Last month a letter signed by many health professionals was sent to Hon’ble President of India, to report the shortcomings and harm which can arise after passing of current draft of Public health bill. The letter discussed various aspects which I am putting forward as an article.
While the media houses have got the Bill in preparation for Monsoon session, it is not shown to We the People of India, yet. But from whatever we gather from media is that it would be 2017 bill which was placed before public for pre-legislative comments plus more definition of lockdown. So, our requests are based on that. Because the government is in the habit of reducing the period or doing away with pre-legislative processes, we are writing to you in advance.
Indian Express https://indianexpress.com/article/india/new-health-law-draft-four-tier-system-clearly-defined-powers-7828695
The Economic Times https://m.economictimes.com/opinion/et-commentary/view-how-to-not-control-a-pandemic/articleshow/90766526.cms
While we recognize that the Public Health in India is a neglected subject for years and a bill to address the issues is required to implement measures to improve the health of people, the bill that was drafted in 2017 and the coming bill, appears to be just another tool to increase Government control and authority over the citizens of the country.
A comprehensive Act that covers the various aspects of health care rights, delivery and related matters has been a pressing need in this country for long. A Bill to that effect was drafted in 2009, but never progressed. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812745/ )
We will address this Bill along with International Health Regulations and the coming WHO Treaty for Pandemic Management, because it is obvious that the draft Public Health Bill 2017 and this new draft are made to fulfill the legal obligations under IHR and coming WHO Treaty. And that is why the requirements of Indian people, Holistic meaning of Public Health are totally missing from this Bill and no other Bill to address the health requirements of our country is given priority.
The serious objections to the contents of this Public Health Bill as follows:
(I) Public Health
It is not limited to infectious diseases or bioterrorist attacks. Health, according to the World Health Organization, is “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.
Ensuring positive health is the most important task at hand in our country where around 2500 children are dying of malnutrition related diseases, Almost 50% of people aged 45 years and above have abnormal lung function, (https://indianexpress.com/article/explained/half-of-people-aged-45-and-older-have-abnormal-lung-function-says-large-study-7135897/)
Infection also affects people whose basic health is compromised. Non-infectious diseases also can be prevented/controlled by healthy lifestyle. Just by creating certain schemes like mid-day meal, the problem of malnutrition is not solved as can be seen from following data, prevalence of wasting in children under 5 years has actually increased from the year 2000 onwards and other parameters (Except Stunting) have not much improved. (https://www.intechopen.com/chapters/71300)
Similarly, just by convincing the world to declare Yoga Day, people of this country do not get the opportunity to practise it. Why no perfect mechanisms thought of and implemented to ensure the positive health for the people?
Without 1st allocating budget, for these priorities, addressing other socioeconomic, lifestyle issues, creating systems, mechanisms by an Act of Parliament, whereby positive health can be built for our people, the experience shows that by emulating suggestions given by a simulation experiment in other countries, we have deteriorated the basic health of people and made them prone to more diseases. For example, more people died by suicide than Corona in 2020. (https://www.news18.com/news/india/india-lost-more-people-to-suicide-than-coronavirus-in-2020-shows-ncrb-data-4388651.html )
(II) Oppose any Treaty with WHO
WHO is not an elected body and it is a privately funded organisation. Obviously private funders have their say in the advices WHO gives. Not only giving complete power to any such outside organisation is giving up our sovereignty but it will be the 2nd episode of East India Rule in India.
WHO Pandemic Treaty Does not make Epidemiological Sense:
Pandemics are driven by regional factors. These factors in turn are dictated by geography, climate, population density, demography such as age profile, health status such as obesity levels, state of health services, urbanization and migration, to name a few. For instance, in spite of similar guidelines followed by majority of countries of the world, the impact of Covid-19 differed vastly in continents.
For a disease having 0.05% Infection Fatality Rate, with 67.6% of adult population already having antibodies, and 99.5% of population never getting any symptoms of Covid in entire Two Years, the vaccination drive of full adult population was started because of WHO advice, when many Indian Public Health Experts had never advised, lockdown for the whole country, vaccine for below 45 years of age. (https://economictimes.indiatimes.com/news/politics-and-nation/shots-for-18-44-yr-group-was-a-political-decision/articleshow/82812610.cms )
There is a mention in the Bill of WHO declaring, “public health emergency of international concern” means an extraordinary event which is determined, as provided in International Health Regulations (IHR) of World Health Organization (WHO);” (In Chapter 1, 2. (z)). But review of that declaration by Indian experts, giving Indian, even different regional conditions and health risk assessment is never mentioned in the draft Bill, 2017.
Height of ignoring Indian experts and without any transparent public debate came when vaccine roll out for children, having none whatsoever risk from Covid, was started, just because it was given in other countries, in spite of a clear “No” from NTAGI. Waste of public money for injecting a substance whose long-term safety data is not known and even short-term data cannot be relied with such small sample size during Trials.
The health requirements, priorities of all countries are different depending on the climatic, cultural, economic and demographic conditions. Imposing western models on our country in spite of Globalisation is Medical Imperialism and has proved damaging to our country.
The signing IHR after SARS CoV (2003) was uncalled for, as a so-called highly infectious virus had infected totally 8098 persons world over and total 774 deaths, in the country of its origin, China – 5327 cases and 349 deaths. It was believed to have started in November, 2002 and with all the international traffic, the world came to know a few cases elsewhere also by March 2003.
But signing WHO Treaty and to formulate a Public Health Act on the basis of such international guidelines will be suicidal.
Role of WHO was exposed enough during Swine Flu. “In a strong indictment of the World Health Organization, a report prepared for the Council of Europe has said WHO wasted large sums of public money by raising unjustified fears of a “pandemic that never really was” and expressed concern over the influence of the pharmaceutical industry on the decisions taken by it regarding the H1N1 virus outbreak.”
“National governments, WHO, and EU agencies had all been guilty of actions that led to a “waste of large sums of public money, and unjustified scares and fears about the health risks faced by the European public,” says the report.” https://www.bmj.com/content/340/bmj.c3033.full
“The step is a long-overdue move to public transparency of a “Golden Triangle” of drug corruption between WHO, the pharma industry and academic scientists that has permanently damaged the lives of millions and even caused death.” https://healthcare-in-europe.com/en/news/european-parliament-to-investigate-who-pandemic-scandal.html
Independent inquiries in Corona pandemic might establish the truth in future. But right now, it is very clear that WHO guidelines for our country have been not in synchronization with Indian Reality. And such inquiry with large scale public participation in an open transparent way is the primary requirement before bringing any Public Health Act focussed solely on infectious disease.
To give WHO guidelines as an overriding factor by way of an Act and not giving any mention of local experts’ advice, wide scale feedback from every corner of the country is inviting disaster.
(III) Epidemic or Pandemic
Even for endemic diseases affecting our country, we will have to have a clear definition of an epidemic, that is at least more than 2 standard deviations above last three years data. Upper control limits must be clearly published in public domain. Chapter II,3, there is no mention of which experts or health departments will be consulted by authorities at all levels.
Even after declaring a pandemic/Epidemic the blunders done during the Covid-19 management have to be consciously avoided.
a. As soon as outbreak of infectious disease is suspected, Government of India / applicable State Government must facilitate study on whether the disease is infectious or not.
b. Do not use any test kit that is not fully authorized / not fully approved, peer reviewed, Test kit should be indigenous i.e. not outsourced to a foreign entity, the testers should not have a conflict of interest on the outcome of the study, conducted in a radiation free environment,
c. The above study must be completed on emergency basis but within one month of the outbreak of the suspected epidemic / pandemic.
During the period the above study is in progress, government
a. Will not restrict movement of asymptomatic people.
b. Will recommend but not force the public to take containment / preventive measures
If within one month the above study is not completed or does not conclude that the disease is infectious then;
a. All the orders passed by government authorities regarding the suspected outbreak of disease become null and void.
b. No opportunity to ask for more time to complete the study.
If the study in point 1 concludes that the disease is infectious but the test kit that is released for the detection of the disease is still in approval phase then Government will;
a. Not isolate / restrict movement of asymptomatic people
b. Not force asymptomatic people to take the test
Even when the test kit becomes fully authorized, Government
a. Will not isolate / restrict movement of asymptomatic people
b. Will not force asymptomatic people to take the test
No measures like mask, distancing, lockdown should be declared as Covid – 19 experiences have produced enough number of studies that these are ineffective and harmful measures.
How can such measures be prescribed in an Act without having any scientific proof and in the presence of proofs against it?
“It is not unreasonable to conclude that surgical and cloth masks, used as they currently are being used (without other forms of PPE protection), have no impact on controlling the transmission of Covid-19 virus. Current evidence implies that face masks can be actually harmful. The body of evidence indicates that face masks are largely ineffective.” https://brownstone.org/articles/more-than-150-comparative-studies-and-articles-on-mask-ineffectiveness-and-harms/
Chapter II, 4, a), gives extra ordinary powers to center without mentioning any process of consultation with state experts. India being a vast country, the local impact of any disease, its management keeping in mind of local factors are always very different for different regions. Even the rural and urban areas have different impact and requirements. If we take the example of Covid-19, with its most dubious unreliable RT-PCR test, the percentage of population having some symptoms varied from 0.1% in UP to 2.9% in Kerala but most states had between 0.2 to 0.7% of people having any symptoms at all.
Treatment protocols should also be decided by the treating doctor with the consent of the patient. No central protocol can be declared as the conditions of the patients are different and the training in the medical colleges are enough for a doctor to decide the line of treatment.
It should be the local bodies in consultation with local experts, not only on government panels but other domain experts with experience and different opinions, having transparent debates at each level should decide on the severity, impact of any disease and the course of action.
(V) Other Knowledge Systems
India has legally functioning systems of knowledge with glorious past, like Ayurveda, Yoga, Unani, Siddha, Homeopathy, Sowa Rigpa, Naturopathy, Nature Cure, and Energy Medicine. These systems are working on the principles of Indian way of life, climate, adapted and developed over years of experience. There are less invasive, less expensive methods to handle many diseases with better results when these knowledge systems are used. We should take full advantage of these knowledge systems and no allopathy protocol be imposed on everybody. There should be open, equal opportunity with publication of results transparently for all systems. Citizens should have choice to select whatever system treatment they want to have.
There is no rationale in following the dictates of western countries with different population profile, climate and other social factors.
(VI) Role of Media
First principle of public health emergency during crisis is to reassure the public. Media has played fear mongering and scared people, calling experts from only one side who would draw the grimmest picture, which ultimately would turn out to be wrong. It happened during SARS Cov (2003), it happened during Covid-19 (2020-21).
The government will take steps to ensure the press does not sensationalize / fearmonger. These steps include –
a. While giving the number of deaths of disease in question, number of deaths because of other causes has to be broadcasted along with.
b. Broadcast number of deaths during the last week and also number of deaths because of similar disease during the corresponding week of previous five years. The public can compare these numbers to determine if there is a real pandemic.
c. Broadcast number of hospitalizations during the last week and also, number of hospitalizations during the corresponding week of previous five years.
d. Experts having different opinion have to be called during any debate on TV, Newspaper.
(VII) Human Rights
Human Rights have to be respected at all costs. And it should be widely publicized that people can refuse testing, vaccine or any other measures taken for Public Health by Government authorities.
Chapter II,3, k) says that authorize any official or person to enter and inspect, without prior notice, any premises where public health emergency has either occurred or is likely to occur.
The above provision can lead to abuse of Human Rights at ground level.
There cannot be any forced testing of asymptomatic people. In any case, in a fast-spreading disease as was found during Covid-19 when you test and detect one person with positive results other 30 to 90 are missed. The whole concept of asymptomatic people being declared cases, and asymptomatic persons can spread the disease is not having any proofs. Without open scientific debates showing evidence 72,000 crores of public money spent in testing with a test kit that is not diagnostic of a disease.
Chapter II,3, f) If any State Government or administration of Union Territory or any district or local authority is of the opinion that a public health emergency has arisen or is likely to arise, it may, by order, conduct medical examination including laboratory examination of, and provide treatment, vaccination or other prophylaxis to any person or class of persons exposed to or suffering from or suspected to be suffering from any such disease as may be stated in the order.
No forced injections of any drug experimental or otherwise, can be ordered. Because citizens have the Right to refuse treatment, preventive or curative, patients’ right to choose the treatment from any medical system has to be respected at all times. There is no mention of with whom the authority will have consultation and take decisions. During Corona episode we have seen the adverse effects of this non-transparency.
Our Rights to Informed Consent and Confidentiality had been violated by giving vaccines without proper information about risk of Corona versus risk of Vaccine. Also asking for vaccine status is violation of Confidentiality Right, as described in Charter of Patients Rights’. (https://www.thebetterindia.com/158829/patient-right-hospital-law/)
Chapter V, 9. (1), 10, 11 say that: No court shall take cognizance of any offence under section 3, section 4 and section 5 of this Act except with the previous sanction of such officer as may be prescribed.No suit, prosecution or other legal proceedings shall lie against any person for anything which is done in good faith or intended to be done in pursuance of this Act or any Rule or Order made thereunder.
The provisions of this Act shall have overriding effect over any provision in any other Law for the time being in force.
The above provisions are not legal and makes the right to approach court impossible. There cannot be any provision in any Act where all other basic Rights of citizens are overridden and even approaching court is made practically impossible. This is nothing but a way to declare Dictatorship in the name of ‘likely’ spread of an infection.
The use of phrase “likely to arise” is the most irresponsible and dangerous word in the draft Public Health Bill 2017, giving rise to misuse of the law. The mathematical models and other predictions have largely proved wrong in the Covid-19 situation. In Chapter II,3, the clause saying “If any State Government or administration of Union Territory or any district or local authority is of the opinion that a public health emergency has arisen or is likely to arise, it may, by order”, has to go.
Decisions taken in full faith also can be challenged is a Supreme Court ruling and no blanket impunity can be awarded to Public Servants in the name of good faith.
Last and the most important point to be understood from the whole Covid-19 episode is that the word Lockdown has to go from the vocabulary of any Health Emergency.
Chapter II,3, m) says among other things, that state will have power to disseminate such information as deemed appropriate and take such other appropriate measures in such circumstances including closure of markets, educational and other institutions and social distancing. (Emphasis added.)
And therefore, we are presenting valid reasons to never think of lockdown again:
Lockdowns are ineffective. In our own country in spite of all containment measures, with innumerable hardships to people, literally ruining their lives, the first serosurvey in June 2020 showed that by June 4th, there were already 64 lacs cases in India, infection mortality rate very low 0.08%, less than seasonal flu. (https://science.thewire.in/…/icmr-seroprevalence…/ )And as it later came out for whatever reason in this scientific study also, some facts were hidden which were showing even larger number of people were actually affected. And therefore, the IFR was still lower. https://www.telegraphindia.com/india/how-covid-numbers-were-hushed-up/cid/1792482
Lockdowns disrupt the social and economic life of people, especially poor people.
“In a letter written to the Prime Minister, the Right to Food (RTF) Campaign has warned that India’s acute post-lockdown hunger crisis will worsen considerably if the government stops providing additional food supplies under the Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) after March 2022. The letter draws from a survey conducted by the Campaign in association with the Centre for Equity Studies and a number of other networks and organisations in December 2021 and January 2022 across 14 states, which made some startling findings:
– 66% people stated that their income had decreased compared to the pre-pandemic period
– 80% reported some form of food insecurity while 25% reported severe food insecurity in terms of – having to skip meals, eating less than usual, running out of food, not being able to eat for a whole day and going to bed hungry due to lack of money or other resources.
– 41% said that nutritional quality of their diet deteriorated compared to the pre-pandemic period.
67% could not afford cooking gas in the month preceding the survey.
– 45% of households had outstanding debt.
Rural and urban women hit hardest by Covid-induced unemployment
As another expert, Dr Amitav Banerjee, Prof and Head, and Clinical Epidemiologist, Department of Community Medicine, Dr DY Patil Medical College, Pune,.), has put it, “Chasing the elusive virus at all costs proved disastrous in almost all countries. An estimated 500 million got pushed below the poverty line globally. Livelihoods were lost and lives endangered. Domestic violence against women and children escalated. And so did violence against the elderly, paradoxically the group to be protected from Covid-19. (https://countercurrents.org/2022/03/rural-and-urban-women-hit-hardest-by-covid-induced-unemployment/)
At the other age spectrum, children experienced negative effects.” (https://www.doublehelical.com/?p=4937)
Lockdown measures decrease the immunity of people because of number of factors, obesity increase in some class of people and people get more prone to other diseases. Countries like Sweden, Belarus, Tanzania and some states in US never had any lockdowns and performed much better than other countries. (https://off-guardian.org/2021/03/23/lockdown-one-year-on-it-doesnt-work-it-never-worked-it-wasnt-supposed-to-work/ )
WHO had refused lockdowns, “The Asian flu of 1957-58 was a deadly pandemic with a broader reach for severe outcomes than Covid-19 of 2020.” “There were two grounds for this rejection: lockdowns would be too disruptive, disabling the capacity of medical professionals to deal competently with the crisis, and also because such policies would be futile because the virus was already here and spreading.” (https://www.aier.org/article/in-the-asian-flu-of-1957-58-they-rejected-lockdowns/)
(IX) Legal objections to the Bill.
This Prospective Bill Contravenes the Indian Constitution
There are grave legal objections to the draft Public Health Bill 2017. It is violative of Article 14, 19 and 21 of the Constitution of India and against the binding precedents of Constitution Bench in Common Cause Vs. Union of India (2018) 5 SCC 1. Article 13 of the Constitution of India says that the Government cannot make any law which is violative of Article 21, 14 etc. of the constitution.
The proposed Health Bill is violative of Article 7 of International Covenant on Civil and Political Rights (ICCPR) prepared by United Nations, which is ratified by Government of India. It is also against the provisions of United Nations, Universal Declaration on Bioethics and Human Rights, 2005 (UDBHR). It is against the law of Informed Consent as has been laid down by the Government of India under Disaster Management Act, 2005 itself.
In this Bill the State wants to repeal the Epidemic Act, 1897 which means, the State wants to repeal the Section 2, which has a provision for granting compensation to every citizen if any measures such as lockdown, night curfew or restrictions are taken by the State. Hence the Bill which is sought to be presented is not for the welfare of public, but for the promotion and profiteering of vaccine companies and the pharma mafia. It is also unconstitutional, null and void and ultra vires.
Therefore, we request you to ensure following things before signing the New Public Health Bill:
Draft Public Health Bill, to be presented in the Monsoon Session of Parliament as per the media reports, should be available to Public well in advance for comments and this being a very important issue affecting every citizen’s life, especially after the experience of Corona episode, a Referendum has to be taken to know the will of WE The People of India.
- Draft should be rewritten to keep priorities of our country in focus and taking the Holistic definition of Health as the basis.
- Any Treaty with WHO should never be signed because health has regional factors to affect and role of WHO is well exposed during Swine Flu. Sovereignty of our country cannot be compromised at any cost.
- Lessons of Corona time, as elaborated above in section III, IV, V, VI, VII, VIII have to be taken into account and corrections given for the draft Public Health Bill, 2017 have to be properly rewritten.
- And therefore Management of pandemic or epidemic should be in a decentralised manner with advice from Local experts not only in the government committees but after having public debates with other domain experts and concerned citizens.
- Role of other medical Knowledge Systems has to be given equal weightage.
- Media should be strictly instructed not to spread panic and action should be taken if they do it. Because it has proved counterproductive.
- Human Rights Violations cannot be tolerated at any cost.
- Lockdowns and other restrictive measures like vaccine mandates for normal life activities, that has affected people’s lives beyond repair should not be imposed at any time.
by Dr Maya Valecha
Email – email@example.com