Mahmood Ali

In Bangladesh there are plenty of organizations which are receiving foreign funds under the pretext of helping the poor of Bangladesh. The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), is such a big one. It is essential to examine their works and demystify their role. Mahmood Ali attempts an exposure of the specific case with documetary arguments. He insists that the ICDDR,B spends money, collected in the name of poor, for purposes which have little to do with the diarrhoeal problem of the people of Bangladesh. We encourage our readers to write more on similar cases.

Deaths due to diarrhoea are reported frequently in the newspapers of Bangladesh. An editorial on this problem published in a leading daily at the beginning of the new millennium is worth noting. It stated, "Although we have stepped into a new century as well as a new millennium, the scourge of diarrhoea is continuing to stalk us. This underlines the grim fact that even now all parts of the country are yet to be in a position where safe drinking water is easily accessible to the people. Moreover, severe financial constraints still hold back development in many pockets of the community making a sad mockery of health, hygiene and sanitation in this 21st century" (1).

On February 11, 2001 the same newspaper had printed a news item on the utilisation of foreign aid in Bangladesh. The title of the news item is self-explanatory. "Where does all foreign aid go? Seventy-five percent of donor's money looted by local, foreign elite". According to this report, foreign aid has created long-term dependency and criminalised the politics and economy of the country. In the light of these developments it is important to take a critical look at those institutions which are receiving foreign funds under the pretext of helping the poor of Bangladesh.

While the Government of Bangladesh may not have adequate funding, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), using the name of the poor of Bangladesh, collects millions and millions of dollars from several countries and organisations. But the ICDDR,B spends money for purposes, which have little to do with the diarrhoeal problem of the people of Bangladesh. The situation is analogous to the owner of a crippled person lying in a small box with wheels underneath. The owner uses the crippled person to collect money. But how much does it really go to the welfare of the crippled person? The owner's livelihood would disappear in the absence of the crippled person. The ICDDR,B is like the owner of the crippled person. Tragically Bangladesh is being treated like the crippled person in the box!

The ICDDR,B's background leading to its foundation:

The ICDDR,B is the continuation of the Cholera Research Laboratory (CRL), originally established in 1960 as a result of the military alliance between Pakistan and USA under the umbrella of the South Asian Treaty Organization (SEATO, 2). After the independence of Bangladesh, Sheikh Mujibur Rahman, the Founding Prime Minister and later President of Bangladesh, did not grant any long-term charter as he wanted CRL to be under national control responsive to the Ministry of Health (3). He was assassinated in August 1975. The idea of converting CRL to an international organisation was launched in April 1976, only a few months after his assassination (4). Dr. David Sack, the ICDDR,B´s present director, came to Bangladesh soon after the assassination of Sheikh Mujibur Rahman. Since then he has been associated with the "activities" of this research Centre. In 1978 the ICDDR,B obtained a 25-year charter from the Government of Bangladesh to operate as a research centre to work on diarrhoeal diseases "with special relevance to developing countries" (Ordinance No LI of 1978 Government of Bangladesh; 6th Dec 1978). The charter was renewed further for 25 years in 1998 and was extended up to 2029.

The ICCDR,B - a club of like-minded friends from USA and Sweden:

A "club" comprising a few scientists from USA and their friends from Sweden basically controls the ICDDR, B. Most of the directors of the Centre including the present one have come from this "club". Under severe criticisms in the 1980´s, the Centre once had an Ethiopian as the director. But he was just window dressing. He was hand picked as he had been long associated with this "club". The ICDDR,B operates through very careful manipulations indeed! The American scientists inside the ICDDR,B do not represent the mainstream of bright and talented scientists of USA who are making scientific breakthroughs. Instead, the American scientists, currently associated with the ICDDR,B including its director Dr. David Sack, have hardly made any significant scientific contributions. Their purpose of staying in Bangladesh may be for something else !

In the late 1970´s Dr. David Sack, the ICDDR,B´s present director, was a junior member of the club controlling the ICDDR,B. He joined in hands with a group of Swedish scientists. Dr. Jan Holmgren, with an experience of only 6 years after the doctoral degree, was made a member of the Board of Trustee of the ICDDR,B. Because of his membership on the Board of Trustee of the ICDDR,B, Dr. Holmgren found his way into the Board of SAREC, an organ of the Swedish government's foreign aid agency. These assignments gave Dr. Holmgren a complete insight and control over development, financing and marketing of the products which he, wife Ann-Mari Svennerholm and Dr. David Sack had been trying to develop at the ICDDR,B. They planned how to get rich quick and found that one of the ways would be to develop vaccines for soldiers and tourists from rich countries, who may require protection for a short period of time whatever may be the cost. They would set up companies to market products and eventually become millionaires. The easiest way to obtain funds for the development of such products would be to use the name of the diarrhoea suffering poor people of Bangladesh. Money would be collected from various international donors such as the World Health Organization (WHO), The United Nations Children's Fund (UNICEF) and foreign aid agencies of various governments such as USA, UK, Japan, Canada and the Kingdom of Saudi Arabia.

Plenty of information has surfaced in the 1990´s. A profit making business venture in Sweden called SBL-Vaccin AB has evolved out of the ICDDR,B's active collaboration with the Swedish scientists. The Swedish government owned SBL-Vaccin AB until 1997 when it was purchased by a private Swedish company Active Biotech. SBL-Vaccin AB has changed hands, its owner since 2003 being Chiron Corporation of USA. SBL-Vaccin AB with Dr. Holmgren as a member of its scientific council has targeted soldiers and tourists from rich countries, who may require protection for a short period of time whatever may be the cost. The company has made several of its key players such as Drs. Holmgren, Svennerholm and their associates multi-millionaires. But the money for the development of all these products were collected from various international donors using the name of the diarrhoea suffering "poor people" of Bangladesh. As documents reveal, the ICDDR,B's director Dr. David Sack has been working for SBL-Vaccin AB (5).

The ICDDR,B´s activities in brief:

The ICDDR,B's ongoing research on "Peru-15": a project to develop a cholera vaccine for the US Army:

The ICDDR,B is currently testing on Bangladeshis a Vibrio cholerae strain entitled Peru-15, which has been developed by scientists of the U.S. Army using techniques of genetic engineering (6). AVANT Immunotherapeutics Inc., a vaccine company from Massachusetts (USA), has been awarded the license to market Peru-15 for commercial purposes such as the development of a cholera vaccine entitled CholeraGrade TM (7). The company has undergone an agreement with the International Vaccine Institute (IVI) of South Korea and the ICDDR,B to conduct a field trial in Bangladesh.

AVANT Immunotherapeutics Inc. maintains very close contact with the U.S. Department of Defence as it has been working on several U.S. defence department's projects aimed to provide better health care to the U.S. Army personnel. To develop CholeraGradeTM as a traveller's vaccine to be used predominantly by soldiers, has been one of the goals of AVANT Immunotherapeutics Inc. This has been mentioned by the company President Dr. Una Ryan, in her report to the U.S. House of Representative's Biological Warfare Programs on October 23, 2001 (8). Thus the ICDDR,B's research on Peru-15 demonstrates the use of Bangladeshis as experimental guinea pigs for a product to be used by the soldiers of the US Army. Has this information been disclosed by the ICDDR,B to the people of Bangladesh? One wonders.

A research carried out covertly on Bangladeshis on behalf of a foreign military constitutes violation of the national sovereignty of Bangladesh. Bangladeshis have a right to demand full accountability and transparency from the ICDDR,B regarding the ongoing vaccine project Peru-15. Thus a detailed information on the parties involved in this vaccine such as AVANT Immunotherapeitics Inc and its relation to the U.S. Department of Defence, the role of the American directed IVI of South Korea, objectives of the trial and rights of the vaccine participants in the trial and future marketing of the vaccine. Incidentally, Dr. John Clemens, Director of the IVI had previously worked as an epidemiologist at the ICDDR,B and is a close associate of the ICDDR,B's director Dr. David Sack. Both were deeply involved in the unethical research related to the Swedish cholera vaccines performed on the Bangladeshis. This would be discussed in detail in section 3.

The ICDDR,B's collaboration with the Israel Defence Force

Collaborative activities among a group of scientists employed by the Government of Sweden, the Swedish company SBL-Vaccin AB, members of the Israel Defence Force and a number of the scientists from the ICDDR,B have been going on for several years with a view to develop a vaccine against diarrhoea caused by enterotoxigenic Escherichia coli (ETEC) which Israel requires for its soldiers. This has been documented in two scientific publications from USA and UK (9, 10). Dr. Ann-Mari Svennerholm, a female scientist from Sweden's state-run Gothenburg University, had been working for several years with the Israel Defence Force. They had been testing the same ETEC-vaccine, which Dr. Ann-Mari Svennerholm and her colleagues at the ICDDR,B had been developing. Dr. Ann-Mari Svennerholm and her principal Bangladeshi co-worker Dr. Firdausi Qadri had also tested the same lot of the highly expensive ETEC vaccine (supplied by Sweden's SBL-Vaccin AB) on the Bangladeshi citizens using them as human guinea pigs. These activities unequivocally establish the close scientific collaboration that is prevailing between the ICDDR,B and Israel via Sweden. The Swedish scientists Dr. Ann-Mari Svennerholm, her husband Dr. Jan Holmgren and a number of their subordinate employees from the University of Gothenburg have been working at the ICDDR,B since 1979. Their principal contact persons during all these years at the ICDDR,B had been its present director Dr. David Sack, Dr. Firdausi Qadri, a Bangladeshi citizen and Dr. John Albert, an Australian expatriate of Indian origin who worked for ten years (1989-1999). The Swedish scientists Drs. Holmgren and Svennerholm are deeply associated with SBL-Vaccin AB. In the share holder's meeting on April 14, 2000, SBL-Vaccin AB's President Mr. S. Andreasson disclosed that the company had been trying the ETEC-vaccine on a large number of Israeli soldiers (11). The ICDDR,B's director Dr. David Sack also works for this company (5). How much activities are these Swedish scientists and their ICDDR,B associates carrying out inside Bangladesh on behalf of Israel is any body's guess.

The ICDDR,B collaborates with Sweden's Karolinska Institute, whose vice-chancellor was also the chairman of SBL-Vaccin AB supplying vaccines to the Israel Defence Force (9). Also, Karolinska Institute has been maliciously engaged in slandering the Muslims (12). Israel has extensive programmes in biological warfare and has reported to have developed "ethnic" bullets selectively killing the Arabs (13).

In the 1980's the ICDDR,B violated the foreign policy of the Government of Bangladesh and collaborated with the apartheid regime of South Africa, which in turn had an extensive collaboration with Israel in areas of biological warfare (14).

One wonders whether the ICDDR,B and the scientists of the Government of Sweden working at the ICDDR,B have revealed their Israeli connection to the Government of Bangladesh and have obtained official permission from the Government of Bangladesh to carry out such collaborative research ventures.

Developing vaccines for rich tourists and soldiers violating the human rights of the poor

In 1985 the ICDDR,B had tried oral cholera vaccines on 90000 women and children of Matlab, Bangladesh (15). The Government of Bangladesh had permitted this trial, as it needed a cholera vaccine providing long term immunity to the people of Bangladesh who suffer from cholera (16). Two Swedish governmental scientists from Gothenburg University (Dr. Jan Holmgren and his wife Ann-Mari Svennerholm) and two expatriate scientists at the ICDDR,B (Drs. David Sack and John Clemens) were primarily associated with the trial. The Swedish Department of Defence had been intimately associated with the diarrhoeal research of the Swedish scientists at the ICDDR,B by providing money, materials and manpower (17, 18 ). The trial had violated the Declaration of Helsinki concerning ethics in biomedical research involving human subjects on a number of counts (19). Firstly, no protocol to record side effects was maintained, even though the trial participants had suffered and complained. Secondly, no proper informed consent was taken from the trial participants. Thirdly, in many cases coercive tactics were applied. Fourthly, pregnant women were immunised and no pregnancy test was carried out. The vaccine, administered by the neutralisation of gastric acid, had produced side effects and even a death had been reported in the Bangladeshi press (20). Finally, the vaccine consisting of a large number of killed cholera cells and the B subunit of cholera toxin (BS-WC) cost several dollars. It was extremely expensive and beyond the reach of the Bangladeshis.

The protective efficacy of the oral cholera vaccine (WC-BS) was short lived, only observed during the initial period of lean cholera incidences and rapidly declined afterwards (21). It was practically ineffective in children, the targeted population in heavily endemic areas like Bangladesh. After monitoring for one year, it was found that more children (3-6 years) in the WC-BS group got cholera than those in other groups including the placebo (21).

The real objective of the trial was to develop a vaccine for soldiers and tourists from rich countries who may require short-term protection at any cost. Since 1990, the Government of Sweden had been making huge profit by marketing this vaccine to soldiers and rich tourists through its vaccine producing laboratory SBL-Vaccin AB. It is sold under the trade names of "Dukoral" and "SBL cholera vaccine" at an enormous cost of Swedish crowns 450 (app. USD 65-75, depending on the exchange rate). The vaccine had been sold to the US Army for its soldiers in its war against Iraq (22). Ironically the vaccine was tested in Bangladesh for use by the poor! To market the vaccine, SBL-Vaccin AB had stated in an information sheet in 1996 that the vaccine could be used upon pregnant women, thus supporting the original unethical intention of using Bangladeshi pregnant women for medical research. If pregnant women were excluded from the trial, as written by Drs. Holmgren, Svennerholm and their ICDDR,B associates in 1986 (15), then how can it be stated in 1996 that the vaccine is safe for pregnant women! In addition, the trial did not have any provisions for recording side effects (23). The reality of the matter is that the whole vaccine research was an exercise in fraud !

Exploitation of Bangladeshi women as experimental guinea pigs

Although cholera can affect both men and women, the trial had predominantly selected females as vaccine recipients (15). All male individuals above 15 years of age were excluded. No scientific explanation of this sex bias has been provided by the Swedish scientists and their ICDDR,B associates. However, Dr. Holmgren on a programme on the Swedish National Radio justified the exclusive use of the Bangladeshi women by stating that men were not available as they work outside their homes (24). The Bangladeshi women are mostly Muslims. They work at home and are easily accessible. So they can be used to test vaccines. This is an excuse to exploit women when it is convenient to do so because of their social and religious status. It is worthwhile to point out that in the 1970's the Indian scientists had carried out a cholera vaccine trial on a large number of participants involving 101,030 volunteers of neighbouring West Bengal (25). The Indian study did not display any sex bias as almost equal number of men and women had participated. If the Indian scientists can carry out an effective vaccine trial without exerting any sex bias, why had the Swedish scientists and their American associates of the ICDDR,B failed to do so? The answer lies in the racist attitude of the Swedish scientists and their American associates of the ICDDR,B towards the coloured women of Bangladesh. It has to be emphasised that the poor women of Bangladesh are not born for testing highly expensive western drugs and vaccines! Their dignity as human beings should be recognised and respected as defined in the Universal Declaration of Human Rights.

The trial and the protest

Protests against the trial had been launched in the press and on the radio both in Sweden and in Bangladesh in the 1980's (20, 23, 24, 26-41). In January 1987, hundreds of leading academicians, politicians and social activists of Bangladesh (including Mr. Mohammed Nasim, Home Minister, The Government of Bangladesh, 1999-2000) had sent a protest letter to the Swedish Prime Minister Mr. Ingvar Carlsson concerning the use of Bangladeshis as experimental animals by Dr. Holmgren, Ann-Mari Svennerholm and their ICDDR,B associates (Postal registration no: 56179, Stockholm, Sweden; January 7, 1987).

Dr. Holmgren's accumulation of massive wealth through the cholera vaccine trial

Drs. Jan Holmgren and his wife Ann-Mari Svennerholm claim to be the inventor of this vaccine Dukoral (42). Dr. Holmgren has illegally obtained a patent on cholera toxin B subunit (CTB) of the vaccine Dukoral, in a number of countries including Sweden and USA (The US Patent # 5268276 dated Dec 7, 1993). He had concealed in his patent application information on the financial support from WHO that he had received for his work on CTB (43) . Besides he had applied as a private person concealing his place of employment. He draws large sum of money as royalty from the sale of the vaccine Dukoral that includes CTB. On 29 June 1998 Dr. Holmgren had obtained for his CTB a cash of Swedish crowns 25.6 million (appx. 3-4 million US dollars) and agreement on a large number of future shares from the owner of the Swedish company SBL Vaccin AB (44). But the vaccine Dukoral was possible only because of the trial that was performed on 90,000 women and children of Bangladesh. WHO and a number of governments such as USA, Japan, Canada and Bangladesh had funded this vaccine trial. But the Swedish vaccine producers (SBL-Vaccin and Active Biotech) had denied this fact and instead had stated falsely that SBL "has financed development and clinical testing without external assistance" (44). Thus, the marketing of the vaccine Dukoral is illegal as it involves cheating the financial donors such as WHO and several governments (USA, Canada, Japan and Bangladesh) and 90 000 trial participants of Bangladesh. Dr. Holmgren has been working as an "expert" in WHO's programmes on diarrhoea and vaccines for several years. Dr. David Sack of the ICDDR,B works for the Swedish company SBL Vaccin AB (5). Thus a racketeering is going on in which the Swedish governmental and private organisations (SBL-Vaccin AB), two Swedish governmental scientists (Dr. Holmgren and wife Ann-Mari Svennerholm) and their ICDDR,B associates (Drs. David Sack and John Clemens) had violated the human rights of the poor people of Bangladesh. They had used them as substitutes for laboratory animals to test highly expensive biological materials with a view to make profits. Dr. Holmgren, Dr. Ann-Mari Svennerholm and SBL-Vaccin AB must return all the ill-gotten money they have made not only to the donors (WHO and several governments), but also to 90 000 poor women and children of Bangladesh.

The ICDDR,B hijacks funds from donors to develop vaccines for soldiers and rich tourists

The ICDDR,B had "hijacked" millions and millions of dollars from donors such as WHO, the governments of Japan, Canada and USA (15) for the development of a cholera vaccine for soldiers and rich tourists. The tax payers of these countries had given money to the ICDDR,B so that the poor people of Bangladesh do not suffer from the scourge of diarrhoea. But the ICDDR,B had utilised that fund to satisfy the greed of a few interested persons, who want to make money by exploiting the poor under the slogan of "combating diarrhoea".

The ICDDR,B's Collaboration with the apartheid regime of South Africa

The ICDDR,B had carried out collaborative research on Vibrio cholerae in the 1980's with the minority white apartheid regime of South Africa, grossly violating the foreign policy of the government of Bangladesh (14). Numerous articles protesting this collaborative research had appeared in the Bangladeshi newspapers and magazines in the 1980s (27-33, 35, 36). In 1998 the Truth and Reconciliation Commission of the Republic of South Africa has confirmed that the apartheid regime of South Africa had used Vibrio cholerae as an agent of biological warfare against the majority black population of the country (45). In January 1999 the BBC-World TV had shown a dramatic film called "The Plague Wars" where these facts have been documented.

Why was a foreign expert in areas of bacteriological warfare (Dr. P.C.B. Turnbull) from a well known biological weapons research centre of the West invited by the ICDDR,B to come to Bangladesh? The ICDDR,B had not given any satisfactory explanations on this matter (46). Is the ICDDR,B carrying out bacteriological warfare or testing agents of bacteriological warfare upon the people of Bangladesh?

The ICDDR,B spreads communal hatred between the Hindus and the Muslims

The American scientists (John Clemens and Roger I. Glass) of the ICDDR, B had been engaged in spreading communal hatred by reporting that the Hindus get more cholera and gastric diseases than the Muslims (47, 48). How rigorous were these studies performed to make a generalisation about the Hindus? Are these American scientists professionally competent to assess great religions like Islam and Hinduism? This is scientifically erroneous as cholera can kill all people irrespective of their religions. This disease was highly prevalent in Europe and America in the nineteenth century killing thousands of the Christians.

Publication of useless and repetitious materials to "please" uncritical donors

Often repetitious and useless "research" papers lacking both novelty and practical values are published in certain western journals where the ICDDR,B has influence. Such useless publications only help to promote scientific careers of the core members of the ICDDR,B who may brag about their long list of publications as signs of accomplishments. Also, uncritical donors can be impressed by such long list of publications. Many publications are nothing but "rediscoveries" like old wine in a new bottle. Ironically, as reported in Bangladesh's largest circulating daily the Ittefaq, most Bangladeshis do not know the difference between "diarrhoea and cholera" (49).

Behind the claims for the development of "the oral rehydration therapy"

The ICDDR, B boasts itself of having developed "the oral rehydration therapy". But it was just a "rediscovery" made in 1968 (50). The original publication of "the oral rehydration therapy" was made by a Bengali scientist Dr. Chatterjee of India fifteen years ago in 1953 (51). In a similar way, cholera toxin, which causes cholera, was discovered by a Bengali scientist Dr. S. N. De of Kolkata (52). The western scientists are very good in "muscling aside" scientists from the developing countries by all means and do not hesitate to rob their ideas and inventions.

Sheltering antique smugglers

The ICDDR,B and its predecessor CRL offer shelter to antique smugglers who do not hesitate to plunder vast amount of the cultural heritage of Bangladesh. The case of the American scientist David Nalin who had smuggled objects from the Bangladeshi museums is well known and had been reported in the Bangladeshi press such as the Bichitra in 1980.

The ICDDR,B: a threat to regional security

Finally, a word of caution has to be put forward. Many people of Bangladesh have their relatives in neighbouring India and vice versa. These people are naturally concerned about the health and welfare of their close-ones on the other side of the border. Infectious diseases can easily spread across the border. Therefore, the activities of a foreign-dominated centre such as the ICDDR,B dealing with highly pathogenic micro-organisms need to be monitored with great caution so that Bangladesh can avoid diplomatic problems with her immediate neighbour.

Under-developing Bangladeshi institutions

It is tragic that while the ICDDR,B squanders away millions and millions of dollars, the Bangladeshi research centres have little fund to function adequately. The pathetic plight of the Bangladeshi scientific community was described by a person no other than the eminent scientist Dr. Wajed Miah, the husband of the former Prime Minister Sheikh Hasina in the Bangladeshi press in 1998. Recently, a professor from Rajshahi University has appealed for help over the Internet for the University's research activities from the University's old students and teachers living abroad.

On the most effective means to combat diarrhoea

In 1988 the Bangladeshi members of the Standing Committee of the ICDDR,B, after realising the dismal performance of the Swedish oral vaccine, had expressed strong reservations. According to an article published in Bangladesh, internationally reputed scientists such as Professors Nurul Islam, Kamaluddin Ahmed and Major General M.R. Chowdhury had questioned whether cholera can be effectively controlled by vaccination (53). They commented, "Instead of vaccination, emphasis should be placed on health and sanitary measures along with the supply of pure drinking water. In this way cholera was eradicated from Sanghai, The Peoples Republic of China. People believe that by taking vaccine cholera is being eradicated. But the reality is different".

In this respect the opinion of a pioneering American cholera scientist Professor R.A. Finkelstein on the Swedish oral vaccine is worth citing. "As these dead oral cholera vaccines are expensive, difficult to administer, insufficiently protective, and potentially non-reproducible (they were constructed arbitrarily and there are no bioassays that reliably predict efficacy), the reader should not come away with the impression that they offer a solution to the cholera problem in the Americas or elsewhere......oral rehydration therapy is effective and relatively cheap. Intelligent epidemiological control measures can help, but the best solution resides in providing safe drinking water and sewage disposal. This can be an expensive investment, but it is one that will also reduce the burden of other diarrheal diseases, which, in some heavily afflicted areas, kill half the children before they reach the age of five" (54).

All what has been described above are scientifically documented and valid. About twenty five years ago National Professor Nurul Islam had written a letter in the British medical journal Lancet expressing his critical viewpoints behind the establishment of such a centre (55). Time has proven the correctness of Professor Nurul Islam, the founder of the IPGMR (now known as Bangabandhu Medical University). Do the people of Bangladesh need a centre like the ICDDR,B working for the interest of rich nations while collecting money using the name of the poor?

References:

The Independent, Dhaka, Bangladesh, 3 January 2000

W. E. van Heyningen and J. R. Seal, Cholera: The American Scientific Experience 1947-1980 Westview Press, Boulder, Colorado, USA, 1983, p 104.

ibid. p292

ibid p294

The Internet press release, Active Biotech/SBL Vaccin AB, Sweden, 29 March , 2000.

Kenner JR, Coster TS, Taylor DN, Trofa AF, Barrera-Oro M, Hyman T, Adams JM, Beattie DT, Killeen KP, Spriggs DR, et al. 1995. Peru-15, an improved live attenuated oral vaccine candidate for Vibrio cholerae O1. J Infect Dis. 172:1126-9.

Avant Immunotherapeutics Inc. USA, Business Wire, 20 January 2004.

The U.S. Congress, Subcommittee on National Security, Veterans Affairs and International Affairs, Hearing on Biological Warfare Defense Vaccine Research & Developmental Programs, 23 October 2001.

Cohen D, Orr N, Haim M, Ashkenazi S, Robin G, Green MS, Ephros M, Sela T, Slepon R, Ashkenazi I, Taylor DN, Svennerholm AM, Eldad A, Shemer J. 2000. Safety and immunogenicity of two different lots of the oral, killed enterotoxigenic escherichia coli-cholera toxin B subunit vaccine in Israeli young adults. Infection and Immunity, 68:4492-7.

Qadri F, Wenneras C, Ahmed F, Asaduzzaman M, Saha D, Albert MJ, Sack RB, Svennerholm A. 2000. Safety and immunogenicity of an oral, inactivated enterotoxigenic Escherichia coli plus cholera toxin B subunit vaccine in Bangladeshi adults and children. Vaccine. 18:2704-12.

The Internet press release, Active Biotech/SBL Vaccin AB, Sweden,: 14 April , 2000; p7.

Lindkvist, P. 1999. Risk factors for infection with Helicobacter pylori. PhD Thesis, Karolinska Institute, Stockholm, Sweden.

Mahnaimi, U and Colvin M, The Sunday Times (London, UK), 15 November 1998. Turnbull PC, Lee JV, Miliotis MD, Still CS, Isaacson M, Ahmad QS. 1985. In vitro and in vivo cholera toxin production by classical and El Tor isolates of Vibrio cholerae. Journal of Clinical Microbiology, 21:884-90.

Clemens JD, Sack DA, Harris JR, Chakraborty J, Khan MR, Stanton BF, Kay BA, Khan MU, Yunus M, Atkinson W, et al. 1986. Field trial of oral cholera vaccines in Bangladesh. Lancet. 19;2(8499):124-7.

Holmgren J and Svennerholm AM. 1985. Vaccine development for control of cholera and related toxin induced diarrhoeal diseases. In Micribial toxins and diarrhoeal diseases. London: Pitman (Ciba Foundation Symposium) 112:242-70.

SAREC Report on Developmental Research in Sweden, (Editor: Cecilia Molander) R2: 1981, Stockholm, Sweden

Svennerholm AM., Holmgren J, Sack DA, Bardhan PK. Intestinal antibody response in humans after immunisation with cholera B subunit. Lancet 1982 i: 305-8.

WHO: Biomedical research: a revised code of ethics. WHO Cronicle 1976; 30:360-2.

One death many questions. The Weekly Ekota (Dhaka) 3 May 1985

Clemens JD, Harris JR, Sack DA, Chakraborty J, Ahmed F, Stanton BF, Khan MU, Kay BA, Huda N, Khan MR, et al. 1988. Field trial of oral cholera vaccines in Bangladesh: results of one year of follow-up. Journal of Infectious Diseases. 158:60-9.

Finkelstein RA. 1995. Why do we not yet have a suitable vaccine against cholera? Advances in Experimental Medicine and Biology. 371B:1633-40.

Radio Ellen: The Swedish State Radio Programme, 25 April 1987.

Radio Ellen: The Swedish State Radio Programme, 1 November 1986.

Pal SC, Deb BC, Sen Gupta PG, De SP, Sircar BK, Sen D, Sikdar SN. 1980. A controlled field trial of an aluminum phosphate-adsorbed cholera vaccine in Calcutta. Bulletin of the World Health Organization. 58(5):741-5.

The Ittefaq, Dhaka, Bangladesh; April 4, 1985

The Sangbad, Dhaka, Bangladesh; 13 September 1986

The Azad, Dhaka, Bangladesh; 13 September 1986

The Janata, Dhaka, Bangladesh; 13 September 1986

The Sangram, Dhaka, Bangladesh; 13 September 1986

The Khabar, Dhaka, Bangladesh; 13 September 1986

The Banglar Bani, Dhaka, Bangladesh; 13 September 1986

Nasser M. ICDDR,B: Healing or Killing? The Dhaka Courier 11 July, 1986 Ali M: Bangladeshis as human guinea pigs: The Swedish connection. The Dhaka Courier May 25, 1987;

The International Centre for Diarrhoeal Disease Research, Bangladesh. 1986. The Hygeia 2:5-12.

Behind the mysterious activities of the ICDDR,B. The Weekly Sandwip, Dhaka, 4 & 11 August 1986.

Eklund A. De fosokstester nytt Svenskt vaccin. Kvälls Posten (Malmo, Sweden) 21 Dec 1986.

Hasan M. Vaccinforsok in Bangladesh. Upsala Nya Tidning 23 April 1987.

Bergman H. Vaccinprovning i Bangladesh: utan respekt for etiken.

Göteborgs Posten, Gothenburg, Sweden, 8 May 1987

Bergman H: Kvinnor blev forsoksdjur. Dagens Nyheter, Stockholm, Sweden, 16 February 1988

Eklöf G. 1987. Fattiga som försökskaniner. Internationalen No 21, p7.

Information on Dukoral, SBL-Vaccin AB, Sweden, 1996

Sanchez J, Holmgren J. 1989. Recombinant system for over expression of cholera toxin B subunit in Vibrio cholerae as a basis for vaccine development. Proceedings of the National Academy of Sciences U S A. 86(2):481-5.

The Internet press release, Active Biotech/SBL Vaccin AB, June 28, 1998.

The International Herald Tribune June 14, 1998

Eeckels R. Brief account of the major allegations in the press against the ICDDR,B.The Dhaka Courier. 29 August 1986, p9-11.

Clemens J, Albert MJ, Rao M, Huda S, Qadri F, Van Loon FP, Pradhan B, Naficy A, Banik A. 1996. Sociodemographic, hygienic and nutritional correlates of Helicobacter pylori infection of young Bangladeshi children. Pediatric Infectious Diseases Journal. 15:1113-8.

Glass RI, Becker S, Huq MI, Stoll BJ, Khan MU, Merson MH, Lee JV, Black RE. 1982. Endemic cholera in rural Bangladesh, 1966-1980. American Journal of Epidemiology. 116:959-70.

The Ittefaq, Dhaka, Bangladesh. 13 September 1987.

Nalin DR, Cash RA, Islam R, Molla M, Phillips RA. 1968. Oral maintenance therapy for cholera in adults. Lancet. 17;2(7564):370-3.

Chatterjee HN. 1953. Control of vomiting in cholera and oral replacement of fluid. Lancet. 265(6795):1063.

De SN. 1959. Enterotoxicity of bacteria-free culture-filtrate of Vibrio cholerae. Nature 183(4674):1533-4.

The Sangbad, Dhaka, Bangladesh, 23 April ,1988.

Finkelstein RA. 1992. Combating epidemic cholera. Science 257(5072):862.

Islam N, Mehtab H, Muttalib MA, Chowdhury Z. 1978. Cholera Research in Bangladesh. The Lancet. p1208.

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By Mahmood Ali mahmood.ali2009@gmail.com