#India – Whistleblower Dr K V Babu’s 5-yr battle for #medicalethics drags on #Publichealth #IMA


WHISTLEBLOWER Dr KV Babu has risked his medical career to expose a gross violation of law by India’s largest body of medical practitioners (Photo: MADHURAJ)

Rema Nagarajan
30 May 2013, TNN

May 30, 2013: It is exactly five years since Dr K V Babu took up the issue of the Indian Medical Association (IMA) endorsing the products of various companies in violation of the medical code of ethics. The case continues to drag on as the Medical Council of India (MCI) gave one more chance for Dr Rajagopalan Nair, Kerala state secretary of the IMA to appear before it after he failed to do so on two previous dates given to him.

On May 30, 2008, Dr Babu complained to the IMA national president about IMAs endorsement of products of various companies like Pepsico and Dabur. Instead of being lauded for having prevented the association from violating the code of ethics, Dr Babu has been harassed by the IMA, which had to forego crores of rupees that it used to earn from endorsement of products.

Even the MCI which is supposed to regulate the medical profession has been dragging its feet in helping an individual doctor’s efforts to ensure compliance of the ethics code. The battle goes on  relentlessly as IMA continues to harass Dr Babu for standing up against the system, while Dr Babu persists in fighting his lone battle against the largest and most powerful association of doctors in the country.

The saga of endorsement and harassment: 

April 2008– IMA Central Working Committee met and decided to endorse Pepsico products -Tropicana and Quaker

May 2008– Dr Babu K V complained to IMA national president that endorsement was unethical according to the Medical Council of India’s (MCI) code of ethics for doctors

June 2008– Complaint was filed against IMA endorsement to MCI.

August 2008-MCI sent show-cause notice to IMA on endorsement issue

November 2008– IMA ratified minutes of the meeting regarding endorsement

May, June 2009– MCI sent several notices to IMA

July 2009– Ethics committee of MCI took up the issue and decided that IMA was not under the jurisdiction of MCI

July 2009– Dr Babu approached the health ministry to take action against MCI for not upholding the code of ethics.

-Health ministry asked MCI to take up the issue again

August/September 2009– MCI sought legal opinion on whether endorsement by IMA was unethical and whether IMA was within the jurisdiction of MCI

November 2009-Dr Babu approached Chief Information Commissioner (CIC) as no reply was coming from MCI on RTI application on whether endorsement by medical associations was unethical or not. CIC directed MCI to reply by December 31, 2009.

November 30,2009– IMA decided to stop all endorsements in future but would continue already signed MoUs for endorsement

December 2009– MCI clarified that IMA was within the jurisdiction of the code of ethics and that code of ethics was applicable not only to individual doctors but also to professional associations of doctors

March 2010– MCI ethics committee again decided IMA not within jurisdiction on basis of legal opinion of an outdated legal opinion prior to the clarification

April 2010– Dr Babu complained again to the ethics committee of the MCI

May 2010– Dr Babu wrote to MCI seeking information on why no action was taken against office bearers of IMA for violating the code of ethics or MCI regulations 2002 which prohibits endorsement of any commercial product by a physician or group of physicians.

June 2010– NHRC in response to Babu’s complaint directed Health Ministry to take appropriate action on complaint against IMA

July 2010– MCI claimed that IMA was not under its jurisdiction and that action could only be taken on complaints against individual doctors

August 2010– Dr Babu sent a complaint to MCI again, naming individual doctors, 187 members of the Central Working Committee of IMA who decided on the endorsement

MCI declared that IMA was under its jurisdiction and sent show cause notice to IMA

November 2010– Board of governors of the MCI declared IMA endorsement unethical and asked for it to be stopped immediately. Penal action, if any, was to be decided on November 9, 2010

Health minister informed Parliament that MCI had decided to remove the names of the national president of IMA Dr G. Samaram and secretary Dr Dharam Praksh, for 6 months and censure 61 members of the IMA executive.

January 2011– Dr Babu filed a complaint filed to Delhi Medical Council pointing out that the endorsement had not been stopped despite MCI directions

February 2011– PepsiCo stopped using logo and health message of IMA on Quaker oats and Tropicana

IMA Kerala branch decided to expel Dr Babu from IMA for bringing disrepute to the association by complaining to MCI and going to the media

Dr Babu complained to MCI, DMC and Kerala state medical council regarding threat of expulsion and harassment

March 2011-Pepsico officially withdrew IMA endorsement nine months before MoU was supposed to run out.

April 2011– IMA CWC rejects request of MA Kerala to expel Dr Babu since it was not as per IMA bye laws. Request for expulsion was sent back to IMA Kerala

May 2011– MCI and DMC refuse to intervene saying it is a dispute between a member and an association

August 2012– Notice issued from IMA Kerala to Dr Babu appear in person for being instrumental in the publication of an article on the endorsement issue in the press.

Dr Babu complained to the MCI to intervene in the matter

October 2012-Dr Babu appealed to the Health Ministry as MCI was not taking any action on his complaint of IMA’s harassment

November 22, 2012– Health Ministry sought comments from MCI on Dr Babu’s appeal

Jan 22, 2013: MCI ethics committee examined the complaint and discussed the issue

March 22, 2013: Summoned Dr Babu and Dr Rajagopalan Nair, former IMA state secretary. Both parties could not attend

April 26, 2013: Dr Babu and Dr Rajagopalan summoned again. Dr Babu appeared before the MCI ethics committee and presented his case and submitted relevant documents. Dr Rajagopalan failed to appear

May 24, 2013– Dr Rajagopalan was summoned again. He did not appear and the ethics committee has decided to give him one more chance to appear next month.

And so the quest for justice drags on beyond five years.

 

From Pepsico To Wal-mart: Selling A Fake Dream #sundayreading


 

By Devinder Sharma

29 September, 2012
Ground Reality

In the mid-1980s, Pepsico came up with a proposal to bring in a 2nd horticultural revolution in Punjab. It was hailed as a path-breaking initiative that would put an end to the continuing distress on the farm. It was expected to usher in the latest technology, improve farm research and extension, create supply-chain infrastructure, and provide marketing linkages from farm to the fork. I remember the kind of excitement that prevailed all around. Politicians, bureaucrats, economists, agricultural scientists and even the Bhartiya Kisan Union (BKU) joined the chorus. All my efforts to reason out the hollowness of the claims, based on Pepsico’s own studies, were simply lost in the din and noise created by the drum-beaters.

Some 15 years after the project was approved, Pepsico’s horticultural revolution is all but forgotten. Agriculture has gone from bad to worse. The food bowl of the country has also become a major hot spot for farmer suicides. While the soft drink giant remains busy marketing its colas, Pepsico has not been held accountable for its failed promises. It will never be punished for selling a fake dream to the beleaguered farming community.

It is now the turn of Wal-Mart and other big retail giants. FDI in retail is once again being projected as a panacea for all the ills plaguing Indian agriculture. FDI in retail will lay out backend infrastructure, bring in a chain of cold storages and improved transportation thereby reducing crop losses; remove middlemen which rob the farmers of profits, and thereby provide him higher prices; bring in improved technology to help in crop diversification; and of course create millions of jobs. The cheerleaders are once again on the road. This time, it is the corporate controlled electronic media that is drumming up the hype.

Having spent Rs 52-crore in two years for lobbying alone, and after the recent New York Times exposure showing how Wal-Mart bribed its way to control 50 per cent of the retail market in Mexico, the Union Cabinet finally allowed big retail to set shop. If Wal-mart could bribe its way in Mexico, what makes us think they have not been able to do so in India?

We are being told that Wal-Mart, Tesco, Sainsbury, Carrefour and a host of other big retail players are expected to increase farm income. In the US, where Wal-Mart has completed 50 years, if farmers were getting a better income, there was no reason why the farming population should plummet to less than one per cent of the population. Farmers in US survive on the farm not because of Wal-Mart but the massive subsidy support, which includes direct farm income. Between 1997 and 2008, Rs 12.60 lakh crore was provided as income support to farmers. A UNCTAD-India study shows that if these subsidies, classified as Green Box in WTO parlance, are removed, the American agriculture collapses.

In Europe, despite the dominance of big retail, every minute one farmer quits agriculture. Europe provides the highest amount of subsidies, including direct income support. But because 74 per cent of these subsidies are cornered by Corporations and big farmers, small farmers are quitting farming. In France, farm income has come down by 39 per cent in 2009, down from 22 per cent in 2008. In OECD, the richest trading block comprising 30 countries, Rs 14 lakh crore was the farm subsidy support in 2009 alone. It is not big retail, but direct income support that keeps farmers in agriculture.

These subsidies also bring down the domestic and international prices as a result of which big retail sells cheap. Empirical studies show big retail charging 20-30 per cent higher than open market in Latin America and Southeast Asia. In India, organised domestic retail has not been able to sell cheaper. A NABARD study for Hyderabad shows Reliance Fresh and other charging 15-20 per cent higher prices. Even at the peak of inflation in India, these domestic organised retailers did not reduce prices. So where is the advantage to consumers?

Studies show in America, before 1950, when farmers would sell their produce for one dollar, 70 cents was his income. In 2005, it had fallen to 4 per cent. With the middlemen wiped out, I thought the farmer’s income should have gone up. No, it is the new battery of middlemen – quality controller, standardiser, certification agency, processor et c—who walk away with farmer’s profits. Number of middlemen, operating under the same hub, actually increases. Let us not forget, Wal-mart is a big middleman, it eats away the smaller middlemen.

There is no evidence that big retail creates backend infrastructure. In US and Europe, rural infrastructure has been created through government support which came in the form of agricultural subsidies. To say that 40 per cent agricultural food that goes waste in India will be drastically reduced is also an illusion. In US also, 40 per cent food is wasted and much of it is after processing where Wal-Mart’s should have played a much important role.

Regarding employment generation and poverty alleviation, lessons need to be drawn from a 2004 study of Pennsylvania State University by Stephen Goetz and Hema Swaminathan, which showed how higher poverty prevailed in areas where Wal-Mart stores had come up compared to those states where big retail was absent. In any case, for a $450 billion turnover, Wal-Mart employs only 2.1 million people. Whereas for an estimated $460 billion market, Indian retail employs 44 million people. Let us not forget, Pepsico had also promised to create 50,000 jobs. As per a question in Parliament, it became known that Pepsico had created less than 500 jobs, including 250 unskilled workers. Moreover, last month, massive demonstrations rocked US by Wal-Mart workers complaining of poor working conditions and exploitative salaries. Who creates employment, and also provides better working conditions, therefore is all evident.

Yes, there is a need to improve rural infrastructure, provide a sophisticated supply chain, and provide better income to farmers. The milkman of India, late Dr Verghese Kurien, had shown us the way. The cooperative dairy structure, which led to the evolution of the Amul brand, is the right approach. If he could do it for milk, which is a highly perishable commodity, there is no reason why it can’t be replicated in fruits, vegetables and other agricultural commodities. From a milk importer, India has now become world’s biggest producer of milk. It is therefore obvious that solutions to the plethora of problems on Indian farms does not lie in the west, but in our own backyard. We need to look inwards. Otherwise we will go on committing the same mistakes, and in the process turn farms into killing fields.

Devinder Sharma is a food and agriculture policy analyst. His writings focus on the links between biotechnology, intellectual property rights, food trade and poverty. His blog is Ground Realityhttp://devinder-sharma.blogspot.in

PepsiCo, KFC, McDonald’s, Nestle’s Maggi get junk rating for misleading consumers


NEW DELHI, ET Bureau : Food items such as potato chips, burgers and noodles almost wipe out one’s daily permissible limits of bad fat, salt and sugar in just one serving, says a study that seeks stronger regulations and labeling rules for food products.
The Centre for Science & Environment (CSE), which tested 16 popular brands including Nestle’s Maggi noodles, McDonald’s, KFC, Haldiram’s aloo bhujia and PepsiCo‘s Lay’s potato chips, on Friday accused most of these companies of misleading the public through wrong claims and insufficient labeling.

PepsiCo, Nestle, McDonald’s and KFC denied the allegation and said their products were free of trans fats, the worst kind of fats. “Most junk foods contain very high levels of trans fats, salt and sugar, leading to diseases such as obesity and diabetes,” said CSE Director Sunita Narain.

“We need stronger regulations that will reduce fats, sugar and salt in junk foods, and force companies to provide information to the public mandatorily,” she said, opening a new front against multinational and Indian packaged foods companies almost a decade after the pesticides-in-cola controversy.

The CSE’s findings of pesticides in Coca-Cola and PepsiCo drinks in 2003, and again in 2006, had led to a drastic fall in sales growth of the two cola majors between 2004 and 2007.

According to the new CSE study, munching a 65-75 gm pack of Lay’s American style cream and onion chips will exceed one’s daily trans fat quota, while a two-piece KFC chicken meal will exceed both trans fats and total fat quota. Trans fats clog arteries and make them narrower. Combined with large amounts of salt, they increase blood pressure in the body.

The World Health Organisation recommends an adult male should ideally consume not more than 2.6 gram of trans fats per day. An adult female’s limit is 2.1 gram and that of a child of 10-12 years is 2.3 gram. A child who eats one McDonald’s Happy Meal finishes 90% of all his/her daily requirement of trans fats, the CSE study said, adding the company makes no mention of this dosage of trans fats.

Rajesh Maini, corporate communications GM of McDonald’s India (North & East), said the CSE study results are “most unusual” because the restaurant chain uses refined, bleached and deodorised palm oil in which trans fats are so low that they are virtually undetectable.

“We will certainly be examining them closely to see how these unexpected results have been arrived at, what testing methods were used, and comparing them with our own in-house testing,” he added. Spokesmen of PepsiCo and Yum! Restaurants India, which runs KFC and Pizza Hut chains, flatly denied the CSE report.

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