Photo: iStock
Photo: iStock

Opinion | India now a key player in neglected disease treatment

The Indian govt is helping to build a thriving community of scientists working to solve health issues

Some of the hardest moments of my career were from my years as a paediatrician, when children came to my clinic and I lacked treatment to cure them—or, existing treatment was painful, unreliable or expensive. As a researcher at the National Institute for Research in Tuberculosis, and through my work leading the Indian Council of Medical Research (ICMR), I witnessed firsthand the huge potential of science to develop new tools and strategies that not only curb disease, but also the dejection and frustration that children, families and doctors too often experience when the medical field fails to offer good solutions to life-threatening problems.

As deputy director-general of programmes for the World Health Organization (WHO), my work looks quite different but my goal remains unchanged: to ensure more people have access to quality, affordable healthcare that meets their needs.

Developing new drugs, vaccines and diagnostics will be critical to achieving this goal. We have seen the power of science and innovation throughout history to dramatically improve health and lift generations out of poverty, from penicillin to the meningitis vaccine. But it is important to remember that breakthroughs require time, patience, partners and significant investment.

That’s why it’s been encouraging to see the Indian government increasingly invest in health innovation. The annual G-Finder report, the world’s most comprehensive analysis of neglected disease research investments, released by Policy Cures Research on 30 January highlights India’s leadership. According to the report, the Indian government scaled its contribution by 38% to $76 million in 2017, upholding its position as the fourth-largest public funder globally. Moreover, the report calls out India as a key driver of 2017’s overall increase in global public funding. A large part of this increase came from ICMR, which substantially increased its investments in malaria, TB and other neglected tropical diseases. For the first time ever, ICMR has been placed in the top four largest funders of TB research and development (R&D). It is also the only organization from low- and middle-income countries to feature in the top 12 funders.

As important, the Indian government is helping to build a thriving community of scientists working to solve health challenges and connecting startups to create a sustainable ecosystem. Apart from providing funding, the Biotechnology Industry Research Assistance Council has developed an ecosystem of programmes and schemes that provide holistic support to startups and small and medium enterprises.

The year 2018 was testament to that value of India’s investments, with the country at the forefront of many exciting scientific advancements. For example, the new triple drug therapy for eliminating lymphatic filariasis (LF) was launched in December 2018. Unlike traditional LF treatments, a single dose of the new triple-drug therapy is enough to kill the adult worm, making it significantly faster, easier and cheaper to cure people. India, which bears 40% of the global disease burden, is the first country in South-East Asia to introduce the new treatment regimen.

Another area of progress is vaccines. In just the past year, two Indian manufactured vaccines (for typhoid and rotavirus) received WHO prequalification. India has also made strides developing affordable and accurate diagnostic tools, including a point-of-care molecular detection platform that can detect a variety of infectious agents. Such innovations will enable better diagnosis and treatment at the primary health centre level.

While these are reasons to celebrate, millions continue to suffer and die each year from diseases that we don’t have the tools to adequately address. Take tuberculosis, a disease with nearly 3 million new cases each year in India, the highest burden in the world. Current treatments are complex and expensive, requiring six months to two years of daily treatment. Moreover, a growing portion of new cases are resistant to existing drugs. An effective TB vaccine for adults could save millions from being newly infected, and therapies to shorten treatment and combat drug-resistant strains could save many more.

Yet, research projects for TB and other diseases are still too often grossly underfunded. WHO recommends that countries donate .01% of their gross domestic product (GDP) to research the health needs of developing countries. In 2017, despite increases, not a single country met this target. Only the US and the UK came somewhat close, underscoring that there is still a long way to go.

Scientific breakthroughs are possible, but far from inevitable. India’s leadership in this space is encouraging, as is its vision for the future: by 2030, the government aims to place India among the top three countries globally in science and technology. To realize this ambition, India will need to sustain science funding and find new ways to incentivize urgently needed innovation. The cutting-edge expertise and technology of the private sector and strong international partnerships will be key. And India will need to ensure that new and existing innovations reach the people who need them the most through parallel investments in its health system. With global funding in 2017 touching the highest level in more than a decade, there has never been more momentum behind research to speed up the fight against neglected diseases. From LF to TB, India is, and must continue to be, a leader in that fight.

Soumya Swaminathan is deputy director-general, World Health Organization

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