Whereas managing the affairs of a medical faculty at a multidisciplinary non-public college, I’ve observed that our medical faculty is usually busy with day-to-day operations associated to affected person and scholar educating. They not often have the time or funding to conduct high-quality, revolutionary analysis. Whereas time is one vital issue, one other is the inertia that causes many to do issues exterior of lecture rooms, lectures, and normal books, largely attributable to the dearth of an optimum ecosystem for conducting analysis. And after a deep examine of the construction of different medical faculties in India, we discovered that the scenario is similar all over the place.
With India boasting a few of the finest docs, experience and medical services at the moment, why does not it produce notable medical researchers? This 12 months’s Nobel Prize in Medication was awarded to Mary E. Brankow, Fred Ramsdell and Shimon Sakaguchi for his or her breakthrough analysis in drugs – the identification of regulatory T cells (Tregs) and the FOXP3 gene, which act as a organic “brake” that forestalls the immune system from attacking its personal tissues. Nevertheless, such pioneering researchers are uncommon within the Indian subcontinent.
Analysis in India
The breadth of human information is awe-inspiring, matched solely by the human starvation to excel and study extra. Nevertheless, the present state of medical analysis in India is much from ultimate.
This situation has began to enhance lately because the nation is changing into a hub for medical trials. In keeping with a report by Make investments India, round 18,000 new medical trials had been registered in India in 2024. This displays improved infrastructure, regulatory frameworks and curiosity from pharmaceutical corporations. This can be a results of elevated consciousness of evidence-based drugs and translational analysis.
Nevertheless, analysis output is extremely uneven, with a small variety of establishments producing the vast majority of publications. In the meantime, many establishments produce just about nothing. In keeping with media stories, the All India Institute of Medical Sciences (AIIMS), New Delhi, reported for the interval 2005-2014 that in this era, there have been 11,377 papers cited in Scopus and eight,145 papers had been cited in PGI, Chandigarh. Most different medical establishments within the nation incur virtually no medical prices.
Globally, the highest nations for medical analysis in 2023 had been the US with 7,040 papers, China with 1,940 papers, and Germany with 1,431 papers, in accordance with knowledge from the Nature Index for Well being Sciences in 2023.
The brilliant facet of the present scenario is that India is quickly rising by way of publication quantity and is among the many high few nations by way of variety of publications. Our development price is powerful, displaying momentum and potential. Now we have a big inhabitants, many ailments, and lots of hospitals and medical establishments. This implies there’s monumental scope for analysis. The unlucky half is that the affect rating is comparatively low. Our analysis outcomes are concentrated in just a few establishments. Spending on analysis can be low, leaving cooperation with worldwide organizations and infrastructure necessities on the again burner.
what wants to alter
To catch up or considerably shut the hole, key actions will embrace bettering the standard and affect (not simply amount) of analysis, rising contributions to high-quality journals, fostering worldwide collaboration, and strengthening institutional capability.
To attain this, you could first be punctual. Professors at public hospitals see greater than 200 sufferers a day, leaving little time for impartial analysis. In distinction, in Nobel Prize-producing environments, medical college usually defend their time and sources for pure analysis.
The second step is infrastructure upgrades and assist. Many in India lack ample laboratories, biostatistical assist, and analysis mentors. There may be little institutional infrastructure for long-term fundamental biomedical science. Medical analysis in India is primarily medical or descriptive, not often mechanistic or molecular, and is the place Nobel-level discoveries are made.
The third is monetary assist. India spends 0.7% of its GDP on analysis and improvement, in comparison with 3-4% within the US, 2.8% in Germany and a pair of.4% in China. Solely a small portion (maybe 10-12%) of that is used for well being and biomedical analysis. Grants are sometimes small, bureaucratic, and delayed. Evaluate mechanisms lack consistency. Most grants are awarded to state businesses, and personal businesses have a tough time getting them. One other issue right here is the significance given to the examine. Promotion and status in medical colleges stays depending on medical seniority and administrative rank slightly than analysis high quality and innovation.
The fourth step is to foster collaboration. Nobel-level biomedicine is performed on the intersection of molecular biology, genetics, biophysics, and drugs. In India, medical universities and fundamental science departments (akin to molecular biology and biotechnology) usually function independently. AIIMS or IISc collaboration is on the rise, however it’s not but systemic or culturally pervasive. Our medical and engineering departments nonetheless work in silos. There’s a lack of collaboration between numerous disciplines, which impacts high-quality analysis. World recognition and integration by main scientific networks (the place vital discoveries are sometimes highlighted and amplified) stays restricted.
Basically, risk-taking and long-term analysis is undervalued. Quick and “protected” tasks are most well-liked for job safety. Administrative procedures akin to buying supplies, importing gear, and hiring analysis assistants can considerably delay analysis. Stress to publish (to fulfill regulatory necessities) can result in amount over high quality, together with publication in predatory journals.
change of focus
Since independence, India has targeted on public well being, epidemiology, and illness management, all of that are vital however unlikely to provide ‘mechanical’ breakthroughs just like the Nobel Prize. Our nice successes, akin to eradicating polio, reasonably priced vaccines, and frugal innovation, are transformative for society, however they don’t seem to be all the time acknowledged by frameworks that reward elementary discoveries.
Basically, to advertise world-class analysis, particularly in drugs, clinician-scientists ought to have the ability to spend 50-70% of their time on analysis. We have to introduce a twin profession monitor of medical excellence and analysis excellence. We have to defend analysis time and reward nice discoveries, not simply affected person prices.
All main medical colleges will need to have biostatistics and epidemiology departments, core molecular and imaging services, and analysis management applications. Nice massive establishments can function regional hubs for mentoring smaller faculties. Aggressive grant funding must be simplified and the period of the grants must be prolonged. There’s a must construct bridges between medical colleges and scientific analysis establishments for collaborative MD-PhD and PhD-MD applications for clinicians and scientists that may translate discoveries into observe. Moreover, coaching in analysis methodology ought to turn into an integral a part of the curriculum from MBBS degree. All graduate theses require acceptable analysis design, statistical evaluation, and moral compliance.
To purpose for Nobel-level analysis, India might want to make investments considerably (greater than 2% of GDP) in R&D with a big and predictable biomedical element. Construct 5 to 10 world-class medical analysis universities with built-in fundamental medical constructions, giving researchers autonomy, results-based funding, and worldwide collaboration. Incentives want to alter. We have to reward originality, depth, and social affect, not simply publication numbers.
Future roadmap
Indian scientists are usually not with out expertise. Many scientists have made important contributions exterior India. For instance, Har Gobind Khorana and Venki Ramakrishnan, each winners of the Nobel Prize in Medication. . The distinction is within the ecosystem. It’s a tradition that rewards sustained funding, institutional autonomy, interdisciplinary collaboration, and long-term, dangerous discovery science.
Nobel-level analysis usually matures over a number of a long time. India’s biomedical analysis tradition is simply 25-30 years outdated. If India develops and implements a roadmap, it’ll have a reputable likelihood of manufacturing Nobel Prize-worthy discoveries within the close to future, particularly in areas that match our strengths and illness burden, akin to infectious illness biology, genetics, and reasonably priced biotechnology.
(Professor Hemant Verma is Vice Chancellor, SGT College, Gurugram. vc@sgtuniversity.org)
