After facing strong backlash from medical experts, civil society groups and activists, Yale University on Wednesday said that it will review it controversial study, which recommends shutting down of red-light areas to reduce Covid -19 spread and deaths in India.
The study titled ‘Modelling the Effect of Continued Closure of Red-Light Areas on Covid-19 Transmission in India’ claims that shutting down red-light districts in Mumbai, New Delhi, Nagpur, Kolkata and Pune can reduce the number of new Covid-19 cases by 72% and deaths by 63% and should, therefore, be closed indefinitely.
The study, published by researchers at Harvard Medical School, Massachusetts General Hospital, and Yale School of Public Health, has invited strong criticism from civil society groups and activists in India.
Registering strong protest over the unscientific method of the study and its ramifications for the community, more than 140 academicians, including medical experts, lawyers and human rights activists wrote to the universities which undertook the study.
In its response, Sten H Vermund, Dean of Yale School of Public Health, said that the university is investigating the best option. “Thank you for sharing your concerns about potential harm so clearly. Either I or a representative of Yale University will be in contact as to our action plan,” the statement said.
Reacting to Yale’s response, former Union Health Secretary Sujatha Rao told Outlook that acclaimed universities such as Yale and Harvard should follow procedures and publish credible reports.
“It’s a very republican, narrow-minded view. The US also wanted to amend the Immoral Traffic Act, saying that all the clients who go to sex workers should be penalised. This study is coming from that kind of a mindset,” said Rao, who is one of the signatories of the statement.
Expressing concern about the manner in which the study has been sensationalised, academicians demanded the withdrawal of the study.
“We strongly express our outrage at the sensationalistic and suspect way that the study has been publicly promoted in India, leading to dozens of news reports with headlines such as this one: ‘Keep red light areas closed post- coronavirus lockdown: Yale School of Medicine.’”
The study was authored by Sudhakar V. Nuti of Harvard Medical School and Massachusetts General Hospital, along with Jeffrey P. Townsend, Alison P. Galvani, Abhishek Pandey, Pratha Sah and Chad Wells at the Yale School of Public Health.
The experts, in their statement, pointed out that “the study has been released without being peer-reviewed, and the research methods have not been made transparent. The authors claim that 522 stakeholders in Red Light Areas (RLAs) were interviewed in the past few months, with two rounds of research. Yet there is no detail on the ethics approval for the study, the informed consent and recruitment procedures, or the partner organizations that facilitated the research.
The signatories include former union Health Secretary, JVR Prasada Rao; Siddharth Dube, a former senior adviser to the Executive Director of UNAIDS; Dr Prabha Kotiswaran, Professor of Law and Social Justice, Dickson Poon School of Law, Kings College, London.
Speaking to Outlook, Meena Seshu of ‘Sampatha Grameen Mahila Sanstha”, Sangli said that sex workers are facing harassment and threats from police after the report appeared in vernacular languages. “The vernacular media has picked up the news and many versions of the study have been published. Using the reports, police is threatening sex workers to close down brothels,” said Seshu, who is one of the signatories.
The petition further said that the ‘study is not clear that informants were told about the objectives of the study or its possible risks for them, including the closure of RLAs and threats to their livelihood.”
Raising doubts over the methodology adopted by academicians, the experts also pointed out in their letter that lockdown in India has been in place since 24th March 2020 and international research boards have mandated that all human subjects research be virtually conducted.
“In this case, the study was conducted through suspect means, making the findings inadmissible. Due to the lack of transparency, the findings are also impossible for third parties to verify. The authors should have been aware of the risks posed by their own research,” it said.
The activists took strong exception to the fact that the authors ignored multiple requests from academics to make the findings available, as well as bypassed civil society organizations completely, sharing the key findings directly with media outlets and political leaders even in the absence of peer review.
The statement pointed out errors in the sources used for collecting data. “The estimate of the number of sex workers in India are based on highly variable sources, and the secondary literature is outdated, citing studies from Pune in 1996 and Surat in 2003, reflecting little understanding of the current realities of sex work in India. Sex work, defined as the provision of sexual services, is provided in a range of locations in India, and only a very small percentage of it takes place in brothel settings.”
“Most sex work takes place on highways, railways, construction sites, bus stations, farmlands, lodges, and residential homes, and sex workers frequently migrate between these settings. Major red-light areas now only exist in three states in India: Delhi, West Bengal, and Maharashtra. Even in these states, brothel-based sex work has sharply declined since the 1990s, with the rise of abolitionist anti-trafficking movements, police crackdowns, and real-estate redevelopment interests. Much sex work has migrated to streets or become internet- and phone-based,” it said.
The authors’ statement that “social distancing is impossible while having sex” misses the point, the statement said.
“In India, 40% to 50% of urban residents live in dilapidated conditions in slum areas, where thanks to a lack of facilities, water supplies, and overcrowding, social distancing is impossible regardless of residents’ sexual activity.”
The activists said that recommendations of this study invite the state to use its coercive powers - police raids and evictions - to victimise the most marginalized of slum-dwellers in the name of public health.
“The authors of the study draw comparisons to countries such as the Netherlands, Germany and Australia, where sex work is regulated in specific jurisdictions, and therefore “shutdowns” are possible. Given the mixed-use nature of urban Indian slums, however, they cannot be “shut down” in the same way as RLAs in Western countries. In India, moreover, brothels inhabit an ambiguous legal position, since the term is defined broadly to include a range of areas inhabited by sex workers and the urban poor,” they said.
Some of the other signatories include Anand Grover, Senior Advocate; Kusum, All India Network of Sex Workers, Delhi; Kajal Bose, Durbar Mahila Samanwaya Committee, Kolkata; Maya Gurav, President, Veshya Anyay Mukti Parishad (VAMP); Dr. Srimati Basu, Professor of Anthropology & Gender and Women’s Studies, University of Kentucky, Lexington; and Uma Chakravarti, Academic, New Delhi.