|Year : 2018 | Volume
| Issue : 4 | Page : 462-464
Innovation in medicine: New ideas for translation
Award Winning Essay in Competition organized by ICMR, 2018
Ajey Singh Rathore
All India Institute of Medical Sciences, Jodhpur, India
|Date of Web Publication||21-Jan-2019|
Ajey Singh Rathore
All India Institute of Medical Sciences, Jodhpur 342 005, Rajasthan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rathore AS. Innovation in medicine: New ideas for translation
Award Winning Essay in Competition organized by ICMR, 2018. Indian J Med Res 2018;148:462-4
|How to cite this URL:|
Rathore AS. Innovation in medicine: New ideas for translation
Award Winning Essay in Competition organized by ICMR, 2018. Indian J Med Res [serial online] 2018 [cited 2020 May 25];148:462-4. Available from: http://www.ijmr.org.in/text.asp?2018/148/4/462/250543
In the early 1960s, on Jaipur-Delhi National Highway, a common man 'Mangilal' met with an accident. The doctor had to amputate his right leg and it was all because of the delay in reaching hospital. To some, it is just a lost leg; to others, it is a lost livelihood, and to a budding cricketer like him, it was a major setback and an abrupt end to his career. Replace Mangilal with any other name, but the story remains the same. Hundreds and thousands of people at that time found their wings cut before their flight. Mangilal and others were aware of the USA-based prosthetics, but these were beyond their reach. Not unawareness, but the inaccessibility of technological advances was and is still a major issue. At this time, Dr P.K. Sethi, an orthopaedic surgeon, could not take the plight of these people and stepped in to bring a change. He along with R.C. Sharma, an illiterate but a skilled craftsman, invented a prosthetic. Now famously known as 'Jaipur Foot', this invention was durable, light, water resistant, easy to use and way cheaper than its US counterparts. The appeal was massive and the impact changed lives.
The above was not a story or a miracle, but an example of what an innovation is or rather what an innovation should be. Innovation is nothing but an idea, an initiative significantly improved to surpass its predecessors that has a revolutionary impact on human lives along with being cost-effective. Citing an example of 1960s in 2018 highlights a paucity of such innovations in India and a grave need to analyze the validity of 'innovation as a concept in the field of medicine'. Before going further, let's ask ourselves some questions that need to be addressed. What is innovation in medicine and what are the prospects of it? What are the issues and challenges faced by us? India's contribution towards this? And most importantly, what should be done to improve the current situation? Finding answers to these questions will help us in finding solutions to our problems.
| Innovations and its prospects in medicine|| |
While dealing with a field as vast and as important as medicine, we need to broaden our innovative horizons. If the use of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) in editing genes of embryo was an innovation, then Murgunathan's attempt to make cheaper sanitary napkins was no less. If the beverage model or Bismarck's model was path-breaking, then Modi's national health policy is a novel approach too. No matter big or small, an idea is what we need.
Innovation is a multidimensional concept and a thorough understanding is necessary, for example:
Innovation in core medical science
If medical science goes stale, will the human bodies not rot? In this fast-paced and ever dynamic world of technological advances, medicine cannot sit back with the concepts of Victorian era. It can only grow when it breaks through the shackles of its own laid back concepts and questions itself. Long gone are the days, when everything that was told, assumed or supposed by the experts was taken as 'Medical Science'. Now, science has taken on a broader meaning and a greater responsibility. In this modern renaissance of medicine, each and every idea, be it a complex surgery or a simple measurement of blood pressure, is subjected to the same litmus test for evidence, thus giving birth to the concept of 'Evidence-Based Medicine'. It means that for any idea to be accepted, it has to prove its worth by giving satisfactory evidence of its efficacy. This non-prejudiced approach eases the development and acceptance of newer and better ideas and has given new opportunities for inventions and innovations.
Medical science all over the world is getting rewritten and India cannot afford to sit back. The time has come for us to unleash the full potential of our diverse and rich human dividend and take India forward on the path of becoming a global leader in the field of healthcare. This step of introducing innovations will be no less than the Indian contribution of 'zero' in the decimal system. We need to redefine the age old ideas, procedures, protocols and guidelines, widely prevalent and religiously followed in the entire world. Moreover, there is a need to rethink the medical education curriculum itself.
Innovation in drug development
Discovery of teixobactin, a new antibiotic after a gap of 30 years, clearly shows our insufficiency in our fight against the bacteria. In the initial phase of antibiotic discovery, it was a huge success because we caught the enemy unguarded and could nearly eliminate the deadliest of them. The times have changed and large numbers of bacteria are reported everyday which are virtually resistant to all available antibiotics. It will be honest to say that we are on the verge of repeating the DDT disaster. One drug in 30 years shows an unprecedented lag in drug development. The situation has caught us off guard with the other side of battlefield lined with highly potent enemy. If any invasion happens by bacteria this time, the damage to the human race will be huge. We have to line the shore with newer and better drugs before the waves hit.
Innovation in devices and instruments
Technology has hastened the development of new instruments and they range from the earliest of X-rays to the newest of portable ultrasounds robotic surgeries and what not. Even with an exceptional growth, this arena still remains the hotspot and the scope of development is enormous. India with its strong technological infrastructure can surpass all expectations.
However, the catch is not just in development of costly technological advancements, but also it is in developing cheaper alternatives and only then will the benefits of science trickle down to the poorest of the poor. Another 'Jaipur Foot'is needed.
Innovation in delivery of healthcare services
Innovation in this area is the least talked about and intellectuals all over have focussed on inventing newer devices and drugs. However, India suffers more due to the inaccessibility of drugs rather than the unavailability of it and performs equally bad when it comes to Doctor:Patient ratio. Newer ideas and initiatives are required for the delivery of healthcare services and also to generate awareness about them as without this basic initiative all other innovations are futile. If we look at the statistics, then India has shown improvement in terms of health indicators compared to the time of independence. The initial improvement was because of benefits of medical science; however, now, after 71 years of independence, the statistics are not good. What we need now is robust infrastructural development. The healthcare department has to achieve the four A's so that every future development quickly reaches the masses.
Need to quantify broader meaning of health
Health as per the World Health Organization is not only limited to physical well-being but also encompasses mental and social health with an upcoming concept of spiritual health. What these concepts lack is objectivity and quantifiability and are more or less vaguely defined. In the absence of sufficient index, it is difficult to understand the extent of disease in people and if the government policies aimed at improving the conditions are of any help.
This is a recognized but unexplored area, and urgent path-breaking improvements in this field are what the nation needs.
Innovation in preventive health
Prevention is recognized as the last resort to stop the development of non-communicable diseases (NCDs), but the ever rising number of patients with NCDs clearly exemplifies that the strategies undertaken could not achieve the set target. Increasing influence of western lifestyle has led India to the verge of becoming the world capital of NCDs. Better preventive strategies and an even better implementation of these are the need of the hour.
| Issues and challenges|| |
The global innovation index ranks India at the 580th position, and we owe this sorry state to not one but many factors.
Lack of investment
With as less as 0.7 per cent of the budget allocated to research and development, every useful investigation suffers roadblocks all through the way. As a result, there is brain-drain of good human capital to other countries.
With its roots in the Macaulay system, our education focuses on producing brain that can just reproduce learnt stuff as and when required. It fails to inculcate creativity and curiosity in young minds which are the foundation stones for any innovation.
Environment of innovation
Lack of financial and supportive environment forces parents to send their child to more rewarding jobs. As a result, the field of research is quickly going down as a career option.
Technical issues such as patents and finances
Patent laws, ethical clearance, etc. are more of restrictive than a pro-research approach. This kills the young innovators and their innovations in budding stages only. They also face a lack of knowledge and source to get finances to develop these innovations into working business models. Frankly then, research does not provide a good future for them to pursue.
| Any solution for promotion of innovation?|| |
With every lock comes a key, the key for these issues hampering innovation lies in innovation itself. We need first to invent new ideas to fasten the pace of innovation in India. Not one but many solutions are there:
To promote research, finances need to be strengthened or rather 'financial autonomy' should be provided to research institutions. This makes them not only more confident but also more independent too.
Education curriculum needs a re-evaluation and should become more creative in their approach. Once the students start questioning the existing knowledge, then only ideas such as evidence-based medicine become successful. Questioning needs to be encouraged only then the environment will develop. E-medicine or telemedicine is the potential solution for problems of healthcare delivery as they help in achieving the four A's. These decrease the burden on the doctor and at the same time increase the reach of health services to far-flung areas and physically handicapped people. This also decreases the cost of service and provides availability of quality doctors and useful medicines at your doorstep. Moreover, patenting laws should be made more consumer-friendly when it comes to essential drugs. This will prevent the big pharmaceutical companies from extracting unreasonable prices from consumers. Relaxation of patent laws on its own will enable development of cheaper devices and instruments too.
Recent steps undertaken by the government were encouraging but not enough and still a long way to go to achieve these goals. Mobile apps or computer programmes may be developed with evidence-based algorithms and thus allows patients to self-diagnose for basic condition and automatically call for physicians' help if needed. This will drastically improve the inefficiency created due to low doctor-patient ratio. Innovation indices or list should be published such as recently published list by 'Cleveland Clinics Medical Innovation Summit'. This will not only encourage innovators but will also provide positive reinforcement too.
In a nutshell, innovation is needed at all levels from individual to family, to society and finally at a nationwide level. No matter in what measures be it big or small, new ideas and newer initiatives will lead India to become the global capital of innovations. It is no longer the survival of the fittest; it is the survival of the unorthodox, of the unconventional and of the unprecedented and the most ingenious of minds. Hence, learn to survive India, learn to innovate.
Conflicts of Interest: None.