Gates Foundation

‘Wai-Wai’ Group Wants Junk Food in Name of Nutrition, Gates Foundation Says No

The Chaudhary Group makes Wai-Wai noodles and says a fortified version of its product will be supplied to the Baliyo Nepal nutrition initiative that the Bill and Melinda Gates Foundation is paying for.

In August 2019, The Kathmandu Post quoted Nirvana Chaudhary, managing director of the Chaudhary Group – makers of Wai-Wai noodles and one Nepal’s largest conglomerates – saying that his company “has teamed up with the Bill and Melinda Gates Foundation for a project called Baliyo Nepal.”

Though the Chaudhary Group has built its fortune on what most nutritionists regard as junk food, the Baliyo Nepal project would “fight against malnutrition and all associated health problems” by the fortification of popular food products. “The idea is that rather than giving them supplements, why not make the existing products that they’re consuming rise to that level,” Chaudhary said.

“The project will be formally announced in September, and launched in an undisclosed province, with fortified CG food products, and would be rolled out countrywide next year,” Kathmandu Post reported. “We will definitely start with noodles, and then move to juice in the later stages,” Nirvana Chaudhary was quoted as saying.

Since the Chaudhary Group has no noodle products other than various brands of Wai Wai instant noodles, it almost seemed as if the Baliyo Nepal project was created for the fortification of junk food by Nepal’s largest junk food producer.

While it is absurd to fortify junk food in the name of better nutrition, the Gates-Chaudhary partnership is problematic even beyond the perspective of health.

The Gates Foundation’s website shows funds to “launch, develop and scale Baliyo Nepal” were granted to the Chaudhary Foundation in October 2018. However, Nirvana Chaudhary’s assertions suggest that the Gates’ money granted to the Chaudhary Foundation – certainly a portion of it, at any rate, if not the entire sum – would actually end up in the hands of the Chaudhary Group itself for the ‘fortified’ noodles it would provide.

Baliyo Nepal was formally launched on November 1. On the day, Swarnim Wagle, who chairs Baliyo Nepal’s board, was quoted in Republicca as saying, “We will work only with products with high nutritional standards, those that meet Australia’s Health Star Rating >3 and it excludes noodles and all junk food.”

While Wagle’s words were reassuring for nutritionists, the fact is that Baliyo Nepal is a project of the Chaudhary Group and the Gates Foundation, and the latter’s funds – amounting to US$ 788,192 – were granted to the Chaudhary Foundation and not to Baliyo Nepal directly. Therefore, the claim that Baliyo Nepal is no longer going to fortify junk food should ideally be made by the Chaudhary Foundation.

What the Gates Foundation website says about the Baliyo Nepal grant for $788,192.

Social Welfare Council’s approval?

Last week, the Himal Khabarpatrika’s reporter Gopal Gartaula raised the issue of how the Gates Foundation’s grant entered Nepal. Under Nepali law, all projects of Nepal-based NGOs that receive funds from foreign donors must be approved by the Social Welfare Council and the funds thus received can only be used for the specific purpose for which they were brought into the country.

The Social Welfare Council’s approval process regulates the activities of NGOs and holds them to account for using the funds in the manner in which they were originally intended and for which they were approved, in much the same as the Ministry of Home Affairs in India regulates the use of foreign donations by NGOs under the Foreign Contributions Regulations Act (FCRA).

The Chaudhary Foundation is familiar with the process of Social Welfare Council (SWC) approval. Gartaula found records at the SWC that the Chaudhary Foundation had received funds worth Nepali Rs. 1 crore 28 lakh (US$ 113,097 by today’s conversion rates) from four different sources: LG Electronics Inc. in Seoul, South Korea, LG Electronics Singapore, Seeds India, and the New Venture Fund of Washington, DC. However, according to the Himal Khabarpatrika article, the SWC does not have records of any proposal made by the Chaudhary Foundation for the “Baliyo Nepal” project with the Gates Foundation as donor.

As an official at the council told Gartaula, “These funds do not seem to have come through the official channels. We will now look into this.”

Under the Social Welfare Act (1992) of Nepal, it is illegal for funding by foreign donors to bypass the Social Welfare Council. Yet, President Bidya Bhandari herself inaugurated Baliyo Nepal on November 1.

Could one explanation for this discrepancy be that Baliyo Nepal has been launched with the Chaudhary Foundation’s own money and that the Gates grant will only come in due course? Perhaps not, since Baliyo Nepal openly claims it is funded by the Bill and Melinda Gates Foundation.

Either way, the lack of clarity on this question, when taken together with the unresolved matter of whether the philanthropic programme will push a ‘fortified’ version of the Chaudhary Group’s noodles brand, has left a bad taste in the mouths of many in the health and development sectors.

Gates Foundation responds

In a statement, the Bill and Melinda Gates Foundation has clarified that “noodles are not one of the foods being promoted by Baliyo Nepal”.

“Noodles are not one of the foods being promoted by Baliyo Nepal, and we do not expect them, including Wai Wai noodles, to be eligible to become a Baliyo Nepal product. To be eligible, partners must ensure foods meet a high nutritional standard, either by being naturally rich in nutrients or by being fortified. Baliyo Nepal verifies nutritional standards by using the Australian Government’s Health Star Rating system and requires all products to have a 3-star rating or higher,” the foundation said.

“Baliyo Nepal is a new nonprofit organization, initially funded by a grant from the Bill & Melinda Gates Foundation to the Chaudhary Foundation, which transitioned Baliyo Nepal into an independent organization governed by a diverse board from Nepali civil society. Baliyo Nepal is collaborating with the food industry to develop more affordable and nutritious food and generating demand through social marketing and behavior change communication. Baliyo Nepal’s first program aims to reduce the risk of nutritional deficiencies among children aged 6 to 23 months by promoting complementary feeding, including partnering with four companies to grow the accessibility, affordability and consumption of eggs and fortified porridge.”

Kathmandu Post stands by story

After Nirvana Chaudhary claimed on Twitter that he was misquoted by The Kathmandu Post, the daily released a statement standing by their story. They said that the reporter had “demonstrated his integrity” in reporting the story, and also published the relevant portion of the full conversation between Chaudhary and the reporter.

Note: The headline of this article has been changed to reflect a clarification from the Gates Foundation. It was also updated on November 7 with The Kathmandu Post‘s response.

Gates Foundation Staffer Resigns Over Award to Narendra Modi for Swachh Bharat

Sabah Hamid has said that honouring Modi while he imposed a communications and movement lockdown in Kashmir was a grave error.

New Delhi: Hours before Prime Minister Narendra Modi officially received the Gates Foundation’s annual Global Goalkeeper Award for his Swachh Bharat Mission, a staff member at the foundation reportedly resigned in protest.

Sabah Hamid, a 42-year-old communications specialist, told TRT World that honouring Modi while he imposed a communications and movement lockdown in Kashmir was a grave error. “Since the foundation seemed set on its course of action to go ahead with the award – which as a private foundation it is entitled to – I could do just one thing: leave,” Hamid said.

The former employee has said that she took up the matter with her superiors, but “realised very quickly that this was a decision that would not be changed”.

Hamid, a Kashmiri, has been with the Gates Foundation for the last 3.5 years. “Being Kashmiri makes it personal. Eight million of my people have been under an undeclared curfew for 50 days now, with minimal access even to medical care, and there is a humanitarian crisis under way in the valley. The Modi led government has not only designed and implemented this crisis, their untruths and the complicity of a large part of the media means they are also trying to hijack the narrative. Being feted at large international gatherings, and winning awards plays right into that,” she said.

Also read: Why We, as Hindu Americans, Are Opposed to Modi’s Undeclared Emergency

There has been widespread global outrage over the Gates Foundation’s decision. From three Nobel laureates – Iranian activist Shirin Ebadi, Northern Irish peace activist Mairead Maguire and Yemini journalist Tawakkol Abdel-Salam Karman – to a civil society group that partners Goalkeepers Youth Action Accelerator, several groups had penned open letters asking the Gates to reconsider.

Gates Cambridge scholars and alumni also said that the decision to reward Modi “while ignoring the gross violation of human rights under his regime is reprehensible”. An online petition seeking a revocation of the award has more than 100,000 signatures.

Two celebrities who were supposed to be present at the ceremony – British Asian actors Jameela Jamil and Riz Ahmed – pulled out of the ceremony after the Indian government’s actions in Kashmir, but have not publicly said if that was the reason from them doing so.

Renowned feminist author and activist Gloria Steinem and noted philosopher Akeel Bilgrami co-authored an opinion article in the Guardian on Tuesday, saying that the award highlighted “the collapse of any sense of international political morality”. “…the Gates Foundation’s award to Modi for starting a sanitation scheme in India seems rather like giving a prize to Mussolini for making the trains run on time,” they have said.

However, as Tuesday’s award ceremony proved, the foundation stuck to its decision despite all the criticism – from both within and outside the organisation.

Global Civil Society Alliance Condemns Gates Foundation Decision to Award Modi

CIVICUS, an alliance “dedicated to strengthening citizen action and civil society throughout the world”, said that the decision to give Modi the Global Goalkeeper Award “sends the wrong message”.

New Delhi: A global alliance of civil society organisations and activists called CIVICUS has expressed disapproval over the decision by the Bill & Melinda Gates Foundation to award Prime Minister Narendra Modi the Global Goalkeeper Award and decided “in principle not to attend the awards ceremony”. CIVICUS is a partner of the Goalkeepers Youth Action Accelerator.

The alliance, which describes itself as an alliance “dedicated to strengthening citizen action and civil society throughout the world”, in a press statement said that the decision to give Modi the Global Goalkeeper Award “sends the wrong message”.

CIVICUS noted that Modi’s violation of civic freedoms and his government’s dismal human rights record “should not be overlooked” and expressed concern over the impact that the presentation of the award would have on global philanthropic endeavours and the collective advancement of human rights

The statement also pointed out that Modi, who is being awarded the Global Goalkeeper Award in recognition of his work to improve sanitation through the Clean India Programme, had persecuted activists and undermined “the watchdog roles of the media and civil society groups”.

Taking into account the Foundation’s efforts and contributions to enhance livelihood around the world in the fields of health and sanitation, CIVICUS pointed out that awarding Modi would mean ignoring “serious concerns raised by civil society on the decline of civic freedoms in India”.

Also read: Gates Cambridge Scholars, Alumni Call on Foundation to Revoke Modi’s Award

The press statement further said that failing to implement commitments related to public access to information, inclusive decision making and fostering civil society partnerships, the Modi government was in breach of the democratic ideals recognised under the UN’s Sustainable Development Goals.

Chief programmes officer at CIVICUS: World Alliance for Citizen Participation, Mandeep Tiwana said that all 17 sustainable development goals were interdependent and co-related. “The Modi government has a lot of ground to cover with regards to the fulfillment of SDG commitments on inclusive governance, civil society partnerships, access to information and fundamental freedoms. In fact, it has deliberately suppressed these,” he said.

CIVICUS cited a slew of anti-democratic measures and a pattern of attacks and violations against freedoms of expression including the recent clampdown in Kashmir, raids on the offices of Lawyers Collective, Amnesty International, and a crackdown on journalists and members of the civil society.

The CIVICUS Monitor, which rates the degree of civic freedom in 196 countries, rates India as ‘obstructed’.

Gates Cambridge Scholars, Alumni Call on Foundation to Revoke Modi’s Award

In an open letter, over 70 signatories have called on the foundation to revoke the award in light of the ‘current climate of violence, intimidation and fear in India’.

New Delhi: Gates Cambridge scholars and alumni have written an open letter to the Bill & Melinda Gates Foundation in connection with its decision to award Prime Minister Narendra Modi the Global Goalkeeper Award.

In the letter, over 70 Gates Cambridge scholars and alumni condemned the decision taken by the Bill & Melinda Gates Foundation to present Narendra Modi with the Global Goalkeeper Award for the Swachh Bharat Mission while ignoring human rights violations that have taken place under his regime.

Pointing out that the Indian government under Narendra Modi has “brazenly pursued an agenda of persecuting minorities” the letter goes on to say that there has been “an exponential rise in hate crimes against minorities”.

Alluding to the intimidation of civil society activists and the arrests and censorship of public intellectuals, the letter notes that the “most recent illustrations of this government’s espousal of Hindu nationalist ideology” was its decision to withdraw the special status of the state of Jammu and Kashmir and the proposal to “to effectively strip the citizenship of 1.9 million citizens” in Assam.

Also read: Riz Ahmed, Jameela Jamil Pull Out of Gates Foundation Event Awarding Modi

The letter further draws attention to curfew and clampdown in Kashmir and reports of house arrests, detentions and complete isolation of Kashmiris. Referring to the National Register for Citizens, the signatories of the letter point out that the “draconian measure” to render 1.9 million citizens stateless was in keeping with the home minister Amit Shah’s proclamation that ‘immigrants’ were akin to ‘termites’.

Addressing the Modi government’s Swachh Bharat Mission, the letter states that the programme was “reliant in large measure on media publicity rather than social change” and that it had failed to remove the widespread practice of manual scavenging.

The letter concludes by noting that as Gates Cambridge scholars and alumni, with a ‘commitment to improving the lives of others’, the signatories have called on the foundation to revoke the award in light of the “current climate of violence, intimidation, and fear in India”.

The full text of the letter is reproduced below:

An Open Letter from Gates Cambridge Scholars and Alumni to the Bill & Melinda Gates Foundation for Awarding Narendra Modi with the Global Goalkeeper Award

As Gates Cambridge scholars and alumni, we unequivocally condemn the Bill and Melinda Gates Foundation’s decision to present the Global Goalkeeper Award to the Prime Minister of India, Narendra Modi. Lauding PM Modi for the Swachh Bharat Mission (Clean India Mission) while ignoring the gross violation of human rights under his regime is reprehensible.

Since 2014, the Modi-led regime has brazenly pursued an agenda of persecuting minorities, particularly Muslims and Dalits, damaging the democratic and secular fabric of India. In the last five years, there has been an exponential rise in hate crimes against minorities, intimidation of civil society activists, use of brute majority power to pass controversial legislation, significant dilution of the autonomy of academic and judicial institutions, and arrests and censorship of public intellectuals. The most recent illustrations of this government’s espousal of Hindu nationalist ideology include withdrawal of the semi-autonomous status of Jammu and Kashmir, the only Muslim majority state in India, and proposals to effectively strip the citizenship of 1.9 million citizens, mostly Muslims, in the north-eastern state of Assam.

In an unprecedented move on 5 August 2019, the Modi-led government announced the withdrawal of the special status accorded to the disputed territory of Jammu and Kashmir. The announcement was followed by a curfew, complete clampdown on communication in the state, and arrest of democratically elected representatives. At the time of writing this letter, there are seven million Kashmiris under military siege lasting for over 40 days. Several media sources have reported on the inhuman conditions in the state, including house arrests, detentions, humiliation, and complete isolation of Kashmiris (The New York Times, The Guardian).

In Assam, on the other hand, the government has launched a bid to identify and drive out ‘illegal immigrants’ through the implementation of a National Register for Citizens, potentially rendering 1.9 million citizens stateless. This draconian measure, which would impact people who are living in poverty in flood-prone areas (Deutsche Welle), is in keeping with Home Minister Amit Shah’s proclamation that ‘immigrants’ are akin to ‘termites’ (Reuters). PM Narendra Modi continually fails to address and indeed, through his silence, abets the rise of Hindu nationalist sentiments and consequent violence against minorities in the country. Indeed, the government is emboldened by Modi’s rise to power despite the 2002 large-scale violence against Muslims in the state of Gujarat under his watch as Chief Minister.

Programmes, such as Swachh Bharat Mission, are then only diversionary tactics, reliant in large measure on media publicity rather than social change. While the Swachh Bharat Mission has been promoted through photos of PM Modi washing feet of sanitation workers, there is negligible effort to address the widespread practice of manual scavenging in the country. Indeed, the initiative perpetuates the historical reliance on the most marginalised castes to clean human excreta, sewage and septic tanks with their bare hands and bodies. The Ramon Magasaysay Awardee and founder of Safai Karamchari Andolan (SKA or the Sanitation Workers’ Movement), Bezwada Wilson, has condemned the Swacch Bharat Mission for its disregard of institutional discrimination against Dalits and their deaths from manual scavenging. He says, ‘Toilet construction will not help us and will, in fact, push us back into manual scavenging, unless the entire exercise is mechanised and well thought out with proper planning’ (The Wire). Regardless of the debatable scope of the initiative, its promise of welfare and dignity for all is at odds with the unprecedented marginalisation of minorities under PM Modi’s government.

As Gates Cambridge scholars and alumni, with ‘commitment to improving the lives of others’, we cannot stand in silence as the Bill and Melinda Gates Foundation supports and encourages the Modi-led authoritarian regime responsible for gross human rights violations in India. By embracing Modi with the Global Goalkeeper Award, the Foundation is indeed going against its own principle that ‘all lives have equal value’. Given the current climate of violence, intimidation, and fear in India, the Foundation needs to condemn and not reward PM Modi’s leadership.

A recent petition by Stop Genocide already reached over 100,000 signatures expressing strong opposition to choosing Modi for the Global Goalkeeper Award. Through this letter, we add our voices to this opposition and call upon the Foundation to revoke the award, allowing us to continue to take pride in Bill and Melinda Gates Foundation’s work for the improvement of living conditions and the promotion of human rights for all across the world.

Sincerely,

Divya Venkatesh, PhD Pathology, 2011-16, Queens’ College
Sagnik Dutta, PhD Politics and International Studies, 2016-2020
Ananya Mishra, MPhil Modern South Asian Studies, 2014-2015; PhD English, 2016- 2020, Corpus Christi College
Draško Kašćelan, PhD Linguistics, 2015-2019
Asiya Islam, PhD Sociology, 2015-2019; Junior Research Fellow, Newnham College
Arif Naveed, PhD Education 2014-18, Lecturer, University of Bath, UK
Callie Vandewiele, PhD Latin American Studies 2014-2018; Lecturer, University of Auckland
Dena Qaddumi, PhD Architecture, 2016-2020
Stephanie Gabriela Lopez, MPhil Latin American Studies 2014-2015
Reetika Subramanian, PhD in Multi-disciplinary Gender Studies 2019-22, Queens’ College, University of Cambridge
Peter Sutoris, PhD Education, 2015-2019, Clare Hall College
Berenice Guyot-Rechard, PhD History, 2009-2013, Trinity College
Maria Hengeveld, PhD Development Studies -2017-20 King’s College
Safwan Aziz Khan, MPhil Public Policy, 2016-17, Christ’s College
Joshua Feinzig, MPhil Criminology, 2016-2017, Pembroke College
Surabhi Ranganathan, PhD Law 2008-2012; University Lecturer, King’s College
Sheina Lew-Levy, PhD Psychology, King’s College; Postdoctoral researcher, Simon Fraser University
Nayanika Mathur, PhD Social Anthropology 2005-2010, Associate Professor in the Anthropology of South Asia, University of Oxford
Gregory Wilsenach, PhD Mathematical Logic, 2014-2018, Postdoctoral researcher, University of Cambridge
Njoki Wamai, PhD Politics and International Studies 2012-2016; Assistant Professor, United States International University – Africa
Tariq Desai, PhD Genetics 2014-2019, Magdalene College
Juliana Broad, MPhil History and Philosophy of Science 2018-2019, Darwin College
Rebecca Love, PhD Medical Science, 2015-2019, King’s College
Margaret Comer, PhD Archaeology, 2015-2019, Jesus College; Postdoctoral Researcher, University of Cambridge
Caitlin Casey, PhD Astronomy, 2007-2010, St John’s College; Professor at University of Texas at Austin
Marina Veličković, PhD Law 2017-2020, Pembroke College
Nicholas Barber, PhD Earth Science, 2018-2022, Churchill College
Solange Manche, PhD French, 2018-2021, King’s College
Elizabeth Walsh, MPhil Social Anthropology, 2015-2016, King’s College
Monica Petrescu, MPhil Economics, 2011-2012
Zoe Stewart, PhD Clinical Biochemistry, 2014-2018, Clare College; Academic Clinical Lecturer, University of Leicester
Collin VanBuren, PhD Earth Sciences, 2013-2017, Christ’s College; Postdoctoral Researcher, the Ohio State University
Anjali B Datta, PhD History, 2009-2014, Trinity College
Ana Maria Guay, MPhil Classics, 2015-2016, Newnham College
Zenobia Ismail, PhD Politics 2013-2017, Wolfson College
Hanna Danbolt Ajer, MPhil Theoretical and Applied Linguistics 2014-2015, PhD Linguistics 2015-present, Trinity Hall
Justin G. Park, MPhil Anglo-Saxon, Norse and Celtic Studies, 2013-2014, Wolfson College
Bhaskaran Nair, PhD Materials Science 2014-2019, Trinity College
Aliya Khalid, PhD Education 2015-2019, Newnham College
Cansu Karabiyik, PhD Medical Science, 2016-2020, Pembroke College
Nandini Chatterjee, PhD History, 2002-2007, St Catharine’s College
Neha Kinariwalla, MPhil Modern Society & Global Transformations 2014-2015, King’s College
Paulo Savaget, PhD in Engineering, 2015-2019, Hughes Hall
Akhila Denduluri, PhD Chemistry, 2017-2021, Murray Edwards College
Minaam Abbas, MB/PhD Medicine and Pathology, 2017-2020, St. John’s College
Sara Kazmi, PhD English, 2017-2021 Queens College
Eddie Cano Gamez, PhD Biological Science, 2017-2020, Selwyn College
Elinor Lieber, PhD Criminology, 2018-2021, Pembroke College
Julia Bolotina, MPhil & PhD Anglo-Saxon, Norse and Celtic, 2011–2016, St John’s College
Saba Sharma, PhD Geography, 2015-19
Lena Dorfschmidt, PhD Psychiatry, 2018-2021, Darwin College
Ramana Kumar, PhD Computer Science, 2011-2015, Peterhouse
Noor Shahzad, MPhil Modern South Asian Studies, 2016-2017, Christ’s College
Leor Zmigrod, PhD Psychology 2016-2019, Downing College; Junior Research Fellow, Churchill College
Hanna Baumann, PhD Architecture, 2012-17, King’s College
Darinee Alagirisamy, MPhil Modern South Asian Studies, 2011-2012, PhD History, Lucy Cavendish
Michael Pashkevich, PhD Zoology, 2017-2021, Jesus College
Dino Kadich, MPhil Geographical Research 2018-19 and PhD Geography 2019- 2023, Emmanuel College
Dorien Braam, PhD Veterinary Medicine, 2018-2021, St John’s College
Anija Dokter, PhD Music 2012-18, Queens’ College
Edyth Parker, PhD Veterinary Medicine, 2016-, Clare College
Paula Haas, PhD Social Anthropology 2008-2012, Murray Edwards College
Anindya Sharma, MSci Systems biology, 2014-2018, Corpus Christi College
Samuel Kebede, MPhil Epidemiology, 2018-2019, Sidney Sussex College
Fahad Rahman, MPhil Social Anthropology, 2015-16, St. Edmunds College
Surrin Deen, PhD Radiology, 2014-2018, Trinity Hall
Nikhita Mendis, MPhil Social Anthropology, 2018, Trinity Hall
Jocelyn Perry, MPhil International Relations and Politics, 2015-2016, Corpus Christi College
Cerianne Robertson, MPhil Sociology, 2016-2017, St Edmund’s College
Anna Kendrick, PhD Spanish, 2011-2014, Emmanuel College
Vincent Kim, PhD Physics, 2014-2018, Selwyn College
Alex Kong, MPhil Biological Science, 2016-2017, Churchill College

India Excels in Funding Neglected Disease Research: New Report

Among other developing countries, India was responsible for the “lion’s share” of public funding.

New Delhi: A new report has found that the Indian government is the fourth largest funder for research and development into neglected tropical diseases.

With USD 1,595 million, the US government is the largest funder. The Indian government contributes USD 72 million.

Increased investments by the Indian Council of Medical Research helped boost India’s position, said Soumya Swaminathan, the deputy director general at the World Health Organisation and formerly the head of the Indian Council for Medical Research (ICMR)

Increased investments by #India @ICMRDELHI and @MRCza helped raise the overall funding for neglected diseases. Trachoma, mycetoma, scabies and hepatitis C need more R&D. https://t.co/px4sYxwZpj

— Soumya Swaminathan (@doctorsoumya) January 23, 2019

Among other low and middle income countries (LMICs), India is credited with being responsible for the “lion’s share” of public funding.

The findings come from an analysis of global investment into research and development (R&D) on new products for neglected diseases in developing countries, as part of the eleventh annual G-Finder survey.

The survey looks at funding for a number of diseases like trachoma, buruli ulcer, rheumatic fever, meningitis, leptospirosis and also for HIV/AIDS, malaria, TB, dengue, hepatitis C and leprosy.

It examines funding from government sources, philantrophies, private sector funding and other types of organisations.

“It is very encouraging to note that investments in neglected disease R&D went up in 2017, especially from middle-income countries,” said Swaminathan. “Millions continue to suffer and new tools are urgently needed,” she said.

At launch of #GFINDER 2018 report, encouraging news. Highest levels of investment ever into #neglecteddisease R&D. Some diseases remain neglected like trachoma and mycetoma. Middle income countries increase their commitment pic.twitter.com/nVmWcCiOac

— Soumya Swaminathan (@doctorsoumya) January 23, 2019

Indian government’s funding to neglected diseases

The need for drugs for neglected diseases and also for drug R&D is high in India. The country tops the number of cases for 11 different neglected tropical diseases such as lymphatic filariasis, visceral leishmaniasis, trachoma, tapeworm, roundworm, hookworm, whipworm, dengue and leprosy.

In 2017, there were around 2.8 million new cases of TB, which brought down the global decline of TB. One third of all TB deaths worldwide happen in India.

According to the G-Finder report, TB research gets the largest of all Indian government funding, with Rs 147 crore (30%). Malaria is a close second with Rs 115 crore (23%), while leprosy gets Rs 39 crore, dengue Rs 35 crore and HIV/ AIDS Rs 14 crore.

This year, India maintains its position as the fourth largest government funder globally into neglected disease research. It tops among other compatriot LMICs, contributing 72% of all the funding towards neglected disease research.

India also records the strongest global growth in public funding for R&D on neglected diseases since 2009.

ICMR gets special attention for its research and development

The top public funding agencies into R&D on neglected diseases in India are the ICMR, the Department of Biotechnology (DBT), the Council of Scientific & Industrial Research (CSIR) and Biotechnology Industry Research Assistance Council (BIRAC)

As Swaminathan noted, ICMR’s overall funding in 2017 increased by 61% to Rs 38 crore. Among global government funders for R&D, ICMR is the fourth largest on TB, the third largest on dengue and the second largest on leptospirosis.

Among LMIC’s, the top three public funders into research in 2017 were India (USD 76 million), South Africa (USD 14 million) and Brazil (USD 9.2 million).

LMIC public funding increased even though Brazil cut back heavily. The ICMR is credited with keeping the funding high. The report says that the increased funding from LMIC’s “was due to a large increase in Indian government investment, which was in turn entirely due to additional funding from the Indian ICMR.”

ICMR’s funding gets special mention also for research on TB, Dengue and Leprosy.

On TB, the ICMR is the only LMIC funder in the top 12 countries.

Dengue saw a big fall in investment in 2017, which is “almost entirely” attributed to the cut back from the US, the Gates Foundation and the industry. But the ICMR increased its funding into dengue research in 2017, even over taking the Gates Foundation to become the third largest funder of dengue research globally.

A similar story is seen with leprosy, where global funding for it has been short in 2017 but despite this, the ICMR “contributed more funding than ever before”.

In This Era of Billionaires and Unequal Funding, Where Is Research Going?

Science’s funding has always shifted, depending on what money is available and who is involved, with oversight in the modern era mostly through peer and grant reviews.

You exit a cramped, hazy subway car with a throng of professionals. As you emerge blinking into Kendall Square in Cambridge, MA, the crowd descends on a nest of pharmaceutical offices huddled around the Charles River, overlooking downtown Boston. MIT, Harvard, bougie cafes and hotels, trendy co-working spaces filled with startups, and giants like Google are dispersed throughout the biotech colosseum. Last but not least, there are the institutes – the Ragon, the Koch, the McGovern, the Picower, the Whitehead, and the Broad – all named after billionaire donors seeding a stake as a powerhouse in their respective fields. And more is on the way. The Gates Foundation is building a nonprofit research institute and China is moving to secure space in the area.

This is why biotechnology and life sciences are exceptionally strong in Boston. Almost everyone in biotech works in Boston, or works with somebody who does. It’s why they continue to bring new students from all over – and why I came here. The area is in a cycle of shared dominance with other epicentres like San Francisco, Research Triangle in North Carolina, the metropolitan New York area, and DC. But these zones represent a growing erosion of geographical diversity in America’s higher education system. These areas are raking in thousands of awards, worth billions, and are reinforced with billions of venture capital funding and huge amounts of new lab space. Even between two major centres, Boston and DC, Boston acquires 151% more funding from the National Institutes of Health, 58% more patents, and 2,010% more venture capital investment. These are the gaps just at the top of the pyramid.

Coming from a public research university in a smaller city, Kendall Square was a stark change. I remember giving tours at my undergraduate university to prospective students, mentioning our benefactor, who donated eight figures to rename and boost our engineering school facilities. As I took the tour group into our workshops, I mentioned the innovation competitions on campus offering thousands of dollars for new, transformative ideas. Now, I work in a single building worth more than a third of my alma mater’s endowment, and work for an innovation programme on campus that offers, collectively, millions every year for hundreds of teams.

It’s a remarkable environment, a place that undoubtedly everyone is thankful to be a part of. But it’s hard to ignore what makes this possible. Universities like Harvard, Stanford, and MIT are supported by progressive state governments, diverse student groups, and endowments totalling nearly $75 billion. These private universities do not experience the same stresses currently affecting public research universities, particularly in the Midwest. These schools have to lobby state governments to secure funding, like my alma mater did last fall, and manage state politics. Successful professors often depart to other universities, especially when a large pay gap exists, sometimes leaving undergraduates without their adviser. Per-student spending has dramatically fallen in states like Illinois, Iowa, and Michigan. And NIH funding underlines these trends. Half of all NIH funding is awarded to only 10% of states and 2% of funded organisations. These imbalances repeat through all the ways technology is commercialised: 20% of universities contribute to 60% of startups.

Beyond the attraction of top faculty and enormous endowments stand the donors, ready with hundreds of millions of dollars for the pursuit of groundbreaking advances in brain science, astrophysics, artificial intelligence, coral reefs, and other interests. If top researchers and universities didn’t collect enough government money, private donors make up the rest, accounting for 30% of all research money at top universities like Harvard, Stanford, and Johns Hopkins. And all money is not equal. Private donors offer independence and inspiration, free of government requirements and filled with curiosity and persistence to solve personal ambitions and altruistic pursuits.

As if this weren’t enough, universities and nonprofits increasingly claim patents on research generated from federally funded projects. The debate surrounding the patents of the controversial gene editing technology, CRISPR-Cas9, is a perfect example: just one company with patent licenses has garnered millions in funding and deals worth hundreds of millions. University patents and licenses are of particular interest to these donors. Take the Chan Zuckerberg Biohub in San Francisco for example, where it has exclusive rights to commercialise research, regardless of whether it was funded by American taxpayers or not. The power to affect research, for better or worse, by “free-market philanthropy” raises yet more questions about the shifting future of American public research.

But on the flip-side, all these patents, venture capital, and startups mean that research, often dense and walled off in academia, is being translated to the public. It means that work performed in the lab – the new diagnostics, medicines, agricultural tools, biomanufacturing, sustainable products, ways to produce meat – will affect someone outside the lab, directly. This is exactly what university research is for.

This is the inherent beauty about the spirit of public research. The collective pursuit of knowledge for the benefit of the greater good, paid for by the greater whole. While I believe this continues to be largely true, many – including Michael Eisen, the outspoken biologist and former California Senate candidate – have pointed out the changing landscape. A large influx of donor money with protected interests has spurred massive, publicly funded grants, incredible facilities to attract talent, and awe-inspiring ambitions and success. And despite many good intentions, these donors have contributed to powerhouse clusters of research – and more stratification of the research ladder system.

Science’s funding has always shifted, depending on what money is available and who is involved, with oversight in the modern era mostly through peer and grant reviews. But as I stop by my institute’s in-house barista, the rich get richer phenomenon is plain as the coffee in my hand. The trends point to growing inequality and declining diversity in our system of world-class universities charged with solving science and society’s biggest challenges.

In a system ripe with reputation-driven incentives, this pattern raises worrisome conflicts. How can we ensure and promote funding diversity while maximising the practical, direct public impact of our work? Wayne Wahls, Professor at the University of Arkansas, proposes some clear, bold empirical steps, such as setting a lower and upper limit to the amount of funding a lab can receive.

I’m unbelievably thankful for the chance to study what I’m curious about, but these trends should make every young graduate student wonder: what will the environment to get a job, publish a paper, or find a fellowship look like in five years? In ten? As some argue, there are too many PhD students, employment after graduation continues to look bleak, and very few actually become professors, perhaps because 40% of the funding goes to 10% of professors.

In this era of billionaires and unequal funding, where is research going? And perhaps more importantly, how will our changing resources affect the training, success, and diversity of the scientists of our future?

I’m a PhD student in Biological Engineering at MIT. Around two billion people in the world are infected with a microscopic bug called Mycobacterium Tuberculosis. Despite this, only a fraction develop tuberculosis. And a fraction of those infected – almost 5,000 a day – die. I put on Stranger Things-esque protection equipment and probe these bacteria to ask, what allows them bacteria to win this tug-of-war? To understand this variation, I look at how both human and bacteria cells change on a genetic level in response to each other, as a member of the Blainey Lab, located in the Broad Institute, and Bryson Lab, located in the Ragon Institute and MIT.

Josh Peters is a PhD student in Biological Engineering at MIT.

The original article was published on the Massive. You can read it here.

Why Public-Private Collaboration is Bad News For Healthcare in India

Public-private partnerships offer little assurance in providing integrated and universal healthcare, and act as means for the expansion of the private sector.

Patients in a government hospital. Credit: Reuters/Files

Patients in a government hospital in India. Credit: Reuters/Files

Collaborations or public private partnerships (PPPs) are becoming the norm in India’s healthcare sector. The new National Health Policy (NHP) focuses on a larger role for the private sector. It reinforces its support for PPPs with not-for-profit and private sector organisations through contracting and strategic purchase of services as a short term measure to fill critical gaps in the health system. The duration of this ‘short term’ remains unspecified.

PPPs are mechanisms whereby the public sector procures services from the private sector. For the past 15 years, they have incrementally expanded their scope and terrain in the health sector. The new NHP proposes PPPs for rural and urban primary health services with not-for-profit and for-profit providers respectively, in areas of skill and capacity building, mental health and disaster management. User charges have made a comeback in primary healthcare services in urban areas, which will be provided in collaboration with for-profit private providers. This assumes that the middle class can pay and are a homogenous group. Within the fold of PPPs, the role of corporate social responsibility, voluntary services or pro-bono services for rural and under-served areas is seen as an innovation – allowing the government to avoid the financial responsibility of increasing budgetary allocation for public provisioning of healthcare services. Setting up volunteering programmes also allows the government to enter into contracts with community based or charitable organisations.

The rationale for adopting and expanding PPPs emerges from the paltry budgetary allocation, widening gaps in service and private investment in areas where there are no providers. Interestingly, the background note on NHP 2017 uses a different rationale for private participation so that market domination does not subvert social inclusion and sustainability. It says that the private health industry needs to fulfil ‘its mandatory obligations in return of myriad benefits provided by the government for 25 years’. However, the justification for PPP really rests on its cost efficiency.

PPPs on ground

In several states like West Bengal, Maharashtra and Bihar, many kinds of services have already been outsourced and contracted through PPPs. The services provided under PPPs range from diagnostic services (digitised radiology, CT scan, MRI, pathology, biochemistry), dialysis services, supportive services like diet, security and waste collection. Surgeries like cataract operation under the national health programmes, and management of primary health facilities are also provided. Service-oriented PPPs have been largely given to for-profit private sector companies – ranging from local entrepreneurs to national level and multi-national corporations like Siemens, Apollo, Ensocare and GE Healthcare. Thus, a range of services are no longer directly provided by the government at hospitals (secondary or tertiary) and primary healthcare facilities. A continuous split between the purchaser and provider fragments the public healthcare system and creates further ground for the insurance services to take-off.

The introduction of private providers within the public healthcare sector changes the legal basis, raises market related concerns of equity, cost of care, quality and health rights. The wide diversity of PPP projects in healthcare, based on the kinds of services it provides, the role and number of private parties engaged in the contract agreements, creates a complex structure over and above the existing public health system. With the overall complexity of PPP structures and the plurality of providers, regulation and monitoring becomes a mammoth task, along with possible increases in administrative cost.

At the local level, continuous monitoring of PPP-based services is weak. The Rajiv Gandhi Super Speciality Hospital in Raichur, Karnataka, which was contracted to Apollo Hospitals Enterprises Ltd (AHEL) to operate and manage, was recommended as a prospective PPP model for tertiary care by the erstwhile Planning Commission. When evaluated for the first time after ten years since its inception in 2002, it showed many discrepancies, with AHEL later withdrawing from it.

Because of the outsourcing, the contractual workforce in PPPs face lower pay and poor working conditions. Public sector authorities for health facilities do not oversee the working conditions of the contractual workers employed by the private contractors. The implementation of quality control – such as in diet services and occupational safety standards of the sanitary workers – by the contractors is weak. All these aspects have an impact on the quality of care imparted to the patients and on workers’ rights.

In the public domain there is inadequate information on PPPs. Recent studies of PPPs and outsourced services in states like West Bengal, Delhi, Chattisgarh, Karnataka and Bihar show that often private companies do not share data in the name of business secrecy. Even though the new policy emphasises digitisation of patient records, patient data from private providers in outsourcing and PPPs are becoming a commodity instead of valuable input that needs to be in the public domain.

The recommendation in the new NHP to scale-up the private sector provision in India draws from the argument favouring the private sector in terms of efficiency, accountability and sustainability. In a 2012 review, Sanjay Basu and others showed that in low and middle income countries the private health sector actually undermined universality by serving higher income groups, and ran the risk of providing low quality healthcare with lower efficiency but higher costs. And, the public sector suffered from a lack of hospitality and timeliness. The US experience shows that a switch to private health care increases the administrative and transaction costs.

Shifts

In real time, the PPPs are evolving fast with the government encouraging private investment for public health infrastructure and related services through a consortium of service providers, banks and builders who raise the finance, design, build and operate health facilities. This is done through a project company that is called the special purpose vehicle for the public sector authority. Last year, the Uttar Pradesh government invited an international competitive bid to outsource primary healthcare centres with the Gates Foundation. While some would argue that the role of private investment is a good step, what is not being talked about is the high cost of finance raised by the private sector since lending to the private sector is considered riskier than loaning to public sector. As the UK’s experience shows, such hospitals have to be accountable to the private equity investors and bankers which increases costs while repaying the debt.

PPPs offer little assurance in providing integrated and universal healthcare and act as means for the expansion of the private sector. Even though the NHP 2017 proposes to increase health expenditure over the next eight years, the present annual budget is at best, not enough to boost the public sector and fails to imagine newer costs that are going to emerge with PPPs through contracts and purchase of services.

Bijoya Roy is a public health researcher and assistant professor at the Centre for Women’s Development Studies, New Delhi.

Brazil’s Sewage Woes Reflect the Growing Global Water Quality Crisis

The water quality of lakes, rivers and coastal shorelines around the world is degrading at an alarming rate. In fact, pollution of the 10 largest rivers on Earth is so significant that it affects five billion people.

The water quality of lakes, rivers and coastal shorelines around the world is degrading at an alarming rate. In fact, pollution of the 10 largest rivers on Earth is so significant that it affects five billion people.

A man runs next to sewage system flowing on Copacabana beach in Rio de Janeiro, Brazil, June 9, 2016. Credit: Reuters/Sergio Moraes

All eyes are turned toward Rio de Janeiro to watch top athletes from all over the world compete. Yet the headlines continue to highlight the problems with the water quality and the risks to the athletes who swim, row and sail, and even to tourists simply visiting the beaches.

Large concentrations of disease-causing viruses have been found in the aquatic venues, particularly in the Rodrigo de Freitas Lagoon, where Olympic rowing will take place, and the Gloria Marina, the starting point for the sailing races. These viruses – adenoviruses, rotaviruses and noroviruses – are coming from human fecal wastes, untreated and/or inadequately treated sewage, and cause a variety of health problems, ranging from milder symptoms such as headache, respiratory infection or diarrhoea to severe illness impacting the heart, liver and central nervous system.

But Brazil’s wastewater woes are hardly unique. The water quality of lakes, rivers and coastal shorelines around the world is degrading at an alarming rate. In fact, pollution of the 10 largest rivers on earth is so significant that it affects five billion people.

One of the root problems in Rio and other places is how water quality is tested. Monitoring for a broader set of viruses and other microbes in water would be a big step in improving public health.

Beyond E.coli testing

Human fecal waste remains one of the most important sources of pathogens. Today, water quality is most often measured by testing for E.coli bacteria, and this is the standard used around the world. But we have better ways to identify the microbes that cause problems when pollution, such as sewage, is released in our rivers, lakes and shorelines.

In my own research, my colleagues and I have tested for the presence of an alternative virus (known as the coliphage) as an inexpensive indicator for evaluating sewage treatment. We also use a whole variety of other tests which allow us to monitor for specific pathogens including viruses.

Our analysis and others suggest we should be striving at a minimum for 99.9% reduction of viruses by the variety of sewage treatment designs. If we rely on testing only for E.coli bacteria, we won’t be able to remove viruses.

Percent distribution by continent of the 1.5 billion people whose sewage is discharged without treatment. (Oceania is less than 1%)

Source: The Water Institute, University of North Carolina at Chapel Hill Get the data

Testing for a broader set of microbes makes it easier to diagnose what the source of pollutants are. For example, these microbial source tracking tools allow one to trace the pollution back to humans, cattle or pigs. We have used these tests throughout the US and Europe, and they are now being used in resource-poor areas including Africa and South America. While these methods are not routine and are slightly more expensive, the results provide valuable information that allows one to better remediate water quality problems.

Studies on how frequently pathogens occur can then be connected back to the sources, with recommendations on treatment in order to reverse pollution trends. Incentives can be used to enhance best management practices such as preventing runoff from farms, composting to reduce pathogens in manure and improved disinfection of wastewater to kill off viruses.

Moving targets

Globally, the challenge of implementing new tests and treatments is immense. In the last 60 years we have seen a great acceleration of population growth, and this, in combination with lack of sewage treatment and failing infrastructure, has caused a continual degradation of water quality, as demonstrated by increasing toxic algal blooms and fecal contamination that cause microbial hazards. Indeed, one of the United Nations’ Development Goals is “access to improved sanitation facilities.”

In international rankings, Brazil went from 67% to 83% access (1990 to 2015) for access to sanitation. Yet progress varies geographically across the states in Brazil. While rural areas may have on-site water treatment systems and urban areas are collecting wastewater, government reports show only 14% to 46% of the sewage generated in Brazil is treated.

Around the world, the regulations governing water quality for recreation are in urgent need of revisions in part because of the growing array of pathogens in wastewater.

Sewage contains well over 100 different viruses (adenoviruses, astroviruses, coxsackieviruses, enteroviruses, noroviruses and rotaviruses) among other pathogens like the enteric protozoa (Cryptosporidium). Newly emerging viruses such as Cycloviruses, which are causing neurological problems in children in Asia, are also showing up in sewage. Thus, the detection of these large concentrations of adenoviruses such as was found in Brazil is likely the tip of the iceberg.

It must be said clearly that the E.coli test simply does not work for viruses, and we must evaluate whether sewage treatment is properly removing viruses. While the World Health Organisation, the US EPA, the EU and the scientific community have known about the deficiencies of the E.coli indicator system for decades, little has been done to address this. Monitoring costs, lack of development of standard methods and no focus on a water diagnostic strategy are among the reasons for this lack of advancement.

Yet to my knowledge, many government agencies and even large nonprofits such as the Gates Foundation are not aware of these limitations. The E.coli approach alone cannot help resolve the questions that need to be answered to improve sanitation, sewage treatment and water reuse while protecting important aquatic ecosystem services.

Different paths of contact

New molecular tests can detect both live and dead viruses. Adenoviruses, for example, have been found in raw sewage around the world. If adequate treatment and disinfection are used, this contamination can be reduced to non-detectable levels.

The numbers of adenoviruses found in Rio were reported from 26 million to 1.8 billion per liter, which is essentially the level found in untreated sewage. It is not known how many viruses were alive but 90% of the samples did contain some level of live viruses.

Adenoviruses have been found in US waters as well, posing a threat to public health. Our studies in Chicago found 65% of the Chicago Area Waterways System (CAWS) which receives treated wastewater tested positive for adenoviruses, with average concentrations of 2,600 viruses per liter in the canals and about 110 viruses per liter on the beaches. These data indicate some die-off as viruses move toward the beach, but some remain alive and would be able to cause disease. About 4% of the people using these waters for boating and fishing became sick. The presence of these viruses and the subsequent illnesses indicate the need for greater testing and treatment.

Around the world, those who swim in and boat on or use polluted surface waters for hygienic purposes such as bathing, cleaning clothes, washing dishes or even for religious purposes are all at risk of diarrhoea, respiratory disease, skin, eye, ear and nose infections. This is the sad state of affairs and the reality for many people throughout the world. This does not even account for the risks associated with irrigation of food crops or use of the water for animals and drinking water.

While the spotlight is shining on the athletes over the next few weeks, let us also shine a spotlight on what we can do to improve and restore water quality around the world through our collective efforts, use of new tools and risk frameworks, moving the political will one step closer toward sewage treatment and protection of the bio-health of the blue planet.

Joan Rose is the Laboratory Director/Principal Investigator in Water Research at the Michigan State University.

This article was originally published on The Conversation.

Malnutrition Affects a Third of All People, Fuels Disease Worldwide: Report

According to the report, malnutrition– either undernourishment or obesity– is responsible for nearly half of all deaths of children under five worldwide and, together with poor diets, is the number one driver of disease.

The legs of women are pictured as they walk along a street in Paris, France, October 14, 2015. Credit: Reuters/Jacky Naegelen/Files

London: A third of people worldwide are either undernourished or overweight, driving increasing rates of disease and piling pressure on health services, a global report showed on Tuesday.

Rates of obese or overweight people are rising in every region of the world, and in nearly every country, according to the 2016 Global Nutrition Report – an annual independent stock take of the state of the world’s nutrition.

Malnutrition comes in many forms – including poor child growth and development and vulnerability to infection among those who do not get enough food, and obesity, heart disease, diabetes and cancer risks in people who are overweight or whose blood contains too much sugar, salt, fat or cholesterol.

According to the report, malnutrition is responsible for nearly half of all deaths of children under five worldwide and, together with poor diets, is the number one driver of disease.

At least 57 countries have a double burden of serious levels of under nutrition – including stunting and anaemia – as well as rising numbers of adults who are overweight or obese, putting a massive strain on sometimes already fragile health systems.

“One in three people suffer from some form of malnutrition,” said Lawrence Haddad, a senior researcher at the US-based International Food Policy Research Institute and a co-author of the report.

The report pointed to what it said were “the staggering economic costs of malnutrition“, warning that 11% of gross domestic product (GDP) is lost every year in Africa and Asia due to the consequences of it.

Individual family costs can also be high. In the US, when one person in a household is obese, that household spends on average an extra 8.0% of its annual income on healthcare. In China, having diabetes results in an annual 16.3% loss of income for the patient.

Despite the problems, there have been pockets of progress, the report found.

The number of stunted children under five is falling in every region except Africa and Oceania, and in Ghana stunting rates have almost halved – to 19% from 36% – in just over a decade.

“Despite the challenges, malnutrition is not inevitable,” Haddad said, as long as there was political commitment to tackle the issue. “Where leaders in government, civil society, academia and business are committed… anything is possible,” he said in a statement with the report.

An independent expert group produces the Global Nutrition Report and the International Food Policy Research Institute oversees it. It is funded by various government and philanthropic donors, including the US and British governments, the European Commission and the Gates Foundation.

(Reuters)