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CAPS Antiviral
• There are no vaccines currently licensed and available for use against any
coronavirus. Coronavirus vaccines for SARS and MERS have been technically
challenging to develop and have not made it out of clinical trials.1-3
• While scientists are researching a vaccine against the FICTIONAL CAPS virus, there
is currently no product in development.
• Development of a vaccine against the CAPS virus will likely take years to achieve.
The vaccine development process can take more than a decade.4 In pandemic
situations, the timeline for vaccine development could possibly be shortened, but
developing and manufacturing a vaccine against CAPS in time to control this
pandemic is unlikely.
• Vaccines against SARS or MERS coronaviruses would likely not be protective
against CAPS, because coronaviruses are prone to genetic reassortment; therefore,
a vaccine against one coronavirus is not cross protective against another
coronavirus.1,5
• Some experiments have raised the possibility that immunity incurred from certain
coronavirus vaccines can be short lived6,7 and that enhanced disease may result
from certain coronavirus vaccines.6-8 This has prompted some concern that
vaccines targeting coronaviruses (eg, MERS, SARS) could lead to adverse events.
Table 1: SARS and MERS Coronavirus Vaccine
and Therapy Trials Listed on ClinicalTrials.gov
Clinical Trial
Status SARS MERS
Vaccines Recruiting 0 19
Active 0 0
Completed 210,11 0
Withdrawn or
unknown status 212,13 0
Therapies Recruiting 0 1
14
or Active 0 0
Treatments Completed 0 315-17
Withdrawn or
unknown status 118 119
• Current supply chain mechanisms exist to distribute vaccines and other medical
countermeasures (MCMs) on a routine basis. However, a centralized and scalable
MCM distribution system for use during pandemics does not exist.
• Multiple systems and stakeholders can facilitate MCM distribution in smaller scale
public health emergencies and could be either scaled up or provide lessons for a
pandemic context. These include:
o The International Coordinating Group on Vaccine Provision (ICG),20 a
coordinating group of key global health stakeholders, including the World
Health Organization (WHO), UNICEF, Médecins Sans Frontières (MSF), and
the International Federation of the Red Cross. The goal of this group is to
handle the allocation of particular vaccine stockpiles for specific diseases
(cholera, meningococcal meningitis, yellow fever).
o WHO also has stockpiles for other diseases, including smallpox and
pandemic influenza.21
o WHO Contingency Fund for Emergencies22
§ Can release initial funds up to $500K in 24 hours
§ Serves as the potential source of funds for initial emergency response
if properly funded
o The US President’s Emergency Plan for AIDS Relief (PEPFAR) is a US-funded
program to control the HIV/AIDS epidemic and is the largest effort by any
one nation to control a disease.23 PEPFAR funds programs aimed at
expanding access to HIV treatments and prevention services in low-income
settings.23,24
o Gavi, the Vaccine Alliance, procures vaccines for low-income countries for
selected routine and emergency immunization. For example, the
organization procured $300 million for Ebola vaccines during the 2014-2016
Ebola outbreak.25
• Challenges with ensuring equitable access to and distribution of MCMs have been
encountered in the past. Countries have withheld sharing samples in an effort to
secure access to MCMs.26,27
10. National Institutes of Health. Phase I Study of a Vaccine for Severe Acute Respiratory Syndrome
(SARS). ClinicalTrials.gov. Updated July 2, 2017.
https://clinicaltrials.gov/ct2/show/NCT00099463. Accessed October 8, 2019.
11. National Institutes of Health. Study of Alferon® LDO (Low Dose Oral) in Normal Volunteers.
ClinicalTrials.gov. Updated April 17, 2013. https://clinicaltrials.gov/ct2/show/NCT00215826.
Accessed October 8, 2019.
12. National Institutes of Health. SARS Coronavirus Vaccine (SARS-CoV). ClinicalTrials.gov. Updated
December 3, 2012. https://clinicaltrials.gov/ct2/show/NCT00533741. Accessed October 8,
2019.
13. National Institutes of Health. Phase I Dose Escalation SARS-CoV Recombinant S Protein, With
and Without Adjuvant, Vaccine Study. ClinicalTrials.gov. Updated February 15, 2013.
https://clinicaltrials.gov/ct2/show/NCT01376765. Accessed October 8, 2019.
14. National Institutes of Health. MERS-CoV Infection Treated with a Combination of Lopinavir
/Ritonavir and Interferon Beta-1b. ClinicalTrials.gov. Updated March 7, 2019.
https://clinicaltrials.gov/ct2/show/NCT02845843. Accessed October 8, 2019.
15. National Institutes of Health. Safety, Tolerability, and Pharmacokinetics of SAB-301 in Healthy
Adults. ClinicalTrials.gov. Updated June 12, 2018.
https://clinicaltrials.gov/ct2/show/NCT02788188. Accessed October 8, 2019.
16. National Institutes of Health. Safety, Tolerability and Immunogenicity of Vaccine Candidate
MVA-MERS-S. ClinicalTrials.gov. Updated October 2, 2019.
https://clinicaltrials.gov/ct2/show/NCT03615911. Accessed October 8, 2019.
17. National Institutes of Health. A Safety, Tolerability, Pharmacokinetics and Immunogenicity Trial
of Co-administered MERS-CoV Antibodies REGN3048 and REGN3051. ClinicalTrials.gov.
Updated February 1, 2019. https://clinicaltrials.gov/ct2/show/NCT03301090. Accessed
October 8, 2019.
18. National Institutes of Health. A Multi-centre, Double-blinded, Randomized, Placebo-controlled
Trial on the Efficacy and Safety of Lopinavir/Ritonavir Plus Ribavirin in the Treatment of Severe
Acute Respiratory Syndrome. ClinicalTrials.gov. Updated August 22, 2013.
https://clinicaltrials.gov/ct2/show/NCT00578825. Accessed October 8, 2019.
19. National Institutes of Health. Anti-MERS-CoV Convalescent Plasma Therapy. ClinicalTrials.gov.
Updated November 21, 2018. https://clinicaltrials.gov/ct2/show/NCT02190799. Accessed
October 8, 2019.
20. World Health Organization. International Coordinating Group (ICG) on Vaccine Provision. April
3, 2019. http://www.who.int/csr/disease/icg/en/. Accessed October 8, 2019.
21. Yen C, Hyde TB, Costa AJ, et al. The development of global vaccine stockpiles. Lancet Infect Dis
2015;15(3):340-347.
22. World Health Organization. Enabling Quick Action to Save Lives: Contingency Fund for
Emergencies. 2018. http://origin.who.int/emergencies/funding/contributions/cfe-impact-
report-web2018.pdf. Accessed October 14, 2019.
23. US Department of State. About Us – PEPFAR. https://www.state.gov/about-us-pepfar/.
Accessed October 9, 2019.
24. US Department of State. PEPFAR 2018 Progress Report: PEPFAR Strategy for Accelerating
HIV/AIDS Epidemic Control (2017-2020). https://www.state.gov/wp-
content/uploads/2019/08/2018-PEPFAR-Strategy-Progress-Report.pdf. Accessed October 14,
2019.
25. Gavi. Gavi commits to purchasing Ebola vaccine for affected countries. December 11, 2014.
https://www.gavi.org/library/news/press-releases/2014/gavi-commits-to-purchasing-ebola-
vaccine-for-affected-countries/. Accessed October 8, 2019.
26. Baumgaertner E. China has withheld samples of a dangerous flu virus. New York Times August
27, 2018. https://www.nytimes.com/2018/08/27/health/china-flu-virus-samples.html.
Accessed October 8, 2019.
27. CIDRAP. Roos R. Indonesia details reasons for withholding H5N1 viruses. CIDRAP July 15, 2008.
http://www.cidrap.umn.edu/news-perspective/2008/07/indonesia-details-reasons-
withholding-h5n1-viruses. Accessed October 8, 2019.
28. Pronker ES, Weenen TC, Commandeur HR, Osterhaus AD, Claassen HJ. The gold industry
standard for risk and cost of drug and vaccine development revisited. Vaccine
2011;29(35):5846-5849. d
29. Adalja AA, Watson M, Cicero A, Inglesby T. Vaccine Platforms: State of the Field and Looming
Challenges. Johns Hopkins Center for Health Security. 2019.
http://www.centerforhealthsecurity.org/our-work/publications/vaccine-platforms-state-of-
the-field-and-looming-challenges. Accessed October 14, 2019.
FINANCE IN A PANDEMIC
Prepared by Richard Bruns
There are several major sources of money that would become available to help respond to
a global catastrophic pandemic.
Pandemic Emergency Financing Facility
The World Bank Group’s Pandemic Emergency Financing Facility (PEF) is a system
designed to respond to specific types of pandemics. It consists of a cash window and an
insurance window.1 The cash window had about $50 million, all of which has been used to
support the response to the ongoing Ebola epidemic in the Democratic Republic of the
Congo.
The insurance window is funded by 2 tranches of catastrophe bonds that pay out under
specified conditions. A coronavirus pandemic would trigger a payout of the Class B notes
after all of the following conditions were met: It kills at least 250 people, lasts at least 12
weeks, has at least 250 new cases in the past 12 weeks, has an increasing average number
of new cases over the past 12 weeks, and kills at least 20 people in a second country. The
payout is based on the number of deaths and the geographic spread of the disease. A
coronavirus pandemic that killed more than 2,500 people would trigger a full payout of the
Class B notes, raising $95 million. It would also trigger a 16.67% payout of the Class A
notes, raising an additional $37.5 million. A full payout of the Class A notes is triggered only
by an influenza pandemic.2
World Bank’s IDA Crisis Response Window
IDA (International Development Association) is the part of the World Bank that gives loans
(called “credits”) to poor countries for development. They meet every 3 years to raise
money and decide how it will be spent. These are called Replenishment meetings. The last
one, the 18th Replenishment, or IDA18, finished in 2016. It raised $75 billion to finance
projects from July 1, 2017, to June 30, 2020. The next meeting in this cycle is October 21-
22, 2019, in Washington, DC.3
Most IDA money is used for long-term development projects, but the Crisis Response
Window (CRW) is a special pool of money devoted to helping countries respond to
disasters. It spent $420 million to fight the 2014-2016 West Africa Ebola epidemic. The
IDA18 replenishment raised $3 billion for crisis response and, as of October 2018, $2.6
billion was still unspent and available for immediate use.4
International Monetary Fund
The IMF has about $1 trillion available to lend.5 However, this is meant to address
temporary issues with a country’s balance of payments and is not intended to be a form of
development aid or response to a health emergency. Lending is usually conditional on
economic policy changes, made after a period of negotiation, and will be made only if the
IMF is confident that it will be repaid.6 Without a significant change in policy, many
countries would not be willing or able to borrow money from the IMF in order to finance a
response to a major pandemic.
National Governments
Total international development aid from governments is about $200 billion per year.7
Although much of this is allocated to specific uses and could not be redirected, some
percentage of it could be made available in a catastrophic pandemic, and/or the total
amount might be increased, if there was sufficient global coordination.
Private Charity
Several financial events and estimates are depicted in the Event 201 exercise. These
represent one possible scenario that could happen in a catastrophic pandemic.
Amount of Money Raised
In the scenario, there is a large and successful mobilization of funds. Donor countries are
convinced to contribute roughly 40% of their annual aid budgets to CAPS response, for $80
billion, and private charities spend down some of their endowments to contribute an
additional $20 billion, for a total of roughly $100 billion in additional financing.
Cost of Supporting Health Systems
About $6 billion was disbursed by donors in response to the 2014-2016 West Africa Ebola
epidemic.10 At the point in the scenario where the $400 billion estimate is made, it is
assumed that CAPS would cause case counts and expenses in low- and middle-income
countries about 2 orders of magnitude higher than the Ebola epidemic.
CAPS would, in many cases, cause emergency spending that would quickly consume all of
countries’ annual healthcare budgets. They would then need a bailout to continue normal
functioning as well as providing minimal pandemic response. Low- and middle-income
countries typically spend about 5% of GDP on health care, and in a crisis situation,
everything gets more expensive. The total GDP of low- and middle-income countries
(excluding China, India, and Russia) is about $14 trillion. If these countries require a bailout
of, on average, slightly more than half of their annual healthcare spending, this would be
$400 billion.
References
2. International Bank for Reconstruction and Development. Prospectus supplement dated June 28,
2017. http://pubdocs.worldbank.org/en/882831509568634367/PEF-Final-Prospectus-
PEF.pdf. Accessed October 14, 2019.
3. World Bank. International Development Association. Crisis Response Window. 2019.
http://ida.worldbank.org/financing/crisis-response-window. Accessed October 14, 2019.
4. International Development Association. IDA18 Mid-Term Review—Crisis Response Window:
Review of Implementation.
http://documents.worldbank.org/curated/en/537601542812085820/pdf/ida18-mtr-crw-
stocktake-10252018-636762749768484873.pdf. Accessed October 14, 2019.
5. International Monetary Fund. Where the IMF gets its money. March 8, 2019.
https://www.imf.org/en/About/Factsheets/Where-the-IMF-Gets-Its-Money. Accessed October
14, 2019.
6. International Monetary Fund. IMF lending. February 25, 2019.
https://www.imf.org/en/About/Factsheets/IMF-Lending. Accessed October 14, 2019.
7. Wikipedia. List of development aid country donors. Updated August 12, 2019.
https://en.wikipedia.org/wiki/List_of_development_aid_country_donors. Accessed October 14,
2019.
8. Council on Foundations. The State of Global Giving by U.S. Foundations: 2011-2015. 2018.
https://www.issuelab.org/resources/31306/31306.pdf. Accessed October 14, 2019.
9. Wikipedia. List of wealthiest charitable foundations. Updated September 27, 2019.
https://en.wikipedia.org/wiki/List_of_wealthiest_charitable_foundations. Accessed October 14,
2019.
10. Huber C, Finelli L, Stevens W. The economic and social burden of the 2014 Ebola outbreak in
West Africa. J Infect Dis 2018; 218(suppl 5):S698-S704.
Prepared by Caitlin Rivers
Date: October 11, 2019
The Event 201 model simulates an outbreak of a moderately transmissible pathogen in a
fully susceptible population. The model is intended to be a realistic representation of how a
novel infectious disease could become a pandemic in the absence of adequate control
measures.
Model Description
We used an ordinary differential equation approach to simulate the Event 201 pandemic. A
graphical depiction of the model structure and a table of the key parameters are available
in the Appendix. The model contains six compartments representing different stages of
infection. Key features of the model include two compartments for individuals infectious in
the community: half develop mild illness (𝐼" ) and half develop severe illness (𝐼$ ). Patients
with severe infection either die (𝐷) or recover (𝑅) at rate 𝛼. Those with a mild infection
move to the recovered compartment at rate 𝛿.
Global Spread
Following the initial spillover event in a large city in South America, 300 of the largest cities
in the world were stochastically seeded with infectious cases to represent disease spread
through international travel. The rate at which new cities were added to the model
accelerates as time progresses, much like the growth of the epidemic itself. The number of
imported cases ranged between 1 and 4 for each city.
The model was run for each individual city in turn. To simulate the stochastic nature of
outbreaks, parameters for each city were randomly selected from realistic distributions.
The force of infection, 𝛽, was chosen from a normal distribution calibrated to produce an
overall basic reproduction number of 1.7 (the reproduction number of individual cities
ranged from 1.1 to 2.6). The case fatality risk (CFR) of hospitalized patients was chosen
from a normal distribution with a mean of 14%, reflecting expected variation in the ability
of healthcare systems to provide high quality care when faced with large numbers of
critically ill patients. Patients with mild illness have a CFR of 0%, for an overall estimate of
7%.
The case counts reported in the exercise represent infections the severe compartment
exclusively, under the assumption that mild illnesses in the community are less likely to be
captured by surveillance systems. The exercise also reports only on the 300 global and 300
US cities represented in the model. For these reasons, the numbers reported in the scenario
are conservative. However, like all models of this type, a core assumption is that the
trajectory of the outbreak remains continuous. In real outbreaks, the trajectory is
constantly changing in response to a number of factors like collective behavior change,
which tend to slow outbreak growth.
COMMUNICATION IN A PANDEMIC
Prepared by Marc Trotochaud and Divya Hosangadi
Effective communication during public health events can be critical to public health
response efforts. Public health messages help inform the public about risks and protective
actions and, done correctly, are a critical component of community engagement and the
buildup of public trust. Yet, true information about public health concerns is increasingly
competing with false messages that can damage public confidence in health interventions
and health authorities. These false messages are often defined as misinformation,
erroneous information shared through various channels, and disinformation, purposefully
spread false or misleading information. The information environment is increasingly made
up of a mix of information coming from web sources and other media, in addition to
historical sources such as print and TV news media. However, the influence of social media
has made the spread of false information even more pernicious.
Over the past 15 years, there has been a global surge in the adoption of social media
technologies. In 2019, 6 social media companies had more than 1 billion active monthly
users.1 Although originally designed for virtual engagement with personal networks, social
media platforms have grown rapidly to share major roles in the economy and the transfer
of information. According to the Pew Research Center, social media officially outpaced
print newspaper as a source of news among the entire United States population.2
Furthermore, across countries, regardless of a nation’s socioeconomic status, younger
populations rely even more heavily on social media as a news source.3
Disinformation campaigns are widely recognized in the political world but have been
identified in the public health realm as well. In the fall of 2018, a team of researchers
systematically identified a concerted effort to spread disinformation and discord about
vaccine safety.4 Public health response efforts for the currently ongoing Ebola outbreak in
the Democratic Republic of the Congo (DRC) have been challenged by disruptive rumors
that have occasionally targeted public health responders.5,6 Misinformation during a public
health emergency is a particularly concerning threat, because of the time-dependent nature
of outbreak response and the corrosive effect misinformation can have on public trust.
Current solutions to the spread of mis- and disinformation are limited. Social media
platforms have attempted to change their algorithms to limit the spread of false
However, censoring social media content and denying a population access to the internet
has serious consequences. In addition to ethical considerations, there is mounting evidence
to suggest that there are serious economic consequences to shutting down the internet.
According to the Indian Council for Research on International Economic relations, the
estimated 16,000 hours of international internet shutdown in India resulted in around
US$3 billion in economic losses.12
Misinformation and disinformation are likely to be serious threats during a public health
emergency. Unfortunately, thus far, there are limited ways to control the propagation of
misinformation, leading to potentially draconian methods to manage this problem.
References
1. Most famous social network sites worldwide as of July 2019, ranked by number of active users
(in millions). Statista. https://www.statista.com/statistics/272014/global-social-networks-
ranked-by-number-of-users/. Accessed October 14, 2019.
2. Shearer E. Social media outpaces print newspapers in the U.S. as a news source. Pew Research
Center Global Attitudes & Trends December 10, 2018. https://www.pewresearch.org/fact-
tank/2018/12/10/social-media-outpaces-print-newspapers-in-the-u-s-as-a-news-source/.
Accessed October 14, 2019.
3. Mitchell A, Simmons K, Matsa KE, Silver L. People in poorer countries just as likely to use social
media for news as those in wealthier countries. Pew Research Center’s Global Attitudes &
Trends January 11, 2018. https://www.pewresearch.org/global/2018/01/11/people-in-
poorer-countries-just-as-likely-to-use-social-media-for-news-as-those-in-wealthier-countries/.
Published January 11, 2018. Accessed October 14, 2019.
4. Broniatowski DA, Jamison AM, Qi S, et al. Weaponized health communication: Twitter bots and
Russian trolls amplify the vaccine debate. Am J Public Health 2018;108(10):1378-1384.
5. Hayden S. How misinformation is making it almost impossible to contain the Ebola outbreak in
DRC. Time June 20, 2019. https://time.com/5609718/rumors-spread-ebola-drc/. Accessed
October 14, 2019.
6. Fidler DP. Disinformation and disease: social media and the Ebola epidemic in the Democratic
Republic of the Congo. Council on Foreign Relations blog post August 20, 2019.
https://www.cfr.org/blog/disinformation-and-disease-social-media-and-ebola-epidemic-
democratic-republic-congo. Accessed October 14, 2019.
7. Matsakis L. Facebook cracks down on networks of fake pages and groups. WIRED January 23,
2019. https://www.wired.com/story/facebook-pages-misinformation-networks/. Accessed
October 14, 2019.
8. Harvey D, Gasca D. Serving healthy conversation. Twitter blog May 15, 2018.
https://blog.twitter.com/en_us/topics/product/2018/Serving_Healthy_Conversation.html.
Accessed October 14, 2019.
9. Funke D, Flamini D. A guide to anti-misinformation actions around the world. Poynter 2019.
https://www.poynter.org/ifcn/anti-misinformation-actions/. Accessed August 26, 2019.
10. Adebayo B, Mahvunga CS, McKenzie D. Zimbabwe shuts down social media as UN slams military
crackdown. CNN January 19, 2019. https://www.cnn.com/2019/01/18/africa/zimbabwe-
army-brutality-allegations/index.html. Accessed October 14, 2019.
11. McCarthy N. Infographic: the countries shutting down the internet the most. Statista
Infographics August 29, 2018. https://www.statista.com/chart/15250/the-number-of-
internet-shutdowns-by-country/. Accessed October 14, 2019.
12. Kathuria R, Kedia M, Varma G, Bagchi K, Sekhani R. The Anatomy of an Internet Blackout:
Measuring the Economic Impact of Internet Shutdowns in India. Indian Council for Research on
International Economic Relations; 2018.
http://icrier.org/pdf/Anatomy_of_an_Internet_Blackout.pdf.
Phylogenetic network analysis of SARS-CoV-2 genomes
Peter Forstera,b,c,1, Lucy Forsterd, Colin Renfrewb,1, and Michael Forsterc,e
a
Institute of Forensic Genetics, 48161 Münster, Germany; bMcDonald Institute for Archaeological Research, University of Cambridge, Cambridge CB2 3ER,
United Kingdom; cFluxus Technology Limited, Colchester CO3 0NU, United Kingdom; dLakeside Healthcare Group at Cedar House Surgery, St Neots PE19
1BQ, United Kingdom; and eInstitute of Clinical Molecular Biology, Christian-Albrecht-University of Kiel, 24105 Kiel, Germany
Contributed by Colin Renfrew, March 30, 2020 (sent for review March 17, 2020; reviewed by Toomas Kivisild and Carol Stocking)
In a phylogenetic network analysis of 160 complete human severe and includes five individuals from Wuhan, two of which are
acute respiratory syndrome coronavirus 2 (SARS-Cov-2) genomes, represented in the ancestral node, and eight other East Asians
we find three central variants distinguished by amino acid changes, from China and adjacent countries. It is noteworthy that nearly
which we have named A, B, and C, with A being the ancestral type half (15/33) of the types in this subcluster, however, are found
according to the bat outgroup coronavirus. The A and C types are outside East Asia, mainly in the United States and Australia.
found in significant proportions outside East Asia, that is, in Euro- Two derived network nodes are striking in terms of the
peans and Americans. In contrast, the B type is the most common number of individuals included in the nodal type and in muta-
type in East Asia, and its ancestral genome appears not to have tional branches radiating from these nodes. We have labeled
spread outside East Asia without first mutating into derived B types, these phylogenetic clusters B and C.
pointing to founder effects or immunological or environmental For type B, all but 19 of the 93 type B genomes were sampled
resistance against this type outside Asia. The network faithfully in Wuhan (n = 22), in other parts of eastern China (n = 31), and,
traces routes of infections for documented coronavirus disease sporadically, in adjacent Asian countries (n = 21). Outside of
2019 (COVID-19) cases, indicating that phylogenetic networks East Asia, 10 B-types were found in viral genomes from the
can likewise be successfully used to help trace undocumented United States and Canada, one in Mexico, four in France, two in
ANTHROPOLOGY
COVID-19 infection sources, which can then be quarantined to pre- Germany, and one each in Italy and Australia. Node B is derived
vent recurrent spread of the disease worldwide. from A by two mutations: the synonymous mutation T8782C and
the nonsynonymous mutation C28144T changing a leucine to a
SARS-CoV-2 evolution | subtype | ancestral type serine. Cluster B is striking with regard to mutational branch
lengths: While the ancestral B type is monopolized (26/26 ge-
BAT
Fig. 1. Phylogenetic network of 160 SARS-CoV-2 genomes. Node A is the root cluster obtained with the bat (R. affinis) coronavirus isolate BatCoVRaTG13
from Yunnan Province. Circle areas are proportional to the number of taxa, and each notch on the links represents a mutated nucleotide position. The
sequence range under consideration is 56 to 29,797, with nucleotide position (np) numbering according to the Wuhan 1 reference sequence (8). The median-
joining network algorithm (2) and the Steiner algorithm (9) were used, both implemented in the software package Network5011CS (https://www.fluxus-
engineering.com/), with the parameter epsilon set to zero, generating this network containing 288 most-parsimonious trees of length 229 mutations. The
reticulations are mainly caused by recurrent mutations at np11083. The 161 taxa (160 human viruses and one bat virus) yield 101 distinct genomic sequences.
The phylogenetic diagram is available for detailed scrutiny in A0 poster format (SI Appendix, Fig. S5) and in the free Network download files.
Type C differs from its parent type B by the nonsynonymous province), in agreement with his travel history. His virus genome
mutation G26144T which changes a glycine to a valine. In the now coexists with those of other infected North Americans (one
dataset, this is the major European type (n = 11), with repre- Canadian and two Californians) who evidently share a common
sentatives in France, Italy, Sweden, and England, and in California viral genealogy. The case of the single Mexican viral genome in
and Brazil. It is absent in the mainland Chinese sample, but the network is a documented infection diagnosed on 28 February
evident in Singapore (n = 5) and also found in Hong Kong, 2020 in a Mexican traveler to Italy. Not only does the network
Taiwan, and South Korea. confirm the Italian origin of the Mexican virus (SI Appendix, Fig.
One practical application of the phylogenetic network is to S3), but it also implies that this Italian virus derives from the first
reconstruct infection paths where they are unknown and pose a documented German infection on 27 January 2020 in an em-
public health risk. The following cases where the infection his- ployee working for the Webasto company in Munich, who, in turn,
tory is well documented may serve as illustrations (SI Appendix). had contracted the infection from a Chinese colleague in Shang-
On 25 February 2020, the first Brazilian was reported to have hai who had received a visit by her parents from Wuhan. This viral
been infected following a visit to Italy, and the network algorithm journey from Wuhan to Mexico, lasting a month, is documented
reflects this with a mutational link between an Italian and his by 10 mutations in the phylogenetic network.
Brazilian viral genome in cluster C (SI Appendix, Fig. S1). In This viral network is a snapshot of the early stages of an epi-
another case, a man from Ontario had traveled from Wuhan in demic before the phylogeny becomes obscured by subsequent
central China to Guangdong in southern China and then migration and mutation. The question may be asked whether the
returned to Canada, where he fell ill and was conclusively di- rooting of the viral evolution can be achieved at this early stage
agnosed with coronavirus disease 2019 (COVID-19) on 27 January by using the oldest available sampled genome as a root. As SI
2020. In the phylogenetic network (SI Appendix, Fig. S2), his virus Appendix, Fig. S4 shows, however, the first virus genome that was
Downloaded by guest on April 12, 2020
genome branches from a reconstructed ancestral node, with derived sampled on 24 December 2019 already is distant from the root
virus variants in Foshan and Shenzhen (both in Guangdong type according to the bat coronavirus outgroup rooting.
ANTHROPOLOGY
man SARS-CoV-2 virus, while the bat coronavirus yielded a sequence similarity
of 96.2% in our analysis, in agreement with the 96.2% published by Zhou et al. ACKNOWLEDGMENTS. We gratefully acknowledge the authors and origi-
We discarded partial sequences, and used only the most complete genomes nating and submitting laboratories of the sequences from GISAID’s EpiFlu(TM)
that we aligned to the full reference genome by Wu et al. (8) comprising Database on which this research is based. We are grateful to Trevor Bedford
29,903 nucleotides. Finally, to ensure comparability, we truncated the flanks of (GISAID) for providing instructions and advice on the database. A table of the
all sequences to the consensus range 56 to 29,797, with nucleotide position contributors is available in Dataset S1, Supplementary Table 1. We thank Arne
numbering according to the Wuhan 1 reference sequence (8). The laboratory Röhl for assessing the network.
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3. H. J. Bandelt, P. Forster, A. Röhl, Median-joining networks for inferring intraspecific
8. F. Wu et al., A new coronavirus associated with human respiratory disease in China.
phylogenies. Mol. Biol. Evol. 16, 37–48 (1999).
4. P. Forster, C. Renfrew, Evolution. Mother tongue and Y chromosomes. Science 333, Nature 579, 265–269 (2020).
1390–1391 (2011). 9. T. Polzin, S. V. Daneshmand, On Steiner trees and minimum-spanning trees in hyper-
5. C. Renfrew, P. Bahn, The Cambridge World Prehistory (Cambridge University Press, 2014). graphs. Oper. Res. Lett. 31, 12–20 (2003).
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At Jeffrey Epstein’s Manhattan mansion in 2011, from left: James E. Staley, at the time a senior
JPMorgan executive; former Treasury Secretary Lawrence Summers; Mr. Epstein; Bill
Gates, Microsoft’s co-founder; and Boris Nikolic, who was the Bill and Melinda Gates
Foundation’s science adviser.
There were billionaires (Leslie Wexner and Leon Black), politicians (Bill
Clinton and Bill Richardson), Nobel laureates (Murray Gell-Mann and
Frank Wilczek) and even royals (Prince Andrew).
[Jeffrey Epstein’s charity: An image boost built on deception.]
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Few, though, compared in prestige and power to the world’s second-richest
person, a brilliant and intensely private luminary: Bill Gates. And unlike
many others, Mr. Gates started the relationship after Mr. Epstein was
convicted
Up-to-date of sex
information on crimes.
coronavirus is available for free. CONTINUE
Mr. Gates, the Microsoft co-founder, whose $100 billion-plus fortune has
endowed the world’s largest charitable organization, has done his best to
minimize his connections to Mr. Epstein. “I didn’t have any business
relationship or friendship with him,” he told The Wall Street Journal last
month.
In fact, beginning in 2011, Mr. Gates met with Mr. Epstein on numerous
occasions — including at least three times at Mr. Epstein’s palatial
Manhattan townhouse, and at least once staying late into the night,
according to interviews with more than a dozen people familiar with the
relationship, as well as documents reviewed by The New York Times.
Bridgitt Arnold, a spokeswoman for Mr. Gates, said he “was referring only
CONTINUE
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residence — and Epstein’s habit of
spontaneously bringing acquaintances in to meet Mr. Gates.”
“It was in no way meant to convey a sense of interest or approval,” she said.
Over and over, Mr. Epstein managed to cultivate close relationships with
some of the world’s most powerful men. He lured them with the whiff of
money and the proximity to other powerful, famous or wealthy people — so
much so that many looked past his reputation for sexual misconduct. And
the more people he drew into his circle, the easier it was for him to attract
others.
Mr. Gates and the $51 billion Gates Foundation have championed the well-
being of young girls. By the time Mr. Gates and Mr. Epstein first met, Mr.
Epstein had served jail time for soliciting prostitution from a minor and was
required to register as a sex offender.
Ms. Arnold said that “high-profile people” had introduced Mr. Gates and
Mr. Epstein and that they had met multiple times to discuss philanthropy.
“Bill Gates regrets ever meeting with Epstein and recognizes it was an
error in judgment to do so,” Ms. Arnold said. “Gates recognizes that
entertaining Epstein’s ideas related to philanthropy gave Epstein an
undeserved platform that was at odds with Gates’s personal values and the
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The First
values of his Meeting
foundation.”
Two members of Mr. Gates’s inner circle — Boris Nikolic and Melanie
Walker — were close to Mr. Epstein and at times functioned as
CONTINUE
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intermediaries coronavirus is available
the two men. for free.
Ms. Walker met Mr. Epstein in 1992, six months after graduating from the
University of Texas. Mr. Epstein, who was an adviser to Mr. Wexner, the
owner of Victoria’s Secret, told Ms. Walker that he could land her an
audition for a modeling job there, according to Ms. Walker. She later
traveled to New York and stayed in a Manhattan apartment building that
Mr. Epstein owned. After she graduated from medical school, she said, Mr.
Epstein hired her as a science adviser in 1998.
Ms. Walker later met Steven Sinofsky, a senior executive at Microsoft who
became president of its Windows division, and moved to Seattle to be with
him. In 2006, she joined the Gates Foundation with the title of senior
program officer.
At the foundation, Ms. Walker met and befriended Mr. Nikolic, a native of
what is now Croatia and a former fellow at Harvard Medical School who
was the foundation’s science adviser. Mr. Nikolic and Mr. Gates frequently
traveled and socialized together.
Ms. Walker, who had remained in close touch with Mr. Epstein, introduced
him to Mr. Nikolic, and the men became friendly.
Mr. Epstein and Mr. Gates first met face to face on the evening of Jan. 31,
2011, at Mr. Epstein’s townhouse on the Upper East Side. They were joined
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by Dr. Eva Andersson-Dubin, a former Miss Sweden whom Mr. Epstein had
once dated, and her 15-year-old daughter. (Dr. Andersson-Dubin’s husband,
the hedge fund billionaire Glenn Dubin, was a friend and business associate
of Mr. Epstein’s. The Dubins declined to comment.)
CONTINUE
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The gathering started at 8 and lasted several hours, according to Ms.
Arnold, Mr. Gates’s spokeswoman. Mr. Epstein subsequently boasted about
the meeting in emails to friends and associates. “Bill’s great,” he wrote in
one, reviewed by The Times.
Mr. Gates, in turn, praised Mr. Epstein’s charm and intelligence. Emailing
colleagues the next day, he said: “A very attractive Swedish woman and her
daughter dropped by and I ended up staying there quite late.”
Mr. Gates soon saw Mr. Epstein again. At a TED conference in Long Beach,
Calif., attendees spotted the two men engaged in private conversation.
Later that spring, on May 3, 2011, Mr. Gates again visited Mr. Epstein at his
New York mansion, according to emails about the meeting and a
photograph reviewed by The Times.
Around that time, the Gates Foundation and JPMorgan were teaming up to
create the Global Health Investment Fund. Its goal was to provide
“individual and institutional investors the opportunity to finance late-stage
CONTINUE
Up-to-date information
global on coronavirus
health technologies is available
that have thefor free.
potential to save millions of lives in
low-income countries.”
As the details of the fund were being hammered out, Mr. Staley told his
JPMorgan colleagues that Mr. Epstein wanted to be brought into the
discussions, according to two people familiar with the talks. Mr. Epstein
was an important JPMorgan customer, holding millions of dollars in
accounts at the bank and referring a procession of wealthy individuals to
become clients of the company.
Ms. Arnold said Mr. Gates and the foundation had been unaware that Mr.
Epstein had been seeking any fee. She said Mr. Epstein “did propose to Bill
Gates and then foundation officials ideas that he promised would unleash
hundreds of billions for global health-related work.”
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At some point in June this year, the total amount given as grants to
food and agriculture projects by the Bill and Melinda Gates
Foundation surpassed the US$3 billion mark. It marked quite a
milestone. From nowhere on the agricultural scene less than a
decade ago, the Gates Foundation has emerged as one of the
world's major donors to agricultural research and development.
Here are some of the conclusions we were able to draw from the
data.
1. The Gates Foundation fights hunger in the South by giving money to the North.
The CGIAR centres have Click to enlarge – Graph 2: the Gates Foundation’s $3
billion pie (agriculture grants, by type of
received over $720 million organisation).
from Gates since 2003.
During the same period,
another $678 million went
to universities and national
research centres across
the world – over three-
quarters of them in the US
and Europe – for research
and development of specific technologies, such as crop varieties
and breeding techniques.
The Gates Foundation's support for AGRA and the AATF is tightly
linked to this research agenda. These organisations seek, in
different ways, to facilitate research by the CGIAR and other
research programmes supported by the Gates Foundation and to
ensure that the technologies that come out of the labs get into
farmers' fields. AGRA trains farmers on how to use the
technologies, and even organises them into groups to better access
the technologies, but it does not support farmers in building up their
own seed systems or in doing their own research.6
A project evaluation
report states that 44% of
the agro-dealers in the
programme were
providing extension
services. According to
the World Bank: “The
agro-dealers have...
become the most An agro-dealer in Malawi. (Photo: AGRA)
important extension
nodes for the rural poor... A new form of private sector driven
extension system is emerging in these countries.”
GRAIN would like to thank Camila Oda Montecinos for her help in
pulling together the database and the graphic materials.
foundation announced a
review of its
investments to assess
their social
responsibility. That
review, however, was
quickly trashed and the
foundation decided to
stick with a policy of
investing for maximum
return.12
$US
Agency Main recipients
million
The CGIAR is a consortium of 15 international research
centres set up to promote the Green Revolution across the
world. Gates is now amongst its major donors. Main
recipients include: IFPRI ($167 million), CIMMYT ($132m),
CGIAR 720 IRRI ($139m), ICRISAT ($76m), IITA ($49m), ILRI ($15m),
CIP ($55m), CIAT ($33m) and others. Most of the grants are
in the form of project support to each of the centres, and
many of them are focussing on developing new crop
varieties.
A total of 14 grants for core support and AGRA's main issue
AGRA 414 areas: seeds, soils, markets, and lobbying African
governments to change policies and legislation.
World Bank - IBRD ($119m); World Food Programme (WFP)
($79m); UNDP ($54m.); FAO ($50 m.) UN Foundation
($30m). The lion's share of the grants to the World Bank are
Int'l orgs
to promote public and private sector investment in
(UN, World 362
agriculture ($60m), WFP is supported to improve market
Bank, etc.)
opportunities for small farmers, UNDP to establish rural
agro-enterprises in West Africa, and the support to FAO is
mostly for statistical and policy work.
AATF (African Agricultural Technology Foundation) is a
blatantly pro-GMO pro-corporate research outfit based in
Nairobi. Gates supported them with almost $100 m mostly
AATF 95
to develop and distribute hybrid maize and rice varieties, but
also to raise “awareness on agricultural biotechnology for
improved understanding and appreciation”.
Over three quarters of all Gates funding to universities and
research centres goes to institutions in the US and Europe,
such as Cornell, Michigan and Harvard in the US, and
Cambridge and Greenwich Universities in the UK, amongst
many others. The work supported is a mix of basic
agronomic, breeding and molecular research, as well as
policy research. A lot of it includes genetic engineering.
Universities Michigan State University, for example, got $13m to help
& National African policy makers “to make informed decisions on how
678 to use biotechnology”.
Research
Centres. Although most of the foundation's grants are supposed
to benefit Africa, barely 12% of its grants to universities
and research centres go directly to African institutions
($80m in total, of which $30m for the Uganda based
Regional University Forum set up by the Rockefeller
Foundation.
Total 3110
$US
Country Main recipients
million
USA 880 By far the largest recipient country of Gates agricultural
grants meant to benefit farmers in poor countries: $880
million dished out in 254 grants. Recipients include US
universities and research institutions to produce for crop
varieties and biotechnology research for farmers in Africa
(e.g. Cornell University, $90m in 12 grants), big NGO projects
mostly oriented to develop technology and markets (e.g.
Heifer, $51m, to increase cow productivity and Technoserve
Inc., $47m, to help poor farmers to “build business that
create income”), and several policy and capacity building
projects to push the foundation's agenda in Africa and
elsewhere.
A total of 25 grants with a focus on academic research such
as for the University of Greenwich to work on cassava value
chains in several African countries (16.6 m), the University of
UK 156 Cambridge to work on epidemiological modelling on wheat
and cassava diseases ($4.2m) and the John Innes Centre to
test the feasibility cereal crops capable of fixing nitrogen
($9.8m).
Three grants for the German Federal Enterprise for
International Cooperation (GIZ) to develop supply chains for
African ca shews and for support to African rice farmers
Germany 115
($51.1m), and another three grants for the German
Investment Corporation to work on African cotton and coffee
farming ($48.8m), amongst others.
Mostly for two grants to the Wageningen University for
Netherlands 61
agronomic research on grain legumes ($47.8m)
Total of ten grants including two grants to PRADAN ($30.8m
India 41 for women farmers training), and to BAIF ($6.3 m. for
establishment of cattle development centres)
Mostly for the Chinese Academy of Agricultural Sciences
China 37 (two grants totalling $33 million) to develop new rice
varieties for farmers across the world.
14 grants to a variety of grantees, including the FANRPAN
network to carry out agriculture programmes ($16m),
University of Pretoria ($4.5m for policy research) Sangonet
South ($1.7m. for mobile phone applications for farmers), SACAU
37
Africa (two grants $5.8m to support farmers organisations and
electronic farmer management systems, and the
Association of African Business Schools ($1.5m to develop
agribusiness management and training programmes).
Mostly for RUFORUM (two grants totalling over $30 million
to support agricultural research universities in the region).
Uganda 36 RUFORUM was established as a programme of the
Rockefeller Foundation in 1992 and became an independent
Regional University Forum in 2004.
A total of 14 grants mostly to universities and research
centres to develop sorghum and cowpea hybrids for Africa
Australia 30 and other sorghum breeding programmes, deliver solutions
to dairy cattle genetics in poor countries, and supply cattle
genotypes to dairy farmers in East Africa, amongst others.
A total of 8 grants mostly to universities to ensure adoption
Canada 20 of new technologies, develop cassava seed supply chains in
Tanzania, and radio programmes in Africa, amongst others.
Total top 10 1413 $1.4 billion, or almost half of all agriculture funding from
Gates in the last decade went to grantees in these 10
countries: 90% to the North.
Notes
8 On the Policy Action Nodes, see: AGRA 2013 Annual Report. For
info about the Ghana Food Sovereignty Network:
http://foodsovereigntyghana.org/
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Kashmir Though r-DNA has been detected in Gardasil in samples from many countries including India, in their
Environment application for licensing MSD pharmaceuticals claimed that there was no hazard because there was no r-
Book Review DNA. GlaxoSmithKline uses a novel technique for producing Cervarix which involves the use of insect cells.
Gujarat Pogrom Their product information admitted to their vaccine containing insect cells and proteins only in July 2011
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are infected with the virus then they do raise the incidence of cervical cancer among those women.
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Gardasil was first licensed in the USA in June 2006. This licensing was done on fast track with numerous
Fair Use Notice
conflicts of interests not only on the review board but also in that that the vaccine patent was held in PPP and
Contact Us the FDA itself as a part of the health department would benefit from the sales.
Search Our Archive
Licensing issues:
Both vaccines were licensed for use among girls and women in India on the basis of very small studies that
Site Search flouted even the liberalized Indian law. This law allows easy access to the Indian market for drugs and
Our Site vaccines produced by multi-national companies once they are approved in the home country. In 2005 this
Web law also made it possible for multi-national companies to hold trials for unapproved drugs in India
simultaneous to international trials.
Subscribe To Our
News Letter Targeting adolescents
Name:
These vaccines are supposed to work best when administered to girls in the age group of 9-14, before sexual
E-mail: debut. In the case of Cervarix GlaxoSmithKline did a trial with just 176 adult women and was granted a
license for an age group of 10-45 year old women. This trial just looked at anti-body levels achieved and
Subscribe
Unsubscribe immediate side effects. No trial was done among Indian girls.
In the case of Gardasil, Merck through its subsidiary MSD signed an MOU with ICMR in 2005 but did not
proceed with the studies that were envisaged involving thousands of women. But once it was licensed in the
USA it did a speedy trial on its own with only 110 Indian girls 10-14 year old again to see immediate immune
response. But it got a license by the DCGI to administer it to women from 9-26 years old though not a single
adult woman had undergone a trial. According to the Indian law a trial on adults has to precede a trial among
children and it was these violations that had been brought to the notice of the Parliamentary Committee that
had asked for a proper enquiry into licensing.
PATH on its own had decided to do studies with the HPV vaccine in four countries and India was one of
them. The Indian market is substantial if a vaccine is accepted in the immunization programme. There is
documentary evidence that though PATH is an NGO in this case it had entered into business agreement with
Merck so that Merck had a ready market for the vaccine in the resource poor countries. In fact PATH got
funding from BMGF in the very month that Gardasil was licensed in the USA. It signed an MOU with ICMR
for this purpose. ICMR played along though it was clear that the vaccine was too expensive for India to
afford. For each girl vaccinated the country would need to spend Rs 10,000 for three shots. The vaccines
were marketed by hyping the risk of cervical cancer. Yet the fruits of this approach were not going to be
reaped for 30-40 years or when the ten year olds crossed the age of forty - the age group when women are
susceptible to cervical cancer. ICMR went ahead though it knew that the country is unable to meet the
present needs of medicines to meet the current problems of the population like T.B. and malaria and could ill
afford to spend money for these uncertain products. Further through its cancer registries it was also aware
that the incidence of cervical cancer was declining and it was not a major health problem of the country.
PATH project was carried out in total disregard to scientific approach. It made false claims about the safety
of vaccines and their efficacy. When the project took off there was no data to figure out the need for boosters,
how the malnourished girls of India would respond to the vaccine that had so far only been administered to a
healthy population. Yet a large number of girls in A.P. and Gujarat were told all kinds of lies and
administered a vaccine that had serious side effects including death. When four girls died in Andhra Pradesh
women’s groups raised a hue and cry in 2010 and the government ordered an enquiry. The Government of
AP, of Gujarat and PATH made depositions and provided data. The Enquiry Committee found that records of
even informed consent had been fudged. The girls were not asked for their assent even though the law
provides for such assent to be taken in writing. Further no arrangements were made for providing medical
care to them if they suffered serious side effects.
Thus the rights of all 24,000 girls who were recruited by PATH in these trials were flouted as they were given
the vaccine without a chance to make free informed choice. This assertion of women’s groups was confirmed
by the enquiry. However, the Enquiry Committee had no legal expert and could not determine the liability of
PATH towards the girls who were duped or forced into participation in PATH trial, those who died during
the trial and those who would have suffered serious side effects.
PATH did everything to prevent the problems of the study from becoming common knowledge and sat on
data on deaths despite women’s groups making a hue and cry about it at a public meeting organized by them
in December 2009. The petitioners have pointed out that the data on death during the project is incomplete,
illogical and full of discrepancies yet the deaths were called as being unrelated to vaccine administration.
Side effects reported by the Study were very rare and this was also brought out in the Enquiry. Yet there is no
provision of continuing health care of these rural girls. Extrapolating from trial data of the two companies
the petitioners have estimated that there are at least 1,200 girls in the two states have suffered from serious
side effects or have developed auto-immune disorders who need continuing medical care and treatment.
These questions have been put before the Supreme Court with the hope that prompt justice and care would
be provided to girls who are suffering as a consequence of an ill designed trial carried out by PATH with the
active support of ICMR and the two state governments. By those very governments who are constitutionally
bound to protect their life and health. Given the serious violations indulged by PATH, the petitioners have
asked that PATH be blacklisted and no other foreign agency be allowed to have field presence.
The petitioners have also asked for the licences of the two products to be suspended and the vaccines recalled
as there has been no scientific basis to allow their administration to girls in the private market either. The
two companies have also flouted Indian law with impunity and have not done the post marketing studies
ordered by the Drugs Controller at the time of licensing. They have not up dated their product information
and hence the Indian medical consumer continues to be in the dark about hazards of these vaccines that
contain insect cells and r-DNA. MSD Pharmaceuticals went a step further and got the eligible age group
extended to 45 year old women in India though this was denied in the U.S.A. thrice.
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07 January, 2013
Countercurrents.org
Supreme Court admits writ petition against licensing and trials with “Cervical Cancer” vaccines
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implicating the Drugs Controller of India, PATH, ICMR and others ordering Government of India to
Popularise CC immediately respond
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Gardasil and Cervarix are two unproven and hazardous HPV vaccines purported to prevent cervical cancer,
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marketed in India by MSD Pharmaceuticals Pvt. Ltd. (subsidiary of Merck) and GlaxoSmithKline Ltd. The
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petition challenging their licensing for use in the private sector and attempts to introduce them in the public
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sector has been filed by Kalpana Mehta, Nalini Bhanot and V. Rukmini Rao representing (Gramya Resource
Editor's Picks Centre for Women from Andhra Pradesh). The petition implicates the Drugs Controller for having licensed
Press Releases the vaccines without adequate research on safety and efficacy; the Health Ministry for not carrying out an
Action Alert enquiry into licensing of these vaccines as ordered by the Parliamentary Standing Committee on Health and
Feed Burner Family Welfare in April 2010 nor taking any action on the report of the enquiry committee set up by itself
despite all irregularities of Program for Appropriate Technology in Health (PATH) project being confirmed.
Read CC In Your
Own Language Rather than looking at safety and efficacy of these vaccines in India, this project was meant to influence the
Bradley Manning government to adopt these vaccines for introduction in the public sector.
India Burning
The petitioners are represented by the well known public interest senior advocate Colin Gonsalves of Human
Mumbai Terror
Rights Law Network who presented the case before the Supreme Court on January 7, 2013. The Supreme
Financial Crisis Court admitted the case and has asked the Government of India to immediately file its reply in the matter.
Iraq
PATH had initiated a project for the introduction of the two vaccines in India by signing an MoU with Indian
AfPak War
Council of Medical Research (ICMR) even before they were licensed by the Drugs Controller of India. This
Peak Oil
project was funded by Bill and Melinda Gates Foundation (BMGF) who had substantial stakes in Merck that
Globalisation produced the vaccine and hence there was a direct conflict of interest. PATH was helped by ICMR in carrying
Localism out large scale trials in the states of Andhra Pradesh and Gujarat unethically and without regard for health of
Alternative Energy poor tribal girls. The unethical nature of the study and deaths of girls became the subject of Governmental
Climate Change
enquiry in 2010 when the matter was repeatedly raised by activists. This enquiry concluded that there were
many gross violations in the project with respect to procedures for taking informed consent, inadequate
US Imperialism
health facilities for dealing with adverse events and medical emergencies. Yet after two years of the enquiry
US Elections
the government had not even initiated any action to redress the situation and to punish PATH and ICMR as
Palestine
admitted by Ghulam Nabi Azad before the Indian Parliament in December 2011.
Latin America
Communalism
The petitioners are health activists who have been raising the issue with the Health Ministry, the Drugs
Controller, National Commission for the Protection of Child Rights and other authorities including the
Gender/Feminism
government of Andhra Pradesh and have not made any headway. Hence a petition was filed under article 32
Dalit
of the Constitution by them..
Humanrights
Economy
Hazards of the vaccines and unproven benefits :
India-pakistan The vaccines are genetically engineered and their hazards are unknown even to the scientific communities.
Kashmir Though r-DNA has been detected in Gardasil in samples from many countries including India, in their
Environment application for licensing MSD pharmaceuticals claimed that there was no hazard because there was no r-
Book Review DNA. GlaxoSmithKline uses a novel technique for producing Cervarix which involves the use of insect cells.
Gujarat Pogrom Their product information admitted to their vaccine containing insect cells and proteins only in July 2011
Kandhamal Violence though the vaccine was already in use since 2007. These residues or adventitious agents enter the blood
WSF stream when the vaccine is injected and are acknowledged to have the capacity to cause infections, tumours
and cancer. What is noteworthy is that neither of these vaccines has been studied to determine their
Arts/Culture
potential to cause cancer. In addition, the Drugs Controller has not even set standards of acceptable limits for
India Elections
such contamination in vaccines on the basis of which he could have found them safe for licensing.
Archives
Links Though both the vaccines are claimed to prevent cervical cancer, the truth is that cervical cancer takes twenty
or more years to develop and the vaccines have just not been around that long to prove their efficacy in
Submission Policy
preventing cancer. But what is known with certainty is that if these vaccines are given to women who already
About Us
are infected with the virus then they do raise the incidence of cervical cancer among those women.
Disclaimer
Gardasil was first licensed in the USA in June 2006. This licensing was done on fast track with numerous
Fair Use Notice
conflicts of interests not only on the review board but also in that that the vaccine patent was held in PPP and
Contact Us the FDA itself as a part of the health department would benefit from the sales.
Search Our Archive
Licensing issues:
Both vaccines were licensed for use among girls and women in India on the basis of very small studies that
Site Search flouted even the liberalized Indian law. This law allows easy access to the Indian market for drugs and
Our Site vaccines produced by multi-national companies once they are approved in the home country. In 2005 this
Web law also made it possible for multi-national companies to hold trials for unapproved drugs in India
simultaneous to international trials.
Subscribe To Our
News Letter Targeting adolescents
Name:
These vaccines are supposed to work best when administered to girls in the age group of 9-14, before sexual
E-mail: debut. In the case of Cervarix GlaxoSmithKline did a trial with just 176 adult women and was granted a
license for an age group of 10-45 year old women. This trial just looked at anti-body levels achieved and
Subscribe
Unsubscribe immediate side effects. No trial was done among Indian girls.
In the case of Gardasil, Merck through its subsidiary MSD signed an MOU with ICMR in 2005 but did not
proceed with the studies that were envisaged involving thousands of women. But once it was licensed in the
USA it did a speedy trial on its own with only 110 Indian girls 10-14 year old again to see immediate immune
response. But it got a license by the DCGI to administer it to women from 9-26 years old though not a single
adult woman had undergone a trial. According to the Indian law a trial on adults has to precede a trial among
children and it was these violations that had been brought to the notice of the Parliamentary Committee that
had asked for a proper enquiry into licensing.
PATH on its own had decided to do studies with the HPV vaccine in four countries and India was one of
them. The Indian market is substantial if a vaccine is accepted in the immunization programme. There is
documentary evidence that though PATH is an NGO in this case it had entered into business agreement with
Merck so that Merck had a ready market for the vaccine in the resource poor countries. In fact PATH got
funding from BMGF in the very month that Gardasil was licensed in the USA. It signed an MOU with ICMR
for this purpose. ICMR played along though it was clear that the vaccine was too expensive for India to
afford. For each girl vaccinated the country would need to spend Rs 10,000 for three shots. The vaccines
were marketed by hyping the risk of cervical cancer. Yet the fruits of this approach were not going to be
reaped for 30-40 years or when the ten year olds crossed the age of forty - the age group when women are
susceptible to cervical cancer. ICMR went ahead though it knew that the country is unable to meet the
present needs of medicines to meet the current problems of the population like T.B. and malaria and could ill
afford to spend money for these uncertain products. Further through its cancer registries it was also aware
that the incidence of cervical cancer was declining and it was not a major health problem of the country.
PATH project was carried out in total disregard to scientific approach. It made false claims about the safety
of vaccines and their efficacy. When the project took off there was no data to figure out the need for boosters,
how the malnourished girls of India would respond to the vaccine that had so far only been administered to a
healthy population. Yet a large number of girls in A.P. and Gujarat were told all kinds of lies and
administered a vaccine that had serious side effects including death. When four girls died in Andhra Pradesh
women’s groups raised a hue and cry in 2010 and the government ordered an enquiry. The Government of
AP, of Gujarat and PATH made depositions and provided data. The Enquiry Committee found that records of
even informed consent had been fudged. The girls were not asked for their assent even though the law
provides for such assent to be taken in writing. Further no arrangements were made for providing medical
care to them if they suffered serious side effects.
Thus the rights of all 24,000 girls who were recruited by PATH in these trials were flouted as they were given
the vaccine without a chance to make free informed choice. This assertion of women’s groups was confirmed
by the enquiry. However, the Enquiry Committee had no legal expert and could not determine the liability of
PATH towards the girls who were duped or forced into participation in PATH trial, those who died during
the trial and those who would have suffered serious side effects.
PATH did everything to prevent the problems of the study from becoming common knowledge and sat on
data on deaths despite women’s groups making a hue and cry about it at a public meeting organized by them
in December 2009. The petitioners have pointed out that the data on death during the project is incomplete,
illogical and full of discrepancies yet the deaths were called as being unrelated to vaccine administration.
Side effects reported by the Study were very rare and this was also brought out in the Enquiry. Yet there is no
provision of continuing health care of these rural girls. Extrapolating from trial data of the two companies
the petitioners have estimated that there are at least 1,200 girls in the two states have suffered from serious
side effects or have developed auto-immune disorders who need continuing medical care and treatment.
These questions have been put before the Supreme Court with the hope that prompt justice and care would
be provided to girls who are suffering as a consequence of an ill designed trial carried out by PATH with the
active support of ICMR and the two state governments. By those very governments who are constitutionally
bound to protect their life and health. Given the serious violations indulged by PATH, the petitioners have
asked that PATH be blacklisted and no other foreign agency be allowed to have field presence.
The petitioners have also asked for the licences of the two products to be suspended and the vaccines recalled
as there has been no scientific basis to allow their administration to girls in the private market either. The
two companies have also flouted Indian law with impunity and have not done the post marketing studies
ordered by the Drugs Controller at the time of licensing. They have not up dated their product information
and hence the Indian medical consumer continues to be in the dark about hazards of these vaccines that
contain insect cells and r-DNA. MSD Pharmaceuticals went a step further and got the eligible age group
extended to 45 year old women in India though this was denied in the U.S.A. thrice.
Tweet
Comments are moderated
How DFID
support for
agribusiness is
fuelling poverty
in Africa
War on Want is a movement of people
committed to global justice.
Our vision is a world free from poverty and oppression, based
on social justice, equality and human rights for all.
We do this by:
• working in partnership with grassroots social movements, trade
unions and workers’ organisations to empower people to fight
for their rights
• running hard-hitting popular campaigns against the root causes
of poverty and human rights violation
• mobilising support and building alliances for political action in
support of human rights, especially workers’ rights
• raising public awareness of the root causes of poverty, inequality
and injustice and empowering people to take action for change
Join us!
The success of our work relies on inspiring people to join the
fight against poverty and human rights abuse.There are three
easy ways for you to donate and join the movement:
Call 020 7324 5046
Visit www.waronwant.org/support-us
Post tear off the membership form at the back of this report,
and send to:
War on Want
44-48 Shepherdess Walk
London N1 7JP
Preface
01
The scandal of global hunger is back in governments to support small farmers and
the news, and rightly so. The fact that genuine agricultural development.
record numbers of people are today
classified as hungry, at a time when there is DFID’s record should be noted by those
unprecedented wealth in the world, is a aid agencies which have been vocal in
testament to the failure of the globalised food congratulating the UK government for its
system. There is a growing consensus that this supposed leadership in the fight against global
failure is the result of deliberate political hunger. Several NGOs spoke out in this vein
choices that favour corporate interests while when British prime minister David Cameron
condemning hundreds of millions to despair. staged a celebrity ‘hunger event’ to coincide
Any system that enriches a few while with the end of the London Olympics in
impoverishing the many is morally bankrupt, August 2012.Yet rather than assisting small
and must be changed. farmers and rural communities to overcome
hunger, this report shows that DFID has
The UK government’s Department for been using the UK aid budget to meet the
International Development (DFID), by commercial interests of major agribusiness
contrast, is using the aid budget to tighten the companies. This is an abuse of aid that needs
corporate stranglehold over the global food to be confronted, not applauded.
system. As this report reveals, DFID has been
using hundreds of millions of pounds of War on Want has engaged with the fight
taxpayers’ money with the express purpose against global hunger ever since the
of extending the power of agribusiness over organisation’s founding 60 years ago. Our
the production of food, especially in sub- work has focused on challenging the root
Saharan Africa. While this will increase the causes of the global food crisis, as well as
profits of corporate giants such as Monsanto, supporting positive solutions that are socially
Unilever and Syngenta, it threatens to equitable as well as environmentally
disempower small farmers and rural sustainable. War on Want has formed
communities and condemn them to long- longstanding partnerships with farmers’
term poverty. DFID’s promotion of genetically movements across the world to promote the
modified crops will also lock small farmers framework of food sovereignty as a positive
into dependency on corporate providers of alternative to a capitalist food system that has
seeds and chemical inputs, undermining any condemned hundreds of millions to despair.
chance of defeating hunger. As described in our recent report Food
Sovereignty: Reclaiming the global food system,
This report also lifts the lid on DFID’s this framework offers a solution to the
support for a complex network of companies food crisis based on principles of local
and investment funds registered in one of empowerment, equity and agroecology. This
Africa’s foremost tax havens. Not only is the is what DFID should be supporting with the
UK aid budget being used to support some of UK aid budget, not more corporate control.
the world’s largest multinational corporations,
but several of the companies and agricultural
investment funds being supported by DFID
are incorporated in the secrecy jurisdiction
of Mauritius. This means that UK aid to
agribusiness is being routed through a known John Hilary
‘conduit haven’, allowing companies to avoid Executive Director
paying taxes that could be used by national War on Want
1. Aid-funded agribusiness
02
for International Development (DFID) (four of which are also among the top
is required by law to devote British aid 10 seed companies) together control
to the reduction of poverty across the 82% of the world pesticides market
market
does to other sectors. DFID claims that
its investment in agriculture helps small
partner for the project.13 Another AATF especially in the case of hybrid seeds
project is Water Efficient Maize for Africa which can be used for only one season.
(WEMA), which is a further GM initiative The multinationals selling the chemicals and
seeking to develop drought-tolerant maize. seeds, on the other hand, reap substantial
AATF notes that WEMA is incorporating benefits from aid projects promoting farmers’
a drought-tolerant trait developed by use of these inputs, since they give these
Monsanto and BASF “using transgenic companies access to new markets. DFID and
breeding, sometimes referred to as genetic Monsanto are also partners in the World
modification”. Field trials of the GM maize are Economic Forum’s New Vision for Agriculture
already underway in South Africa, Kenya and and its SAGCOT project, described later
Uganda, while Mozambique and Tanzania are in this report.
also working towards starting similar trials.14
Overcoming popular resistance to GM in In Kenya and Tanzania, DFID has been
Africa is integral to WEMA’s success: funding a company called Farm Input
“Creating awareness on the benefits that the Promotions Africa (FIPS-Africa) in
WEMA drought-tolerant maize varieties will projects to provide farmers with
bring to smallholder farmers in Sub-Saharan agro-chemicals and seeds supplied by
Africa and to build support from all the companies including Monsanto, Bayer
relevant stakeholders is a crucial component and DuPont Pioneer.17 By developing
of the project.”15 networks of village-based agricultural
advisers who conduct demonstrations
The AATF not only develops GM technology of seeds and chemical products and sell
but seeks to counter opposition to it through them to farmers, FIPS-Africa has become
changing national regulation. In June 2012, “an integral part of Monsanto’s marketing
AATF Executive Director Denis Kyetere operation to small farmers in Kenya”.18
referred to “immediate challenges to By September 2010 the scheme
overcome so as to advance biotechnology had reached more than 37,000 smallholders
development” in Africa, which included in 165 villages in western Kenya.19 DFID
“emerging regulatory / biosafety frameworks reports note that “in cooperation” with
that may delay smallholder farmers from Monsanto and a Kenyan firm, the Western
accessing the tools of biotechnology”. Seed Company, 15,000 mini-packs of seed
Kyetere was referring to the fact that only varieties were distributed to farmers
three countries – South Africa, Burkina Faso in Kenya and a network of over 120 farm
and Egypt – have so far commercialised GM input stockists was established throughout
crops, while a further six countries have the country’s Central Province. In addition,
biosafety laws in place allowing for such “FIPS-Africa, with cooperation of Monsanto,
commercialisation.16 developed a new method for promotion
of herbicides” by which around 3,000
DFID promotes Monsanto’s interests in a farmers were visited and Monsanto’s
number of projects which deepen farmers’ herbicide Roundup Max was demonstrated
reliance on chemical pesticides, herbicides, on a 5 x 10m plot. “It can be concluded
fertilizer and hybrid seeds. These inputs are that the promotion method was very
expensive for poor farmers, and reliance on successful in catalysing adoption of Roundup
them can lock farmers into dependency on Max by small-scale farmers,” the DFID
the multinational corporation concerned, document notes.20
3. DFID and Monsanto in Malawi
06
to small farmers, and an alternative to the organisation funded by USAID and DFID,
government’s agricultural extension service. and its local affiliate the Rural Market
A project evaluation report states that 44% Development Trust (RUMARK), whose
of the agro-dealers in the programme were trustees include four seed and chemical
providing extension services.27 Indeed, a suppliers: Monsanto, SeedCo, Farmers World
World Bank report notes that: and Farmers Association.29 CNFA argues that
“leveraging the power of private enterprise –
The agro-dealers have…become the most from large multinational corporations to local
important extension nodes for the rural poor… input supply stores – is the best route to
A new form of private sector driven extension sustainable, market-based development
system is emerging in these countries [Malawi, solutions”.30 The organisation was “at the
Kenya and Uganda] as the major agricultural forefront of development in the early 1990s
input supply companies are increasingly building free market systems in the Newly
conducting commercial demonstrations of new Independent States of the former Soviet
technologies in rural areas with rural stockists.28 Union”.31CNFA’s president and founder,
John Costello, is a member of the US State
The agro-dealer project in Malawi has Department’s Advisory Committee for
been implemented by CNFA, a US-based International Economic Policy.
Unilever are both Task Force members of this report, small farmers will be mainly
Grow Africa, along with Syngenta, Diageo outgrowers working for large agribusiness
and Yara, among others.40 corporations. Indeed, SAGCOT project
documents are explicit in affirming “the
DFID works alongside Unilever in the importance of incorporating smallholder
Investment Climate Facility (ICF) for Africa, farmers within commercial agriculture
an initiative set up with DFID money in 2005 businesses”.44 It is also noteworthy that
to “help bring about more business friendly SAGCOT’s investment blueprint defines small
policies, laws and regulations across the farmers as those with a turnover of less than
continent”.41 By August 2012, DFID had $5,000 per year – 10 times more than most
spent £17.9 million funding the ICF. Unilever, Tanzanian small farmers – suggesting that the
one of the ICF’s corporate sponsors, also project will mainly target larger farmers. The
contributed $1 million over two years to the SAGCOT documents also make clear that the
ICF, its press release noting: “We want to project will lobby for low taxes for investors,
work with the ICF to lift the constraints such as corporation tax holidays and
that currently exist for business in terms exemptions from VAT and withholding tax.
of bureaucracy, capacity, finance and good
business planning.”42 The ICF’s first chair The SAGCOT project’s executive committee
was Niall Fitzgerald, former CEO of Unilever has been co-led by the Tanzanian Minister of
from 1996 to 2004. Agriculture and a vice-president of Unilever,
and delivered an investment blueprint for the
Unilever is a key player in the Southern corridor. The committee also established the
Agricultural Corridor of Tanzania (SAGCOT), SAGCOT Centre to coordinate and mobilise
a project that comes out of the DFID-funded investments and partnerships in the corridor,
Grow Africa and New Vision for Agriculture and a Catalytic Fund to spur investments.45
initiatives. Launched at the World Economic The Catalytic Fund for SAGCOT is managed
Forum Africa in 2010, SAGCOT is a public- by AgDevCo, a company with links to DFID
private partnership that aims to bring as described later in this report.
350,000 hectares of land under agricultural
production and to generate $2.1 billion of Few companies exemplify better than
private sector investment in agriculture over Unilever the personal nexus of relations
20 years. The project’s founding partners between the UK government and
include Unilever, Monsanto, Diageo, Syngenta, agribusiness. Nick Dyer, DFID’s current
SABMiller,Yara, AGRA and DuPont. DFID Director of Policy, started his career in
joined with the EU and USAID in September Unilever before joining DFID in 1990; prior
2012 to earmark funding for an upgrade of to joining DFID’s policy department, Dyer
road infrastructure in the corridor – “the first headed up DFID’s programme in Malawi.
component of a significant UK programme of Douglas Brew, Unilever’s current External
support to SAGCOT”, according to Diane Affairs Director for Africa, spent nearly nine
Corner, British High Commissioner to years at DFID as a Senior Adviser and Africa
Tanzania.43 Regional Manager, joining the company in
2012 after being Head of Africa, Development
SAGCOT states that it will benefit small and Humanitarian at the UK Representation
farmers but, just as with the Beira Agricultural to the EU. Unilever has also been represented
Growth Corridor project described later in by its retired Senior Vice President Jeroen A.
10
Committee of the pro-GM DFID-funded The company has for many years received
HarvestPlus initiative, described below. substantial funding from DFID, and in the
three years to March 2012 was paid over
Unilever’s board of directors is truly £113 million from the aid budget.46
a revolving door from UK government
cabinets. Three former Conservative Other current non-executive directors of
ministers were until recently on the Unilever also have connections to the
board as non-executive directors: government. Byron Grote, formerly at BP, was
a member of the UK Business-Government
• Baroness Lynda Chalker, the former UK Forum on Tax and Globalisation from 2008
Minister for Overseas Development, was an to 2010, and Vice-Chairman of the UK
advisory and then a non-executive director government’s Public Services Productivity
of Unilever from 1998 to 2007, and is Panel from 1998 to 2000. Paul Walsh, non-
currently a trustee of the Investment executive director of Unilever and also CEO
Climate Facility for Africa, of which of Diageo, is a member of the government’s
Unilever is a corporate sponsor. Business Advisory Group (described in
more detail below) and an adviser to the
• Leon Brittan, now Baron Brittan of Department of Energy and Climate Change.
Spennithorne, a high-ranking Conservative
minister in the 1980s and then European Yet few business leaders can boast such
Commissioner, joined the Unilever board close association with the UK government’s
as a non-executive director in 2004. international development effort as Unilever
CEO Paul Polman, who has a personal
• David Simon, now Baron Simon of Highbury, interest in selling agro-chemicals (a key DFID
former UK trade minister and CEO of BP, policy) since he is also non-executive director
also joined the board as a non-executive of Dow Chemicals. Polman sits on the UN
director in 2004. panel co-chaired by UK prime minister David
Cameron, whose mandate is to determine
On the current Unilever board as a the direction for international development
non-executive director is Sir Malcolm Rifkind, in the period after 2015, the target date
the former Foreign Secretary, who is also set for the achievement of the Millennium
a non-executive director of Adam Smith Development Goals. Such a position affords
International, the consultancy created out Unilever a unique measure of influence,
of the right-wing Adam Smith Institute. enabling the company to argue for more
Adam Smith International is an explicitly pro- pro-corporate policies on a panel which has
privatisation consultancy that works to create been widely criticised for failing to include
“an enabling environment for market and any civil society representation.47
5. DFID and Syngenta
11
Syngenta, BASF, Dow and DuPont. GM built on our first demonstration of any
The Hunger Games How DFID support for agribusiness is fuelling poverty in Africa
crops have been largely developed for global transgenic banana with a useful trait carried
commodity markets served by large-scale out in other work funded... by Syngenta”.60
farmers growing maize, soya and cotton.56
There is little evidence that GM crops Syngenta is also a partner in the DFID-funded,
produce higher yields (their supposed pro-GM African Agricultural Technology
rationale) but considerable evidence of the Foundation (AATF), described earlier in this
risks involved in reliance on GM technology report. In addition to its other GM trials, the
– even before the furore in September 2012 AATF is carrying out field trials of GM
caused by new research linking exposure to bananas in Uganda based on original research
Monsanto’s GM maize and Roundup herbicide conducted at Leeds University, which was
with tumours in rats.57 If small farmers use funded by DFID and the Biotechnology and
GM crops, they are locked into buying Biological Sciences Research Council.61
expensive seed from large corporations, David Lawrence, former Head of Research
as well as often needing to use more and Development at Syngenta and now one
chemical pesticides. This has been shown of the company’s non-executive directors,
to be a sure route to indebtedness and is a member of the Biotechnology and
long-term poverty.58 Biological Sciences Research Council, and also
of the Industrial Biotechnology Leadership
One earlier DFID-funded project involved Team, another body advising the government
a partnership with Syngenta Bangladesh to on biotechnology policy. Lawrence was also
promote pest management for rice farmers. a member of the Lead Expert Group advising
The project documentation noted that it the government on global agriculture policy,
enabled partners “to assist Syngenta to assure which wrote the influential Foresight report
quality, and promote the technology to on The Future of Food and Farming.62
farmers and policy makers” in the context of
Syngenta holding a 70% share of the pesticide Syngenta also enjoys other personnel
market in Bangladesh. The DFID project connections to the UK government.
involved “providing training to Syngenta Andrew Bennett, a board member and
personnel, pesticide retailers affiliated to former Executive Director of the Syngenta
them, and their customers… in parallel with Foundation, was previously Director of
training of Syngenta marketing personnel and Rural Livelihoods and Environment at DFID.
pesticide retailers”. The project was “designed He is also a board member of UK-based
to transfer knowledge to Syngenta and their consultancy CABI, which receives £1.2 million
dealer network” and “to assist Syngenta to DFID funding for its CABI Development
develop strategies for promoting pheromone Fund as part of DFID’s contribution to the
products to a receptive farmer population in CGIAR.63 The Chair of CABI, John Ripley,
order to enable sustainable transfer of the spent 35 years at Unilever, most recently
technology into the market place.”59 Another as Head of Corporate Development.
DFID-funded project involved promoting The Chair of Syngenta is Martin Taylor,
transgenic (i.e. GM) resistance to pest former CEO of Barclays plc, who served
damage. The project was “the first as a member of the Independent Banking
demonstration world-wide of a transgenic Commission established in June 2010
East African Highland banana” and “the results by Chancellor George Osborne.
6. DFID and Diageo
13
British mining corporation Rio Tinto, on In June 2010, SABMiller won nearly
The Hunger Games How DFID support for agribusiness is fuelling poverty in Africa
whose board sits DFID non-executive $1 million funding from the Africa Enterprise
director Vivienne Cox. Cox’s biography Challenge Fund (AECF) to “introduce an
describes her as the “lead independent innovative local sourcing model for cassava”
director on the Ministerial Board of the through a local subsidiary; SABMiller will
Department for International Development”, contribute $2 million through the partnership
and she has remarkable personal business
to match the funding provided by the AECF.84
contacts, sitting also on the boards of BG
In addition to SAB Miller’s cassava project,
Group (formerly British Gas), Pearson
(owner of the Financial Times),Vallourec another AECF project is the Ghana Grains
(a manufacturing company for the energy Partnership, which supports one of the
industry) and INSEAD (an elite business world’s largest fertilizer corporations,
school with offices worldwide). She is also a Yara, to supply chemical fertilizers to
former executive vice-president of BP, where farmers, alongside the Dutch / Ghanaian
she worked from 1981 to 2009. Rio Tinto company, Wienco, supplying pesticides.
is described as a “strategic partner” of The project seeks to provide maize
AgDevCo and has “partnered with AgDevCo, farmers with access to chemical fertilizer
the Government of Mozambique and the and seed, along with extension services.
British Government to assist farmers in Project documentation notes that Yara
the vicinity of mines in Moatize, central conducts demonstration plots and trains
Mozambique, to boost their crop yields for
the farmers on the use of fertilizer, while
commercial food production”.82 Rio Tinto
“Yara and Wienco have also jointly
has recently gained access to Mozambique’s
large coal reserves through its acquisition developed small plots within the
of Australian mining company Riversdale, communities to communicate the
and has been negotiating with the message of new inputs techniques and
Mozambican government to upgrade the the financial implications of embracing
country’s infrastructure in order to facilitate new technology”.85 This model is being
the transportation of coal from Moatize replicated in the Beira Corridor and
to the coast.83 SAGCOT projects.
8. The Mauritius connection
17
Chad and India. The GuarantCo concept funded by DFID, as described earlier in
The Hunger Games How DFID support for agribusiness is fuelling poverty in Africa
came from the PIDG, and DFID has provided this report.98
$42 million in funding to GuarantCo, some
through the PIDG Trust, with plans to spend AGRA has also had a long relationship with
£102 million in 2011-15.95 Pearl Capital Partners, a specialist agriculture
investment firm that has invested in small and
The DFID-funded Alliance for a Green medium-sized East African agribusinesses
Revolution in Africa (AGRA) is also closely since 2006.99 While it has offices in Kampala
linked to companies incorporated in and Nairobi, the company is licensed in
Mauritius. The African Agriculture Fund (AAF), Mauritius. Pearl Capital’s Managing Partner is
a special initiative of AGRA, is a company Tom Adlam, formerly chief financial officer of
incorporated in Mauritius.96 The AAF the UK government’s CDC Group’s African
“supports private agricultural companies and agro-industries investment portfolio. As head
cooperatives that implement strategies to of Pearl Capital, Adlam is also managing
increase and diversify agricultural production director of African Agricultural Capital (AAC),
in Africa and reduce risks from volatility in a fund which has had a long relationship with
commodity prices” and aims to grow to a AGRA through the African Seed Investment
size of €500 million.97 The AAF is run by Fund, also managed by Pearl Capital.100
Phatisa Fund Managers, a subsidiary of Phatisa According to DFID, AAC is one of the
Group Ltd, also incorporated in Mauritius. investment funds acting as a co-funder
Phatisa is also involved in the Beira on initiatives with the Africa Enterprise
Agricultural Growth Corridor project being Challenge Fund.101
PIDG Trust
FMFML
AGRA
GuarantCo
EAIF
AAF Phatisa
This report has traced how the UK assistance.Yet the crisis in the global food
government’s Department for International system has revealed the need for alternative
Development (DFID) is spending hundreds models of food production, distribution and
of millions of pounds of taypayers’ money consumption that guarantee communities
in order to expand corporate control over control over their own natural resources,
agriculture in Africa. At the same time as vast strengthen local and national markets and
tracts of African farm land are being handed promote agroecological production methods.
over to private investors, DFID is seeking to These positive alternatives come together
bring millions of African farmers under the under the framework of food sovereignty
control of the world’s largest agribusiness as developed by the worldwide farmers’
companies through increased dependency on movement La Vía Campesina and described in
corporate seeds and chemicals and through full in War on Want’s report Food Sovereignty:
their transformation into outgrowers for Reclaiming the global food system.
private sector investment initiatives. In some
instances, such as the Malawi case study War or Want believes that:
featured in this report, agricultural extension
projects funded by DFID are the sole means • DFID should suspend its support for
by which corporations are able to penetrate initiatives promoting land grabbing
these new markets. The fact that much UK by multinational corporations and
aid to agribusiness is being routed through agricultural extension activities involving
the tax haven of Mauritius adds further insult the sale of corporate seeds and chemical
to injury. inputs to small-scale farmers. In their
place, DFID should respond to the call
DFID is using the UK aid budget to from Olivier De Schutter, UN Special
drive forward the privatisation of African Rapporteur on the Right to Food, who
agriculture, denying people’s right to control has urged all states to promote the model
their own food production. Rather than of agroecology in their plans to reduce
meeting DFID’s mandate of poverty reduction, poverty and climate change.
this pro-corporate agenda threatens to • DFID should suspend its funding for
deepen hunger and poverty among rural research into GM crops. Instead, DFID
populations into the long-term future. There should support agricultural research focused
is an urgent need to halt DFID’s support for on sustainable, low-input and traditional
the corporate takeover of African agriculture breeding programmes developed by
before irreversible damage is done. small-scale farmers around the world.
Notes
The Hunger Games How DFID support for agribusiness is fuelling poverty in Africa
1
‘Agriculture’, at www.dfid.gov.uk 17
‘FIPS-Africa helps farmers in Makueni district
2 improve their crop yields through promotion of
improved seed, fertilizer and soil management’,
Towards a Green Economy: Pathways to Sustainable
Development and Poverty Eradication: UNEP, 2011.
The six biggest pesticide companies are: Syngenta DFID, April 2007
(Switzerland), Bayer (Germany), BASF (Germany), 18
Blind Alley? Is DFID’s policy on agriculture in danger
Monsanto (US), Dow (US) and Dupont (US). The 10 of failing to deliver food and environmental security?
biggest seed companies are Monsanto (US), Dupont GM Freeze, June 2009
(US), Syngenta (Switzerland), Limagrain (France), Land 19
‘RIUtv meets Benson Maniaji from FIPS-Africa’,
O Lakes (US), KWS (Germany), Bayer (Germany), 22 September 2010
Dow (US), Sakata (Japan) and DLF-Trifolium 20
‘Crop Protection Programme: Improved access to
(Denmark). The seven biggest fertilizer companies are:
appropriate farm inputs for integrated maize crop
Yara (Norway), Mosaic (US), Agrium (Canada), K+S
management by small-scale farmers in Kenya and
Group (Germany), Israel Chemicals, CF Industries
Tanzania’, DFID, 31 December 2005; ‘Appropriate
(US), Potashcorp (Canada); see Who Will Control the
inputs for Kenya’s farmers: How farmers can increase
Green Economy? ETC Group, November 2011
yields while reducing costs’, DFID, 28 March 2006
3
Food Sovereignty: Reclaiming the global food system, 21
War on Want, October 2011
Malawi Agro-Dealer Strengthening Program, Interim
Evaluation Phase 1 Report, University of Malawi
4
The Aid Funded Business Service, previously a Centre for Agricultural Research and Development
team within UK Trade & Investment, has now been (CARD), December 2009
outsourced to a joint venture run by British Expertise 22
Interview with Paul Chimimba, February 2011
and the Birmingham Chamber of Commerce.
23
Interview with Godfrey Chapola, RUMARK,
5
‘Working as one team at Post: Guidance for DFID,
February 2011
UKTI and FCO staff on HMG’s Commercial
Diplomacy and Untied Aid Agenda’, April 2011
24
Interview with Paul Chimimba, February 2011
‘Africa is open for business’, Andrew Mitchell, speech
25
6 Malawi Agro-Dealer Strengthening Program, Interim
to London School of Business, 11 July 2011 Evaluation Phase 1 Report, University of Malawi
7 Centre for Agricultural Research and Development
(CARD), December 2009
Leading in Innovation: 2011 Annual Report,
Monsanto, 2011
26
8
‘AGRA: A partnership for change’, at http://www.agra-
Malawi Agro-dealer Strengthening Program:
Interim Report 7, University of Malawi Centre for
alliance.org; for a full critique, see Alliance for a Green
Agricultural Research and Development (CARD),
November 2010
Revolution in Africa (AGRA): Laying the groundwork for
the commercialization of African Agriculture, African
Centre for Biosafety, September 2012
27
Malawi Agro-Dealer Strengthening Program, Interim
Evaluation Phase 1 Report, University of Malawi
9
For more details, see Food Sovereignty: Reclaiming the
Centre for Agricultural Research and Development
global food system, War on Want, October 2011
(CARD), December 2009
10
‘Bridging the gap to new technologies for 28
‘Developing Rural Agricultural Input Supply Systems
smallholder farmers in Africa’, AATF Strategy
for Farmers in Africa’, in Fertilizer Toolkit: Promoting
(2007-2015), November 2006
Efficient and Sustainable Fertiliser Use in Africa, World
11
‘Ending Striga’s reign with IR maize’, DFID, March Bank, 2007
2011 29
Interview with Godfrey Chapola, February 2011
12
‘Bridging the gap to new technologies for 30
‘CNFA: A Market-Driven Approach’, CNFA Fact
smallholder farmers in Africa’, AATF Strategy
Sheet, August 2012
(2007-2015), November 2006
31
‘Our History’, at www.cnfa.org
13
Details from the AATF website: http://www.aatf-
africa.org
32
See Paul Polman, ‘Towards inclusive growth: a new
model for capitalism’, International Trade Forum
14
WEMA Progress Report May 2012, AATF, 2012
Magazine, 1 April 2012; statistics from Unilever
15
WEMA Progress Report 2008-2011, AATF, 2011 annual and CSR reports
16
‘Support biotechnology development in Africa – 33
‘Tomatoes bring hope for Ghanaian farmers’, in
private sector urged’, AATF, 20 June 2012 Development Works, DFID, June 2006; ‘Promoting
growth and jobs’ in G8: Two Years On, DFID, March
2008; The Farmer Field School Project: Growing
Sustainable Tea in Kenya, Unilever, 2009; ‘ProTaNut:
Profitable Tanzanian Nut’, DFID (undated)
21
34
The Engine of Development: The private sector and 55
Mae Wan-ho, ‘Golden Rice’: An Exercise in How Not to
prosperity for poor people, DFID, May 2011 Do Science, Third World Network, 2002; Charito P.
35
‘Intervention summary for Programme Partnership Medina, ‘Who Needs Golden Rice?’, in Genetic
Arrangement with Oxfam, 2011-2014’, DFID, 2011 Engineering and Food Sovereignty, EED, 2009, pp48-52;
Christoph Then, The campaign for genetically modified
36
‘An “Avon lady” of Bangladesh tells her story’, DFID,
17 April 2012
rice is at the crossroads: A critical look at Golden Rice
after nearly 10 years of development, Foodwatch,
37
Paul Polman, ‘Towards inclusive growth: a new model January 2009
for capitalism’, International Trade Forum Magazine, 56
1 April 2012
Blind Alley? Is DFID’s Policy on Agriculture in Danger
evidence of Gareth Thomas MP, 17 June 2008 (Ev32) and ‘ARD contribution to the Africa Enterprise
53
Challenge Fund General Window: Agribusiness
Africa Window’, DFID, August 2011
Growth and poverty reduction: the role
of agriculture, DFID, December 2005
69
Jessica Silver-Greenberg, ‘Land Rush in Africa’,
54
‘Biofortification: Frequently Asked Questions’, at
Business Week, 25 November 2009; Abdul Mahmud,
www.harvestplus.org; in addition, DFID has spent
‘Dominion Farms Ltd, Nigeria government and land
£4 million on the Harvest Plus Challenge
grab’, Elombah News, 24 February 2012; Justus
Programme since 2008
Ochieng, ‘Kenya: Dominion Farms chief fears for his
life’, Nairobi Star, 30 August 2011; Calvin Burgess,
‘Response to Article in Business Week, November
2009’, available on www.dominion-farms.com
22
The Hunger Games How DFID support for agribusiness is fuelling poverty in Africa
70
Understanding Land Investment Deals in Africa: Country 86
Nicholas Shaxson, Treasures Islands: Tax Havens and
Report – Sierra Leone, Oakland Institute, 2011; the Men Who Stole the World, Bodley Head, 2011; Anil
Concerns of Bread for All on the Addax Bioenergy Sasi, ‘40% of India’s FDI comes from this bldg’, Indian
Project in Sierra Leone, Bread for All, November 2011 Express, 21 August 2012
71
‘Addax Bioenergy response re report alleging human 87
‘Business case and intervention summary: Private
rights abuses at an Addax Bioenergy project in Sierra Infrastructure Development Group (PIDG)’, DFID
Leone’, Addax Bioenergy, 17 June 2011 project record at www.dfid.gov.uk
72
Addax’s Memorandum of Understanding with the 88
‘Emerging Africa Infrastructure Fund’ at
Sierra Leonean government is reproduced online www.dfid.gov.uk
at http://farmlandgrab.org 89
See http://www.frontiermarketsfm.com
‘Multilateral Aid Review: Assessment of the PIDG
73
“Waiting Here for Death”: Forced Displacement and 90
“Villagization” in Ethiopia’s Gambella Region, Human (Private Infrastructure Development Group)’, DFID,
Rights Watch, January 2012; Hansard HC Deb, February 2011
22 May 2012, c587W 91
PIDG Annual Report 2010, Private Infrastructure
74
Hansard HC Deb, 12 September 2011, c1015W Development Group, 2011
75
‘UK Aid to Ethiopia probed in legal action over 92
‘Private infrastructure development group (PIDG)’,
alleged human rights abuses’, Leigh Day press at www.dfid.gov.uk
release, 6 September 2012 93
‘PIDG: Core Support to Private Infrastructure
76
‘F12 full year results: SABMiller drives strong results Development Group’, and ‘Business case and
in developing markets’, SABMiller, 24 May 2012 intervention summary: Private Infrastructure
77
‘AgDevCo announces the launch of the second Development Group (PIDG)’, DFID project
funding round for the Beira Agricultural Growth records at www.dfid.gov.uk
Corridor Catalytic Fund’, 25 March 2011; 94
See www.guarantco.com
beiracorridor.com/news.php 95
‘Business case and intervention summary: Private
Infrastructure Development Group (PIDG)’, DFID
78
Beira Agricultural Growth Corridor: Delivering the
Potential, InfraCo, January 2010 project record at www.dfid.gov.uk; PIDG Annual
79
‘Beira Agricultural Growth Corridor (BAGC)’, Report 2010, Private Infrastructure Development
DFID project record at www.dfid.gov.uk Group, 2011
80
‘Mozambique: Significant Opportunities for 96
‘Frequently Asked Questions about the African
Agribusiness Investment’, brochure prepared for the Agriculture Fund’ at http://www.phatisa.com
Grow Africa Investment Forum 2012, available from 97
‘Special Initiatives’ at http://www.agra-alliance.org
growafrica.com; Beira Agricultural Growth Corridor: 98
Delivering the Potential, InfraCo, January 2010
Beira Agricultural Growth Corridor: Delivering the
Potential, InfraCo, January 2010, Annex C: ‘Key
81
‘About Us’, at www.agdevco.com players and institutions active in the Beira corridor’
82
‘Strategic Partners’, at www.agdevco.com 99
See http://pearlcapital.net
83
‘Rio Tinto makes first coal shipment from 100
See http://www.aac.co.ke
Mozambique’, Rio Tinto, 25 June 2012 101
‘ARD contribution to the Africa Enterprise
84
‘SABMiller wins smallholder funding for Southern Challenge Fund General Window: Agribusiness
Sudan’, SABMiller, 25 June 2010 Africa Window’, DFID, 17 August 2011
85
Patrick Guyver and Mavis MacCarthy, ‘The Ghana
Grains Partnership’, DFID, 2010
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source=fiHeadlineStory
By Karrie Kehoe
LONDON, Nov 5 (Thomson Reuters Foundation) - The Bill & Melinda
Gates Foundation has rejected accusations that too much of its
funding goes to Western researchers, saying it is helping small
farmers in African countries.
GRAIN analysed funding from the Gates Foundation since 2003 and
found that of the more than $3 billion the charitable body gave in
food and agriculture grants, just 5 percent of funds went to African
groups besides the Nairobi-based Alliance for a Green Revolution in
Africa (AGRA) and the African Agricultural Technology Foundation
(AATF).
The Bill & Melinda Gates Foundation said the report was
"deliberately misleading".
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Better-known for its battles against global disease, the Gates Foundation has also become a
force in journalism. The foundation's contributions to nonprofit and for-profit media have
helped spur coverage of global health, development and education issues. But some people
worry that its growing support of media organizations blurs the line between journalism and
advocacy.
Did you catch ABC’s recent special on an incubator to boost preemie survival in Africa and a new machine to
diagnose tuberculosis in the developing world?
Perhaps you saw Ray Suarez’s three-part series on poverty and AIDS in Mozambique on the PBS NewsHour. Or
listened to Public Radio International’s piece on the rationing of kidney dialysis in South Africa.
Beyond their subject matter, these reports have something else in common: They were all bankrolled by the Bill
& Melinda Gates Foundation.
Better-known for its battles against global disease, the giant philanthropy has also become a force in journalism.
The foundation’s grants to media organizations such as ABC and The Guardian, one of Britain’s leading
newspapers, raise obvious conflict-of-interest questions: How can reporting be unbiased when a major player
holds the purse strings?
But direct funding of media organizations is only one way the world’s most powerful foundation influences what
the public reads, hears and watches.
To garner attention for the issues it cares about, the foundation has invested millions in training programs for
journalists. It funds research on the most effective ways to craft media messages. Gates-backed think tanks turn
out media fact sheets and newspaper opinion pieces. Magazines and scientific journals get Gates money to
publish research and articles. Experts coached in Gates-funded programs write columns that appear in media
outlets from The New York Times to The Huffington Post, while digital portals blur the line between journalism
and spin.
The efforts are part of what the foundation calls “advocacy and policy.” Over the past decade, Gates has devoted
$1 billion to these programs, which now account for about a tenth of the giant philanthropy’s $3 billion-a-year
spending. The Gates Foundation spends more on policy and advocacy than most big foundations — including
Rockefeller and MacArthur — spend in total.
Much of the money goes to analyses of policy questions, such as the best way to finance vaccines for poor
countries. But the “advocacy” side of the equation is essentially public relations: an attempt to influence
decision-makers and sway public opinion. The ultimate goal is to boost funding and focus from governments,
businesses and other foundations for the battle against disease and poverty — particularly now, as Congress
considers deep cuts in foreign aid.
“As big as the foundation is, there is no single area we work in where we can remotely succeed without other
partners and actors,” said Mark Suzman, head of policy and advocacy for the foundation’s global-development
programs.
While the aims may be laudable, the ability of one wealthy foundation to shape public discourse is troubling to
some.
“Even if we were to satisfy ourselves that the Gates Foundation were utterly benign, it would still be worrisome
that they wield such enormous propaganda power,” said Mark Crispin Miller, professor of media, culture and
communications at New York University.
Some of the foundation’s approaches are controversial, such as its embrace of genetically modified crops and
emphasis on technological fixes for health problems. Critics fear foundation funding of media will muffle those
debates. And with only three trustees setting the overall strategy — Bill and Melinda Gates and fellow billionaire
Warren Buffett — there’s something “deeply anti-democratic” about such a concentration of influence, Miller
said.
“We’re not dealing with a lively discussion among players. We’re dealing with one gigantic entity … that seems
to be very skilled at promoting its agenda,” he said.
Foundation officials say they’re not out to control the way the media cover global disease and poverty, or even
the foundation’s own programs. They just want increased visibility for life-and-death issues that often get
ignored, especially in the face of shrinking newsroom budgets.
“We’re trying to do everything we can to make sure people understand not just the need, but the opportunity, to
make a huge difference in the lives of millions of people around the world,” said Joe Cerrell, who oversees the
foundation’s policy, advocacy and communications work in Europe. “For us, it’s about making sure that these
stories get told.”
There’s nothing new about powerful organizations attempting to massage media and get attention for their
causes.
“It would be naive to believe big-money foundations don’t play the same game that corporations and other
special interests do,” said Marc Cooper, assistant professor at the University of Southern California’s Annenberg
School for Communication & Journalism. “I don’t find that inherently troubling.”
New York Times columnist Nicholas Kristof recently argued that “good people engaging in good causes” need to
sell the public on the need to take action when children are starving or being stunted by preventable disease.
No charity is better positioned to take on that challenge than Gates, with assets totaling more than $60 billion
(including Buffett’s donation) and Microsoft’s media-savvy legacy to draw upon.
The foundation’s direct funding for media and media programs, which so far totals nearly $50 million, initially
followed the path taken by other foundations and corporations: Money for journalist training and for nonprofits
such as NPR and PBS. But rather than providing general support, Gates usually stipulates reporting on the
issues it cares about most: diseases such as HIV, malaria and TB; poverty in the developing world; and
education in the United States.
The International Center for Journalists got nearly $6 million for a program that pairs veteran journalists with
news organizations in Africa. One collaboration helped reverse a ban on midwives in Malawi by pointing out the
hazards faced by pregnant women en route to clinics, said program supervisor Jerri Eddings. 484 developing-
world journalists have been trained in reporting about AIDS through a Gates grant to the National Press
Foundation.
At PBS’ NewsHour, Suarez said a $3.6 million Gates grant has allowed him to cover stories that would
otherwise have been out of reach, such as river blindness in Tanzania and Mexican programs to improve
nutrition among the poor.
Other grants include $3.3 million to Public Radio International, $5 million to NPR and $1 million to Frontline.
Grumbling among media observers peaked late last year when the foundation for the first time teamed up with
major for-profit operations such as ABC and the Guardian.
The foundation provided ABC $1.5 million to fund overseas travel for reports on global health and development.
ABC put up $4.5 million. Neither the foundation nor the Guardian will reveal the dollar amount of the deal that
helped the British daily establish an online forum on global health and development.
The Seattle Times received a $15,000 Gates grant through Seattle University for a series of stories on
homelessness in 2010.
Some uneasiness
Recipients of Gates’ largesse all say the foundation does not dictate the specific stories they cover.
Foundation officials did provide the NewsHour a list of potential story subjects, but no mandates, Suarez said.
“The beauty of this relationship is that they trust our editorial process,” he said. “It’s not like we’re getting calls
from Washington state saying: It’s time to do HIV. It’s time to do malaria.”
But some journalists are uneasy with the arrangements. Seattle freelancer Robert Fortner stopped writing about
Gates for Crosscut after the local online news site received general support grants that total $500,000,
contingent on matching funds. Guardian health Editor Sarah Boseley has said she often shies away from
coverage of the foundation — positive or negative — for fear of being accused of a conflict.
Cooper, the journalism professor, finds it “laughable” when media claim Gates money doesn’t influence their
coverage. Every grant comes with at least one string attached, he said: the hope that the grant will be renewed.
Recipients can be reluctant to bite the hand that feeds them.
Indeed, few of the news organizations that get Gates money have produced any critical coverage of foundation
programs. The Guardian is an exception, with a recent blog post that blasted the foundation’s associations with
agricultural giant Monsanto, a leader in genetically modified crops.
“I don’t know if the Gates Foundation’s projects work,” Cooper said. “And if the Gates Foundation is going to
pay for all the news coverage around this, we’re never going to know.”
A blurry line
A larger question is whether Gates funding steers media coverage in directions that serve specific foundation
goals, both humanitarian and political, diverting attention from other issues.
Some grants have indeed spelled out coverage topics, including male circumcision to reduce transmission of
AIDS, and clinical trials — the latter of which are crucial for Gates-supported vaccines and drugs being tested in
the developing world.
The foundation’s latest media push, launched by Melinda Gates in 2010, is to shift coverage from stories of
despair to stories that show problems can be solved.
“People need to hear and see these success stories,” she said. “In the U.S. media, too often you hear what is not
working.”
There’s nothing wrong with telling positive stories, said global- health expert Laurie Garrett, of the Council on
Foreign Relations, which has received Gates funding. But it’s important to recognize that it’s also a political
tactic, she pointed out. Everyone who works in international aid and development is terrified government
spending will be slashed. Gates-sponsored research shows people are more likely to donate or support foreign
aid after seeing hopeful news. Success stories also show that past investments haven’t been wasted, the
foundation’s Suzman said.
To get those positive stories to the public, the foundation has launched a blitz that covers multiple bases,
including the establishment of digital outlets that bypass conventional media. After commissioning a British
think tank to identify development and health successes, the foundation showcased such stories in a series of
videos and articles called “Living Proof.”
At least one of the “Living Proof” stories touted by Melinda Gates has already found its way into the mainstream
media. The use of skin-to-skin cradling called “kangaroo care” to boost newborn survival was featured recently
in a New York Times column.
When ABC launched its Gates-funded global health initiative, “Be the Change: Save a Life,” it mirrored that
positive approach. Each segment of the inaugural program, hosted by Diane Sawyer, paired problems with
possible solutions, like a low-cost incubator for premature babies.
A website encourages people to donate money. Within the first week, more than $600,000 poured in.
Foundation officials say they don’t require ABC to report positive stories, though one of the grant’s goals is to
“inspire and motivate the millions of viewers to take action.”
Another foundation grant, to California-based LinkTV, is explicit in its aim of spreading good news. The
satellite network got $2 million to create a digital video library that spotlights progress in global development
and health. Called ViewChange, its target audience includes bloggers and journalists, as well as nonprofits that
can use the videos in their own advocacy campaigns, said general manager Wendy Hanamura.
Some news outlets present reports from Gates-funded health organizations as “news,” but those reports aim to
inspire people to donate money, rather than uncover facts, according to a recent analysis of global-health
journalism.
And while many positive stories are valid, media observers point out that an emphasis on good news can mean
less watch-dogging of programs that may not be working.
A wide reach
Beyond direct links to media, the foundation also supports a dizzying mix of organizations whose goals include
influencing media coverage. An interested citizen might think she’s getting news and information from a variety
of sources, but many of them might be funded by Gates.
The Henry J. Kaiser Family Foundation, a health-care think tank, has received nearly $20 million from Gates to
provide global health information and analyses. That includes media fact sheets and reporting guides, a free
video library for journalists and an influential daily roundup of global health news.
Gates gives money to policy magazines such as Health Affairs and Global Health Magazine, and has funded
scientific journals to publish articles on global health. Scientists trained in a Gates-funded program to “engage
policy makers, thought leaders, the media and the public” brief lawmakers and write op-ed pieces that appear in
newspapers and on news sites.
In the field of education, where Gates’ emphasis on teacher quality and small schools has been hotly debated, a
$500,000 grant to the Brookings Institution aims to “re-engineer media coverage of secondary and
postsecondary education.” Education Week magazine has received $4.5 million from the Gates Foundation.
These are just a smattering of the hundreds of policy and advocacy grants the foundation has issued. Gates isn’t
the sole funder for most of the groups, nor does Gates money mean grantees march to the same beat. But with
virtually every major player in global health — and many in education — receiving Gates money, it’s clear the
foundation’s voice is highly amplified in the media and beyond.
Garrett, a Pulitzer-Prize winning journalist, said she would prefer a more diverse set of voices. But without
Gates funding and interest, long-neglected diseases and the suffering of the world’s poor would receive far less
attention than they do today, she pointed out.
“Back when I was covering global health, I was pretty much the only person on the beat,” she said. “That’s not
the case anymore, and that’s good news.”
Kristi Heim
HOME
Remember something else too: the value of Microsoft has undoubtedly been
in ated by its tax planning. Low taxes equals higher value is a golden rule of the
stock market: it's the motive for tax avoidance.
So ask a question: how much of Gates' philanthropy has been paid for by the US
Exchequer? Quite a lot, I suspect. It's still philanthropy, but not quite as it rst looks.
And does philanthropy subsidised by the Exchequer really give a right to try to
direct how state funding is spent, as so many philanthropists of this sort seem to
think? I question that.
I'd go further: I'd rather less philanthropy, less hype, less high pro le giving to
publicity laden causes and rather more tax paid to ensure that the government in
each country in which a multinational corporation trades has the tax due to it to
ensure it can supply the public services the people in that country deserve.
But I question whether it's all quite such a good cause as some would claim, or
even as generous as it might seem. There's too much tax distortion in it all for me
to feel comfortable with any such suggestion.
HOME
0 0
11
11 Responses
Steve says:
June 8 2011 at 12:51 pm
And how much value for the US Exchequer has Gates created over the years?
I suppose in your view, he should be grateful that they allowed him to start a business?
I don’t suppose Gates set out to create a penny of value for the US Exchequer
Steve says:
June 8 2011 at 5:06 pm
I’m sure his intention was to make a tonne of money, which he plainly has.
I suppose that he pays personal tax on income and capital gains, his rm pays tax in
multiple jurisdictions, his employees pay tax, his customers pay sales tax, and I’ve
probably missed o several other taxes, and all the US Exchequer needs to do is sit there
and wait for the cheques to roll in – they are doing pretty well out of the deal all things
considered.
A bit of tax relief would seem to be fair to the man.
Are you implying that without the tax relief, Gates would not give to good causes?
Rather mean-spirited of you…
HOME Richard Murphy says:
June 8 2011 at 5:30 pm
Hardly…much of the evidence in the Uk suggests that without tax relief the rich would not
give, and as a proportion of income they give less than the poor, many of whom get no tax
bene t. But Gates may be an exception – but I really do expect he claims the relief
What Bill Gates seems to fail to mention re his admitedly large donations for Polio eradication is
that it is a
50:50 donation partnership with the Rotary organization. As a member of Rotary I and others are
getting a little fed up that he does not mention us in PR opportunities that we are giving half of the
donations from the funds we raise.
SadButMadLad says:
June 8 2011 at 8:30 pm
So instead of Bill Gates spending his money on worthy topics of his choosing you would rather he
give the money as tax for the state to spend on worthy topics of its choosing. If they topics of both
are the same you would still prefer the state to collect the tax and then spend it? With
governments known to be very good at spending money e ciently.
I like it
Don’t you?
As for state altruism – isn’t that your metaphor for hating democracy?
I would perhaps take your comment about straw men slightly more seriously if you hadn’t
gone and constructed one of your own about ‘state altruism’ meaning ‘hating democracy’.
All State Altruism means is actions taken by the state for the intended bene t of its
citizens, which I’d presumed you were in favour of.
However, the broader point – which I accept I failed to entirely capture – about tax
deductibility is interesting. But isn’t it the case that we want more spent on what could be
considered social goods, and that it doesn’t matter who does it? Whether the state or the
individual does good, that good is still done for that amount of resource.
Take it seriously or not: if you can’t be bothered to say what you mean in comprehensible
fashion then I didn’t create a straw man, I misunderstood you
I did however consider your comment on state altruism pretty weak – do you always
HOME
argue in absurdum?
And no – I don;t agree with you: means are important to ends. The state is accountable in
ways the individual is not: especially a wealthy individual able to impose a personal
agenda of priorities on others
Richard Murphy
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Way back in 2005 I was involved in the rst ever story on Microsoft's tax dodging.
Microsoft has saved nearly $7 billion o its U.S. tax bill since 2009 by using loopholes
to shift pro ts o shore, a Senate panel said in a report released Thursday.
Levin acknowledged that Microsoft has broken no laws. But he blamed a loose tax
code, Congress and tax o cials for allowing the loopholes.
"The tax practices and gimmicks range from egregious to dubious validity," Levin said.
"What these gimmicks do is shift the burden of taxes to citizens that don't use armies
of lawyers and accountants and subsidiaries to lower their tax bill."
In the case of Microsoft, the company transferred nearly half of its net revenue from
U.S. retail sales to a Puerto Rican subsidiary between 2009 and 2011. That saved the
rm $4.5 billion in U.S. taxes, according to the panel.
And the Irish ruse I was involved in exposing in 2005 continues, of course.
I agree with Levin's comments.
HOME
But think of this another way. Bill Gates has given billions to charity. I acknowledge
the philanthropy. But it's fair to ask how much of that
philanthropy was possible because his company avoided tax? And to ask how
much good might have been done if that tax had been paid?
It's a strange world where we grant power and status to those who secure
in uence with government based at least in part on the ability of their companies
to not pay the right amount of tax in the right place at the right time where right
means that the economic substance of the transactions undertaken coincides with
the place and form in which they are reported for taxation purposes.
0 0
5
5 Responses
Patrick says:
September 21 2012 at 2:50 pm
Hum... says:
September 23 2012 at 5:48 pm
James says:
September 21 2012 at 3:09 pm
It’s a fair question about the Gates Foundation (and one you could just as well ask of Bono).
Part of the answer is tied up in how much of Microsoft Bill still owns or controls. From what I
understand he is still (non-executive) chairman and owns about 6% of the stock (the largest
individual shareholder), but he gave up being CEO in June 2008. So he doesn’t have an awful lot of
control over its operations.
But part of it, I suspect, is also the geek in him saying “it’s OK to do it, because I can do it”. If you
look at the sort of things he got up to as a kid – nding bugs in operating systems and exploiting
them to get free computer access, writing programs to schedule high-school classes that put him
in with a large number of girls – you can see the pattern. Because he was Microsoft for so long, it
is not entirely surprising that the company went looking for tax loopholes. It is interesting to see
that Apple, Google, Amazon and HP – all companies stacked full of geeks – are all similar in this
respect to MS.
And yet… there is a signi cant contradiction. Gates set his rst charitable trust up in 1994, long
before you broke the tax dodging story. The Gates trust is reputedly transparent about what it
gives and to whom. There might be something in the geek ethos of “it’s OK because I can do it” in
the way the trust runs – having seen how intergovernmental initiatives like the UN’s 0.7% take
forever to get anywhere, Gates reckons that his gains, ill-gotten or otherwise, can get a result
faster and cheaper. (And to be honest, he might be right).
On the substantive question: yes, as CEO in 2005 he would have to hold up his hands to the
“Double Irish” (was it the Double Irish and Dutch Sandwich?). I think you cannot directly blame him
for the Puerto Rican dodge Sen Levin is talking about, but there is, of course, the question of
company culture (and that could take decades to turn around).
But on the whole I think that Bill Gates is not fundamentally an evil man: awed certainly – but not
beyond redemption. Someone with the intelligence and wealth Gates has could destroy the earth
if he chose, and what I see says that is not his choice – unlike, say, Bob Diamond, a man who
apparently has no moral compass whatsoever.
Fair comment
Richard Murphy
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Local authorities cannot take any of the finncial burden of
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its power to use direct monetary funding of government
spending by central banks
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Princess Charlene of
Monaco calls for people
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alongside Patrick
Dempsey and Pharrell
EXCLUSIVE Ex Vogue
editor André Leon Talley
rips into Anna Wintour,
revealing friendship
ended because he was
'too old, overweight and
uncool'
'She is homeschooling
three kids!': Rio
Ferdinand leaps to wife
Kate's defence after
she's accused
of 'having too much
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DailyMailTV: Dr. Phil and
Robin McGraw get
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while they make the
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'This experience is
overwhelming': Sienna
Miller reflects on the
challenge of
homeschooling
daughter Marlowe, 7, in
a global pandemic
Suki Waterhouse
shows off her svelte
frame as she slips into a
satin bra and shorts
while larking around at
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Cristiano Ronaldo's
girlfriend Georgina
Rodriguez shows off her
pert posterior as she
works out at home amid
the coronavirus crisis
Catherine Tyldesley
looks incredible as she
debuts 'experimental'
rose gold hair in sultry
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Professor Green
reveals he is observing
Ramadan for the first
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Morocco... yet is
accused of 'trivilising'
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Sophie Ellis-Bextor's
eldest son Sonny
celebrates 16th birthday
in lockdown as singer
shares rare family snap
to mark special day
Whitney Houston
biopic moves forward
as Bohemian Rhapsody
screenwriter signs up
Christie Brinkley's
daughter Alexa Ray Joel
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photo as she shares
'blessings'... after
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Ryan Gleason
RHOBH's Denise
Richards says she fears
daughters could grow
up with 'daddy issues'
like the women their
troubled father Charlie
Sheen 'entertained'
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EXCLUSIVE Caprice's
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and she is desperate to
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'It's difficult as a
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content in the GYM as
she discusses return to
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Holly Willoughby
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RHOBH's Garcelle
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NAKED as style guru,
56, shares beauty tips
from the bathroom
Robbie Williams
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knight for VERY
dramatic reading of
Aqua's Barbie Girl in
bizarre video from
lockdown
lockdown
Orlando Bloom
displays his hunky
physique as he goes
shirtless for a splash in
the sea in California
A grand piano
serenade, balloon arch,
and a VERY sparkly
gift... Adam Thomas
marks wife Caroline's
30th birthday with EPIC
lockdown surprise
Coronation Street's
Alan Halsall and
girlfriend Tisha Merry
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Peaky Blinders-inspired
ensembles for fun quiz
night at '£750k home'
Kate Middleton
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by Sainsbury's for his
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signature style
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Chicago PD is thrown
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out by a federal judge -
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Empire actor can refile
IF he is found not guilty
Pregnant Vogue
Williams covers her
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mint hoodie as she
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adorable son Theodore
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Jacqueline Jossa
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trains in lockdown and
says it has given her the
chance to refresh
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white portrait with
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Playful Prince Louis
beams as he smears
rainbow paint across
his cheeks in a VERY
messy new picture
taken by Kate Middleton
taken by Kate Middleton
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positive!' Gemma
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swimsuit throwback as
she urges fans to keep
their chins up during
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Coronation Street's
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young people as she
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Designer wallpaper
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BURSTING with luxury
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Princess Beatrice
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time since postponing
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Nicole Scherzinger
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goodbye forever
Ashley Roberts
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Pat on his 70th birthday
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Michelle Hardwick
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some vaccines, warning that it only serves to deter pharmaceutical
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companies from working on life-saving products for poor countries.
“Pneumococcus vaccine saves lives for about $1,000 per life saved,” said
Gates. “So if you are going to do any helping at all, ever build a hospital, ever
pay a doctor, you would [be willing to] pay for pneumococcus vaccine.”
The humanitarian aid organisation Médecins sans Frontières (MSF) last week
called publicly for the two big pharma companies making the vaccine to drop
the price to $5 per child. Each child needs three doses of the vaccine.
At the pledging meeting for Gavi, the global vaccines alliance, hosted by
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developing world with help from Gavi.
On Monday, Pfizer offered to cut the price from $3.30 a dose to $3.10.
The $7.5bn will help fund the vaccination effort in poor countries over the
next five years. Gates and the UK government put in the largest sums, at
about $1.5bn each.
Although he did not name MSF, Gates made clear his opposition to the
organisation’s views, as well as his admiration for its other work: “I think
there is an organisation that’s wonderful in every other respect, but every
time we raise money to save poor children’s lives, they put out a press
release that says the price of these things should be zero. Every five years
when we are raising billions – that is the most effective foreign aid ever given,
that saves millions of lives.
“In fact, there is a legitimate element to it, which is that we have to make
sure we understand the cost structure of making those vaccines. In the case
of pneumococcus, believe me – the amount we’ve studied it and gone to the
factories – this thing is super, super complicated. The quality you want for
these things to be made is really pretty mind-blowing. To focus on ‘why isn’t
everything free’ is a misdirection that has to do with the fact that they don’t
actually know anything about the costs.”
Gavi says that half a billion children have been immunised through its
suport in the 15 years since it was founded and 7 million lives saved. It hopes
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They continued:
“VDPVs can cause paralytic polio in humans and have the
potential for sustained circulation. VDPVs resemble WPVs
biologically and differ from most vaccine-related poliovirus
(VRPV) isolates by having genetic properties consistent with
prolonged replication or transmission. VDPVs were first
identified by sequence analyses of poliovirus isolates.”
(emphasis added)
The CDC recommended that the best way to deal with this
[adrotate banner=”9″]
In this short video clip, Bachchan can be seen giving these deadly
drops to the children of India during a recent advertising
campaign promoting the vaccination. [3] [video_player
The Activist Post has a point, however; the public health ‘experts’
are way off target regarding the numbers of children suffering
from vaccine-associated polio paralysis. According to the Oxford
Journal – Clinical Infectious Diseases, there have been many
more cases than those being reported. They reported that:
proportions.
A paper written by Neetu Vashishi and Jacob Puliyel published in
“… while India has been polio-free for a year, there has been a
huge increase in non-polio acute flaccid paralysis (NPAFP). In
2011, there were an extra 47,500 new cases of NPAFP.
Clinically indistinguishable from polio paralysis but twice as
deadly, the incidence of NPAFP was directly proportional to
doses of oral polio received. Though this data was collected
within the polio surveillance system, it was not investigated.
The principle of primum-non-nocere was violated.” [7]
Conclusion
With numbers of this size being reported about vaccine-induced
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6137a3.htm
2.
http://umm.edu/Health/Medical/Ency/Articles/Immunodeficienc
y-disorders
3. http://www.youtube.com/watch?v=oUDtkYrmas4
4.
http://www.bollywoodhungama.com/celebrities/features/type/vi
ew/id/5085
5. http://www.activistpost.com/2012/01/polio-vaccines-now-1-
cause-of-polio.html
6. http://cid.oxfordjournals.org/content/49/8/1287.full
7. http://www.ncbi.nlm.nih.gov/pubmed/22591873
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COMMENTS
Polio programme: let us declare victory and move on
Neetu Vashisht, Jacob Puliye
DOI: https://doi.org/10.20529/IJME.2012.035
Abstract
It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made
eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last
10 years was unethical.
Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP).
In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the
incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio
surveillance system, it was not investigated. The principle of primum-non-nocere was violated.
The authors suggest that the huge bill of US$ 8 billion spent on the programme, is a small sum to pay if the world learns to be wary of
such vertical programmes in the future.
“For of all sad words of tongue or pen, the saddest are these: ‘It might have been’!”
John Greenleaf Whittier (1807-1892)
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January 12, 2012, marked a significant milestone for India. It was the first anniversary of the last reported wild polio case from India.
Keeping the country free of polio for a whole year was a feat that is a tribute to the Government of India and its 2.3 million vaccinators,
who visited over 200 million households to ensure that the nearly 170 million children (under five years in age) were repeatedly
immunised with oral polio vaccine (OPV) (1). India’s programme has largely been self financed. The country has thus far spent more
than Rs 120 billion (US$2.5 billion US$ 1 = Rs 50) on polio eradication after the programme started here in 1994 (2). The $2.5 billion
spent by India must be seen against $2 billion spent by the United States of America on world-wide polio eradication (3), the $1.3
billion expended by Bill Gates (4), and the $0.8 billion raised by the loudest voice for polio eradication – Rotary International – over
the last 20 years (5).
The celebrations of January 12, 2012 would have been accompanied by a collective, massive sigh of relief because a new ‘name and
shame’ policy has been adopted by the World Health Organisation (WHO), apparently without approval (6), to boost the eradication
effort. In this vein, the acronym PAIN has been used, while referring to the polio-endemic countries of Pakistan, Afghanistan, India and
Nigeria. While the exact origin of this oft-repeated acronym is unclear (7, 8), India will be happy to be rid of the opprobrium.
Internationally, supporters of eradication desperately needed a victory in India to drum up enthusiasm, at a time when commitment to
the programme had been flagging, and funding was rapidly drying up. With a $410 million shortfall in the funds available, this gap
threatens to undermine eradication efforts (9). While India chalked up a year of being polio free, four other countries, Angola, Chad,
the Democratic Republic of Congo and Sudan, have had year-long outbreaks. Another 13 countries have had recent infections – eight
in Africa, along with Nepal, Kazakhstan, Tajikistan, Turkmenistan and Russia (10). The ethics of spending so much on polio
eradication has been challenged by Richard Horton, editor of The Lancet(11), and Arthur L Caplan, director of the University of
Pennsylvania’s bioethics centre (12). Besides, former supporters of the programme are now questioning its feasibility (13, 16).
It is noteworthy that the Pulse Plus programme was begun in India with a $ 0.02 billion grant from overseas in 1995 (18), at a time
when experts in India felt that polio eradication was not the top priority for the country. Four years into the programme of eradication,
in 1998, Dr T Jacob John wrote, “Today poliomyelitis is not the number one priority of public health in India. However, we must
eradicate it for the sake of the rest of the world.” (19). Having accepted the grant of $ 0.02 billion, India has spent a hundred times as
much. This is a startling reminder of how initial funding and grants from abroad distort local priorities.
Control is the reduction of disease to a locally acceptable level as a result of deliberate efforts; continued intervention is required to
maintain the reduction.
Elimination is reduction of the incidence of a disease to zero in a defined geographical area as a result of deliberate efforts. Even
after elimination, continued intervention is needed to maintain the incidence at zero.
Eradication is the permanent reduction to zero of the worldwide incidence of infection as a result of deliberate efforts such that
intervention is no longer needed.
Extinction is said to have occurred when the specific infectious agent no longer exists in nature or in the laboratory.
Eradication spares future generations the risk of infection and renders further vaccination unnecessary. Eradication is thus considered
an investment with resultant huge savings from not having to vaccinate any more (6, 21). Caplan, in his essay entitled ‘Is disease
eradication ethical?’, has noted that eradication may be public health’s greatest rhetorical weapon and unmatched in its ability to
command funding, popular support, the attention of politicians and positive media coverage (12). The stakes involved portend relief
forever as well as the ability to relax humanity’s guard against the disease (12).
The elephant in the room: the problem of non-polio Acute Flaccid Paralysis (AFP)
It has been reported in the Lancet that the incidence of AFP, especially non-polio AFP has increased exponentially in India after a
high potency polio vaccine was introduced (25). Grassly and colleagues suggested, at that time, that the increase in AFP was the
result of a deliberate effort to intensify surveillance and reporting in India (26). The National Polio Surveillance Programme maintained
that the increased numbers were due to reporting of mild weakness, presumably weakness of little consequence (27). However in
2005, a fifth of the cases of non-polio AFP in the Indian state of Uttar Pradesh (UP) were followed up after 60 days. 35.2% were found
to have residual paralysis and 8.5% had died (making the total of residual paralysis or death – 43.7%) (28). Sathyamala examined
data from the following year and showed that children who were identified with non-polio AFP were at more than twice the risk of
dying than those with wild polio infection (27).
Data from India on polio control over 10 years, available from the National Polio Surveillance Project, has now been compiled and
made available online for it to be scrutinised by epidemiologists and statisticians (29).
This shows that the non-polio AFP rate increases in proportion to the number of polio vaccine doses received in each area. Nationally,
the non-polio AFP rate is now 12 times higher than expected. In the states of Uttar Pradesh (UP) and Bihar, which have pulse polio
rounds nearly every month, the non-polio AFP rate is 25- and 35-fold higher than the international norms. The relationship of the non-
polio AFP rate is curvilinear with a more steep increase beyond six doses of OPV in one year. The non-polio AFP rate during the year
best correlates to the cumulative doses received in the previous three years. Association (R2) of the non-polio AFP rate with OPV
doses received in 2009 was 41.9%. Adding up doses received from 2007 increased the association (R2 = 55.6% p < 0.001) (30).
Population density did not show any association with the non-polio AFP rate, although others have suggested that it is related to polio
AFP (31).
The international incidence of non-polio AFP is said to be 1 to 2/100,000 in the populations under 15 (32, 33). The benchmark of good
surveillance is the ability to detect one case of AFP per 100,000 children even in the absence of polio (34). In 2011, an additional
47,500 children were newly paralysed in the year, over and above the standard 2/100,000 non-polio AFP that is generally accepted as
the norm. (32, 33). It is sad that, even after meticulous surveillance, this large excess in the incidence of paralysis was not
investigated as a possible signal, nor was any effort made to try and study the mechanism for this spurt in non-polio AFP. These
findings point to the need for a critical appraisal to find the factors contributing to the increase in non-polio AFP with increase in OPV
doses – perhaps looking at the influence of strain shifts of entero-pathogens induced by the vaccine given practically once every
month.
From India’s perspective the exercise has been extremely costly both in terms of human suffering and in monetary terms. It is
tempting to speculate what could have been achieved if the $2.5 billion spent on attempting to eradicate polio were spent on water
and sanitation and routine immunisation. Perhaps control of polio, to the level of elimination, may well have been achieved as it has
been in more developed countries. When the US was badly mired in Iraq in 2005, Joe Galloway suggested that the US must simply
declare victory, and then exit (35). Perhaps the time is right for such an honourable strategy with regard to polio eradication.
Strategy for the future
Eckard Wimmer has noted the WHO’s current policy calls for cessation of OPV vaccination three years after the last case of
poliovirus-caused poliomyelitis. Injectable polio vaccine (IPV) will replace OPV in countries which can afford it. The risks inherent in
this strategy are immense. Herd immunity against poliomyelitis will rapidly decline as new children are born who have not been
infected with wild-type viruses or were not vaccinated, a situation that has never existed in human history. Thus, any outbreak of
poliomyelitis will be disastrous, whether it is caused by residual samples of virus stored in laboratories, by vaccine-derived
polioviruses, or by poliovirus that is chemically synthesised with malignant intent (24).
The huge costs of repeated rounds of OPV in terms of money and non-polio AFP shows that monthly administration of OPV must
cease. The low incidence of non-polio AFP in places given less than six doses, suggests that routine immunisation is relatively safe.
Our resources are perhaps better spent on controlling poliomyelitis rather than trying to eradicate the disease. Routine immunisation
must be strengthened and perhaps one or two rounds of pulse polio may be needed.
The problem however is that the manufacturers of OPV may cease to produce the vaccine – a scenario that was predicted for India
eight years ago (36). The Government of India is in a quandary, having given up its capacity to manufacture OPV indigenously, on
misguided advice from overseas (37). It is now dependent on international manufacturers for its supplies. India needs to urgently
ensure that adequate supplies of the vaccines that it requires are available for our children, so that this eradication adventure does
not transform itself into an epidemic disaster.
Conclusion
The polio eradication programme epitomises nearly everything that is wrong with donor funded ‘disease specific’ vertical projects, at
the cost of investments in community-oriented primary health care (horizontal programmes) (38). Gilliam has described how vertical
programmes undermine broader health services through duplication of effort (each single disease control programme requires its own
bureaucracy), distort national health plans and budgets and, because salaries of donor-funded vertical programmes are often more
than double those of equally trained government workers, lead to a diversion of skilled local health personnel from primary healthcare,
causing an ‘internal brain drain’ (39). We have seen how polio, that was not a priority for public health in India, was made the target
for attempted eradication with a token donation of $ 0.02 billion. The Government of India finally had to fund this hugely expensive
programme, which cost the country 100 times more than the value of the initial grant.
De Maeseneer and colleagues suggest that vertical programmes have unwittingly increased the incidence of other diseases and
broken the first rule of medicine-primum non nocere- first do no harm. They cite the example of HIV and hepatitis caused by WHO-
endorsed immunisation programmes against other diseases (40). With polio eradication there was a huge increase in non-polio AFP,
in direct proportion to the number of doses of the vaccine used. Though all the data was collected within an excellent surveillance
system, the increase was not investigated openly. Another question ethicists will ask, is why champions of the programme continued
to exhort poor countries to spend scarce resources on a programme they should have known, in 2002, was never going to succeed.
In the final analysis, if the right lessons have been learnt and the world does not repeat these mistakes, the costs may yet be justified.
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