"Notwithstanding such concerns about the high costs and meager benefits of the vaccine, Gates, through his surrogates at GAVI, PATH, and WHO successfully arm-twisted the Indian government in 2007–8 into introducing the hepatitis B vaccines. GAVI pushed WHO to change the official policy to a universal recommendation, meaning that even countries with low disease burdens would be required to vaccinate. GAVI hoped this would reopen the Indian markets. WHO obligingly changed its recommendation to include universal immunization with hepatitis B vaccine for all countries, even those where HCC was not a problem. The Indian government obediently adopted WHO’s recommendation."