Lok Sabha Question No. 4763 (UNSTARRED), answered on 2018-03-23
Subject: Bio-Medical Research
Ministry: HEALTH AND FAMILY WELFARE
Asked by: AJAY NISHAD, K. C. VENUGOPAL

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH RESEARCH

## LOK SABHA UNSTARRED QUESTIO N NO. 4763 TO BE ANSWERED ON 23 rd MARCH, 2018

## BIO - MEDICAL RESEARCH

## 4763. SHRI AJAY NISHAD: SHRI K.C. VENUGOPAL:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether bio - medical research work undertaken in the country are of international level, if so, the details thereof and if not, the reasons therefor;
- (b) the number of medical research centres/institutes functioning under Indian Council of Medical Research (ICMR), State/UT - wise along with the achievements therefrom;
- (c) whether the Government proposes to upgrade the said research centres/ institutes in the country to international level and whether the state of the art technology is proposed to be implementedin the medical sector;
- (d) if so, the details thereof and the assistance provided or proposed to be pr vided in this regard; and
- (e) the details of mechanism adopted by the ICMR to boost quality h ealt research output by way of building alliances and partnerships in the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a): Yes, ICMR is an apex and premier medical research organisation in the country of international level.

(b):

1. Andaman and Nicobar Islands -01
2. Assam -01
3. Bihar -01
4. NCT of Delhi -03
5. Gujarat -01
6. Karnataka -02
7. Madhya Pradesh -02
8. Maharashtra -04
9. Odisha -01
10. Puducherry -01
11. Rajasthan -01
12. Tamil Nadu -02
13. Telangana -01
14. Uttar Pradesh -02

Achievements of these institutes are annexed.

- (c) & (d): The said research institutes have international recognition.
- (e): ICMR has signed MoUs with a number National and Internation al organisations in the research field. Under 'Policy on Contributions and Partnerships', partnership with Government and private sector is being encouraged for up - scaling, validation and translation activities.

## Achievements of ICMR (Institute - wise)

## ICMR - National JALMA Institute for Leprosy & Other Mycobacterial Diseases (NJILOMD), Agra

- Tested adjunct role of MIP in treatment of TB with standard regimen : in pipeline for acceptance by the respective National programme.
- TIE - TB project: A unique Active Case Finding Model comprising of Mobile TB diagnostic van for diagnosis o f TB was initiated in 17 districts in 5 states.
- Extensively researched the Immunotherapeutic and immunprophylatic role of MIP in leprosy : The MIP vaccine is now being taken up by NLEP under IR mode.
- National level mycobacterial reference laboratory for providing clinical samples to various researchers at national level.
- Contributed to Revised National Tuberculosis Control Programme (RNTCP ) and National Leprosy Eradication programme (NLEP).
- Contributed in understanding the transmission of leprosy by using combination of molecular methods and traditional epidemiology on transmission aspects of leprosy.

## ICMR - National Institute of Occupational Health (NIOH) , Ahmedabad

- Health Status of Coal Mines workers: Study suggest measures like using protective appliances (e.g. PPEs), pre - placement -and periodic medical examination.
- Environmental cum epidemiological study on arsenic toxicity from surface and underground water
- Indoor air pollution from biomass combustion and health hazards : 12 PAHs were identified which are reportedly hazardous for human health.
- Occupational health assessment survey among asphalt associated job workers in India: Suggests that road paving associated job workers are under risk of development of adverse health effects
- Efficacy of Personal Colling Garment (PCG): Developed to protect workers who are exposed to hot environment.

## ICMR - National Institute of Traditional Medicine, Belagavi

- Validation of traditional medicinal practices for Arthritis and Dengue: Results of arthritis is expected to be translated soon through IPR registration, etc. Similar AYUSH formulation for Dengue is under clinical evaluation with modern parameters forevaluation.
- Established 'School of Traditional Medicine' with an 'Integrated clinic' to validate the traditional medicine practices and generate human resource in the area.
- Herbal remedies for improving quality of life of critically /terminally ill patien Studies have been taken up to find the beneficial role of cocoa powder on cancer c lines and cancer induced models.
- Outbreak investigations, referral services and support to State Health Services: Reported rising number of diphtheria cases in the S tate of Karnataka. A policy brief has been submitted to the Govt of Karnataka by ICMR on ways to reduce mortality.
- Model Rural Health Research Unit at Sirwar, Raichur is being set up: Baseline study conducted this year identified Pregnancy Induced Hypertension as a major problem in the region. A study conducted in this area found anaemia and malnutriti be high.

## ICMR - National Centre for Disease Informatics and Research, Bengal uru

- Developed 'Cancer Samiksha': a web based tool on assessment and analysis of cancer  (http://ncdirindia.org/cancersamiksha/)
- Developed NCDIR e - Mor: an electronic mortality software .The software is being deployed in various hospitals and public health systems.
- 10 States -Assam, Arunachal Pradesh, Gujarat, Haryana, Karnataka, Manipur, Mizoram, Punjab,  Tripura and West Bengal have noti fied cancer as a notifiable disease.
- Prepared Report on Cancer Burden in North Eastern States (2012 -2014) : r evealed that high burden of exposures such as tobacco consumption, alcohol, indoor air pollution are contributing to high incidence of cancers in north eastern states.
- Released National Ethical Guidelines for Biomedical & Health Research Involving Human participants and National Ethical Guidelines for Research Involving Children

## ICMR - National Institute for Research in Environmental Health (NIREH), Bhopal

- Services to Respiratory Disease s OPD of Kamla Nehru Gas Rahat Hospital by the Pulmonologist of NIREH . About 2,000 respiratory disease patients were examined and advised treatment
- Follow up of about 30,000 toxic gas exposed survivors for their health problems

## ICMR - National Institute for Research in Tuberculosis (NIRT), Chennai

- Clinical trials aiming to shorten TB treatment to 4 months using fluoroquinolones in pulmonary and extra pulmonary TB :  The results would go a long way in deciding future TB therapy in India.
- Multi- centric cohort study of relapse in pulmonary TB treated under RNTCP was completed and detailed analysis is underway.
- Clinical trial testing the dosing schedule of treatment in HIV -TB coinfection indicates daily regimen to be more efficacious.
- Pharmacokinetic study of Rifabutin : showed that 300mg thrice weekly a nd 150 mg daily were similar suggesting to the programme that either doses may be used.
- Characterized the prevalence and pattern of drug resistance mutations in ARTnaive and ART - exposed HIV - 1- infected children from south India.

## ICMR - National Institute o f Epidemiology (NIE), Chennai

- In- country data verification for Elimination of Mother - to - Child Transmission of HIV and Syphilis in 6 States in India, 2017
- Strengthening Tuberculosis and HIV detection and management through intensified case finding in Central Jail, Aizawl, Mizoram
- HIV sentinel Surveillance among ANCs and HRGs
- Process Evaluation of Integrated Management of Neonatal and Childhood Illness (IMNCI) Program
- Integrated Road Traffic Injury Surveillance system (IRIS) Chennai, Tamil Nadu
- Prevalence of Leptospiral infection among fever - case - patients seeking referral pu blic health facilities in the peri - urban areas of Chennai and distribution of leptospiral genotypes and serovars
- Hospital Based Sentinel Surveillance of S. pneumoniae and other I nvasive Bacterial diseases
- NIE - ICMR - WHO Ethics Course For Indian Ethics Committees
- Health- needs assessment (HNA) of selected hill tribes (Palliyar and Muthuvan) in Western Ghats of Tamil Nadu and, to estimate the disease burden amongst them
- Status of l abelling, drug information and branding in marketed anti - diabetic Siddha formulations : Cross - sectional study: Chennai, Tamil Nadu
- Health systems preparedness for interventions for diabetes, hypertension, chronic respiratory diseases, cardiovascular disease and cancers and deaths due to non -communicable diseases among the tribal population in India
- Coverage Evaluation Survey: Measles Rubella Vaccination Campaign Phase 1 (India CES - MRVC - P1, 2017)
- Risk factors of scrub typhus among children and progression to AES in Gorakhpur division, Uttar Pradesh
- A multi - centric study to estimate the sero - prevalence of dengu e virus infection in India

## ICMR - National Institute of Malaria Research (NIMR), Delhi

- Monitoring of vector susceptibility to the insecticides being used in the progra different ecotypes . - input to DDT Mandate committee.
- Monitoring  therapeutic  efficacy  of  antimalarials:  Switch  over  from  chloroquine Artemisinin based Combination The rapy (ACT; AS+ SP) to ArtemeetherLumefantrine (ACT; AL).
- Ban on Artesunate oral monotherapy.
- Evaluation of LLIN -Introduction in the programme
- Three  Biolarvicides -Bacillus  thuringiensis  israelensis ( Bti ), Bacillus  sphaericus ( BS) and Bti Aqeous Suspension.
- Diflurbenzuron and {Insect Growth Regulator (IGR)} Larvicides .
- Pirimiphos Methyl  (Chemical Larvicide)
- Chemical LarvicideFenthion withdrawn from the programme based on evaluations.
- Biological control agents -larvivorousfish .
- Phase III  clinical trials o f antimalarials led to registration  with regulatory author Alpha beta Arteether, Bulaquine, Arterolanepiperaquine, Artesunateamodiaquine artesunatemefloquine, DihydroartemisininPiperaquine.
- Evaluation  of  malaria  rapid  diagnostic  tests  (paracheck  and parahit)  leading  to introduction in the programme.

## National Institute of Pathology (NIP), New Delhi

- Molecular diagnostics for Chlamydiasis, Leishmaniasis and Tuberculosis
- Live attenuated Leishmania parasite as vaccine candidate for visceral leishmaniasis/kal -azar (Collaborators US -FDA) US and Indian patent granted
- Cultured epithelial graft for treatment of burns patients
- Breast Cancer Cell lines of Indian Origin
- Pathological studies in autopsies  of Bhopal gas victims to analyse the effect of isocyanate

## National Institute of Medical Statistics (NIMS), New Delhi

- Establishment of Clinical Trials Registry -India (CTRI), in collaboration with DST and WHO.
- Collaboration with CBHI and ECTA and Development of Health Policy Reforms Options Data  (HSPROD)  base  and  collected  large  number  of  health  reforms  in  India  as  on  t website of MOHFW.
- Established the NIMS as the nodal Institute for:
- Implementat ion of IDSP -NCD risk factor survey.
- NACO's  programme  on  HIV  Sentinel  Surveillance,  Modelling  Estimation  and Projection of HIV/AIDS in India.
- Conduct  of  integrated  behavioural  and  biological  assessment  along  nation highways (IBBA - NH) among truckers for HIV epidemic in India.

## ICMR - National Institute of Nutrition (NIN), Hyderabad

- Mapped B12 deficiency in 9 states.
- Carried out NCD Monitoring activities in Telangana and Andhra Pradesh.
- Established Nutrition Surveillance System in 6 states
- Introduction of Multi- component health and Nutrition Intervention in 14 high burden districts in Jharkhand, Gujarat, Andh Pradesh and Telangana.
- The results of a study on fatty acids reinforce the current recommendations of restricting the intake of trans fats , moderate the intake of n - 6 PUFA and increase the intake of n - 3 PUFA for the prevention of diet related chronic diseases including NAFLD.
- Determined Nutritive Value of Indian Foods
- Dissemination workshop on ' Health and Nutrition awareness ' was conducetd for ICDS and Health functionaries working with Chencus.
- Developed Double Fortification of Salt (DFS)
- Exploded the protein myth and highlighted the calorie gap as a major bottle ne Protein Energy Malnutrition (PEM)
- Studi ed efficacy of Iron folate supplementation in pregnancy
- Established Recommended Dietary Allowances (RDA) for Indians
- Formulated dietary gu idelines for Indians

## ICMR - National Institute for Research in Tribal Health (NIRTH) , Jabalpur

- Malaria Elimination Demonstration Project (MEDP ) in Mandla district of Madhya Pradesh initiate The goal of Malaria Elimination Demonstration Project (MEDP) i todemonstrate elimination of malaria and prevention of re - establishment of malaria is feasible in a high - endemic region of India.
- An outbreak of Chronic Kidney diseases (CKD) failure was investigated Supebeda Panchayat of Deobhog Block of District Gariaband, Chhattisgarh.
- Outbreak of cholera in tribal district Katni was investigated and appropriate suggestions regarding mitigations were given.

## ICMR - National Institute of Cholera and Enteric Diseases (NICED) , Kolkata

- Establishing community - based enteric fever surveillance for estimating typhoid fever burden as a prerequisite for implementation of TCV at the national level.
- Establishing efficacy of pentavalent rotavirus vaccine in a multi - centric RCT , which aided its introduction in the national immunization program.
- Continuing hospital - based diarrhoeal disease surveillance with mapping of enteric pathogens and their antimicr obial resistance to facilitate deployment of evidence -based responses undertaken by the state health authorities.
- Developing candidate vaccines against shigellosis and typhoid .
- Identification of antimicrobial resistance in bacteria belonging to

Enterobacteriaceae causing neonatal sepsis, mechanism o f resistance and resistance gene transmission mechanisms, developing cationic antimicrobial peptide -based therapy for sepsis caused by Gram Negative Bacteria.

- Continuing active participation in the multi - state surveys for Soil Transmitted Helminth (STH) in fecti on under the joint program of Ministry of Health, GOI and respective state health authorities for school aged children.

## ICMR - National Institute for Research in Reproductive Health (NIRRH), Mumbai

- Conducted baseline survey in two tribal blocks in Palg har district of Maharashtra: to improve health and nutritional status of vulnerable segment of population b implementing multi - component health and nutrition education intervention as a sustainable model of intervention.
- Demonstrated Estrogen, the female hormone, to be involved in regulating spermatogenesis and male fertility .
- Prepared Standard Operating procedures for Linking HIV with Family Planning services in public health settings:  Outcome -Many unintended pregnancies are prevented by use of dual contraception by PLHIV.
- Developed PBIT, an online webserver for identification of drug targets for infecti diseases (www.pbit.bicnirrh.res.in.)
- Initiated a multidisciplinary model of care for women with PCOS : with a team of IVF sp ecialist, endocrinologist, dermatologist, dietician and yoga expert. This

unique platform wherein research and services meet and is first of its kind in the government research Institute in India.

## ICMR - National Institute of Immunohaemotology (NIIH), Mumbai

- Established Advanced Centre for Diagnosis and Management of Primary Immunodeficiency Disorders (PID)
- Discovered a novel molecular mechanism predominantly responsible for weak D variant in Indian population
- Developed a nanoparticle based point of care technique for the diagnosis of von willebrand disease (VWD): No commercial rapid test kit is availabl e for diagnosis of any of the common bleeding disorders
- Demonstrated siRNA silencing of protein C gene  to improve the clinical phenotype of hemophilia A
- Demonstrated Interplay of miRNA expression and the epigenetic factors in sickle cell anemia patients following hydroxyurea treatment

## ICMR - National Institute of Cancer Preventi on and Research (NICPR), Noida

- Developed a hand -held device, ' Magnivisualiz er' with digitized image capture options for detection of precancerous cervical lesions
- Developed ' OrCanome ', a comprehensive database with genomic, transcriptomic and proteomic information of genes dysregulated in oral cancer
- Developed ' India Against Cancer ' website, a bilingual (English & Hindi) web portal that provi des information on the leading cancers in India and promotes cancer awareness
- Developed natural product ' Plant based anticancer activity database ' for facilitating traditional drug discovery. Natural antioxidative agent curcumin h been demonstrated to be an anti -HPV molecule.
- Developed first ever ' Global database for cervical cancer genes (CCDB)' involved in disease progression

## ICMR - Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna

- Conducted  In - depth  review  of  kala - z r  programme  to  find  out  gaps  and strengthening of elimination strategeies
- Miltefosine,  the  first  ever  oral  drug,  for  treatment  of  Kala - azar and  PKDL; Paromomycin  and  amphomule  registered  by  DCGI  for  Kala - azar  treatment;  and Single dose ambisome and combination therapy of miltefosine and Paromomycin introduced in programme.
- Established  Slow  release  emulsified  suspension  (malath ion)  as  an  alternative  to DDT in vector control.
- Established insectorium for sandfly rearing, regeneration and colony maintenan and Leishmania Parasite repository & Sera bank.
- Developed Monitoring and evaluation toolkit for IRS in consonance with W HO TDR for vector control

## ICMR Vector Control Research Centre (VCRC), Puducherry

- Safety study on triple drug administration for LF elimination
- ZIKAV surveillance through networking i n the country
- Xenomonitoring protocol to evaluate the impact of MDA for LF elimination
- Implementation study to minimize risk of transmission of JE through vector control intervention measures in Gorakhpur, UP
- Mapping of insecticide resistance among malaria vectors in Southern Odisha

## ICMR - National Institute of Virology (NIV) , Pune

- Reporting of First Zika Virus case in India -
- Training & supply of Zika Diagnostic reagents to 30 laboratories.
- Establishing Zika Surveillance network in India
- Discovery of 03 new viruses
- Measles diagnostic IgM kit technology transferred to M/Cadila, Ahmedabad
- Surveillance of fever, influenza like illness and dengue like illness has helped to know the base line incidence of viral diseases syndromes and seasonal variation of various viral bacterial diseases in community.

## ICMR - National AIDS Research In stitute (NARI), Pune

- Supports National AIDS Control Program (NACP) through data validation for elimination of mother to child transmission and providing recommendations for documentation of elimination planned for 2020 by GOI
- World Health Organizations (WHO) has recognized NARI as a center for pre -qualification of diagnostic test kits .
- Preparation of modules based o n evidence generated for prevention of intimate partner violence .
- In the non - HIV area,  generation of causal evidence for Acute Encephalitis Syndrome (AES) as caused by scrub typhus and  community engagement to implement control of JE.

## ICMR - Regional Medical Research Centre Bhubaneswar

- Study on Mid - Day Meal Programme in Odisha: Various e -study tools have been developed at the levels school, school monitoring committee, parents, cluster, block are tested on pilot basis. The study is planned to implement in various districts in 3 zones in the state.
- Enhancing bio risk mitigation awarene ss in public health community and creating laboratory networks for enhanced diagnostic capabilities to deal with surveilla and outbreaks of high -risk group viral pathogens causing viral haemorrhagic fevers and respiratory infections.
- A study on the Effectiveness of Food supplementation on Treatment Outcomes and Nutritional status of A dults with Pulmonary Tuberculosis in Odisha : Difficult to reach areas, lack of pre - treatment counselling are few of the reasons quoted for lack of follow - up, high default rates and hence low cure rate in this region.
- Anthrax in Odisha ( Koraput, Rayagada, Malkangiri, Sundargarh ) -Cutaneous Anthrax was found to be high, attributing to slaughtering, butchering and deskinning of animals by male respondents.
- Asymptomatic malaria infection below 5 years and mode of transmission in Kandhamal di strict

## ICMR - Regional Medical Research Centre Dibrugarh

- Developed the capacity to provide diagnosis for 41 different viral infections within 48 hours. A total of ~3000 samples have been tested for ~9,000 different viral pathogens in last 1 year.
- Evaluated the effectiveness of single dose of SA - 14-14- 2 (JE) vaccine administered inadults (2012 - 16): Found to be effective.
- Developed ' Malaria Epidemiology Database and Retrieval system of North East, India ' and identified lead molecules against Malaria, Hepatitis and Cholera through virtual screening.
- Established evidence of major rickettsial infections viz., spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) beside scrub typhus (ST) important vector borne disease in NE India.
- a significant gradual decrease in malaria positive cases from 153 positive cases (1st survey) to 7 positive cases (5th Su · Drug sensitivity testing of MTBC isolates collected from Sikkim has revealed
- Community Survey of malaria showed
- significantly hi gh number of multi drug resistance (MDR) TB cases .
- Demonstrated the Grou p B streptococci (GBS) colonization among pregnant women at 35 - 37 weeks, also established GBS as an invasive isolate from neonatal sepsis cases. Hence routine antenatal screening could be of public health importance
- Providing early warning for occurrence of Japanese encephalitis at village level in three districts of Upper Assam for 2017 (viz., Dibrugarh, Tinsukia and Sivasaga in a GIS format.
- Development of a community based IEC in tervention module for dietary salt restriction and reduction of blood pressure
- Identificat ion of the association of pro - inflammatory and anti - inflammatory cytokine genes with the risk of gastric cancer in Tripura and Nagaland.
- Association of promoter hyper methylation of TP53, BRCA1 and BRCA2 genes with increased risk of breast cancer in females from NE region of India has been identified.

## ICMR - Regional Medical Research Centre Port Blair

- Health profile and burden  due to infectious and non - infectious disea ses among the particularly vulnerable tribal groups viz., Onges, Shompen and Andamanese
- Substantial reduction in filariasis prevalence among the Nicobarese of Nancowry group of islands through mass distribution of DEC fortified salt

## ICMR - Desert Medicine Research Centre (DMRC), Jodhpur

- Promotion of protective devices for the prevention of hypertension in brine (salt) workers.
- Screened and established the Sickle Cell Disease in the tribal population of Rajasthan.
- Diagnosis, phylogenetic analysis and molecular characterization of H1N1 virus .
- Established the Trans Ovarian Transmission in Aedes aegypti vector .
- Improving Health and nutritional status of vulnerable segment of population by implementing multi - component health and nutrition education intervention
- Mapping of insecticide resistance in malaria and dengue vector of the state.