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Union health minister's one-size-fits-all ploy: One world, one health... and one gender?

By Dr Amitav Banerjee, MD* 

As an average middle class citizen, I too own a car. The chassis has a unique number which is linked to the registration certificate, insurance and other details. Besides, the car has to undergo periodic servicing every few months. When I visit the service station, the attending executive can easily access the past jobs done on the car. Based on this, the car undergoes oil change, filter change, wheel alignment as and when due and other interventions on a periodic basis.
The poor car has no choice, no autonomy, no privacy, and no gender either! The service station has full view of its exteriors as well as interiors. Even this cannot establish any gender identity of the car. I as the owner of the car do not have much of an option to what the car is subjected to.
Besides periodic servicing, the car has to have its “up-to-date” pollution certificate, FASTag recharge, up-to-date insurance and so on. Without it, I as its occupant can to be fined by the traffic police and the car will not be able to cross state borders.
In the future, will humans be subjected to the same indignity? Some disturbing developments indicate so. Taken in isolation, most of these developments seem benign and even beneficial. But connecting the dots gives that uneasy feeling which is difficult to describe but gives a sense of foreboding.
It started with the UID or unique identifier for citizens – the aadhaar card. Despite the legality of the aadhaar getting challenged in the court from time to time, its linking to various services has compelled majority of Indians to register for it. Even schoolchildren of government and aided schools have this unique identifier, while the legality of such a requirement continues to be debated.
Subsequently, Aadhaar Enabled Biometric Attendance System (AEBAS) was rolled out in many organizations, including educational institutions. Aadhaar linking to PAN Card, mobile number and bank accounts became for all practical purposes mandatory. During the pandemic it was linked to the Vaccination Certificates and the RTPCR tests.
The Prime Minister’s Office (PMO), on 09 June 2023, tweeted an article by our honourable Health Minister, titled, "One World, One Health," the catchphrase circulating currently across the globe. We should be wary of misuse of slogans which are signs of authoritarianism. Slogans over-simplify complex issues, promote groupthink, and discourage critical thinking. They become efficient tools of propaganda and mass hypnosis.
Portions of the article are disconcerting. For example, the honourable health minister explains at length of India’s “transformative digital tools” during the Covid pandemic which generated digital certificates as proof of vaccination. Does this not contradict the government’s affidavit in the Supreme Court stating that the vaccination for Covid was completely voluntary! Why the need for digital certificates as proof of vaccination if it was voluntary?
The writing on the wall is ominous. The World Health Organization (WHO) and the European Union (EU) are contemplating Digital Vaccine Passports. The Covid-19 vaccine fiasco has not dampened their zeal it seems. According to the WHO, this will be scaled up to a Global Digital Health Certificate.
With the proposed Pandemic Treaty, the introduction of Digital Vaccine Passports, and Global Digital Health Certificates, the ambition of the WHO to take on the role of an extra-constitutional seat of power is becoming evident to all. Except perhaps to our honourable health minister parroting the “digital vocabulary” with its motley of jargons promoted by the WHO and EU. Reminds one of newspeak in Orwell’s satire “Nineteen eighty-four.”
The average reader will not comprehend much of the technicalities in the health minister’s writing nor its implications. On the contrary, the upwardly mobile laptop class will be impressed by the promise of technology and its applications to health care. Little realizing that technology cannot address our basic deficiencies in public health infrastructure.
If there are no well equipped public hospitals and public health centres, how will digital connectivity help? The technology will again be a boon to the laptop class covered by private health insurance accessing corporate hospitals. Inequities in access to health care will increase.
“One World, One Health” is the take-home message. How appropriate it is?
According to the WHO’s own definition of health, “ is a state...” that means not static, be it at individual level or population level. A person in perfect health today may be sicker tomorrow and vice versa. His or her needs during perfect health would be different than his needs during sickness. Similar fluctuations will be at the population levels, across countries. Just as all individuals at a given time will not have the same level of health (some may be healthy, while others may be sick and have different grades like mild, moderate or severely ill states), nations vary in their levels of health.
Not only health, the determinants of health such as per capita income, housing, population density, social inequalities, age structure and various other known and unknown factors having a bearing on health and will differ across nations.
If we look from this perspective, “One World, One Health” is an oxymoron. It misses the finer nuances and diversities which determines the health of nations. Just to drive home the point, our country like many poor countries are struggling with under-nutrition, huge burden of communicable disease (far lethal than Covid), overcrowding (which makes physical distancing impossible), most of which are due to poor housing, poor sanitation and air and water pollution.
The richer countries on the other hand are mainly struggling with diseases of affluence like obesity, and diseases of the elderly. They have better housing, sanitation and water supply, low population density and higher per capita income.
Epidemiology studies these differences based on which the interventions are customized for different regions. Way back, when WHO was still a credible source, it adopted the strategy, "Think Globally, Act Locally," which made perfect sense epidemiologically.
Disease dynamics are far more complex. The ham-handed approach of One World, One Health will ruin human lives
The slogan, “One World, One Health” implying one size fits all, breaches all epidemiological principles. It will put the poor countries at a disadvantage. Its paternalistic approach, bordering on authoritarianism with loss of autonomy of nations and human rights violations of citizens is not compatible with a vibrant democracy like India. Digital health, digital identity and use of technology for intrusive monitoring of common citizens on the pretext of health are reminiscent of Orwell’s satiric novel.
Perhaps, in the near future, humans will have as much autonomy and privacy as their cars. They will have to be “up-to-date” on vaccines, medical procedures, and other interventions. They will not be able to travel if their “digital health card” shows that they are lagging in any of these things.
Diversity among nations and cultures and of course gender is what gives beauty to life and determines health in different ways across countries, culture and gender. It also preserves autonomy and human rights of citizens. One has to devise custom made solutions to health problems in diverse situations. One World, One Health concept will not fit all scenarios.
All chessboards have the same 64 squares and the same 32 chess pieces. But each game of chess is unique and the two players have to think themselves.
Disease dynamics are far more complex than a game of chess. The ham handed approach of “One World, One Health” will ruin human lives and enslave countries. The slogan seems to harmonize with the WHO’s proposed pandemic treaty which will give extraordinary and extra constitutional powers to the much maligned organization without any accountability.
Adding to the conundrum of “One World, One Health,” is the statement by the Chief Justice of India, Honourable DY Chandrachud, on gender, “It is not a question of what your genitals are. It is far more complex... the very notion of a man or a woman is not an absolute based on the genitals.” Gender is not what is between the legs, but what is between the ears, the proponents of gender neutrality propose.
Are we looking forward to a future, say by 2084 (may Orwell rest in peace), of “One World, One Health, One Gender!” We would be passing through life like driverless cars with gender neutral AI replacing our natural brains inside our skulls. And our nature bestowed biological genitals will wither away without the agony and ecstasy of first love driven hormonal stimuli to be replaced by artificially created genders of our choice! The future looks rather dull.
*Post doctoral in epidemiology who was a field epidemiologist for over two decades in the Indian Armed Forces. He was awarded for his work on Tribal Malaria and Viral Hepatitis E. He is currently Professor at DY Patil Medical College, Pune, and an Academic Editor at PLOS ONE


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