Who's Immune To This Disease?

A bare-torsoed Salman Khan exhorts a delirious throng to practice safe sex with pelvic thrusts at glittering song-and-dance jamborees. A dolled-up Manisha Koirala makes impassioned appeals at public functions. Amitabh Bachchan walks down the ramp and Nafisa Ali, in a matching combo, goes to town about it. All for the 'cause' of aids. The fell disease is the new glamourised concern of high society. Better still, it is the most saleable charity in Indian market. And a whole generation of quick-fix ngos are marketing it aggressively.

It wasn't surprising then that the Maharashtra assembly's estimates committee tabled a report recently stating that there were a large number of bogus ngos working in the field of hiv/aids prevention. While some confined their work to putting up stickers in local trains, a large number merely existed on paper, the report said.

"The report is an eye-opener. It says over 60 per cent of ngos in hiv/aids in the state are frauds. This is significant since the biggest share of funds from all sources is diverted to Maharashtra. Most of the big-budget ngos in the state are run by political parties," says Bitra George, a dermatologist associated with the Delhi-based ngos, Salam Balak Trust and Sharan.

The shrill hype about aids has a disconcerting ring about it. Says George: "There is a need to check the status of ngos which are frequently organising fashion shows, five-star dinners and star nights. It could well be a plain money-laundering exercise." Other ngos, assuming they're in it for pious reasons, are simply so inefficient that they don't even get to spend the money allotted to them. Saying that the money given to such ngos had been wasted, the committee emphasised that they should have been properly evaluated. It clearly suggested that the state government hardly had any control over these agencies and their huge finances.

Maharashtra's case adequately sums up the larger picture of fake and non-performing ngos that have permeated the remotest corners of the country riding on the hiv/aids bandwagon. With grants worth thousands of crores coming from foreign donor agencies and to some extent the Indian government, starting an ngo for hiv/aids prevention is fast becoming an instant-returns industry. And both the Centre and the state governments have little control over them. A majority of such agencies are merely implementing awareness or prevention programmes approved or set by the foreign donors. With big-time donor agencies like Action Aid, UK's Department for International Development (dfid), usaid, Oxfam, Ford Foundation and the Rockefeller Foundation promising money, the list is only growing rapidly.

All such ngos, that survive on direct foreign funding, have to register themselves with the Ministry of Home Affairs under the Foreign Contribution (Regulation) Act (fcra), 1976. Till March 31, 1999, as many as 19,825 associations—ngos and other voluntary bodies—working in various fields were registered under this act. These included a significant number of ngos working for hiv/aids prevention all over the country. The stakes involved can be gauged by the fact that foreign contribution to all associations collectively for a single financial year of 1998-99 amounted to a whopping Rs 3,402.90 crore. The top grossers included associations in Andhra Pradesh (Rs 487.29 crore) followed by Delhi (Rs 487.28 crore) and Tamil Nadu (Rs 486.36 crore).

According to the fcra, it's mandatory for all associations permitted to accept foreign contributions to file annual returns, giving details of the receipts and purpose-wise utilisation of foreign funds. But in reality things are much different. In the absence of a watchdog, many ngos make hay with the foreign booty. Not surprisingly, over 6,000 associations did not even bother to file their returns for 1998-99. The Ministry of Health and Family Welfare remains curiously ignorant on how the funds are being utilised. Unlike its counterpart, the Ministry of Social Justice and Empowerment, which routinely blacklists defaulting ngos funded by it, the Health Ministry is still struggling to put a definitive monitoring system in place. "It's very difficult to watch all the ngos. But we are considering a monitoring mechanism," says a senior bureaucrat.

On the other hand, the National aids Control Organisation (naco)—the prime executive body established by the Centre in 1992 to work for prevention and control of aids—has made little headway in streamlining awareness and prevention campaigns. It has often got embroiled in controversies, with the latest being accusations that it fudged the figure of hiv-infected people in India to attract foreign funding.

Says Anju, an activist with Joint Action Council Kannur (jack), an ngo which is vehemently protesting against the functioning of naco: "After we protested against the fraudulently inflated statistics projected by naco, they brought it down to 3.5 million from the earlier figure of 8.5 million. But even this is not correct".

A 65-member parliamentary standing committee headed by S.B. Chavan had warned two years ago that the government was losing its control over the hiv/aids programme in the country. The committee's 73rd report on 'Dreaded Diseases' made a caustic reference to ngos and international agencies. The report said that the committee is "constrained to note that the central government, which sanctions funds to ngos, does not even have a list of those working under the programme in various states." It further said: "The committee has learned that various international agencies are implementing various programmes in different parts of the country for tackling the problem of hiv/aids. In this connection, the committee is constrained to note that naco is not involved in the implementation of all projects in all parts of the country."

On the other hand, naco, which has about 400 ngos associated with it, has till date not found a single agency guilty of misusing funds or of non-performance. Neelam Kapoor, naco joint director, attributes this to its 'stringent selection procedures'. Says she: "We have an effective state-level monitoring system to assess the performance of the ngos funded by us. Besides, the selection process itself is so rigorous that only genuine ngos are selected for financial assistance and programme implementation."

At present, naco is implementing the second phase of the five-year-long National Aids Control Project (nacp) with a whopping Rs 1,425 crore reserved for the purpose. "Foreign donor agencies are sanctioning huge grants to ngos which deal directly with them. However, naco monitors only the ngos that work with it," she adds.

With unscrupulous ngos making up the dominant hiv/aids lobby, fears are being expressed that the hiv scare in the country may be getting stage-managed by foreign agencies and interested market forces. Says jack convener Purushothaman Mulloli: "The modus operandi of foreign donors has evolved into a fairly standard procedure. Often these are not voluntary agencies, but arms of large corporate houses or management consultancy firms or just friends and relatives of bureaucrats and politicians."

It is all about new concepts of colonisation in the form of control over markets. The foreign agencies are serving their agendas with the complicity and cooperation of politicians, bureaucrats and the ngo sector. Mulloli adds: "Even if we believe that there are 3.5 million hiv-infected persons in India, the country requires Rs 56,000-crore worth facilities and infrastructure to upkeep them. This is a vast potential market."

Clearly, exploiting 20th century's most fashionable cause is the most happening racket in the country. The loser is the still stigmatised patient, usually abandoned and languishing in a grubby shelter.