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Under scrutiny, India’s premier medical research council faces review

BANGALORE — A high-powered panel set up at the request of India’s Ministry of Finance is reviewing the work of the Indian Council of Medical Research (ICMR), the country’s primary funding and coordinating body for biomedical research, based in New Delhi.

The ICMR has faced criticism that the medical research it supports does not adequately address public health problems. Such critiques, it seems, have prompted the ministry to seek an external audit of the ICMR’s research programs before the government releases the 85 billion rupees ($1.6 billion) that the council has asked for over the next five years—twice as much as it got for the previous five years—including 31.5 billion rupees for new scientific institutes and an upgrade of existing ones.

Prakash Tandon, a neurosurgeon at the government-funded National Brain Research Centre in New Delhi who heads the 11 member committee, told Nature Medicine that a new direction for medical research will be formulated after critical evaluation of the usefulness and public health relevance of programs in each of the ICMR’s 27 institutes. It’s likely that a number of duplicated programs across different ICMR institutes will be recommended for closure, added pathologist Indira Nath, an emeritus professor at the National Institute of Pathology in New Delhi and a committee member. The review of the ICMR began two weeks ago and a report will be submitted within the next two months, according to Tandon.

The ICMR, India’s equivalent of the US National Institutes of Health, grew out of the Indian Research Fund Association, which was founded in 1911 when the country was under British rule. The scientific body was restructured and designated under its current name in 1949, two years after India gained independence. However, its recent progress has come under scrutiny.

The 12th five-year plan document, released late last year by India’s Planning Commission, the apex body chaired by the Prime Minister that formulates five-year plans and allocates money for various ministries, stated that “health research in India has yet to make a major impact” on public health, noting that the nation bears a high proportion of the global burden of diseases such as tuberculosis and leprosy. The infant mortality rate is also still high (44 per 1,000 births) as is the prevalence of anemia and malnutrition.

“Recurrent epidemics of Japanese encephalitis, Dengue and Chikungunya continue to haunt India,” says Payyalore Rajagopalan, former director of ICMR’s Vector Control Research Centre in Pondicherry. Rajagopalan explains that he resigned from the committee advising ICMR on malaria research after he found that the ICMR “was not keen on a long-term objective and was happy carrying out fire-fighting operations during epidemics apart from conducting meetings and producing reports and recommendations.” The Tandon-led committee, he says, is simply “another bureaucratic exercise.”

Kalyan Banerjee, former director of ICMR’s National Institute of Virology in Pune, agrees. “We cannot expect too much from this review,” he told Nature Medicine. “Each ICMR institute has a [scientific advisory committee] that meets every year and if the ICMR translates the [committee’s] recommendations into action, where is the need of an enquiry by external experts who may not have the solutions for the ICMR’s problems?”

Vishwa Mohan Katoch, ICMR director general, declined to speak to Nature Medicine, but the agency’s former chief Gowdagere Satyavati points out that the ICMR alone cannot be blamed for poor impact on public health. “There are other organizations in the health ministry for health delivery, and don’t forget that health is a state subject,” she says. “The central government formulates programs but the states must implement them.”

A version of this story appears in the April 2013 issue of Nature Medicine.

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