The powerful Public Health Foundation of India or PHFI is packed with corporate luminaries and India’s most powerful bureaucrats, international academics, Nobel prize winner Amartya Sen and global NGOs to enhance its credibility. But instead of being a shining example of smart policy making in the crucial healthcare segment, why does it appear dodgy about facts and economical with the truth?
Wrong facts, false information, changing descriptors (sometimes as an autonomous body, at others a public-private-partnership) in official communications—make for a rather dubious image for the powerful Public Health Foundation of India (PHFI). How and why is the government indulging in this obfuscation? Let’s look at more ways in which PHFI seems to be pulling the wool over the public’s eyes.
For starters, the government told Parliament and a parliamentary panel that PHFI would limit itself to public health education and, at the most, some research work that can be put to use in policy making. Specifically, it said, “…this experiment will be confined to the area of public (medical) education only”. But very swiftly, PHFI was turned into a virtual government body. It has been allowed to participate directly and widely in policy formulation, win very lucrative public procurement contracts without any competitive bidding, and even receive aid as part of the health-related agreements that the Centre signs with the foreign governments.
* PHFI acted as a secretariat for the High-Level Expert Group on Universal Health Coverage, chaired by its president Srinath Reddy at public cost. The report of this group is meant to be a blueprint for national health policy for many years to come.
* PHFI was chosen without any competitive bidding as technical partner in the National Initiative for Allied Health Services (NIAHS), an Rs1,100 crore project of the health ministry for expanding paramedical capacity. (The list of handsomely paid central and state projects that it has bagged is too long to be documented here.)
* PHFI received hefty funding from the Norwegian government as part of the Norway India Partnership Initiative (NIPI) for reduction of child mortality in five states.
Private body in public garb
The parliamentary panel was also given an exaggerated sense of government’s ability and intent to influence decision-making at the PHFI. It transpires that the government has never had any significant power—or even the intention—to influence any decision at PHFI. In fact, it does not have direct power to even convene a meeting.
PHFI’s rules limit the number of government representatives on the board and also give non-government members (read Big Business) the super-majority to decide who would be recognized as a “government representative”. For instance, “MS Ahluwalia is a member of the PHFI board as MS Ahluwalia, not as deputy chairman of the Planning Commission,” a counsel for PHFI informed the Central Information Commission (CIC) on 24th January at a hearing that this writer attended.
This is a new record of pushing powerful public servants into powerful bodies by inducting them in their “individual capacity”. It opens the doors to lawlessness and corruption and creates a situation, which the CIC termed as “untenable”.
“It is difficult to assume that senior public servants can be on the board of an organization like PHFI, which has numerous interactions with the government, in private capacity. In fact, this would necessarily imply a conflict of interest. The Commission can only assume that such public servants must necessarily be acting on behalf of the government, when they are required to take executive decisions as members of the board… Any other conclusion would be an improper slur on their integrity,” the CIC wrote in its decision of 14 February. This “improper slur on their integrity” was, nevertheless, written into the rules of PHFI with the connivance of the “senior public servants” themselves.
The government’s covert and overt support to PHFI has been deliberately obfuscated from the very beginning. In February 2006, Srinath Reddy, then head of the cardiology department at AIIMS, and RA Mashelkar, then secretary-DSIR, were encouraged to team up with Rajat Gupta, his two McKinsey colleagues and two corporate lawyers to register PHFI as a society. The Central Civil Services (conduct) Rules, 1964, don’t allow a government employee to form an organization that will replicate or resemble the work of his parent organization on a significant scale and explicitly prohibit him from soliciting funds.
Information obtained through RTI shows that Dr Reddy’s ‘deputation’ from AIIMS to PHFI —effected by a ministerial fiat—was irregular and arbitrary. The AIIMS rules do not allow any such deputation, nor was the proposal was ever placed before AIIMS governing body. Dr Reddy is currently drawing a salary of Rs 60lakh a year and has been provided bungalow accommodation for this job of improving public health and public finances. In fact, ‘deputations’ of all government employees to PHFI can only be regarded as illegal because PHFI does not fit the description of any organization to which rules would allow public servants to be seconded.
Information released by DSIR pursuant to an RTI query shows that it hastily certified PHFI as a Scientific and Industrial Research Organization (SIRO) without any worthwhile record of research work or visiting its facilities. Similarly, PHFI’s public health management courses have no recognition or accreditation from any statutory regulator in the country. This clearly raises several queries.
Whys and the wherefores
(a) Why would the government deceptively empower what is essentially a private club to make crucial decisions in the sensitive area of public health policy concerning a billion plus people?
(b) If the government really wanted a PPP to take care of India’s public health policy and administration, why didn’t it first create policy framework for its operation?
(c) Why did the government lavish vast public resources on an organization without demanding control, accountability and public audit?
(d) Why would the government parcel out the ability to influence public policy to chosen individuals based on their influence, connections, or ability to pay?
(e) Why would the government choose not to have the power to influence decision-making at PHFI (which is packed with big private business houses), when is contrary to notoriety acquired by our bureaucrats for never giving up power?
(f) How has the government addressed the possible conflict of Big Business on PHFI who have an incredible opportunity to further their interest?
g) A look at PHFI’s super powerful board of director will explain why the lack of clarity and transparency is so worrying. The board comprises NR Narayana Murthy, Dr Montek Singh Ahluwalia, Ashok Alexander from the Bill and Melinda Gates Foundation, Ms Mirai Chatterjee- SEWA, Dr Lincoln Chen-Global Equity Center, Harvard’s Kennedy School, Dr James W Curran- Dean, Rollins School of Public Health, Emory University, Dr Gary Darmstadt- Director, Bill & Melinda Gates Foundation, Dr Timothy G Evans-Dean, James P Grant School of Public Health, Bangladesh, Dr Vishwa Mohan Katoch-Director General, Indian Council of Medical Research, Uday Nabha Khemka -Vice Chairman, Sun Group, Gautam Kumra -Director, McKinsey & Company, Dr David Lynn-Director, Strategic Planning & Policy Wellcome Trust, Ms Kiran Malhotra-chairperson, AKM Systems Pvt Ltd, Dr Raghunath A Mashelkar-CSIR Bhatnagar Fellow, National Chemical Laboratory, Mr Raj Mitta-Chairman, Essential Value Associates Pvt Ltd, Mr Shiv Nadar -Founder, HCL, TKA Nair-Advisor, Prime Minister's Office, Dr Ravi Narayan -community health advisor, SOCHARA, Dr Peter Piot-director, London School of Hygiene & Tropical Medicine, PK Pradhan -Secretary, Ministry of Health, Dr Jagdish Prasad -Director General of Health Services, Ministry of Health, JVR Prasada Rao, UNAIDS India, Prof K Srinath Reddy -President, Public Health Foundation of India, Dr Y Venugopal Reddy-Former Governor, Reserve Bank of India, Dr Anil Seal-Director, Cambridge Commonwealth Trust, Dr Amartya Sen-Professor of Economics & Philosophy, Department of Economics, Harvard University, Dr Jaime Sepulveda-Executive Director, Global Health Sciences, University of California, Dr AK Shiva Kumar -Advisor, UNICEF, Mr Michel Sidibé -Executive Director, UNAIDS, Mr Harpal Singh-chairman, Fortis Healthcare (India) Ltd
These questions need to be answered in public interest by PHFI’s eminent board. The writer has written several letters of complaint to at least a dozen members of PHFI’s governing body, including Nair, Ahluwalia, PK Pradhan (Secretary Health), Amartya Sen and Mirai Chatterjee, but has not yet received acknowledgement from any of them.
This is the concluding part of a two-part series.
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(The writer is a Delhi-based freelance journalist who has written about PHFI in the past. He will have much more to say on the topic in the coming days. He has since made his formal complaint about forgery, in the form of first RTI appeal to PHFI.)