREGA. Advocate Udaybhan Yadav, who was instrumental in getting this investigation done, was threatened by the Gram Pradhan Dinesh Verma and his men. On February 28, 2009, when the men of Gram Pradhan were beating a dalit labourer Parasuram, who was vocal in questioning the fake muster roll in which wages were withdrawn in his name whereas he had not even worked under NREGA, Udaybhan intervened. He was also beaten up. A dalit, Kapil Dev, receiving patronage from the Pradhan, registered a FIR against Udaybhan and a case under (Prevention of) Atrocities against S.C./S.T. Act was filed. Under political pressure, Udaybhan and his father Hari Yadav were arrested on March 9. Parasuram’s brother Ram Bharat and father Jaikaran were also arrested but released later.
Fight for wages
In the village Panchayat Aira Kake Mau of Bharawan Block of Hardoi District, workers had assembled on January 14, 2009, at the door of the Gram Pradhan as previously agreed, to seek their unpaid wages. The husband of the Gram Pradhan, Ghanshyam, who runs the show here on behalf of his wife, first tried to threaten the labourers. The police arrived when the situation became tense. When the workers wanted to file complaints against the Gram Pradhan for violation of their rights under the NREGA, Ghanshyam ordered his men to rain lathis on the labourers and social activists present there in support of the workers in the presence of the Station House Officer and the police of Atrauli Police Station. One dalit labourer, Medai, and a social activist, Ram Bharose, sustained injuries on the head. Although a case was filed against Ghanshyam, in spite of repeated applications to various authorities by dalit labourers who were present at the site of incident, (Prevention of) Atrocities against S.C./S.T. Act has not been used against Ghanshyam and no action has thus far been taken against him.
In Kopaganj Block of Mau district, labourers from the villages Devkali, Bishunpur, Purana Kopa and Jairamgarh, mostly women and dalit, had assembled at the office of the Block Officer, merely eight km from the district headquarters, to demand wages due for the last six months. One of the labourers was called inside the office for dialogue and beaten up by those inside. The labourers were furious. The Block Development Officer, Ram Dular and an employee, Sanjiv Singh, had to bear the brunt of the anger. Some women also got hurt in this scuffle. Full wages have still not been paid and nobody involved in beating the worker has been punished.
In the village Panchayat Rura of Kasmanda Block of District Sitapur, a pond deepening work was in progress on February 28, 2009. Some women labourers wandered off to drink water from a hand pump. The hand pump belonged to a powerful person from the locality, Madan Dixit, popularly know as Madan Muni in this area. The women had to face obscene comments. When the male members of the families wanted to register their protest against these obscene remarks, they were beaten up. When the workers reached the police station to file a case against their tormentors, Madan Muni was already there. The workers wanted to register a case under the (Prevention of) atrocities against the S.C./S.T. Act. The police asked them to come next morning in an attempt to arrive at a compromise. When the workers were unmoved from their demand the next day, two men and two women labourers were beaten by the police inside the police station. premises. With the help of social organisations of the area a case was finally registered against Madan Muni under the (Prevention of) atrocities against the S.C./S.T. Act but no action has been taken against the police personnel who were involved in beating the workers.
Underpaid
In the Cholapur Block of District Varanasi, about 200 workers belonging to Dhaurahra, Saryan and Munari were not paid their wages for about a month for deepening a pond in Saryan G.P. The Junior Engineer had measured the work and calculated payment of wages at the rate of Rs. 39.80 per day. The workers were not satisfied as for similar work in Dhaurahra G.P. workers were paid the minimum wages of Rs. 100 per day. On February 26, 2009, the Village Development Officer gave in writing that all workers would be paid at the rate of Rs. 100 per day on March 3, 2009. When the workers assembled on March 5, at the Block Office, the BDO was absent. On the advice of a Block employee they decided to block the Varanasi-Azamgarh Highway. The SHO of Cholapur P.S. arrived and the workers were lathi-charged quite mercilessly. About 50 people including approximately 10 women were badly hurt. Heerawati, who was pregnant, was also hurt. The SHO took 20 people and 50 bicycles with him to the police station and the workers were released on personal bonds. When asked as to what action he would take against the VDO for violating the legal rights of workers under NREGA by not paying the wages, the SHO said he was merely following the orders from the higher ups. He refused to reveal the name of the officer who had ordered lathi charge. The next day, wages at the rate of Rs. 42 per day were transferred into the accounts of the labourers.
The repression of workers is now emerging as a trend. The political ruling class has decided to deal with the demands being raised by workers for their legal rights strongly. The workers will be punished. The ruling elites realise that these demands ultimately will lead to a clamour for a more equitable society and wider and deeper participation of workers in the decision making process in our democracy. They do not want to give away this power easily. The above-mentioned incidents also indicate that the workers are now getting better organised than before. NREGA has at least helped achieve that. We hope that the problems of workers will be resolved within the constitutional framework peacefully and will lead to further democratisation of society and government.
Arundhati Dhuru & Dr Sandeep Pandey
[
[Dr Sandeep Pandey is a Ramon Magsaysay Awardee (2002) for
emergent leadership, member of National Presidium, People's Politics Front (PPF), heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at: ashaashram@yahoo.com. Website: www.citizen-news.org][Published in THE HINDU, 5 April 2009]
Diagnosing the doctor
[Published in THE TEHELKA, 3 April 2009]
Dr. Manmohan Singh has survived a full five year term in office as PM, which itself is an achievement in the post-Indira Gandhi era of coalition politics. It is a different matter that he jettisoned a more respectable and ideologically sound support from the Left Front in exchange for an opportunistic support from the Samajwadi Party on the issue of Indo-US Nuclear Deal when he was facing a confidence motion in Parliament last year. For him the Deal was a prestige issue and defending it he was his most assertive self, a rare sight, even launching a frontal attack on L.K. Advani for his role in supervising the Babri Masjid demolition.
Dr. Manmohan Singh will be remembered as the harbinger of neo-liberal economic policies of liberalization- privatization-globalization in this country first as Finance Secretary, then as Finance Minister and finally as the PM. However, it is ironical that towards the end of his term as PM he is abdicating his responsibility towards the desired results of these policies, even though his Party is desperately trying to project these policies as success by launching the ‘Jai Ho’ campaign. But isn’t ‘Jai Ho’ just another name for ‘India Shining?’ Actually, he gave indications of his shaking confidence in these policies in two meetings of CII, much before the global recession set in abroad and Satyam happened at home, by making utterances which scandalized the corporate barons of this country. He suggested that CEOs must consider placing voluntary ceilings on their salaries. He said that the gap between the rich and poor would produce social unrest. He said that for an unemployed youth a 9% growth rate didn’t mean anything. He added that CEOs must not treat their wealth for personal consumption only but should consider using it for general good of society. He invoked the much forgotten ‘trusteeship principle’ of Mahatma Gandhi, which probably no politician in independent India has ever mentioned. Now, these thoughts would make a very sound policy if the objective was to create a humane and equitable society instead of elevating the growth rate. But coming from Manmohan Singh, these appeared out of place. He probably didn’t take them seriously either. It was more of a frustration on account of his inability to control farmer suicides in spite of maintaining a very good growth rate of the overall economy. His abovementioned statements go against the basic training that he has got as an economist and probably his colleagues Montek Singh Ahluwalia and P. Chidambram, who were with him in implementing the LPG policies, wouldn’t endorse these utopian ideas. Nevertheless, any economist would agree that the effect of neo-liberal policies has been the widening gap between the rich and poor. In fact, before the Mumbai attack, Manmohan Singh has said more than once that naxalism is a bigger threat to India than terrorism.
Dr. Manmohan Singh failed to prevent the spread of either naxalism or terrorism. His government’s policy of using brute force to crush these forces has produced backlash. Irom Sharmila continues to fast in her ninth year in custody at the Jawaharlal Nehru Hospital in Imphal demanding the repeal of Armed Forces Special Powers Act. She came to New Delhi in 2006 but there was no positive response from the government. The government doesn’t know how to deal with people who take up arms and it doesn’t know how to deal with the most imaginable form of peaceful protest. It goofs up by keeping Dr. Binayak Sen in jail as a naxalite sympathizer, without any concrete evidence against him and denying him bail. On the other hand convicted persons like Navjot Singh Sidhu, Shibu Soren and Sanjay Dutt have no problem in pursuing their political goals.
By continuing to support the American policy of war against terror in addition to the economic policies of LPG, Manmohan Singh has helped the difference between the BJP and Congress Party disappear. The post-Mumbai response of the government appeared to be to deny the plank of terrorism to BJP in the forthcoming elections. Its tough stand against the civilian Pakistani government forced the Pakistani politicians to retract from their initial cooperative response and stalled the Indo-Pak peace process, an area in which Manmohan Singh probably made the most significant contribution along with Musharraf. The resumption of Srinagar-Muzaffarabad bus service in 2005 and opening of various trade routes produced a thaw in relationship. We also learn that the two governments were on the verge of a solution on Kashmir which was arrived at taking into confidence the Hurriyat. Manmohan Singh was able to achieve so much, as no PM in the past, possibly because his heart ruled over the traditional bureaucratic-military thinking in this matter. This is also probably the only area where he took decisions as an ordinary human being, his family affected by partition like that of Musharraf, instead of as a modern trained expert.
But he has compromised India ’s sovereignty by signing the Indo-US nuclear deal. His own planning commission doesn’t think that nuclear energy has a future. He was an ardent supporter of renewable sources of energy, like any right thinking individual, until he got invited to Washington DC in 2005. He became ambitious by the encouragement received from George Bush and possibly saw India ’s destiny as a great world power in this cooperation. By agreeing to become the junior military ally of the US and Israel , he reversed the policy of Nehru-Shashtri-Indira-Rajiv of maintaining a respectable distance from the US and being the leader of Non-Aligned Movement. Eager to sign the deal with US, he lost out not only on Iran but also on Myanmar . India was hoping that by stopping to support the cause of Aung San Sui Kyi, Myanmar might consider giving its gas to it. This would have made it easier for it to turn down the Iranian offer and hence please the US . In the end Myanmar gave its gas to China and India lost face on the issue of support to pro-democracy movement in Myanmar . Manmohan Singh has demolished the peace loving sovereign supporter of the people of third world image of India and made it the target of Islamic fundamentalists. His government couldn’t control the terrorist incidents in the country and his police continued to implicate innocent Muslim youth thereby producing further alienation among Muslims. The Batla House encounter will remain a blot on his government, on which in spite of widespread demands for a judicial enquiry, including from within his own Party, ultimately nothing happened. It was his bad luck that just when the Maharashtra ATS was beginning to unravel the Hindu terror network, attack on Mumbai took place, which compounded matters further.
The coming generations of democratic India will remember the Manmohan Singh government for RTIA and NREGA, two of the most pro-people Acts legislated so far in independent India . Sonia Gandhi probably deserves the credit for these more than the PM. Manmohan Singh was supportive of the attempts to scuttle the RTI Act in the name of making amendments until Sonia Gandhi intervened again. But these two Acts will have the same transformative effect on governance as probably the implementation of Mandal Commission report had had on the politics of this country, even though presently the bureaucracy, the judiciary and the ruling class with vested interests are working overtime to kill the spirit of these Acts. The RTI and the social audit provision in NREGA have opened a window for the common citizen where she can participate in the democratic system rather than merely be a voter once in five years and a mute spectator in between two elections.
Dr Sandeep Pandey
(The author is a Ramon Magsaysay Awardee (2002) for emergent leadership, member of National Presidium, People's Politics Front (PPF), heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at: ashaashram@yahoo.com. Website: www.citizen-news.org)
Published in THE TEHELKA, 3 April 2009
Will IMF deliver G-20's booster for world economy?
Earlier this week the Group of Twenty leaders announced a USD 1.1 trillion booster-dose into the world economy by the end of 2010 through multilateral institutions like the International Monetary Fund (IMF). However, in July 2008, analysts from Cambridge and Yale Universities had reported that tuberculosis (TB) in countries with IMF loans rose sharply.
The strict conditions on IMF loans were blamed for thousands of extra TB deaths in Eastern Europe, and former Soviet republics. A UK TB charity backed the Public Library of Science (PLoS) study findings - but the IMF had firmly rejected them, as per a BBC news (July 2008).
David Stuckler from Cambridge University had said to BBC in July 2008 that "If we really want to create sustainable economic growth, we need first to ensure that we have taken care of people's most basic health needs."
Most alarming was when the levels of drug-resistant TB shot up in eastern Europe and former soviet union.
The BBC news further said that "in recent years, it [IMF] has offered assistance to 21 countries in the region, in the form of loans offered in exchange for the meeting of strict economic targets. The researchers claimed it was efforts to meet these targets that were undermining the fight against TB by drawing funding away from public health."
Most striking was the analysis in BBC news that "without the IMF loans, they suggested, rates would have fallen by up to 10%, meaning at least 100,000 extra deaths. Countries which accepted IMF loans averaged an 8% fall in government spending, a 7% drop in the number of doctors per head of population, and a fall in a method of TB treatment called "directly observed therapy", which is recommended by the World Health Organisation."
It is not surprising that healthcare doesn’t get the mandate at forums like G-20 in the manner in which it should. Before the G-20 began, there was a growing public movement globally to put pressure on G-20 countries to put a currency transaction levy of 0.005% to raise dedicated resources for funding health programmes. This currency transaction levy of 0.005% can potentially generate USD 30-40 billion a year.
It is vital to understand the health funding in these times of global economic meltdown. The single largest donor of AIDS, TB and Malaria programmes globally - the Global Fund to fight AIDS, TB and Malaria (GFATM) has just 37.5% of its estimated budget for 2009-2010. The donor countries haven’t kept their promises to fund the 'Fund'. The GFATM projected budget for 2009-2010 was USD 8 billion and it just has USD 3 billion in its kitty, falling short of USD 5 billion.
The donor countries that haven’t kept their promises include the United States of America that is also the biggest defaulter. It is not that US doesn’t have money, it gave about the same amount it owed to GFATM to Merrill Lynch as bail out money. It gave hundreds of times more to other private banks as bail out money. The banks distributed this amount amongst themselves as 'holiday bonuses'.
Another example comes from one of the most severely TB-HIV hard-hit regions - Africa. Despite of African governments declaring TB as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global Plan to Stop TB by 2015.
The countries in Africa had achieved a milestone by endorsing the African Union Abuja pledge of allocating 15% of national budgets to health but they have bitterly failed to act on this pledge. Only Botswana has kept the promise of allocating 15% of the national budget to health, the rest of the countries in Africa need to keep their promises.
As per a report of the World Bank and Stop TB Partnership (December 2007), high-burden TB countries are likely to recover 9-15 times of their investment in TB control. This report indicates that the economic cost of not treating TB to Africa between 2006 and 2015 would be USD 519 billion while TB can be controlled with USD 20 billion in the same period.
It is clear that despite evidence, health is not perceived as a smart investment. Possibly imposing currency transaction levy of 0.005% can generate a pool of dedicated financial resources to strengthen health systems globally.
It is high time to be clear on what kind of a development we want for the world - a model which serves the capital interests of corporations or a model which serves the most basic needs for all, including that of healthcare?
One good analysis which further highlights this debate is from India. The Indian Prime Minister Dr Manmohan Singh gave indications of his shaking confidence in neo-liberal economic policies of liberalization- privatization-globalization in India in two meetings of Confederation of Indian Industries (CII). "He suggested that CEOs must consider placing voluntary ceilings on their salaries. He said that the gap between the rich and poor would produce social unrest. He said that for an unemployed youth a 9% growth rate didn’t mean anything. He added that CEOs must not treat their wealth for personal consumption only but should consider using it for general good of society. He invoked the much forgotten ‘trusteeship principle’ of Mahatma Gandhi, which probably no politician in independent India has ever mentioned. Now, these thoughts would make a very sound policy if the objective was to create a humane and equitable society instead of elevating the growth rate" said Dr Sandeep Pandey, Ramon Magsaysay Awardee (2002) and a National Alliance of People's Movements (NAPM) leader.
Are G-20 leaders listening?
- Bobby Ramakant
Activists reject capitalist, communal, criminal and corrupt politics
The activists have launched a 'chunaav par nazar' abhiyaan to reject politics which is based on capitalism, communalism, caste, corruption or criminalization.
The National Alliance of People's Movements (NAPM) has launched this 'chunaav par nazar' abhiyaan to mobilize public opinion to increase transparency and accountability in the forthcoming 15th Lok Sabha elections in India.
Election dates for the 15th Lok Sabha have been announced and there is again a huge challenge before us to ensure that the real issues of people are buried by political rhetoric. All the existing and newly forming political fronts, if anything, have a most striking similarity with amoebas - whether it is the 1st Front or the 4th Front. It is impossible for people to grasp where a front stands either on issues or vis-à-vis other parties/fronts, whether they are independent fronts or fronts within fronts! Whatever little difference did exist between so-called 'communal and secular' parties or 'capitalist and socialist' parties is visibly diminishing day-by-day.
It is, therefore, highly important, for us, people's movements and organizations to raise basic and burning issues on the one hand as well as enable an opportunity to link up local and regional issues and struggles with the national.
During the Meeting of the National Conveners of NAPM held at Nagpur on the 1st and 2nd March, we had discussed our role during the upcoming Lok Sabha elections. We decided to organize the preparatory meetings at the earliest, as the poll dates are nearing and this process must be taken forward on a war-footing. The following key issues are being discusses during the state meet:
- Compliance with the Model Code of Conduct (MCC) for candidates and political parties as defined by the Election Commission of India.
- Analyse the records of the present member of parliaments (MPs) by trying to identify MPs with criminal record, involvement in corrupt practices, involvement with casteist and communal organizations, working as the frontman of any corporate or builder group and bring these facts into the public domain.
- Monitoring the existing property of candidates, income, the number of vehicles, amounts spent on literature, campaign material, advertising and other propaganda.
- Group/ State Unit should prepare the list of general malpractices during elections such as distribution of cash, kind, liquor, booth capturing, delivering communal/ casteist speeches, rigging of votes, making false promises or allurements etc. It may be re-stressed that after announcement of elections, no declaration of new schemes can be made by the state/ central Government ministries or politicians.
- Use the right to information Act (RTI) extensively to find out how many complaints were received during the last Assembly/ Parliamentary elections and the action taken on the complaints.
- Prepare a format to make complaints to the Returning Officer of the Lok Sabha constituency: Election Observer, State Election Commissioner (SEC) Member-in-charge of the State from the Election Commission of India, Delhi and also the Superintendent of Police of the District
- Bring together a state level Committee to observe elections and distribute work amongst the Committee.
- You may send a list of the NAPM Election Observers (from each state) to the Election Commission of India along with a letter to the State Election Commission for associating these persons in the election monitoring process to ensure free and fair elections. A delegation of the NAPM (State) Election Monitoring Committee can meet the SEC and maintain regular communication with him.
Methodology during the pro-people election watch campaign:
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i. Details of the announced candidates of various political parties must be compiled.
ii. Fixing up of a date with the candidates for open discussion with the electorate (Try to call the candidate for a public meeting in the area). Obtain the oral and written commitment of candidates on specific laws and policies/issues.
iii. Prepare few people with questions about the common problems issues and problems like: displacement and rehabilitation, social security to unorganized sector workers, right to housing, water, unemployment, need for health services, schools, public rationing, better public transport, commitment to ban liquor etc.
iv. Prepare a list of speakers who will address the gathering on behalf of NAPM after the Q&A Session is over with candidates.
v. We request people's groups in the state to send us a brief summary of national as well as local/ regional issues that must highlighted during the campaign at the meeting in your area, along with soft copies of the manifestos of the parties contesting elections there.
vi. Prepare a note for need of the various electoral reforms on behalf of NAPM state unit. Nationally, identify at least 10-15 candidates / black list them to demonstrate what kind of politics we reject. (Politicians like Kamal Nath, LK Advani, Rajnath Singh, Sharad Pawar and others are to be questioned – add to the names please)
vii. NAPM has its People's Resolve, which is more or less the NAPM manifesto which needs to be publicized and presented during our aforesaid programmes and meetings. Any of you can propose or add anything specific to the Manifesto and use it in the meetings / dialogues. Please do send your suggestions to the below mentioned emails.
'chunaav par nazar' yatra
At least one major city / capital is planned to be covered in different states, which shall include a meeting with representatives of people's organizations, a press conference and a public meeting.
We also propose to organize a travelling poster exhibition and also have documents already prepared by Election Watch plus comparative analysis of party manifestoes (2004 and 2009) along with a People's Manifesto by NAPM. The posters would also contain data on various unlawful and unethical antecedents of candidates/ parties.
We will have with us at different places, former Advisor to the Election Commission of India, Shri K. Jagannatha Rao, along with mass-based people's representatives, thinkers and conscience-keepers such as you to address the mass gathering of people and also the press, which certainly create a positive impact.
Justice (Retd.) Rajinder Sacher, Trilochan Sastry, Association for Democratic Reforms, Sharad Chadra Behar, Former Chief Secretary, Govt. of Madhya Pradesh, Prof. Ramdayal Munda, Senior adivasi rights activists, Former Vice Chancellor, Birsa Munda University, Ranchi ,Meher Engineer (West Bengal) President, Indian Social Science Academy,Prof. Amit Bhaduri, Economist and supporter of people's movements, Ulka Mahajan, Sarvahara Jan Andolan and NAPM , Arvind Kejriwal, Right to Information Activist, Parivartan, Gautam Bandopadhyay, Nadi Ghati Morcha, Medha Patkar, National Convenor, NAPM and some other Convenors and Members of NAPM have confirmed their presence at different places. Other special invites are yet to finalize.
It would undoubtedly strengthen the process if you can join this effort from one or two places at least and raise the people's agenda before the elections. It would also greatly help, if you can in whatever way, try to mobilize resources for the campaign, which would include travel expenses, amounts for stationery and poster material etc.
Attached with this Note is a tentative schedule of the list of cities / places to be covered in the coming few weeks of April before the Phase I of the Lok Sabha Elections. We look forward to your support and involvement.
Anand Mazgaonkar: anandpss@gmail.com; napmindia@gmail.com
Medha Patkar: phone - 09423965153 (nba.medha@gmail.com)
ELECTIONS 2009: Lok Rajniti Manch to field 3 candidates in UP
Lok Rajniti Manch to field 3 candidates in UP
The Lok Rajniti Manch has decided to field S.R. Darapuri from the Lucknow Lok Sabha constituency in the approaching general elections as part of its efforts to establish a pro-people politics. Darapuri, an IPS officer, retired as Inspector General of Police from the UP cadre and is a prominent social and human rights activist. He is part of the people's movements aimed at empowerment of common people. During service he was regarded as an honest and diligent officer.
Lok Rajniti Manch desires to build a new political culture which will be an alternative to the dominant money and muscle powered politics, which will bring the common people's issues to the core of politics, where the candidates will have a history of serving the people, where the politicians will not require armed security, where the candidates will strictly follow the code of conduct set up by Election Commission, where the election expenses will be made public and where the candidate will conduct himself/herself in a transparent manner and will be accountable to the people. The candidate irrespective of the result of the election will continue to serve the people.
This is a small beginning to challenge the stranglehold of crime and corruption over politics. We know that this is a long battle but we are into it for a long haul. The people, sooner or latter, will reject the corrupt and criminal candidates and elect honest and committed ones.
Until the dominant criminal and corrupt political culture is not challenged the true democracy can never be realized because the benefits of various social welfare and developmental schemes will never reach the people. To eliminate the conditions of poverty, unemployment, destitution, exploitation, crime from this society a new political culture will have to be nurtured which will build a pro-people alternative to the present anti-people system. This is India 's second freedom struggle. The majority population of the country which is yet to taste the benefits of freedom will wage this battle.
With Darapuri's joining the election fray now the LRM has three candidates from Uttar Pradesh in the forthcoming elections for the Lok Sabha. Ram Sagar Verma is contesting from the Mishrikh reserved seat and Ram Naumi Yadav is the candidate from Salempur in eastern part of the state. Overall, about a dozen LRM candidates will be contesting natioanally.
Dr Sandeep Pandey
(The author is a Ramon Magsaysay Awardee (2002) for emergent leadership, member of National Presidium, People's Politics Front (PPF), heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at: ashaashram@yahoo.com. Website: www.citizen-news.org)
Contact mobile numbers of three Lok Rajniti Manch candidates from U.P.
(1) Ram Sagar Verma, Mishrikh, 9450503639
(2) Ram Naumi Yadav, Salempur, 9918631076
(3) S.R. Darapuri, Lucknow , 9415164845, srdarapuri@yahoo. co.in
If G-20 agrees, health financing might come from Currency transaction levy
There is a growing public movement globally to put pressure on the Group of Twenty (G-20) Finance Ministers and Central Bank Governors that will meet in London, UK, on 2 April 2009, to put a currency transaction levy of 0.005% to raise dedicated resources for funding health programmes. This currency transaction levy of 0.005% can potentially generate USD 30-40 billion a year.

It is vital to understand the health funding in these times of global economic meltdown. The single largest donor of AIDS, TB and Malaria programmes globally - the Global Fund to fight AIDS, TB and Malaria (GFATM) has just 37.5% of its estimated budget for 2009-2010. The donor countries haven’t kept their promises to fund the 'Fund'. The GFATM projected budget for 2009-2010 was USD 8 billion and it just has USD 3 billion in its kitty, falling short of USD 5 billion.
The donor countries that haven’t kept their promises include the United States of America that is also the biggest defaulter. It is not that US doesn’t have money, it gave about the same amount it owed to GFATM to Merrill Lynch as bail out money. It gave hundreds of times more to other private banks as bail out money. This was tax payers money of the people - which was handed over to the banks. The banks distributed this amount amongst themselves as 'holiday bonuses'. Outrageous? May be, but possibly the health advocates didn’t do a good job of convincing the policy makers that health investment is a smart investment, with promising returns.
Despite of African governments declaring tuberculosis (TB) as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global Plan to Stop TB by 2015. This fact came in spotlight when the TB funding in Africa required to meet the TB-related targets of millennium development goals (MDG) by 2015 was analyzed, said Kenyan activist Lucy Chesire.
The countries in Africa had achieved a milestone by endorsing the African Union Abuja pledge of allocating 15% of national budgets to health, which was also reiterated at the 2008 African Union Summit in Egypt, the 2008 Conference of African Finance Ministers, and 2008 Special Conference of African Health Ministers. But they have bitterly failed to act on this pledge, said the activists. Only Botswana has kept the promise of allocating 15% of the national budget to health, the rest of the countries in Africa need to keep their promises.
"The current global economic crisis is all the more reason why high burden TB countries in Africa should invest in TB control. As per a report of World Bank and Stop TB Partnership (December 2007), high-burden TB countries are likely to recover 9-15 times of their investment in TB control" said Mayowa Joel of Nigeria. This report indicates that the economic cost of not treating TB to Africa between 2006 and 2015 would be USD 519 billion while TB can be controlled with USD 20 billion in the same period.
It is clear that health is not considered as a smart investment. Possibly imposing currency transaction levy of 0.005% can generate a pool of dedicated financial resources to strengthen health systems globally.
Trading volume in the foreign exchange (FX) market has now topped USD 1000 trillion a year. In this financial crisis, unlike most other areas of the finance industry, the FX market is still growing. This provides a very solid base from which the currency transaction levy can produce a sustainable and substantial income stream. As well, the market is fully electronic. Collection would be computerised with payment automatic every time a currency trade is settled. Thus it is efficient and inexpensive to implement with little scope for avoidance.
The proposed rate of 0.005% is too small to alter decision making in the FX market and yet high enough to yield a sizeable revenue stream. In recent work for the UN University, Professor Rodney Schmidt undertook the most detailed econometric modeling to date, showing this rate is too low to affect market structure whilst at the same time producing potential revenue of the order of USD 30-40 billion a year.
There are mechanisms like the currency transaction levy that have proven to work. Like the UNITAID. In 2006, France, Brazil, Chile, Norway and the United Kingdom decided to create an international drug purchase facility called UNITAID to be financed with sustainable, predictable resources. As an economically neutral tool the tax on air tickets was considered as the most suitable instrument. This mechanism seeks to fill a critical gap in the global health financing scenario: the need for sustained strategic market intervention to drive price reduction and increases in supply.
Potentially the currency transaction levy can radically change the global health financing landscape and bring in more sustainability but the world - for now the G-20 countries - need to be covninced why health financing is a smart investment.
- Bobby Ramakant
People with drug-resistant tuberculosis are neglected by governments
The countries that report high burden of tuberculosis (TB), particularly, drug-resistant strains of TB, are the ones not moving fast enough to provide life saving treatment. According to the International medical humanitarian organization, Medecins Sans Frontieres (MSF) or doctors without borders, less than one percent of those with multi-drug resistant TB (MDR-TB) get access to proper treatment as per the International standards of treatment and care guidelines of World Health Organization (WHO). Even the Stop TB Partnership agrees that about three per cent of those with MDR-TB might be receiving proper treatment.
"Only 3% of people who have MDR-TB have access to effective treatment. We have compelling evidence that we know how to prevent and treat MDR-TB and treatment success rate is 80% in low resource setting. Its intervention is complex but is effective, feasible and is cost-effective" stressed said Dr Ernesto Jaramillo, Medical Officer, Stop TB Department, World Health Organization (WHO) at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil.
Dr Mario Raviglione, Director of the WHO's Stop TB department, said that "the WHO Global Tuberculosis Control Report 2009 confirms the notion that there might be more than half a million MDR-TB cases every year. 54 countries have reported extensively drug-resistant TB (XDR-TB) to us."
As ministers from high-burden multi- and extensively- drug-resistant TB (M/XDR-TB) countries gather from 1-3 April 2009 in Beijing, China, for a high-level ministerial meeting on M/XDR-TB, MSF calls on them to commit to treating more people with MDR-TB, and to conducting necessary research to improve current treatment options.
The WHO reports that there are more than 500,000 new MDR-TB cases each year, but that under 30,000 people were detected and notified last year and only 3,681 are known to have started treatment according to international guidelines and with quality-assured medicines.
“The slow progress in treating people with MDR-TB is particularly striking because high-burden MDR-TB countries are definitely not the least developed in the world,” said Dr. Tido von Schoen-Angerer, Director of MSF’s Access to Essential Medicines Campaign. “They have the capacity to act, and need to make this a priority and put people on treatment.”
MSF is concerned that many countries, particularly those that are classified by WHO as ‘high-burden’, like China, South Africa or India, are not doing enough to provide treatment to patients in need. In addition, not providing appropriate treatment further contributes to the spread of drug-resistant TB.
China, for example, has a quarter of the world’s MDR-TB cases. Answering to an initial request made by the Chinese National TB Programme, MSF then failed to obtain the authorisation to provide care for MDR-TB patients in inner Mongolia, despite two years of negotiations with national, provincial and regional authorities. MSF has now abandoned its attempts to open the project.
“Not being able to act when there are people that need life-saving treatment is extremely frustrating,” said Meinie Nicolai, MSF Director of Operations. “Because we did not manage to reach an agreement, we could not put a single patient on treatment. And because they can’t get treated anywhere else, many people will have died while we were stalled in meetings these past two years.”
“Crucially, high-burden countries have the skills and some of the resources needed to conduct the research to improve MDR-TB treatment,” says Dr. von Schoen-Angerer. “The Beijing meeting is an opportunity for high-burden countries to take the lead in addressing this crisis, by setting targets to put more patients on treatment, by agreeing to import quality-assured drugs, and by establishing a joint research effort to improve existing treatment.”
In 2007, MSF treated 574 patients for MDR-TB in 12 projects including in South Africa, India, Uzbekistan, Georgia and Armenia.
According to the World Health Organization (WHO), the countries with the highest burden of MDR-TB are India (131,000 cases), China (112,000), Russia (43,000), South Africa (16,000) and Bangladesh (15,000).
The High Level Ministerial Meeting on M/XDR-TB is being organized by WHO, the Ministry of Health of the People's Republic of China and the Bill and Melinda Gates Foundation.
This meeting is likely to bring together health ministers and other stakeholders from 27 high M/XDR-TB burdened countries, including justice and science ministry delegations and representatives from international agencies, civil society, research communities and the corporate sector.
"We have been able to convince the ministers of health of 27 high burden M/XDR-TB countries to come to the Beijing meeting and commit to achieve the targets of the Global Plan to Stop TB" said Dr Ernesto Jaramillo, Medical Officer, Stop TB Department, WHO at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil.
"The 2nd Global Plan to Stop TB which was launched in 2006 had laid out specific targets for MDR-TB, to provide universal access to diagnosis and treatment of MDR-TB by year 2015" said Dr Jaramillo.
The 27 countries represented will be Armenia, Azerbaijan, Bangladesh, Belarus, Bulgaria, China, the Democratic Republic of Congo, Estonia, Ethiopia, Georgia, India, Indonesia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Myanmar, Nigeria, the Philippines, the Russian Federation, Pakistan, South Africa, Tajikistan, Ukraine, Uzbekistan and Viet Nam.
The highest levels of MDR-TB ever recorded were reported by WHO in its 'Anti-tuberculosis Drug Resistance in the World' report in February 2008 with nearly half a million new MDR-TB cases emerging worldwide. According to the new WHO report (Global Tuberculosis Control report 2009), the levels of multi-drug resistant TB might be more than half a million as previously thought.
The threat of MDR-TB and XDR-TB can be halted but few of the 27 high MDR-TB burdened countries have response plans in place. Many of these countries are not even properly equipped to diagnose drug-resistant TB.
"We need political commitment from the countries. The XDR-TB task force had met in April 2008 in order to assess the progress we had made in response to MDR-TB and XDR-TB. The Task Force came up with lot of positive things, major progress in many areas. However the number of people on treatment was far below the target. One of the clear recommendations coming out of the XDR-TB Task Force meeting was to convene a high level ministerial meeting where we can get ministers of countries responsible for the 85% of the global M/XDR-TB burden, to achieve the target of universal access to diagnosis and treatment of MDR-TB by 2015" explained Dr Jaramillo.
Countries with low resources are building their capacities to make things happen. Lesotho was able to make a state-of-the-art laboratory for diagnosis of MDR-TB in six months. "We have countries like Nepal, Philippines, Peru that despite of weakness in health systems are providing universal access to MDR-TB diagnosis and treatment" said Dr Jaramillo.
"So far the Green Light Committee (GLC) mechanism, which is an initiative of WHO, and has played an instrumental role in leading the response, began with only one country in the year 2000 - Philippines. Now 8 years later we have 58 countries that have 116 projects approved by GLC. However we have less than 20% of countries that are moving towards scale up country wide of these interventions" said Dr Jaramillo.
Dr Jaramillo expressed his concern that "Countries are not moving fast enough in order to prevent the death of 1000 people with MDR-TB every day."
Vice Premier of China, the Director-General of WHO and very likely that Bill Gates and ministers of health confirmed so far from 21 high burden M/XDR-TB countries will be taking part in the Beijing meeting opening next week.
"We are expecting that this will be a watershed meeting in response to M/XDR-TB" said Dr Jaramillo.
"After this meeting we will like to move towards a World Health Assembly (WHA) resolution. The resolution of WHA is powerful in the sense that countries really commit to do things. After the Beijing meeting, one month later, the Government of China has agreed to submit a proposal of a resolution to the WHA in order to accelerate the response to M/XDR-TB" shared Dr Jaramillo.
Investing in research is also necessary. Treating MDR-TB is complex, lengthy and involves the use of drugs that can cause severe side effects and are not optimally effective. There is therefore an urgent need to speed up the development of newer, better tests and drugs, and to conduct studies to optimise MDR-TB treatment.