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AIDS in India: What Can The Indian Government Do Different?

Posted by Indian Muslim Observer | 24 November 2012 | Posted in , , , , , ,

By Dr. Sukant Khurana & Dr. Gaurav Sharma

As another world AIDS day passes by and the epidemic shows no sign of end, we need to evaluate the status of AIDS in India. Our country is one of the hotspot of acquired immunodeficiency syndrome (AIDS), an incurable syndrome that eventually befalls on large fraction of human immunodeficiency virus (HIV) positive individuals. While globally the number of AIDS patients has started to stabilize but epidemic is nowhere close to being over. This global epidemic has already turned out to be a major killer of humankind on an epic scale comparable to black death and smallpox. As per the latest estimates by UNAIDS, it is the fourth leading cause of death. In India, the state of affairs is so unsatisfactory that we still have frequent cases of mass infection of poor patients due to the negligence of hospitals, horrible mistreatment of HIV positive individuals and lack of even basic care for millions of AIDS patients. While the problems of AIDS in India are manifold and would require efforts from all the sectors of Indian society, in this article we want to bring forward key failures of the Indian government. We focus on five core issues that require immediate attention, if we wish to see the tail of this AIDS epidemic:

1) Demographic and epidemiological understanding

2) Awareness

3) Screening and counseling

4) Treatment facilities and medicines

5) Need to develop indigenous cures

Demographic and epidemiological understanding: In India, it is difficult to trust the total number of AIDS patients, as grossly contradicting government figures makes one wonder if the actual magnitude of the epidemic is even larger than what is currently reported. The latest estimates released by the National AIDS Control Organization (NACO), an organization run under the auspices of the ministry of health, indicates that national adult HIV prevalence in India is approximately 0.29%, which corresponds to an estimated 2.27 million people living with HIV in the country (Annual report NACO 2009-2010). In contrast in 2005, NACO reported 5.21 millions HIV positive individuals. One can only wonder if such a change in the figures is an effort to put lipstick on the pig or there was a fundamental error in one of the two estimates. There has been some beating around the bush, blame laying and unsatisfactory explanations in response to this contradiction but if there was a genuine error then what is conclusively being done to avoid future errors, is currently not clearly known. Apart from getting the right overall numbers, what is also needed, is detailed demographic and epidemiological data. Different strains of HIV are prevalent in the different parts of the world and progression of AIDS is also different in people of different genetic background, for example there is a very small fraction of people that innately do not contract AIDS. Such trends of immunity to AIDS are either absent or currently not known in the Indian population. It is rather appalling that in India, the land that holds genetic diversity next to the continent of Africa, we for some silly reasons have been using data solely from the White Caucasian populations. This over dependency on western data is wrong for three reasons: 1) The strains of HIV prevalent in different regions are different, 2) The genetic diversity of India makes comparison to one ethnic group meaningless and 3) Apart from the Anglo-Indians with significant European heritage, no ethnic group in India, whatever be their surname and notions of self identity, share that close of genetic identity with the European populations to justify the current usage. What is needed is to understand the spread of different strains of HIV in India and the progression of diseases in individuals with a different genetic background.

Awareness

The first case of AIDS in India was diagnosed way back in 1986. Subsequently some apparent movement of bureaucratic and political machinery took place that in the following year resulted in the formation of National AIDS control program (NACP). In reality, the understanding of Indian government and media on the danger of this disease was largely missing until recently and is still rather poor. Even till late nineties, it was not entirely uncommon to hear voices in the Indian media claiming that AIDS is likely a trouble of promiscuous foreign lands and not of a conservative India. The media and the government forgot that this land of billion plus is first the land of Kamasutra and then of Gandhian moral curtains. Such ethnic biases that come wrapped in moral judgments cost lives everywhere. Even in the United States, initially AIDS was largely thought to be a disease of homosexuals and Afro-Americans, a curse of God for the decadent. In India, the lackadaisical approach in dealing with AIDS was also due to undermining the spread of HIV through blood transfusion and not realizing the severity of needle sharing by drug addicts and poor hospital administrative/clinical measures. As an addition to the existing policy, firstly the government needs to be aware of the full cost of AIDS and then it needs to take action to better inform the health care professionals and public at large. Media also adds to the trouble by rarely looking beyond less glamorous issues than some odd cricketing century of Tendulkar or birth of Bachchan granddaughter, occasionally mentioning somewhat sensational denial of basic services to HIV positive individuals or some innocent people being infected at a mass scale, instead of serious discussion of issues. Serious discussions, even when managing to creep in from the nooks and crannies of the sensational mainstream news, fails to gather attention beyond one media cycle.

Is this lack of information spread, a result of lack of resources or is it due to lack of political will? A significant chunk of taxpayer’s money on AIDS, like any other resource in India has been squandered with significant chunks making it to the chauffeurs of the corrupt. Lack of adequate money is definitely a problem, but a relatively minor one, compared to the mismanagement of the available resources. An approach for awareness, with low cost and huge promise, is the proper training of health care professionals. Mandatory improvements in the syllabus of medical schools and compulsory training of health care professionals to be better deal with immunocompromized AIDS patients, providing all medical services to HIV positive patients and to counsel patients on screening and precautions can be a game changer. While some namesake changes have been made in some medical curricula of advanced training but none to the internationally acceptable standards and barely any that impact primary care providers dealing with majority of patients. Formulation and implementation of laws against discrimination of HIV positive patients is also needed urgently. Another dimension of information dissemination and care is to focus on special groups. Recent international attention and support from charitable organizations along with government of India’s initiatives on free distribution of condoms to sex workers has been very productive. Successful select programs are currently targeting high-risk populations like truck drivers and sex workers but the biggest group with this affliction is currently ignored. This group is of the displaced urban poor migrant workers who are forced to work in non-native cities and seek sexual favors in questionable places. In a nation, that is busy unsuccessfully dealing with the symptoms of poverty and displacement, by the means of handouts that reach only select few and harassment to silence dissent, one needs to cure the actual disease of poverty that accentuates problems such as AIDS by means of holistic socio-economic development.

Screening and counseling

Roughly 85% of new infections are via the heterosexual route and efforts towards premarital counseling for HIV can reduce half to three fourth of this spread. In Goa and Andhra, the high prevalence states, the state governments proposed bills in 2006 to make HIV testing compulsory before marriage, but ethical concerns and political issues have thus far stopped the actual implementation. This issue of mandatory testing poses a real ethical concern as on one hand we do not have any patient confidentiality where people are denied their due rights due to their HIV status and on the other hand, who can justify the infection to innocent spouses, mostly females via their less than faithful counterparts? One needs to evolve a system where an employer and an insurer, cannot know the HIV status of the patient but a spouse can. It is not going to an easy nut to crack for any government, leave alone Indian, but the administration has not even started inching in the right direction of evolving such a mechanism.

Treatment facilities and medicines

National AIDS control program (NACP-III, 2007-2012) of India has a total budget of about 2.6 billion dollars but only a minor fraction of it is for the treatment. This is unacceptably low amount of money being spent on treatment, especially the amount that finally trickles down the bureaucratic apparatus. One may wonder what do we mean by treatment of an incurable syndrome? The progression of HIV positive individuals to AIDS is very different. Once patient contracts full blown AIDS his/her survival can vary from months to decades. This survival, apart from patient to patient variability, depends on the availability of antiviral drugs and treatment facilities. It is possible that India may have lost much of its potential to produce generic and cheap anti-retroviral relief due to twists in the international politics and India’s easy compliance with pressures. It is possible that recent aid to African countries to counter AIDS, has likely come with strings attached as they have almost stopped use of cheaper generic anti-retroviral drugs. Indian anti-retroviral drugs that were much cheaper than Western products have not just lost a market in Africa but their share in India is also tapering. We would recommend evolution of an informed policy that considers efficacy and costs of all compounds with the goal to save as many lives as possible.

Need to develop indigenous cures

Let us focus on vaccines, a preventative approach that actually holds a long-term cure of AIDS. While there have been some sporadic islands of successes in the ocean of failure in finding vaccine for AIDS, the international efforts are finding new promises and ruling out failed ideas with every passing day. We wonder why not a single significant effort worthy of mention is being pioneered in India? Given that we as Indians have become comfortably numb to the thought of India as a second or third grade country that is a recipient of high-end technology and fruits of scientific research, an average Indian, even if bluntly reminded of the state of affairs, howsoever offended, will not break sweat for long about the lack of innovation. The concern is far graver than the lack of innovation and the lack of national pride. If we need vaccine for AIDS, as soon as it is available in the West, unlike the case with polio or smallpox, we cannot take our begging bowl to world as we did in early years after independence or grossly overpay our way out, as we frequently do to procure any technology, ranging from our medicines to our warplanes. The problem with HIV vaccine stems from to the issues of demographics and epidemiology. Different strains of HIV are prevalent in different parts of the globe. HIV is very diverse, in fact some strains only show 40% homology between each other, not that different of genetic homology between you and a banana and in fact less than you and an earthworm. Thus to combat a hyper-mutable virus one needs to work on local strain and keep local population genetic profile and overall epidemiology in mind to solve the AIDS epidemic in India.

Will India rise to the challenge novel anti-retrovirals and indigenous vaccine? Likely not. Even in the well developed sectors like information technology, India only delivers small software packages for foreign products and does not manufacture a single major internationally recognizable product. This is not due to dearth of scientists or of money. In fact, India has very high numbers of biomedical scientists and research institutions spread across the country for the size of its economy. The problem is of incompetence, lack of management, corruption and nepotism. The political infestation of research is palpable in Delhi where corruption and lack of accountability permeates all levels of research epithet. One need not go into the obvious appointment of unqualified vice chancellors and administrators of universities and directors of research institutes based on proximity to political parties in power. A look at say, the University of Delhi University, a supposed prime University of India, can give you an idea of the political stooges running the show of research in India. Apart from corrupt management, there exist a large number of the so-called scientists who do not have a single major internationally known finding to their name but are busy sliding papers in “friendly” obscure journals and frequently get awarded national and regional honors. This abysmal state of affairs keeps very successful and patriotic scientists out of this Indian swamp that is sure to kill any good science.

In summary, current government efforts are either missing or misplaced and are largely wrought with corruption and inefficiency. A significant blow can be landed to AIDS epidemic with effective government policies. We hope that this article along with many other efforts raises awareness of public and its representatives for better combating the scourge of AIDS.

[Dr. Sukant Khurana is a New York based scientist, innovator and author of Indian origin. He is known for his research in the field of sensory perception, addiction, learning and memory, apart from his recent involvement in many high tech sectors of India. He is active in campaigning for issues of corporate responsibility, education, scientific thinking and improving affordable healthcare. He can be contacted at sukantkhurana@gmail.com. Dr. Gaurav Sharma is a postdoctoral scientist at the Department of Transplant Immunology and Immunogenetics of All India Institute of Medical Sciences. He has been a part of the esteemed group involved in the first demographic study, characterizing the progression phenotypes such as rapid and long-term non-progressors in India and HIV/AIDS related genetic determinants.]

Higher Education Under Attack in India

Posted by Indian Muslim Observer | 16 November 2012 | Posted in , , , , , ,

By Sukant Khurana

While opinions vary on the performance of the first Indian governments in different sectors, higher education is a sector where India’s first steps usually evoke a positive response across the board. One can clearly see the success of secular advanced education that has paid dividends in India in a strong contrast to the other countries of the Indian subcontinent where either higher education was not given enough emphasis or was not secular in its character. Do not get me wrong, higher education in India has clearly not been an all-sunshine story, as India is far from its true potential but what I am trying to emphasize is that it is not a complete failure as yet. You will get to see that ‘as yet’ is the operational word, as we are soon heading down the lane of Pakistan and Afghanistan, courtesy of the dirty politics of New Delhi.

Let us take the example of the University of Delhi, one of the largest of the central government universities that once used to be projected as a pride of India. It is now suffering from the same structure that initially served it well. The University is structured such that power is in the hands of few people who are politically appointed, instead of entirely merit-based autonomous council that is outside the influence of politicians. The University of Delhi has a Visitor who in theory has the ultimate power. This Visitor is the President of India. Then comes the Chancellor, who is the Vice President of India. The president of India on the advice (but in reality on the dictates) of the office of the Prime minister and the ministry of Human Resource Development appoints the Vice-Chancellor. The Vice Chancellor (VC) is in effect the head of the University. The VC can act like the dictator of the University, if he or she wants to, with obviously no reporting to the constitutional namesake head of India – the President. The VC appoints his team that plays a role in deciding the allocation of resources, approval of course work, appointment of college principals, teachers and eventually all policy matters. Although certain academic bodies involved in decision-making, like the executive and academic council have some elected members, usually no member gets elected without a political affiliation and backing.

This structure is in a strong contrast to the free merit-based truly autonomous academia in the developed parts of the world. The reason this structure worked to some extent in the first few decades after independence is because educated ruling class understood that academia should be run mostly on merit if the nation has to prosper. Unfortunately the structure that was evolved depended on the wisdom of the Prime Minister but not a structure that was free from political intervention. This structure although constitutionally has some balances and checks in the form of some elected members in the administrative bodies and vibrant trade unions but to overcome this menace of democracy, Kapil Sibbal’s men have decided not to call any meetings of these bodies and rule by decrees. With Sibbal’s blessing, these men have forced academics to knock the doors of court on every matter if they do not like their dictatorial and inane decisions. One should wonder the wisdom of haphazardly changing the curriculum, introducing semester system without understanding logistics, pros and cons, whimsical twists to examination patterns, attendance policies that destroy precious years of young students and alter their career paths midway. We should systematically explore the various criminal actions of VC, various deans and heads of departments against educators, like blocking their promotion, holding back pension money and encouraging harassment of dissidents to score political points. In any advanced country with a rule of law, this kind dictatorial and incompetent conduct would get the criminals, not just the cronies but central government ministers and the ultimate puppet masters behind bars for decades. Only in countries where education agenda can be set by people with fake degrees and false claims of ties to Harvard and Cambridge that the business goes on as usual despite the ongoing rape of education and motherland in general.

The academically honest section of faculty has been attacked is by exemplary punishments ranging from everyday discrimination to blocking promotions, derecognizing existing promotions, blocking salaries and pension money. Instead of directly hearing grievances for even most serious matters, the Vice Chancellor appoints someone on his behalf for representation. This representation is not acknowledged in writing and minutes of meetings are never provided to the complainant to evade any legal action. Though such attacks have been on people with saffron background too but these attacks have been more focused on people with secular credentials, as these people would not let Sibbal use academia as place for communal electoral politics. Politicians are now using vote bank politics of appeasing fundamentalist demands of different communities and keeping Indian society divided from the stage of once sacrosanct academic settings. A recent look at sub judice cases on Indian academic giants will open eyes of anyone wanting to see the carnage by the bulldogs of 10 Janpath to enforce their corrupt dictatorial agenda. . I would clarify that my refrain is not in any way to honor the farcical judicial system but I do not want the victims of Sibbal to face additional pressure. After years of research in US, I spent one year (2011) in India to explore the current scientific and socioeconomic landscape of my home country and witnessed carnage of Sibbal and corruption of academia up close. While I am keeping detailed account of this experience for later, I would briefly like to point to the fact that corruption of academic culture enables significant portion of research to be plagiarized in India and original research to be below par – reminding me of a Samuel Johnson witticism “Your manuscript is both good and original. But the part that is good is not original, and the part that is original is not good.” This open politicization of education enables funding grants for non-existing research, denial of positions and funding to deserving candidates, existence of redundant institutions with zero productivity, harassment of researchers, violations of basic ethical codes of conduct, including the use of research facilities and funds for personal benefits, open solicitations in a supposedly blind peer review system.

If one is looking for obvious examples of this corruption, one can see a blatant hiring scam in the recruitment of several new teachers in some of the new colleges of the Delhi University. In a central university where everyone is supposed to be paid by the University Grant Commission (UGC) there are now many teacher appointments within the University of Delhi that are illegally paid from the chauffeurs of the state of Delhi. This constitutional breach of paycheck coming from state budget for a central university in its most optimistic scenario reeks of lack of any planning by the incompetent men and at its worst and more likely scenario, a tool to change demographic to less competent but more sympathetic to 10 Janpath. A simple look at the recent appointments of college Principals can show you the infestation of Indian academia by Congress honchos. For some merely accidental reasons (pun intended) an overwhelming number of recent College Principal appointments seem to be of young Punjabi female teachers who once used to teach science and are strongly affiliated with Yuvraj Rahul’s gang. I have nothing against young age, being a young scientist myself, neither against women, for whose rights, I have been fighting for all my adult life and nothing against Punjabis, which is my paternal ethnic heritage but I cannot stand having any other criteria than merit to decide the future of our country. What sense does it make to appoint a science faculty as Principal to a college with only humanities subjects, unless it is for simple political reasons? From over a decade ago, before I moved to top Indian research institution and then to top US research facilities, when I was young undergraduate student at this same university, I knew a very incompetent teacher who used to knit sweaters in our classroom, while reading textbooks verbatim. Her acts and intelligence could have made middle school teacher look Aristotle or Socrates in comparison, though she did order free tea for us in cold December months. In sympathy with other women, she frequently advised my female classmates against pursuing a postgraduate degree telling of non-academic compromises it took for her to get a Ph.D. The last I heard from her is when she became a Principal of a new college under this new administration because of proximity to Indian National Congress. Sitting in a U.S. research institution that has produced one of the most numbers of Nobel laureates in the field of Medicine, I have no problem pointing out some individuals in India but pointing few such examples would not solve much and it would be unfair for only one or two incompetent political puppets to be recalled due to my finger pointing while the epithet of corruption remaining the same. So, I will leave pointing lower level individuals for some later stage, just giving them chills for now but focus on Rahul baba, puppet prime minister, corrupt ministers and VCs ruining our education.

Few years ago at the University of Delhi, a collusion of BJP and Congress’s political interests, led to a laughable act of allowing astrology (no, not astronomy but dumb stone age astrology) to be part of its curriculum. After much of controversy and worldwide ridicule acclaimed intellectuals it was eventually withdrawn. One may wonder that after such infamy the government would not redo such mistake again but alas. The trend of non-secular intervention continues unabated. Somehow magically fundamentalist administrators, be it a Muslim, Sikh, Christian or Hindu whosoever suits Congress’s electoral play continues being appointed. Some of the ethnically focused institutions, whether for segments within minorities or majorities were created to encourage enrollment of students from segments who otherwise faced the danger of being left out without such privileged institutions. The goal was to create a modern alternative to inadequate and often sectarian madarasa or ashram kind of religious education that these youngsters might be turned to in absence of secure modern alternatives. To provide such education faculty from all ethnicities were hired and promoted. Now with politicization, somehow the faculty enrollment has started paralleling the bias in student enrollment, throwing the criteria of merit of faculty in the dirty ditch of politics. Such bias denies good quality education to target segments that these institutions were in the first place set up to provide for.

While a trip around the University of Delhi would bear out many such examples of decadence of this administration, I would like to point out a single notable piece of capitulation to religious fundamentalism so you can better see how appeasement of different ethnic group works for political convenience. Recently based on orders from Congress headquaters, the Vice Chancellor forced the University to withdraw ‘Three Hundred Ramayans’, a great text by AK Ramanujan that quite clearly captures the ubiquitous nature of Ramayana tales in the whole of Indosphere, even beyond Indian subcontinent like in the islands of Indonesia or lands as distant as Cambodia. The text educates to the fact that Ramayana has many local variants and it is a truly a tale of all Indic region with amazingly deep cultural penetration that has sway in shaping even an atheist like me, leave alone some orthodox Vaishnav Hindu. After saffron politicians stroke trouble objecting to this long-standing course material the talibanized RSS goons of akhil bhartiya vidyarthi parishad (ABVP), the student wing of BJP got offended to this whiff of knowledge. Their argument (or more accurately non-argument) was that Valmiki Ramayana is the accurate one. The claim that one version of Rmayana is celebrated more is correct, especially when viewed with strictly North Indian Vaishnav lenses but the argument is ridiculous, as the material was not taught as a course on religion. This text was not an effort to say one version is right or wrong or which imaginary fried should one believe in or which organize religion is better but a historical collection of different texts that exist in the Indosphere. Five exemplary texts that captured the largest heterogeneity were chosen to capture the diversity of cultural heritage. Congress did not want to loose Hindu fundamentalist votes to BJP, so to one up the idiots of sangh, Sibbal decided to use his bully pulpit to remove the text from the course work all together. This move, where history and literatures appropriateness is decided by the sentimentality of ill educated political goons instead of facts, is no different than banning some book because of a fatwa by some crazy Mullah in streets of Lahore, Ryadh or Kabul. Such yielding to pressure from religious bigots in general public life of India is not new and not even unique to Delhi’s Congress-BJP dominated politics. Who can forget unsympathetic treatment meted out to Taslima Nasreen by the stalwarts of left, the so-called secularists? What is new is the systematic attack on academic integrity by a demon of religious fundamentalism, corruption and dictatorship that is unleashed by Sibbal on the commands from 10 Janpath. This removal of highly acclaimed assay is being condemned worldwide and such acts continue to degrade the legitimacy of Indian education and validity of higher academic degrees. More than the damage to Indian image or to the validity of Indian educational credentials, the impact from such acts, if recurrent, will render an already barren Indian innovation and academic landscape to become completely sterile. A healthy academic culture, where one can discuss life stories surrounding the myth and reality of lives of Prophet Mohammad, Guru Nanak, Jesus Christ or Lord Rama, when in the context of history or of linguistic style, independent from the sentimentality of religion or conduct research on the impact of a particular pesticide on human health, independent of the connections of that pesticide company to the ruling party, is a necessary backbone of any country aspiring to innovate and grow. I am actually not much of a Nehru fan on most socioeconomic and defense issues but what I think was his singular undisputed legacy of sowing the seeds of higher education is now being destroyed by his own great grandson.

I also want to this article to serve as warning that if the state of affairs of Indian academia gets worse then international condemnations, signature by top academics including Nobel laureates, boycotts and derecognizing several academic degrees would have to initiated to stop this rot of academia in India. Such actions to improve India would not be entirely unprecedented for Indian expatriates. Recently, to stop the murder of the rule of law by Indian judiciary that was allowing indefinite detention of people without evidence, the international community including many notable Indian expatriates jumped into action, shaming India at the world stage. This external ridicule and pressurization is the least pleasant and most painful thing an Indian can do but when reform does not come from within then one is not left with any other option. One may be aware of the fact that many degrees from India are not recognized internationally and the list is not shrinking. If this corrupt management run by Sibbal’s cronies continues ruining the quality of graduate and post graduate education and stifles the intellectual output then whether one likes it or not, several more Indian academic honors, intellectual exchange programs will almost justifiably face an international axe. While there shall soon be action from international intellectual community if the victimization of secular teachers and Talibanization of education continues but what is truly needed in India is an internal change. No international pressure, punishment or encouragement can drag India to the modern era. Only Indians living in India can do so. The sleeping elephant has to wake up on its own, assuming the elephant is sleeping and not comatose or cold dead. It is unlikely that academic causes on their own would generate equal anger as has the corruption on street but all versions of Ramayana teach us that all sins add up. This murder of intellectual culture of central universities may provide additional fuel to the funeral pyre being readied for the political class if change does not come soon.

[Dr. Sukant Khurana is a New York based scientist, innovator and author of Indian origin. He is known for his research in the field of sensory perception, addiction, learning and memory, apart from his recent involvement in many high tech sectors of India. He is active in campaigning for issues of corporate responsibility, education, scientific thinking and improving affordable healthcare. He can be contacted at sukantkhurana@gmail.com]

GUEST EDITORIAL: Can we afford another unquestionable Mahatma?

Posted by Indian Muslim Observer | 24 January 2012 | Posted in , , , , ,

By Sukant Khurana

Most people are predisposed to consuming news, views and analysis that fits their own world-view. To save you the effort of reading a critique of Anna and then being disappointed that it was not from the perspective of saying he is on the wrong side, I will state upfront that I stand strongly with the anticorruption drive. In fact, I am for expanding the revolution to a progressive holistic drive with bigger goals of sustainable development and socioeconomic level playing field for everyone in the country. This is a criticism of the unquestioning wide-eyed support and personality cult resulting in both deification and vilification of heroes instead of the focus being on policies. An unquestioning support during our independence struggle to those who made money on the name of the saint of Sabarmati or those who came to power by stoking religious fervor, gave us broken, fractured and chaotic countries instead of a possible modern, secular, progressive and united Indic region. I do not wish to see a repeat of our past mistakes of having too much reverence and faith in leaders. The personality cult of leaders, Gandhi, Jinnah and others at the time of independence and now of Anna or Nehru-Gandhi royalty is a manifestation of an infantile weak spot of our culture. Just as Gandhi played an important role in the fight against British, so have Anna and his team, in what is essentially a revolution of our generation but if we put blind faith in anyone, instead of harbingering a real change in Indian life, we could be cheering for exit of one corrupt politician in New Delhi, only to make way for another. If we let political opportunists ride people’s genuine discontentment against corruption, then only the masks in Delhi would change but not the corrupt culture. The goal for a common man is not to replace a crook that comes with a label of UPA, with another crook having a label of NDA or communist or regional party but a genuine transformation of the system.

Personality cult and following should not be confused with a questioning admiration of leaders and their veiws. Let me make it clear too that I admire Anna as a person and more importantly the movement he symbolizes on many but not all the issues. I do not want to make a great hero into a scapegoat just as I would not see him made into a sacred cow. I am also not interested in driving the catalyst of this anticorruption campaign into ditch by promoting questioning of personal conduct and beliefs too much. Beliefs and personal conducts of leaders are important but vastly less than the policies they guide, hence my admiration and criticism is mainly about the policies of the team Anna. Just as we question the direction of anticorruption movement, it is far more important to question a government that has been arrogant, incompetent, unjust, corrupt and dictatorial. In the same breath of questioning Anna, we also need to ask ourselves if we should buy into the demonization of Anna, the person, as well as the phenomenon. This demonization of Anna by the bulldogs of Congress would not have been much different by any other party in power. Support and opposition to this bill is based on shear political equations and not because of principles. So my criticism is of the whole opportunistic political class in general and not specifically of the chamchas yes men of Sonia memsahib and Yuvraj Rahul, the heir apparent. We need heroes to be the Sutradhars between chapters of history (those who connect one episode of the play to another, providing continuity and transition) but not be the Margdarshaks (spiritual guides). We all need to be our own margadarshaks for a vibrant democracy. Heroes are required as catalysts of struggles but they should never be made bigger than issues. We need our Irom Sharmilas, Medha Patkars and Anna Hazares to lead in fights to make a better India. We need to stand by our heroes when they make sense and we need to pack them home when they don't. The dangers of personality cult, irrespective of the current portrayal in popular history, of Gandhi, Nehru, Subhas, Patel, Jinnah, Hitler, Roosevelt, Mandela, Stalin, Mao and Churchill etcetera are all too evident to me at least, to do the mistake of putting anyone above questioning.

While I was very active in my humble internet activism ways in recruiting people for the campaign, I never said that "I am Anna", wore his cap or will ever do such a thing but I never miss any opportunity to land a right hook or a straight jab at the corrupt political class within the confines of currently popular and pragmatic ahimsa sentiment. I was not yelling in unison along with the drunk on patriotism crowd that was at times (not always) rather poorly informed, unquestioning and wide-eyed, looking for a miracle cure to corruption. Yet, despite my serious differences, I was not throwing the kitchen sink at Anna when the political class had let its hounds free to tarnish his image. My resurgent support and criticism comes at this crucial juncture now when we need to unite again for a next big round of fight with the ruling elite so that we can have a better-informed campaign. This opinion piece in essence is an appeal to have an independent and critical thinking. I believe such an approach would increase participation in social campaigns, including the ongoing anticorruption struggle rather that decrease ones enthusiasm. I believe this questioning would help us to steer this campaign away from becoming a tool of selfish politicians back to the original intent of being a vehicle of people’s voice. This questioning would also make us realize that lokpall (citizens' ombudsman bill), if successfully implemented, can only take out some corruption but not the whole of it. It is not a panacea but just a step in the right direction. Questioning will lead us to desire a bigger cultural and educational shift, judicial reform, executive reform, and checks on corruption-infested media, armed forces and corporate houses, while in parallel laying foundations for construction of an alternative system based on evidence and not ideology. This questioning spirit will also dissuade genuinely and justifiably angry people from supporting reactionary ideologies that advocate overthrowing a rotten system without presenting viable better alternatives.

During this campaign I was also not sure if the Bharat Mata that was being invoked every time by my neighboring shopkeeper, few of my corrupt-to-core relatives, a poor rickshaw wallah, an idealist retired teacher, poor homeless kids, a hideously corrupt local MLA, a military widow of a shaheed sipahi, all those were the same Bharat Matas. I am not sure whether my Bharat Mata would even be able to stand the reeking presence of Bharat Matas of one my corrupt relatives, policemen, the local MLA, the kind of criminals whose day starts with corruption laden ritual of bribing a some God with a ‘chadhawa’ (bribe), with a hope that in their whole day they can in return get enough chadhawa from lesser mortals than themselves. I am in the struggle not because of emotional appeal on the name of mother India but because I see hope in eyes of people for whom this fight is not just a vain vent to their middle class anger but a fight for a better tomorrow. I see with such an involvement, a chance for our nation to reach its full potential. No, I am not completely immune to sentimentality myself, though I prefer not to leave my objectivity glasses at home. I fell in tragic love with the sentiment too, when as a bystander, I heard in a solidarity march that erupted spontaneously, poor street kids and some handicapped old women sing Vande Matram. For all my cold-blooded intellectual analysis, it was difficult for me to stop my tears from trickling. It was impossible not to feel overwhelmed with joy to see such hope and I could also not stay untouched by a deep sense of sorrow and shame to see that the banner of hope is held high by the ones with the most hopeless predicament. How much I wanted to tell them that it would not be all right for them even after an effective lokpall bill is enacted, that it will take a bigger transformation but I could not be heartless enough to break their transient hope bubble.

On the other hand, at times, I found the crowd quite unbearable, especially when I saw someone with enough gold on them, guaranteed from black money, to feed at least hundred people for a month. One could find both a well-fed fat man and a skeleton of a human marching together with fist up against the dysfunctional and non-representative but supposedly elected government, with slogans of “inqalaab zindabad” (long live revolution). This imagery reminded compatriots involved in the anticorruption campaign of the struggle of Chadrashekhar Azaad, Gandhi and Bose while the same imagery was portrayed by the government sympathizers as similar to one during the rise of the Third Reich. Undoubtedly this push towards increased transparency and democracy is an ongoing revolution of our generation, with Anna’s galvanization of public outpour a chapter worth writing with golden letters but is there a genuine parallel with the Fascist and the Nazi rise? Yes for sure, in terms of imagery, but not because that is the overwhelming character of the anticorruption revolution at least up till now but because all revolutions whether good or hideous in consequence, are all born of social crises and these occasions give hope to the needy and are grossly capitalized by the greedy. So the fat cat who wants bigger profit than what he can get from the current system will also march with the skeleton of a human- who has nothing but a hope to live on, only chains to free from. It is for a vibrant democracy to make sure that the outcomes of such social upheaval are good and not disastrous. Whenever people stop questioning their leaders, revolutions start to rot and produce fat cat politicians. Were participants bending and breaking the constitution? Absolutely and unapologetically yes, just as Gandhi was during his salt march. In fact the break from constitution was a lot less radical than the actions of our heroes of yesteryears like Batukeshwar Dutt and Bhagat Singh who had to make noise loud enough to make the deaf hear. Were they democratic? Yes and no, it depends on the aspects and consequences of this campaign. Let us talk about it in a little bit after we have looked at whose campaign it is, as of today.

For a complete understanding of what precipitated this mass movement, we need to look back at the oppression and failure of the conglomerate of the political, bureaucratic and ruling corporate class over these years, along with the various short and long-lived violent and non-violent responses to the shortcomings of this constantly evolving Indian story. We need to look at the sources, the catalysts and the vehicles of mass struggles including the different colors of this Anna carnival, as it is proceeding under the full media glare of 24-7 television. A look at faces of people involved, can tell you who started the fire and who provides the fuel. This struggle in the beginning of its first round, acted as a safety valve for the middle class anger, releasing the pressure and hence preventing an Arab Spring like uprising. By the end of the first round, the idea reached out to almost all sections of our society. The message now resonates with street hawkers and rickshaw pullers who have to pay the policemen a bribe to do their business, it resonates with farmers suffering from local and state corruption and it resonates with youth who have to frequently pay bribes to get decent education and jobs. Now looking at the faces of this campaign one sees politicians on stage trying to cash in, when the fruit of public discontentment is ripe for harvest. One has already seen the drama of Advani’s anti corruption yatra where press reporters were given envelopes with cash so they cover his anticorruption drive and how Modi spent money from state budget on his anticorruption fast while refusing to accept a lokayukta to enquire 17 serious charges of multimillion embezzlement and corruption against himself. Who can forget Yedurappa of Karnata in cahoots of mining mafia either? Does one have to travel much deep into UP to see the corrupt fangs of Maya madam? I think just a trip to Noida can be enough. It is not just Lalu but almost everyone who ends up eating chara. Only in India can an uneducated coolie rise to be a multibillionaire, no, not through innovation or entrepreneurship, certainly not through hard physical labor but by whoring out the state resources in position of a chief minister to the mining mafia. The corruption of politicians does not fail to leave a mark even on national defense, whether it is purchase of guns like Bofors or coffins for our martyrs. Corruption and incompetence does not come with the slap of congress alone, it comes in form of trident of RSS up an aam admi’s rear and it also comes in the form of a hammer and sickele of CPM. Some abhineta may apologize to the neta log for the fear of consequences of telling that the king is naked but does an aam admi have any doubt of how someone’s fortunes change when they get elected or marry someone in power, say a rise from a small time scrap dealer to a billionaire for marrying into royal political dynasty? While the middle class started this fire, the whole Indian population continues to provide the fuel and now the political vultures are already eyeing the carcass of the current government, getting ready for a cannibalistic orgy of sorts.

The protest to this point has been mostly about reforming the current economic road that India has taken, with even the central architects of this campaign not thinking in terms of bigger socioeconomic structures responsible for corruption and bigger issue of underdevelopment, ecological rape, socioeconomic inequity and ethnic strife. The movement at present does not have any realistic ideas of dealing with the pillage of globalization, either of changing the course or of staying on course but making modifications to maximize the benefits for a common man while minimizing the losses. In some senses, this campaign is not that different than our freedom struggle in the very beginning of 20th century where ideas, ideologies and plans for long term combat are still in utero but what is clear is the dire need of reduced corruption. What is a common unifier for people with very different views of India, ideologies and objectives, is currently a common enemy and this time it is the Bhura sahibs sitting tight on kursi instead of the Gora sahibs. It is also not that different than our freedom struggle in the sense that literate and well to do sections first took fancy to the idea but the movement really took its wings with a mass appeal galvanized by Anna. It is also not that different in character from our Independence struggle that the butchers, both in power and opposition, with shear personal ambitions are already sharpening their knives in anticipation of the innocent lamb of Indian aspirations to become fat enough for slaughter.
Let us return to the question of the democratic impact and long run imprint of this campaign. This movement marked for the first time in the history of independent India a successful bending down of representative democracy for the sake of a participatory democracy. It may sound all good and definitely has great positive potential that attracted me to it but it is a gamble with the future, a real tryst with our destiny, unlike a mere transition in the skin color of the rulers of India. The reason it is a great gamble is that with over 1.2 billion people in India, in its current form, it is impossible to have a participatory democracy for all issues or on regular basis. If people need to stop their work and fight against the system for making changes every time, we will eventually descend into anarchy. Can better ways be evolved with technology to have more participation? The use of technology for better participation is certainly possible but I will keep that analysis for some other place. There is a big question in minds of many that if unelected people can speak on behalf of majority of the country. At this moment that is not the biggest concern, at least to me, as most of India stands behind this anticorruption drive. That does not mean that such questions could not be a valid at other times but as of today there are other more valid concerns on the lines of chaos of participatory democracy. Let us evaluate these concerns in some detail.

What happened to the voice of voiceless? What happens to questions that matter to a small group but not everyone: questions like AFSPA that affect Indians in Kashmir and North-East? What happens to rape and harassment of poor villagers by the men in uniform, done to advance interests of the mining mafia and other business interests in collusion with politicians on the pretext of containing naxalites? What happens to people displaced due to so-called developmental projects of national importance, some agreeably real projects with positive impact, while others farcical schemes designed for land grab? Who will come to protest in the capital for this silent scattered voiceless humanity? Will these not so catchy and primetime-worthy protests in the far-flung regions of interior India matter to the media and hence to the public of India in general?

Can this way of Indian politic result in a hooligan culture? Is India strictly a country where one with bigger voice due to majority or vocal minority, ends up having their say? Are we forgetting the fear of a majority dictatorship, some real threat due to intolerant and bigoted actions of Hindu right wing at that time and some due to fictional concerns of a Hindu raj stoked by the selfish separatist leaders to create our militarily strong yet culturally and economically stillborn sibling of Pakistan? If resolution of issues will depend on a show of strength in few metropolitans, will this way of political life become a means of suppressing minority viewpoints? Aren’t we are all minorities on some issue? Only conformists with no brain of their own, seek comfort in being part of a sizable group to feel they are on the right side. Any freethinker is bound to be a minority at more than one occasion. Will the Indian story, a sublime and subtle failure in many dimensions but also one with great accomplishment of having some semblance of a democracy be thrown to dogs, with such a change in political culture? There were traces of fascist tendencies in crowd with youngsters of clearly affluent family having a picnic, yelling vande matram without understanding the meaning of it. Near zero understanding of problems facing India in some of the blind hero worshipping followers of this campaign, beyond empty sloganeering at high decibels could make anyone afraid of this crowd’s destructive potential. For some of the upper-middle privileged class, in the gym I went to while staying in Delhi, the protests were just cool, a place for socialization and meeting other single people. While this hooligan and picnic culture has been a lopsided picture portrayed by the pro government critiques, this aspect is almost completely ignored by those razzled-dazzled by Anna mania. This picture is undeniably true to a small extent but it is only one small dimension of the participation. This image ignores a significant informed activist section and an overwhelming majority that was seeking to be increasingly more informed. Anna’s team has not failed to inform people but when information has to come from the mouth of campaign alone, instead of proactive information gathering by the public from multiple sources, it can hardly be called an overwhelming success of informed democracy. If we are going to enter a much-needed era of increased participatory democracy, our struggle needs to meet the challenge of finding better mechanisms to counter and discourage hooligan culture soon.

Is majority always right? Most villagers in villages with honor killings done due to the rotten taboo of inter-cast relationships of Hinduism agree with their Panchayats. Has one forgotten the story of a poor Muslim woman ordered by Islamist panchayat of her village to marry her father in law who raped her? Are we not aware of sectarian feudal stone aged judgments anchored in stupid religious and cultural bigotry of Hinduism, Islam, Christianity and Sikhism alike that is passed by local majority in many regions of India on an everyday basis? Are dumb people in street more dangerous than their voices filtered through structures of so called democratic apparatus? This mass movement if gone awry can set a precedence for people to go against the constitutional framework that provides options of standing against popular sentiments to preserve modernity. No, I am not saying that the dysfunctional and corrupt judiciary often has any guts or conscience to stand up for the best national interests but there are few examples where progressive decisions have been made despite largely unpopular sentiments. Let me also make it clear the flip side of the coin, an argument for an elitist approach that some people have more wisdom than others is an equal recipe for dictatorship. The solution lies in balancing the two forces. Current constitutional fix of balancing safeguards and popular vote is not an optimal one but it is better than nothing. We soon need to find novel solutions to protect from the dangers of herd dictatorship without stifling the immense productive and transformational potential of participatory democracy.
While these questions remain in my mind and so does my support and criticism of the movement but I believe staying on the sidelines will not result in a better future for our country. I urge you to hop on this wagon of struggle. The journey is not going to be easy but it will be worthwhile. Express your views and question everything if you want to shape this revolution. We already had one Mahatma; one too many. We frankly cannot afford another one. We need more questionable and life like heroes like Gandhi (not Mahatma), Maulana Azaad, Ghaffar Khan, Bose, Ashfaqulla Khan, Bhagat Singh of yesteryears and leaders of today who hold no ambition of a political position like Irom Sharmila, Medha Patkar and Anna Hazare but most importantly we need politically active, everyday common man, woman and child to fight for India. With a questioning and healthy irreverent spirit, my dear compatriots may long live our revolution - Inqalaab Zindabad!

[Dr. Sukant Khurana is a New York based scientist and author of Indian origin. Some of his social commentary can be read at: https://sites.google.com/site/sukantkhurana2/. He can be contacted at sukantkhurana@gmail.com]

The future of mobile technology in India: looking beyond the hype and scandals

Posted by Indian Muslim Observer | 18 January 2012 | Posted in , , , , ,

By Sukant Khurana

When we think of mobile communication there are few images that flash in ones mind: one of the ongoing saga of telecommunication scandals, an image of people constantly talking on mobile phones and another of catchy advertisements inundating all forms of media. What gets hidden behind the curtain is the irreversible socioeconomic transformation of our society, hidden costs and benefits, changes in trade and foreign relations and most importantly the immense future possibilities. Here, we assess the road taken by the mobile sector till now, so that we can better shape the future. We ask if this technology can be the leading first sector where a currently non-existent dimension can be added to the Indian growth story; that of an innovation based economy.



First, let us look at the ways mobile technology has changed our lives. Primary service of the mobile technology, when initially introduced in 1999, was to provide voice communication but over the years, internet, mobile enterprise services, mobile-commerce and entertainment, are some of the services that have been added to the milieu. The reach of the mobile technology has changed accessibility and communication everywhere. Its use has spread in regions where the landline use is rather limited, for example even in a war-ravaged country of Afghanistan that has barely any landlines, 150,000 new cell phone subscribers are added every month. According to the telecom regulatory authority of India in October 2011, India had 600 million plus active wireless subscribers with around 65% subscription from urban areas. The evolution of wireless technology and the growth in data transfer rates has facilitated the spread of internet on mobile devices. With declining voice tariff, mobile operators have started providing entertainment services such as mobile music, mobile TV, mobile gaming, audios, videos and social networking etc. Mobile music that includes ring tone and song downloading is the most used service in India, primarily because of the urban youth use patterns. Rural sector usage is very utilitarian, with a whopping 40% of usage related to gathering agricultural information, while entertainment services are at a much lower 16%, and financial services such as mobile remittance and money at a healthy 8%, showing the pragmatic side of the country folks. This increased communication increases social mobility and are already proving to be a vehicle of social and economic transformation. 

In recent years, availability of services in various regional languages has made mobile services reachable to a bigger spectrum of people. To much chagrin of the political elites, mobile communication and internet have acted as a catalyst for social and political change, like the Arab spring, the Occupy movement, and our very own anti-corruption frenzy. The telecom industry currently directly contributes to more than 1.5% to the Indian GDP. When the tele-density saturates, then also for many years total usage will continue to increase, so this sector has immense potential for growth. More than 5 million jobs are created in India, directly or indirectly due to the telecom sector and this is expected to increase to 12 million soon but this is an underestimate of the true social and economic impact. This is the first time for many in the remote regions to know about supply and demand dynamics of their business on everyday basis and being able to talk to end user of their product. Urban migrant workers and troops stationed in remote regions can get in touch with their family on a regular basis now and financial transactions can be conducted at ones fingertips, bypassing the long queues and the customary bribing of the clerical staff. This transformation and mass empowerment is reflected by the fact that currently 1% growth in tele-density results in a 3% increase in the rate of GDP growth. Given such an important role of mobile sector in developing world, one can consider it a basic utility and should be vary of not repeating mistakes of US of letting some unaccounted monopolies develop in this sector.

Wait a minute; let us not make you feel that there are way too many rainbows in this sunny story of mobile revolution. There are dark sides of the mobile sector; some, where light can reach easily and some that would need novel solutions. These are two dimensions of negatives of this mobile revolution in India: one the negative impact of the mobile technology itself and the other where Indian society is specifically lagging behind in gaining from this transformation. In India, one undergoes an unabated harassment of unsolicited calls, texts, pop ups, and gets enrolled in unwanted services without ones consent. Even though National Do Not Call Registry has been set up to curb unsolicited calls and there is now a daily limit of sending 200 SMSs per number, spammers and sales people seem to be outpacing sluggish control measures. Indians are also yet to catch up with the global usage for smarter monitoring of constantly evolving situations like stock markets and developing news stories of their concern. Mobile commerce has enabled increasing number of Indians to do their money transaction in a secured manner using mobile technology, including buying or selling goods, financial services like accessing bank accounts, booking tickets, paying bills and stock trading but the segment using these services from mobile is somewhat limited due to unfamiliarity with the services and also due to security concerns. Bandwidth insufficiency and unreliable network connectivity are the limitations that cause security concerns in India. Mobile technology has a potential in healthcare and education but that potential remains largely untapped at present. Mobile usage and internet in general have changed the work habits for some people in negative ways and usage of mobile sets during driving has increased traffic accidents. Fixing the behavior of public and cops, who violate traffic laws alike, is an easier fix than the attention related issues and internet addiction. The use of current technology of batteries in mobile devices is a concern world over due to limited charge storage issues and dependence on rare earth metals from China for their manufacture. In a recent spat with Japan, China stifled the supply of these metals sending alarm signals all across the globe. Many emerging technologies that promise solutions to both issues are on horizon and these may not be long lasting concerns. India suffers from a lack of proper disposal of mobile parts in an environmentally sound manner, though higher second hand usage of instrument reduces the total environmental footprint.

Apart from the above-mentioned problems, there are some issues that are closest to our hearts. Despite 600 million plus users in India, double the size of total American population, leave innovation, even manufacture sector thrives mostly on compiling products manufactured elsewhere, instead of significant domestic production. This lack of high tech production and innovation is not unique to the mobile sector but a general plague afflicting India. Apart from the drawbacks of the industry that need fixing, the failure to innovate is in a bigger part a result of failure of the academic and the governmental research institutions. In US, Europe, Japan and South Korea, fundamentals of novel technologies are born either in the research universities or in the governmental institutions. Indian government and academic settings, especially ones located near centers of power, like the University of Delhi, a darkest example of what is rotten in Indian research, are a swamp for the talented to perish and a bottomless pit for sucking taxpayer’s money. These universities with departments conducting research, have politically appointed cronies in the positions of vice chancellor, dean of research, and heads of departments, people that have no single internationally known academic achievement or mentionable success in translating an idea to a commercially viable product. These small men who cast long shadows, meddle with research, play political games and harass academics to maintain their positions are frequently guilty of prolonging failed mega projects to fatten their chauffeurs. A vibrant industry and academia interaction is the backbone of an innovation-based economy and for such a healthy interaction to occur in India, a transparent process of depoliticizing academia and government run research initiatives is direly needed. We hope more Indians, whether in India or abroad would see this bad situation as a challenge and an opportunity, as we do, to lead innovation though efforts in basic research and industry. The business sector also needs visionaries and business leaders who can enable innovation by choosing to invest in the right people to do the right projects, more so in the times when there exists not much of a respectable academic research apparatus. Given that we have one of the largest mobile market in the world, and the presence of necessary expertise, the mobile sector has a very large potential to emerge as a leading light for India to be an innovation-driven economy. If India wants to shine, then we hope that becomes known for bringing the next G to the world and not just a scam associated with 2G.

[Dr. Sukant Khurana is a New York based scientist, innovator and author of Indian origin. He is known for his research in the field of sensory perception, addiction, learning and memory, apart from his recent involvement in many high tech sectors of India. He is active in campaigning for issues of corporate responsibility, education, scientific thinking and improving affordable healthcare. He can be contacted at sukantkhurana@gmail.com]

AIDS in India: What Can The Indian Government Do Different?

Posted by Indian Muslim Observer | 16 January 2012 | Posted in , , , , ,

By Dr. Sukant Khurana and Dr. Gaurav Sharma

As another world AIDS day passes by and the epidemic shows no sign of end, we need to evaluate the status of AIDS in India. Our country is one of the hotspot of acquired immunodeficiency syndrome (AIDS), an incurable syndrome that eventually befalls on large fraction of human immunodeficiency virus (HIV) positive individuals. While globally the number of AIDS patients has started to stabilize but epidemic is nowhere close to being over. This global epidemic has already turned out to be a major killer of humankind on an epic scale comparable to black death and smallpox. As per the latest estimates by UNAIDS, it is the fourth leading cause of death. In India, the state of affairs is so unsatisfactory that we still have frequent cases of mass infection of poor patients due to the negligence of hospitals, horrible mistreatment of HIV positive individuals and lack of even basic care for millions of AIDS patients. While the problems of AIDS in India are manifold and would require efforts from all the sectors of Indian society, in this article we want to bring forward key failures of the Indian government. We focus on five core issues that require immediate attention, if we wish to see the tail of this AIDS epidemic:

1) Demographic and epidemiological understanding
2) Awareness
3) Screening and counseling
4) Treatment facilities and medicines
5) Need to develop indigenous cures

Demographic and epidemiological understanding: In India, it is difficult to trust the total number of AIDS patients, as grossly contradicting government figures makes one wonder if the actual magnitude of the epidemic is even larger than what is currently reported. The latest estimates released by the National AIDS Control Organization (NACO), an organization run under the auspices of the ministry of health, indicates that national adult HIV prevalence in India is approximately 0.29%, which corresponds to an estimated 2.27 million people living with HIV in the country (Annual report NACO 2009-2010). In contrast in 2005, NACO reported 5.21 millions HIV positive individuals. One can only wonder if such a change in the figures is an effort to put lipstick on the pig or there was a fundamental error in one of the two estimates. There has been some beating around the bush, blame laying and unsatisfactory explanations in response to this contradiction but if there was a genuine error then what is conclusively being done to avoid future errors, is currently not clearly known. Apart from getting the right overall numbers, what is also needed, is detailed demographic and epidemiological data. Different strains of HIV are prevalent in the different parts of the world and progression of AIDS is also different in people of different genetic background, for example there is a very small fraction of people that innately do not contract AIDS. Such trends of immunity to AIDS are either absent or currently not known in the Indian population. 

It is rather appalling that in India, the land that holds genetic diversity next to the continent of Africa, we for some silly reasons have been using data solely from the White Caucasian populations. This over dependency on western data is wrong for three reasons: 1) The strains of HIV prevalent in different regions are different, 2) The genetic diversity of India makes comparison to one ethnic group meaningless and 3) Apart from the Anglo-Indians with significant European heritage, no ethnic group in India, whatever be their surname and notions of self identity, share that close of genetic identity with the European populations to justify the current usage. What is needed is to understand the spread of different strains of HIV in India and the progression of diseases in individuals with a different genetic background.

Awareness: The first case of AIDS in India was diagnosed way back in 1986. Subsequently some apparent movement of bureaucratic and political machinery took place that in the following year resulted in the formation of National AIDS control program (NACP). In reality, the understanding of Indian government and media on the danger of this disease was largely missing until recently and is still rather poor. Even till late nineties, it was not entirely uncommon to hear voices in the Indian media claiming that AIDS is likely a trouble of promiscuous foreign lands and not of a conservative India. The media and the government forgot that this land of billion plus is first the land of Kamasutra and then of Gandhian moral curtains. Such ethnic biases that come wrapped in moral judgments cost lives everywhere. 
Even in the United States, initially AIDS was largely thought to be a disease of homosexuals and Afro-Americans, a curse of God for the decadent. In India, the lackadaisical approach in dealing with AIDS was also due to undermining the spread of HIV through blood transfusion and not realizing the severity of needle sharing by drug addicts and poor hospital administrative/clinical measures. As an addition to the existing policy, firstly the government needs to be aware of the full cost of AIDS and then it needs to take action to better inform the health care professionals and public at large. Media also adds to the trouble by rarely looking beyond less glamorous issues than some odd cricketing century of Tendulkar or birth of Bachchan granddaughter, occasionally mentioning somewhat sensational denial of basic services to HIV positive individuals or some innocent people being infected at a mass scale, instead of serious discussion of issues. Serious discussions, even when managing to creep in from the nooks and crannies of the sensational mainstream news, fails to gather attention beyond one media cycle.

Is this lack of information spread, a result of lack of resources or is it due to lack of political will? A significant chunk of taxpayer’s money on AIDS, like any other resource in India has been squandered with significant chunks making it to the chauffeurs of the corrupt. Lack of adequate money is definitely a problem, but a relatively minor one, compared to the mismanagement of the available resources. An approach for awareness, with low cost and huge promise, is the proper training of health care professionals. Mandatory improvements in the syllabus of medical schools and compulsory training of health care professionals to be better deal with immunocompromized AIDS patients, providing all medical services to HIV positive patients and to counsel patients on screening and precautions can be a game changer. While some namesake changes have been made in some medical curricula of advanced training but none to the internationally acceptable standards and barely any that impact primary care providers dealing with majority of patients. Formulation and implementation of laws against discrimination of HIV positive patients is also needed urgently. Another dimension of information dissemination and care is to focus on special groups. Recent international attention and support from charitable organizations along with government of India’s initiatives on free distribution of condoms to sex workers has been very productive. Successful select programs are currently targeting high-risk populations like truck drivers and sex workers but the biggest group with this affliction is currently ignored. This group is of the displaced urban poor migrant workers who are forced to work in non-native cities and seek sexual favors in questionable places. In a nation, that is busy unsuccessfully dealing with the symptoms of poverty and displacement, by the means of handouts that reach only select few and harassment to silence dissent, one needs to cure the actual disease of poverty that accentuates problems such as AIDS by means of holistic socio-economic development.

Screening and counseling: Roughly 85% of new infections are via the heterosexual route and efforts towards premarital counseling for HIV can reduce half to three fourth of this spread. In Goa and Andhra, the high prevalence states, the state governments proposed bills in 2006 to make HIV testing compulsory before marriage, but ethical concerns and political issues have thus far stopped the actual implementation. This issue of mandatory testing poses a real ethical concern as on one hand we do not have any patient confidentiality where people are denied their due rights due to their HIV status and on the other hand, who can justify the infection to innocent spouses, mostly females via their less than faithful counterparts? One needs to evolve a system where an employer and an insurer, cannot know the HIV status of the patient but a spouse can. It is not going to an easy nut to crack for any government, leave alone Indian, but the administration has not even started inching in the right direction of evolving such a mechanism.

Treatment facilities and medicines: National AIDS control program (NACP-III, 2007-2012) of India has a total budget of about 2.6 billion dollars but only a minor fraction of it is for the treatment. This is unacceptably low amount of money being spent on treatment, especially the amount that finally trickles down the bureaucratic apparatus. One may wonder what do we mean by treatment of an incurable syndrome? The progression of HIV positive individuals to AIDS is very different. Once patient contracts full blown AIDS his/her survival can vary from months to decades. This survival, apart from patient to patient variability, depends on the availability of antiviral drugs and treatment facilities. It is possible that India may have lost much of its potential to produce generic and cheap anti-retroviral relief due to twists in the international politics and India’s easy compliance with pressures. It is possible that recent aid to African countries to counter AIDS, has likely come with strings attached as they have almost stopped use of cheaper generic anti-retroviral drugs. Indian anti-retroviral drugs that were much cheaper than Western products have not just lost a market in Africa but their share in India is also tapering. We would recommend evolution of an informed policy that considers efficacy and costs of all compounds with the goal to save as many lives as possible.

Need to develop indigenous cures: Let us focus on vaccines, a preventative approach that actually holds a long-term cure of AIDS. While there have been some sporadic islands of successes in the ocean of failure in finding vaccine for AIDS, the international efforts are finding new promises and ruling out failed ideas with every passing day. We wonder why not a single significant effort worthy of mention is being pioneered in India? Given that we as Indians have become comfortably numb to the thought of India as a second or third grade country that is a recipient of high-end technology and fruits of scientific research, an average Indian, even if bluntly reminded of the state of affairs, howsoever offended, will not break sweat for long about the lack of innovation. The concern is far graver than the lack of innovation and the lack of national pride. If we need vaccine for AIDS, as soon as it is available in the West, unlike the case with polio or smallpox, we cannot take our begging bowl to world as we did in early years after independence or grossly overpay our way out, as we frequently do to procure any technology, ranging from our medicines to our warplanes. 

The problem with HIV vaccine stems from to the issues of demographics and epidemiology. Different strains of HIV are prevalent in different parts of the globe. HIV is very diverse, in fact some strains only show 40% homology between each other, not that different of genetic homology between you and a banana and in fact less than you and an earthworm. Thus to combat a hyper-mutable virus one needs to work on local strain and keep local population genetic profile and overall epidemiology in mind to solve the AIDS epidemic in India.

Will India rise to the challenge novel anti-retrovirals and indigenous vaccine? Likely not. Even in the well developed sectors like information technology, India only delivers small software packages for foreign products and does not manufacture a single major internationally recognizable product. This is not due to dearth of scientists or of money. In fact, India has very high numbers of biomedical scientists and research institutions spread across the country for the size of its economy. The problem is of incompetence, lack of management, corruption and nepotism. The political infestation of research is palpable in Delhi where corruption and lack of accountability permeates all levels of research epithet. 

One need not go into the obvious appointment of unqualified vice chancellors and administrators of universities and directors of research institutes based on proximity to political parties in power. A look at say, the University of Delhi University, a supposed prime University of India, can give you an idea of the political stooges running the show of research in India. Apart from corrupt management, there exist a large number of the so-called scientists who do not have a single major internationally known finding to their name but are busy sliding papers in “friendly” obscure journals and frequently get awarded national and regional honors. This abysmal state of affairs keeps very successful and patriotic scientists out of this Indian swamp that is sure to kill any good science.

In summary, current government efforts are either missing or misplaced and are largely wrought with corruption and inefficiency. A significant blow can be landed to AIDS epidemic with effective government policies. We hope that this article along with many other efforts raises awareness of public and its representatives for better combating the scourge of AIDS.

[Dr. Sukant Khurana is a New York based scientist, innovator and author of Indian origin. He is known for his research in the field of sensory perception, addiction, learning and memory, apart from his recent involvement in many high tech sectors of India. He is active in campaigning for issues of corporate responsibility, education, scientific thinking and improving affordable healthcare. He can be contacted at sukantkhurana@gmail.com. Dr. Gaurav Sharma is a postdoctoral scientist at the Department of Transplant Immunology and Immunogenetics of All India Institute of Medical Sciences. He has been a part of the esteemed group involved in the first demographic study, characterizing the progression phenotypes such as rapid and long-term non-progressors in India and HIV/AIDS related genetic determinants.]

Fear of police killed many in Hooch tragedy. Will the men in uniform ever be made into decent public servants?

Posted by Indian Muslim Observer | 04 January 2012 | Posted in , , , , , ,

By Sukant Khurana and Brooks Robinson

In India, unless you were born with a sliver spoon in your mouth, you know the true face of the Indian police force. You may just have been at the viewer end, not at the rough end of the stick and not the one being saluted by these men. After returning from US to stay in India for significant duration after 7 years abroad, I (S.K) found absolutely no change in the behavior of the Delhi police force even after the magical transformation of the “India shining” and the 9% growth rate story. Travel around the country confirmed that the situation has not shown any change outside the capital either. A simple experiment will give one a clear understanding of the two faces of this force: being a lap dog of the privileged and a biting bulldog to the poor. Compare behavior of policemen by wearing shabby torn clothes and asking for directions vs. stopping abruptly in the middle of the road while driving a new Mercedes and yelling obscenities at a friend in guise.

Everyone is equal though some are more equal in the eyes of these men. You can alternatively conduct a less involved experiment by just standing at any intersection of say Rohini East, in the heart of Delhi and count people driving a motorcycle without a helmet. It would be a surprise if you found lay public to violate the law more often then men in brown. For the have-nots the police atrocities cover the whole gamut from mild harassment of verbal bullying, and everyday corruption at one end to murder and rape at the other end. One need not turn back some historical leaf to read the account of last encounter, brutality in the lockup, unprovoked beating of blind students or unionized labor, to view the nature of the police and have-nots relation. It is a common practice for police to deny filing a complaint by poor and voiceless and to fail to act against powerful, when poor manage to push through a well supported complaint.

In a country where money talks, poor people are afraid to seek police help or report a crime, leave alone go to them when they have actually broken the law. The recent hooch tragedy in West Bengal is a glaring example of the fear of the police force in a poor man’s eyes where technically the victims of this tragedy were in violation of the law. It is high time that we start demanding from these public servants to start acting like public servants soon, instead of being a veritable arm of the political and ruling class. First this tragedy would not have happened, if the police forces were not in the pockets of the local alcohol mafia. Secondly, and more importantly even when people started feeling the symptoms of methanol poisoning, shockingly they did not head to hospitals for the fear of police harassment. Sadly this is not the first instance of this nature. On a similar note of everyday relevance, even though the rules have changed “on paper”, people still are afraid to take an injured stranger to a hospital for the fear of police harassment. Earlier physicians could not even legally start treating patients until a police report was filed.

Instead of Mamta or some other politician playing the standard blame game after a tragedy hits their state, what is needed is a two fold change at the end of police function: the police force needs to be put in its place as a public servant and secondly, at the legislative level, for all health related problems police should be required to help before any questioning. It is sad itself that such tragedies happen frequently in India due to lack of equitable socio-economic growth but what is worse is fear of police brutality increasing the death toll.

[Dr. Sukant Khurana, Ph. D. is a New York based scientist of Indian origin who is working on both basic and applied side of many health issues. In collaboration with Brooks Robinson, a neuroscientist working on addiction, learning and memory, Dr. Khurana is working on a book on alcohol issues of India. Their public outreach writings relevant to alcoholism are available at: https://sites.google.com/site/sukantkhurana2/ and https://sites.google.com/site/sukantkhurana/alcoholism-writing-of-sukant]

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