Health Research: An Investment Worth Making to Achieve Health Equity
By Dr Renu Swarup and Dr Shirshendu Mukherjee
The World Health Organization (WHO) set the ‘Health for All’ goal in May 1977. Ambitious and difficult, it is yet to come to fruition in India despite concerted efforts towards and improvements in the public health outcomes over the years. The 72nd World Health Assembly – recently concluded in Geneva wherein global and country-specific health agenda was discussed – thus forms the perfect backdrop for reassessing India’s progress and accelerating its Universal Health Coverage (UHC) initiatives.
The persistent health-related challenges, including maternal and child mortality and disease outbreaks, exemplify the need for a better and stronger health care system in India, while also highlighting the need for us to improve, protect and restore the health of our people. UHC is one such way to do so. Under the gamut of the healthcare access challenge within the Sustainable Development Goals (SDGs), UHC outlines the goal to ensure that all people and communities across the globe receive health services without facing financial hardships.
Currently, nearly two-fifth of India’s infants do not receive the required vaccinations and approximately millions are pushed to poverty due to catastrophic out-of-pocket health expenses. These statistics clearly outline the need for ensuring UHC. India, by achieving its UHC target by 2030, will not only improve the health of its people but will also strengthen its foundations for long-term economic growth. However, for the UHC objective to be met, we require a robust understanding of the gaps within the national health delivery systems. For this, health research is key.
Health research is the foundation for any public health scheme, health delivery system reforms and targeted health innovations. Simply put, it provides important information about disease trends and risk factors, health care costs and uses, outcomes of treatment or public health interventions and patterns of care. Health research forms the nucleus that further aids in health sector discoveries, development of new therapies and public policy reform. However, this nucleus is many a times grappling with the lack of accurate, factual and descriptive data, thus leading to skewed results and data deficient outcomes and recommendations.
Biotechnology Industry Research Assistance Council (BIRAC), with its vision to nurture strategic research and innovation, early on recognised the gaps within existing health data and its effect on research. Consequently, under the umbrella of Grand Challenges India (GCI), the Healthy Birth, Growth and Development knowledge integration India (HBGDki India) programme was launched to develop large cohort data around the health outcomes amongst Indian children and infants. HBGDki India will aid in developing a rapid understanding of the multiple interrelated issues that result in poor growth outcomes for the world’s children and to use this evidence to design interventions and policies to address such issues. The initiative is also focused on developing a knowledge compendium that will allow researchers and others to access a variety of data from different parts of the world and obtain a much clearer picture of global trends and analyses on factors that affect child birth and subsequent development.
Health research also copes with the paucity of novel and innovative methods of data analysis. A large amount of data collected remains raw and is not utilised effectively. Developing and validating health approaches due to the challenging interactions of biological, environmental, and social factors remains a difficult problem. Furthermore, policy recommendations for such approaches frequently lack sufficient supporting scientific evidence, exacerbated by the fact that clinical trials are expensive, time-consuming, and difficult to implement. Thus, creating an opportunity in the area to find new ways of analysing existing data and developing cost-effective and data-driven health recommendations.
To this end, GCI has called for proposals under the knowledge integration (ki) data Challenge for Maternal and Child health, wherein innovators have been asked to develop original approaches to analysing existing Indian public health data and evidence in the form of clinical research data, surveys and other related data sources from India to produce novel insights which can be used to improve maternal and child health in the Indian context as well as around the world. The ki initiatives undertaken by GCI not only work towards addressing the data challenge gap, but also tie into the objectives of fostering universal health coverage.
Additionally, the Knowledge Integration and Translational Platform (KnIT) was launched in 2016 by GCI, which works on collating and analysing available evidence within India, to inform policymakers and health authorities. This, in turn, aids in the development of evidence-based policy to address the inequalities in health outcomes in the country. With a focus on two tracks – maternal and child health and nutrition – the KnIT platform aids the state governments in developing and implementing cost-effective, equitable, impactful and multisectoral health interventions, informed by scientific evidence and health data.
Therefore, data-driven approaches can play a key role in the herculean task of ensuring health coverage to all within the nation in particular and the world in general. India, with a current ranking of 56 on the UHC index, should now look at strengthening its healthcare delivery system foundation through evidence based public policies and reforms. Data should not only be the parameter for developing targets but also the basis of a situation analysis to understand the strengths, weaknesses, opportunities and threats within the Indian healthcare landscape.
It is through robust health research that targeted actions can be defined and undertaken to ensure health services are available for all. Thus, creating a lasting and profitable investment in healthcare equity is essential for improving India’s social, economic and developmental outcomes.
Dr Renu Swarup is the Secretary, Department of Biotechnology Ministry of Science & Technology, Government of India and Chairperson, Biotechnology Industry Research Assistance Council (BIRAC).
Dr Shirshendu Mukherjee is the Mission Director, Grand Challenges India.