--- On Fri, 11/2/11, Saheli Women <[email protected]> wrote:



From: Saheli Women <[email protected]>
Subject: [nccindia] Saheli finds Enquiry of PATH project on HPV vaccines still 
shielding the guilty
To: 
Date: Friday, 11 February, 2011, 14:59


  




Saheli finds Enquiry of PATH project on HPV vaccines still shielding the guilty
 
Our worst fears about unethical conduct of bio-medical research have been 
confirmed by the interim report of the enquiry panel set up by the Ministry of 
Health and Family Welfare to enquire into violations in PATH-ICMR project 
though on each count the enquiry  has fallen short of full investigation and on 
fixing responsibilities.
 
It has drawn attention to the fact that in getting vaccines free of cost from 
the two companies does raise concerns about undeclared conflict of interest 
since the results of the study may be used to influence the decision by the 
government. But it has failed to note that PATH itself was funded for this 
exercise by Bill and Melinda Gates Foundation which had a substantial share in 
Merck at the time the formative research by PATH was conducted and its findings 
used to carry out the project under question. 
 
The report has warned that vaccination should be viewed as a supplement to 
cervical cancer screening and not to replace such a programme. We have 
constantly drawn attention to the fact that in the entire district of Khammam 
where the said project is going on there are no screening facilities. The 
enquiry panel has not commented on this single minded pursuit of vaccines.
 
The enquiry panel has questioned the AP government for authorizing school 
authorities to sign consent on behalf of minor girls and said that everyone 
should desist from research on tribal population, except where it benefited 
them. We welcome this recommendation and hope it is taken seriously. However we 
wish to reiterate that the panel has not commented on the misinformation 
contained in the proect literature which mentioned none of the systemic side 
effects of the vaccines but only talked of minor irritations at the injection 
site. It has also failed to highlight that there are certain claims made such 
as no adverse effect on fertility which are as yet unsubstantiated. It has 
failed to link the unfounded claims to the formative research done by PATH 
where the villagers had raised concerns about these safety and future fertility 
very specifically.
 
The enquiry panel has accepted that the distinction between the regular 
immunization programme and research was blurred. When we look at findings of 
PATH formative research we find that this blurring was intentional as the 
villagers found the regular immunization by the government by and large 
acceptable and had stated that if the government endorsed the vaccine they 
would be willing to go ahead with it. 
 
The panel has not commented on the failure of the project to administer three 
doses systematically. On the basis of information received by us from 
government records through RTIs filed by us it is amply clear that there have 
been gross violations in this regard at least in Gujarat where many girls 
received only two doses as against three and some received only one dose as no 
repeat visits were made. 
 
The enquiry panel has agreed that bio-medical guidelines have been violated and 
adverse events have not been monitored and investigated. This is a major 
problem because as per the package inserts of Gardasil and Cervarix almost all 
systems of the body – immune system, musculoskeletal system, blood, and nervous 
system can be affected by the vaccines. If these are not even recorded on what 
basis has the claim been made that deficiencies are minor in nature?
 
Again death has been mentioned in the US package insert but conveniently 
removed from the Indian one without carrying out the necessary trials which 
would have laid the ground for changing the package insert. Yet the enquiry 
committee has not linked the seven deaths to the array of side effects but has 
merely drawn a conclusion that the deaths are “most probably unrelated to it, 
as there is no characteristic and uniform pattern of illness preceding the 
deaths, or temporal/spatial clustering going by the FIR”. We would like to 
which FIRs  have been used if the adverse event reporting itself was deficient. 
 
We had raised the question of ethics of bio-medical research which had been 
violated by the said project. In fact, the Andhra Pradesh Government had stated 
before the National Commission for Protection of Child Rights that the question 
of welfare of the research subjects was “irrelevant” as the vaccines had 
already been approved by the Drugs Controller General of India and endorsed by 
various professional bodies.
 
Where we disagree totally with the enquiry panel is that it has maintained that 
the deficiencies are minor in nature. How can violation of rights of 24000 
girls be a minor matter? How can printed misinformation overstating benefits 
and hiding known problems of the vaccines be a minor offence? How can death and 
debility arising from bio-medical research not even be monitored, treated and 
compensated? How can these be ignored in the context of  licences which have 
been granted without phase II and Phase III trials considered necessary by ICMR 
itself?
 
We do not understand what good is going to be achieved from completing the 
paperwork from this project which has failed to deliver the vaccines, failed to 
record adverse events and has been conducted in disregard to ethics. No 
meaningful information or conclusions can be drawn from this exercise.
 
The enquiry panel is correct in stating that no one agency could be held 
entirely accountable for the lapses but the lapses are serious and the case 
must be put before a competent authority to assess the damage and provide for 
medical attention and compensation to be recovered from the government, Bill 
and Melinda Gates Foundation, Merck and GlaxoSmithKline. It is a matter of 
criminal and financial liability.
 
Lastly we welcome the suggestion of the enquiry panel for a review of all 
pending HPV research projects and demand that this review be held in public 
domain with full transparency. We demand that the authorities review the 
licensing of Gardasil and Cervarix which has been done with practically no 
Indian data and we recommend that in addition to future studies the licence for 
sale of these vaccines be kept under suspension till adequate data become 
available after well designed and ethically conducted research among the 
potential users who can afford the vaccines at the prevailing market price.
We demand that the report of the enquiry committee be placed in the public 
domain.
 
Nalini, Kalpana,Vani and Vineeta for Saheli
contact 9212449198 for any clarifications
-- 

Saheli Women's Resource Centre
Above Unit 105-108
Defence Colony Flyover Market
New Delhi 100 024
www.saheliwomen.org



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