Biomed Analysis: Indian scientists must stand for health
Should science be political? Government funding policies for science and health often appear to be at the whim of the ruling political party.
But scientists worldwide are often reluctant to engage with the politicians who wield such influence on their work, fearing they will be suspected of ulterior motives.
In developing nations scientists are notoriously timid about engaging with politicians, especially when it comes to lobbying for funding.
But when health is badly neglected, as it is in India, researchers and doctors need to take a much stronger political stand.
No pressure for change
Last week, The Lancet, in collaboration with the Public Health Foundation of India, called for India to implement an ambitious universal health service by 2020.
This would be no mean feat. It would require mammoth reshaping of infrastructure, many more health workers, cheaper drugs, and better infectious disease surveillance.
India has several formidable non-governmental organisations (NGOs) that have had a vital role in implementing health programmes, especially in rural communities. But universal health coverage goes well beyond the capability of NGOs — it will demand enormous political buy-in.
One major reason that public health practice and research is so dismal in India, say the Lancet authors, is because there is so little political incentive to fix things. Remarkably, health has never been an important election issue.
Right now, India invests in the life sciences only selectively — to develop biotechnology, for example. Public health gets little funding and virtually no oversight. So even the meagre funds allotted are often siphoned off or lost through inefficiency.
With no pressure from the public or from researchers, almost every aspect of health, from research to treatment, has been severely neglected or mismanaged.
To obtain secure grant funding, better salaries, or more universities and training facilities, Indian researchers and doctors must begin to champion science and health.
But this is a tricky tightrope to walk. Asking for money sets the power dynamic between politicians and scientists as a donor-recipient relationship — and, it risks creating an environment where those who shout loudest get the most.
Instead, India's science community should have a more skilled and nuanced role in communicating with politicians. Rather than simply asking for more funding, researchers need to convince ministers and policymakers that investing in science and health is vital.
As there is little political commitment to a viable public healthcare system, researchers might have more luck convincing politicians of the economic and development imperative to improve health.
The government has no desire to curb economic growth, but this growth will clearly not be sustainable for long when half of India's population lives on less than a dollar a day and has no access to healthcare.
But to have an impact on the national agenda for healthcare, scientists will need to sharpen the way they communicate with the media and the public, and take responsibility for publicly discussing their research.
Reaching the public
Poor public communication is a charge often levelled at scientists, not only in India. Although it is unfair to criticise those who have never been media-trained, Indian scientists do seem to display a lack of interest in engaging with journalists.
Too often, researchers don't respond to emails, or do so only after long delays. Institutional press offices, which can improve communication when they function well, are either non-existent or pathetically bad at connecting scientists with the media.
Indian researchers may feel that the media sensationalise or misreport news. But even if there is truth in that accusation, keeping communication channels open is the only way to solve the problem.
And scientists need to engage the public far more than they do — public advocacy groups for health are few and far between in India. In a country with a large illiterate population, reaching the public is a daunting task. Yet the enormity of the challenge is not an excuse for inaction.
Given India's poor procedures to control infections, with protocols common in developed countries often missing from hospitals, it is crucial that individuals understand the risks that infectious diseases pose and learn how to avoid them.
Health education will become even more important as the country faces new public health problems, such as the growing burden of chronic disease.
All this is certainly asking a lot of India's scientists and doctors. But the health of their country is on the line. Politicians continue to turn a blind eye to the broken healthcare system. The science community cannot afford to do the same.