Making Meds in India

For the past several years, I’ve been following the news of how India’s pharmaceutical patent laws are gradually changing. What sometimes reads as pure legalese actually has far-reaching implications, because many of the medicines that treat poor people around the world are made here at low cost. But last year, India’s government moved to restrict their dynamic pharmaceutical industry.

I’ve always had it in the back of my mind that I should write a story that pulls everything together: the personalities, legislation, science, business, etc., rolled into one package that explains it all. Well, Erika Check beat me to it in her recent Wired magazine piece. Excellent work!

The Ethics of Biotech

I found an interesting article (“How India Reconciles Hindu Values and Biotech,” New York Times) by Indian author Pankaj Mishra the other day. It’s from last year, but still very relevant. He paints an unusually complex picture of how Hinduism plays out in India’s wider cultural and political climate.

Micro Health Insurance Hedges Risk for India’s Poorest

After attending a conference on micro health insurance in Delhi last week, I wrote this story for the Christian Science Monitor. Interesting stuff.

All the community-based groups providing the insurance plans seem to be doing remarkably well, but like almost everyone I talked to, I’m wondering how long this movement can last in micro form. If the Indian government increases their regulation of micro insurance, it may be hard for the smaller groups to prove their financial stability and expertise. If this idea becomes a well-known success story, large companies may be tempted to see how they can profit.

And, as Mukti Bosco of Healing Fields Foundation points out: insurance alone cannot cure the ills of India’s health system. Even with the best of insurance plans, rural people may not be able to find competent doctors or well-equipped clinics near their villages.

In Andhra Pradesh, a Healing Fields hospital facilitator (right) helps a woman speak with her doctor. (Photo credit: Healing Fields Foundation)

Long time no blog

Well, three weeks later, here we are! I thought about adjusting the date of my original post, but that would be oh so dishonest. I’ll just pick up where I left off, I guess.

The big news around here is dengue, though it looks as if the mini-epidemic may be waning. Dengue, caused by four closely related viruses, is carried by the Aedes aegypti mosquito. From what I gather, it’s an unusual mosquito-borne disease in that that its carriers thrive in an urban environment, don’t need murky water to live, and bite mainly during the day. Most cases of dengue are rather uneventful; if you catch only one virus subtype at once, you have flu-like symptoms, pain behind the eyes, and bone pain. But catch one or more in quick succession and there’s trouble: possible hemmorhaging and death. With proper medical treatment, only 1% of those with the severe dengue die. In India’s current outbreak, nearly 6,000 people have been infected and over 100 have died (according to National Geographic news)

My friends and I have been pretty concerned about this (though to be honest the nervousness is wearing off) because the epicenter of the outbreak occured at the All Indian Institute of Medical Studies (AIIMS), a nearby medical school and hospital. The word is that on-campus hygiene was so bad that the dengue mosquitos took over. This explanation kind of perplexes me, since the whole weirdness of Aedes mosquitos is that it doesn’t take standing dirty water to breed the things. But whatever. Point is, it’s awfully disconcerting to have medical students and doctors dying a mile or so away, and that the big plan was for most people in the city who had symptoms to go to AIIMS for testing.

I’m a little hazy on the logistics of how Delhi’s healthcare system handled the huge intake of patients, but this article in Frontline discusses some of the issues that dengue has exposed in the past two months.

In a related note: I learned recently from a 2002 World Bank report that approximately 25 percent of Indians who are hospitalized drop below the poverty line because of that hospitalization. Interestingly, despite the fact that that report is entirely focused on addressing the health needs of those Indians without much money, it is not available free online. $13 is a lot of rupees.

Hello world!

Hello everyone! Welcome to my very first blog: Coevolution. I’m learning as I go, so hopefully it won’t be too bumpy in the beginning.

About two weeks ago, I arrived in New Delhi. I’m very fortunate to be here for about one year, during which time I can completely devote myself to the kind of writing I most value. In other words, I hope to write stories that show how the world is always more complicated than we might assume.

My general topic will be how science and medicine engage each other across the cultural and political borders between the United States and India. How are they sharing new concepts and research methods? And how are they applying the results based on the realities of each country? To avoid several of my pet peeves about how India is portrayed in the media, this blog will not be about tradition versus modernity. If you ever catch me giving simplistic explanations, where the U.S. is handing down cutting-edge technology to India, while India offers up the wisdom of the ages…well…please start a roaring discussion to alert me to my short-sightedness. Both countries are active participants in the science and medical communities.

I would love to start off with an astute observation of my time hear thus far, but so far it’s all been about finding an apartment, registering with the local cops, and buying sheets and towels. I’ve made a few contacts in public health and molecular biology that will hopefully be very useful, but I don’t want to reveal too much yet.

Tomorrow I’ll start rounding up stories from the local papers, so that you can see what I’ve been reading.

~C