IN the field of medicine and health, we have come a long way since Independence. Governments, both central and state, strive to provide affordable care at all levels. We now have world-class medical expertise and are proud to be a healthcare tourism hub. Patients from Central Asian, African and South Asian countries come with the confidence of getting quality health care at a cheaper cost than in the West.
But the one thing that should give us pause is that in the last 75 years, we’ve never even gotten a nomination for the Nobel Prize in Medicine. As we compete with China for economic growth, what about the growth of medical research? A Chinese medical scientist, Tu Youyou, shared the Nobel Prize for Medicine in 2015. When will we get this distinction? Of course, we know that one Indian and three people of Indian birth and descent who later acquired foreign citizenship won the Nobel Prize in Science.
What we lack is not talent, but the environment, infrastructure and incentives necessary for quality research and innovation. The Prime Minister, while addressing the 42nd AIIMS convocation in New Delhi, said India was lagging behind in medical research and more work needed to be done. It is important to promote a research environment in major medical institutes and emphasize its national significance.
Unfortunately, the quality of research conducted in most medical schools is dismal and there are data showing that some schools have not even published a single article in a peer-reviewed journal. Even in major medical institutes, although there are a good number of research publications, it is certainly not encouraging to note that 90% of these publications have less than 25 citations. So, it is not only important to do research, but also to look at the quality of the research. Most of the publications follow on from ongoing research in Europe or the United States.
We need to inculcate a habit of original thinking and innovation in our young people. Recently, during the inauguration of a scientific conclave, the PM mentioned that the inclination towards science, technology and innovation is in the DNA of our young people and that we must support them with all our might. So we need to think about how to promote good quality research.
First, training in research methodology is important; it’s a bit lacking right now. As a result, residents and even faculty members are unable to analyze research papers. Residents should be encouraged to do research projects and produce a good publication and they should be counted for selection to professorships as an incentive for the promotion of research.
Additionally, there is a lack of communication and collaboration between clinical and basic scientists to do good research. This leads to a lot of unnecessary research. A “positive research” culture environment should be fostered in faculties and institutes of medicine. It helps to explore ideas, make mistakes and learn from them; it teaches openness and integrity. The environment should inspire young people to aim for the stars and dream big.
Medical schools should be encouraged to collaborate with other basic medical science institutes of ICMR, DST CSIR and even biomedical institutes like IITs. Such relationships will foster problem-oriented and translational research.
The industry, both pharmaceutical and biomedical, should promote and invest in the production of new drug molecules and biomedical materials for medical use.
We need to integrate with our native Ayurvedic system to evaluate our ancient knowledge scientifically to prove its usefulness. Tu Youyou was tasked by Mao Zedong with finding a cure for malaria which was killing many soldiers. After extensive research and using her knowledge of ancient Chinese text and clinical tests, she created a drug, artemisinin, which helped to lower cases of malaria. It shows that traditional research and clinical research can complement each other if scientific methods are used.
At the same time, high-quality research work has been carried out in the medical field, of which we can be proud. India has contributed significantly to the identification of iodine deficiency disorders; he showed that iodized salt significantly reduces the incidence of iodine deficiency disorders. Commercially available iodized salt was made possible through this research. If a pinch of salt prevented iodine deficiency, we have our researchers to thank.
Another significant work is the discovery of the cholera toxin by Dr. Sambhu Nath De. De’s clinical work led him to the bold thought that dehydration was a sufficient cause of cholera pathology that cholera toxins could kill simply by stimulating water secretion in the gut. De’s research became the basis for today’s most life-saving recommendation for diarrhea: the use of oral rehydration therapy (ORT).
Ironically, De’s seminal research, done entirely in India, first gained recognition abroad and only after that did the Indian medical community praise him to heaven. We must learn to be proud and appreciate the achievements of our scientists. Besides demonstrating ORT, research by the National Institute of Cholera and Enteric Diseases has shown that common household drinks like nimbu pani, coconut water and rice water are just as effective as oral rehydration solutions to prevent diarrhea-related mortality and are more palatable.
The contribution of Indian scientists to the treatment of tuberculosis and leprosy has also been significant. Their role in the development of the Covid vaccine has also been very successful. We should be proud and appreciate the accomplishments of our scientists.
It’s time to promote and create attractive incentives for good medical research. This is the only way to arouse the interest of the younger generation to pursue research activities. A physician/scientist’s contribution to research should be an important criterion for faculty positions in medical schools.
The Prime Minister hailed the importance of the research by announcing “Jai Anusandhan” and adding it to the mantra of “Jai Jawan, Jai Kisan and Jai Vigyan”. Let us now strengthen our efforts and aim for a Nobel Prize in medicine.
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