PHA-Exchange> Polio and OPV in India : a dead end street? (2)

[Claudio]

From: "g_upham" <g_upham at club-internet.fr>

Comments from a "VAPP" old survivor (i.e. someone who got over 85%% 
paralysis, in four limbs, from a polio vaccine in the  'rich' country of 
Switzerland)
The argument presente is a mixture of sound and unsound arguments. I say 
that as a friendly debate.
1) TRUE: TB is more a priority than polio, India has had high rates of multi 
drug resistant TB and now "Extreme DR TB" that cannot be treated as in South 
Africa.
2) UNTRUE: a priory assumption that money is available in fixed quantities, 
and budgeting people are 'forced' to allocate this limited quantity among 
different priorities in a form of triage. This is bad economics, this is IMF 
accounting. Look at one of the 'poorest' countries on earth in terms of 
economic output: Cuba. They have less than 0.5% HIV rates and neighbouring 
Caribbean islands have rates of up to 35%... The question is one of emphasis 
in economic thinking. Stop thinking of 'money'.  I am just saying that money 
and credit does not exist in 'fixed' quantities to do things, except when 
the IMF puts conditions to the people as in Africa.
What is needed is for people to demand good TB, and good polio control, and 
primary health care for all, for anyone who needs it. We should reject 
triage on a monetary basis. YES we should increase budgets, but more than 
that, we need to START from PEOPLE's NEEDS, and then figure out the 
technical and human resources expenditures we need for the task. Not the 
other way around.  Take any country in the world, the state of health of the 
population is proportional to the quality and equitable nature of its PUBLIC 
health system.
3) UNTRUE: polio went down with economic improvement in the West in the 50s: 
not true; it went down with vaccination, there is no doubt about that. 
Epidemics were terrible in Switzerland after the war, and they did not come 
down at all until AFTER vaccination came, and it came internationally 
because of a POPULAR movement for the kids, not from a technocratic 
decision- that is why we need a mass-based popular movement for the Right to 
health today.
4) DANGEROUS: the proposal to shift to injectable vaccination: NOT until 
India has cleaned up its act in terms of dirty injections and UN agencies 
have become more responsible in this. The INCLEN study of injection safety 
in India shows over HALF of all INJECTIONS FOR CARE IN INDIA every year ARE 
DIRTY. Today these injections are spreading HIV and Hepatitis. Recent 
studies indicate that the risk of contracting HIV from a needle can be as 
high as 10%. (study examining iatrogenic outbreak of the past few years). 
BUT I agree: INDIA should clean up its dangerous practices IN THE NEXT FEW 
MONTHS, and restore decent infection control in hospitals to stop XDR TB 
spread in health care settings (as in South Africa's outbreak).
5) Last but not least, VAPP need not monetary compensation, but decent 
rehabilitation services, physiotherapy, access to school and jobs.
Because the pharma industry dominates research, for any neuromuscular 
diseases there are about 400 drugs trials on new stuff for physiotherapy: 20 
studies only.
Those of us lucky enough for have full access to physio, ressources, and 
creative thinking, recovered to the extent of being able to lead a full 
productive life... and 40 years of walking with no braces, even with 
'hopeless' 90% paralysis to start with. I only got into a bit of trouble at 
53.
I was a lucky one, but if I could 'manage' like that being a hopeless case, 
then it is murderous not to assist polio people today... Again, if people 
and science came first instead of short term profit and Malthusian thinking, 
this planet would be wonderfull for everyone. That's my dream.
Garance