A recent civil society-led investigation has highlighted serious ethical violations in a trial of the Human Papilloma Virus vaccine on girls in Khammam district in Andhra Pradesh. The findings are presented along with a review of clinical trials of the hpv vaccine in India and an analysis of the Drugs and Cosmetics Act and Rules. Together they illustrate how the promotional practices of drug companies, pressure from powerful international organisations, and the co-option of, and uncritical endorsement by, India's medical associations are influencing the country's public health priorities.