India is firing dozens of foreign-funded health experts working inside the government, seen as part of a broader clampdown to reduce the influence of non-government organisations (NGOs) on policy.
The loss of these professionals, most of whom are Indian nationals, has raised concerns that signature programmes to combat HIV/AIDS and tuberculosis may suffer just as they face funding shortages due to slow bureaucracy.
A shortage of technical experts has for years forced India to turn to the World Health Organization (WHO) and aid groups like the Bill & Melinda Gates Foundation to manage large-scale public health schemes.
Of the nearly 140 people who run India’s HIV/AIDS programme, 112 are consultants seconded from foreign organisations. Some are engaged in planning and monitoring of prevention activities in high-risk Indian states.
Last week, Prime Minister Narendra Modi’s government ordered 45 of them to be removed from service by June as they had served more than three years, according to health ministry officials and a document seen by Reuters.
By December, 70 of these experts will leave, while others, who have worked for less than three years, face a government screening committee to decide whether they are needed.
“It’s like questioning our integrity just because we are foreign funded,” said an HIV/AIDS consultant who worked in the health department for three years and is now looking for a job.
The programme has won global acclaim for sharply reducing annual new HIV infections, but the rate of decline has slowed in recent years. India recorded 86,000 new infections last year.
S Selvakumar, a joint secretary in the finance ministry who signed off on clarifications to the new policy rules in January, said he did not know why consultants working in the government were being removed. He said the finance ministry received a request from the cabinet secretariat to compile a list of government consultants last May.
Two other finance ministry officials said the move was driven by fears that foreign agencies could use their consultants to influence policy in New Delhi. “Their loyalties would be divided,” said one.
The security of information was also a concern, the other officer said.
More than 500 consultants work across the Indian government, about half in the health sector alone. Some are from Britain’s Department for International Development (DFID) and the United Nations’ UNICEF.
A spokesperson for the Bill & Melinda Gates Foundation did not comment on the government’s decision, but said it would adhere to the directive. A DFID spokesman said the department had “not received any complaints from the government of India about data theft or undue influence on policies.”
The WHO and UNICEF did not respond to requests for comment.
Fixing the system
The move on consultants employed by government departments but who get their salaries from the parent organisations comes at a time when the government has tightened controls on foreign NGOs operating in India.
Last year it froze funding and cancelled licences of thousands of non-profit organisations for not declaring international donations. The government said it was seeking to bring transparency to the functioning of these entities.
The new rules apply only to government workers funded by global aid agencies, and not to all those associated with international groups.
A senior government source said the new policy on consultants working in the government will help streamline the older, loosely regulated system and ensure they have proper approvals.
Nearly 70 experienced consultants in the tuberculosis programme risk losing their jobs following the government order. India accounts for almost a quarter of global TB cases and the most deaths - 220,000 in 2014.
Keshav Desiraju, a former health secretary, said consultants play a vital role in running public health schemes but are not involved in policy formulation.
“Consultants do a lot of data work, and it will be immature to suggest they can influence government policy,” he told Reuters.