I write in response to Outlook’s cover story on the dreadful nexus of immunisation that enables doctors and foreign companies to make money (Vaccine Vendors’ Greed Gone Viral, April 17). Prevention is better than cure, which equally applies to all human ailments, and is essential for newborn babies and growing children. Undoubtedly, vaccination offers an opportunity for pharma companies and doctors to make money, but a lot of its misuse stems from the ignorance of common people. Many educated people, for example, would insist on a ‘tetanus’ shot even if there are a few scratches after a fall. In reality, it would be enough to clean the area and apply tincture. Of course, periodic booster shots for babies up to the age of five make up a bulk of vaccination. With many vaccines being supplied free of cost or at a nominal price, professionals have now started targeting senior citizens, whose numbers are on the rise. Their concern is about our ‘immunodeficiency’. My own case is an example. At 81, the urologist had advised me to take four doses of vaccines to guard against hepatitis B, pneumonia and typhoid (vaccigrip). Mark-ups and commissions are normal for doctors. Of course, one spends lakhs to become a doctor and has to wait for a few years till they are well-known. Their earnings have also fallen with various government restrictions. As far as vaccines are concerned, ‘make hay while the sun shines’ seems to be the norm.
A.S. Raj, On E-Mail
I am a retired professor and erstwhile head of the department of clinical virology at the Christian Medical College in Vellore and have headed medical organisations such as the Indian Association of Medical Microbiologists and the Indian Academy of Paediatrics. As such, I read your cover story with keen interest. Modern medicine has two lines of intervention—prevention of diseases, and their actual treatment. Among the hundreds of infectious diseases to which humans are vulnerable, about two dozen can be prevented by immunisation. Some physicians and pharma majors fear that by prevention, they might be losing money from the business of diagnosis and treatment. On the other hand, for obvious reasons, paediatricians are in favour of prevention by immunisation. Outlook’s cover story is biased in favour of treatment.
The government’s national immunisation programme is to reduce the burden of select diseases for which vaccines are relatively inexpensive and the disease burden relatively high. The cost is covered by revenue income. For other vaccines, out-of-pocket payment is necessary. This raises the economic and equity questions that the cover story has addressed. Primo Levi had said, “When you see torment, you become a tormentor if you do not mitigate the situation.” Prevention is a moral duty of those who know how to.
Dr T. Jacob John, Vellore
The cover story on vaccines is an unverified bag of lies. There must have been a motive behind it; it aims at misleading readers and stopping the protection every child deserves. If not for vaccination, hundreds of thousands would perish; it would be a terrible blight on society. The government has intensified the National Immunisation Programme (NIP) and the Universal Immunisation Programme (UIP) to bring down the Neo-Natal Mortality Rate (NMR), the Infant Mortality Rate (IMR) and the Under 5 Mortality Rate (U5MR). It just cannot provide all available vaccines free of cost to every individual. The National Technical Advisory Group on Immunisation (NTAGI) has recommended the inclusion of other vaccines like pneumonia vaccine (PCV) and typhoid vaccine as soon as possible. Such an irresponsible article might actually encourage people to reject vaccines; I sincerely hope the author isn’t influenced by the anti-vaccine lobby, which wants to profit from the actual (and far costlier) treatment of diseases. As a paediatrician, I thought the article was irresponsible.
Dr Alok Gupta, Jaipur
This is apropos the interview with Dr Vipin Vashishtha (‘Pharma money is corrupting paediatrics academy’). I would like to state that pharmas not only endeavour to corrupt IAP members for their seal of approval for useless paediatric medicines and useless injections. This is a big racket—patients often die, even after meeting the exorbitant costs of spurious and useless drugs. It’s a case of drug manufacturers flouting all norms set by the WHO. India is fast becoming the supply capital of counterfeit drugs and medicines.
Ranjit Sinha, New Delhi
The hands that needlessly inject babies in the name of vaccination must be tied in cuffs.
Dr George Jacob, Kochi
This refers to The Shah of Political Chess (April 17), your story on BJP chief Amit Shah, who seems to be heading a party of innovation. They talk of hyperloop transport systems and bullet trains. Has the Congress ever promised any such fantasies? When was the last time the Congress took a stand for progress and good governance. As far as Shah is concerned, he isn’t as important as Modi is to the masses, for the simple reason that the chief of the ruling party is not seen as a government functionary. But Shah is surely more significant than Yogi Adityanath, as it was Shah who most likely elevated the latter to the post of UP CM. Whenever other politicians grope for an answer, Shah has one up his sleeve. I want to ask if he has a solution for Kashmir. Or does Modi have one? Why are they playing a wait-and-watch game? The Congress could never have a clear mandate to set things right in Kashmir, but why are Modi and Shah dithering despite the huge mandate they have got?
Aditya Mookerjee, Belgaum
The alleged bungling of an EVM test ahead of a bypoll in a Madhya Pradesh assembly constituency only underlines the need to use VVPAT or the voter verifiable paper audit trail system (Symptom of Transitional Hiccup, Is it?, Apr 17). Let’s not forget that the incorporation of VVPAT to the voting machine is one thing the Supreme Court ordered way back in 2013. It’s only good if the Bhind episode has led the EC and the general public to go for VVPAT in a regular way from now. In a country like India, where elections are invariably near-chaotic, it’s best to have a back-up system that ensures the system is foolproof.
L.J. Singh, Amritsar
This refers to K.M. Gopakumar’s review of K. Sujatha Rao’s book, Do We Care? India’s Health System (Apr 10). The author bemoans the minuscule allotment of money towards healthcare in the GDP and the inability of the government organisations to spend it properly. Here, I would like to talk about our district government headquarters hospital—the first to get a NABH accreditation in Nagercoil district, which has quite a few private and missionary hospitals, some of them over a century old. Our Government Medical College also has a very good blood bank, with which no one can compete. These two hospitals, by dint of dedication and hard work, have been serving the people brilliantly. What I’m driving at is that if the people who run government hospitals are resourceful and dedicated, any manner of bureaucratic hurdles can be overcome.
A. Lino Samuel, Nagercoil
Sujatha Rao’s book on the abysmal state of healthcare is timely. Outlook actually could have a dedicated cover on this topic. As with vaccines, the private sector will exploit healthcare if let in through the door. If unchecked, healthcare in India will become as expensive as it is in the US. But even in the West, where there’s efficient government aid in health, the delays are huge, which is why a lot of them come to India for medical tourism. I have seen the Chinese healthcare system albeit superficially; the hospitals are good, with enough doctors. I wonder if democratic India, with its fundamental rights but no duties, can ever manage it similarly. Corporates can use their CSR to support private sector initiatives. However, the government has to provide infrastructure in a big way, especially in the rural sector.
Santhanam Krishnan, On E-Mail
Given the increasing number of cries against EVMs, it’s high time the Election Commission found a way that would restore voters’ confidence in the country’s voting system once and for all (Symptom of Transitional Hiccup, Is it?, Apr 17).
J. Akshobhya, Mysore
The ‘ugly Indians’ are powerful politicians (The Feudal Republic of India, April 10). Power gives them an adrenaline rush. You must have seen how they hold up traffic, trains and flights, leaving us, the people who elected them, helpless. We have a former MP who was given loans despite low credit-worthiness and is now out of the country after defaulting on taxes and debt repayment. For ordinary citizens, delay in paying service tax leads to arrest and salaried employees defaulting on loans often get threatened by recovery agents of the banks. A Shiv Sena leader once hit a woman constable because she pulled him up for speaking on the phone while driving. You must have observed how it is mostly cars sporting flags of one or the other political party that break rules on the road. We must stop this VIP culture. MPs and MLAs should respect people, not power.
Kamal Anil Kapadia, Mumbai
It takes only a peek at Indian films or television serials to sense the intensity of racism in the country (Brewing Racism Blows Up, Apr 10). The heroes and heroines are extraordinarily fair while the black person is always the villain or, at best, the domestic help. Going by the recent comments of a BJP ex-parliamentarian, his dusky-skinned compatriots should be thankful to the fair-complexioned to be still belonging to the nation. Such insensitive remarks from a leader who also happens to be erudite—at least going by the fact that he was the editor of a magazine! No wonder his BJP is struggling to get a foothold in the Deccan, where people are increasingly angry with the NDA government’s consistent moves to impose Hindu/Hindiness on anything and everything around.
H.N. Ramakrishna, Michigan
This refers to your story on the drought in Tamil Nadu (There Isn’t Even a Straw Left, April 10). Farmers from the southern state protesting in New Delhi for the past one month have failed to prick the conscience of the nation. The relief offered is a pittance. Clutching skulls and ropes, the farmers’ protest makes for TV spectacle, but nothing stops the authorities from looking the other way. The politicians are only interested in photo-ops to project themselves as being sympathetic to the farmers. The larger issue is that the farmers allowed the two Dravidian parties to rule them for decades, and all that the parties did was talk big and dole out freebies. During election time, the voters got their quota of liquor, money, sarees and so on. The sincere, visionary leaders are no longer around. That is why there is no comprehensive agriculture policy that covers the farmer for crop failure, ensures remunerative prices for their crops and gets rid of middlemen. Not just the state government but also the Centre is to blame for this situation.
Rangarajan, On E-Mail
It was saddening to read about the plight of farmers across the country. It made me feel guilty to be sitting in the national capital and getting subsidised water and power. Arvind Kejriwal’s Aam Aadmi Party has done good work on health and education, but why should they promote this subsidy culture, which others may emulate?
S.K., On E-Mail
The number of letters on China and the UN—the last one being from P.S. Kaur (letters, Apr 17)—prompts me to write this. K.R. Narayanan, on a visit to Nepal as India’s president, revealed that late US president John F. Kennedy (who was a great admirer of Jawaharlal Nehru even before he became the first Indian prime minister) had offered to give India a permanent seat in the world body’s Security Council. This was the time when nationalist China had lost all legitimacy, having been confined to Formosa (Taiwan) for over a decade, and it was a decade before the US badly mauled Communist China in Vietnam. Narayanan was not only our president, he was earlier an illustrious diplomat. What he said was reported widely by the press at the time.
P.V. Iyer, Bangalore
China looks like the proverbial cat on the hot tin roof as far as the Dalai Lama’s visit to Arunachal Pradesh is concerned (The Monk Who Stung A Hornet, April 17). The furore raised by it over the spiritual leader’s trip to the northeastern state is unwarranted, it actually amounts to Beijing meddling in the internal affairs of India. The Chinese foreign ministry’s veiled threat that the visit will cause “serious damage” to the bilateral ties is, without doubt, an attempt to put pressure on India. The Dalai Lama is an honoured guest in India and his presence enriches the socio-cultural-spirutal ethos of this country. China’s baiting of the Lama, whom it calls a “dangerous separatist” does not befit its global stature.
Meghana A., New South Wales
Former top executive J.S. Bhargava reminds us that a government employee, even of the IAS cadre, has to be politically neutral (Boardroom Diary, Apr 3). But is it anymore so today? We live in times where accomplished bureaucrats themselves publish articles that hail Prime Minister Narendra Modi even as it simply goes against the conduct rules of public servants. The times are such that anything spoken against the rulers is termed anti-national! Those holding high constitutional posts are supposed not to own gifts from the public (as they are given to the office they hold and not the individual). That way, they are not supposed to take them home after retirement either. But then, in our feudal bureaucratic structure, who cares to stick to such principles!
J. Ravindranath, Hyderabad
