Wednesday, March 26, 2014
Polio battle won, war far from over for India! A tale of two assassinations and lessons from past mistakes
If only the Indian government had heeded advice given by seasoned Indian polio researchers, it is foreseeable that the country’s war against polio could have been won long ago, and more significantly, astounding as it may sound, but 3 million children could have been saved from being crippled for life. A walk down memory lane also reveals that the twin assassinations of Indira Gandhi and Rajiv Gandhi pushed polio eradication back by decades.
Even as we celebrate the success of the possible elimination of polio from India, a quick reality check: did the country fail its own people by not heeding to sound Indian advice, relying instead on overseas advisors unfamiliar with the ground realities of India? The hard-fought battle against polio has almost been won by India and on March 27, 2014 the World Health Organisation (WHO) finally `certified’ India and the South-East Asian region to be `polio free’. Indeed a great landmark since after small pox and Guinea worm this would be the third human disease whose end is near in India.
The disease burden was astounding, studies in India in the 1980s suggests that in 1978 every day some 500 children or almost 200,000 children were being infected with polio annually and soon when the world is free from polio every year some $ 2 billion could be saved. Participating in the celebration on India’s victory over polio Prime Minister Manmohan Singh on February 11, 2014 rightfully said `this is indeed a historic day, it is a day that we have worked for tirelessly … as we celebrate three years without polio’.
The road ahead is still bumpy. Experts like Dr Nata Menabde, WHO Representative in India warn `this progress in polio eradication cannot afford to pause and we cannot rest on our laurels’. Also, unbelievable as it may sound, but the main weapon against polio in India, the Oral Polio Vaccine (OPV), itself poses one of the biggest hurdles in the `end game’. There are also many lessons to be learnt from the past, from the burden of delayed implementation of effective strategies to how the sound advice given by Indian experts was consistently disregarded by the Indian government. These are painful lessons, for they led to the unfortunate and needless paralysis of some 3 million children due to polio. All this led to over a decade’s setback in polio elimination. Interestingly the twin assassinations of Prime Minister Indira Gandhi and a few years later of Rajiv Gandhi also became a severe impediment in tackling this crippling disease.
The immediate battle against polio has been won but the war is far from over as the `endgame’ against polio is going to be tough. India’s neighbours like Pakistan and Afghanistan still harbour the wild polio virus and this deadly `tiny terrorist’ could well sneak in across the heavily armed borders.
Ill-advised plans
On advice from global experts in 1978 Indian government chose to use OPV as the preferred weapon to tackle polio, choosing it over the more effective but relatively more expensive Injectable Polio Vaccine (IPV). Pushpa Mitra Bhargava, founder director of the Centre for Cellular and Molecular Biology, Hyderabad recalls that ` developing countries were taken for a ride as there was clear serological evidence to suggest OPV was not as effective as IPV’, but then as he says at that time WHO advised `poor’ developing countries to use the cheaper OPV while it advised the developed nations to pursue the IPV route to try and eliminate polio from their soils.
Even as recently as the 1980s Indian vaccine experts like T. Jacob John at the Christian Medical College, Vellore had raised the red flag against the use of OPV as a preferred weapon: although much easier to administer, OPV has a serious flaw, it is manufactured using a form of the `live polio virus’ whose potency to cause polio has been blunted, nevertheless there are rare cases in which the virus regains its virulence and starts paralysing children. Such cases are not counted since they are taken as adverse reaction to the vaccine. The vaccine virus can also regain its infectivity and virulence and even cause polio outbreaks. In effect the cure becomes the cause for the disease burden. WHO statistics reveal that in the last 14 years 20 outbreaks of polio associated directly with the polio vaccine regaining infectivity have occurred in 20 countries and some 655 individuals have contracted polio through this route. If this doesn’t erode the credibility of the vaccine in the eyes of mothers, it would be a surprise.
Experts say this was an `acceptable’ risk since in all 10 billion doses of the vaccine were given in this same 14 year period. But the situation would get very complicated soon when the OPV is to be withdrawn as part of WHO’s `end game’ strategy at that point experts fear there could be hordes of children who may once again become infected with the vaccine derived viruses and be vulnerable to paralysis. In this last lap the use of the OPV is like having the tiger by its tail.
Writing an anguished editorial in the highly regarded Current Science journal recently John said `for three decades policy-makers ignored Indian science on polio – allowing over 3 million children paralysed unnecessarily and delaying polio elimination by 11 years.’ The problem arose as `decisions were made on the basis of opinion fit for western nations’ explains John suggesting that `in case of polio they [the government] made bad mistakes’ since Indian research studies in the 1970s had established `why western tactics would fail’. The Indian government instead relied on foreign advisors which compounded the problem.
In the early part of this decade India faced a peculiar problem of children having been administered more than 10 doses of the oral polio vaccine still coming down with polio. It was soon deciphered that the OPV itself was the problem as it was not as effective since this three in one combination called a trivalent vaccine was trying to tackle simultaneously three strains of the polio virus Type 1, 2, & 3. In 2005 based on old Indian research a more potent monovalent OPV that targets only type 1 and 3 was introduced and it immediately started yielding the desired results and the last wild polio case was detected on January 13, 2011 in West Bengal.
Unfortunately the problem of polio is not going away anytime soon even after India is `certified polio free’ since clinically paralysis caused by the wild polio virus and the disease caused because of OPV regaining virulence in the environment are virtually indistinguishable and in 2013 four such cases occurred in India, where the vaccine had gone rogue.
While polio occurring due to the vaccine virus in vaccinated children could be easily solved once OPV is withdrawn but the problem of the vaccine virus that becomes virulent in the transmission chains among children could become a huge problem since in the future when OPV is totally withdrawn children would not have the immunity against the virus, but hopefully by then the more expensive IPV would have made sufficient in-roads to provide immunity to the children of the future.
Menabde does not hide her trepidation when she says `the polio end game strategy involves a switch from trivalent oral polio vaccine to bivalent oral polio vaccine and phased withdrawal of the oral polio vaccines from the program with the POSSIBLE introduction of inactivated [injectable] polio vaccine (IPV) in routine immunisation schedule’.
By 2015 it is hoped the more potent IPV would have become part of routine immunisation but here again lies a tale of missed Indian opportunities, and a lot of irony: India will now have to follow WHO directives and by force have to import the required IPV, since the country’s own indigenous capacity was forcefully shut down.
Tale of two assassinations
In 1983 the man who invented IPV, Jonas Salk, visited India and advised then Prime Minister Indira Gandhi to introduce IPV, and by 1986 a combination of 4 vaccines (Diphtheria-Pertussis-Tetanus plus IPV) was readied but it was suddenly withdrawn by the government the same year. It was in 1984 that Mrs Indira Gandhi was assassinated and John says ‘if she were alive in 1986, India would have routinely been using the combination vaccine’. It may be pertinent to note that three decades later as part of the `endgame strategy for polio’ the combination vaccine is again being dusted up!
Another mishap occurred a few years later when Sam Pitroda was heading up the famous `technology missions’ in Prime Minister Rajiv Gandhi’s tenure. After a great deal of effort by Pitroda, the Indian Vaccine Company Limited (IVICOL) was set up on the outskirts of New Delhi in 1988, costing some Rs 900 million. But then, in 1991, Rajiv Gandhi was assassinated and in 1992 for reasons not so scientific the unit was hurriedly closed down. John says had Rajiv Gandhi `been alive we would have been using IPV on a large scale, but that was not to be … damage had been done’.
Meanwhile the country celebrates a much-needed and long overdue success story of nearly vanquishing the dreaded polio virus -- in times when scandals are tumbling out dime a dozen. This success rests on the shoulders of nearly 2.3 million vaccinators (the Indian army is only a little over one million strong) who battled tremendous odds to vaccinate in every Pulse Polio round almost 170 million children (equivalent to about half the population of USA) in more than 240 million households spending some $ 3 billion in funding. But as John laments `while global experts are lauding India for its success and goading India towards the end game, we know that India could and should have led the developing world, since we had all the right evidence and ideas to go precisely through this route towards a world in which no child ever gets polio’.
It seems global health politics triumphed over cold hard facts put forward by top class Indian researchers in the last century. So in the current election season will Rahul Gandhi and Narendra Modi learn some lessons from history on how to fight diseases the Indian way, especially as the country now begins its efforts to eradicate another big killer, measles that kills some 66,000 children annually?
Missed opportunities, misplaced advice, overt reliance on global directives and several wrong decisions – chances are all will be forgotten as the battle to end this scourge is celebrated across the world.
Pallava Bagla
(Pallava Bagla is Science Editor for New Delhi Television and correspondent for SCIENCE. Views expressed are personal. He can be reached at Pallava.bagla@gmail.com)
Saturday, February 15, 2014
ISRO unveils space capsule that will fly Indian astronauts
ISRO unveils space capsule that will fly Indian astronauts
Pallava Bagla
After its Mars mission, India now aims to puts humans into space. The first steps towards flying Indian astronauts into space could be taken in weeks.
The Indian astronaut capsule has been unveiled for the very first time. If all goes as per plan it will be tested in the first experimental flight of India's latest monster rocket, the Geo-synchronous Satellite Launch Vehicle Mark III is likely to be tested as early as May or June from Sriharikota.
The GSLV Mk-3 could see this astronaut module being flown into space for the very first time, but in a sub-orbital flight. In its first test flight no crew or any animals are likely to be flown.
"Only re-entry technologies and flight dynamics will be tested and the capsule will be recovered 400-500 kilometers away from Port Blair in the Bay of Bengal," Indian Space Research Organisation (ISRO) chairman K Radhakrishnan told NDTV.
ISRO has been dreaming of putting an Indian into space using an Indian rocket launched from India soil. ISRO has sought funding worth Rs. 12,500 crores from the government for the program. It says once the approval comes, an Indian astronaut can be flown in a low Earth orbit in about seven years from the time the approval comes from the government.
When it happens, India's human space capsule could be sent on a seven day mission for two-three astronauts in a low Earth orbit of 300-400 kilometers above earth.
Till date only Russia, USA and China have successfully flown astronauts into space with the latest entrant being China in 2003.
The outer skeleton of Indian human space capsule has been fabricated by Hindustan Aeronautics Limited (HAL), Bangalore and was handed over to ISRO which developed it. HAL says the first crew module will be further equipped with systems necessary for crew support, navigation, guidance and control systems by ISRO for experimentation in the forthcoming GSLV-MK3 launch.
"HAL takes pride in the India's space programmes and our Aerospace Division has produced this Crew Module in a record time to meet the requirements of ISRO", said Dr RK Tyagi, Chairman, HAL.
While the government has hesitated to clear a hefty bill of Rs. 12,500 crores as desired by ISRO for its human space flight program, but so that there are no delays in the development work the Indian government has already sanctioned Rs. 145 crores for the development of what it calls 'critical technologies'.
http://www.ndtv.com/article/india/isro-unveils-space-capsule-that-will-fly-indian-astronauts-483605
Wednesday, February 5, 2014
Monday, February 3, 2014
At Jammu new science initiatives announced by PM Manmohan Singh as he prepares to hand over `baton’
At Jammu new science initiatives announced by PM Manmohan Singh as he
prepares to hand over `baton’
New Delhi, February 3, 2014
Pallava Bagla
Prime Minister Manmohan Singh speaking at 101st session of
the Indian Science Congress being held for the very first time in Jammu a part
of the troubled state of Jammu and Kashmir, where some 8000 scientists have
gathered for this annual event.
The Prime Minister highlighted some aspects in his
speech:
“To do science,
someone must pay for it. We must increase our annual expenditure on science and
technology to at least 2% of our GDP. This has to come from both government and
industry. In countries such as South Korea, where a high percentage of the GDP goes
to science, the contribution of Korean industry is indeed very significant. I
am happy to say that our Department of Biotechnology has activated private
public partnerships in R&D in biotechnology. I appeal to the corporate
sector to join hands with the government in realizing the goals that we have
set for more our nation.
A major research
funding organization, the National Science and Engineering Research Board, has
just started functioning. This Board is managed by scientists and it has
simplified funding procedures. We expect much more from it in supporting
individual scientists as well as groups of scientists in creating small units
devoted to crucial sectors at the very frontiers of science.
India currently
occupies an enviable position in the field of atomic energy and high-energy
physics. Indian nuclear scientists are attracting global interest in their
effort to develop a Fast Breeder Reactor. I expect the prototype under
construction in Kalpakkam to be completed this year. It will be a great day for
Indian science and technology because we will be one of the few countries in
the world with leadership in a completely new area of nuclear technology that
can contribute non-polluting electrical power.
I recognise and we all
recognise that the Government must also focus on creating new opportunities for
our bright and socially conscious scientists. To ensure food security and to
improve land and water productivity, we have to launch a national drive for an
ever-green revolution. This will test the ingenuity of our agricultural
scientists. Climate-resilient agriculture and modern bio-technological tools
hold great promise. Use of bio-technology has great potential to improve
yields. While safety must be ensured, we should not succumb to unscientific prejudices
against Bt. crops. Our government remains committed to promoting the use of
these new technologies for agricultural development. I urge our scientific
community to increase communication and engagement with society at large in
explaining socially productive applications of technology alternatives and for
improving the productivity of small and medium enterprises.
Our Government has
invested in many areas to ensure that India remains at the cutting edge of
science. I am happy to announce another National Mission on High Performance
Computing with an outlay of Rs. 4500 crores. We are also considering
establishment of a National Geographical Information System with an outlay of
about Rs. 3000 crores. A National Mission on Teaching to enhance the esteem of
our teachers is also being launched.
I am also happy to
announce that India will partner the international scientific community in the
establishment of some of the world’s major R&D projects. In the
Gravitational Wave experiment, India intends to host the third detector. A
Neutrino-based Observatory is proposed to be established in Tamil Nadu at a
cost of about Rs 1450 crores. India is also joining the famous CERN institute
as an associate member.
Before I close, I
would like to stress on something that has troubled me for some time. I worry
some time that science has not yet got its proper due in our value system. I
would like science to be high in our value system so that our entire society
provides both moral and material support for its development. This is not only
necessary because our future depends on it, but also because instilling a
scientific attitude and temper in our population is essential for developing a
progressive, rational and humane society. I do hope that our scientists and
educators will ponder seriously on how we can achieve this transformation in
the mind set of our society. This year,
our Government selected Professor CNR Rao for the highest civilian award of
Bharat Ratna. Let this be only the first step in creating an environment that
gives birth to many more Bharat Ratnas in the field of Indian science. That is
my wish that is my prayer.”
Saturday, July 7, 2012
God Particle almost revelaed
NDTV
Dated: July 4, 2012
God Particle Almost revealed
44 minutes of video on the special show
http://www.ndtv.com/video/player/india-decides-9/the-9-oclock-news-the-biggest-stories/238274
Dated: July 4, 2012
God Particle Almost revealed
44 minutes of video on the special show
http://www.ndtv.com/video/player/india-decides-9/the-9-oclock-news-the-biggest-stories/238274
CERN scientists to reveal God Particle today?
From : NDTV
July 4, 2012
CERN scientists to reveal God Particle today?
http://www.ndtv.com/video/player/news/cern-scientists-to-reveal-god-particle-today/238161
July 4, 2012
CERN scientists to reveal God Particle today?
http://www.ndtv.com/video/player/news/cern-scientists-to-reveal-god-particle-today/238161
India to launch $75m mission to forecast rains
From: BBC
India to launch $75m mission to
forecast rains
India is launching a
$75m (£48) mission using computer models to understand the south-west monsoon
and forecast the rains more accurately, officials say. Experts say scientists
all over the world struggle to forecast weather patterns
India receives 80% of its annual rainfall during the summer
monsoons between June and September.
Forecasting the monsoon is a tricky task, as India's meteorologists have discovered time and again.
The Indian Meteorological Department (IMD) admitted later
that it was "not very accurate" in its forecasts.
In its 137-year history the IMD has never been able to predict a drought or a flood - the two extremes of a monsoon season - successfully.
Title: India to launch $75m
mission to forecast rains
Date: July 2, 2012
By: Pallava Bagla
By Pallava Bagla
Delhi
A significant shortfall in rain can trigger drought, which
can cause great damage to India's 235 million farmers.
There have been reports that this year's monsoons have been
less than satisfactory so far.
"Understanding the monsoon will be a major priority of
the government for the next five years," says Shailesh Nayak, a senior
official in the ministry of earth sciences.
He said efforts will be made to understand the rains using
computer models developed by the UK and the US and gathering fresh data.
Forecasting the monsoon is a tricky task, as India's meteorologists have discovered time and again.
Last year they predicted a bad monsoon, but in the end the
rains turned out to be in excess of what was forecast.
In its 137-year history the IMD has never been able to predict a drought or a flood - the two extremes of a monsoon season - successfully.
Experts say scientists all over the world struggle to
forecast weather patterns.
They say the IMD does a "commendable job, putting its
reputation on the block" by making monsoon forecasts every year.
Monsoon watchers like Prof J Srinivasan from the Indian
Institute of Science says seasonal forecasts for drought and floods are
relatively accurate for the Sub-Saharan region in Africa, but no agency in the
world has ever been able to predict a drought or flood for the Indian region.
The US weather office also struggles to predict droughts for
North America but there have been occasions where they have been able to make seasonal
drought forecasts, experts say.
Pallava Bagla is a
correspondent for Science magazine
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