August 2019: “The very purpose of clinical research is to improve health. Hence, everyone who participates in clinical trials is a partner and should be deemed as champions of the cause, and hence it is the responsibility of us professionals to serve these people to the best of our ability. Without their trust, the advancement of both clinical science and medical practice would falter,” observed Professor Gagandeep Kang, Executive Director, Translational Health Science and Technology Institute (THSTI), while delivering the keynote address on ‘Trials and Tribulations: Clinical Research in India’, at IIM Bangalore. She was speaking on Day One of the XIV International Conference on Public Policy and Management, organized by the Centre for Public Policy (CPP) at Indian Institute of Management Bangalore (IIMB), from August 22 to August 24, 2019.
She went on to say that such trials need to be carried out responsibly and ethically, based on a relationship of trust with the participants where total understanding is a given, and the findings are shared with the communities. “There are regulatory bodies to raise the standard of clinical research and curb unethical practices. But although we have very good basic biology institutes, investment is still not to the level that it should be,” she lamented.
Prof. Kang, who is an Infosys Prize Winner in Life Sciences and in 2019 was elected to the Fellow of Royal Society, the first Indian woman to achieve this, began her address by providing a background to public health in India, and proceeded to talk about the need for clinical research, the different players of healthcare delivery, and also gave an insight into her ongoing research and future work.
‘Need to build trust and accountability’
She listed the factors that have worked so far in this domain as: identification of needs in public health research, partners who provided appropriate training, targeted and monitored mentoring, commitment to the communities that professionals work in and with as well as commitment to quality, building multidisciplinary research groups of young faculty, availability of academic positions and funding, working in collaboration with government and like-minded institutions, more investment in R&D, and new initiatives in public health. She said that lack of value systems, lack of systems, sclerotic bureaucracy, hierarchy, restrictive polies and lack of institutional support were some of the challenges of clinical research.
“Going forward, we need to focus on setting priorities, looking at evaluating effectiveness, access, and healthcare management. As academicians, we need to help the government in setting priorities, carry research, translate results into practice in India, and extend and reinforce research and training.” She cited the example of the rotavirus vaccine which was developed overseas and was very costly. An Indian vaccine was developed as an alternative based on estimates which was introduced in 2016.
Prof. Kang rounded off her discussion by highlighting the importance of teamwork. She also said: “High quality clinical research is being and can be done in India. Policies can be changed with planning and evidence accumulation”.
“Be curious, ask questions and find answers. Believe you can solve problems. Know you can make a difference”, she advised the participants.
The ‘how’ of Public Policy
Earlier in the day, in his welcome address, Dr. G Raghuram, Director, IIMB, said: “The very presence of the Centre for Public Policy at IIMB and the fact that we are committed to Public Policy has an induction effect on the other areas be it Marketing, Finance, or Economics. This conference promises wonderful fare, relevant to the Public Policy context in India. Often, the issues are not limited to ‘what’ we address; the ‘how’ is critical—how Public Policy gets resolved and executed is essential.”
While emphasizing the need for clarity on addressing the ‘how’ with regard to Public Policy in India, he explained: “Coordination across different domains and verticals emerges as an interesting dynamic. The issue of how you leverage competition is a major challenge. An interesting question that needs to be researched and a proper framework be arrived at is, should public legacy institutions be allowed to bid for public delivery under a public-private partnership framework?”
Professor Hema Swaminathan, Chair, Centre for Public Policy at IIMB, set the context for the three-day conference which will has eminent researchers and speakers sharing their perspectives on current policy issues like Education in India, Infrastructure Development, Health Sector: Issues and Solutions, Public Expenditure Review of Health and Education, Barriers to Trade, Political Economy and Governance, Trends in Migration, Economics of Inequality, and many more. The three-day conference has plenaries on ‘Changing Faces of Media in the New Era,’ and ‘Federation and Decentralization’.