India Seminar and Study Tour

Richard Tren recently returned from India where he was hosted by International Policy Network, the Liberty Institute and the Centre for Civil Society. The reason for the visit was to present at two seminars held by these groups and also to conduct research for the upcoming collaborative study on malaria control with the Liberty Institute.

Malaria Seminar - Wednesday 27 March 2024

The first event was co-hosted by the Liberty Institute and International Policy Network and was titled 'Strategies for Malaria Control: Need for a More Participatory Approach.' The workshop was held at the India Habitat Centre and was designed as a 3 hour interactive session with numerous stakeholders. The two speakers were Dr. Sarala Subbarao, director of the Malaria Research Centre in Delhi, and Richard Tren of Africa Fighting Malaria. In attendance was Dr Kaul of the Indian National Anti-Malaria Programme, representatives from the Department of Agriculture, Department of Health, the Centre for Science and Environment, Hindustan Insecticides Limited, Toxics Link and other interest groups.

The first presentation was made by Dr. Subbarao and highlighted the history of malaria control in India and explained some of the ongoing difficulties faced by malaria control officers in the fight against the disease. The emergence of resistance to insecticides, drug resistance, management difficulties and funding were all discussed at length. In addition, Dr Subbarao explained some of the research that the Malaria Research Centre is conducting in bio-environmental control of malaria, which is proving to be successful in some areas. Dr. Subbarao stressed the continued need for DDT in malaria control, even though its use is being reduced. The insecticide is particularly effective against the most efficient malaria vector, An. fluviatilis and therefore any pressure to reduce the use of DDT would be highly counter productive.

The presentation made by Richard Tren was titled 'DDT and Malaria: Environmentalism and Development'. The presentation highlighted some of bias, junk science and political influence behind the banning of DDT and the ongoing pressure against the use of the insecticide. Richard went on to discuss the problems of the Stockholm Convention on Persistent Organic Pollutants on the procurement and trade in insecticides which has the potential to disrupt and delay malaria control efforts around the world. In addition, the widespread adoption of the precautionary principle in international treaties and as guidelines for regulators is making the development of new technologies and chemicals more and more difficult. This makes the task of malaria control officers all the more difficult and when faced with malaria vectors that can develop resistance to insecticides very quickly can and will result in increased incidence of disease and loss of life.

Malaria and DDT: A Case Study in Environmentalism and Development

The discussion that followed was highly charged with Ravi Aggarwal of Toxics Link challenging the need for synthetic chemicals in the fight against malaria and highlighting the fact that insecticides that are destined for malaria control frequently end up being used in agriculture. After much discussion, the various participants stressed the fact that bio-environmental control of malaria, while important, does not exhibit the same efficacy as residual house spraying with synthetic chemicals and that there was a strong need for DDT and other new chemicals in order to save lives. The workshop was considered highly beneficial for all and allowed for a great deal of knowledge sharing and for the development of new contacts.

Poverty Diseases Seminar - Thursday 28 March 2024

The Poverty Diseases seminar was organised by International Policy Network in conjunction with the Centre for Civil Society and was held at the India Habitat Centre. The seminar was designed as an interactive session with economists, medical personnel, policy makers and other stakeholders. The aim of the meeting was to get a better understanding of what poverty diseases were and the best ways of tackling them.

Among the participants and speakers were representatives from the WHO, the Nursing Council, the Apollo private medical centre and the Leprosy mission. Two sessions were held, the first dealt with institutions and fighting disease and the second dealt with two case studies of poverty diseases, namely malaria and leprosy.

Richard Tren was the first speaker of the first session and his presentation titled 'Government failure in South Africa' highlighted the changes to legislation, breakdown of the bureaucracy and the activities of Aids activists that are discouraging investment and involvement of pharmaceutical firms in developing countries.

Bimla Kapoor, a reader at the Indira Ghandi National Open University and Programme Coordinator for Nursing in India made the second presentation. Bimla Kapoor's paper dealt with the relevance of licensing and legislation in the nursing profession and highlighted the need for a relaxation of the licensing rules and for nurses to be able to play a more active role in healthcare provision, particularly in the remote rural areas.

Dr. Derek Lobo of the Communicable Diseases Department at the WHO began his presentation with a discussion of the main reasons that developed countries in the North managed to rid themselves of the major communicable diseases. Economic advancement, wealth and an ability to provide clean water and safe sanitation lie behind the main achievements in disease control in Europe and North America, while the development of vaccines and new drugs played a relatively minor role. Dr Lobo went on to call for greater involvement and funding from the donor community, developed country governments, charities (such as the Global Fund) and the pharmaceutical industry.

Dr. Parth Shah, director of the Centre for Civil Society, challenged the concept of health as a public good and discussed the issue from a philosophical and economic point of view.

During the second session, V J Sharma, the former head of the Malaria Research Centre made a presentation on the economic costs of malaria, with particular reference to India. Dr Sharma highlighted the work done by Dr. Jeffrey Sachs and others that details the enormous drain that malaria places on national economies, particularly in Africa. Dr Sharma pointed out the link between malaria and poverty and the important contribution that malaria control can play in ensuring the economic development of poor, malarious countries.

Richard Tren expanded on the link between poverty and malaria. While research has been done that shows that malaria causes poverty and keeps people and areas poor and undeveloped, the lack of malaria does not necessarily stimulate growth. Government policies that ensure economic liberty, ensure the rule of law, protection of private property and limited government involvement are far more important for wealth creation than the control or eradication of malaria.

Mr Tren was followed by D Vijaya Kumar from the Leprosy Mission in Delhi who explained the work that their charity is doing to combat leprosy which remains a very significant problem in India, particularly for the poor. This presentation was followed by Dr Ahmed Zaheer, a skin specialist at the private Apollo Hospital. Dr Zaheer's paper detailed the problem of leprosy in India and gave a clear presentation of the medical effects of the disease. He went on to discuss the leprosy vaccine that he had been developed in India in conjunction with government research agencies. The vaccine has dramatically increased the recovery period of leprosy patients and is helping to avert new cases of the disease. Despite this, the vaccine is not used by the WHO in its work to control and treat leprosy in India.

The presentations were followed by highly interactive and informative discussions from the floor where there was a very wide range of stakeholders and interest groups.

Other Activities

Richard Tren also attended a workshop held by International Policy Network and the Liberty Institute on Intellectual Property Rights (IPR). The workshop was designed to benefit journalists and gave an opportunity for Indian experts on intellectual property to discuss the relevance and need for strong IPR. This was done with relation to the entertainment industry, the computer industry and with respect to the provision of health care.

In addition to the above, Richard spent a great deal of time with researchers from the Liberty Institute discussing and reviewing the work and research that has been done on the upcoming AFM publication on malaria control in India. A great deal of information has already been sourced and it is hoped that an informative and relevant study will be produced with policy recommendations for government, aid agencies, researchers and other interest groups.