India must combine its infectious diseases data-mining prowess with advanced medical technologies.
By: Kiran Mazumdar Shaw
The coronavirus pandemic is a lesson that governments worldwide ignore research into infectious diseases at their own peril.
The Covid-19 outbreak has taken the world completely unawares, exposing the vulnerability of public health systems in coping with infectious disease pandemics. Effective governance of pandemics involves preparedness, response and recovery at local, national and international levels. As the world has fallen short on all these counts, the failure has allowed Covid- 19 to spread like wildfire across hundreds of countries, affecting lakhs & killing thousands.
While many apocalyptic predictions are being made about a post-Covid-19 world, it can act as a wake-up call for all of us, as individuals, as a society and as a country. Life after Covid-19 will not — and should not — be the same. It will call for a change in priorities, in focus and in the way we do things.
The coronavirus pandemic is a lesson that governments worldwide ignore research into infectious diseases at their own peril. Avian flu, SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome), Ebola, Zika, Nipah, etc, are a clear example of the warning signals they have sent to us. Moreover, with bacterial infections becoming increasingly resistant to antibiotics, common infections can potentially become life-threatening in the future.
Infectious diseases, which posed a significant disease burden in developed countries until the mid-20th century, gradually declined due to better standards of living and improved hygiene and sanitation. The advent of antibiotics in the 1940s-50s further lowered the threat.
As a result, research into infectious diseases started losing sheen in the developed countries. Globalisation and market forces meant that even in poor countries such as India, this kind of research went into the backburner.
In a post-Covid-19 world, there needs to be a course-correction. While it is virtually impossible to predict what the next pathogen threat will be, from where it will emerge and when it will strike, pandemic-focused research could give us a future head start in the battle against infectious diseases.
India has a very important role to play in this battle. Given the long history of this type of diseases in our country, we have accumulated years of experience and scientific knowledge to prevent and treat them. Institutes like the National Institute of Epidemiology in Chennai, the National Centre for Disease Control in New Delhi, the Centre for Infectious Disease Research in Bengaluru, and the National Institute of Virology in Pune, already exist. GoI will need to invest significantly in strengthening the capabilities of these institutions to give a fresh impetus to research into infectious diseases.
India urgently needs to create a virus repository with genomic data. This will be tremendously useful in developing diagnostics and vaccines for these diseases, thus helping to control them early and stopping their spread. In tackling pandemics like Covid-19, rapid response is going to be very important and bioinformatics will play a key role in this.
The large infectious diseases burden in India presents a very important research resource. We need to combine India’s world-class IT prowess in mining infectious diseases data to crack the genetic code of pandemic-causing viruses. Combining this knowhow with advanced medical technologies will enable us to develop a battery of low-cost rapid diagnostic tests for various infectious diseases.
At present, India is mostly dependent on imported diagnostics. An India-US joint venture, CoSara Diagnostics, became the first company in India to develop a US Food and Drug Administration (FDA)-approved Covid-19 diagnostic test that is awaiting a licence from the government to manufacture coronavirus test kits.
Expedited regulatory clearances, and the right kind of support from GoI will enable many more companies in India to come forward for developing these diagnostic tests indigenously. GoI can also allow companies to deploy their corporate social responsibility (CSR) funds for this kind of capacity creation.
As vaccines are the most important tool for reducing the high morbidity and mortality invariably associated with pandemics, governments across the world will explore ways to expedite the development of these therapeutics.
While the Indian vaccine industry has been instrumental in facilitating cost-effective immunisation in the country and the rest of the developing world, suboptimal public sector investment in vaccine research poses a major challenge for future preparedness. Indian vaccine producers cater to 50% of global needs of MMR (measles, mumps, rubella), diphtheria, tetanus, polio, pertussis and BCG (Bacillus Calmette-Guérin) vaccines (used primarily against tuberculosis) in volume terms.
The development of new vaccines is fraught with risk and requires heavy investment over long periods. Which is why, public investment and government support are indispensable for driving a dedicated vaccine research programme. We need to go beyond developing ‘me too’ vaccines that build on basic research overseas to developing pandemic vaccines for novel influenza viruses.
Indigenously developed vaccines from India could help save millions of lives and help Indian companies capture a larger share of the international market.
The current crisis has reiterated the fact that healthcare and life sciences is the biggest opportunity for a country like India. GoI needs to seize this moment to redirect its focus on biotechnology, life sciences and healthcare, and work together with the private sector to make India not only the ‘Pharmacy of the World’ but also the ‘Laboratory of the World’.