Q&A: Living and working in India
In this article, Puthusserickal A. Hassan discusses balancing research and home life in India.
What do you do?
I am a full-time research scientist working in the field of self-assembled materials. Currently, our focus is to understand the role of antifreeze protein mimics in sustaining self-assembly at sub-zero temperatures. My research objective is to understand how small molecules undergo association in various solvents or experimental conditions, leading to an entire gamut of structures with nanometre-scale features. Looking at the structure-property correlations of such colloidal assemblies gives an insight into the role of intermolecular interactions in governing the microstructure. Many natural systems rely on such intermolecular associations to develop macroscopic objects to carry out specific functions or even to modulate their existence in extreme conditions.
Do you enjoy it? Why?
In my opinion, research is something you explore using your brain and sophisticated tools to understand how various processes happen in nature. Each experiment is a learning experience and gives new information which is hitherto unknown. By seeing new results, I feel like a child who gets to play with a new toy every day.
What was your earliest career ambition?
My ambition was to become a teacher with resources for research. During my graduate days, I wondered if I could see, one day, organic molecules the way that they are depicted in textbooks. Later, I realised that no one saw the molecules, but that the structures were deduced from a combination of different spectroscopic tools.
What are some of the challenges in your job?
The challenge today is that most of the scientific problems we try to address require interdisciplinary expertise. You need to expand your knowledge base by cutting across disciplines to understand how things work in nature.
How do you deal with those challenges?
Collaboration with experts is the best way to meet this challenge. It is not only the advanced instruments you use that are important, but also the proper utilisation and interpretation of data, which needs specialised learning across disciplines. Through discussions and collaborations with physicists and biologists, many challenges can be tackled.
How does being based in India affect the way you work?<
Research becomes successful once it is translated into products on the market. Despite having a good number of skilled workers, Indian industry lacks disruptive innovation. I feel that this is primarily because Indian industries do not invest enough in completely new products or processes, fearing commercial failure. For example, most pharma companies focus on the supply of generic drugs and very few attempts are being made at drug development. By incentivising industrial R&D in high-risk areas and supporting industry-academia joint projects, the transition from lab to land can be realised in many niche areas.
What advice would you have for others trying to work in a similar sort of environment?
It is a wonderful experience to explore new things in science. My advice is that one should first become a master in a specific area of interest. This mastery can be gained by nurturing a new idea that is just reported. This will provide the opportunity to gain knowledge about the tools and techniques needed for the specific problem. The next step is to think beyond what is reported. Speculate on an idea and see if you can prove that by using the tools you have acquired. When you prove an idea that was previously unknown, the excitement is unimaginable.
What do you love about living and working in India?
I love the culture of the place where I grew up. Living in India helps me to connect with my close relatives. Balancing my professional life with family, parents and relatives has been a top priority for me and being in India has made this possible.
What's your top career tip to younger colleagues?
First, assess your ability to explore new things in science. There may be several hurdles and failures along the way to cracking one problem. But the excitement you get once you resolve the issue is phenomenal. If you love exploring things that you have not come across before, go for research.
What else would you say to others trying to build a scientific career in India?
India is a hub of opportunity and it needs scientific solutions to help tackle many of its local problems – water purification, affordable healthcare and low carbon emission technologies, to name a few. This is both a challenge and an opportunity for young researchers. By addressing these challenges, you can help create an impact in society.
How Indian scientists have been scrambling to contain antimicrobial resistance for years
In 2017, the World Health Organization (WHO) came up with a new classification system for antibiotics on its essential medicines list: Access, Watch, and Reserve. Antibiotics on the Access list were narrow spectrum antibiotics — only effective against a small range of organisms — that would be recommended as first and second treatment options for common clinical infections. Those on the Watch list were broader spectrum, able to tackle a wider range of pathogens and therefore considered more important for human medicine. The Reserve list describes antibiotics of last-resort; only for use when all other antibiotics had failed. As SARS-CoV-2 wreaks havoc around the world, antibiotics have fallen off the agenda; they are completely ineffective against a viral infection. But antibiotics do work against the disease-causing bacteria that are responsible for millions of deaths worldwide each year. Antibiotic resistance was a critical health issue long before COVID-19 exploded into hospitals and headlines, and it will continue to be one long after the pandemic has been brought under control. Antibiotics on the Access list are the ones that should be the most widely available and the most widely used, and the WHO says by 2023, 60% of all antibiotics consumed should come from the Access group. Unfortunately in India, that trend is going in the opposite direction, says Jyotsna Singh, program officer at humanitarian organisation Medicins Sans Frontiers’ Access campaign in Delhi. One 2017 analysis found that while sales of key Access antibiotics had risen 20% since 2007-2008, sales of Watch group antibiotics had risen by 73% and sales of Reserve antibiotics increased by 174%. “What we are seeing is that in the Access category there are medicines which are in shortage, which is becoming a huge problem,” Singh says. It means that instead of treating infections in a targeted fashion, with antibiotics specifically tailored to individual pathogens, doctors are using broader spectrum antibiotics from the Watch and Reserve categories. Not only are these antibiotics supposed to be used only for more difficult infections, but they are associated with a higher likelihood of resistance developing. “You have to save Watch and Reserve for certain infections which cannot be treated otherwise,” she says, “or in the long term patients’ health will be put at risk.” This has already cost lives. Each year, more than 58,000 newborns in India are estimated to die from bacterial sepsis that is resistant to first-line antibiotics. Individuals in India infected with bacteria resistant to more than one antibiotic are two to three times more likely to die than those with non-resistant infections. Another study has found that 40 per cent of pregnant women and 60 per cent of schoolchildren are carrying strains of E. coli bacteria resistant to at least one antibiotic. In 2019, India scored highest of 41 countries on the Drug Resistance Index — a measure combining both antibiotic use and resistance levels, and by 2050, antimicrobial resistance has been forecast to claim an additional two million lives per year in India. But Satya Sivaraman, who develops communications strategies on antibiotic resistance with ReAct Asia Pacific — one arm of the global ReAct network created in 2005 to focus on antibiotic resistance — says many healthcare professionals face a bigger issue. “If you talk to doctors on the ground about antimicrobial resistance, they’ll say ‘yes it’s a problem in some cases, but the bigger problem is that we don’t have antibiotics at all,’” says Sivaraman. In a country with such a high incidence of infectious disease, the lack of any treatment is killing more people than treatment resistance. It also means India is a huge reservoir of infectious pathogens: a “factory of disease production,” he adds. At the same time, antibiotics are being overused and misused to such an extent that even India’s massive generic drug manufacturing industry can’t keep up with demand. New antibiotics Singh says generic drug manufacturers — many of which produce copies of brand-name medications in India’s thriving pharmaceutical manufacturing sector — blame the shortage on the low price set for antibiotics by India’s price control mechanism, which limits what pharmaceutical companies can charge the government and consumers for essential medicines and makes them a far less attractive business. Some state governments in India are taking matters into their own hands to ensure a supply of antibiotics. In 1974, for example, the state government of Kerala established its own, government-run pharmaceutical manufacturing operation — Kerala State Drugs and Pharmaceuticals — which supplies essential and life-saving medicines, including antibiotics, to government hospitals. The other problem is that, around the world as well as in India, pharmaceutical companies are pulling out of research and development of new antibiotics, leaving it to governments to pick up the slack. Sidarth Chophra, microbiologist and professor at the Central Drug Research Institute (CSIR) in Lucknow, India, is hunting for new molecules specifically targeted at drug-resistant bacteria. One focus is the so-called ESKAPE pathogens which are responsible for the majority of hospital-acquired infections and which all show resistance to multiple existing antibiotics. CSIR is directly funded by the Indian government. The speed with which bacteria evolve resistance to new antimicrobials presents a huge challenge, says Chopra. “I tell my students all the time, this is like playing chess with a grand master,” he says. Chopra and colleagues are trying every trick in the book to gain the upper hand. First, they’re looking at existing drugs to see whether any might also show antimicrobial activity, because that can help speed up the drug development and testing process. One molecule showing antibiotic properties is disulfiram, which is normally used to treat chronic alcoholism. They’re also looking at molecules that might otherwise not be considered potential candidates because they don’t meet the so-called Lipinski’s rule of five for predicting compounds that are likely to succeed as drug candidates. “We are more than happy to look at unconventional molecules which a normal medicinal chemist would not touch with a barge pole,” Chopra says. Funding healthcare Even if vital antibiotics become more widely available in India, there is still the problem of how, in a country with an overwhelmingly private healthcare system, many citizens could afford to access the doctors who prescribe them. A report published in April this year by the Center For Disease Dynamics, Economics & Policy, a public health research organisation based in Washington DC and New Delhi, found that 65% of health expenditure in India comes from the pockets of individual patients, compared to 13% in Germany. The cost of health care is estimated to drive 57 million Indian residents into poverty each year. Philip Mathew, a public health consultant with ReAct, says that universal health coverage might help enable many poorer patients to access essential medicines such as antibiotics. “A universal health care system in developing countries can solve many, many issues associated with access to essential antibiotics,” he says. The Indian government is moving in that direction. In 2018, it announced the creation of the ‘Ayushman Bharat — National Health Protection Mission’ to provide health coverage worth up to 500,000 rupees (US$7,000) per family for 100 million poor and vulnerable families. The plan also includes ‘health and wellness centres’, which are intended to provide primary care, free diagnostic services and essential drugs. But there are questions about how the government of India will pay for the scheme, given its spending on public health is one of the lowest among low-middle income countries. Another challenge is ensuring that clinicians in that healthcare system prescribe antibiotics appropriately. Because of their seemingly miraculous curative powers, antibiotics have become a victim of their own success. Patients — not just in India but around the world — have come to view antibiotics as a magic bullet for all ailments, and expect them from their doctor. “They are paying some fee to the private doctor for the consultation, and they want to know that they’ve actually taken some strong medicine back with them, so this whole cycle, the patient-doctor cycle, is completely skewed,” Sivaraman says. This situation is further exacerbated by climate change, which is changing patterns of infectious disease outbreaks, and contributing to the emergence of new diseases for which there are no or only recently developed vaccines, such as dengue and chikungunya. The latter re-emerged in India in 2005 after a twenty-year hiatus and since then, over one million cases of the mosquito-borne viral infection have been reported. A vaccine is now available, but has limited efficacy. “These viral fevers get confused with bacterial infections and then people tend to use antibiotics, so that contributes to the problem,” says Jyoti Joshi, head of South Asia at the Center for Disease Dynamics, Economics & Policy in New Delhi. Changing the minds of doctors is one thing; changing the expectations of patients is another, says Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics & Policy in Washington DC. “Here you’re saying ‘don’t take an antibiotic, not because it will necessarily harm you but because you’re ruining the chances for someone else to be treated with that antibiotic. Human beings tend to work in selfish ways and in this instance it doesn’t work out so well for us.” Cost of resistance Every year in India, 1 million children die in the first four weeks of life. 190,000 of these deaths are attributable to neonatal sepsis, and just over 30% of those sepsis deaths are attributable to antibiotic resistance. But the true scale of the antibiotic resistance is concealed by a lack of data because when someone dies in hospital from infection, it’s rarely recorded as a death from antibiotic resistance. “It’s not something that the common man observes to say, ‘oh my God: people are dying of drug resistance’,” Laxminarayan says. It is clear, at least, that antibiotic resistance rates continue to increase. Since 2008, the proportion of pathogenic bacteria found to be resistant to important antibiotics has risen significantly; in some cases, tripled or even quadrupled.. In 2017, the Indin government released its National Action Plan on Antimicrobial Resistance. This identified six strategic priorities including improved awareness, better surveillance, reducing infection rates, and improved antibiotic stewardship. The priorities were aligned with global action plans on antibiotic resistance, but Joshi says this approach is not a magic bullet for all developing countries. “The models that have worked in the ‘developed’ world cannot be copied back and implanted here … so you can't copy and paste,” she says. While India now has an action plan, she says it’s going to take some time for that cookie-cut plan to adapt to the Indian way of doing things. “We need to really dirty our hands and get models that work for us in our settings with all the resource limitation and competing priorities, and try them out to control the scourge of antimicrobial resistance,” she says. While there are likely to be successes and failures, she believes the country will learn from those experiences, “and then come out and say, ‘yes, this is what can be done, and this is how it should be done.’” Antibiotics in agriculture Studies show that India’s booming poultry industry is a potential danger to health. By Bianca Nogrady, a freelance science writer in Sydney, Australia While antibiotic use in agriculture has caused headaches in many western countries, India’s primarily vegetarian diet has meant the problem of agricultural antibiotic use is much less severe. But, thanks in part to a booming poultry industry, it’s becoming a bigger issue. Poultry samples have found resistance rates to streptomycin as high as 75%. Resistance rates to other antibiotics including ampicillin and rifampicin were over 40%. “You have these huge poultry farms where there’s a huge amount of overcrowding, and antibiotics are used to cover up your hygiene and biosecurity practices,” says Robin Paul, Quality Manager in the State Laboratory of Kerala’s State Veterinary Department in Kochi. A 2019 study identified India and China as the largest low-middle income global hotspots of antimicrobial resistance in animals, and singled out the antibiotic colistin — an antibiotic that the WHO recommends be reserved to treat multi-drug-resistant human infections — as a particular source of resistance and public health concern. In July 2019, India followed China and banned the sale and use of colistin in the agricultural industry, because of the risk to human health. But Paul says more needs to be done to help farmers better manage their farms without resorting to antibiotics. “The crux of animal health is to manage the health of animals so that they don’t need to go on antibiotics,” he says. But that can be challenging in a nation such as India, where there is widespread malnutrition and rising demand for protein, and Paul says farmers are likely to oppose any restrictions that could impact production.  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30071-3/fulltext  https://adoptaware.org  https://msfaccess.org  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30365-0/fulltext  https://www.cddep.org/wp-content/uploads/2017/06/swa_edits_9.16.pdf (pg8)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669283/  https://www.cddep.org/wp-content/uploads/2017/06/swa_edits_9.16.pdf  https://gh.bmj.com/content/bmjgh/4/2/e001315.full.pdf  https://www.bbc.com/news/health-30416844  https://www.reactgroup.org/contact/react-asia-pacific/satya-sivaraman/  http://www.ksdp.co.in/index.html  https://www.genengnews.com/insights/as-novartis-exits-who-will-make-new-antibiotics/  https://cdri.res.in/1826.aspx?id=1826  https://cdri.res.in/profile.aspx  Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter,  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/disulfiram+antabusepatient+information+sheet  https://cddep.org/publications/access-barriers-to-antibiotics/  https://www.reactgroup.org/contact/react-asia-pacific/philip-mathew/  https://www.india.gov.in/spotlight/ayushman-bharat-national-health-protection-mission  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057252/  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978971/  https://www.who.int/immunization/research/development/dengue_q_and_a/en/  https://cddep.org/profile/jyoti-joshi-2/  https://cddep.org/tool/burden_antibiotic_resistance_indian_neonates/  https://resistancemap.cddep.org/CountryPage.php?country=India  https://www.bmj.com/content/358/bmj.j2687  https://pib.gov.in/newsite/PrintRelease.aspx?relid=161160  https://science.sciencemag.org/content/365/6459/eaaw1944  https://www.who.int/foodsafety/cia/en/  https://www.newtonfund.ac.uk/news/success-stories/antibiotic-colistin-now-banned-as-feed-additive-for-animals-in-china/  https://timesofindia.indiatimes.com/city/chennai/centre-bans-colistin-for-animal-rearing/articleshow/70311797.cms
Q&A: Navigating academia and industry in India
What do you do? Do you enjoy it? Why? I am a doctoral candidate at the National Institute of Technology Karnataka. My dissertation focuses on intelligent systems for predictive modelling in financial applications. Aside from my PhD research topic, I enjoy working on problems that have the potential to make an impact through different aspects of research such as social, business and technology. Through my PhD programme, I have moulded research skills to work on funded projects or serve as independent consultant. What were your early career ambitions? After not performing well at school, my parents suggested that I take up a course at an ITI (Industrial Training Institute). This meant that I would be a skilled technician in an organisation after graduating. However, I decided to study for a Diploma in Electronics and Communication Engineering, which is technically a higher degree, as I did not want to limit my career prospects. The initial semesters were tough, but later I picked up with the help of learning in peer student groups. How did you make the decision between pursuing a career in academia or industry? Once I completed my diploma, thoughts of applying for jobs surfaced. However, at that time in India, a new scheme was introduced whereby diploma holders could apply and join the second year of an undergraduate programme. I stayed at the same institute where I had studied for my diploma and was awarded a BTech in Information Technology in 2007. Around this time, the economic recession was prevailing, the dot-com bubble had mostly subsided and the industry in India was changing rapidly. I felt that my place was not in industry, as I did not believe I had the excellent coding skills it required. I took up my first job as a lecturer on a contractual basis at Cochin University Engineering College at Kuttanad, which is a state-funded public university. After my first stint as a lecturer, I personally felt that academia provided a better comfort zone and space for professional growth. What were some of the challenges on your journey? Most of colleges where I worked already started to regulate for more qualified (PG/PhD) teaching staff. I was interviewed and received a job offer from Amrita University in Quilon in early 2008. But in that year, a breakthrough occurred while I was trying to qualify for GATE (Graduate Aptitude for Engineering), a national exam that provide chances to pursue Master’s and PhD programmes. More recently, this exam has been a criterion for selection for some positions public sector companies. I received a strong grade and rank, which I don’t think I would have got without the exposure and subject knowledge I’d acquired during my undergraduate training. What did you do next? After unsuccessful applications to graduate schools for Master’s programmes, I worked for a short period as technical staff at an institute for a government funded project on digitisation of a library with nationwide reach. Later in 2009, I applied for an MTech (Master of Technology) programme at a state public university and was selected for a teaching assistance scholarship. As part of the dissertation project work, I applied for an internship at ISRO (Indian Space Research Organization). Even without support from the university or a scholarship from ISRO, I worked on a two-semester project on the development of a software tool prototype for space research applications, which resulted in a related IEEE publication. How does being based in India affect the way you work? There have not been many drastic changes in India, from academic point of view, in recent years. There are constant checks and performance reviews either in government posts or private institutions. To an extent, although private institutions offer higher salaries, they also demand a higher workload as part of accreditations that may actually work positively in long run. What advice would you have for others trying to work in a similar sort of environment? There can be a sense of lethargy and inertia certain positions. The best policy is to keep searching for grants for funded projects, extend your professional skills, such as research reviewing and talking at conference and workshops. Undertake student support programmes like mentoring and community initiatives for spreading knowledge. What do you love about living and working in India? In my case, the government funded my research and hence I feel a sense of moral duty to give back to my nation. India has potential for growth both scientifically and economically; at least historically that has been evident. What’s your top career tip to younger colleagues? Stay focused and keep your eyes open for higher education and research opportunities. Reach out to your seniors, teachers and peers for advice. What else would you say to others trying to build a scientific career in India? From my experience, joining the best-ranked institute does not necessarily mean you will receive top training or skills, unless you have a true passion for your research. Smart work and motivation can instil students with the confidence to perform well and be recognised in academia. Make use of generous government scholarships as well as privately funded schemes.
Multidisciplinary Research: Pros and Cons
By bringing together experts from different disciplines we can find the solutions for today’s global challenges. Having spent a year in a multidisciplinary research group, Mit Bhavsar shares his thoughts on the advantages and disadvantages of multidisciplinary research in science. The increasing popularity of mixed scientific disciplines like mechatronics, bioinformatics, biomedical engineering and biophysical chemistry is evidence of the importance of multidisciplinary. And, based on the number of multidisciplinary conferences taking place around the world, it seems that many policymakers agree that bringing scientists from a variety of different backgrounds together is a crucial part of fixing the world’s problems. Going multidisciplinary does not mean leaving behind your own skills — it means heading in new scientific directions using your own specialties. I completed a neurophysiology PhD in a monodisciplinary research group. Now, I’m working as a postdoc in a multidisciplinary research group in the field of regenerative medicine. Here are my perceived advantages and challenges. Advantages One problem I’ve found with a monodisciplinary research group is a lack of creativity when it comes to working out what kind of work can be done. A multidisciplinary group can combine the expertise of your field with other fields and create a varied team. Such combination can lead to creative and high impact research. For example, my lab is working on tissue regeneration and repair through electrical stimuli. For such kind of research, one often needs expertise in the field of medicine and electrical engineering. For me, the most attractive part of multidisciplinary research is that you can work on projects that involve more than one discipline of science. This meant honing my existing skills and learning a whole lot more from scientists I’d never previously had a chance to interact with. As well as that, because I’m the only expert in my field in my group, I can work independently to address problems when they come up. Multidisciplinary research also leads to unusual scientific inventions. A lot of great science has come from the robust interactions of researchers from different fields. A good example of this is the discovery of “Magnetic resonance imaging” by Paul Lauterbur (a chemist) and Peter Mansfield (a physicist) — for this they were awarded the 2003 Nobel prize in Physiology or Medicine. An independent researcher designing and conducting their own separate experiments would never have had these opportunities. Challenges One of the common challenges of working in a multidisciplinary research group is a lack of a “common language.” It’s hard to find a way to start working on a problem when everyone has been trained to approach it from different directions. For me, this makes it difficult to discuss ideas with team members and get the right feedback. This problem feeds into feeling of loneliness — I’m surrounded by lab mates but I’m the only one working on this particular problem in this particular direction in my lab. Another issue: there is no meaningful criticism and evaluation of your work. Your ideas and suggestions are either accepted without any questions or they will be rejected without constructive criticism. If you can deal with these challenges, it can be very rewarding to do multidisciplinary science. To facilitate multidisciplinary research, universities and research institutes should encourage interaction between different disciplines where scientists can meet, share ideas and discuss problems. Mit Bhavsar is a researcher living and working at Frankfurt Initiative for Regenerative Medicine (FIRM) Frankfurt, Germany. You can contact him on: email@example.com