Working with India to Advance Cancer Research

September 15, 2017, by Douglas Puricelli Perin

Early July was a busy period for our team, visiting India to further develop our collaboration in cancer research. Thirty-three meetings over 10 days, in New Delhi and Hyderabad, engaging public and private sector partners and institutions involved in cancer research and biotechnology. The cancer scenario in India is important and very relevant to the U.S. and the world when we consider that:

• India’s large population, currently standing at 1.3 billion people, already accounts for 7 of every 100 new cancer cases in the world. As it continues to grow, age and urbanize in the coming decades, cancer cases will increase, offering an opportunity to study interventions that can effectively control the burden and cancer types that are uncommon in other settings.
• The genetic makeup of Indian population and certain lifestyle behaviors may lead to higher susceptibility to certain cancer types, noting the higher incidence of gallbladder and oral cancers in India, and understanding these factors would contribute to improved cancer prevention and control strategies among Indian immigrants and descendants living in the U.S.
• Traditional medicine practices in India, such as Yoga and Ayurveda, are becoming common strategies for managing side effects of cancer treatment, pain management and alleviation, and certain compounds may interact with drugs and chemotherapy. Standardized and controlled research of Indian traditional medicine may lead to beneficial and improved therapies to cancer patients in the U.S.

We started our journey in New Delhi. On July 5^th, we had meetings with some institutes that greatly contribute to advancing cancer research in India, including:

• All India Institute of Medical Sciences (AIIMS), where we reviewed major collaborations including U.S. NCI’s technical support for the design and construction of AIIMS-National Cancer Institute;
• contacts with the Science and Engineering Research Board, and the Indo-U.S. Science and Technology Forum, to understand where we have opportunities to jointly promote and fund cancer research;
• the Department of Biotechnology (DBT) and the Biotechnology Industry Research Assistance Council, to continue well-established dialogues that increase investment in research and development for oncology and facilitate international collaboration.

 

In addition, we visited the World Health Organization (WHO) Regional Office for Southeast Asia, and WHO Country Office for India to have a broader understanding of cancer prevention and control in India and the region, and assess opportunities for joint work. We identified areas of strong mutual interest in tobacco control, HPV vaccination, and cancer screening research and implementation.

 

Exploring opportunities for training in cancer research and science communication was an important part of our program. On July 6^th, we met with Wellcome Trust/DBT India Alliance, a great partner for increasing the number of cancer researchers in the global community. Fellows from India, U.S., or any other country can apply for funds to work with Indian institutions, develop their research interests and gain excellent skills in grant management. Next, we visited Nature India to discuss potential publications that highlight advances in cancer research produced by India and U.S. The day continued at the Biotech Consortium India Limited (BCIL), a public company created by DBT, where we learned about their strengths in innovation, technology transfer and project management. BCIL is working on an herbal formulation to treat HPV and other infections, and has other products already available. Finally, Dr. Ravi Mehrotra hosted us for an evening at the National Institute of Cancer Prevention and Research, and we heard about their actions to implement India’s screening programs for breast, cervical, and oral cancers in 109 districts, and HPV vaccination campaigns in Punjab, Sikkim and Delhi.

 

On July 7^th, we visited the All India Institute of Ayurveda, followed by a meeting with the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH), to explore ways to advance scientific investigation of cancer-related applications of these ancient practices, such as the benefits of Yoga in a patient’s life after cancer, or Ayurveda for management of side effects from cancer therapy. We continued our scientific discussions with Dr. Soumya Swaminathan, head of the Indian Council of Medical Research, where priorities included leveraging India’s traditional knowledge, increasing biomedical research capacity, improving the country’s data systems, translating evidence into policy, and developing implementation research. Science communication and training scientists and policy makers on how to communicate with media and general audience were also in the agenda. We were warmly welcomed by Dr. R.K. Grover at the Delhi State Cancer Institute, and had the chance to talk with staff and visit innovative human-centered facilities where 90% of patients are treated free of cost. Later, we were led to evening meetings with the Lieutenant-Governor and the Minister of Health of Delhi to discuss possibilities for collaboration. Our last stop before heading to Hyderabad was the Max Super Specialty Hospital, Saket. The extensive Max network of hospitals sees approximately 6,000 cancer patients per year, and trains over 4,000 students. Although patient care is their priority, clinicians are increasingly recognizing the importance of research for improving therapy and outcomes.

 

 

 

During our three days in Hyderabad, we came into contact with India’s growing biotech industry and explored opportunities for cancer research collaboration with local institutes. A courtesy call with the U.S. Consul General in Hyderabad gave us insights to U.S. health efforts in the region. We started with visits to Basavatarakam Indo American Cancer Hospital & Research Institute, a nonprofit organization that offers integrated cancer care; and, to Apollo Institute of Medical Sciences & Research, where we met the visionary founder of Apollo Hospitals Group, Dr. Prathap C. Reddy. Hyderabad also houses the Center for Cellular and Molecular Biology (CCMB), a research institute operating under the Indian Council of Scientific and Industrial Research, and the Center for DNA Fingerprinting and Diagnostics, funded by DBT, where we had engaging discussions on priorities for basic cancer research. Our last day started with a videoconference hosted at the Pilani campus of Birla Institute of Technology and Science, that included researchers from all four campuses presenting a broad spectrum of basic, clinical, and translational cancer research activities. Finally, at the Genome Valley, we met with leaders of Bharat Biotech, learning about their successes in vaccine development and long-standing collaboration with NIH; and, IKP Knowledge Park, a science park and incubator that cultivates entrepreneurs and foster innovation in India.

 

We were back in New Delhi on July 13^th to debrief the Chargé D’Affaires, and Economic, Environment, Science, and Technology Officers at the U.S. Embassy, where we also enjoyed lunch with USAID’s senior advisor for innovation and partnership. At the Ministry of Health and Family Welfare, we discussed our continued engagement and technical support to the implementation of India’s cancer screening programs, highlighting the importance of a research framework through appropriate data systems, monitoring and evaluation to sustain and improve these programs. We finished our trip talking with US-India Educational Foundation about exchange programs and other training opportunities for early-career and senior researchers; and, about public-private partnerships to advance cancer research with the US-India Business Council.

 

India is teeming with great opportunities for scientific collaboration and Indian scientists and decision makers are ready to work together with us to solve important questions in cancer prevention and control. We will continue to build lasting partnerships with Indian institutes to strengthen cancer research and translate findings into policies and programs that can benefit our populations in the long term.