A new window of opportunity

Virander S Chauhan and Rajat Goyal May 15, 2012  The mandate for healthcare — a key BRICS (a group comprising Brazil, Russia, India, China and South Africa) collaborative area — stands at a crossroads. There is a greater emphasis on funneling new investments into efforts to improve health in the poorest countries, thanks to the rise of domestic biotechnology and pharmaceutical industries. The health biotech sector in India, particularly vaccines, is a case in point. While figures point to an innovation-fuelled boom (India produces about 60% of the world's vaccines and accounts for 60-80% of annual UN vaccine purchases), a cautionary note needs to be sounded here.  The emphasis on the South-South collaboration appears to be in the non-innovative sector, says a study ('South-South Entrepreneurial Collaboration in Health Biotech', Nature Biotechnology Volume 8, Number 5, May 2010). Of the firms surveyed in the study, the 13% citing research and development as one of the collaboration sectors contrast sadly with the 72% citing distribution and 34% citing marketing. Compared with the extent of R&D collaboration in the North-North space, in a similar study (20% in the mid-to-late 1990s, up from 6% in the 70s) this is a rather dismal figure.  On a positive note, however, southern firms are becoming epicentres of new knowledge products, particularly with the emergence of institutes like the Beijing Genomic Institute. Global collaboration in the Indian health biotech sector has seen a perceptible shift towards the South in the past decade with the graduation of start-up firms from concept development to drug development. Clinical Research Organisations (CROs) are now developing their own drugs.   While India is well ahead in the volume game (the last decade saw about 240 CROs emerging in India), there are gaps in knowledge-sharing. South-South collaboration is underpinned by parity in socio-economic development and in some instances, culture.  The 'Big 3' killer diseases — tuberculosis, malaria and Aids — currently lack vaccines and require a strong focus on collaborative research. Efforts like the ongoing South Africa-India Bilateral Collaboration for HIV antigens, in particular, have tremendous benefit for India and South Africa as well as for research in HIV.  It's becoming evident that there are multiple collateral benefits to be derived from such collaborative efforts. It would be useful to note that both the means and ends for some of these collaborative efforts converge at some point during the process path.  Innovation: India's focus on innovation has helped it strengthen South-South regional collaboration and allowed an effective engagement with the global North. The emphasis on upgrading traditional skills and developing advanced capabilities in frontier areas of science appears to be an approach that is well placed, demonstrating how modern science and technology is helping lower the burden of disease and spur economic growth. India's success in containing polio is a good example of how science and innovation is delivering broader socio-economic benefits.  Collateral benefits: A key incentive for collaboration, especially in HIV vaccine R&D, where India has built robust programmes in applied research as well as those resulting in the completion of three Phase 1 clinical trials of HIV vaccine candidates. The conduct of these trials has helped in creating benchmarks for good clinical practices, good clinical laboratory practices and good participatory practices. These standards ensure ethical and effective trials of HIV vaccine candidates and establish capacity for clinical research to address other health challenges facing the country.  National ownership: Crucial for any collaborative effort of this nature, Indian industry must sustain the shift in investment towards research, to the development of medicines that prevent, treat or cure and tackle unmet medical needs over the next decade or so.   A close examination of geopolitical trends suggests that the BRICS configuration has some way to go before it can become a more effective platform for regional collaboration. The good news is that India is beginning to show that it has much more to offer to the world as its in-country R&D expertise grows significantly in both public and private sectors.  Though there are several factors that contribute to South-South collaboration in global health biotech, the overarching aim remains constant — one that can deliver good science with humanism for the greater public good.  Virander S Chauhan is director International Centre for Genetic Engineering and Biotechnology, Delhi; Rajat Goyal is country director, International AIDS Vaccine Initiative, Delhi