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Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages

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  • Omesh Bharti
    Dear Friends,                       As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine
    Message 1 of 6 , Jul 21, 2010
    View Source
    Dear Friends,
                          As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
     
    Thanks,

    Dr. Omesh Kumar Bharti
    M.B.B.S.,D.H.M.,M.A.E.(Epidemiology)

    Directorate of Health Safety and Regulation,

    SHIMLA, Himachal Pradesh, India.
    +91-9418120302

    bhartiomesh@...; bhartiomesh@...

     

    --- On Wed, 21/7/10, drbabukv <drbabukv@...> wrote:

    From: drbabukv <drbabukv@...>
    Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
    To: fourth-estate-critique@..., growingknowledge@..., "Omesh Bharti" <bhartiomesh@...>, madhukairali@..., "Madhavi Yennapu" <y_madhavi01@...>, sajukr@...
    Date: Wednesday, 21 July, 2010, 2:01 PM



    ---------- Forwarded message ----------
    From: drbabukv <drbabukv@...>
    Date: Tue, Jul 20, 2010 at 8:34 PM
    Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
    To: 1977nishad@..., basanth67@..., jk_narikkutty@..., Saikiran K P <kpsaikiran@...>, "oc.mohanraj" <oc.mohanraj@...>, Brinda Karat <brinda@...>, bajji01@...


    Pl see the attachments


  • Jugal Kishore
    Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then
    Message 2 of 6 , Jul 21, 2010
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      Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then making the statement at this point of time is just washing their hands from the damage they have incured.


       
      On Wed, Jul 21, 2010 at 10:56 AM, Omesh Bharti <bhartiomesh@...> wrote:
       
      [Attachment(s) from Omesh Bharti included below]

      Dear Friends,
                            As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
       
      Thanks,

      Dr. Omesh Kumar Bharti
      M.B.B.S.,D.H.M.,M.A.E.(Epidemiology)

      Directorate of Health Safety and Regulation,

      SHIMLA, Himachal Pradesh, India.
      +91-9418120302

      bhartiomesh@...; bhartiomesh@...

       

      --- On Wed, 21/7/10, drbabukv <drbabukv@...> wrote:


      From: drbabukv <drbabukv@...>
      Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
      To: fourth-estate-critique@..., growingknowledge@..., "Omesh Bharti" <bhartiomesh@...>, madhukairali@..., "Madhavi Yennapu" <y_madhavi01@...>, sajukr@...
      Date: Wednesday, 21 July, 2010, 2:01 PM



      ---------- Forwarded message ----------
      From: drbabukv <drbabukv@...>
      Date: Tue, Jul 20, 2010 at 8:34 PM
      Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
      To: 1977nishad@..., basanth67@..., jk_narikkutty@..., Saikiran K P <kpsaikiran@...>, "oc.mohanraj" <oc.mohanraj@...>, Brinda Karat <brinda@...>, bajji01@...


      Pl see the attachments





      --
      Prof. Jugal Kishore
      MBBS, MD, PGDCHFWM, PGDEE, MSc., FIAPSM, FIPHA, FIMAAMS,
      Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

      Please visit for more details: http://drjugalkishore.blogspot.com

      Exectuvie Director (Hony): Center for Inquiry, India

      President (Hony): Kishore Foundations, Sabasva Foundation,

      Authors of:
      National Health Programs of India
      A Dictionary of Public Health
      Practical and Viva of Community Medicine
      A Comprehensive Review of Community Medicine
      A Textbook of Health for Health Care workers
      Biomedical Waste Management in India
      A pioneering Social Reformers of India
      Great Warriers of Human Rights Movement From India
      Vanishing Girl Child
      Living With out God
      Bhavnayen (An anthology of poems in Hindi)

      For my books please Visit http://centurypublications.co.in
    • Prof. Umesh Kapil
      Dear  all  Members I am sharing the manuscript entitled  Ensuring the quality of vitamin A capsules used in supplementation programs    published
      Message 3 of 6 , Jun 20, 2011
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        Dear  all  Members


        I am sharing the manuscript entitled "Ensuring the quality of vitamin A capsules used in supplementation programs "   published in American Journal of Clinical Nutrition, Vol. 87, No. 5, 1539-1540, May 2008 for your kind perusal.

         

         

         According to this  the United Nations Children's Fund (UNICEF) and Micronutrient Initiative (MI) provide >95% of the global supply of vitamin A capsules. Therefore, they can confirm that >95% of the 100 000-IU and 200 000-IU vitamin A capsules manufactured, procured, and delivered through child survival programs and other public health programs to children <5 y old in >100 countries undergo rigorous quality-assurance procedures.


        I hope you would find this information  useful

        With best regards

        Umesh Kapil


        American Journal of Clinical Nutrition, Vol. 87, No. 5, 1539-1540, May 2008
        © 2008 American Society for Nutrition


        LETTER TO THE EDITOR

        Ensuring the quality of vitamin A capsules used in supplementation programs


        Venkatesh Mannar

        Micronutrient Initiative 
        180 Elgin Street, Suite 1000
         
        Ottawa, ON
         
        Canada
         
        K2P 2K3
         
        E-mail: 
        vmannar@...



        Alan Court

        Programme Division 
        UNICEF
         
        3 United Nations Plaza
         
        New York, NY 10017
         
        E-mail: 
        acourt@...


        Dear Sir:

        We are writing to comment on a letter by Newton et al (1) that was published recently in the Journal. The authors raised important questions about the issue of the quality of vitamin A capsules used in the trial they discuss in the letter; however, their findings cannot be generalized to vitamin A supplementation programs.

        Together, the United Nations Children's Fund (UNICEF) and Micronutrient Initiative (MI) provide >95% of the global supply of vitamin A capsules. Therefore, they can confirm that >95% of the 100 000-IU and 200 000-IU vitamin A capsules manufactured, procured, and delivered through child survival programs and other public health programs to children <5 y old in >100 countries undergo rigorous quality-assurance procedures.

         

        The soft-gel vitamin A capsules supplied by UNICEF and MI are in the World Health Organization, UNICEF, and International Vitamin A Consultative Group (WHO/UNICEF/IVACG)-recommended dosages of 100 000 and 200 000 IU. They also are manufactured according to strict specifications set by the WHO, UNICEF, and MI and are very closely monitored for quality assurance at the point of production and onward for distribution to countries.

         

        Because the effect on child survival of vitamin A supplementation programs relies heavily on the quality of the supplement itself, the specifications and procedures are taken very seriously. Before a vitamin A capsule supplier is selected, it must show that its product, in its defined packaging, has undergone a rigorous stability testing in the laboratory, in accordance with guidelines of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Through this process, we are assured of their stability and performance throughout their shelf life in field conditions, which can include high temperatures and humidity. All capsule manufacturers are also required, through regular authorized Good Manufacturing Practice (GMP) inspections by UNICEF, to ensure that the product is manufactured in accordance with WHO GMP guidelines. Moreover, random sampling and testing of the capsules by UNICEF's Supply Division on receipt from the suppliers validates the accompanying certificates of analysis, and past sampling and testing of capsules showed satisfactory and reassuring performance. In the unlikely event that problems arise in the field, UNICEF and MI have stringent processes in place to follow through on the batches in question and to investigate breaks in the supply chain process all the way back to the manufacturer.

         

        However, despite the assurances of performance in the laboratory, we agree that it is very important to periodically assess on a larger scale the retinol stability of vitamin A capsules that have been exposed to real field conditions. For this reason, MI in collaboration with UNICEF is in the process of systematically collecting samples of capsules that have been in the field since 2004 from 20 countries for independent laboratory analysis. Newton et al also raised the very important point that all stakeholders involved in vitamin A supplementation programs, from manufacturer through purchaser to end user, should remain vigilant against any practices that will compromise product quality.

         

        We therefore believe that the quality assurance systems currently in place will continue to reinforce the current high level of confidence in vitamin A supplementation programs and will allow us to focus on increasing the coverage of these life-saving supplements so that more children around the world have a chance to reach—and exceed—their fifth birthday.

         

         

        ACKNOWLEDGMENTS

         

        Neither of the authors had a personal or financial conflict of interest.

         

        REFERENCE

         

        1.    Newton S, Owusu-Agyei S, Kirkwood B. Is there any monitoring of the quality of vitamin A capsules used in supplementation programs? Am J Clin Nutr 2007;86:1254 (letter).[Free Full Text]




        Dr. Umesh Kapil,
        Professor , Public Health Nutrition,
        Human Nutrition Unit,Old OT Block
        All India Institute of Medical Sciences ,
        New Delhi, 110029,
        India 110029
        Mobile :09810609340,
        Office 911126593383;  Fax 911126588461 
        www.samchild.com
         


        --- On Wed, 7/21/10, Jugal Kishore <drjugalkishore@...> wrote:

        From: Jugal Kishore <drjugalkishore@...>
        Subject: Re: [iapsm_youthmembers] Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
        To: iapsm_youthmembers@yahoogroups.com
        Date: Wednesday, July 21, 2010, 9:07 AM

         
        Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then making the statement at this point of time is just washing their hands from the damage they have incured.


         
        On Wed, Jul 21, 2010 at 10:56 AM, Omesh Bharti <bhartiomesh@ yahoo.com> wrote:
         
        [Attachment(s) from Omesh Bharti included below]
        Dear Friends,
                              As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
         
        Thanks,

        Dr. Omesh Kumar Bharti
        M.B.B.S.,D.H. M.,M.A.E. (Epidemiology)

        Directorate of Health Safety and Regulation,

        SHIMLA, Himachal Pradesh, India.
        +91-9418120302

        bhartiomesh@ yahoo.com; bhartiomesh@ gmail.com

         

        --- On Wed, 21/7/10, drbabukv <drbabukv@gmail. com> wrote:


        From: drbabukv <drbabukv@gmail. com>
        Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
        To: fourth-estate- critique@ googlegroups. com, growingknowledge@ googlegroups. com, "Omesh Bharti" <bhartiomesh@ yahoo.com>, madhukairali@ gmail.com, "Madhavi Yennapu" <y_madhavi01@ hotmail.com>, sajukr@gmail. com
        Date: Wednesday, 21 July, 2010, 2:01 PM



        ---------- Forwarded message ----------
        From: drbabukv <drbabukv@gmail. com>
        Date: Tue, Jul 20, 2010 at 8:34 PM
        Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
        To: 1977nishad@gmail. com, basanth67@gmail. com, jk_narikkutty@ yahoo.com, Saikiran K P <kpsaikiran@hotmail. com>, "oc.mohanraj" <oc.mohanraj@ gmail.com>, Brinda Karat <brinda@cpim. org>, bajji01@gmail. com


        Pl see the attachments





        --
        Prof. Jugal Kishore
        MBBS, MD, PGDCHFWM, PGDEE, MSc., FIAPSM, FIPHA, FIMAAMS,
        Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

        Please visit for more details: http://drjugalkisho re.blogspot. com

        Exectuvie Director (Hony): Center for Inquiry, India

        President (Hony): Kishore Foundations, Sabasva Foundation,

        Authors of:
        National Health Programs of India
        A Dictionary of Public Health
        Practical and Viva of Community Medicine
        A Comprehensive Review of Community Medicine
        A Textbook of Health for Health Care workers
        Biomedical Waste Management in India
        A pioneering Social Reformers of India
        Great Warriers of Human Rights Movement From India
        Vanishing Girl Child
        Living With out God
        Bhavnayen (An anthology of poems in Hindi)

        For my books please Visit http://centurypubli cations.co. in
      • Prof. Umesh Kapil
        Dear All GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ?  Regards, Umesh Kapil ABP News  Child dies, 21 taken ill after
        Message 4 of 6 , Jul 19, 2013
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          Dear All

          GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ? 

          Regards, Umesh Kapil




          ABP News 

          Child dies, 21 taken ill after taking Vitamin A tablet
          SharePrintE-mail
          Press Trust of India
          File pic








          Gaya (Bihar): After midday meal tragedies in Chhapra and Madhubani, one child died and 21 other children fell ill after taking vitamin A tablets given to them at an anganwadi centre in Gaya district on Wednesday.
          The tablets were given to children, aged between 8 -12, by the anganwadi centre at Kumbharan Bigha village under Atri police station, District Magistrate Bala Murugan D said.
          Altogether 22 children out of 36 who were given the tablet fell ill and were taken to Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) here.
          One of them, identified as Roshan Kumar (10), died during treatment in ANMMCH, the DM said adding others were discharged from the hospital late this evening.
          The family of the deceased would be paid a compensation of Rs 1.50 lakh.
          Civil Surgeon of Gaya has gone to the village to look into the incident. 

           
          Dr. Umesh Kapil 
          Professor Public Health Nutrition 
          Room Number 118; 
          Human Nutrition Unit,
          Old OT Block,
          All India Institute of Medical Sciences 
          New Delhi,  India ,110029
          Mobile 91-9810609340

           
           


          From: Jugal Kishore <drjugalkishore@...>
          To: iapsm_youthmembers@yahoogroups.com
          Sent: Wednesday, July 21, 2010 6:07 AM
          Subject: Re: [iapsm_youthmembers] Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages

           
          Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then making the statement at this point of time is just washing their hands from the damage they have incured.


           
          On Wed, Jul 21, 2010 at 10:56 AM, Omesh Bharti <bhartiomesh@ yahoo.com> wrote:
           
          [Attachment(s) from Omesh Bharti included below]
          Dear Friends,
                                As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
           
          Thanks,

          Dr. Omesh Kumar Bharti
          M.B.B.S.,D.H. M.,M.A.E. (Epidemiology)
          Directorate of Health Safety and Regulation,
          SHIMLA, Himachal Pradesh, India.
          +91-9418120302
           

          --- On Wed, 21/7/10, drbabukv <drbabukv@gmail. com> wrote:

          From: drbabukv <drbabukv@gmail. com>
          Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
          To: fourth-estate- critique@ googlegroups. com, growingknowledge@ googlegroups. com, "Omesh Bharti" <bhartiomesh@ yahoo.com>, madhukairali@ gmail.com, "Madhavi Yennapu" <y_madhavi01@ hotmail.com>, sajukr@gmail. com
          Date: Wednesday, 21 July, 2010, 2:01 PM



          ---------- Forwarded message ----------
          From: drbabukv <drbabukv@gmail. com>
          Date: Tue, Jul 20, 2010 at 8:34 PM
          Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
          To: 1977nishad@gmail. com, basanth67@gmail. com, jk_narikkutty@ yahoo.com, Saikiran K P <kpsaikiran@hotmail. com>, "oc.mohanraj" <oc.mohanraj@ gmail.com>, Brinda Karat <brinda@cpim. org>, bajji01@gmail. com


          Pl see the attachments





          --
          Prof. Jugal Kishore
          MBBS, MD, PGDCHFWM, PGDEE, MSc., FIAPSM, FIPHA, FIMAAMS,
          Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

          Please visit for more details: http://drjugalkisho re.blogspot. com

          Exectuvie Director (Hony): Center for Inquiry, India

          President (Hony): Kishore Foundations, Sabasva Foundation,

          Authors of:
          National Health Programs of India
          A Dictionary of Public Health
          Practical and Viva of Community Medicine
          A Comprehensive Review of Community Medicine
          A Textbook of Health for Health Care workers
          Biomedical Waste Management in India
          A pioneering Social Reformers of India
          Great Warriers of Human Rights Movement From India
          Vanishing Girl Child
          Living With out God
          Bhavnayen (An anthology of poems in Hindi)

          For my books please Visit http://centurypubli cations.co. in


        • Prof. Umesh Kapil
            Dear All GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ?  Regards, Umesh Kapil ABP News  Child dies, 21 taken ill
          Message 5 of 6 , Jul 19, 2013
          View Source
          • 0 Attachment
             

            Dear All

            GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ? 

            Regards, Umesh Kapil




            ABP News 

            Child dies, 21 taken ill after taking Vitamin A tablet
            SharePrintE-mail
            Press Trust of India
            File pic








            Gaya (Bihar): After midday meal tragedies in Chhapra and Madhubani, one child died and 21 other children fell ill after taking vitamin A tablets given to them at an anganwadi centre in Gaya district on Wednesday.
            The tablets were given to children, aged between 8 -12, by the anganwadi centre at Kumbharan Bigha village under Atri police station, District Magistrate Bala Murugan D said.
            Altogether 22 children out of 36 who were given the tablet fell ill and were taken to Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) here.
            One of them, identified as Roshan Kumar (10), died during treatment in ANMMCH, the DM said adding others were discharged from the hospital late this evening.
            The family of the deceased would be paid a compensation of Rs 1.50 lakh.
            Civil Surgeon of Gaya has gone to the village to look into the incident. 

            Dr. Umesh Kapil 
            Professor Public Health Nutrition 
            Room Number 118; 
            Human Nutrition Unit,
            Old OT Block,
            All India Institute of Medical Sciences 
            New Delhi,  India ,110029
            Mobile 91-9810609340

             
             


            From: Jugal Kishore <drjugalkishore@...>
            To: iapsm_youthmembers@yahoogroups.com
            Sent: Wednesday, July 21, 2010 6:07 AM
            Subject: Re: [iapsm_youthmembers] Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages

             
            Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then making the statement at this point of time is just washing their hands from the damage they have incured.


             
            On Wed, Jul 21, 2010 at 10:56 AM, Omesh Bharti <bhartiomesh@ yahoo.com> wrote:
             
            [Attachment(s) from Omesh Bharti included below]
            Dear Friends,
                                  As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
             
            Thanks,

            Dr. Omesh Kumar Bharti
            M.B.B.S.,D.H. M.,M.A.E. (Epidemiology)
            Directorate of Health Safety and Regulation,
            SHIMLA, Himachal Pradesh, India.
            +91-9418120302
             

            --- On Wed, 21/7/10, drbabukv <drbabukv@gmail. com> wrote:

            From: drbabukv <drbabukv@gmail. com>
            Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
            To: fourth-estate- critique@ googlegroups. com, growingknowledge@ googlegroups. com, "Omesh Bharti" <bhartiomesh@ yahoo.com>, madhukairali@ gmail.com, "Madhavi Yennapu" <y_madhavi01@ hotmail.com>, sajukr@gmail. com
            Date: Wednesday, 21 July, 2010, 2:01 PM



            ---------- Forwarded message ----------
            From: drbabukv <drbabukv@gmail. com>
            Date: Tue, Jul 20, 2010 at 8:34 PM
            Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
            To: 1977nishad@gmail. com, basanth67@gmail. com, jk_narikkutty@ yahoo.com, Saikiran K P <kpsaikiran@hotmail. com>, "oc.mohanraj" <oc.mohanraj@ gmail.com>, Brinda Karat <brinda@cpim. org>, bajji01@gmail. com


            Pl see the attachments





            --
            Prof. Jugal Kishore
            MBBS, MD, PGDCHFWM, PGDEE, MSc., FIAPSM, FIPHA, FIMAAMS,
            Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

            Please visit for more details: http://drjugalkisho re.blogspot. com

            Exectuvie Director (Hony): Center for Inquiry, India

            President (Hony): Kishore Foundations, Sabasva Foundation,

            Authors of:
            National Health Programs of India
            A Dictionary of Public Health
            Practical and Viva of Community Medicine
            A Comprehensive Review of Community Medicine
            A Textbook of Health for Health Care workers
            Biomedical Waste Management in India
            A pioneering Social Reformers of India
            Great Warriers of Human Rights Movement From India
            Vanishing Girl Child
            Living With out God
            Bhavnayen (An anthology of poems in Hindi)

            For my books please Visit http://centurypubli cations.co. in


          • Prof. Umesh Kapil
            The Nutrition Challenge: Can evidence and conflict of interests go hand in hand? Arun Gupta Share on facebookShare on twitterShare on linkedinMore Sharing
            Message 6 of 6 , Jul 19, 2013
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              The Nutrition Challenge: Can evidence and conflict of interests go hand in hand?
              Jul 17, 2013
              'Manipulation by association’ seems to be a clever strategy used by the private sector in marketing, 

              In an unprecedented gesture of advocacy on nutrition, the Lancet , a scientific and academic journal, launched its Series on Nutrition in London and Delhi in June 2013. Ten  “evidence” based nutrition specific interventions are recommended, eight of which are products. It has a chapter on nutrition sensitive interventions and another on “The politics of reducing malnutrition: building commitment and accelerating progress”.
              An Indian expert group shot a letter to the Government of India and Minister Jairam Ramesh who was to inaugurate. They challenged the academic excellence and power of evidence and pointed out that authors of Lancet Series had conflict of interest.
              This statement was widely quoted in the media before and after the launch.
              Priority in Lancet
              The Lancet authors have done an exercise to estimate total additional annual cost of achieving 90% coverage with ten nutrition interventions, in 34 countries with more than 90% of the burden of malnutrition. It comes to about 9.6 billion dollars and large part of this is expected to be spent on nutrition products. It is recommended that priority should be given to management of ‘severe and moderate acute malnutrition’ (SAM and MAM) as these can prevent highest number of under five deaths. As per the indications in Lancet, most children suffering from SAM would be expected to consume Ready to Use Therapeutic Foods (RUTFs), almost at a unit cost of US $ 220. In fact out of 9.6 billion dollars projected, 27% i.e. about 2.6 billion dollars has been estimated to be spent on SAM management. This was challenged and so was the use of multiple micronutrient powders.
              What went wrong? The science behind it, and conflict of interest
              An Indian professor of pediatrics Prof. Vinod Paul at AIIMS, who was among the panel of experts at the launch, said in no uncertain words, “4 out of 10 recommendations will not work in India”. He shared that an independent and transparent exercise involving over 60 Indian scientists and policy makers, had rejected four Key Interventions (mega-dose Vitamin A supplementation, preventive zinc supplementation, multiple micronutrient supplementation in pregnancy and management of MAM).
              At the same time two new systematic reviews by the Cochrane Collaboration appeared on the scene and provided solid arguments to challenge the evidence presented in Lancet. Cochrane is recognized as the international benchmark for evaluating the effectiveness of health interventions. In the first analysis of Ready to Use Therapeutic Foods (RUTFs) for the home treatment of children with Severe Acute Malnutrition (SAM), the Cochrane authors conclude "Current evidence is limited and, therefore, we cannot conclude that there is a difference between RUTF and flour porridge as home treatment for severely malnourished children, or between RUTF given in different daily amounts or with different ingredients. Either RUTF or standard diet such as flour porridge can be used to treat severely malnourished children at home. Decisions should be based on availability, cost and practicality. In order to determine the effects of RUTF, more high-quality studies are needed".
              In this context I do want to let the readers know that India was under tremendous pressure from the UNICEF and others in 2009 to use commercial RUTF for SAM. After this Government of India did constitutes a committee to undertake local research and results should be made available in 1-2 years.
              The second Cochrane analysis reveals that giving Lipid-based nutrient supplements (LNS) does not reduce progression from Moderate Acute Malnutrition (MAM) to SAM and has no impact on child mortality. Whatever benefit emerged from the studies on MAM was in the form of weight gain (which was not as lean body mass- the muscle mass), and higher rates of recovery; however, a significant proportion of recovered infants and children relapse into MAM within six months. It also takes note that no research was done to compare commercial with home-made foods and continued breastfeeding – the most sustainable approach to reducing the burden of child malnutrition.
              What do you do when you have such an influential journal on one side and other experts have an opposing view? If we believe the Cochrane and Indian experts views to be right, you have to ignore Lancet. Treating SAM and MAM finds a high value in saving under five child deaths in the Lancet without convincing evidence. Going by the calls to spend as much as 27% on SAM management then is questionable. The authors later denied that they are for commercial RUTF products; they recommend local foods with good quality. However, costing is done with RUTF use. 
              Conflict of interest
              Conflict of interest weakened the power of evidence. The Lancet seems to have ignored the fact that many of the authors or advisors have a perceived or declared conflict of interest. The lead author and one more have declared that they sit on the ‘Nestlé’s Shared Value Advisory Committee’. I believe, if any one is a member of this committee of world’s largest baby food manufacturer he or she subscribes to the viewpoint of the company. It is not about financial transactions or paid positions. It is about “association”. ‘Manipulation by association’ seems to be a clever strategy used by the private sector in marketing. How do people interpret such associations?
              While I appreciate Lancets role in advocacy on nutrition, I wonder what consideration was given to the public perception that a lead author is a member of a board created by the world’s largest food company that violates internationally agreed recommendations and laws on a routine systematic basis. This is not history – these violations continue.
              The industry front organisation Global Alliance for Improved Nutrition (GAIN) is an advisor. GAIN's stated objective is to benefit the 600 odd industries in order to reduce malnutrition with a focus on fortification. Did Lancet look at the conflict of in this case? GAIN is a significant player in the infant and young child nutrition world that lobbies governments and the UN to open up markets for its many corporate partners. Issues around GAIN have been raised since 2008 in India. In India GAIN briefed a group of MPs, and within few weeks a private members Bill on fortification was introduced.
              In January 2013 GAIN was refused accreditation by WHO as an NGO pending answers about “the nature and extent of the Alliance’s links with the global food industry, and the position of the Alliance with regard to its support and advocacy of WHO’s nutrition policies, including infant feeding and marketing of complementary foods”
              Lets have a look at the organisers in India launch in the context of conflicting interests. Event in India was co-sponsored by Coalition of Nutrition Security that has never set its rules to avoid conflict of interests (personal experience) and it has GAIN as its members. It is hosted by ‘Save the Children India’ who receive funding from many including Pepsi. Another organiser was IFPRI, who had organised an international event in 2011 on nutrition and agriculture funded by Gates foundation and Pepsi. This is what Pepsi representative said to Times Of India at that time, “We would need market based solutions that will leverage the capabilities of food companies like PepsiCo that have competencies across the value chain ranging from agriculture, processing and mass distribution.''
              Is it about private sector or science?
              I think this Lancet series is quite an example of promotion of private sector. The Paper 4 “The politics of reducing malnutrition: building commitment and accelerating progress,” suggests that the private sector is called upon for the “Generation of evidence about the positive and negative effects of private sector and market-led approaches to nutrition.” This provides no clarity on how the private sector should be involved but suggests that new forms of Public Private Partnerships should be found. The Scaling up Nutrition movement (SUN) is presented as a viable alternative to a fragmented nutrition system. Yet SUN has food industries and GAIN on its lead body and promotes the creation of multi-stakeholder platforms at national level with a  ‘business network’ as an integral part. The authors agreed when asked a question about SUN’s promotion but deny that they promote any product or industry.
              There are more pointers to promote or take a soft view of private sector and its role in tackling nutrition. The impression is given that a big opportunity would be lost if we failed to engage with private sector. Another Lancet article in February 2013 in fact points the opposite concluding, “Despite the common reliance on industry self-regulation and public—private partnerships, there is no evidence of their effectiveness or safety. Public regulation and market intervention are the only evidence-based mechanisms to prevent harm caused by the unhealthy commodity industries”
              Private sector is known to call for friendly legislations. It is worth mentioning here that India faced a tough call in 2005, when a call to repeal one of its progressive legislations Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, and Amendment Act 2003 was proposed to be repealed and it took many months to un do that decision.
              The World Health Assembly has been repeatedly calling for the application of clear conflict of interest rules since 1996, so that private commercial entities are not allowed undue influence over policymaking. But private sector continues relentlessly to defeat this agreed intent. Furthermore, the Supreme Court of India recently observed that while scientific panels can consult with industries, the members of the panels must be independent and conflict of interest free.
              In the interest of translating evidence into policy – rather than policy driven evidence - and maintaining the credibility of science, I think the Lancet could have seen this conflict of interest more effectively. Declaration is not enough. If that is enough, readers have their interpretations presented here. It is a call for revisiting existing policies in academic journals.
              Laudable work of the Lancet, with its important implications for public health, should not be allowed to tainted with the suspicion of its authors and their conflict of interest.
              Arun Gupta is Member, Indian Prime Ministers’ Council on India’s Nutrition Challenges and Convener, Alliance Against Conflict of Interests(AACI).
               
              Dr. Umesh Kapil 
              Professor Public Health Nutrition 
              Room Number 118; 
              Human Nutrition Unit,
              Old OT Block,
              All India Institute of Medical Sciences 
              New Delhi,  India ,110029
              Mobile 91-9810609340

               
               


              From: Prof. Umesh Kapil <umeshkapil@...>
              To: "iapsm_youthmembers@yahoogroups.com" <iapsm_youthmembers@yahoogroups.com>
              Sent: Friday, July 19, 2013 12:18 AM
              Subject: Re: [iapsm_youthmembers] Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages

               

              Dear All

              GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ? 

              Regards, Umesh Kapil




              ABP News 

              Child dies, 21 taken ill after taking Vitamin A tablet
              SharePrintE-mail
              Press Trust of India
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              Gaya (Bihar): After midday meal tragedies in Chhapra and Madhubani, one child died and 21 other children fell ill after taking vitamin A tablets given to them at an anganwadi centre in Gaya district on Wednesday.
              The tablets were given to children, aged between 8 -12, by the anganwadi centre at Kumbharan Bigha village under Atri police station, District Magistrate Bala Murugan D said.
              Altogether 22 children out of 36 who were given the tablet fell ill and were taken to Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) here.
              One of them, identified as Roshan Kumar (10), died during treatment in ANMMCH, the DM said adding others were discharged from the hospital late this evening.
              The family of the deceased would be paid a compensation of Rs 1.50 lakh.
              Civil Surgeon of Gaya has gone to the village to look into the incident. 

               
              Dr. Umesh Kapil 
              Professor Public Health Nutrition 
              Room Number 118; 
              Human Nutrition Unit,
              Old OT Block,
              All India Institute of Medical Sciences 
              New Delhi,  India ,110029
              Mobile 91-9810609340

               
               


              From: Jugal Kishore <drjugalkishore@...>
              To: iapsm_youthmembers@yahoogroups.com
              Sent: Wednesday, July 21, 2010 6:07 AM
              Subject: Re: [iapsm_youthmembers] Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages

               
              Then why they were silent so long when it was appearing in newpapers and various channels. Now government is in favor and seeing the futility of closure then making the statement at this point of time is just washing their hands from the damage they have incured.


               
              On Wed, Jul 21, 2010 at 10:56 AM, Omesh Bharti <bhartiomesh@ yahoo.com> wrote:
               
              [Attachment(s) from Omesh Bharti included below]
              Dear Friends,
                                    As the enclosed report specifies that WHO never said for the closure of the public sector Vaccine units, we must look for the traitors who were hand in glove with private vaccine manufacturers to force closure of the vaccine units in government sector in India.
               
              Thanks,

              Dr. Omesh Kumar Bharti
              M.B.B.S.,D.H. M.,M.A.E. (Epidemiology)
              Directorate of Health Safety and Regulation,
              SHIMLA, Himachal Pradesh, India.
              +91-9418120302
               

              --- On Wed, 21/7/10, drbabukv <drbabukv@gmail. com> wrote:

              From: drbabukv <drbabukv@gmail. com>
              Subject: Fwd: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
              To: fourth-estate- critique@ googlegroups. com, growingknowledge@ googlegroups. com, "Omesh Bharti" <bhartiomesh@ yahoo.com>, madhukairali@ gmail.com, "Madhavi Yennapu" <y_madhavi01@ hotmail.com>, sajukr@gmail. com
              Date: Wednesday, 21 July, 2010, 2:01 PM



              ---------- Forwarded message ----------
              From: drbabukv <drbabukv@gmail. com>
              Date: Tue, Jul 20, 2010 at 8:34 PM
              Subject: Javid chowdhary Report -WHO never ordered the closure of Vaccine PSU's-Relevant pages
              To: 1977nishad@gmail. com, basanth67@gmail. com, jk_narikkutty@ yahoo.com, Saikiran K P <kpsaikiran@hotmail. com>, "oc.mohanraj" <oc.mohanraj@ gmail.com>, Brinda Karat <brinda@cpim. org>, bajji01@gmail. com


              Pl see the attachments





              --
              Prof. Jugal Kishore
              MBBS, MD, PGDCHFWM, PGDEE, MSc., FIAPSM, FIPHA, FIMAAMS,
              Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

              Please visit for more details: http://drjugalkisho re.blogspot. com

              Exectuvie Director (Hony): Center for Inquiry, India

              President (Hony): Kishore Foundations, Sabasva Foundation,

              Authors of:
              National Health Programs of India
              A Dictionary of Public Health
              Practical and Viva of Community Medicine
              A Comprehensive Review of Community Medicine
              A Textbook of Health for Health Care workers
              Biomedical Waste Management in India
              A pioneering Social Reformers of India
              Great Warriers of Human Rights Movement From India
              Vanishing Girl Child
              Living With out God
              Bhavnayen (An anthology of poems in Hindi)

              For my books please Visit http://centurypubli cations.co. in




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