(Written for Publication of CII)
One of the things which we can be proud of, is that, after independence, we have been able to build some of the international standard medical and engineering schools in this country. If we look at the figure below, annual budget of our top engineering school and top medical school is not very far behind their top international counterparts once we balance these numbers with purchasing power parity.
I myself am a PhD from IIT Madras and have done postdoc at Harvard medical school. Comparing both these systems, I can say pretty confidently that in terms of infrastructure, funding and manpower, our elite institutions are second to none in the world. In a way, the key infrastructure and funding required for successful healthcare innovations are already there in place. But, this has not led to many significant number of translational research in medical technology space. India contributes less than 1% of global trade of medical devices. While we have many companies in other technology domains which have already arrived at the international space same has not happened in health technology and medical device space
One of the major obstacles in this translation, I believe, is the big engineer doctor divide in this country. If you look at the faculty profiles of most high ranking international medical technology research centres, there is a healthy mix of both engineering, sciences and medicine PhDs. Most of the bigger universities in the developed world, have both medical and engineering disciplines in the same campus. This is almost never the case in India. The system by its very design divides both disciplines into watertight compartments. We have not created formal channels for interaction among our institutions of eminence in medicine and research; our engineers and doctors almost never interact. I am afraid, unless we work towards bridging this gap, we shall keep trailing behind in successful medtech innovation and translation. IIT labs doing great research in health technology need support from clinical community for clinical inputs, trials and translation; and clinician community needs access to the technical capabilities and know-how of the engineering research community to translate their clinical observations and ideas into possible products.
There is a need of developing medical innovation ecosystems in this country where we may have rich interaction of all stake-holders which can include doctors, engineers, industry and policy makers. And I firmly believe that this change can happen within the existing frameworks by building formal connecting links through relatively simple policy shifts by government. Interdisciplinary collaborative regional research centers by coupling one major teaching hospital with one major engineering research institute within a region can be a great start. This kind of center can take formal assignment of associate faculty from both the institutes and may focus on facilitating interaction.
Over the last couple of years, data science and machine learning has opened up new avenues of data driven research in medical sciences. India being one of the most populous countries, our big medical centers are sitting over mines of clinical data. One of the aims of building bridges between our institutions, should be to facilitate access to these databases through proper formal channels.
Lack of formal ethical clearance structures in engineering institutions and painfully slow ethics committee clearances in major hospitals is another major roadblock in promoting medical technology research. Government and policy makers should keenly focus in removing these major roadblocks, without which doing international standard medtech research is going to be a challenge.
Industry academia collaborative research, I believe has great potential but most of the time we do not have formal channels of initiating such collaboration. There is a lot of excellent research expertise and equipment available in major research institutes which can be leveraged for research and development by small and medium enterprises, and startups. But most of it remain unexplored due to information gap. The information available on the websites of most top research institutes of the country are paltry and lack clear guidelines on starting a collaborative project with industry. As a result, industry doesn’t know whom to connect with or how to approach the academic institutes to carry out research or initiate consultancy projects. This is also true the other way round. If a faculty wants to initiate a project with industry, it is often impossible to find the right contact person in a company through an organic internet search. Only thing that works currently is to painfully sift through tertiary personal and business contacts to find the right resource person. In my opinion, Medical technology businesses, which stand to gain a lot by way of collaborative research with research institutes and hospitals should maintain a research liaison officer who can be the first point of contact for any researcher to contact.
Academic capability being conventionally measured on number of papers one can publish in a year, the focus of research tend to be on volume of publications. Faculty are pushed towards doing non-relevant research just for the sake of publications. More cited research is the considered most impactful. As international research journals are dominated by western research, Indian researchers are also driven into solving high level problems related to the developed world while many of our own problems remain untouched. They are working for years on problems that may have no relevance to indian context. We have too many academics working either on incremental solutions for old problems or on completely theoretical and non-translatable problems. The only fate of such projects is the production of a thesis which go into the library and would be read only by four people in its lifetime. On the contrary, industry has totally different priorities. Publications do not count for much. Industry requires fast time bound solutions to its projects which many times do not match the slow paced but meticulous approach of academia. This mismatch in expectations and timelines has to be understood and adjusted for by both parties, and funding, publications, patent and consultancy model should be clarified at the very beginning of a project to ensure successful collaboration.
I sincerely hope that the government, administrators of our elite research and medical institutes, and industry heads will push towards above policy changes which I believe would be key drivers in pushing medtech innovations in India to the global stage.