Jan Vishwas Bill: A prescription for disaster

Vishwas is the Hindi word for trust. Since the pandemic years, that term ‘trust’ has been wielded like a magic wand to quell misgivings. Remember that famous phrase “Trust the science”, propagated by Dr Anthony Fauci? The catchy phrase defined ‘science’ as he and his acolytes desired. All those with alternative views were dubbed conspiracy theorists spreading misinformation. Disagreement and debate, so essential for science, were suppressed. Science degenerated into dogma.

The world blindly followed the US, which blindly followed Fauci. In spite of violating all scientific principles, he arrogantly implied that if you attacked him, you were attacking science. Albert Einstein had cautioned, “Unthinking respect for authority is the greatest enemy of truth.” Anthony Fauci’s aura ensured he went unchallenged. He was human, after all. Having no critics to make him strong, he became complacent and made errors of judgment. Humanity suffered and posterity will not judge him kindly.

Closer home, we are facing a similar predicament—in science, and in politics as well. Science today is dictated more by politics than by scientific principles. Like Fauci, the leaders of the ruling political party, after winning two terms in a row and eyeing a hattrick, do not welcome criticism. While Fauci proclaimed that if you attacked him, you attacked science, these complacent leaders and their blind followers would have you think that if you criticise them, you undermine national interest.

Kamran Abbasi, in a hard-hitting editorial in the British Medical Journal, wrote, ‘When good science is suppressed by the medical–political complex, people die.’ Are we poised for just such a betrayal of innocent people by the Jan Vishwas Bill, passed by both the Lok Sabha and the Rajya Sabha without any real discussion or debate?

The Lok Sabha on 29 July 2023 and the Rajya Sabha on 2 August passed the Jan Vishwas (Amendment of Provisions) Bill. The bill was introduced in December 2022 and referred to a Joint Parliamentary Committee for review. It essentially decriminalises 183 provisions in 42 laws, ostensibly in order to promote ‘ease of doing business’ in the country.

An amendment in the Drugs and Cosmetics Act, 1940, proposed in the Jan Vishwas Bill has a provision of ‘compounding’ for some offences, i.e., paying a fine instead of facing imprisonment. The bill amends Section 27 (d) of the Drugs and Cosmetics Act, 1940. This allows for ‘compounding’ of offences that can be compromised and where the complainant can agree to take back the charges. Non-compoundable offences are more serious, where there can be no compromise. Small mercies!

On the face of it, it is aligned with the catchphrase ‘minimum government, maximum governance’, which is supposed to make India a preferred country for the pharmaceutical industry. Whether this will compromise the safety and health of the people is a worry. In the race to become the pharmacy of the world, will quality suffer?

Dinesh Thakur, author of The Truth Pill, which created quite a flutter, tweeted, “The Lok Sabha passed the Jan Vishwas Bill 2023 with little debate. This bill fulfils a longstanding wishlist of the industry that if you suffer bodily harm from substandard medicine, no one will be held punitively accountable.”

Member of Parliament Asaduddin Owaisi also expressed concerns: “When we buy a medicine, we assume the government has verified that it will work and it won’t harm us. But the proposed amendment will now reduce punishments for medicines that are not of standard quality. It benefits big business but harms all of us. Very dangerous.”

In isolation, the Jan Vishwas Act amendment compromising on punitive action for substandard drugs is serious enough. Taken in a larger context of subtle but cumulative tinkering with the goalposts of public health at a population level, the issue becomes sinister.

The Union health ministry and the department of biotechnology are considering requests from certain quarters which, if accepted, will dilute norms for biosimilars (a drug which is similar to another approved biological product) entering the market. These relaxations, in an attempt to make medicines affordable, will also compromise patient safety.

Science also took a back seat to politics and commercial interests when the government rolled out fortified rice under the Public Distribution System (PDS), without any scientific evidence of its role in eliminating anaemia and other deficiency disorders. To make matters worse, iron fortification of rice can in fact harm certain groups of people.

Going one step further now, to eliminate any future evidence of its failure (if any) to eliminate anaemia, the government has decided to drop this parameter from future National Health Surveys. Meanwhile, a recent Lancet report just told us, yet again, as to how badly anaemic we all are, especially women and children.

The National Family Health Surveys (NFHSs) are large-scale, multi-round surveys conducted through representative sampling of households throughout India. They collect vital information on the health status of the population.

The last survey, NFHS-5, had revealed that over 57 per cent of women and 67 per cent of the children suffer from anemia in our country. The government, in an unholy haste, introduced iron-fortified rice to eliminate anaemia, without having any sound evidence of its impact. Removing the question of anaemia from the NFHS now, meanwhile, will deprive us of any tool to measure the impact of the large-scale population rollout of iron-fortified rice at great cost to the taxpayer and huge profits to industry. It will be like launching a ship on unchartered waters without a compass. It will also make it nigh impossible to course-correct in the future, without updated data to hand.

Finally, the government eliminated the messenger of the bad news and inconvenient truths. It suspended the director of the International Institute of Population Sciences (IIPS), KS James, on some frivolous grounds. The IIPS brings out the data on the periodic NFHS surveys on population health. The government firmly seems to believe that statistics should serve the State, and never otherwise. It believes in positive data only, not inconvenient truths.

The latest survey, the NFHS-5, had brought out such inconvenient truths as India being ‘nowhere near’ open defecation-free as claimed, even by the prime minister; that 40 per cent of us did not have clean cooking fuel, putting a question mark on the Ujjwala Yojana; and also that anaemia was on the rise, while already affecting well over half of our women and children.

Amendments without any logic or science, rushed through to favour commerce and industry for political gains, will harm the people of India in the long run. This should surely be self-evident and not require further scientific study.

Surely the scientific advisors to the government should demonstrate moral courage to assert the facts and data, even if it means putting their jobs on the line? And people in power should pay more heed to their critics than to sycophantic career-minded scientists. As Napoleon Bonaparte famously said, “The people to fear are not those who disagree with you but those who disagree but are too afraid to tell you so.” If politicians in power fail to listen to criticism, history will not judge them kindly either.

DR. AMITAV BANERJEE is a professor at a medical college in Pune. He has served in the Indian armed forces as a field epidemiologist