India’s cancer burden: Why the govt’s CL ruling is so important #drugpricing #goodnews

Jan 15, 2013, First post

Early last year, when the Union government allowed the production of
Nexavar, a liver and kidney cancer drug, by an Indian company against
the wishes of multinational pharma major Bayer, the prices of several
indigenously made cancer drugs tumbled.

It was a complete game-changer in affordable healthcare in India,
which not only reduced the price of Nexavar from a prohibitive Rs. 2.8
lakh a month to Rs. 6,600, but also led to the reduction of prices of
a few other cancer drugs as well.

The step that led to this dramatic fall of prices was by an
intervention of the Union government called “compulsory licensing
(CL), by which a national government can allow somebody to produce a
patented drug without the consent of the patent owner.

After Nexavar, the government of India has begun steps to issue
compulsory license for three more cancer drugs – Trastuzumab,
Dasatinib and Ixabepilone.

Compared to Nexavar, the impact of this move is going to be
unprecedented because Trastuzumab is a wonder drug against a certain
type of breast-cancer that affects about 100,000 women in India.
Breast cancer tops the cancer burden in urban India, and an aggressive
HER+2 type of cancer is increasingly more prevalent among young women.

Indian companies don’t have a generic alternative to the breast
cancer drug yet. Reuters About 28-35 per cent of all cancers among
women in major cities is breast-cancer. Trastuzumab not only reduces
the mortality of patients with HER+2 cancer, but also is effective
against the spread of malignancy to other parts of the body.

So far, there is no other drug against HER+2 cancer with such
efficacy. It can be administered alone, along with chemotherapy and
after surgery. In many cases, it even helps avoid surgery, which many
find disfiguring.

However, majority of women with HER+2 breast cancer do not benefit
from the wonder-effect of the drug because of the prohibitive prices
by its manufacturer and patent-holder, Roche, the multinational drug
company. A full course of the drug costs anywhere between Rs six to
eight lakhs. A generic version – in this case a bio-similar product –
should not cost more than a tenth of this price.

Unlike Nexavar (chemical name Sorafenib), no Indian company has yet
started making generic versions of Trastuzumab. According to available
information , three Indian companies are currently involved in
creating this molecule, but it is a difficult process because they
have to take the biotechnological route to replicate it.

Commonly, generic versions of patented drugs are chemical copies made
by reverse engineering of the final molecule through chemical
processes. In simple terms, what it entails is taking the final
molecule (of the drug) and working backward to create the same
molecule through an alternative process.

Technical expertise, research facilities, appropriate investment and
availability of high quality human resources are important for such
processes. Endowed with all the four, India is a leader in generic
production of drugs. What it requires, however, is an enabling
environment, most of which is legal and patent-related.

In the case of Trastuzumbad, the generic version will be a biological
equivalent and not a chemical copy because this drug cannot be
replicated chemically. A biological process is trickier and more

The government decision on Trastuzumbad and the other two cancer drugs
will be significant because Indian companies are reluctant to invest
on developing a bio-equivalent, if the drug is still under patent. The
patent on this wonder drug is due to expire in 2014, but Roche has
filed several patent applications to Indian patent offices to block
any such development even beyond 2014.

Under such uncertain patent regimes, no company would risk its
investment. If the government issues a CL, the Indian drug companies
can safely invest and fast track the process. Apparently, one of the
Indian companies developing the drug is in the third stage of the
process and hence if a compulsory license comes through, the Indian
version will be out in the market sooner than later.

The latest development is yet another example of informed civil
society pressure leading to concrete results as seen in countries such
as Brazil and Thailand. In November 2012, the Campaign for Affordable
Trastuzumab, a citizens’ collective, wrote an open letter to the Prime
Minister, signed by around 200 cancer survivors, women’s groups, human
rights and health rights campaigns and treatment activists from around
the world, urging the government to make the drug affordable and
freely available to patients.

Drug companies are holding our health hostage to their greed for
profits” said Kalyani Menon-Sen, coordinator of the Campaign. “Roche
should not be allowed to get away with such predatory prices. Courts
and other authorities like the Competition Commission must take suo
moto action against Roche for abusing its dominant position in the

She also called on Indian manufacturers to expedite the production of
bio-similars of Trastuzumab.

Compulsory licensing is one of the two flexibilities provided under
the TRIPS (Trade Related Intellectual Property Rights) to allow member
countries of WTO (World Trade Organisation) to prevent the abuse of
patents. Contrary to the general belief, compulsory licenses are
issued not only by developing countries, but also by countries such as
Canada, USA, UK, France and Australia, whenever it suits them.

India joined TRIPS and complied with its rules in 2005 by amending the
patent act of 1970, which also meant giving up a lot. However, it does
have flexibilities such as CL to ensure that its citizens have access
to affordable care and multinational companies don’t get away with
predatory pricing. All that it takes for such a move is immunity from
vested interests and political will.

“Such a move will not only make healthcare more affordable, but will
also lead to domestic competition among generic manufacturers, which
in turn will lead to further fall in prices” said KM Gopa Kumar, legal
advisor and senior IPR researcher at Third World Network, a global
think tank on development issues.

The other TRIPS flexibility that WTO allows its members to protect its
citizens’s health is parallel importing, under which countries without
technical capability to produce the generics can import from other
countries. India may not be a beneficiary of this provision, but it
can help other countries. Indian generic drugs are imported by several
countries in the world.

Generic manufacture of potent MNC drugs against HIV and multi-drug
resistant TB and their dramatic price falls are the inspiring success
stories of the last decade. Cancer seems to be the new frontier. There
are also illnesses such as hepatitis-C, the treatment of which can
become affordable if a generic version of the MNC drug is available.
The MNC drug at present costs about Rs. 6 lakhs and the country has a
huge hepatitis -C burden.

In the coming years, the generic intervention and similar price cuts
will have considerable impact on treatment of cancers and other
non-communicable illnesses as well as infections such as hepatitis-C.

Without being apologetic to anybody – the MNCs and their parent
countries – the government just has to take proactive steps that are
vital for its citizens.


#India-The burden of being a dissent in democracy -Story of J Roslin #RIP

By Tariq Abdul Muhaimin12/27/12, Newzfirst


In an age where the State defines its role as ‘emancipating’ and ‘empowering’, the plight of several oppressed individuals, some of whom have even succumbed to injuries obtained in the course of their struggle, remind us of the increasing exercise of authority and power by the State with an effort to contain the rising trend of ‘hitting the street’ or ‘raising a question’ over the efficient functioning of public institutions by concerned civil society members and groups.

Through a series of articles to be published over a period of time, NEWZFIRST will highlight the plight of many such activists and rights’ campaigners by speaking to the ones closest to them.

Starting from the most recent death of an anti-nuke activist who succumbed to health issues which only exacerbated during the period she spent in jail after she was arrested on charges of ‘waging war against the state’ and ‘sedition’, we go on to explore the stories of many others who experienced a similar – if not such dreadful – fate.

Story of J Roslin

As the anti-nuke struggle at Koodankulam enters the 500th day, we revisit the heart-wrenching tale of J Roslin, a 63-year old woman and mother of three, who died on 21 December at Idinthikarai, the nucleus of anti-nuke struggle against Koodankulam Nuclear Power Plant (KNPP).

J Roslin was among the 7 women who were randomly picked up from Idinthakarai beach during the police crackdown on anti-nuke activists, who were protesting the coming up of KNPP, on 10 September 2012.

She was put in Trichy women’s prison along with three other women – Xavier Ammal, Sundari and Selvi.

She was charged under sections 147 – Rioting, 145 – continuing in unlawful assembly, 163 r/w 144, 222, 252, 255, 294(b), 207 and 427 r/w 149 of Indian Penal Code (IPC), in the case for which she was arrested (Crl OP 15389/2012, Crime No. 349/2012, Offence date: 10.9.2012).

At the time of arrest, she complained about her ailing health. She said that she was extremely unwell and had been suffering with frequent bouts of vomiting, and needed urgent medical attention and diagnosis. These facts were also registered in the records, prior to her detention in Trichy prison.

However, she was not given adequate treatment in the prison and her requests for medical attention went unheeded.

“The very first day after she was arrested, she was vomiting and could not eat. During her stay in the prison, doctors visited her and prescribed some medicines, but her health continued to worsen”, Pushparayan Victoria, leader of Peoples Movement Against Nuclear Energy (PMANE), told Newzfirst.

“She was given I.V fluids once after which she felt little better. She complained to the Magistrate, who released her on conditional bail after 50 days”, Pushparayan added.

After she was granted bail in the case for which she was arrested, the police filed two more cases and prolonged her stay in prison.

She was charged under sections 121 (Waging war against the State), 124A (Sedition) and 142 (Unlawful assembly) of IPC in two different cases (Crl OP 15368, Crime No. 70/2012, Offence date: 16.2.2012 and Crl OP 15385, Crime No. 300/2012, Offence date: 11.6.2012).

“The police had kept several blank spaces in the list of accused for different cases, so her name was added there”, Pushparayan said.

She was finally released from prison on 30 October 2012, on the condition that she should sign her presence at a police station in Madurai.

As her condition worsened, it became impossible for her to visit the police station, and she was hospitalized in the Madurai General hospital. The doctors said that she had a serious illness. After staying there for about 10 days, she was moved to Idinthakarai where she died during the early hours of Friday, 21 December.

“She was a woman in her 60’s and was fighting for her livelihood; fighting for her children. She had no grudge against the nation. She was accused and arrested on false grounds. She was ill and could not even speak properly. She only came to the protest site to sit and watch. It is very unfortunate that the government is acting in such a ruthless way”, Pushparayan said in a tone of disappointment.

The protesters experienced police crackdown twice this year – once on 19 March and again on 10 September. Although there has been no crackdown since then, the villagers of Idinthikarai and Koodankulam have experienced restrictions in terms of mobility – both in and out of the area.

The police also detained several activists and foreign nationals in the last 2 months for trying to visit the protest site.

“The anti-nuclear struggle has been completely peaceful. There has been complete failure on behalf of the administration and judiciary. Here the people are trying to secure their livelihood and land, whereas the government is bent on helping the MNCs who are coming from other countries”, said Pushparayan.

Roslin, a victim of neglect and vengeance of the State, reminds us that having an opinion contrary to that held by the Govt., is a crime warranting imprisonment under harsh sections of IPC.


#India #Koodankulam Letter to Heads of States/Governments

October 31, 2012
People’s Movement Against Nuclear Energy (PMANE)
Idinthakarai 627 104
Tirunelveli District
Phone: 98656 83735; 9842154073
The Heads of State/Government
c/o The Embassies (or) High Commissions
New Delhi
Your Excellency:
We, several millions of people from the southernmost tip of India, are writing to you to seek your support for the peaceful and nonviolent struggle that we have been waging for almost a quarter century against the Koodankulam nuclear power project (KKNPP). We have intensified our struggle since August 2011 with indefinite hunger strikes, relay fasts, massive marches, siege protests and so on.
This mega nuclear power park is being built with Russian loan and technology against the will and wishes of the local people. The Indian authorities have not conducted any public hearing to seek our permission or consent for this project. They have not shared the Environmental Impact Assessment (EIA) Report, the Site Evaluation Report, and the Safety Analysis Report with our people. These reports are made available to the public on the internet in countries such as the United States, the United Kingdom and Canada. After a long and hard struggle of more than 22 years, we have just obtained a copy of the EIA report which is outdated and so full of inaccuracies and incomplete information.
As the Indian authorities unleash all kinds of atrocities on us such as dangerous cases (like sedition, waging war on the state etc.), imprisonment, curfew and prohibitory orders, intimidation campaigns, home searches, physical attacks on our persons and properties, police atrocities and other such high-handed behavior, we are forced to seek justice from the international community. After all, nuclear energy is a global issue and the effects of it cannot be restricted to any national borders or international boundaries.
The world knows fully well that nuclear power and bomb programs are the two sides of the same coin. And this is the reason why the international community objects to the development of nuclear power by certain countries and calls for the abolition of nuclear weapons altogether. In fact, Nuclearism has become a dangerous ideology that corrupts politics, threatens democracy, imperils freedom and endangers human existence on the Earth. Such a comprehensive humane global look at the world economy, politics and security makes the International Atomic Energy Agency (IAEA) redundant. It is high time we abolished the IAEA that has a mission to, among other things, facilitate “the transfer of such technology and knowledge in a sustainable manner to developing Member States.”
Although the global nuclear industry tries to promote nuclear power as the answer for global warming and climate destruction, the international community knows for sure that poisoned Earth with nuclear waste cannot be the answer for polluted air. Moreover, our fragile planet has been facing natural calamities of all sorts with increasing frequency and added potency. And it would be foolhardy to add to our woes with nuclear threats and dangers.
We have no moral legitimacy whatsoever to produce electricity for our present needs and endanger the futures of our children and the unborn generations with the dangerous booty of nuclear waste, contaminated sites and deadly radiation. It is not only immoral but also illegal to help the profiteering MNCs, corrupt politicians, bureaucrats and technocrats make money at the cost of the Earth, the future inhabitants and their common futures.
When terrorism spreads all over the world like an epidemic and nuclear terrorism is fast becoming a dreadful reality, proliferation of nuclear weapons, promotion of nuclear technology and fostering of nuclear material will be suicidal. Science and technology are important tools for our progress and prosperity but when that quest shuns human values, moral principles and political ethos, we suffer from God-complex and dig our own graves.
Scores of countries around the world have chosen not to hoard fissile material, develop or test nuclear weapons, or build nuclear power plants. In fact, many countries that have relied heavily on nuclear power so far have decided to phase out. So let us make a solemn resolve here and now to build a new world that has no Uranium mines, no nuclear reactors, no waste dumps and no nuclear weapons.
Looking forward to your government’s and citizens’ support and solidarity for our anti-Koodankulam struggle and a nuclear-free world campaign, we send you our best personal regards and all peaceful wishes.
S. P. Udayakumar
M. Pushparayan
M. P. Jesuraj
Fr. F. Jayakumar
R.S. Muhilan
Peter Milton



#India #Nuclear – The ‘Koodankulam Conflict’ Map #mustread




Fisherfolk, farmers, workers, Dalits, Muslims, women, children etc.

Supporters in Tamil Nadu, Kerala, and rest of India.

Supporting political parties,

Social movements, Human rights groups etc.

Some sections of Media

Some international friends

Government of India

Government of Tamil Nadu

 Army, Navy, Air Force, Coast Guard, CISF, Tamil Nadu Police, Central and State intelligence agencies etc.

 Atomic Energy Commission, DAE, NPCIL, AERB etc.

Political parties such as Congress, BJP, DMK, AIADMK etc.

Indian Bureaucracy

Much of Indian Media

US, Russia, France governments

MNCs of these countries

Spy agencies of these counties

IAEA etc.


Nuclear power is bad, ugly and expensive.

Nuclear power plant is dangerous and unwanted.

Let us think like a creative leader and look beyond thermal and nuclear energy.

Let’s consider ‘New Energies’.

Let’s put Indian citizens’ interests first.

Nuclear power is good, clean and cheap.

Nuclear power plant is safe and badly needed.

Let us continue our colonized thinking and persist with thermal and nuclear energy.

Let’s consider nuclear energy.

Let’s put foreign countries’ and their MNCs’  interests first.

Interests Safeguarding India’s natural resources such as sea, seafood, land, ground water, air etc.

Protecting ordinary people’s livelihood and sustainable development.


Ensuring everyone’s food security, nutrition security, water security etc.


Avoiding health problems of ordinary people; and protecting the progeny.


Protecting Nature, Life, Future

Producing more electricity and ensuring energy security and national security.

Promoting the development agenda of the rich and famous and powerful.


Ensuring the power brokers’ profits, commissions and kickbacks.


Ignoring such hidden costs and persisting with short-term gains.



Money, Money, Money

Gain A few menial jobs


Low income from shops, services

Lots of good jobs


Lots of contracts, sub-contracts


Money, Power, Prominence




Good life

Loss 350+ serious cases and legal hassles


Police action and harassment


Loss of income and wealth


Natural resources






Wellbeing of children and grandchildren





Dangerous false cases such as sedition, waging war on the State etc.


Arrests, imprisonment, torture.


Imprisoning women, juveniles, and children.


Legal hassles, refusing bail.


Police searches, attacks and harassment.


Having anti-social elements vandalize private properties and homes with police connivance.


Attack on negotiating team.


Intelligence departments’ psychological warfare.


Tear gas attack, lathi charge, firing.


Murder by police.


Aerial harassment of Coast Guard planes.


Death threats.

Nonviolent and peaceful siege, processions and agitations (for a few hours).


Instigated by opposition parties.


Small group’s protest.


Fishermen struggle.


Christian struggle.


Foreign countries’ and agencies’ plot.


NGO-funded struggle.


Missionaries’ and priests’ protest.


Struggle promotes smuggling in the sea and coasts.


Undertaken to harass governments.


Struggle promoted by incentives such as Rs. 500, biriyani and alcohol.


Misguiding innocent people.


Stubborn and unwilling to listen.


Receiving foreign money.


Using human shield.


Character assassination of leaders, casting aspersions on leaders’ integrity etc.


Accusing of using violence.


Publishing leaders’ addresses, contact numbers, emails in a newspaper.


Doubting people’s sanity and sending psychiatrists.


Arresting foreigners and connecting with struggle.


Linking us with Naxalites, terrorists, ISI spies etc.


Insulting women and questioning their morality.




Telling half-truths and non-truths to people.


Dividing people with the help of immoral media persons.


Setting up corrupt media persons against the struggle.


Spreading rumors and  harassing people.


Dividing people along caste and religious lines.


Trying to instigate violence in the protest programs.


Trying to ‘buy’ weak protestors.


Splitting people by creating gangs and planting goons.


‘Buying’ media and media persons.


Instigating businessmen and industrialists against people.


Using scientists and experts to confuse people.


Setting up proxy protesters against the struggle.


Setting up religious leaders to influence people’s opinion.


Distributing freebies.


Canvassing students and youth in colleges with government influence.


Doing campaigns with government influence.


Creating artificial power cuts.


Sending in spies and agents to endanger peace.


Promising houses, roads and other “development” projects.


Promising crores of rupees and wooing panchayat leaders and local leaders to the government side.



Abandon all NPPs


Focus on ‘New Energies’

Start more NPPs


Produce nuclear energy

The Way Out ·         Announce a moratorium on all nuclear activities all over the country.

·         Present a Cost-Benefit-Procedural Impact analysis of NPPs.

·         Do financial, energy, environmental, social audit of the existing NPPs.

·         Set up an “empowered and independent” regulatory authority.

·         Ensure transparency, accountability, and popular participation in nuclear installations.

·         Facilitate a national debate on nuclear deals, Uranium mines, reactors, waste dumps, and nuclear bombs.

·         Let people decide what they need!


By S. P. Udayakumar <>, R. S. Muhilan and M. Pushparayan.

Aamir Khan, The Ambanis And Medical Ethics

Vidyadhar Date 

28 May, 2012

Dr Ravi Bapat is the man Amir Khan should have featured in his television programme on health issues Satyameva Jayate telecast on May 27. Dr Bapat is also much nearer home , in Mumbai. Dr Bapat is committed, has a long record of serving the poor in a public hospital and he has written about the importance of public hospitals and corruption in the private sector in two books.

Social commitment and medicine run in the family. Dr Bapat’s father Dr Dinkar Bapat removed 400 doctors from the employees’s state insurance scheme on charges of corruption when he was its director in the sixties. He conducted raids and found that some doctors ran bogus clinics and gave bogus certificates.

He got so fed up with the corruption that he sought a transfer and wrote an article on the decline in the morality of doctors in Mumbai.

So what Amir Khan highlighted was important but by no means new. For example Dr Bapat points out on page 165 in his more recent book Post Mortem that if a doctor takes a seriously ill patient hurriedly for an operation, it is likely that the patient is already dead but all operation charges will be recovered from the family.
Hysterectomy is the bread and butter of gynaecologists and appendix of general surgeons. Many of these surgeries are unnecessary, he says.

Dr Bapat’s book Ward No 5, KEM, published six years ago, is published in Marathi as well as English and the more recent is Postmortem which is in Marathi and deserves to be urgently translated into other languages.

God forbid if a major calamity strikes Mumbai because we are weakening our public hospital infrastructure, warned Dr Bapat in Ward NO 5, KEM. .

It is only in the last few years that the craze for private, expensive hospitals and private medical colleges has begun. Formerly, prominent political leaders regularly took treatment in public hospitals. Members of the Bal Thackeray family including wife Meenatai used to get treatment in the municipal KEM hospital. Dr Ravi Bapat recalls this in his book .

The book reads like a novel because it deals with such a wide variety of characters. Nowhere else can a doctor get such experience as a public hospital. Ravi Bapat has treated all sorts of people from senior politicians to gangsters, artistes, sportspersons and social activists.

In 1983 when Bal Thackeray’s ailment could not be diagnosed, Bapat examined him, stopped his homeopathic treatment, gave him new medicines and restored his health. One needs to make it clear that Bapat is not at all close to the Thackerays. Far from it. He was very close to many activists and leaders of left wing trade unions during the more militant days of the sixties and seventies.

Bapat’s father and wife too studied in G.S. medical college of KEM and as a student he got guidance from such stalwarts of those days as Dr A.V. Baliga, G.M. Phadke, Arthur D’sa , B.N. Purandare and P.K. Sen.

Bapat is troubled by the growing privatisation, commercialisation of medicine. He has seen it all from close quarters as a practising senior surgeon and later as vice chancellor of Maharashtra university for medical sciences. Doctors are so busy chasing money these days that they are putting their own health at risk, Bapat says.

Many doctors have a long record of dedicated social service and many are brilliant writers. The foremost among them is A.J. Cronin, who did pioneering work in the field of occupational health among mine workers in the U.K. and his writing was responsible for the much lauded British health service. More recently, Dr Atul Gawande, a U.S. born son of a doctor couple, has done pioneering work in the profession and on writing on it. However, the profession also has been lampooned for its downside. I remember a Sanskrit proverb Yamaraj Sahodar which says a doctor is like the elder brother of Yama, the god of death, Yama only takes your life, the doc takes both your life and money.

Way back in 1978, the book Chloroform, written by Dr Arun Limaye while losing his battle against cancer, questioned various aspects of the medical profession. The book was published by Granthali. It was a landmark book and Limaye’s premature passing away left a void.

The irregularities and crimes of multinational pharmaceutical companies are regularly exposed in the Western media and literature but so little notice is taken of these in India. John La Carre’s novel The Constant Gardner shows the crimes of the MNCs which included the murder of a British diplomat’s wife in Africa because she is a committed campaigner.

Amir Khan’s programme is good and many decent people are connected with it. But it is completely marred by the exhortation by Mrs Nita Ambani of the Ambani Foundation and there arises a very big question of credibility.

She talks of taking India from darkness to light, from ignorance to knowledge, from dependence to self reliance and so on. While she speaks softly, the import is extremely arrogant as it seeks to project the foundation as the solution of all of India’s problems. Even an election campaign speech has more credibility.

The Ambanis are simply using a good programme to brighten their extremely controversial image. Of course, there is no shortage of collaborators in the media trumpeting for the Ambanis.

And an Ambani-sponsored programme on health issues seems extremely odd considering the record of the Kokilaben Dhirubhai Ambani hospital at Andheri though it belongs to the rival Anil Ambani group. Just read the damning report of the auditor and comptroller general presented to the Maharashtra legislature recently.

That apart the programme and much of the discussion elsewhere on health issues is too focussed on big hospitals, doctors and treatment. The more crucial issue of prevention is generally neglected. It is much more important to provide clean drinking water, air and nutritious food and basic health services to the masses than to build expensive, high tech hospitals. But hospitals bring more publicity and strengthen the vested interests in the medical corporate complex.

(Mr Vidyadhar Date is a senior journalist and author of the book Traffic in the era of climate change. Walking, cycling, public transport need priority.


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