Dr VM Katoch
MD, FNASc, FASc, FAMS , FNA
NASI-ICMR Chair on Public Health Research at RUHS, Jaipur
Former Secretary, Department of Health Research, Govt of India
and Director-General, Indian Council of Medical Research
Since Independence India has achieved major successes in combating problems of several infectious diseases, malnutrition and key aspects of mother and child health. On the other hand, it is also a fact that we have not succeeded uniformly across the country – successes and failures are state / area specifics and we have to go a long way to be a happy and healthy nation. Access to appropriate preventive, promotive and curative services to all needy Indian people is clearly the limitation and major challenge.
It is desirable that health research agenda of country gives due attention to overcome this challenge. As expected terms “health/ biomedical research” have different meaning to different people – all may be right in their own way. India has many bright capable individuals, good departments and institutions and we are capable of succeeding in all spheres we choose. However, considering the limitations of financial, human and other resources priority setting has to be well thought and revised/ fine-tuned as we move forward.
Bhore Committee report (1946) implemented in 1952 laid the foundation of primary health care in India at least 25 years ahead of other countries. Thereafter, we have periodically assessed our progress and needs from time to time. Accordingly, biomedical/ health research priorities have also been debated and set/reset at different intervals. National Health policy announced by present government reflects well on contemporary needs. Over the years research out-put from Indian institutions has also made some impact on policy. A number of innovations from Indian scientists and institutions in areas pertaining to diagnostics, therapeutics and prevention are on record.
It is time to reflect whether we have done enough in innovations, and or made optimum use of technologies developed and knowledge generated. In order to have in-depth understanding of health problems prevalent in different parts of country, health issues relevant to different subsets of population and need of new strategies using appropriate tools, our research agenda needs to be specific and target oriented.
Research on health systems (basic required at peripheral and optimal at various referral levels) appropriate to different geographical areas has to be given top priority. Research aimed at knowledge generation and management as per specific needs of people in different areas will be the key to reduce the morbidity and mortality to minimum and achieve desired health standards of physically , mental and social well being – minimum should be globally best. Experience shows that our biomedical, engineering/ other institutions are capable of developing any technology and we also have clinical set ups to evaluate them.
Efforts of ICMR and DHR have led to creation of networks across the country to identify problems and try to solve them – these networks have a focus on empowering state systems. Besides ICMR and DHR, several other agencies DST, DBT, CSIR, ICAR, DRDO, UGC, government departments/ ministries like Health and Family Welfare, Ayush, Mother and Child , Space, Atomic Energy, Environment and Forests, Electronics and Telecommunication etc have been contributing/ have greater potential to contribute provided the agenda and immediate, medium and long terms targets and roles are well defined. Climate change has to be adequately factored in.
Synergy with regulators like DCGI, Department of Pharmaceuticals, NDMA, Meteorology, water resources, rural/ urban development, state agencies, NGOs/ private players specially industry has to be thought of and ensured. Besides allocation of adequate resources, other essentials for success include a strong mechanism and defined command structure to ensure proper monitoring and evaluation systems. Current mechanisms for intersectoral coordination in DHR and other departments are not adequate to guarantee that we remain on track and achieve the results in a time bound manner. Many areas/ aspects are important, only some are listed as from my personal experience, these need priority.
