The importance of medical research can not be underestimated, this pandemic has demonstrated the fact that no matter how powerful a country is, medical infrastructure and research facilities are most important for overall development. The aim of medical research is to improve health and health care systems.
There is no doubt that health care systems have globally witnessed major revolution with rapid technological advancements, but the question remains- Are we really faring well?
We could get a glimpse of the present Indian scenario from Dr. Rittwika Bhattacharya. She did her PhD from National Institute of Cholera and Enteric Diseases (NICED) and pursued postdoctoral studies at Pennsylvania State University in bacterial host pathogen interactions. Next, she returned to India and joined Chittaranjan National Cancer Institute (CNCI) as a research associate exploring cancer cell signalling. Dr. Bhattacharya is presently a scientist in Netaji Subhas Cancer Research Institute (NCRI), Kolkata, India.
When asked about her journey to the present position Dr. Bhattacharya said “I knew I wanted to be in academics but did not have the provision to leave my hometown Kolkata. My mentor Dr. Chinmay Kumar Panda at CNCI supported me a lot and informed me about an opening at NCRI. He suggested I apply there. Yes, there was provision for a project at that time but with nobody to lead. So, I consider myself lucky to receive an ICMR funded project.”
“I worked with Dr. Panda in the field of breast cancer earlier and I am currently communicating projects on lung cancer and breast cancer to the various Indian funding bodies. Till date, I feel I will be privileged if I could continue in the field of translational oncology considering present funding situations.”
How supportive is the Indian government to young investigators in terms of funding?
Dr. Bhattacharya expressed her concerns when asked about the funding status. “To be specific and honest, we are having a hard time getting projects sanctioned. One reason being we represent a private institute and are not funded by either state or central governments. We are however putting our best efforts to bridge the gap between basic and clinical research. NCRI is a hospital cum research institute and is a brilliant place to bring together basic science and translational research due to ease of access to patient samples, clinical data, and trials. Still funding is meagre! I dread that post-corona era would be even more difficult for us….. but let us see.”
What does statistics say?
In 2016, a study was published that compared the research outputs of 579 hospitals and medical institutes in India during the period from 2005 until 2014 to some of the best research centres in the world. It revealed that only 25 or 4.3% of the institutes had around 100 publications a year, but alarmingly 57.3% of the medical colleges did not have a single publication! In contrast, the annual research outputs of Mayo clinic and Massachusetts General Hospital were 3700 and 4600, respectively. So, we are losing out on a lot of precious clinical information and data.
Why are we not able to compete with international standards?
According to Dr. Bhattacharya, more funding needs to be routed to clinical research. She said, “When I was a post-doctoral fellow abroad, it was like a cakewalk for me, but this transition from a student to a mentor is huge and filled with hardships. It becomes even more difficult, if it is a hospital cum research institute. It took me just 4 months to sort out the chemicals to be ordered for establishing a lab from scratch. Space crunch is an issue. There is presently no animal house facility which is another challenge. Hospitals in India often do not have the proper instrumentation required to do cutting-edge research. Hospitals definitely should be well-funded but the attached research wings should also be given its fair share!”
Several factors are behind this. Some examples are shortage of funds, dearth of infrastructure, delay in acquiring chemicals, not enough collaborations between physicians/clinicians and researchers. More transparency, sharing of data (both basic and clinical) and research facilities between hospitals and central facilities can strengthen collaborations and clinical research in India. Only public research institutes receive the bulk of funding. The private hospitals with research wings are suffering somewhere.
Dr. Bhattacharya suggested that the government should understand that R&D is important and needs to be nurtured alongside defence. “We in hospital research wings are also into research and without the translational angle to it, basic research alone will not be sufficient to eradicate the diseases. The number of academic positions at present are not enough. We need more skilled people to be able to compete with the western countries. India should empower its scientists with the cutting-edge technologies and state-of-the-art infrastructures. Nepotism is another hurdle that I believe is in every sphere and R&D is no exception. Substantial brain drain happens because of this. If India wants to retain its talents, then this must stop.”
Her message to the young post-docs and newcomers who wish to remain in academia and research– “Just retain your perseverance, retain your scientific aptitude and love for it. One day we will see the light at the end of this gloomy tunnel through our hard work and efforts.”
India has a population size of 130 crore, and with this huge wealth of human resources, surely we can do better as a nation if we can train and channelize manpower! Research output is linked to a country’s expenditure on its R & D sector. In 2012, the National Institute of Health (NIH) in the U.S. spent a total of 119.3 billion dollars on biomedical research. While NIH has a yearly expenditure of 32 billion dollars, Indian Council of Medical Research (ICMR) funded by the Union Ministry of Health and Family Welfare has an annual expenditure of only 232 million dollars. Physicians should be encouraged to take up research. Exchange programmes between central institutes and hospitals should be introduced for both PhD students and medical students (MBBS, MD) to foster healthy collaborations and proper utilisation of resources.
References:
- Ray S, Shah I, Nundy S. The research output from Indian Medical Institutions between 2005 and 2014. Current Medicine Research and Practice 2016; 6 (2): 49-58.
- Bhavna ChawlaMedical Research in India: Are We There Yet? DJO 2017; 28:4-5