Tuesday, December 16, 2008

The Acid Test For Indian Society

A week back three youngsters in their budding twenties poured acid on two unsuspecting girls causing serious third degree burns in Warangal in Andhra Pradesh, India. The reason for this heinous crime was one of the girls had spurned the overtures of one of the culprits. Both the girls are battling for life with one girl, doctors say may lose vision permanently and both the girls, if survive, will need multiple plastic surgeries. It is no wonder that the entire town came out in rallies and expressed sympathy for the girls. However, what was surprising was every section of the society, including the students, demanding the police to catch the suspects and encounter them which meant shooting them to death. Instant justice in this instant world ! A day later the three suspects were caught, interrogated, confession extracted, paraded before the media in the late evening and Lo and behold ! all the three suspects end up dead in the middle of the night on the outskirts of the town. The official version was police had taken them to a location where the suspects said they hid a stolen motorcycle but when they reached the spot, the suspects tried to attack the police and so were promptly shot to death. This usually is the standard official version for most of the deaths in the police shootouts. As news spread, there were celebrations in the town, people praising the police for swift action and awed college students pestering the police officers for autographs. Even in state capital, the educated elite were openly praising the police for this instant justice delivered. To my horror, even the state government released a statement that indirectly meant that any such acts will invite similar response. A few sane voices and their feeble protest at this form of delivering instant justice were drowned out in the cacophony of jubilation. We have been witnessing similar jubilation and approval across the country whenever such incidents take place. In the wake of sympathy on the plight of the girls and the hatred on the perpetrators of the crime, we seem to have forgotten that we are in a civil society governed by the laws of the land and judiciary. While it is true that many of our laws do not reflect the modern realities and need to be comprehensively changed, it is as reprehensible as the crime itself to eulogize custodial deaths. Instead of bringing pressure on the governments to amend the laws to make the punishments more stringent and revamp the judicial process for quick trials, we seem to have taken the easier option of condoning and even demanding instant justice. We should not for a moment forget that this makes every individual policeman, the investigator, the prosecutor, the judge, the jury and the executioner. Is any one person or a group capable of playing all these roles without bias.
Have we as a part of the civil society forgotten the brutal Bhagalpur blindings in 1980, where the police blinded about 30 undertrials with cycle spokes and then poured acid into the eyes. Most of them were petty thieves, waiting for the trial to commence. Can we condone the act in the name of instant justice since the case would have taken a long time to conclude in the usual process? Or for that matter, the police shooting of a business man to death last year in Delhi due to mistaken identity. It could be you and me tomorrow in the place of the businessman.
I ask those of you who have openly come out in support of the police shooting to death the three suspects, shall we as a society dispense with the judicial system altogether and give rights to the police to deliver instant justice. A thief can have his hands amputated, a person accused of murder can be hung to a lamp post and eve teasers stoned to death in public. There are societies where such forms of public punishments are in vogue. We call those states barbaric.
Despite the passing of the Protection of Human Rights Act in 1993 and establishing a National Human Rights Commission, incidents of police brutality continue to take place in various parts of the country. This is because of the silent approval of the public.
The acid test for the Indian society is whether in the near future it opts to pressurize governments to amend the laws and make punishments more stringent, revamp the judicial process for speedy trials, demand better policing methods and respect the Human Rights or continue to encourage models of instant justice. There will lie the answer to where as a nation we are headed.

Saturday, December 13, 2008

The Vampire Companies In Drug Trials

It was an innocuous small news item buried in the local pages of the Hyderabad based newspapers a few days back. The news was that a person undergoing drug trials complained of chest pain and died before he was shifted to a corporate hospital. Hardly any news, when in our country only double digit deaths find space on the front page. However, this is no ordinary death. The death is due to the plague that is the hallmark of a majority of Indian entrepreneurs. The plague of greed for money at any cost. At the cost of the lives of thousands of poor citizens of this country through clinical trials, which are outsourced by the giant global pharma and bio technology companies. A city based bio company has been conducting drug trials on this person, which the company spokesperson accepted and added he was a “Volunteer” who was administered a dose one day earlier, was put under observation for 24 hours and released. So he argued the reasons for the death of this “Volunteer” cannot be attributed to the drug trials. Shockingly, he also added that this “Volunteer” was also undergoing a drug trial for another company. As a spin doctor of the bio company, he should have known that the rules of the Central Drugs Standard Control Organization clearly forbid clinical trials of more than one drug in a span of 90 days on the same person. But that is only the Law and in this country it is the least respected, especially by the money-making class.

So what in essence are these drug trials, called as clinical trials? When a new drug is formulated in the research labs of the pharma companies, it needs to be extensively used on human beings to determine dosage, efficacy and after affects. In the US and Europe, trials for one drug costs anywhere from 100 to 150 million dollars because of the stringent conditions and high hospital costs. To save such a huge spending, these corporations have started outsourcing to Indian companies at one –tenth of the cost. Where on Earth can one find a nation with a deadly cocktail of half a billion people mired in rampant poverty and illiteracy, a plethora of diseases, two million private hospital beds , completely unethical and greedy entrepreneurs, lack of proper regulation, blatant corruption and a slipshod state machinery to enforce whatever little regulations are in force. So almost all the giant pharma . corporations have zeroed in on India. According to a Confederation of Indian Industry study, clinical trials in India in 2002 generated $70 million in revenues and reached $200 million by 2007. McKinsey estimates that by 2010, global pharma majors would spend around $1 billion for drug trials in the country.
How do the Indian clinical trial companies which grab the outsourcing deals conduct the clinical trials? The modus operandi is simple. Middle men sift through the records at the government hospitals to identify those with a particular disease or a combination of diseases. They are then filtered as per the need of the age / gender group. Since most of the visitors to the government hospitals are poorest of the poor, it becomes a cake walk for the middle men to cut a deal. For as little as 100 to 150 rupees a day!! The “Volunteers” are regularly monitored with changes in dosage. At prior defined periods, the “Volunteers” are examined for any symptoms of side effects and the progress of the disease. If there are indeed side effects, sometimes fatal, they are disposed off with a few thousand rupees. Since the law stipulates that drug trials can be conducted only on “Volunteers”, the illiterate “Volunteers” are made to sign /put thumb impressions on the declaration of volunteerism absolving the companies from any legal consequences. The poor “Volunteers” get a few thousand rupees each in a year and in most cases life time misery with side effects, the middlemen get a few lakhs each for supplying the “Volunteers” and the company profits by a few million dollars. The entire process or the findings need not be registered with or divulged to any regulatory body. Perfect, isn’t it?

What has happened as a stray incident in 2000 has become rampant today across India. In 2000, the use of a banned drug on unsuspecting poor cancer patients by the prestigious U.S. John Hopkins’ Hospital in collaboration with the Regional Cancer Treatment Centre in Kerala was exposed by the centre’s radiology head. Two patients died as a result of the drug trial. Bowing to the public demand, the Kerala Government requested Dr Parikh of the Tata Memorial Hospital in Mumbai to probe the incident. Dr Parikh collected documentary evidence of JHU releasing funds for the drug trials with the conscious knowledge of that drug having been banned by the US Food and Drug Administration. The drug was developed by a team of researchers of JHU's department of biology. This has forced the Indian Council of Medical Research (ICMR) to inquire into the trials. As usual, the results are still not public and no action has been taken against those responsible, where as the Johns Hopkins University barred the principal investigator from heading future research with human subjects. NGOs estimate that at any given point of time, clinical trials are being conducted for more than 100 new drugs in India involving thousands of “Volunteers” across multiple cities. They fear several of these drugs are either banned in the developed countries or new experimental component mixtures derived from the banned drugs.
Recently, India has made some regulatory attempts, amending its Drugs and Cosmetics Act to require compliance by trial conductors with a set of good clinical practices / guidelines along with the ethics committee that the ICMR formulated. But this is clearly not enough. The government should make registration of every drug trial compulsory, the findings to be divulged, mandatory compensation payment for those affected and strong penalties against the defaulting companies.

Till then, like vampires sucking blood out of the living, companies will continue to suck out profits from the misery of the Poor.

Sunday, December 07, 2008

Banner Anger

The anger against politicians for not taking the November 26th terrorists attack on Mumbai seriously was uniform across the country. Here are some of the banners giving a glimpse of the anger, mailed to me by one of my friends, Kali Krishna.