Need to rescue Indian medical research from its moribund state
Why is there so much of night blindness in Rajasthan, so many women suffer from cervical cancer and so many people die of malaria and other communicable diseases? Posing these questions the late prime minister Indira Gandhi wanted to know what the Indian Council of Medical Research (ICMR) had done about them. That was some time in the 1980s.The question she raised then is very much...
Why is there so much of night blindness in Rajasthan, so many women suffer from cervical cancer and so many people die of malaria and other communicable diseases? Posing these questions the late prime minister Indira Gandhi wanted to know what the Indian Council of Medical Research (ICMR) had done about them. That was some time in the 1980s.
The question she raised then is very much relevant today. Had she been alive she would have asked why there has been no progress towards control of dengue, chikungunya, Japanese encephalitis and malaria.
Dr. C.G. Pandit, the first Director General of ICMR, was a visionary responsible for starting many research institutions, and under whom the maximum development of ICMR took place. His successors -- Dr. C. Gopalan, Dr. V. Ramalingaswamy and Dr. A.S. Paintal -- will always be remembered for promoting quality research.
The decline of ICMR started in the 1990s. It created many new institutions in different parts of India because politicians wanted an institute in their constituency or some scientist had to be rewarded with a director's post.
As far as I know there are many ICMR institutions replicating the work of their sister institutions. The net result is their contributions are only on paper and not geared to solving problems on the ground.
There has been no equivalent of green revolution or white revolution in the biomedical field. On the contrary, problems affecting human health are only increasing because, as the 12th plan document said, "health research in India has yet to make a major impact" on public health.
It is to the credit of Gopalan that the institution of Scientific Advisor Committees (SAC) was started for each Institute. This was meant to have some kind of performance audit. The SAC of each institute used to be chaired by the Director General himself and was an occasion for intellectual discussion and positive directions.
Things are very different now.
The Director General does not attend the SAC meeting of any institute, and the meetings in some institutes are only tamashas.
At a SAC meeting where I was a member, the chairman asked questions like how many Ph.Ds have you produced; how much money have you managed to get as project grants from abroad, and so on. Not a single question on what work you have done and what problem you have solved.
When the questions I raised were all deleted from the minutes, I resigned from the SAC.
In olden days, to study basic and fundamental aspects of medical research, financial grants were made available to research scientists from universities and medical colleges who applied for grants for specific projects.
The project-oriented time-bound projects really helped in the development of fundamental research. It is a tragedy that ICMR discontinued this practice and tried to do everything in its own institutes but failed.
The decline of the ICMR nosedived in the 90s. Even now we tend to follow the directions from international organizations like the World Health Organization (WHO).
The WHO always dangles a carrot - foreign trips, short and long-term consultancies -- to scientists from developing countries provided they do what they are told.
There are several examples of WHO carrying out so-called research in many developing countries, most of which had not yielded any fruitful results. In one research project undertaken by the WHO, not many years ago in Delhi, plans were made to release millions of the laboratory reared Yellow Fever mosquito, Aedes aegypti, in a crowded town.
It must be mentioned that there is no Yellow Fever in India, and the avowed objectives of the project were control of malaria and filariasis vectors through genetic control.
There was a political storm and the project was ordered closed. In this particular case, the WHO was the "middle man" that brokered an agreement between the US Public Health Service and the Indian health ministry.
Many multinational drug manufacturers find it easier to test their products or carry out vaccine trials in developing countries through the good offices of the WHO.
Imagine an ICMR institute, meant for vector research, undertaking long-term hospital-based trials of an anti-filarial drug produced by a multinational company, and which was earlier condemned by Parasitology Today (British Scientific Journal) as not only ineffective but also dangerous.
In recent years, the red tape and the "committee culture" have made the ICMR and its institutes moribund.
Can the ICMR emulate the Indian Institute of Science or Tata Institute of Fundamental Research in quality research? This is a big challenge before Dr. Soumya Swaminathan, a medical scientist of repute who has been named as the new director general of ICMR.
(Padma Shri Payyalore Rajagopalan is Fellow of the Royal Society of Tropical Medicine and former director of ICMR's Vector Control Research Centre in Pondicherry. The views expressed are personal. He can be reached at firstname.lastname@example.org)
Meghna A Singhania is the founder and Editor-in-Chief at Medical Dialogues. An Economics graduate from Delhi University and a post graduate from London School of Economics and Political Science, her key research interest lies in health economics, and policy making in health and medical sector in the country.She is a member of the Association of Healthcare Journalists. She can be contacted at email@example.com. Contact no. 011-43720751