It is just as well that this country’s health authorities have at last seen it fit to order a thorough scientific investigation into the charge levelled overseas that water and air in India, particularly in the nation’s capital, are susceptible to harbouring a dangerous gene that can render treatment all but impossible.
In August 2010, Lancet, the highly-respected British medical journal, published a controversial study suggesting that metallo-beta-lactamase, the gene in question, had been found in international patients who had undergone surgery and treatment in New Delhi’s hospitals. When this gene enters pathogen (organisms — bacteria or any other — that cause disease), the consequences can be frightening, as the pathogen is rendered resistant even to carbapenem, the most powerful generation of antibiotics. This virtually means that no medicines will work. To make matters worse, the study christened the gene the New Delhi Metallo-beta-lactamase-1 (NDM-1). To a fair-minded observer, this was hitting below the belt, as the gene was not being discovered for the first time, and its existence was known for a number of years in Europe and the United States, which pride themselves on their hygiene. To then say the gene originated in New Delhi does not appear to bear an imprint of the scientific method. The inference being drawn by many is that naming of the gene in such a prejudicial manner was aimed at dissuading patients from around the world to visit India for medical treatment. There has, for some years, been a surge in medical tourism to India — including from Western Europe and the US — as our doctors and facilities are deemed high-grade and the costs only a fraction of that in the West.
Only a few days back, Lancet had gone a step further and suggested in a second study that it wasn’t just Indian hospitals but also the water system in New Delhi (and elsewhere) that harboured the virtually indestructible NDM-1. This understandably outraged many. Two studies on the same lines in four months appeared to be deliberate and concerted targeting of India and its medical facilities, whose super-speciality areas enjoy a well-deserved reputation worldwide. It might have been a lot better — when the subject was so controversial and laden with commercial implications — if the journal had sought pre-publication comments from respected Indian scientists even if it did not wish to obtain the authorities’ response. Lancet had reportedly first rejected the study for publication, only to change its mind later. Also, the study in question was funded by the European Union and not an independent scientific investigation. This brings up the question of a possible conflict of interest as EU countries are losing out patients in good numbers to Indian medical establishments. Another thing. The Lancet article appeared on the eve of the UN-designated World Health Day, whose theme this year is resistance to antibiotics. This heightened the sense of external agencies trying to unfairly target India.
But while we are aware of the study’s shortcomings, patriotic name-calling will not do in so grave a matter. We have the scientific capability in the country to conduct a thorough investigation of the issues raised. Given the nature of the subject, this can be done in a relatively short time. After making a thorough evaluation of the results, our scientists should return the compliment by actually inviting Lancet editors, and the scientists whose findings the journal had reported, for a professional discussion. This should be done in the wider interests of our own people, and not from the perspective of challenging the British study or its publication. The public health system in India does, after all, leave a lot to be desired.