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Business News/ Opinion / Online-views/  Nobel season
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Nobel season

Nobel season gives us the opportunity to ponder whether government policy in India enables or disables drug discovery

Photo: DMRCPremium
Photo: DMRC

October was Nobel season. In India, it was dengue season (among the victims this year in Bengaluru was Samuel Paul, a tireless crusader for better governance). The two worlds intersected in this year’s awards, with the Medicine Nobel going to a trio who wrought huge reduction in human suffering by finding cures for mosquito-borne diseases like malaria and filariasis.

The Swedish Embassy in Delhi marked Nobel season by putting up in Rajiv Chowk metro station a temporary exhibit on the eight Nobel prize winners that India claims as its own, cumulating over all years (on the boundaries of that ownership, more later). Large posters showed photographs of these eight distinguished people, accompanied by their individual histories.

The idea of having a Nobel exhibit in Rajiv Chowk metro station was excellent. It diverted the attention of the young, if only for the duration of a glance, to human achievements other than smartphones and apps. But surely they would have been more fully inspired if there had instead been a story on drug discovery, with a focus on this year’s winners. That story would have been more closely relevant to the daily challenges faced today by the young people hurrying past, among them the dengue they were trying to dodge right here in Delhi.

Of the three prizewinners for Medicine this year, the story of Youyou Tu is the most inspiring. In the 1960s, when chairman Mao found that Viet Cong mortality was inflicted more by the humble mosquito than the imperial forces of the West, he commanded Chinese scientists to find a cure for malaria. But the modern biologists who could have bent themselves to the task had been scattered by the Cultural Revolution. Those of them that were alive were hoeing potatoes or tending pigs in the countryside. So he turned to the China Academy of Traditional Chinese Medicine, which had been spared the purge, and commanded them instead.

Youyou Tu found in an ancient Chinese medical treatise mention of a substance useful in fighting fever of the kind experienced by malaria victims. Luckily, she was sufficiently well-versed in modern biochemistry to be able to extract the malaria-fighting compound from it. Artemisinin, the compound she extracted, came on the market just as quinine, the traditional cure, was proving increasingly ineffective. (Parenthetically, Youyou Tu has tried repeatedly but failed to get admitted to membership of the Chinese Academy of Sciences—even China has not found a cure for gender prejudice).

Many decades later, artemisinin itself is proving ineffective with the malaria parasite having developed immunity, especially in Vietnam where it was heavily used. The search for a successor to artemisinin, and if possible a vaccine, is on. The Foundation Day lecture at the National Institute for Immunology, held as it happened the day after the Nobel announcement, described ongoing work in Australia in that quest.

Filariasis, most fortunately, has become so rare that most people do not even know what it is, or the ravages it visited upon its victims. In some parts of Alappuzha district in Kerala in the 1950s, one in 10 people walked on legs horrendously distorted by the disease (also called elephantiasis, because it permanently expanded human legs to elephantine proportions). The muscle fibre thickened by filariasis was so intertwined with nerves and blood vessels, that surgeons were unable to restore the legs of affected victims to anything resembling their former size. The co- winners of the medicine prize this year brought an end to that nightmare.

The Nobel prize is about human triumph. It is not like the Olympics, with national medal tallies and anthems and flags. Although the biographical information issued by the Swedish Academy on each prize winner does mention their national point of origin, rightly causing great rejoicing in those countries, the prize at the end of the day is about how the human spirit has confronted life.

In keeping with that, the Swedish exhibit at Rajiv Chowk station could instead have been about continuity in the human battle against disease over the centuries as exemplified by the Youyou Tu story, about how that kind of continuity is enabled by literacy and, most importantly, about how such knowledge as is gleaned from the past needs to be subjected to the rigour of modern validation. Even if the exhibit wished to stay within Nobel confines, it could have extended the malaria story back to Ronald Ross. He won the Nobel prize for medicine in 1902, for discovering that the malaria parasite was transmitted by mosquitoes. That was a fundamental breakthrough in the understanding of malaria, although quinine as a prophylactic and cure had already been in use for several hundred years.

It is difficult for the Swedish Embassy in Delhi to assemble that kind of exhibit in a hurry, so perhaps they should establish a network of scientific institutions, who could be called upon to quickly provide material for such an exhibit, depending on which area of award they choose for focus and display in any particular year.

The economics of drug discovery today does not encourage search for cures or vaccines for devastating diseases with small numbers of victims. Japanese encephalitis, a mosquito-borne disease, is a reliable annual post-monsoon visitor in several districts of Uttar Pradesh and Bihar. It leaves dead and mentally-disabled children in its wake. There is a potential market for the vaccine, but over a small area and among poor people. A public exhibit against the background of Nobel glamour provides the right opportunity to play up the unfinished task of the battle against the mosquito. And for us to ponder some hard questions. Do our current drug discovery protocols encourage or discourage soldiers in this battle? Does Indian policy enable or disable the fight in India? Will we ever succeed in the way of Cuba, which has supported the search for cures and vaccines for deadly diseases that affect citizens too few and too poor to constitute a market for pharmaceutical companies? Has government in India provided the governance identified in the work of Angus Deaton, the economics laureate this year, as necessary for life with dignity?

Finally, on national prize tallies—we claim Mother Teresa among our eight, but not Ronald Ross, who similarly did his prize-winning work in Calcutta. Ross was even born in India, and made his discovery as a member of the Indian Medical Service. Maybe the difference is that Mother Teresa took Indian citizenship, although admittedly she did more than just adopt Indian citizenship. She introduced the sari among the permissible range of habits worn by Catholic nuns, and made its three-banded blue border an internationally recognized symbol of compassion rivalling the Red Cross.

If we go by karma-kshetra (place of work) and not by place of birth, we should not claim three of our four scientist winners, who although born in (undivided or post-Independence) India, took foreign citizenship and did their work on foreign shores. Maybe we are just being generous and grand in including them. In any case, no one would probably question our claim, since those kinds of polysyllabic names could only have originated in India.

But maybe we should be grander still and include one Nobel prize winner who has been steadily kept out of the Indian list. Vidyadhar Surajprasad Naipaul was born in Trinidad, and did his work in England. But his background is arguably closer to gritty India than that of any of our home-born winners. His name is Sanskritized; his parents were Seepersad and Droapatie. He grew up in a large Bhojpuri-speaking joint family of agricultural workers, emerged out of indentured labour into hard-scrabble subsistence cultivation, and in the case of his father into a job as a journalist. What made the difference was that on a small island under colonial rule, the distance to a first-class education was far shorter than it would have been in an equivalent setting in Gorakhpur. Naipaul was irresistibly drawn to the country of his ancestors, even managing to locate his grandfather’s village. He offended Indians by writing three very critical books about the country, and his personal conduct was deplorable, but he derives undeniably from the Gangetic heartland.

Equally undeniably, it is far better for us to abandon the idea of tallying our score, and to look at the new prize winners each year, and what they represent in terms of the human endeavour. Such a display in Rajiv Chowk would have had far greater appeal to the young ridership of the Delhi Metro, and would have been more educative. One of the winners this year has even worked on India—Angus Deaton. Aside from his formidable body of work on design and analysis of household surveys, he has worked on Indian National Sample Survey data, testing, among other things, for boy-girl discrimination within households.

Indira Rajaraman is an economist.

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Published: 06 Nov 2015, 01:18 AM IST
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