The transformation of Dr K S Reddy and the Public Health Foundation of India from the preferred partner of government of India to one whose activities are not under scrutiny through a “swadeshi” lens has been rapid. In a free-wheeling interview, – his first since PHFI lost its FCRA registration – Dr Reddy talks about how the action defied principles of natural justice, the initial warning signs that PHFI ignored and his willingness to step aside if that helps his organisation. Excerpts:
It’s been three months since PHFI was debarred from taking foreign funding. How has that affected your work?
Many ongoing projects are stalled, funding frozen, newly approved projects cannot commence because funds cannot come in without FCRA registration renewal. Further problem is pending payments for work already done with international funding agencies which pay on reimbursement basis; the invoices have been approved but because we cannot accept foreign remittances payments are stuck.We have responded in great detail with adequate documentary support to questions posed to us (first in April and then in June).
What sort of information did they seek in June?
In June they asked us for information related to 26 items including questions related to Parliamentarians politicians and activists that anybody from PHFI had met in the last seven years and the purpose of each of those meetings. Since we are a large organisation operating across the country it is difficult to collate that information in a short period of time. We have gathered as much information as possible.
Before this have you faced problems in getting foreign funding for any of your projects?
Over a period of a year we have had two projects in which we were told that some adverse observations mainly related to our link with BMGF and participation in immunisation programme were quoted as grounds by some agencies of the government to stall our foreign funding even though those projects had nothing to do with BMGF or immunisation. For example an UHC project in two states funded by a different donor was stalled by invoking tie up with BMGF. Fortunately health ministry came to our rescue by clarifying the matter with the agencies concerned and it was sorted. But it does appear that some misconceptions based on misinformation – I do not know whether tobacco industry fuelled it or not – seems to have clouded the judgement of some agencies who should have known better
Have health ministry projects suffered because of the FCRA restrictions?
We were providing technical support for the National immunisation Programme, including Mission Indradhanush. The technical component was supported by PHFI out of which one part concerned NTAGI (National technical Advisory Group on Immunisation). That has been transferred. Because of funding issues the role of supporting the programme through the Immunisation Technical Support Unit has been handed over to John Snow Incorporated. It is interesting that people protesting PHFI’s involvement in immunisation are silent when the programme has been handed over to JSI which is a foreign entity. So now you have a foreign funded foreign entity supporting India’s National Immunisation Programme. This has only happened because PHFI’s FCRA licence is held up.
The other activity that is coming to a close because of this is our technical support to the national HIV-AIDS programme. Our technical assistance to Kerala and Karnataka to design and implement district level pilots for universal health coverage too will have to cease because of the FCRA freeze. There’s a big project on retinopathy funded by the Queen’s Diamond Jubilee Trust. In this we are partnering central government and several states to prevent blindness in people with diabetes and in newborns. Even that is getting affected now.
What kind of signals are you getting from the government?
We have been assured by the health ministry that because of our close association they are advocating our case and hope that the matter will be resolved soon. As far as the home ministry is concerned, we are told that the matter is under review.
There is a perception that you were too close to the UPA government and whatever is happening on the FCRA front is actually political.
Both as a doctor and as a public health advocate, I have firmly believed that service in medicine and public health is beyond political affiliations. I never enquired about a patient’s political beliefs while treating him and will never look at at public health from the lens of party politics. I have never been member of any political party. I was officially appointed as a physician to two Prime Ministers by the government. During 2000-2003 and again in 2016, I was asked by the Government of the day to officially represent India in FCTC and COP7 negotiations. I was proud to do serve my country in all of these capacities. Anyone who wants to brand me is obviously unable to grasp the concept that there can be Indians who do not define their identity in monochromatic partisan colours. We are a non-political organisation we were set up in 2006 as a PPP. We have worked with variety of state governments, in fact our first campus is in Gandhinagar where land and monetary support was granted to us by Shri Narendra Modiji then CM of Gujarat. It was inaugurated by Shri Vijay Rupaniji, CM of Gujarat. His predecessor Anandibenji has granted through an act of the state legislature, university stature to IIPH in Gandhinagar. Narendra Modiji performed Bhoomi pooja on the land allocated on banks of Sabarmati. I had promised him the first campus would be there and first academic programme would come up in IIPH Gandhinagar. We also worked with government of Chhattisgarh for placements in areas affected by left wing extremism.Public health has no political affiliation. Institutions are set up to serve the country and they will continue to do so even if the party in power is a different party. PHFI is a servant of the nation many regard it also as an asset to the nation and it should be regarded as such
In the light of what the Philip Morris papers have revealed and also that after the action on PHFI the tobacco industry put up hoardings thanking the government, how much of a role do you think the tobacco industry played in all this?
The Philip Morris papers have been a revelation. It is very clear that the multinational tobacco industry has identified several organisations as being their adversaries, they have listed eight professionals as champions of tobacco control, I have been listed among those eight but marked out by a red circle around my photograph. The fact that documents mention PHFI, quote number of my observations on tobacco control from various articles show that they have been paying keen attention to me and PHFI. Indian tobacco industry too sees as an adversary. The fact that in November 2016 around COP7 we had the tobacco industry putting up hoardings against FCTC, denouncing the Indian health ministry suggest that the tobacco industry was openly challenging the health ministry. But when our FCRA was annulled in April, to have the tobacco industry put up hoardings thanking the government for action against us proved that they were clearly lobbying for this action to be taken.
You have been accused of being “too close” to BMGF – BMGF is also mentioned in the writ petition tobacco farmers filed in the Delhi High Court. Do you also see the tobacco industry as a player in the accusations that have been made against PHFI for its work on the vaccines programme?
PHFI was conceived as an innovative PPP. BMGF came in as one of the three inittal contributing partners, others being the government of India and private philanthropic organisations. We have subsequently competed for and received many international grants. We are not in any way tied to BMGF or governed by them. Our board does not have any BMGF representation. There is only an observer who comes in as an invitee sometimes. BMGF has been providing support to us essentially to support the national programmes – immunisation, AIDS control.All of this has been done with the approval of the health ministry at every stage. It is interesting that one of the charges levelled against us is that we are actually aiding BMGF in serving interests of multinational vaccine manufacturers. Health ministry and health secretary have clarified on several occasions the NTAGI is chaired by three secretaries of the government of India – health, health research and DBT – the members are all independent experts. WHO-endorsed vaccines are procured from Indian manufacturers. There is nothing sinister about what we are doing. It is a GOI programme, that we are proud to be associated with. It is curious that the tobacco industry in its November petition brought in the BMGF connection to the pharmaceutical industry and the immunisation programme to tie all things together in a totally bizarre fashion. But is also raises the question whether the tobacco industry has been feeding or fuelling this kind of a misinformation campaign to discredit PHFI.
You have been the fact of PHFI, you are a very tall person in the international public health scene. Do you see that as something that is harming PHFI right now?
If I have a role to play in the international public health arena it is mostly because of what PHFI has accomplished. I cannot claim to have done things in public health in India that is separate from the organisations that I have worked for, be it PHFI or AIIMS. There could be people jealous of me or the institution. I am inconsequential people doing this are harming India. Any narrow minded attempt to pull us down because of jealousy is actually counter productive and anti national. Anybody supporting tobacco industry are on the wrong side of history.
If jealousy is indeed a factor, are you willing to step aside in the interest of the organisation?
I do not know if jealousy is a factor…For me the country comes uppermost and after that my organisation. If I have to protect my organisation to serve the county and if that calls for me to step aside at any time I will be most happy to do so. The tobacco industry certainly is targetting me. Are Philip Morris and Indian tobacco industry worried about me taking a principled stand on tobacco? I hope they are. We believe sincerely that tobacco harms people it is there in SDGs, India is a signatory to SDGs we are only doing what government of India promised to do.
How long do you see this playing out?
As a citizen I have to have implicit faith in the wisdom and fairness of the government. For whatever reasons our FCRA licence which was issued in August 2016 was cancelled in April 2017 without even giving us a notice. A provision was invoked to avoid even the requirement of asking us for clarifications. In effect what has been said is that the renewal of licence that was granted in August 2016 should be treated as non-existent. This militates against the principles of natural justice.