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EDITORIALS

Fear of truth
Liberhan panel is probe in perpetuity
O
ne does not know how Justice M.S. Liberhan himself reacts to heading the country’s never-ending commission of inquiry, probing the demolition of the Babri Masjid in Ayodhya, but both the Congress and the BJP would perhaps not be displeased, considering that the attempt all along seems to have been to let the inquiry go on forever.

Deaths on the road
Traffic cops need to enforce law
The death of Punjab Cooperation Minister Capt Kanwaljit Singh in a road accident followed a day later by the deaths of two-dozen pilgrims returning from Naina Devi marks the rising incidence of road accident fatalities that have been snuffing out the lives of thousands of people with grim regularity in this region.



EARLIER STORIES



It’s all in the family
A Delhi role for Karunanidhi’s elder son
T
he decks have been cleared for the entry of Tamil Nadu Chief Minister Karunanidhi’s elder son Azhagiri into Parliament. The decision of the party to field him for the Madurai Lok Sabha seat is a clear attempt not only to catapult him to the role of party pointsman in New Delhi but also to ensure that the eventual passing of the chief ministerial mantle to Mr Karunanidhi’s younger son Stalin goes unchallenged.

ARTICLE

India-US nuclear face-off
Arms reduction no guarantee for disarmament
by G. Parthasarathy
F
or over three decades two Washington-based institutions — the Carnegie Endowment for International Peace and the Brookings Institution — have spearheaded an international campaign to compel India to “cap, roll back and eliminate” its nuclear weapons programme. It is symbolic of how times have changed following the nuclear tests of May 1998.

MIDDLE

Sydney encounters
by V.S. Chaudhri
I
n 1982, I was deputed by the government for a three-month fellowship programme to the International Training Institute, Sydney. We were about 15 from 11 countries. Two of us were from India. I was the only vegetarian in the whole lot.

OPED

Facing downturn
Negative impact on the poor
The following are excerpts from the ESCAP’s “Economic and Social Survey of Asia and the Pacific 2009”:
As the global financial crisis is still unfolding, its impact on people’s income levels and their welfare is difficult to estimate. Preliminary estimates indicate in 2009 that unemployment in Asia-Pacific could increase by 7 to 23 million workers.

Voice of moderation no more
by Gobind Thukral
T
HE hundreds of people who thronged the PGI in Chandigarh on that fateful evening of March 29 when they heard of the tragic accident involving the Akali leader and Punjab Cooperation Minister, Capt Kanwaljit Singh, and then the massive sea of humanity that bade him tearful adieu next day are a testimony of the goodwill the late leader created over the years. This might have surprised him.

Health
A cheap pill for heart attacks
by Jeremy Laurance
A pill which could prevent hundreds of thousands of deaths from heart disease, the biggest killer across the Western world, has been shown to be safe and effective in its first trials on humans.


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EDITORIALS

Fear of truth
Liberhan panel is probe in perpetuity

One does not know how Justice M.S. Liberhan himself reacts to heading the country’s never-ending commission of inquiry, probing the demolition of the Babri Masjid in Ayodhya, but both the Congress and the BJP would perhaps not be displeased, considering that the attempt all along seems to have been to let the inquiry go on forever. They have shown no urgency or interest in bringing the probe to a logical conclusion. If the BJP was directly linked with the demolition, the ugly episode took place during the Prime Ministership of Narasimha Rao, who adopted a do-nothing policy. Neither the NDA nor the UPA government has had any particular interest in its early completion. Perhaps that is one of the reasons why the single-judge panel has been suffering from the lack of demand, urgency or interest on any party’s part. With as many as 48 extensions being given to it, it has become a veritable farce which has been enacted to hoodwink the people who would like those responsible for the demolition to be punished.

It will be interesting to find out if it already qualifies to be one of the longest-running inquiries fit enough to be on the Guinness or the Limca Book of Records. To keep it going for more than 16 years, the poor public has had to shell out nearly Rs 8 crore without getting any tangible result. More than the money, what matters is the time spent. It is already way too late and it is high time it was either wound up or came to a final conclusion. It is strange that Justice Liberhan has not thought it necessary to resign from the Commission which is not able to conclude its work and has lost its meaning.

The inquiry was set up by the P. V. Narasimha Rao government 10 days after the shameful demolition of the Babri Masjid on December 6, 1992 — an event which traumatised a shocked nation. Ironically, the order setting it up had stipulated that it would complete the inquiry “as soon as possible but not later than three months” and submit its report immediately thereafter. Not just three months but 16 years have come and gone, still there are no signs of the much-trumpeted Liberhan report. The bottom line is that the passage of such a long time has reduced the inquiry into a farce, and it would be worthwhile to call a halt to it. It is too clear the BJP does not want the report to be published because it does not want the truth to come out about the role of the BJP and the Sangh Parivar in the demolition of the Babri Masjid. The Congress, whose government was in power at the Centre, is equally afraid of the truth which would have highlighted its failure to protect the mosque. It is surprising that Justice Liberhan should continue to hang on to an exercise that was undertaken mainly to hide the truth. The Commission and its work are apparently being subjected to die a slow death by all the parties concerned — the BJP, the Congress and the judge.

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Deaths on the road
Traffic cops need to enforce law

The death of Punjab Cooperation Minister Capt Kanwaljit Singh in a road accident followed a day later by the deaths of two-dozen pilgrims returning from Naina Devi marks the rising incidence of road accident fatalities that have been snuffing out the lives of thousands of people with grim regularity in this region. The road fatality statistics for the region are indeed frightening with Punjab ignominiously topping the list. In 2007 and 2008, respectively, Punjab recorded 3,363 and 3,333 deaths in over 10,000 accidents. The death toll in Haryana and Himachal Pradesh may have been less at 1,006 and 927, respectively, in 2007, but then the number of people injured in the two states was high at 2,137 and 5,021 respectively.

The rapid growth in the number of vehicles and the slow pace of both construction and widening of roads have, no doubt, contributed to a sharp rise in fatal accidents in a region (as also the country) where bullock-carts, cycles, two-wheelers, overladen trucks and high speed cars compete for space on the same stretch. The biggest killer of all is rash and fast driving by the drivers for which neither the state of the roads nor the rising number of vehicles can be blamed. Certainly, this is entirely on account of sheer carelessness, which is often compounded by the thrill for speed, consumption of alcohol and poor driving skills of drivers, who have no consideration for either their passengers or others on the road. How else does one explain a truck colliding into a tree, a bus falling off a cliff because the driver is preoccupied with changing a CD, or a driver of a minister’s luxury car ramming into a truck while negotiating a bend at 110 km per hour?

India, with just 1 per cent of the world’s vehicles, accounts for 10 per cent of the road fatalities worldwide and has the worst accident record. Indeed, everywhere in India, roads are a testimony to self-before-others culture. The government and the police, who are generally lax in enforcing traffic rules, must give priority to preventing the loss of valuable lives in mindless road accidents. They must ensure that unfit drivers are not issued licences, and speed limits and road discipline are adhered to, and traffic violators severely punished. Stern, deterrent action is what is needed to prevent deaths on the road.

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It’s all in the family
A Delhi role for Karunanidhi’s elder son

The decks have been cleared for the entry of Tamil Nadu Chief Minister Karunanidhi’s elder son Azhagiri into Parliament. The decision of the party to field him for the Madurai Lok Sabha seat is a clear attempt not only to catapult him to the role of party pointsman in New Delhi but also to ensure that the eventual passing of the chief ministerial mantle to Mr Karunanidhi’s younger son Stalin goes unchallenged. Mr Azhagiri is a power to reckon with in south Tamil Nadu and has in the past not hesitated to remonstrate with his father against favoured treatment to Mr Stalin. By sending him away to the Centre and promising him a key role there, Mr Karunanidhi is hopeful that there would be no succession battle in Chennai.

It has indeed been a while since DMK politics began revolving around the Karunanidhi family. The way things are, it would seem that it is sacrilege for anyone outside the patriarch’s family circle to aspire for the chief ministerial office or for a key role as pointsman for the party in Delhi. The irrepressible MDMK leader Vaiko was at one time in the DMK and was seen by many as a rising star in DMK politics. It is no secret that he was jettisoned because he was perceived as a threat to Stalin’s ambitions. After the last Lok Sabha elections, Mr Karunanidhi’s grandnephew, Mr Dayanidhi Maran, took on the role of pointsman in Delhi but when a newspaper published by his brother carried a survey showing Mr Azhagiri in poor light, he was sent packing and only recently rehabilitated when the latter condescended.

With the Lok Sabha elections round the corner, Mr Karunanidhi indeed has much else to worry about. The recent PMK decision to leave the DMK fold and move over to Ms Jayalalithaa’s AIADMK combined with the anti-incumbency factor may give the DMK a rough time. It is time Mr Karunanidhi shed his family obsession and put governance above all else if he is to have any chance of beating the AIADMK.

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Thought for the Day

Teach him to think for himself? Oh, my God, teach him rather to think like other people! — Mary Shelley (on her son’s education)

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ARTICLE

India-US nuclear face-off
Arms reduction no guarantee for disarmament
by G. Parthasarathy

For over three decades two Washington-based institutions — the Carnegie Endowment for International Peace and the Brookings Institution — have spearheaded an international campaign to compel India to “cap, roll back and eliminate” its nuclear weapons programme. It is symbolic of how times have changed following the nuclear tests of May 1998. The Prime Minister’s Special Envoy for Nuclear Issues and Climate Change, Mr Shyam Saran, visited Washington to proactively spell out where India stood on the issues many feared could become sources of friction with the Obama Administration, which is influenced by those popularly referred to by their Indian counterparts as the “Ayatollahs of Non-Proliferation”. More importantly, Mr Saran spelled out India’s position publicly on March 23 at the Brookings Institution.

Mr Saran did not fight shy of addressing issues like the Comprehensive Test Ban Treaty (CTBT) and the Fissile Material Cut-Off Treaty (FMCT) at the Brookings Institution. He made it clear that while India remained committed to its unilateral moratorium on nuclear testing, there were serious reservations about the CTBT because the Treaty was not “explicitly linked to nuclear disarmament” and the manner in which it was accepted was obviously meant to circumscribe Indian nuclear options. He added that while “we cannot be part of a discriminatory regime where only certain states are allowed to possess reprocessing or enrichment facilities”, we would be willing to work with the US to curb nuclear proliferation.

Welcoming President Obama’s plan to expand the “Proliferation Security Initiative” (PSI) from merely stopping illicit nuclear shipments to eliminating the remnants of organisations like the Abdul Qadeer Khan Organisation, Mr Saran signalled Indian flexibility in looking afresh at the PSI.

Another crucial issue which Mr Saran alluded to was India’s readiness to accede to an FMCT provided that it was a “multilateral, universally applicable and effectively verifiable” treaty. India has to insist on the treaty being non-discriminatory and internationally verifiable, given China’s readiness to transfer fissile material and nuclear weapons knowhow to Pakistan. But what the US is going to find it difficult to address is that despite President Obama’s stated intention “to make the goal of eliminating nuclear weapons a central element of US nuclear policies”, the American establishment is going to have serious reservations about making any commitment to eliminate their nuclear weapons within a reasonable time-frame.

All that the Americans presently appear to be ready to do is to seek agreement with Russia to reduce their strategic nuclear arsenal to around 1000 warheads. It is astonishing that between them the Americans and Russians today possess over 20,000 nuclear warheads. Moreover, for the first time, there seems to be recognition among the scholars in the US that moves towards nuclear disarmament can succeed only if the concerns of all “nuclear-armed states”, including India, Pakistan and Israel, are addressed while noting for the first time that Indian concerns about China’s nuclear weapons cannot be brushed aside.

Mr Saran spoke of India’s readiness to work with the US to set up a working group for nuclear disarmament in the UN Commission on Disarmament. But what he did not mention is the recent propensity on the part of the US, France, the United Kingdom and NATO to threaten the use of nuclear weapons against those they choose to characterise as “rogue states”. Even the Russians do not subscribe to a doctrine of no-first use and never using nuclear weapons against non-nuclear weapons states. The Chinese claims of adhering to a doctrine of no first-use are suspect, given their deployment of scores of missiles targeting India.

India needs to sensitise world opinion to the fact that refusing to rule out the use of nuclear weapons runs contrary to the historic World Court ruling of July 8, 1996, which held that the countries possessing nuclear weapons had not just have a need but an obligation to commence negotiations leading to nuclear disarmament, and that the use or the threat of use of nuclear weapons was generally contrary to the principles of international law. In fact, the least the nuclear weapons powers could do was to de-alert their nuclear missiles and separate their missiles from warheads.

The Nuclear Non-Proliferation Treaty (NPT) of 1968 was premised on its “three pillars” of non-proliferation, nuclear disarmament and the right of access of nuclear technology to its signatories. While the five “nuclear weapons powers” amassed nuclear weapons and refused to abide by any commitment not to use these weapons against those who foreswore their acquisition, they also refused to move towards nuclear disarmament and placed highly selective restrictions on the others seeking to acquire nuclear technology. The net result was that the fifth review conference of the NPT in 2005 ended in a fiasco, with divisions between those who possessed nuclear weapons and were unwilling to make any commitments on nuclear disarmament and the others refusing to go along with the violation of two of the “three pillars” of the treaty.

The US and its partners recognise that the forthcoming NPT review conference in 2010 will end in a similar fiasco unless they can claim movement forward towards a nuclear weapon-free world. Hence the feverish moves to show progress towards disarmament by agreeing to discus cuts in nuclear stockpiles with Russia. The point India has to emphasise is that arms reductions by themselves do not constitute a credible move towards disarmament unless accompanied by the guarantees of no-first use and de-alerting of nuclear delivery systems and the separation of warheads from missiles.

India has conveyed that with the estimated investments of $150 billion in nuclear power, it stands by its letter of intent for the acquisition of 10,000 MW of nuclear power reactors from the US, provided Washington fulfils its side of the bargain, recognising India as a “responsible state with advanced nuclear technology” by upfront approval of reprocessing of spent fuel for the reactors it supplies. With former Congresswoman Ellen Tauscher slated for her appointment as the State Department’s non-proliferation Czar, India can never be too careful on this score.

With Mr Saran noting that while India was scheduled to purchase around $120 billion of defence equipment, with the US entering the market in a significant manner once the concerns about the “reliability” of supplies were addressed and with growing convergence on the issues ranging from the proliferation security initiative to the FMCT, there does appear to have been sufficient groundwork done for moving matters forward in the India-US relationship after the general elections. Another important area of dialogue would be the prevention of military conflict in space and negotiations on an agreement to prohibit the testing of anti-satellite weapons. Much will depend on the political dispensation that emerges in New Delhi after the polls.

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MIDDLE

Sydney encounters
by V.S. Chaudhri

In 1982, I was deputed by the government for a three-month fellowship programme to the International Training Institute, Sydney. We were about 15 from 11 countries. Two of us were from India. I was the only vegetarian in the whole lot.

When I went to the mess in the morning on the first day, the chef tried to pour some preparation which appeared to me to be non-vegetarian in my plate. I told him that I was a vegetarian and did not take any meat. The chef looked at me with curious eyes and remarked that I could have some eggs or fish, instead.

I thanked him, and took some bread, butter, cornflakes and milk. The chef pointed out towards me and told his fellow helpers in hushed tones: “Look, here is a person who did not take any meat, fish or eggs.”

The next day when I went for breakfast, a lady in the kitchen staff treaded softly towards me and asked me very gently: “Will you please tell me as to how you grew so big without taking any meat?” I pondered for a moment, took a sip of milk and asked her if she had ever seen an elephant. She said, “yes of course; quite a number of them.” I told her that the elephant also did not take any meat and yet it was the biggest creature on earth. The maid nodded, smiled and walked away with gleaming eyes.

We, the two Indians, generally went out together in the evening after supper for a stroll and window shopping. Dollars were quite scarce as board and lodging were free and we were paid only a small daily allowance to meet sundry expenses. We did not make any major purchases and we kept a mental note of the amount spent by one on the other to be adjusted on the next opportunity.

We often stopped over at a corner shop and one of us would order two cups of coffee, tea or icecream and pay for both. The salesgirl at the counter would be surprised and ask. “Are you paying for both?” She would always greet us by waving and calling us as “two good friends from India” but she could not detect the trick that we played.

One day we were going leisurely when somebody shouted from behind: “Gentlemen, gentlemen, listen”. We stopped, looked back and found a person beckoning us. We went to him and found that he was struggling with himself. He was a little tipsy. He asked us if we could make him cross the road. We said there was no problem.

We held him by the arm and when there was no traffic, we crossed to the other side of the road. The fellow took out some dollars from his pocket and offered to us. We declined to accept. Tears rolled down his cheeks. He repeatedly said had we not helped him, he would have been crushed by some motorist. He insisted that we accompanied him to his house, which was nearby.

We obliged him. He wanted us to come inside and have some drink but we excused ourselves saying that we would call on him some other day. Ah! poor chap might be waiting for us all these years.

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OPED

Facing downturn
Negative impact on the poor

The following are excerpts from the ESCAP’s “Economic and Social Survey of Asia and the Pacific 2009”:

As the global financial crisis is still unfolding, its impact on people’s income levels and their welfare is difficult to estimate. Preliminary estimates indicate in 2009 that unemployment in Asia-Pacific could increase by 7 to 23 million workers.

In 2008, the greatest employment impact was felt in the export manufacturing sector, including garments, electronics and autos, which constitutes a large part of many East and South-East Asian economies. The crisis is also expected to hit such sectors as construction, tourism, finance, services and real estate.

The countries experiencing the greatest impact will be those with slowing economies and rapid labour force growth, such as Cambodia, Pakistan and the Philippines. Wage growth is slowing across the region – the average wage growth in real terms in 2009 is unlikely to exceed 18 per cent – and an outright wage reduction in countries with low economic growth seems inevitable.

Mere unemployment figures tend to mask the full extent of the problem. Hundreds of millions more will bear a disproportionate cost of the crisis. As the 1997 crisis showed, when people are affected by sudden shocks, the ones most at risk are the poor, women who are labourers in the manufacturing sector, the youngest and oldest populations and socially excluded groups.

Not only do these groups have fewer resources with which to cushion the impact of shocks, such as real assets and savings, but they also have less influence on economic and political decision making.

The negative impacts last much longer than the crisis itself: although economic growth resumed relatively quickly after the 1997 crisis, in some countries it took up to 10 years to recover lost ground in the struggle against poverty.

Communities or groups that have been excluded from productive resources, decent work and social security are likely to be highly vulnerable to the negative impact of the global financial crisis and to volatility in food and fuel prices.

Such groups include indigenous communities; ethnic minorities; persons with disabilities; populations displaced due to conflict, large development projects, environmental degradation or disasters; stateless people; and migrants.

In particular, many refugees and internally displaced populations depend on food assistance for their survival and generally do not have access to land for farming, employment or income generation.

During a crisis, low-skilled immigrants, especially the untrained, are among the first to be laid off because they are concentrated in vulnerable sectors, such as construction or tourism, and often hold temporary jobs. The very poor and the socially excluded as well as non-citizens are especially at risk of being exploited due to an inability to earn enough to obtain basic necessities for themselves and their families and due to their lack of access to social protection.

But even there, however, families may require greater financial assistance and care in response to rising costs. Families, and especially women, may experience the additional pressure of job insecurity on top of unpaid work, straining the capacities of households to cope.

The financial crisis could exacerbate the child labour situation. In the Asia-Pacific region, for children may have to go to work to supplement household income. As of 2004, by ILO estimates, 122 million children were economically active in the region. Children are also at risk of being withdrawn from school or not enrolled.

Where families have to pay school fees for their children, economic hardship often leaves them with no option but to keep their children out of school.

When families have to cut back on the quantity and quality of food, poorer nutrition in children can have permanent effects on intellectual capacity and cause chronic poor health, which, along with lower educational completion rates, could undermine human capital development and set back economic and social development for decades.

It is expected that men and women will be affected somewhat differently by the current financial crisis. In the Asia-Pacific region, especially with the growth of exports, many women have entered the labour market, but many of them work in export processing zones, where they may not have labour rights, or in industries which sometimes offer very low wages, poor working conditions and no job security.

Many women also work in the informal sector, which is precarious and offers no social protection. Although in many cases women have taken up paid work because male household members lost their jobs, women and girls may be seen as a burden on the family because their work may not be valued as highly as that of male household members.

In difficult times, families often rely on women to care for the sick, older persons and those who cannot fend for themselves, making it difficult for women to earn an income outside the home. Culturally, women and girls are often expected to contribute financially to the family regardless of how that money is earned.

When there are few opportunities for wage work, girls and women may end up being trafficked through the promise of a job or being lured or forced into prostitution and other forms of extreme exploitation. Men may migrate out of rural areas, leaving women as household heads and often among the most poor. In general, households in which only women earn an income and those with many dependents are the poorest.

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Voice of moderation no more
by Gobind Thukral

THE hundreds of people who thronged the PGI in Chandigarh on that fateful evening of March 29 when they heard of the tragic accident involving the Akali leader and Punjab Cooperation Minister, Capt Kanwaljit Singh, and then the massive sea of humanity that bade him tearful adieu next day are a testimony of the goodwill the late leader created over the years. This might have surprised him.

What kind of person and leader Capt Kanwaljit Singh was that evoked a spontaneous emotion – a sense of loss? What marked him out of the crowd of cronies, hangers-on and the corrupt and even criminals? Leaders are there dime a dozen. Remembered today, forgotten the next day.

Three decades ago when he was loudly thinking of joining active politics and travel on the rough and slippery road marked by elections, he was a man with many questions and concerns.

His father the late Sardar Dara Singh, who had been a judge, a minister in PEPSU and an honest lawyer to the core, was there to offer frank advice. Capt Kanwaljit Singh had his task cut out: Like a good soldier, perform your task well. Keep off fundamentalism of any variety and remain closer to the ground reality.

This was evident when Punjab witnessed the rise of militancy. As a Minister for Home Affairs, he tried his best to rein in police excesses, often with limited success. Anyone can read Julio Riberio’s book and note that. He was clear that Punjab had to be pulled out of militancy without compromising on essential values. Later events proved him right.

But his role as a secretary general of the SAD, offering a clear moderate liberal agenda at the Moga conference in April 1985, set the tone and temper of Akali politics in Punjab. This rekindled much hope in Punjab and relaunched not only the Akali Dal, but also Mr Parkash Singh Badal .

“I want the Akalis to play a leading role in making the Centre agree to more fiscal powers to the states and restore the State List in the Constitution. It had considerably shrunk in the past”, he had then said.

Economic and political issues were brought to the centrestage and the communal agenda was pushed back. He got into an overdrive to push the Akali Dal from the hard-line position enshrined in the Anandpur Sahib Resolution. He could have silently watched the Akalis, particularly its present leadership, pay the price and take advantage. No, Punjab counted first and foremost. In him Mr Badal has not lost a rival, but a thoughtful adviser.

Capt Kanwaljit Singh aspired to the top position and perhaps no one deserved better than him, yet politics for him was not a means to power alone. It meant the well-being of the people. Resolutions at the Moga conference were not just empty words, but solid messages to be followed in letter and spirit.

Capt Kanwaljit Singh was a human being too. He felt hurt when this time he was denied the portfolio of Finance. His seniority demanded that he should have been consulted also. Yet he did not take it to heart.

I asked him how he felt when downgraded by his leader; he had a hearty laugh, that contagious loud burst and said, “Would I wish him not to accept the portfolio of Cooperation and remain sulking?”

He was in touch with Bangladeshi Nobel laureate Muhammad Yunus who has transformed the lives of millions of poor through his Gramin Bank. Another three years would have seen the cooperative movement in Punjab take new wings.

He converted his bad time into pleasant rewarding work. He was indeed disturbed at the state of finances, offered advice only when sought. He would not relish failure of his party or a colleague.

There was another trait that marked him out. He had a way of discussing serious issues in a mature fashion, posing questions, seeking answers and never imposing arguments, only stating these cogently. Never loud, always measured and tempered in reason.

Capt Kanwaljit Singh was not only a leader of the SAD and Punjab, but one of the few visionary and dedicated leaders around us who could transform the way we are governed today, the way our policies work.

One of the remarkable achievements in his life was to strengthen the atmosphere of communal harmony among various religious sections in the state. That was the reason that late comrade Harkishen Singh Surjeet, who as a personal friend of his father sought him out and wished he should have been with the communists. Many leaders in the BJP thought the same way.

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Health
A cheap pill for heart attacks
by Jeremy Laurance

A pill which could prevent hundreds of thousands of deaths from heart disease, the biggest killer across the Western world, has been shown to be safe and effective in its first trials on humans.

The magic bullet, containing five medicines in a single capsule, sharply reduced cholesterol and blood pressure levels and has the potential to “halve cardiovascular events in average middle-aged individuals”, the researchers say.

The finding is a major boost for a medication with huge potential against the worldwide epidemic of heart disease and stroke. Doctors say that, if further trials prove successful, all men aged over 50 and women aged over 60 should be offered the pill in what would be the first example of mass medication for the middle-aged in Britain.

Yet no Western pharmaceutical company has shown interest in developing the so-called polypill because it does not promise big profits. It would sell for pennies because its five constituent medicines are cheap, have been around for decades and their patents have expired.

In the UK, one in three men and one in four women die prematurely from heart disease and stroke. In 2005, cardiovascular disease caused more than 208,000 deaths, about four in 10 of all deaths.

The idea of combating the heart disease epidemic by combining existing medicines into a drug cocktail called a “polypill” was first proposed six years ago. The pill contains aspirin to prevent blood clots, a statin to lower cholesterol and three blood pressure-lowering agents – a diuretic to remove water from the tissues, a beta-blocker to regulate the heart beat and an ACE inhibitor to relax the arterial muscles.

The current UK strategy of identifying and treating people at high risk of heart disease is failing because one-third of those who have a heart attack have no risk factors and one-third of those die. By giving the pill to everyone, the problem of identifying those at high risk is removed.

When the idea was published in the British Medical Journal in 2003, it was described as a “step of genius” and “possibly the most important paper the journal has published in 50 years”. But progress in developing the idea has been slow, and the UK has been left behind.

Now, in the first trial to be published in a mainstream medical journal, researchers from McMaster University, Canada and St John’s Medical College, Bangalore, have tested a version of the polypill in 2,000 people in 50 centres in India. The results, published in The Lancet, show that over 12 weeks the polypill reduced blood pressure and cholesterol in a similar way to its individual constituent drugs without increasing side effects. As patients are poor at taking multiple drugs, the single pill combination could “substantially improve adherence and therefore the benefits”, they say.

Professor Malcolm Law of the Wolfson Institute of Preventive Medicine in London, one of the originators of the polypill concept, said he was encouraged by the results. “It shows you can make it, it works and it doesn’t cause side effects,” he said.

He and Professor Nicholas Wald, joint authors of the 2003 BMJ paper, have had talks with the Government’s Heart Czar, Roger Boyle, and the Medicines and Healthcare products Regulatory Agency (MHRA) about obtaining a licence.

Progress has been held up by a lack of funding and charitable foundations are being approached for support. “We have a patent and work is underway to do the necessary studies to gain a product licence through the MHRA,” said Professor Law.

Professor Boyle suggested in 2007 that all middle-aged men and women should take a daily statin, one of the constituents of the polypill. The National Institute for Health and Clinical Excellence (Nice) said last year that more than one million adults at high risk of heart disease were missing out on statins that could save their lives. Nice said GPs failed to identify those at risk because patients were not routinely assessed.

— By arrangement with The Independent

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