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What is Science Policy and Diplomacy?

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Editor’s note: Science is a universal language and it knows no bounds. In her new post, Debanjana talks about why science should be at the center of all diplomatic relations – Neha Bhutani

 

I had promised in my last blog to be back with an article to discuss some plausible paths to a career in science diplomacy. However, I gleaned from the reader comments that the concept of science diplomacy seemed abstract to many. Therefore, before we get to careers and transition paths, I would like to linger a little longer on the definition and cite a few concrete examples.

 

Policy is a two-way street between the government and the public1,2. Science policy experts are links between the world of research, the government, and the public. These experts are entrusted with the responsibility of shaping and formalizing the government’s stance on particular scientific issues and controversies, as well as drafting legislation to address them. Besides their own policy experts, politicians often call upon outside analysts working at scientific non-profits for recommendations and reviews on the bills they draft. In the words of Dr. Laura Hoopes, emeritus professor at Pomona College, CA and former AAAS-fellow, ‘Science Policy really addresses two different themes: policy for science and science for policy. Policy for science is probably what most scientists think of when they think of “science policy”. It revolves around questions on how to fund science, and how to create goals for scientific research. In contrast, science for policy is more about how scientific evidence can contribute to the decision-making process.’’

Policies are drafted not only at national level, but also at subnational as well as international level. This leads us to the topic of ‘science in diplomacy’ where some policy experts, by dint of their background in specific scientific disciplines as well as economics and international affairs, advice to inform and support foreign policy objectives of a country. For example, Swedish International Development Cooperation Agency (SIDA) is a government agency of the Swedish Ministry for Foreign Affairs which works to reduce poverty and promote development and equality. The SIDA-supported Health Nutrition and Population Sector Programme (HNPSP2) in Bangladesh is the world´s largest health sector programme3.

‘Science in Diplomacy’ is crucial in combating issues that have far-reaching consequences well beyond national levels, such as climate change, emergence of new infectious diseases, antibiotic resistance etc. An erroneous policy of one nation can impact the health and economy of not only its neighboring countries but the entire world. United Nations is constantly pushing for evidence-based policies customized to the needs and circumstances of every stake-holder to realize the sustainable development goals (SDGs) worldwide.

 

As I had mentioned in my earlier blog, ‘Science Diplomacy’ refers to three main types of activities:

  1. “Science in diplomacy”
  2. “Science for diplomacy”
  3. “Diplomacy for science”

 

Since we already touched upon the topic of ‘science in diplomacy’, we are left with the other two undertakings. The way I see it, ‘Science for Diplomacy’ is when scientific collaborations are used as a tool to improve diplomatic relationship between two nations. However, not all international scientific cooperations qualify. Such cooperations when established, and maintained with an ulterior diplomatic motive constitutes science diplomacy. Scientists are at a unique position to foster such connections. The relationship between two countries could be strained but they are usually still open to the idea of scientific exchange for the greater good. Prior to Obama administration, this approach was popularly known as ‘soft power’. The US-Iran nuclear deal of 2015, recent improvements in US- Cuba relations are prominent examples. Despite half a century long political impasse between US and Cuba, American Association for the Advancement of Science had been silently collaborating with the Cuban Academy of Sciences since 1997. This scientific cooperation formed the bedrock for the reestablishment of bilateral relations in December 2014. Contrary to popular notion, it is not always that the less developed country gets to benefit more from such relations. An interesting example is the US discovery of Cuba-developed lung cancer vaccine, Climavax, which has now been approved by FDA. Here are some good articles describing the role of science diplomacy in rebuilding of US-Cuba relations:

http://www.worldpolicy.org/blog/2016/07/11/science-diplomacy-and-us-cuban-relations

https://www.aaas.org/news/science-diplomacy-improves-cuba-us-relations

http://www.sciencediplomacy.org/perspective/2015/building-lasting-cuba-us-bridge-through-science

 

Update: This article was written prior to the executive order by President Trump to revise some of the Cuba policies of Obama era. The extent to which the diplomatic and scientific cooperation between the two countries would change is unclear at present.  

https://www.washingtonpost.com/politics/trump-announces-revisions-to-parts-of-obamas-cuba-policy/

 

The flip side of the coin are the nations with friendly diplomatic relations who could still benefit from establishing better and more effective ties through scientific collaborations (Diplomacy for Science). The most personal example in my mind is that of Germany and India. Historically, these two nations never faced any insurmountable diplomatic obstacle. Nevertheless, recognizing the benefits of science and technology collaboration with India and possibly, as a strategy to attract young highly-skilled talent into the country (Replacement Migration4), Germany has been making great efforts in engaging with India through ‘Science Diplomacy’. Unknowingly, we ourselves might have reaped positive benefits from such efforts. Back in 2010 when I set off for the Germany, little did I know how my career path had already been touched so closely by science diplomacy. German House for Research and Innovation at New Delhi is actively involved in facilitating bilateral projects in higher education, language, science, research and innovation. One significant step forward in the bilateral relations was signing of a Memorandum of Understanding in April, 2006 during the visit by the then Indian Prime Minister, Dr. Manmohan Singh to Germany. As a part of this Science and Technology Collaboration, the Indo-German Science Centre for Infectious Diseases (IG-SCID) was opened in 2007. To foster cooperation through joint workshops and exchange programs, the IG-SCID brought together the Indian Council of Medical Research, the Helmholtz Centre for Infection Research and the Hanover Medical School (MHH). This policy had impacted me personally as I was able to interview in-person with professors from MHH at New Delhi to secure a full scholarship for my doctoral studies at MHH. Such stories are only a small part of the boon of such diplomatic endeavors.

 

I hope that this article sheds some more light on the premise of science diplomacy. The next blog topic would be career track in science policy and diplomacy. So long!


1http://www.asbmb.org/asbmbtoday/asbmbtoday_article.aspx?id=10188

2http://www.sciwri.club/archives/2453

3http://www.sida.se/English/how-we-work/our-fields-of-work/health/

4http://www.un.org/esa/population/publications/migration/migration.htm

 

About the author: 

 

 

 

 

 

 

 

Debanjana is an Immunologist / Clinical Coordinator at Columbia University, NY.  She is passionate about traveling, dancing, and languages. She is here to share the musings of her meandering mind.

 

 

Featured image: Pixabay

This work by ClubSciWri is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

Increasing public perception of science via robust science communication

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Science is essential to the economic, societal and environmental growth of a country. Science improves the quality of life by providing better medical care, healthier environments, increased efficiency in industries, secured financial trading, improved food safety, strengthened border security, stimulating environment, etc. However, a lack of understanding of the scientific advances can have dire consequences. Take for example the issue of climate change, where a number of factors including inefficient communication of fundamental climate data to the public has not only created misunderstanding of scientists and their research, but has also influenced the government decision-making with regards to environmental regulations, science policy and funding. The importance of proper science communication is not just limited to the issue of climate change. With the development of new technologies like genome sequencing and personalized medicine, general public needs to know the complex scientific intricacies so that they can make decisions that directly affect the quality of their life. Thus, it is essential for the general public to know the basics of science to make informed decisions.

Scientific advancements and breakthroughs are channeled to the public through different media platforms. It is usually believed that any information that passes through a journalist’s filter is of high quality. As such, media coverage is widely considered as an indicator of relevance and success, as in the field of policy, related to science. However, an oversimplification of scientific jargon by journalists can not only water down the nuances of real science but also distort the information. Complicated situations arise when many journalists try to polarize the audience in a way that benefits their own vested interests, hence, blurring the lines between advertisement, journalism and advocacy. Unfortunately, the problems do not really end here.

With the advent of social media (YouTube, Twitter, Instagram, Facebook, and others), traditional media platforms, such as television and radio, for communicating science with the public, are getting outdated. While social media has made information more easily accessible to the public, these platforms are predated with fake news, alternative facts, hoaxes, misinformation, personal beliefs and political agendas. As a result, numerous people develop bizarre and inaccurate ideas about science. To make matters worse, any endeavor at rational discussion between the public and scientific community usually gets reduced to a clash between extremists, resulting in polarized societies. This can have real, negative consequences for the public support for science and the funding that goes into the scientific research all over the world. The recently released review of the funding for fundamental science in Canada, called the Naylor report, is one such example of decreasing support for basic science. Circumstances are not great too in other parts of the world.

Because of the decreased availability of funds, many researchers are spending a major proportion of their time writing grants. Early career researchers (ECRs) and young trainees (PhDs and post-docs) are especially affected in more ominous ways to the extent that many of them quit academia and even science. This can have potential long-term consequences for the future of science and society. Only a conscious and well-informed society can assess how crucial investments in science are and how future prosperity depends on new ideas. While increased funding for basic science would be the first right step in this direction, transparent science communication and promoting a two-way discussion between the general public and the scientific community is essential to strengthen public’s trust in science and the peer-review process.

Over years, few scientists and science enthusiasts have turned to various media platforms to promote public dissemination of scientific knowledge. Carl Sagan, who created the popular TV show “Cosmos” paved the way for such communication. In recent years, the popularity of the likes of Bill Nye -the Science Guy, Chris Hadfield, and Neil deGrasse Tyson, has provided further momentum in this direction. As such, many scientific organizations and individual scientists have also turned to writing blogs, participating in social networks and uploading videos about their research. However, the same people and their efforts have also received a lot of criticism from their peers as this is not what regular scientists do. This is regrettably true because governments generally judge the merit of a scientist based on the number of the grants and publications the person has. Science communication and outreach activities are rarely counted towards promotion in the university system and are often frowned upon as a means of distraction from the research agenda. Moreover, scientists who have a lot of responsibilities of reviewing papers and grants for free, undertaking a lot of journal editorial responsibilities, etc, may find communication an extra burden. There is paramount need to provide incentives to people who are engaged in science communication and other outreach activities.

While increased efforts by the scientific society to educate the public about the scientific progress, reasoning and critical thinking is the need for the hour. In a hostile environment of alternative facts and misinformations, it is imperative to explore avenues to foster optimal communication with the public, to bolster their participation in debates pertaining to science and policy, and also discourse the ethical, legal and social implications of research.

In conversation with Joanne Thomas (JT) of UK-based Sense about ScienceNida Siddiqui (NS) uncovers steps that need to be taken to increase public trust in science.

NS: Could you please tell us about yourself and your educational background?

JT: I am a program manager at Sense about Science, where I coordinate the “Voice of Young Science”, a network of engaged early career researchers, and deliver public engagement projects in partnership with researchers. Before joining the team in 2015, I completed a Masters degree in Science Communication at the University of the West of England and previously worked at the Science Media Centre, a press office that aims to improve media coverage of science. I also have an undergraduate degree in Biological Sciences from the University of Oxford.

 

NS: What motivated you to be a part of Sense about Science?

JT: During my undergraduate degree, I became really interested in the science communication movement and in how science and evidence interacts with society, particularly around issues related to GMOs (Genetically-modified organisms). I wanted to work for an organization that champions open discussions about [scientific] evidence and encourages researchers to engage with the public. Sense about Science was a great fit — it’s a dynamic organization that equips the public to make sense of science and evidence and encourages researchers to be open about their research findings and to communicate them in a clear, accessible way to public audiences.

 

NS: Tell us about the initiatives at Sense about Science.

JT: Sense about Science runs a series of programs, campaigns and projects to challenge misrepresentations of science in public life and to give people the tools they need to make sense of science and evidence.

Our biggest campaign is Ask for Evidencehttp://www.askforevidence.org. This is a wide-reaching public campaign which helps people request for themselves the evidence behind news stories, marketing claims and policies. We hear daily claims about what is good for our health, bad for the environment, how to improve education, cut crime, treat disease or improve agriculture. Some are based on reliable evidence and scientific rigor. Many are not. How can we make companies, politicians, commentators and official bodies accountable for the claims they make? If they want us to vote for them, believe them or buy their products, then we should Ask for Evidence. This campaign is about holding powerful figures to account and not having the wool pulled over our eyes on important issues. It is making sure that a discussion about the evidence is happening when it really matters. You can read some of the claims people have been asking for evidence about on the Ask for Evidence website.

Another big initiative of ours is the Voice of Young Science (VoYS) program. VoYS is a unique and dynamic network of early career researchers across Europe committed to playing an active role in public discussions about science. By responding to public misconceptions about science and evidence and engaging with the media, this active community of 2,000+ researchers, engineers, scientists and medics is changing the way the public and the media view science and scientists.

The program includes a series of free Standing up for Science media workshops each year. These full day events encourage early career researchers to get their voices heard in public discussions about science. Early career researchers have the chance to hear directly from respected science journalists, as well as from scientists with media experience. It’s an opportunity to learn how the media works, how to respond and comment, and what journalists want and expect from scientists. And at the heart of VoYS are myth-busting and evidence-hunting campaigns led by members who, inspired by the workshops, are passionate about taking on bad science, tackling misconceptions and sharing insights from their research. These campaigns have ranged from homeopathy and detox to meteorology:  http://senseaboutscience.org/activities/voys-campaigns/.

Our VoYS program is also now expanding into Europe – and we’re running our first VoYS EU workshop in Brussels in June 2017. You can read more about Ask for Evidence, VoYS, and other areas of our work on our website: www.senseaboutscience.org.

 

NS: Why is it becoming increasingly important for early career researchers (ECRs) to communicate science?

JT: The importance of ECRs communicating science has always been clear, and has increasingly become so in an environment where a huge amount of information is publicly available yet often conflicting, and where there are ever more pressures on researchers’ time. ECRs are often at the coal face of research – they are the ones in the lab carrying out the research day-to-day so are often best placed to communicate what the research is aiming to achieve, how and why. Additionally, all researchers have a responsibility to communicate their research with the public and we’ve seen the real impact that researchers, and particularly ECRs can have on public discussion. We encourage researchers not to wait until they are professors before taking on the responsibility to get involved in public debates.

 

NS: Any thoughts on how can we bridge the gap between the public (understanding) and scientists (discoveries) and improve public engagement in science?

JT: In order to close gaps between public and scientific discussion on issues and to engage more people, we must encourage and support more researchers to communicate clearly and openly with wide public audiences. Researchers must also involve many public groups early in the research process, to not only inform their research questions but also to help them to plan how they should communicate their findings. To increase public trust in science – researchers must first trust the public, by being clear about their findings and the uncertainty within them: sharing what their research can and can’t tell us. Our public guide Making Sense of Uncertainty sets out why uncertainty is central to science and to communicating research.

Increasing public trust in science can also come from talking more openly about the process of science; how it works. For example, peer review, which is an essential process to science, can also be a useful tool for the public too. If people know about the peer review process, when they come across scientific claims, they can then ask is it peer reviewed? This is a useful first question for everyone to ask in order to weigh up the quality of evidence. See our public guide to peer review I don’t know what to believe for more details: http://senseaboutscience.org/activities/i-dont-know-what-to-believe/.

 

NS: Is there a considerable impact of science communication done by ECRs (blogs and social media) on mainstream science journalism?

JT: Early career researchers certainly can and are having an impact on public and media discussions about science and evidence. Voice of Young Science members have launched a number of successful campaigns in recent years which have been covered in mainstream media: http://senseaboutscience.org/activities/voys-campaigns/.

For example, in spring 2009, VoYS sent an open letter to the World Health Organisation, calling for the body to issue a clear international communication about the inappropriate use of homeopathy for five serious diseases. VoYS had become aware of widespread promotion of homeopathic treatments for serious diseases in developing countries and saw that there were no clear guidelines available on this from the World Health Organisation (WHO). VoYS joined with other early career medics and researchers working in Africa and pressured the WHO to condemn the promotion of homeopathy for the treatment of serious diseases. On 21st August 2009, the WHO responded to the open letter stating clearly that it does not recommend the use of homeopathy for treating HIV, TB, malaria, influenza and infant diarrhoea. VoYS members then wrote to the health ministers of all countries to publicise the WHO’s position, asking them to combat the promotion of homeopathy for these dangerous diseases. This campaign was covered in the Times, the Guardian and by the BBC.

Individual VoYS members have also been standing up for science as individuals – for example last year Britt Marie Hermes wrote an extraordinary investigative piece in Forbes magazine, delving into the evidence behind health claims for a new device, UVLrx; Leah Fitzsimmons helped the BBC fact-check a segment on cold sores for Trust Me, I’m a Doctor and RPS members Hayley Gorton and Ryan Hamilton organised a We Pharmacists twitter chat about evidence-based medicine that reached over 1 million people.

So early career researchers can and do make a difference! The message of VoYS is not to wait until you’re later in your career to get involved, so stand up for science now.

 

About Joanne Thomas (JT):

Joanne is a program manager at Sense about Science. She coordinates Voice of Young Science (VoYS), a unique and growing network of over 2000 early career researchers who are committed to playing an active role in public discussions about science. Joanne is also part of Sense about Science’s public engagement team, which helps researchers to make complex scientific issues widely accessible, guided by the people who will use them. Prior to joining the team in 2015, Joanne completed a Masters degree in Science Communication at the University of the West of England and previously worked at the Science Media Centre, a press office that aims to improve media coverage of science. Joanne also has an undergraduate degree in Biological Sciences from the University of Oxford.

 

Co-author: Nida Siddiqui, who is currently pursuing final year Ph.D. at the Centre for Mechanochemical Cell Biology, University of Warwick, UK. Follow her on LinkedIn and twitter as @siddnida.

Edited by: Sayantan Chakraborty, PhD

Photo credit: Pixabay

 

This work by ClubSciWri is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Unity in diversity – Göttingen’s March for Science

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  • March-for-science-1-1.jpg?fit=2453%2C3468

Göttingen, the city of science, is not called so for nothing at all. In nineteenth century, seven professors from Göttingen university, now popularly called Göttinger Sieben, dared standing up against the Kingdom of Hanover, protesting against the alteration of the constitution. Inspired by them the Göttinger Achtzehn, a group of 18 nuclear scientists from the city stood against the Adaneuer government to stop propagation of nuclear weapons in 1957. Clearly the university here has always kept itself connected with politics, contributing in shaping the policies and creating Germany as a liberal country.

Today, on 22nd April, 2017 it stood by its tradition where the Göttingers took to a peaceful demonstration to March for Science. Starting at around 10 am, the march gathered around 2000 Göttingers – a huge, diverse, international crowd ranging from university students, researchers, politicians, media personnel and science supporters outside academia. The reasons for their participation varied widely – for funding, evidence-based policy making to creating a collaborative space between researchers, advocating for open science and to create access to scientific research for public.

Yuko Maeda, one of the organizers of the event said, “Science is a core democratic value. I stand up for communication of science. The discussion should not around the facts (that we get from science), but rather what do we do with those facts.” The President of the university, Prof. Ulrike Beisiegel emphasized on the importance of people understanding the philosophy and process of science, dealing with hypothesizing, experimentation, analysis and validation. On similar lines, Prof. Quadt, a particle physics researcher himself, reminded the audience of the famous quote by Richard Feynman – “It doesn’t matter how beautiful your theory is, it doesn’t matter how smart you are. If it doesn’t agree with experiment, it’s wrong.” He aptly reminded the audience the importance of pursuing global science, relating with the advances in particle physics, a field that has largely benefited from international collaborations. A Turkish academician, who lost her research position for being a part of Academics for Peace petition in Turkey, and now staying in exile in Germany, emphasized on the needs of ensuring a world that embraces diversity. And the Minister for Science and Culture in the state of Niedersachsen, Ms. Gabriele Heinen-Kljajić, who was present for the event, expressed solidarity for the threatened researchers and journalists worldwide.

And if you are still apprehensive of what an amalgamation of science and politics should look like, take a look at the pictures from the event. Remember that this is a March for Science, not for scientists. It is a global march that can affect all of us, as mankind. And science cannot keep itself away from politics, for then you risk not being a part of the policy making.

Illustration: By Ipsa Jain

About the author:

Somdatta Karak works with Club SciWri as a project co ordinator and Corporate Liaison. She is a doctorate in neuroscience from Georg August University, Göttingen, Germany and has been a Teach for India fellow (2014-16). She loves putting her analytical skills to build newer and more sustainable solutions, enjoys traveling and communicating and takes every opportunity to expand her horizon.

You can reach her here.

In the marriage of Science & Politics – How separated are they?

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  • vinita_MFS.jpg?fit=840%2C578

Trump government’s travel ban troubled numerous scientists working in the USA, hurting science as a whole, without any need to stress upon how difficult it was for those who were banned. Those who weren’t affected by the ban have enough to take care of by tackling visa policies. Brexit came with its own share of additional insecurity amongst the European research community. Budget cuts in science have become common worldwide. A new Hungarian law threatens closure of one of their leading universities. And there are numerous examples in both developed and developing countries where there is an enormous disconnect between what the scientists claim, what the citizens perceive and what laws and policies revolve around those.

Assuming that politicians and scientists strive only for the betterment of their countries, and for the human society as a whole, then why do we see a lack of healthy amalgamation of these two communities? Why are we seeing an increase in decisions that are clearly not healthy for science, and a paucity of significant public interest in it? As scientists have we failed miserably to communicate not only our passion but also the importance of our work to the society? Do the statesmen really understand the criteria on which they base their decisions that impact science? Are they willing to get into their details? Are there unbiased, progressive platforms that can facilitate discussions between scientists and statesmen that assist them in taking informed decisions?

Although we might have reached this sad state of facing the short end of the stick, as the sufferers, it’s high time that we, scientists, took charge of connecting with the public – the layman and the politician. After all, they need convincing that our ever-increasing, complicated research has a potential to widen the frontiers of human knowledge – some of which might help us develop a life-saving invention in the coming month and some might need years of hard work. It is also necessary for people to be actively made aware that they are surrounded with discoveries, quite a few of which have taken decades of intellectual perseverance before they evolved into usable products. And it’s only with public support that the rather small scientific community can channelize its importance to the law and policy makers.

As a coordinated global step towards facilitating a healthy relationship between science and society, the community of supporters of science (both from scientific and other backgrounds) are organizing ‘March for Science’ at more than 500 locations worldwide on 22nd April, 2017. Backed by universities, reputed research institutes and well-known organizations that support socio-scientific causes, the marchers plan to connect people with science via media, talks and activities. The hope is that it will spark the necessary enthusiasm to engage the public scientifically, that will finally trickle down to gathering their support for science in politics, policy and law-making. The aim is that this would trigger a cascade of dissolution of barriers between scientists and the society, such that we all understand our inter-dependence and acknowledge our roles in growing a better world.

What are the chances that a single event will potentially enable a heroic task of taking off the perceived alien mask donned by science? Maybe the scale of the event globally will suffice for such a miracle to happen or at least it might mark its beginning. All of these remain to be seen and answered. But not ascertaining different ways of taming this demon and analyzing the efficacies of such movements, aren’t options anymore. The problem, too big and daunting, is staring at our faces. It is time that we all must roll up our sleeves and put on our thinking hats to show what it takes to make it possible for scientists to reach out to our fellow citizens and let them appreciate that science aims to make all our lives better.

Check the different locations where March for Science is going to be held. See if your town/ city also has one. I hope you attend the event, and let me know your thoughts about it – its success and areas of development, in the comments section.

I thank Vinita Bharat, PhD for her help with the illustration and Sayantan Chakrabarty, PhD for his help with editing the article.

About the author:

Somdatta Karak works with Club SciWri as a project co ordinator and Corporate Liaison. She is a doctorate in neuroscience from Georg August University, Göttingen, Germany and has been a Teach for India fellow (2014-16). She loves putting her analytical skills to build newer and more sustainable solutions, enjoys traveling and communicating and takes every opportunity to expand her horizon.

You can reach her here.

 

 

Why I Left Bench Science and How I Found Science Diplomacy

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Editor’s Note: Have you ever wanted to transition out of lab but the path seemed obscure? Don’t worry! You are not the only one! Read about Debanjana‘s first steps to “extraordinariness” and tune into her blog posts to follow her journey from lab to diplomacy. –Neha Bhutani

 

This is not the first time some disgruntled postdoc decided to write about his/her ‘break-up’ with science. Indeed, such stories have been told and retold; articles have been published arguing in favor of leaving academia as the most sensible option. However, not all of us learn from anecdotal evidence. We believe our story could be different (and don’t get me wrong, some stories certainly are). So we stay, and persevere, till the circumstances or our inner compass directs our departure. Nevertheless, I felt that an introduction to my past would help my readers follow my journey. Perhaps, another poor postdoc somewhere would identify and feel a little less lonely in his/her struggle. Therefore, despite the risk of being redundant, here I go:

I was born and brought up in Howrah, an industrial city whose inhabitants, including some of my closest friends and family, found their life purpose and contentment in their immediate surroundings. I would never know the precise reason why I never felt at home there. I was always too curious, too eager to feel the flow of life in cultures and lands far-away. To my relief, my educational path allowed me to move to Kolkata, Delhi, and eventually, Germany for my doctoral studies.

Germany… the land of ideas (and also of ‘kartoffeln, bratwurst and sauerkraut’, extensive recycling, Autobahns, Oktoberfest and Christmas markets). I exchanged the familiar dusty sultriness and chaotic vibrancy of Howrah with the verdant serenity and disciplined monotone of the crisp Hannover air. It was a love-at-first-sight. My PhD journey was something I cherished, thanks to a kind and supportive mentor and amazing colleagues. My stay in ‘Deutschland’ gave me some of my fondest memories, deepest life-lessons, and the official permission to call myself Dr. Chatterjee. In those four years, I was able to travel to more than a dozen countries. I discovered that my love for travel, languages, cultures equaled, if not surpassed, my love for science. However, I still wanted to continue in academia and I thought I was ready for the long grinding path of ‘postdoc’-ing for several years to land an elusive tenure-track position. Up, as I always am, for a new adventure, I set out for New York to start the next phase of my research career. The work pressure and ambition that ivy leagues abound in, added to the fast-paced life of the city, was a starkly contrasting experience to that of my German tryst. It took a while but I adapted, found great friends, as well as brilliant (yet helpful) colleagues. The project too seemed to be on a good track, with the work being recognized at multiple conferences, leading to a grant. However, my relationship with supervisor was already showing signs of strain. With time, things continued to worsen. It started taking a toll on my general enthusiasm for the project. Benchwork was never my forte; what intrigued and stimulated me about Science was the realm of ideas. As all of us academics know, everyday Science barely about the thrill of discovery. It is about long hours, failed experiments, unending patience for the minutiae, and coming home to a meagre paycheck. I began to dread every session spent with a multi-color flow-cytometer, or the hours spent readjusting a figure for the umpteenth time for a manuscript that would take forever to be published. I was miserable. I knew I had to change but I had always imagined my future in academia. So the path to change was almost obscure. After some soul-searching, I fathomed that I love people interaction and started applying for clinical research coordinator (CRC) roles. Many friends discouraged me saying that I would be taking several steps back. However, I needed a break. A regular job seemed the best option while I strived to figure out my future track. I was very lucky to find a position where I could split my time between working as a CRC and some benchwork as a postdoc. It was perfect.

The first few months of the new positions were a whirlwind with a flurry of new information, demanding clinic schedules, and a significantly different work culture. Apart from the clinical knowledge I imbibed, this contact with patients and health care providers offered me important insights on the impact of policy on healthcare and science (e.g. Affordable Care Act, Genetic information Non-discrimination Act, etc). In the mean time, I continued racking my brains about my future. I vacillated between day-dreams of lucrative pharma positions offering the delicious taste of affluence and the closeted yearning for a profession more meaningful.

Four months into this new life, I witnessed the political environment in USA turn topsy-turvy. The impending policy changes directly affected the research community as well as the hundreds of patients I had began to know in person. I strove to keep abreast with all the recent developments and did my best to assuage patient concerns regarding potential loss of health insurance for pre-existing medical and genetic conditions. However, I mostly felt like an on-looker with little to do to change the course of things.

The idea of science diplomacy dawned on me in manner no less than a revelation (dramatic drum beats…). One fine evening I was in a café reading ‘A bend in the River’ by V.S. Naipaul. The novel recounts the tale of a character named Indar, friend to the protagonist. Indar is a man of Indian descent, brought up in an affluent merchant family in East Africa, who later finds himself in London pursuing his dreams educational dreams. In the novel, Indar mentions a lady who had given him his first significant career advice. In his words,

“This lady had the idea that people like myself were at sea because we were men of two worlds. She was right, of course. But at the time it didn’t seem so to me–I thought I saw everything very clearly… this lady also thought that my education and background made me extraordinary, and I couldn’t fight the idea of my extraordinariness. An extraordinary man, a man of two worlds, needed an extraordinary job. And she suggested I should become a diplomat.“

I did not feel extraordinary. However, as a person who rediscovered her love of Rabindranritya in Hula, prepared garam masala-infused Paellas, and was about to pursue an undergraduate degree in Literature before changing her mind, the idea of being a person of multiple worlds really clicked with me. However, I did not see how I could be a diplomat with my background in Science. A random, off-hand search on the internet and lo and behold, I stumbled upon several articles on science diplomacy, a career track whose existence I was not even aware of.

I read with interest that the Royal Society and the American Association for the Advancement of Science had put-forward a summary of what “science diplomacy” entails. To quote Wikipedia, it refers to three main types of activities:

  • “Science in diplomacy”: Science can provide advice to inform and support foreign policy objectives.
  • “Diplomacy for science”: Diplomacy can facilitate international scientific cooperation.
  • “Science for diplomacy”: Scientific cooperation can improve international relations.

I was immediately attracted to the prospect to being able to utilize my knowledge and expertise in science to make an impact in the real world by helping shape evidence-based policies.

Since that fateful evening in mid December, I have spent hours googling for possible paths to break into the field. I have been able to gather a good amount of information, especially relevant to immigrant Indian postdocs like me. I plan to jot this information down in my next post. So, all the future science diplomat aspirants, Auf Wiedersehen!

 

 

 

 

 

 

 

 

 

About the author:  Debanjana is an Immunologist / Clinical Coordinator at Columbia University, NY.  She is passionate about traveling, dancing, and languages. She is here to share the musings of her meandering mind.

 

Featured Image Source: Pixabay

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Science Policy: Shaping the Future

in Poli-Scie by

Editor’s Note: Our lives are blessed with the fruits of science, like that self-driven car which might soon be a regular feature on our streets. If science is so self-sufficient in discoveries then why does science policy matter? Well, what would that artificially intelligent car in your driveway be without a set of instructions to abide by traffic rules and the roads to choose for reaching the destination safely. This is the role of Science policy makers, who serve as the guardians to the use of science, because Science is good servant and a bad master. Neha Bhutani kickstarts a new series on Science Policy at #ClubSciWri. In her first blog she talks about its very definition and the ramifications to  decipher “the known knowns, the known unknowns and the unknown unknowns.” After pipetting and more pipetting, didn’t know this was coming right?- Abhinav Dey

 

 

What is Science Policy?

Science policy can be defined as the organized measures that governments take to promote the development of research in the field of science and technology (S&T) and, in particular, to guide the utilization of research results for the advancement of economic growth and welfare of society. Since 1960s, United Nations Educational, Scientific and Cultural Organization (UNESCO) is engaged internationally to recognize the important role of S&T in national development, especially, towards creating awareness among public and political leaders of the importance of S&T in the modern world and of the need for more systematic measures by governments to direct and control their use. A 1963 Organization for Economic Cooperation and Development report stated: “To say that a government needs an articulated science policy is simply to note that there has devolved upon that government a major and continuing responsibility to make choices about issues that involve science.”

Science policy has 2 complementary aspects: firstly, policy for promoting science, i.e., governments’ provisions of an environment that fosters growth of S&T knowledge; and secondly, policy for using science, i.e., the exploitation of this knowledge for the development of the public and society. In this article, I will be delving mostly into the second aspect of science policy, i.e., the use of scientific knowledge for the development of society. This aspect of science policy is essential to fully realize the benefits of society’s investment in science. It can help governments to use the ultimate products of science, which is evidence, to support policies and decision-making.

 

Linking the scientific and public policy communities

Policy-making is a two-way approach between the government and the public; and the policymakers can work at either end. They can work for the legislators or for various societies like the American Association for Advancement of Science (AAAS), Society for Neuroscience (SfN), etc. Science policymakers serve as a bridge between researchers and  the public- finding ways to translate obscure, often highly technical, scientific issues into something that can be sold as a policy. These professionals have advanced degrees in science and some are just good at advocating for a topic they believe in. What all experts have in common is literacy in science, politics, and economics.

By and large, the field of policy making consists of people coming mainly from two communities the scientific and the public policy communities. Both communities harbor very different cultures and hence do not interact much with each other. The ideal network of a scientific community includes the expertise of the public, private, and academic sectors. Its culture constitutes a high degree of interaction between scientists and engineers based on their knowledge and expertise, rather than position and rank; on peer review and assessment, rather than deference to the authority of their internal organizational. Recognition among scientists and engineers is based on intellectual assessment as judged by their peers, rather than by the superiors in an organization. On the other hand, the culture in many government organizations is based on bureaucracy and hierarchy. The scientific values are consistent worldwide despite cultural differences between populations. These values make the distinctive scientific culture incompatible with the structure of the public sector, hence making the connection between the two communities difficult to maintain.

There is a strong need for the two communities to invest in the improvement of their mutual understanding. However, hurdles exist at various levels. Firstly, students aiming for a career in government or science do not learn much about the other field. The academic curriculum needs to be reviewed to bridge this gap and provide students with opportunities that can aid in the expansion of their knowledge regarding the “other world.” Secondly, academia, which pushes towards specialization, does not give incentives for public engagement and communication. On the other hand, sound policy-making requires broader perspectives. This raises an important question that how can one create values for S&T personnel to interact with the government, and how can bureaucracies be restructured to allow for a freer flow of outside experts in the government machinery. New Zealand has a very good federal funding support for science communication. United States has recently started giving some recognition to public sector work. While in Canada, grant/ fellowship funding agencies do not acknowledge the advocacy and outreach activities, rather they focus only on the publications in peer-reviewed journals. There is an increased need for the role of government departments to provide dual science/policy career paths for their employee scientists. In this regard, there are organizations like the American Association for the Advancement of Science (AAAS), Canadian Science Policy Centre (CSPC), etc., that are offering fellowships to faculty and post-doctoral researchers. Having said this, although new unique opportunities are opening up for people to make a transition to the field of science policy, one needs to have a healthy dose of scientific expertise and a strong interest in advocacy and outreach.

 

Understanding the role of S&T in policy-making

For a very long time, S&T have helped improve the quality of life by providing better medical care, healthier environments, increased efficiency in industries, secure financial trading, improved food safety, strengthened border security, and providing a stimulating environment. In short, S&T are essential to the economic, societal, and environmental growth of a country.

An expert scientific advice is fundamental to the process of policy-making. It can provide evidence for decisions; confirm the reliability of policy in areas where the evidence is conclusive; define the contours of uncertainty and trade-offs where the likely outcomes cannot be known for sure. Given the challenges faced by the governments, ranging from climate change to poverty issues, it is of utmost importance to have inputs from researchers across disciplines. Evidence-based policies are robust in long term as compared to those designed in the absence of scientific evidence. One can distinguish many functions of scientific evidence in policy-making, such as, regulation and oversight, knowledge creation, knowledge translation, aggregation and interpretation. Such an advice can be trusted because the science behind it is continually subject to criticism and peer review. This promotes the evolution of science and does not let it change from one government to the next. Strengthening the process by which scientific advice contributes to government policy-making is rapidly becoming a characteristic of the richest democracies in the western world.

However, one must keep in mind the complexities associated with it. As mentioned above, scientific evidence plays a very different role in situations in which the research is conclusive as compared to situations in which there is conflicting evidence. In the first case, evidence can be used to confirm a course of action. However, in the second case, there is a strong need for inputs from researchers as politicians might want to cherry-pick those evidences which support their approach towards policy. It is important for the scientists to proactively advice if they want a voice in policy-making. It is not sufficient to just provide answers to questions that are put in front of them by the decision-makers. They must responsibly anticipate future needs and volunteer their advice on issues that are likely to surface in the future. A “pull” created by the policy demands and a “push” created by the scientific enquiry are necessary to build the relationship between science and government. One should also keep in mind the importance of interdisciplinary cooperation and dialogue, as the scientific expertise leading to the policy process involves many disciplines. Thus, a great deal of knowledge transfer from the scientific and technological communities to the government policy-making process is crucial for policy-making.

While governments are generally supportive of the scientists and their research, they often assess the value of research in terms of their commercial and economic value. This tension becomes daunting when investments in science do not pay off the right away or when money is put into basic research. Presence of conflicting scientific evidence and the inability of the media to distinguish areas in which the scientific evidence is genuinely contestable from those in which one view has clearly and overwhelmingly debunked adds another level of complexity. The tendency of journalists to provide balanced coverage by giving both sides equal time, regardless of the weight of the scientific evidence supporting one side has reinforced a false sense of relativity in policy debates (if ever they happen) about science. It is important for the experts to act as credible referees for those debates. Thus, there is a strong need for the scientists to communicate their work to the public. As Donald Rumsfeld, the former US defense secretary once said, the scientists need to provide “the known knowns, the known unknowns and the unknown unknowns.” This will help build an environment for public debate and in turn help in the process of policy-making.

 

 

 

Acknowledgements: Sayantan Chakraborty (Editing); Ipsa Jain (Featured Image)

 

 

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Transitioning into Science Policy: In conversation with Zane Martin, Ph.D.

in Face à Face/Poli-Scie by

The process of bringing bench side discoveries to bedside not only involves the efforts of scientists and doctors, but also people who serve as a bridge among the researchers, policymakers, and the public at large. These individuals work in areas involving the policies that apply science for the benefit of society in a profession that is colloquially termed ‘Science Policy’. The science policy umbrella is diverse, ranging from scientists working in federal agencies, serving as Congressional staff, or providing science policy guidance for non-profits, academia, or industry. Duties include but aren’t limited to grant management, regulatory oversight, and science communication with policymakers and the public with the goal of progressing science. Every country that pursues scientific research with the aim of bringing the discoveries to the society has people involved in this profession. Although different governments work different, interacting with a science policy professional can always provide an idea of an alternative career for Ph.D. graduates.

Becoming a policy maker or an implementer by itself involves a lot of training (apart from bench work) and persistence. Although the internet provides a lot of resources, the best information can be obtained during a personal interaction with a professional working in this area. Serendipity created an opportunity for me to interview Dr. Zane Martin who gladly obliged to talk about her role in Science Policy and how her efforts during her graduate studies landed her some prestigious science policy fellowships.

SC: Could you tell us about your educational background?

ZM: I attended graduate school at the University of Texas Medical Branch, where I investigated drug discovery techniques for neurodegenerative diseases. While completing my Masters’ thesis in Pharmacology, I synthesized and screened a library of compounds to evaluate their prophylactic/therapeutic efficacy against amyloid-beta aggregation, one of the neuropathological hallmarks of Alzheimer’s disease (AD). Thereafter, I completed my Ph.D. dissertation in Neuroscience, investigating another therapeutic strategy based on inhibiting a cellular signalling event involved in synaptic plasticity implicated in Parkinson’s disease. Following my Ph.D., I completed a postdoctoral position at the NYS Institute for Basic Research, where I investigated potential therapeutics against tau hyperphosphorylation, another hallmark of Alzheimer’s. During my postdoc, I was awarded the Jeanne B. Kempner Postdoctoral Scholar fellowship to fund my work. Collectively from these studies, I authored several peer-reviewed publications and won travel awards to several conferences to present my work.

SC: What is your current position and what does a normal day at work look like?

ZM: I am currently completing an American Association for the Advancement of Science (AAAS) Science and Technology Policy Fellowship at the National Institutes of Health (NIH). Along with the training opportunities that I avail as a recipient of this fellowship, I work at the National Institute on Aging in the Division of Neuroscience. I am involved with the implementation of the National Alzheimer’s Project Act. I help regulate funding through both grant management and by developing resources to help progress science. Examples of resources at the NIH typically involve databases like PubMed, ClinicalTrials.gov, and GenBank. The database I am working on is based on Alzheimer’s preclinical studies with the aim of improving science rigor to increase success in clinical trials.

SC: What motivated you to transition from laboratory science into science policy?

ZM: As an AD researcher, I was aware of the potential healthcare havoc we will experience if no treatment strategy for AD is discovered as demographic shifts increase the percentage of the population over age 65. Because of this, I developed a deep respect for the policies that help with the progression of biomedicine for the betterment of our society. The NIH is a global pillar for the worldwide coordination of scientific and healthcare related collaborations to address all global health needs. By including legislation, synergies become established to help pinpoint critical global health challenges, such as finding better treatments for diseases like AD.

SC: What were your approaches to pursue science policy? Did you exploit other resources during your Ph.D. or postdoc tenure to gain skills pertaining to your goals?

ZM: I first got involved during graduate school by participating in advocacy networks in different scientific societies. I attended advocacy meetings and volunteered to help with advocacy events. To increase experience in leadership positions, I was the president of my local Association for Women in Science (AWIS) chapter during my last two years in graduate school, where I organized several local functions and chapter meetings.

During my postdoc, I created a local science advocacy group with the American Society for Biochemistry and Molecular Biology (ASBMB). My group met with our Senator’s staff to campaign for increased biomedical funding. I also volunteered as an Alzheimer’s Congressional Team Member for the Alzheimer’s Association, where I wrote OpEds for our local paper and met with policymakers to discuss the importance of biomedical funding for Alzheimer’s research.

From volunteering at societies, I found an opportunity to become a science policy intern at the American Brain Coalition (ABC). For this internship, I participated in meetings with the Congressional Neuroscience Caucus to analyse the impact and effectiveness of the BRAIN Initiative. I wrote reports from these meetings for the ABC members, and I provided other material for the ABC website, such as creating a Capitol Hill Toolkit.

I also started a blog to practice writing for different audiences. I wrote about current policy events, such as appropriations proceedings involving biomedical funding, and legislations dealing with climate change and energy, evolution and schools, and vaccination enforcement. This blog led to a consultation gig with AAAS, where I submitted blogs about science policy topics for their MemberCenter website.

I recently completed a Mirzayan Science Policy Fellowship at the National Academy of Sciences working in the Board on Life Sciences, Division on Earth and Life Studies. I helped manage projects by organizing expert speakers, panelists and reviewers, selecting the literature to guide the attendees, participating in workshops and webinars, and co-authoring the workshop summaries.

SC: Could you share your thoughts on how can a person who has no experience in science policy transition into such a role?

ZM: First and foremost, complete a Ph.D. program. Ph.D. graduates have a greater advantage because they understand science, and they know how to think critically. Another important suggestion is to network. Volunteer for science societies and nonprofits, and ask for informational interviews from people that interest you. Don’t be shy! You’ll be amazed at how receptive people really are when you reach out. And most importantly: WRITE. Write for multiple audiences. Along with scientific manuscripts, write Letters to the Editor or OpEds for your local paper, blog, submit articles to societies and nonprofits. Finally, don’t get discouraged with rejection. The great thing about science policy is that every person takes a different path to get there. So, if one path doesn’t work, try another.

SC: What are the long-term satisfactions associated with a career in this field?

ZM: I feel more purposeful in this career trajectory. Being a bench scientist is also admirable, but working in science policy is more “big picture” with work potential having a greater impact. Overall, working for the government is highly rewarding because I am serving the society.


About Zane:

I am an AAAS S&T Policy Fellow at the National Institute on Aging – National Institutes of Health, where I help with the implementation of the National Alzheimer’s Plan. I have a Ph.D. in Neuroscience and M.S. in Pharmacology from the University of Texas Medical Branch, and received postdoctoral training at the New York State Institute for Basic Research in Developmental Disabilities. My research career focused on drug discovery strategies to combat Alzheimer’s disease and related dementias. Follow her on Twitter @ZaneMartinPhD.

About Sayantan:

I’m an IRTA postdoctoral visiting fellow at the National Institute on Aging – National Institutes of Health, Baltimore, USA. Apart from science, I invest my time in networking, writing, organizing events, and consolidating efforts to build a platform that brings together scientists and industry professionals to help spread the perception of alternate careers for life science graduates. Follow me on Twitter @ch_sayantan

 

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MedNess- At the frontier of Medicine, Pharmaceutical and Healthcare Business

in Poli-Scie/SciBiz/Uncategorized by

Hello and welcome to the biweekly roundup of Healthcare business top stories. Please follow us on Twitter and LinkedIn

MedNess 

BMS’s injectable Opdivo approved by FDA for bladder cancer

FDA approved intravenous use of Opdivo (nivolumab), a PD-1 checkpoint inhibitor for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have not benefitted from platinum-containing chemotherapy or in cases where the disease progressed within 12 months of neoadjuvant or adjuvant treatment with platinum containing chemotherapy. Last year, FDA approved Roche’s Tecentriq, a checkpoint inhibitor, for the treatement of bladder cancer.

From the business standpoint, this was much awaited good news for BMS as the Opdivo did not make the cut as first line monotherapy study in non small cell lung cancer (NSCLC) in 2016. However, Merck’s Keytruda gained FDA approval soon after Opdivo failed in NSCLC study (Fierce Pharma).

 

The battle of patents: bad news for Teva Pharmaceuticals

Genric drug maker giant: Teva Pharmaceuticals lost the patent challenge in U.S. District Court, safeguarding their star drug Copaxone against generic competition. Copaxone, approved in 1996, became the most prescribed drug for the treatment of multiple sclerosis. The patents protecting Copaxone against generic competition expired two years ago for 20mg dose. Novartis and Momenta launched their 20 mg alternative (Glatopa) in 2015. To recuperate, Teva launched a 40 mg formulation of Copaxone. However, this week, U.S. District Court invalidated Teva’s last and fourth key patent protecting 40 mg Copaxone from generic drug competition. Teva lost other 3 patents last year (Madison.com).

Trump pledges to bring drug costs down

Pharmaceutical industries were told by Trump that the drugs should be manufactured in the USA and the foreign countries buying US manufactured drugs should pay “fair share”. These changes in addition to “better innovation” will help bringing prices down for the US patients (CNBC).

MedNess from MedPol: Amgen CEO Robert Bradway announced that soon nearly 1600 jobs will be added. Bank of America Merrill Lynch predicted that Trump’s policies could help Amgen recover their stocks by 23% in the next 12 months (CNBC)

MedPol

US President’s executive order on immigration: the aftermaths

This is not a political blog, but the executive order has a very significant impact on the scientific, medical and healthcare community. In the following paragraphs, I will brief you with the sectors that have been affected.

  • NRMP issues the statement for the upcoming Match

Nearly 260 people from seven nations affected by travel ban, applied through National Resident Matching Program (NRMP) for medical residency in the USA (Association of American Medical Colleges, AAMC). Both the applicants and the hospital programs are concerned and affected by the travel ban. However, NRMP has urged the programs and the applicants to be discrete in their decisions that are in the interest of healthcare. The official statement issued by NRMP on their website states, “The medical education community must support all international medical graduates and their families during these difficult times. As for the current Match cycle, NRMP encourages applicants and programs to make the best decisions they can under current circumstances. For its part, NRMP will be liberal in granting waivers to applicants and programs if they cannot meet their respective Match obligations because of the effects of the Executive Order” (NRMP.org).

  • Dark times for the US hospitals and patients from seven nations affected by travel ban

Ill patients scheduled for treatment at the USA’s premier healthcare centers, John Hopkins Medicine and Cleveland Clinic are uncertain of their treatment options. Hopkins is taking a step ahead by either urging the patients to postpone their travel or sending their staff abroad for their treatment (STAT News)

We wrap up our biweekly MedNess and MedPol news section. Have a great weekend!

Image source: https://unsplash.com/search/medicine?photo=nss2eRzQwgw

Twitter Townhall @ClubSciWri #AskICMRsoumya on 30th April, 2016

in ClubSciWri/Face à Face/Poli-Scie by

soumya_poster2

Continuing to bringing forth science and healthcare policy makers for an informal discussion with our readers, we now invite Dr. Soumya Swaminathan, Secretary, Department of Health Research, India and also the Director General of the Indian Council of Medical Research (ICMR). Dr Soumya is an expert on tuberculosis research in India and has not only steered research but also generated awareness towards management of this ancient disease, which continues to plague India.

With her recent appointment as a Director General of ICMR, it would be interesting to discuss research and funding policies of ICMR and also have a frank dialogue about the current scenario regarding disease management. So kindly participate in our second twitterchat (#AskICMRsoumya) with Dr. Soumya Swaminathan on the 30th April, 2016 from 11:00 – 12:00 hrs, IST. You can participate in person or post us (email: sciwri2016@gmail.com) your questions/suggestions if unable to make it on the scheduled time.

N.B. Enter the discussion using the following link on 30th April, 11:00 am IST

http://tweetchat.com/room/AskICMRsoumya

TB: the end is near?

in Poli-Scie by

Last week March 24th was observed as World Tuberculosis day. The World Health Organisation (WHO) has been marking this day since 1997, to not only generate awareness and to mobilise activity by government and public health organisations, but also inspire efforts among researchers and local communities towards ending tuberculosis/TB – billed as one of the top infectious diseases in the world. With anti-TB drugs available since 1948, it is hard to believe that this disease has proven to be a formidable nemesis with alarmingly high mortality rates in the modern world.

Tuberculosis is caused by Mycobacterium tuberculosis, a bacteria characterised by the special architecture of its mycolic acid-containing cell wall. On inhalation by a susceptible human, the bacteria travel to the lungs where it is ingested by the immune cells called macrophages as a normal protocol of the human body’s defence mechanism against foreign substances. This bacterium is capable of manipulating the human host’s cellular immune response to its own advantage and persist in the form of calcified granuloma/lesion bodies containing macrophage ingested bacteria surrounded and restricted at the site by macrophages and T cells. The bacteria can remain dormant in the lungs for years or decades and in 5-10% of the infected individuals undergo TB-reactivation triggered by a number of pre-disposing factors, mainly lowered immunity. Apart from other biological factors, the vulnerable group is characterised by individuals with organ transplants, kidney dialysis, HIV-infection, etc. Socio-economic factors like poverty, drug abuse, homelessness and depression also form characteristics of the at risk population.

Said to have originated in the horn of Africa and earlier known as ‘consumption’, TB has come a long way to evolving and diverging along with the human race, to becoming a world pandemic claiming ~1.4 million victims in 2014.

Figure: Lienhardt C. et al, Nat Rev Microbiol, 2012;10(6):407-416

The WHO lists countries with high incidence of TB cases as High Burden Countries (HBC)s, which are further classified as

1) TB, when the infection can be completely cured by a 6 month treatment which consists of a 6 month long course involving antimicrobial drugs like rifampicin, isoniazid, pyrazinamide, ethambutol and streptomycin

2) MDR-TB (multiple-drug resistant TB), where the infection is resistant to at least two of the most powerful anti-TB drugs – rifampicin and isoniazid. Resistance to yet more drugs is a dangerous manifestation and is termed as XDR-TB/’extensive resistance to anti-TB drugs’, which is sadly on the rise. The causes for a treatable resistance to manifest into a drug resistance is mainly due to discontinuous treatment due to irregular medical supplies, ignorance and poverty. This is currently an area where action is required, esp. regarding diagnosis in children.

3) TB/HIV, where HIV co-infection complicates an active or latent TB condition. Neither infections make an individual prone to the other, but once co-infected there is a rapid acceleration in the progression of both diseases, hence doubling the fatality rate. This condition requires treatment with anti-TB drugs and anti- retroviral therapy

Given that the bacterial spread is mainly air-borne from human to human (cough, sneeze etc.), and human migration becomes more common with easier travelling options and accessibility, TB is no longer a tropical disease. In fact, the WHO puts the number of infected individuals (latent carriers included) as 2 billion or 1/3 of the world population. Yet, there seems to be a higher concentration of TB cases within certain countries – 80% of TB cases are concentrated in just 22 countries, and India figures as one of them (http://stoptb.org/countries/tbdata.asp).

TB in India

It is not known why some individuals are resistant to TB, however being malnourished/immunocompromised does pose to be a risk factor. Much has been written about the causes of TB and why it is prevalent especially among the poor and the undernourished. But in India, it is not uncommon to hear of TB occurrences in unexpected or non-impoverished circumstances. Coupled with the rising number of MDR-TB and XDR-TB, this presents an alarming situation and could be a great setback to a developing economy.

In an endeavour to control TB by 2030 (2050 for India), the WHO has published a detailed country-wise TB profile for helping one understand the magnitude of the problem as well as the steps being taken to control TB by the global funding bodies as well as local government expenditure. The report for India suggests that there is more streamlined reporting of TB occurrences now due to mandatory national web-based reporting since 2012. The recent list drawn up for 2016-2022 is a matter of concern points out that India along with Indonesia and China accounts for 43% of global cases (23% individually). where one sees a drop in domestic funding in WHO 2015 TB reports.

Source: http://www.who.int/tb

India is a signatory to the World Health Assembly which endorses the ‘End TB strategy‘ and aims for 50 % reduction in incidence and 75% reduction in TB related deaths by 2025, the ultimate goal being complete eradication of TB. Due to its alignment with poverty- a socio-economical problem, TB proves somewhat complicated to understand and hence difficult to address. Prof Soumya Swaminathan, Director General of Indian Council of Medical Research has been spearheading a movement to bring about awareness about India’s struggle with paediatric and MDR-TB and has previously stated that rising numbers of TB cases are a blot on India’s growth story with the burden disproportionately borne by the poor. Hence elimination of TB does boil down to a great extent, on eradication of poverty.

Meanwhile with the impeding launch of the new drug Bedaquiline, the intense awareness being created by media and the support system provided by various community lead programs show some promise. We plan to shed more light on this issue in the future and hence stay tuned to hear more about Prof Swaminathan’s work and opinions on the current policies regarding TB drugs and whether a TB-free India an achievable target. Do not forget to follow us on Twitter for updates about the tweetchat,

Recommended reading:

About the Author: Kartika Shetty, Ph.D. is a biophysicist specialising in protein-protein and protein-ligand interactions. Her recent focus is drug discovery and development for targeting lymphomas, along with her fellow researchers at the Institute of Cancer Research, London. Kartika is a member/editor of the ClubSciWri team and is an avid science quiz enthusiast. An alumnus of the Indian Institute of Science, she has been involved in participating and hosting in quiz events in and around the IISc campus (for reasons unknown, now is restricted to pub quizzes, since moving to the UK ! ).

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