Drug development is a science, not politics

First, a disclaimer, I worked as a drug discovery scientist for more than a decade working on different projects including anti-HIV and antibacterial. I was fortunate enough to work in such a creative enterprise with some of the best talents in the world in academia as well as in the pharma industry. So, this blog post is based on my training and experience as a drug discovery scientist.

Drug development is not an easy endeavor. It is a risky, expensive, and prolonged process with absolutely no guarantee of success. Many countries in the world where protection for intellectual property for drug development is non-existent or pathetically inadequate don't even engage in this endeavor even though their population needs new drugs for almost every lethal disease that exists in this world. These countries depend entirely on developed countries for drug discovery, even for the drugs for diseases like malaria and tuberculosis that are eradicated from most developed countries but are very much a public health concern in most other countries. Drug development is a scientific endeavor, a very challenging and complex problem, it's not politics and the two should not be mixed.

There are arguments on various social media platforms in India about different types of medicines like allopathy, homeopathy, Ayurveda, home remedies, alternative medicine, or whatever. This argument is more emotional or political than a scientific argument. There is no data, no experiments, or any scientific principles that are debated, there are just accusations and counter-accusations, just like most political discussions. The debate is devoid of any scientific spirit and temper. People engaging in the debate are not even interested in knowing how a drug is developed or approved, they only want to prove the other side wrong, by hook or crook. Once politics enters any argument the first two causalities are rationality and common sense.

Either something is a medicine (drug), or it's not. Over the period of time, the scientific community and governments have developed a reliable, reproducible, and verifiable mechanism to evaluate the approval of a drug. It is called clinical trials, and the data submitted for this purpose is publicly available, almost every country has a competent body to evaluate such data, for example, the US has Food and Drug Administration (FDA). If there is no such data, it cannot be called medicine, it is that simple, it can be anything else but not medicine or an approved drug. So, there is no secret sauce to develop any drug or medicine, there is no need for a statement of an expert, you just need clinical data that can be verified by an independent body. So, anyone or any company claiming anything as a drug doesn't need any celebrity, govt backing, or opinions, just producing clinical data, proving the drug's safety and efficacy, and getting the approval. You just need one reproducible experiment with verifiable data to prove or disapprove any scientific hypothesis right or wrong, it's that simple, but it's not at all easy as collecting such data may not be easy in some cases. Drug development is science, not politics.

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India's self-inflicted Covid disaster

India's struggle in dealing with the second wave of COVID-19 infections has made it into almost every major news portal in the world. Covid-19 is a pandemic. The entire world is battling with it. Many countries are struggling to deal with the unprecedented burden on their public health system. There are concerted efforts on every level and at on never seen before levels to revamp even well-functioning public health systems. In light of all this, India's struggle is a self-inflicted disaster. Many countries in South Asia, including India, got lucky during the first wave of COVID-19 infection. Countries like India, Pakistan, Bangladesh, Nepal, and Shri Lanka didn't get hit that bad or didn't feel any pressure on their already struggling public health systems. This should have given them an advantage and some extra time to prepare for a possible second wave. History (Spanish flu) suggests that most viral infections don't just come once, many of them come in multiple waves and some reoccur every year that too with the mutated virus. Somehow, this thought didn't cross the mind of policy and decision-makers in India, they declared victory over Corona and started as if the pandemic was over, at least for them. The biggest mistake one can make against a highly infectious virus is to allow large public gatherings and India did exactly this. Large religious congregations, state elections, local elections, massive election rallies, everything was allowed without any COVID protocols. How did an opportunistic virus, like COVID-19 miss such a golden opportunity, it did exactly what it is good at, it spread like wildfire across India. The second wave not only caught Indians unprepared but it also created a policy paralysis where the lack of coordination of the governments at the state and national level was exposed. The government did not even try to show that it was capable of handling the crisis. People turned to social media to get help from whatever sources they can. Most of the relief work was done on an individual level, help seekers turned to social media more than the government portals. Many people got infected even after taking precautions as it was impossible to stay away from infected people. Many lives that could have been saved were lost, due to lack of proper and timely medical care.

It is still a great puzzle why a country with the world's largest vaccine manufacturer and largest generic drug industry didn't stock enough vaccines and drugs for its own people. When the entire world was procuring vaccines and drugs from these manufacturers by investing money, collaborating with them, and placing advance orders with almost every vaccine inventor and maker, what the Indian government was doing? What is their rationale behind not going for aggressive vaccination even after knowing that the country's public health system is utterly not capable of taking the load from any pandemic? I don't know if Indians will bother to ask these questions to their respective public representative, somehow in India, such issues don't make a good topic for a political discussion. Politics is unusually focused on caste, religion, and national security. In India, Pakistan can be a bigger election topic than the deaths of thousands of Indians due to the government's mistake, sad but a reality. 

What's the lesson? First, listen to scientists, don't try to underscore the damage by shutting up voices that ask questions, no matter how uncomfortable to difficult those questions are. Second, provide public health institutions reliable data, freedom to share information, and some platform to discuss and communicate this information with world experts. By sharing and analyzing such data only one can come up with the best policy decision in any pandemic. No country is risk-free in a world pandemic, all need to fight it and help each other when needed. This is why when India needed help arrived from all over the world. Finally, ask for accountability. A disaster of such a magnitude cannot happen without failures at every level starting from the top. If Indians don't ask these questions, demand honest answers from respective authorities, and fix the accountability they are going to face the same problems and wonder what went wrong from one disaster to another.

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