India After Covid-19: Let us be a science-driven nation

Henceforth, individuals, societies and entire nations shall live and transact lives in two acronyms: BC and AC, i.e., Before Covid and After Covid, respectively. The real difference shall emerge once nations press the reset button and redefine goals and priorities for the future. Though learning from the past is partly going to shape future destinies, countries which have invested in science and technology have come to rule the world stage and are clear leaders and path-definers of the modern era. Therefore, the pertinent question for India shall be as to how much we have learnt in the last half a century or so and how much are we willing to change from here on?

Look at South Korea, which used to be one of the poorest countries of the region and rose spectacularly to be one of the leading industrialised and developed nations of the world in a few generations. South Korea has switched gears from industries like ship building, electronics, and automobiles to niche and science-driven areas like bioengineering, industrial robotics, microelectronics, medicine and many more to place itself in an unenviable position. This transformation has been enabled by a rigorous education system churning out a highly motivated and educated populace. India also produces such professionals but, sadly, end up exporting the intellect.

China emerged on the world stage as the state-manufacturing powerhouse of the eighties, lifting a large population out of poverty. However, the centrally planned system has gradually given way to a more market-oriented approach. The country now boasts a GDP of close to 15 trillion dollars. What has catapulted China to be the world leader is not the mass manufacturing and massive exports it began with but incorporation of science and technology as the bedrock of the next generation of developmental efforts, giving it national prestige in a time no other country has been able garner. Very quietly China has transitioned into science-driven areas of high-tech manufacturing, indigenous innovation, drug discovery, artificial intelligence leading to a plethora of high-quality academic publications in reputed medical science and technology journals.

With two such examples from the Asian continent, where should India go from here? Do we confess that our priorities must change? Would we still be waiting for the faulty Chinese equipment to arrive to start our war against the next virus? There has been enough slogan mongering and procrastination over the last 70 years. A population of 135 crores needs its own medicine in times when the everlasting patents will continue to deprive us of the recent advances in medical treatments. Indians shall continue to live with drugs of yesteryears if we don’t innovate. The problem has been stated many times to have acquired the status of an entity nobody is interested in. Is it really the lack of money only? No. Many more issues plague our prioritisation, decision making and resource allocation.

So where does the solution lie? As a nation we need to look inward and draw from our strengths more than weaknesses. There could be very many answers. However, the least money-consuming options could be placed on the table first.

No more us v them

First, the medieval bureaucratic approach of “us vs they” must be dismantled. The superior and all-controlling feeling of “us” of the ruling class must go away and go away very quickly to bring this country on the trajectory of growth which it needs desperately. The bureaucracy must align itself to the “theys” of civil society and the private sector in a more intense and result-oriented manner with clearly defined goals and accountability. Projects meant to change the treatment paradigms should be led and championed by a sub-specialised cadre of bureaucrats dedicated to the subject. The elitism of the ruling class turns out to be the greatest impediment in this engagement. Even school and college curricula go through a constant change, it seems the same has not happened in the schools where our bureaucrats are trained; otherwise how could the obstructionist mindset perpetuate decade after decade?

Second, there is a need to bring private enterprise and government institutions engaged in cutting-edge research closer to each other, particularly in the field of medicine. Why the USA has been the powerhouse of drug innovation and new treatment discoveries is simply because they linked all the basic science research laboratories to major medical institutions and encouraged them to engage meaningfully as equal partners in the quest of new drug discovery. Even our founding leaders had envisaged the same by establishing many labs under the umbrella of the Council of Scientific and Industrial Research (CSIR) with a singular aim of doing cutting-edge research relevant to this country. Time is not lost. Even now these 37 high quality labs can find enough partners in the government as well as private sector to engage in full-scale clinical development of new drug entities. This, indeed, will be a low-cost or a no-cost solution as the readily available capabilities of the highest order in these labs shall kick-start our research activities. These labs have done tremendous amount of research work to find publication space in the best journals of the world. But sadly, the work stops once an idea is published and the next one is pushed up the pecking order. Every lab curiosity or a potential drug candidate molecule must finally go for rigorous clinical testing and this is where exactly this linkage with clinical researchers shall be of the greatest relevance. With close to 3500 of the 4000 known medicinal plants growing in India, this proposition assumes greater significance as these labs are embedded in different geographic and ethnic environs and are thus uniquely placed for drug discovery. Remember, India needs its own medicine and healthcare solutions for its large population, many out of which have scanty access to newer therapies. Such an arrangement would instantly open the doors for engaging many of the PhDs who are either underemployed or leave the shores for better opportunities elsewhere. Also, drugs and treatments emanating from India could make the lives of billions healthier and more cost-efficient around the world. Additionally, all universities, both private and public, could be encouraged to find partners for clinical research. Funding and spending in these partnerships could find innovative ways to come through. The IITs have their own vital role to play in this scheme of things. The critical action required to link all these great institutions to clinical establishments for an end-to-end development of new research ideas most relevant to the gene pool of our population.

Our continuing misplaced faith and overdependence on state enterprise and government-controlled manufacturing units is like chasing a mirage. Medical science today is far beyond manufacturing few chemical entities of the seventies and eighties. We have more than seen that in the era of Covid-19. Molecules of today are far more complex and require intense scientific inputs and a rigorous developmental protocol. This is a far cry. We could not produce a PPE kit worth its standard and had to wait till China came to our rescue. Sloganeering like ‘Make in India’ sound hollow in the light of the fact that we could not develop a single Covid-19 testing kit and found a lame excuse in the faulty Chinese stuff. There was no appeal or an effort to get the private sector on board.  Even the active pharmaceutical ingredients required for common drugs hit a critical level of stocks due to our overdependence on China. It is shocking to know that there is not a single manufacturing unit for thermometers in India today. This is our degree of apathy towards our own self as a nation and love cheap imports which may come at any cost and peril. There is an urgent need to invest in health and healthcare infrastructure. The private sector will be a willing partner. In China, 60% of the GDP, and 90% of new jobs are coming out of the private sector. India needs a serious look at these statistics and find ways of unshackling the healthcare manufacturing. The recent appeal by our Prime Minister for self-reliance is not the first in the history of independent India. But the only hope is his decisive approach and we may see the desired push, finally.

Countries which shall invest into and be science and technology-driven shall continue to rule the world order. The choice is ours. Do we want to continue to exist as a nation where priorities are more of party and vote bank politics and the health of the society shall assume significance, only sometimes? Let India of the After-Covid era be a science-driven society which shall not only modernise the nation but also pull it out of the quagmire of socio-ethnic stresses and make it a true world leader.

Dr Ashok K Vaid, MD, DM, is chairman of the Medanta Cancer Institute,  Medicity, Gurgaon, India.