Science discovers, technology develops and public health delivers. This has been the mantra of health care transformation in the 20th century, alongside social and economic development which promoted health through improved living conditions. As India now sets out on an ambitious path of accelerated economic development, can it use technology to improve India’s lagging health indicators which will be a drag on the economic growth engine? The Prime Minister’s call for innovative technologies to provide breakthrough solutions is most relevant for the health sector, where many Indians face accessibility and affordability barriers to appropriate health care and public health is in a precarious state of neglect in many parts of the country.
It is not just high cost imaging technologies (CT, MRI, PET scans), new cardiac stents or surgical robots that matter in healthcare, though Indian industry should aim to produce these too over time. It is the more widely used and less expensive technologies that need to be prioritised for ‘Make in India’. These will range from simple diagnostic tests for common infectious and non-communicable diseases to vaccines and from disability assist devices to electronic
decision support systems that can empower primary care providers.
There are promising indications that this is beginning to happen. The Indian Council of Medical Research and the Innovation Foundation of India organised an exhibition of innovative health technologies in Rashtrapati Bhavan in March 2015. Among the 46 exhibits on display were a point of care diagnostics assembly on an Android tablet for use by frontline health workers, a smart cane whose sensor helps the visually challenged to avoid raised objects, a wheel chair that negotiates stairs, an Indian made vaccine for Japanese Encephalitis and an inexpensive baby warmer. The next exhibition in 2016 will see more exciting innovations.
It is not surprising that a country which produced the internationally acclaimed technologies of Jaipur Foot and Arvind Intra-Ocular Lens should be seen as a potential crucible for frugal innovations that can benefit health care across the world. We have, however, not geared up to even meet our domestic needs, with technologies like the Kalam-Raju stent and Chitra valve unable to displace imported cardiac devices. We have to strengthen the whole value chain from product innovation, evaluation and legal protection to design, manufacture, marketing and supply chain management to avoid the trap of niche innovations that fail the mass application test.
There are several reasons why India can emerge as a leader in the affordable health care technology space. The low costs of research and manufacture do help. The major catalyst for innovation will, however, come from the need to
provide technologies that can improve access and effectiveness of health services to reach the unreached. Many
of these frugal innovations will be globally portable.
However, this will need a new environment that fosters trans-disciplinary research, supported by cross domain professional collaborations that thread seamlessly through all stages of product development. Though many of our universities have failed to provide an environment where engineers and health professionals can meet to ideate and
innovate, new partnerships are developing that hold promise. The Stanford-India Bio Design programme brings
together the All India Institute of Medical Sciences, Indian Institute of Technology (Delhi) and Stanford. IIT (Kharagpur) and Birla Institute of Technological Sciences (Hyderabad) are collaborating with clinicians and public health professionals to develop innovation centres for health technologies.
Health services can also draw immense strength from IT. Surveillance of risk factors and diseases can become
nationally representative, with real time data. Electronic health records, telemedicine and m-health through cellphone messaging and apps are all likely to provide value in coming years.
However, all of these will flounder if a weak public health system fails to deliver the intended beneficiaries. Such
technology pile up can be prevented by developing a strong delivery vehicle through a robust public health system. Will 2016 see the marriage of health services with appropriate and innovative technologies that can improve our population health outcomes and bridge gaps in health equity?
Tail Piece: Innovations can be in the use of existing technologies too. Here is an idea for the PM to consider. The public announcement system in medium and long distance trains can be used at 30 minute intervals during the day for crisp, attractively produced 30 second jingles, jokes and celebrity messaging conveying health information to millions of captive listeners. Any takers for “Health On The Move”?
K SRINATH REDDY IS PRESIDENT, PUBLIC HEALTHCARE FOUNDATION OF INDIA