Thank you for electing me as President for another term.
The Indian section of IACS has grown slowly but steadily during the last three years. You have all been updated with our activities through the communications from our Secretary General.
I would for your consideration, like to deliberate on some of the challenges that cardiovascular scientists in India face today. Most of these are indeed, not unique to our country.
I see four major challenges, some of which seem to expand. The first one is to meet the societal expectations from us.
Thanks to advances in early diagnostic tests, risk factor management and improvements in treatment strategies, many patients who previously would have died because of heart diseases now survive. Be that as it may, the impact of chronic heart disease and comorbidities on quality of life and health care resources continues undiminished.Heart disease continues to be major killer of both men and women around the world and in India as well. The problem continues to expand despite a steady stream of advances. Aging population, deteriorating life style related behaviours due to changes in environmental and socioeconomic conditions and the epidemic of obesity and diabetes contribute to increasing prevalence of heart diseases. There is a significant increase in the prevalence of heart failure, a condition that can persist for years, causing much suffering and involving considerable expense. Further advancesin cardiology practice would require exploration of novel disease mechanisms that would result in the discovery of strategies for disease prevention, to arrest disease progression and for therapeutic intervention. Recognizing genetic variants and analyses of genome expression, including epigenetics, proteomics and big data offer further opportunities to develop novel biomarkers and discover new therapeutic targets.
The second challenge is the decline in research funding and erosion of societal support. The reasons for these are competing demands from other domains and possibly an inadequate awareness of the benefits of research investment among policy makers and the public. We may have to attempt to tap non-profit funders and philanthropists as alternate sources to support our research.If investments for basic research are unsatisfactory, investigators may abandon the field for other pursuits and that could compromise training of the next generation of cardiovascular scientists.
We need to convey more effectively the societal benefits of what may appear to non experts to be incomprehensible. We must convince political leaders and administrators of funding agencies, the value of investing in fundamental discovery.We must strengthen our efforts to make our case and dissipate the idea that health care innovations could escalate treatment costs. We can cite the examples of the wide range of powerful drugs that are now available to treat hypertension and diabetes and risk factor reduction strategies as evidences for fundamental research leading to improvements in health of the society and improvements in productivity and societal prosperity.Economic analyses have documented economic benefits of publicly funded basic research roughly in the range of 20%-40%. We need to recognize that the lag time from discovery to clinical impact with respect to cardiovascular research is estimated to be 13 years and hence patience is necessary to reap the benefits of investment in fundamental research. Innovation and advances in the biotechnology and pharmaceutical industries are spurred by the spin offs of the knowledge base derived from basic research.
The third challenge is to foster collaborations with clinicians and biomedical engineersto pursue the full spectrum of biomedical research from basic to clinical.Many advances in cardiology have culminated from explorations of fundamental mechanisms of disease related structural, molecular and electrical alterations recognized by clinicians and contributions from technologists who helped to invent various implants, devices and instruments.Enhanced interaction among researchers, clinicians and the public fosters basic research with clinical focus and achieve translational results with wide impact.
The fourth challenge is to improve the quality of cardiovascular research in India. A recent analysis of publications by Indian cardiovascular researchers has revealed that though there has been a steady increase in the number of publications during the last decade, publications in high impact journals are small in number and many of these are either reviews or case reports. We have also not made any major discovery or inventions. Given the rise in number of Indian investigators and the growth of infrastructure for science during the same period, the result of the analysis is worrying. A stimulatory training environment, structured mentorship and financial support for a career development in research could facilitate transition from a novice science student or clinician to a successful explorer or inventor.
I hope you would ponder on these issues and advice what action the Academy can take to meet the above challenges.We have to be aware of our responsibility to our society and aim to provide a return for their investments in our research.