A Report on ICDDRB Anomalies in recruitment, failings in research publications Analysis

A Report on ICDDRB
Anomalies in recruitment, failings in research publications
Analysis , by Morshed Ali Khan , 24-July-2006
[Blog]

‘Within the last decade over 100 major research protocols were funded by ICDDR,B but not a single report on these researches was published or made public. Neither was the management able to show any breakthrough in combating diarrhoeal diseases.... It is the only institution in the country that has the legal mandate for movement of biological materials in and out of the country.’ Daily Star, the leading daily of Bangladesh published an investigative report on this. A rejoinder from the authority was also published later with a reply from Morshed Ali Khan, the reporter. Here is the report alongwith rejoinder and the reply.


The only international centre of its kind in developing countries, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is fast losing its reputation due to alleged anomalies in management, recruitment and researches.

Within the last decade over 100 major research protocols were funded by ICDDR,B but not a single report on these researches was published or made public. Neither was the management able to show any breakthrough in combating diarrhoeal diseases.

Although ICDDR,B's two hospitals and its diagnostic facilities in Dhaka and at Matlab in Chandpur district are well reputed in the country, annually treating over 130,000 patients suffering from diarrhoeal diseases, its contribution towards researches and studies remains unknown, at least to Bangladesh.

With 'discriminative and anomalous' decisions made at the top level, ICDDR,B is now alleged to have become a one-man show with its executive director deciding over controversial recruitment and alleged unethical researches.

Resentment among ICDDR,B's Bangladeshi scientists, experts and employees run high with allegations of discrepancies in salaries and recruitment, and discrimination in fund allocations for research works of Bangladeshi scientists.

Although ICDDR,B is owned and largely funded by the Bangladesh government, since its inception no Bangladeshi has ever been considered for the post of its director. Currently 20 foreigners with top grade international salaries and facilities work for the centre.

The management of ICDDR,B however remains defiant to its ordinance when it comes to the payment of Bangladeshi workforce. Although the ordinance clearly states in section 14 (2) that salaries for non-international level positions should be comparable to the salaries paid by the United Nations organisations in the country, the Bangladeshi workforce of ICDDR,B does not even receive 50 percent of the UN salary structure.

"We cannot afford to pay the local staff as per the ordinance, we have to run the centre first," said David A Sack, executive director of ICDDR,B, who has been serving for seven years.

Sources alleged that the management overtly gives priority to foreign scientists over the local ones who submit proposals for research. They said Bangladeshi scientists are often subjected to long delays in processing their papers for funds.

"When a local scientist does his research work, he is paid from the fund available for the particular project, but a foreign scientist continues the same work with a top grade fixed salary, made available from a special fund," said a source.

With a fund of US $19 million in 2005, ICDDR,B, since its inception 28 years ago, has spent over $300 million to run the centre. The bulk of the fund is provided by the Government of Bangladesh with almost a million dollar in cash annually, and with assets and exemptions from taxes, duties and rates for the centre and its 2000 personnel. Other major donors are Switzerland, the Netherlands, UK, USA, Sweden, Canada and Japan.

Recently, two recruitment in ICDDR,B for the posts of director of human resources and the finance director, with top international tax free salaries (around US $8,000 a month) and facilities, created more resentments among its staff. The recruitment were carried out violating the charter under which ICDDR,B is supposed to run. Sources said prior to the appointments no advertisement was published in the mass media to ensure wide participation. Sources also said quite a few eyebrows were raised throughout the office when an external auditor of ICDDR,B, belonging to a foreign audit firm engaged in auditing the centre's finances, was given the position of the finance director of ICDDR,B with a top international salary. The auditor's independence and neutrality was instantly assumed to be compromised when he was offered the job during an external audit of the centre. The auditor immediately went back to his country of origin, resigned from the auditor's post and returned to join ICDDR,B as the head of its finance department.

The director of human resources, also a foreign national, was previously working for an international school in Dhaka as its head of 'after school extracurricular activities'. Allegedly she is a family friend of Professor Sack, and the position she was given requires a highly skilled person with relevant qualifications.

Professor David A Sack said he does not think the recruitment are in violation of any norm or 'a conflict of interest'.

"He was an external auditor and he knows the centre, and he totally disassociated himself from the other firm. He is very skilled, very qualified and he knows his job," said Sack.

ICDDR,B has a 16-member board of trustees where Bangladesh as the host is the only country represented by three members. By virtue of a decision made by the erstwhile president of the country, late Ziaur Rahman, the health secretary and the secretary to the Economic Relations Division become members of the board of trustees automatically. The Ministry of Health selects the third member, with relevant qualifications and expertise. The current Bangladeshi members are Secretary to the Ministry of Health AKM Zafar Ullah Khan, Secretary to the Economic Relations Division Mohammad Ismail Zabihullah and for the first time ever Secretary General of the Bangladesh Medical Association (BMA) Dr AZM Zahid Hossain.

The trustees meet twice a year supposedly to take some of the vital decisions on recruitment, researches and important other issues. The chair of the board is Prof Terence H Hull from Australia while the member secretary is Prof David A Sack.

ICDDR,B sources said the role of the trustees during meetings remains 'totally insignificant', where all decisions made by Prof Sack are silently accepted and approved.

"Most of the members are very busy executives both in Bangladesh and abroad, who hardly have time to scrutinise facts and figures, so they trust the executive director working directly in the field," said a top-level source.

Sources said the silence of Bangladeshi board members is usually managed by hefty honorariums, foreign trips and lucrative consultancies. A former health secretary to the Ministry of Health was offered the post of an 'adviser', a completely new position, with a top international salary. He joined the post a day after his retirement, raising questions as to how sincerely he served Bangladesh's interest while in the office.

Despite repeated attempts over a period of several days, the secretary of health and the secretary general of BMA could not be reached.

But, Secretary to the Economic Relations Division Mohammad Ismail Zabihullah said Bangladeshi board members are never consulted before any recruitment.

"I have heard about some anomalies in the centre and we would like to convene an urgent meeting to discuss the issues," he said.

The ICDDR,B ordinance clearly says that the board of trustees must approve the appointments of all top level personnel in the centre. David A Sack however said he usually takes approvals of the members over the telephone.

The executive director denied the allegations saying, "I hope that is not true [that he runs a one-man show], these [members] are experienced people and we have a majority of people [members] coming from developing countries."

Over the last 28 years, the centre has conducted eight 'candidate vaccine trials' on lakhs of people at Matlab in Chandpur but mysteriously failed to produce a single report on the trials.

Officials who were serving at the time of 1985 vaccine trials on the people of Matlab alleged that the trials were run without the consent of the people on whom the experiment was conducted. Following the allegation of 'unethical research' the government then formed a task force to look into the matter. The report of the task force was never made public.

According to Sack, the cholera vaccine trial conducted in 1985 in Matlab was 'quite successful'. After 20 years, the same vaccine tried on the people of Matlab, has been patented by a Swedish company, and licensed and marketed in Europe, he said.

"It's too expensive to make it available in Bangladesh, but now WHO is making recommendations for use of the same vaccine in Bangladesh. We are working to develop a formulation which would be inexpensive for the people to use here, I am afraid that might take years," Sack said.

According to the ICDDR,B Ordinance 1978, the centre is to undertake and promote study, research and dissemination of knowledge in diarrhoeal diseases and directly related subjects with a view to developing improved methods of healthcare. The centre is to provide facilities for training to Bangladeshi and other nationals in collaboration with international institutions.

Although the executive director denied it, recently ICDDR,B in a clear violation of its charter, decided to hand over its training division to a top NGO, whose expertise in training personnel in the field of diarrhoeal diseases is not known.

"We are working with BRAC in their school of public health, the students of the school come to ICDDR,B for the second half of the school year for training, it is not true that we are handing our training division over to anyone," Sack claimed.

But the dean of BRAC's school of public health, also Deputy Executive Director A Mushtaque R Chowdhury told The Daily Star that talks are underway to hand over the international training division of ICDDR,B to BRAC.

"We have long experience in public health related work and we are preparing to take over the training division of ICDDR,B," Chowdhury said.

There are two distinct components of training -- diagnostic and clinical. For the former extensive laboratory work is necessary, and for the latter a well functioning hospital is needed. BRAC does not have either of the two. How can BRAC impart training is a question that experts familiar with ICDDR, B's work are asking.

ICDDR,B was set up by an ordinance in 1978, giving it immunity from local taxes, rates and duties. The ordinance offers a wide range of privileges for its foreign employees including exemption from income tax and privilege of duty free import of all personal and household items. The chairman, trustees, director, officers and employees of ICDDR,B are also immune from any legal proceedings with respect to acts performed by them in their official capacity. It is the only institution in the country that has the legal mandate for movement of biological materials in and out of the country.

June 16, 2006

Rejoinder and the Reply

1. After living in Dhaka for nearly 13 of the last 29 years, I have deep regard for the people who work at the International Centre for Diarrhoel Diseases, Bangladesh (ICDDR,B), its Board of Trustees, and the people who are helped by our hospital. I generally have high regard for the press of Bangladesh as well. Thus, I was extremely disappointed by the article by Mr Morshed Ali Khan in The Daily Star regarding the ICDDR,B (16 June, 2006). As Executive Director of the Centre, I can say that the allegations contained in this article were unfounded and untrue. One wonders how an esteemed newspaper like The Daily Star could print such an article without first checking its facts. That the article appeared during the first day of the semi- annual meeting of our international board of Trustees, and at a time the Board is planning to begin searching for the next Executive Director is a curious coincidence. In fact, the centre is a highly respected international research institute whose results are known throughout the world and whose efforts locally save the lives of thousands in Bangladesh each year.

2. An obvious error in article states that "within the last decade over 100 major research protocols were funded by ICDDR,B but not a single report on these researches was published or made public." This statement is obviously false given the thousands of scientific papers that have been published by scientists at the Centre. This could easily have been understood if the writer had taken the time to visit any medical library or even consulted the internet. The Daily Star regularly uses information from our quarterly bulletin in its newspaper, and several articles from The Daily Star have praised the work of the Centre. My office has an entire file containing many articles from The Daily Star reporting on the findings from the ICDDR,B. Even last week, two articles written by the Bangladeshi scientists at the Centre were published in two of the most prestigious international journals -- the New England Journal of Medicine, and the Proceedings of the National Academy of Sciences. Each of these articles was accompanied by an editorial highlighting the importance of the findings. In addition, the Centre publicizes important new findings quickly through a quarterly bulletin for medical professionals (the Health and Science Bulletin) and to grass roots workers through newsletters (Shayasta Sanglap). In addition, dissemination seminars are held regularly including the ASCON and ASCODD conferences, and the scientists from ICDDR, B participate regularly in seminars and symposia in other institutions. Lack of publications and dissemination is hardly an issue.

3. These publications have an impact all over the world. The development of methods for treating diarrhoel diseases, including oral rehydration solution. Has saved the lives of over 40 million children all over the world during the last two decades. Other research efforts toward helping children pneumonia, reducing deaths in newborns, and mothers, and assisting the government in their family planning programmes are well known. These contributions were recognized by the first ever Gates Award for Global Health in 2001 and by the Independence Day Award in 2005.

4. The writer attempted to distort the work of the Centre to create the impressions that Bangladeshi scientists were somehow disadvantaged. In fact a majority of the scientists at ICDDR,B are from Bangladesh. They regularly develop projects and publish their results. As a result of their productivity and their contribution to health research, many of the Bangladeshi scientists have now been promoted to the international level.

5. The article also does a disservice to the more than 2000 staff members of the Centre both in Dhaka, Matlab, and other areas of Bangladesh who are literally working night and day to help the poor people of Bangladesh. Last year more then 110,000 patients sought care from our Dhaka Cholera Hospital, about 20,000 of whom had a life- threatening diarrhoel disease. The lives of these mothers, fathers and children were saved through the efforts of our hospital staff.

6. Recruitment of all staff at the Centre is totally fair and open. For staff at the highest international levels, the international Board of Trustees must approve these selections and they take this responsibility seriously. The board has an established and transparent process for the selection. As an international institution, the ICDDR,B attempts to recruit the best and brightest individuals from around the world -- including Bangladesh and including one of the Division Directors who is from Bangladesh. Recruitment for all local positions is also through a totally transparent process. We seek to find the women and men who are best qualified to fill the job.

7. Among the allegations, the writer says that the there have been no reports from 1985 cholera vaccine field trial in Matlab. In fact, more than 40 publications have been published in international journals. The vaccine was found to be totally safe and based on the experience in Matlab; it was later evaluated in other countries, most recently in Mozambique where its effectiveness was again reconfirmed. Due to the knowledge gained in Matlab and these other countries, the vaccine is now licensed in Europe and many countries and the World health Organization now recommends its use for persons who are vulnerable to cholera epidemics. One of the Centre's activities now is to develop a formulation of the vaccine to be practical and inexpensive so that it can be made available to people in this country who choose to take it. It is important to note that all studies at the ICDDR,B involving humans are approved by our Ethical Review Committee including the 1985 study. This committee is composed primarily of Bangladeshi people outside the Centre who also take their responsibility very seriously.

8. I especially object to the photo of the students who are shown working in the immunology laboratory of the Centre. At present, 27 M.Sc. students from different universities in Bangladesh are working diligently toward their degree, and they are using the facilities of the ICDDR, B to help them achieve this goal. The scientists at the ICDDR,B coordinate with faculty supervisors at these universities to facilitate the training experience of these students. The caption under the photo belittles the efforts of these students who are contributing to the scientific output from Bangladesh while at the same time, preparing for a future career in health research.

9. In summary, the article by Mr. Khan was most unfortunate. The fact that the Daily Star chose to print the article with so many obvious misstatements was doubly unfortunate. The ICDDR,B is the only such international health research institute in a developing country. Other international centres have headquarters in Geneva or New York, but we are proud to claim that the headquarters for this international centre is in Dhaka. Under the direction of a distinguished international Board of Trustees, we work for the people of Bangladesh in partnership with the ministry, provide opportunities for Bangladeshi health professionals, and build the knowledge for life saving solutions that benefit poor people all over the world.

The Reply:

We generally do not publish full text of such big rejoinders, especially when they fail to respond to points we have raised. We are doing so to show before the public how David A Sack's rejoinder avoids answering the main questions we have raised. We address his rejoinder in detail and provide our response below.

In paragraphs 1, 2 and 3 David A Sack details international publications of ICDDR,B's research works but fails to elaborate as to how Bangladeshi medical science and especially medical practitioners have benefited from those. His rejoinder mentions some international publications but does not mention how these research works were made available to Bangladeshi people or professionals. He refers to some The Daily Star articles that referred to ICDDR,B works or events but this cannot be taken as substitute for research publication that were made available internationally, but not, to our knowledge, nationally.

In paragraph 4 and 5 Sack says that majority of scientists in the centre are Bangladeshi and that they are not disadvantaged. He fails to answer our question about salary discrepancies of Bangladeshi staff in violation of the ICDDR,B Ordinance. There is also no response from Sack about Bangladeshi scientists receiving research grants from project fund only, while foreign scientists receiving the grants from a special fund. Instead, he tries to play on emotion by saying how thousands of Bangladeshi workers are working day and night. This is precisely our point. When Bangladeshis are working so hard, day and night, then why pay them a discriminatory salary?

In Paragraph 6, the Executive Director makes general comments about the openness in recruitment policy. In our report we made two specific allegations. Firstly, appointment of the Human Resources Director, who was head of after school extracurricular activities at an international school prior to joining the post. Secondly, we raised questions about the appointment of former auditor of the centre as a Finance Director. This is clearly a case of conflict of interest. Questions naturally arise when an auditor is offered a job in the same organisation whose financial propriety he is supposed to be investigating.

The Executive Director clearly avoids answering these two specific issues.

In Paragraph 7 he mentions about the cholera vaccine, experiment of which was conducted in Matlab, being available in Mozambique and many other countries. This is precisely the point we made in our article. The vaccine for which our people were experimented upon, is now licensed in Europe and sold in many other countries except ours. We did not even know about these experimental developments. Is it fair that Bangladeshi people should not benefit from a medicine, in the discovery of which we were experimented upon?

In conclusion we reiterate the fact that we made allegations or discrepancies in salaries, discrepancies in fund allocation for research, recruitment and management but Sack has failed to address any of the questions raised.

A Mushtaque Chowdhury's letter and reply

We also received a letter from A Mushtaque R Chowdhury, Dean of James P Grant School of Public Health, who denied having told The Daily Star correspondent that BRAC was planning to take over the International Training Division of the ICDDR,B. He said that he was misunderstood by the correspondent. The BRAC School of Public Health is a joint collaboration between BRAC and ICDDR,B. At the moment the BRAC school students spend half of the time at ICDDR,B utilising their facilities including the library, classrooms, laboratories, filed sites and more importantly the researchers most of whom also teach at the school.

Our reply: We are further investigating this point, and reserve our response at this point.

Terrence H Hull's letter and our reply

Terrence H Hull, the Chair Board of Trustees, ICDDR,B in a letter claims, "The Board is responsible for reviewing senior appointments made at ICDDR,B and can affirm that there are no anomalies in the appointment procedures or selections as asserted by our article. Those assertions contained neither evidence nor attribution to a source that could have possibly had any knowledge of the matter..."

Our reply: Like Sack, Terrence H Hull also gives a general reply and does not answer the point we raised about two specific senior level appointments, which should have been reviewed by the Board of Trustees. We specifically ask Hull, "did the Board review the appointment of the Human Resources Director? What qualified a former instructor of after school program of an international school to qualify for such a senior post? As for the director finance, doesn't the Chair of the Trustee Board find anything curious in the appointment of an auditor during an audit, as its finance director?"

Our readers would be well served and we may even stand corrected if the Chair of the Board of Trustees is so kind enough to let us know how the Board discharged responsibilities in appointing these two directors. For the sake of transparency and accountability, we will welcome any information by the Chair other than affirmation that "....that there are no anomalies in the appointment procedures or selections as asserted by our article."