According to you, is India on the path of innovation in healthcare?
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Prof Anil Gupta
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No, it’s a definite no! If it was, then so many innovators would be developing diagnostic or palliative devices or surgical devices. New therapeutic approaches would not have been struggling for support for science validation, value addition, testing, clinical trials etc.
There are three inadequacies in the innovation ecosystem for healthcare:
- Existing innovations which are rising, inspired out of the system, are not being leveraged and supported both from a policy and institutional perspective except to some extent in the biotechnology space, thanks to Biotechnology Industry Research Assistance Council (BIRAC);
- We are yet to start using distributed knowledge platforms like techpedia.in for collaborative, open, and modular technology development and dialogue,
- Extremely affordable service delivery models that have been developed in eye care, heart care are not being replicated due to lack of sufficient policy and institutional support.
Healthcare innovations are extremely crucial for those whose entire savings of last few years may evaporate in a single adverse episode. The preventive and synergistic healthcare streams combining AYUSH and allopathic systems are not on the radar of the policymakers.
What is the kind of innovation that India currently needs?
India needs innovations that meet three criteria: affordability, accessibility and availability.
It is possible to do so. We have extremely cost effective mocks like:
- dialhealth.com
- Gandhian Young Technological Innovation Awards’ winner “Chetna” – a device developed for tracking pregnancy developed at IIT Guwahati,
- Non invasive haemoglobin measuring device by myshkin,
- Threenethra that diagnose more than five ailments of eye at a very low cost,
- Other winners include qualitative diagnostic test for Vitamin B12 within fifteen minutes, etc.
Many of the examples, I have mentioned above (like techpedia.in/GYTI award winner) are at the proof of concept stage. They need to be taken to the prototype, product and utility stages. There is no funding for these fledgling entrepreneurs and innovators. We can expand the innovation spectrum in healthcare very soon by throwing challenges to young technology and management students to harness their vitality and irreverent attitude toward change.
Everyone talks about inclusive healthcare in India, however there are umpteen challenges involved. Do you think that these challenges call for a rethink about every link in the healthcare chain?
Yes, we need to learn to make tradeoffs sometimes between accuracy and affordability.
Let us take a hypothetical case where there are two drugs available for a particular illness. One of them costs Rs 100 a month and gives 80 per cent relief without any significant adverse side effect and another drug for the same ailment gives 95 per cent relief but costs Rs 1000 per month. Should only the first drug be developed and allowed to be released?
The whole regulatory system is designed on a Western model where the healthcare system is broken. We need to develop our own healthcare goals and approaches for solving national problems. Many times, we don’t realise that when we bring a disease or disorder under 80 per cent control, say a threshold value, then remaining control may be achieved by the auto-immune system. We must work with nature and not against it.
Likewise, the role of functional foods grown in mineral rich soils in rain fed regions must be looked at afresh. Food and nutrition are getting attention but cooking in a cast iron vessel is not popularised still to overcome iron deficiency.
Knowledge networks among doctors are yet to be developed as are disciplines and super specialties. Every medical intern during rural service or urban slum service must be asked to make an inventory of unmet healthcare needs as well as grassroots innovations. This will help in reorienting the medical education as well as practice. How else can we explain wide prevalence of horizontal posture delivery tables when squatting position is known to be far more convenient for mothers and a fact that has been known in Indian tradition for ages. There has to be a complete rethink across all links in the healthcare value chain.
What else is important to understand in this regard?
The triggers for innovations exist all around and many doctors do innovate. But many are busy treating patients and don’t get time to document their creative experiences. Same is true of many hospitals.
We need open innovation platforms, challenge awards like X-prize, reforms in curricula to increase awareness about innovation, intellectual property rights as well as open source solutions, collaborative learning, linkage between formal and informal grassroots sector, engaging with patients who can also contribute towards innovations and above all, a regulatory system which stimulates innovation and not stifle it.
Holistic medicine, systems biology approach and blending different pathologies are also essential.
What innovative strategies are needed to make inclusive healthcare ; especially in the primary care sector?
We need linkage between people’s knowledge, practitioner’s knowledge and researcher’s expertise without too many barriers and with considerable mutual respect. We also need risk funds to encourage young inventors and innovators. Overall context of health, hygiene, food, nutrition, lifestyle and socio-cultural context of happiness needs redefinition.
How can we make this possible?
Well, we need to expand the usage of techpedia.in, upload all medical thesis abstracts on it, and encourage dialogue on that site.
Culture specific challenges are then open to practitioners and youth. The curriculum should incorporate indigenous examples of innovations and corporations should contribute towards creation of creative, collaborative, compassionate and caring ecosystems.