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Rajya Sabha Secretariat, New Delhi

PARLIAMENT OF INDIA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE

RAJYA SABHA

REPORT NO.

69

ON HEALTH AND FAMILY WELFARE

April, 2013/Vaisakha, 1935 (Saka)

SIXTY-NINTH REPORT

Demands for Grants 2013-14 (Demand No. 49) of theDepartment of Health Research

(Ministry of Health and Family Welfare)

(Presented to the Rajya Sabha on 26th April, 2013)(Laid on the Table of Lok Sabha on 26th April, 2013)

Website:http://rajyasabha.nic.inE-mail:[email protected]

PARLIAMENT OF INDIARAJYA SABHA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEEON HEALTH AND FAMILY WELFARE

SIXTY-NINTH REPORT

Demands for Grants 2013-14 (Demand No. 49) of theDepartment of Health Research

(Ministry of Health and Family Welfare)

(Presented to the Rajya Sabha on 26th April, 2013)(Laid on the Table of Lok Sabha on 26th April, 2013)

Rajya Sabha Secretariat, New DelhiApril, 2013/Vaisakha, 1935 (Saka)

Hindi version of this publication is also available

CONTENTS

PAGES

1. COMPOSITION OF THE COMMITTEE ......................................................................................... (i)-(ii)

2. PREFACE ............................................................................................................................... (iii)-(iv)

3. LIST OF ACRONYMS ................................................................................................................ (v)

4. REPORT ................................................................................................................................... 1—20

5. OBSERVATIONS/RECOMMENDATIONS — AT A GLANCE .......................................................... 21—25

6. MINUTES ................................................................................................................................. 27—33

(i)(i)

COMPOSITION OF THE COMMITTEE(2012-13)

RAJYA SABHA

1. Shri Brajesh Pathak — Chairman

2. Dr. Vijaylaxmi Sadho*3. Dr. K. Chiranjeevi

4. Shri Rasheed Masood

5. Dr. Prabhakar Kore

6. Shri Jagat Prakash Nadda

7. Shri Arvind Kumar Singh

8. Shri D. Raja

9. Shri H. K. Dua

10. Shrimati B. Jayashree

LOK SABHA@11. Shri Ashok Argal

12. Shri Kirti Azad

13. Shri Mohd. Azharuddin

14. Shrimati Sarika Devendra Singh Baghel

15. Shri Kuvarjibhai M. Bavalia

16. Shrimati Priya Dutt

17. Dr. Sucharu Ranjan Haldar

18. Mohd. Asrarul Haque

19. Dr. Monazir Hassan

20. Dr. Sanjay Jaiswal

21. Dr. Tarun Mandal

22. Shri Mahabal Mishra

23. Shri Zafar Ali Naqvi

24. Shrimati Jayshreeben Patel

25. Shri Harin Pathak

26. Shri Ramkishun

27. Dr. Anup Kumar Saha

28. Dr. Arvind Kumar Sharma

29. Dr. Raghuvansh Prasad Singh

30. Shri P.T. Thomas#31. Shri Chowdhury Mohan Jatua

* Ceased to be Member of the Committee w.e.f. 28th October, 2012.@ Ceased to be Member of the Committee w.e.f. 9th January, 2013.# Nominated as a Member to the Committee w.e.f. 14th December, 2012.

(ii)

SECRETARIAT

Shri P.P.K. Ramacharyulu, Joint Secretary

Shri R.B. Gupta, Director

Shrimati Arpana Mendiratta, Joint Director

Shri Dinesh Singh, Deputy Director

Shri Pratap Shenoy, Committee Officer

(iii)

PREFACE

I, the Chairman of the Department-related Parliamentary Standing Committee on Health andFamily Welfare, having been authorized by the Committee to present the Report on its behalf,do hereby present this Sixty-Ninth Report of the Committee on the Demand for Grants (DemandNo. 49) of the Department of Health Research, Ministry of Health and Family Welfare, for the year2013-14.

2. The Committee held one sitting, on 5th April, 2013 for examination of Demands for Grantsof the Department of Health Research and heard the Secretary (Health Research) and other Officersthereon.

3. The Committee while making its observations/recommendations has mainly relied upon thefollowing documents:–

(i) Address by the President of India to both Houses of Parliament assembled together on21st February, 2013;

(ii) Speech of Finance Minister on 28th February, 2013 while presenting the Union Budget2013-14;

(iii) Implementation of Budget Announcements 2012-13;

(iv) Detailed Demands for Grants of the Department of Health Research for the year 2013-14;

(v) Annual Report of the Department for the year 2012-13;

(vi) Outcome Budget of the Department for the year 2013-14;

(vii) Detailed Explanatory Note on Demands for Grants of the Department of HealthResearch for the year 2013-14;

(viii) Physical and financial targets fixed and achievements made during the Eleventh Planperiod;

(ix) Projection of outlays for the schemes to be undertaken by the Department during theTwelfth Five Year Plan;

(x) Details of under-utilization of the allocations made under different heads during the lastthree years;

(xi) Written replies furnished by the Department to the Questionnaires sent to them by theSecretariat; and

(xii) Presentation made by the Secretary (Health Research) and other concerned officers;

(xiii) Written clarifications furnished by the Department, on the points/issues raised by theMembers during the deliberations of the Committee.

4. The Committee considered the Draft Report and adopted the same in its meeting held on23rd April, 2013.

5. For facility of reference and convenience, observations and recommendations of theCommittee have been printed in bold letters in the body of the Report.

BRAJESH PATHAKNEW DELHI; Chairman,April 23, 2013 Department-related Parliamentary Standing

Vaisakha 3, 1935 (Saka) Committee on Health and Family Welfare

(iv)

(v)

LIST OF ACRONYMS

ACTREC – Advanced Centre for Treatment Research and Education

AIIMS – All India Institute of Medical Sciences

BMHRC – Bhopal Memorial Hospital and Research Centre

DHR – Department of Health Research

DBT – Department of Bio-Technology

DoPT – Department of Personnel and Training

EFC – Expenditure Finance Committee

ICMR – Indian Council of Medical Research

JIPMER – Jawaharlal Institute of Postgraduate Medical Eucation and Research

JWG – Joint Working Group

MRUs – Multi-Disciplinary Health Research Units

MRHRU – Model Rural Health Research Unit

NGO – Non-Government Organisation

NIF – National Innovation Foundation

PPP – Public Private Partnership

RMRC – Regional Medical Research Centre

RDB – Rapid Diagnostic Kit

RTI – Reproductive Tract Infections

STI – Sexually Transmitted Infections

TRU – Translational Research Unit

1

REPORT

I. Introduction

1.1 The Department of Health Research was created in the Ministry of Health and FamilyWelfare in 2007 and became functional in November, 2008 with appointment of the first Secretary,who is also the DG, Indian Council for Medical Research (ICMR).

The following work has been allocated to the Department of Health Research:

1. Promotion and co-ordination of basic, applied and clinical research including clinicaltrials and operational research in areas related to medical, health, biomedical andmedical profession and education through development of infrastructure, manpowerand skills in cutting edge areas and management of related information thereto.

2. Promote and provide guidance on research governance issues, including ethical issuesin medical and health research.

3. Inter-sectoral coordination and promotion of public-private-spartnership in medical,biomedical and health research related areas.

4. Advanced training in research areas concerning medicine and health, including grant offellowships for such training in India and abroad.

5. International co-operation in medical and health research, including work related tointernational conferences in related areas in India and abroad.

6. Technical support for dealing with epidemics and natural calamities.

7. Investigation of outbreaks due to new and exotic agents and development of tools forprevention.

8. Matters relating to scientific societies and associations, charitable and religiousendowments in medicine and health research areas.

9. Coordination between organizations and institutes under the Central and StateGovernments in areas related to the subjects entrusted to the Department and for thepromotion of special studies in medicine and health.

10. Administering and monitoring of Indian Council of Medical Research.

1.2 The Department has informed that the work relating to Indian Council of Medical Research(ICMR) was the only on-going scheme to have been transferred to the Department and other ninefunctions are new.

1.3 As per the information given in the Outcome Budget 2013-14, five new schemes have beenformulated so as to fulfill the mandate and work entrusted to the Department and efforts areunderway to secure mandatory clearances for them:–

The Schemes are:–

(i) Human Resource Development for Health Research

(ii) Grants-in-Aid Scheme for Inter-sectoral Convergence and Promotion and Guidance onResearch Governance Issues

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(iii) Establishment of Multi-Disciplinary Research Units (MRUs) in Government MedicalColleges under the initiative of Infrastructure Development for Health Research

(iv) Establishment of Model Rural Health Research Units (MRHRUs) in the States Collegesunder the initiative of Infrastructure Development for Health Research

(v) Establishment of a network of Laboratories for Managing Epidemics and NaturalCalamities.

II. Budgetary Allocation

2.1 The Committee was informed that against the approved plan outlay of Rs. 4496.08 croreby the Planning Commission for the Eleventh Plan (2007-08 to 2011-12), the actual allocation tothe Department of Health Research was to Rs. 2116.65 crore and the actual expenditure wasRs. 1933.00 crore. The year-wise budgetary allocations and actual expenditure under plancomponent during the Eleventh Plan are as follows:–

Plan

(Rs. in crores)

Financial Year BE RE Actual Remarks on actualExpr. expenditure

2007-08 176.15 176.15 144.15 Excludes expenditure ofRs.32.05 crores in NER.

2008-09 420.00 420.00 350.18 Excludes expenditure ofRs.40.00 crores in NER

2009-10 420.00 400.00 359.50 Excludes expenditure ofRs.40.00 crores in NER

2010-11 500.00 530.00 515.12

2011-12 600.00 588.00 564.05

TOTAL: 2116.15 2114.15 1933.00

2.2 For the Twelfth Plan an outlay of Rs. 10029.00 crore has been approved for theDepartment, though the projected demand of the Department was Rs. 15,500.00 crore. Out ofRs. 10029.00 crore, Rs. 5229.00 crore has been earmarked for the new schemes/projects of theDepartment and Rs. 4770.00 crore for the schemes/projects of ICMR. The scheme-wise allocationfor the Twelfth Plan is as follows:–

(Rs. in crores)

Sl. Schemes of Department Scheme-wise Projected AllocationNo. of Research bifurcation of requirement for

Twelfth Plan for 2013-14 2013-14allocation(2012-17)

1 2 3 4 5

1. Human Resource Development 812.00 123.00 45.00for Health Research

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1 2 3 4 5

2. Infrastructure Development for 1118.00 363.00 60.00Promotion, Coordination and HealthResearch involving Establishment/Strengthening of Multi-disciplinaryResearch Units in State MedicalColleges and the Research Institutes.

3. Establishment of Model Rural Health 246.00 53.00Research Units in the States

4. Establishment of a Network of 1084.00 367.00 45.00Laboratories of Managing Epidemicsand Natural Calamities

5. Grant-in-aid for Inter-Sectoral 1953.00 283.00 40.00Convergence and Promotion andGuidance on Research GovernanceIssues and trans disciplinary andIntegrative Research

6. Grant-in-aid to ICMR 4770.00 1086.00 531.00

7. Governance and departmental expenses 46.00 8.00 5.00

TOTAL: 10029.00 2283.00 726.00

2.3 As is evident from the above table against the projected demand of Rs. 2283.00 crore underthe plan head for the year 2013-14, the actual allocation is Rs. 726.00 crore only.

2.4 On being asked about the updated status of the Schemes, the Department has informed thatthe latest status of the scheme is as follows:–

Sl. No. Name of the Scheme Status Road Map for implementation

1 2 3 4

1. Human Resource The EFC meeting Subject to the clearance of theDevelopment for is yet to be held. scheme by the EFC/Cabinet, it isHealth Research expected to be rolled out sometime

in early part of 2013-14. 3500fellowships/scholarship are targetedto be awarded.

2. InfrastructureDevelopment forHealth Research

(i) Establishment of The EFC meeting It is expected to be rolled outMulti-Disciplinary was held on sometime in early part of 2013-14.Health Research 22.3.2013 and the 150 medical colleges wereUnits in Medical scheme was proposed. However, EFC approvedColleges approved. EFC only 80 medical colleges under

approved the Scheme.Rs. 503.83 crore

4

1 2 3 4

(ii) Establishment of The EFC meeting It is expected to be rolled outModel Rural Health was held on sometime in early part of 2013-14.Research Units in the 22.3.2013 and the 50 units were targeted to beStates Scheme was established but the EFC approved

approved. EFC only 15 units.approved Rs.67.66crore.

3. Establishment of a The EFC meeting It is expected to be rolled outNetwork of Laboratories was held on sometime in early part of 2013-14.for Managing Epidemics 22.3.2013 and the It was proposed to establish 6and Natural Calamities. scheme was Regional + 48 State + 200 Medical

approved. EFC College Labs. The EFC approvedapproved Rs.646.83 10 Regional + 30 State + 200crore. Medical College Labs.

4. Grant-in-aid Scheme for The EFC meeting Subject to the clearance of theInter-Sectoral Convergence is yet to be held. scheme by the EFC/Cabinet, it isand coordination for expected to be rolled out sometimePromotion and Guidance in 2013-14.on Health Research

2.5 In reply to a query, the Department has informed that the expenditure vis-v-vis the Planallocation made for the Department during 2012-13 is as follows:–

(Rs. in crore)

Sl. Scheme BE RE Actual exp.No. 2012-13 2012-13 March, 2013

1 2 3 4 5

1 Secretariat expenditure 8.00 0.83 0.05

2 Human Resource Development 22.00 4.02 0.00for Health Research

3 Infrastructure Development for Health Research

(i) Establishment of Multi-Disciplinary HealthResearch Units in MedicalColleges 44.00 6.62 0.06

(ii) Establishment of ModelRural Health Research Unitsin the States

4 Establishment of a Network of 34.00 6.4 0.00Laboratories for ManagingEpidemics and NaturalCalamities.

5

1 2 3 4 5

5 Grant-in-aid Scheme for Inter- 34.00 6.13 0.06Sectoral Convergence andcoordination for Promotion andGuidance on Health Research

6 Indian Council of Medical 518.00 440.00 460.14Research

TOTAL: 660.00 464.00 460.31

2.6 The Committee observes that the five new schemes/projects of the Department ofHealth Research could not be made operational even during 2012-13 due to lack ofapprovals, though the Department had come into existence in 2007 and become functionalin 2008 with the appointment of its first Secretary. The Committee is unable to comprehendthe reasons for not getting the required approvals even after a lapse of five years since thecreation of the Department, which has resulted in massive financial underperformance vis-à-vis the approved outlay of Rs. 4496.08 crore for the Eleventh Plan. The Committee hasbeen exhorting the Department to pay focused attention for completing all pre-projectformalities and obtaining necessary approvals on time so that the budgeted funds are notlocked up for want of approvals and surrendered later. The Committee is, however,constrained to note that little attention seems to have been paid to its advice in this regardwhich has resulted in persistent and substantial under-utilisation of budgeted funds. Thefirst year of the Twelfth Plan Period has already elapsed and the current year is the 2ndyear of the Twelfth Plan. The Committee notes that the EFC approval for the three newSchemes were accorded, albeit belatedly, on 22.03.2013. Two of the five new schemes havenot been approved as yet. The Committee, therefore, recommends to the Department tomake more rigorous efforts and proactively pursue approval of the remaining two schemeswith the agencies concerned. The Committee desires to be apprised of the updated statusin this regard. The Committee also recommends that a roadmap be chalked out toimplement the Schemes and progress of their implementation be monitored at highest levelin the Department so that the desired outcomes are achieved. The Committee desires thatall the approved schemes should be made operational at least during current financial year.Approvals to the remaining schemes may be accorded at the earliest so that they may alsobecome operational during the current year.

2.7 The Committee notes that there is significant variation between the BudgetEstimates and the actual expenditure incurred in respect of the five new schemes of theDepartment. Persistent mismatch between the Budget Estimates and the actual expenditureindicates that budget formulation is being done without applying proper financial yardsticks.The Committee feels that there is an imperative need to minimize the huge mismatchbetween the Budget Estimates and the actual expenditure so as to observe the fiscal normsin letter and spirit. The Committee, therefore, recommends that corrective measures beinitiated and implemented for realistic projection of fund requirements of the Departmentin future.

2.8 Highlighting the reduced allocation of Rs. 726.00 crore under plan head for 2013-14 againstthe projected demand of Rs. 2283.00 crore, the Department has stated that this reduction in theallocation will affect almost all the on-going as well as new schemes. While the ICMR will not beable to approve new extramural projects at desired level and will have to delay initiation of the newprogrammes for which SFC/EFC have already been approved or under progress, physical targets

6

of the new schemes of the DHR will have to be curtailed quantitatively to nearly 40 per cent. TheDepartment has informed that it proposes to request for adequate funds at the RE stage.

2.9 The Secretary during the course of his deposition before the Committee reiterated the factthat the reduced allocation for 2013-14 would adversely affect the physical targets proposed in thefive new schemes of DHR and result in curtailment of several on-going and new intramural andextramural research programmes of ICMR. Specifying the activities to be affected adversely dueto the less allocation for 2013-14, the Secretary stated the following:–

• Setting up/strengthening of various centers of ICMR (EFC approved/in process).

• New Research Programmes in gap areas including bone health, allergy, mental health,oral health, socio-behavioural health.

• Research on Tribal, Marginalized/ unprivileged population.

• Special Programmes for Medical Colleges and strengthening infrastructure.

• Research on issues related to Bhopal gas tragedy.

2.10 The Committee observes that scientific knowledge generated through health and bio-medical research is used to develop drugs, diagnostics, vaccines and devices that ultimatelyfind place in the health care systems of the country. It is also worth mentioning that healthresearch has a vital role to play in the discovery and development of indigenous healthproducts. Taking all these factors into account, the Committee apprehends that allowing thenew schemes to be plagued with under-funding from the very beginning would provedetrimental to generation of new knowledge in the area of health research. The Committee,therefore, lends its support for enhancement of funds for the schemes at the RE stage. TheCommittee, simultaneously, recommends to the Department to pay focused attention tomore efficient deployment of the available resources.

2.11 In reply to a question, the Department has informed that out of the approved outlay ofRs. 10029.00 crore (against the projected demand for Rs. 15,500.00 crore), for the Twelfth Plan,an allocation of Rs. 5229.00 crore has been earmarked for new schemes/programmes of theDepartment and that this would by and large suffice to meet the requirements for implementationof the 5 new schemes.

2.12 As regards the programmes of ICMR, there will be curtailment of some of its Plans suchas establishment of new Centres in gap areas (many of which are at advanced stages of processingfor seeking approvals) and also extramural grants to various medical and research institutions. TheDepartment will request for more money after the appropriate mid-term review of the progress ofits programmes and activities.

2.13 The Committee observes that the ICMR is the main technical wing of theDepartment of Health Research and is responsible for formulation, coordination andpromotion of bio-medical research in the country. The Committee, therefore, notes withserious concern the likely adverse impact of the funds crunch on the intramural andextramural research priorities of ICMR. The Committee desires that Planning Commission/Ministry of Finance may reconsider the allocation for ICMR for the Twelfth Plan aftermaking a fair assessment.

III. Indian Council of Medical Research

3.1 As per the information given in the Annual Report of the Department, the ICMRconcentrates on knowledge generation and affordable technology development and serves as thefulcrum of the Department.

7

3.2 On being asked about the achievements of ICMR during the Eleventh Plan, the Secretary,Department of Health Research during the course of his deposition before the Committee on the5th April, 2013 submitted the following:–

• Establishment of New Institutes

• National Institute for Research in Environmental Health, Bhopal

• National Institute for Disease Informatics and Research, Bangalore

• Takeover Bhopal Memorial Hospital and Research Centre (BMHRC), Bhopal byICMR

• School of Public Health, Chennai

• Establishment of disease specific labs for research on Indoor Air Pollution at Chennai,Cancer Genetics and Genomics at ACTREC, Mumbai, Pharmacogenomics, JIPMER,Reverse Pharmacology in Traditional Medicine, Mumbai, Yoga and Neurophysiology atBangalore, Evidence Based medicine at Vellore and Chandigarh; Neonatology at AIIMSetc.

• Development of indigenous reagents for testing for JE and Dengue.

• Development of testing reagents and vaccines to combat Influenza A – H1N1Pandemic.

• Establishment of 1st BSL-IV Lab at Pune.

• Establishment of 16 new (14 BSL-II and 2 BSL-III) Labs for viral diseases andTuberculosis.

• Identified 75 leads of potential public health importance for development and evaluationof affordable diagnostics, including indigenously developed tests for diabetes; severalother infections and cancer.

• Four flagship programmes on Health Research viz., Tribal Health Research Forum,Vector Science Forum, Special support to medical colleges and Translational Researchhave been initiated during this plan.

• 15 Centres for Advanced Research were established in addition to 283 multi-centresTask force studies and 623 ad-hoc research projects.

• Creation of New Infrastructure

• New field station of RMRC Port Blair at Car Nicobar, Kamorta, Nancowry.

• New field stations of RMRC Bhubaneshwar at Rayagada and Kalahandi.

• Model Rural Health Research Unit at Ghatampur was strengthened so as todevelop it as a model of partnership with states for transfer of technology to endusers.

• Technology Development and Translational Research

• Indigenous production of monoclonal antibodies PfHRPII and pLDH achieved forimproved diagnostics for malaria.

• JE kit developed and supplied for national programme.

• New rapid molecular methods and DNA fingerprinting for detection of resistanceTB developed.

8

• Development of PCR based method to detect food borne pathogens.

• Rapid Diagnostic kit (RDB) for the detection of β-thalassemia syndromes.

• A cyclic lipopeptide of Bacillus subtilis subsp. subtilis (VCRC B471) with potentialto kill mosquito stages.

• PCR assay detection kit for Kala-Azar.

• Cancer screening device, Magnivisualizer.

• Technologies of double fortified salt (DFS) and fortification of wheat Atta withiron and other essential nutrients transferred to the industry.

• 12 different clinical trials undertaken for Cholera Vaccine, MDT (Leprosy),Filariasis, Male Contraceptive, Eclampsia, Female Reproductive Disorders,Neurocysticercosis etc.

Guidelines developed

• National Guidelines developed for Prevention, Management and control of ReproductiveTract Infections including Sexually Transmitted Infections (RTIs/STIs).

• Guidelines for Management of Diabetes were developed.

• Guidelines for management of three type of cancers (oral, buccal and stomach)developed.

• Guidelines for revised standards for nutritional standards.

• Management of Obstructive Sleep Apnea.

• Management of Chronic Obstructive Pulmonary Diseases in MIC affected population.

Human Resource Development

• ICMR Awards/Prizes, MD-Ph.D. Programme, International Senior and JuniorFellowship, Centenary Post-doctoral Fellowship scheme, Indo-German Science Centrefor Infectious Diseases fellowships, Advanced trainings under cross cutting areas likeGenomics, Proteomics, Health Informatics etc.

• Number of Scientists benefitted-900.

3.3 The Committee places on record its appreciation for the achievements of ICMRduring the Eleventh Plan. However, in view of the dynamic international health researchscenario and the current and future health challenges of the country, the ICMR has anuphill task to accomplish and milestones to achieve. The Committee would, therefore, likethe ICMR to collaborate with internationally acclaimed institutions in the field of Healthresearch in order to facilitate a vibrant and relevant health research system in thecountry.

3.4 In reply to a question, the Department has informed that a High Power independentCommittee has been constituted by the Hon’ble Minister of Health and Family Welfare to evaluatethe research activity of the Council. The High Power Committee has already met thrice to reviewthe activity of the ICMR for Eleventh Plan Period and two more meetings have been scheduled forMarch, 2013. The recommendations of the Committee shall be sent to the Department of HealthResearch, Ministry of Health and Family Welfare.

9

3.5 The Committee welcomes the on-going evaluation of the research activities of ICMRby an independent Committee. The Committee would impress upon the Department toexpedite submission of the recommendations of the independent Committee and place themin the public domain. The Committee desires to be apprised of the composition, findings ofthe independent Committee and the follow-up action taken thereon. The Committee wouldalso like to know if it is possible to involve reputed scholars of developed countries in theevaluation of the research projects of ICMR.

3.6 As per the information given in the Outcome Budget 2013-14, the ICMR with Plan budgetof Rs. 477.40 crore for 2013-14, will accord priority to the important scientific activities underthe following heads:–

(a) Translational Programmes

(b) Programmes on Health Systems Research and Social and Behavioral Research

(c) Programmes on Reproductive and Child Health

(d) Programme on Communicable Diseases

(e) Programme on Non-Communicable Diseases

(f) Strengthening of the existing ICMR infrastructure to enable the Institutes/RegionalCentres/Units to enable them to handle the challenges of the on-going epidemiologicaland demographic transition as emerging and new areas of research.

(g) Strengthening International Cooperation

(h) Tribal Health

(i) Human Resources Development

(j) New Research Programme

(k) Specilised Centres

(l) Establishment of new centres

(m) Outbreak/Disaster Response Fund.

3.7 The Committee notes that some very important research activities/projects in variedareas are targeted to be undertaken/continued during the year 2013-14. The Committeewould like to be apprised in due course of time, of the quantifiable and specificachievements made vis-à-vis targets set for the year 2013-14.

3.8 In reply to a specific query about the steps taken by the Department to orient researchactivities towards developing indigenous pharma products and medical devices and the outcomethereof, the Department has stated that seventy five top priority programmes/technologies havebeen identified/ and are being carried out in the institutes of ICMR which are now in differentphases of development and evaluation. These technologies are on development of new tools forvector control, diagnostic methods for cancer, diabetes mellitus and various infectious diseasesincluding dengue and chikungunya, lung fluke, tuberculosis; new treatment methods to improve thetreatment of tuberculosis, leprosy, cancer, malaria, diabetes mellitus, prevention of occupationalhazards etc. and vaccines for different infectious diseases.

3.9 Shedding light on the expected outcome, the Department has submitted that thirtytechnologies are targeted to be ready by 2014. Twenty seven translational research cells aretargetted at ICMR’s Institutes/Centres and a translational research unit (TRU) at ICMR

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Headquarters alongwith the IPR unit facilitates in carrying forward these technologies for theirimplementation into the health care system/clinical practice. A separate review mechanism has beenestablished and fresh guidelines for funding of the research projects on a fast track basis finalised.Further, a committee has been constituted to identify the leads emerging out of the completedextramural projects which may be pursued on priority basis for translation.

3.10 The Committee notes that a number of outcomes have been projected for the year2013-14. The Committee recommends that the desired outcomes be achieved within thetargeted time-frame. The Committee desires to be kept apprised of the achievements madevis-à-vis the targets set. The Committee observes that it takes time to translate theresearch leads into tangible health products or in application of the knowledge generatedthrough research and a lot of work remains to be done to bridge the gap between ‘what isknown’ and ‘what is done’. Concerted efforts are required to be made to bring researchoutcomes into application in the better interest of the public. The Committee would,therefore, like to be apprised of the finding of the Committee constituted to identify theleads from the completed extramural research projects. The Committee would also like tobe intimated of the specific health products/processes accruing from the above researchprojects.

3.11 On being asked about the major research project undertaken by ICMR on traditionalmedicine and follow-up action for bringing the achievements thereof in the mainsteam for thebenefit of public and the updated status of such on-going projects, the department in a writtensubmission has stated the following:–

3.12 ICMR promotes research in the area of traditional medicine through intramural andextramural programs.

(A) Intramural Research

3.13 Intramural research is being pursued through Regional Medical Research Center, Belgaumwhich is focusing on: (a) scientific validation of Herbal Medicine, (b) role of herbal medicine intreating diseases in the region; (c) preparation of database of ethno-medicinal plants of WesternGhats; (d) strengthening human resource in the area of herbal and traditional medicine;(e) collaboration with traditional and herbal medicine practitioners in the region to create awareness,promote scientific temperament, collect, collate and disseminate relevant scientific information inthe area of herbal medicine. The center is successful in: (a) preparation of database, establishmentof museum and herbal garden of ethno medicinal plants of Western Ghats and creating awarenessamong visitors regarding traditional medicine system in the region; (b) providing services toneighboring research institutes and NGOs in respect of identification and authentication of medicinalplants and information on collection, cultivation and utility of medicinal plants; (c) establishment ofmolecular and microbiology laboratory for testing of herbals against highly resistant bacteria.

(B) Extramural Research

3.14 Extramural research in traditional medicine is supported through Center for advancedresearch, ad hoc research schemes and fellowships as well as through inter-agency programs:

(i) Centre for Advanced Research - Following Centres for Advanced Research havebeen established:

• Centre for Advanced Research in Yoga and Neurophysiology at SwamiVivekananda Yoga Research Foundation, Bangalore. Studies demonstrated theoverall neurophysiological correlates of meditation offer objective support for

11

meditation as therapy and as an effective strategy to perform better in cognitivetasks and to organize higher brain functions specific to education in children andadults. The centre has produced 7 Ph.D thesis and 8 MSc dissertations and fourAnnual month long training programs and 7[1 international] short term researchtraining were conducted. Three booklets are published and 1 being finalized, aTraining Video and a website on science of meditation are also established.

• Advanced Centre of Reverse Pharmacology in Traditional Medicine, KasturbaHealth Society, Mumbai. Studies demonstrated that Curcuma longa and curcuminhave proliferative effects in the hippocampal neural progenitors in aged rats, withcognitive improvement. Nyctanthes abor-tristis showed antimalarial efficacy andsafety in vitro and in vivo. W. somnifera showed good tolerability and strength-enhancement in human volunteers.

(ii) Fellowship projects:- Presently 40 fellowship projects are ongoing in traditionalmedicine.

(iii) Ad hoc projects- Presently 44 ad hoc research projects are ongoing in the area

(iv) Inter-agency programmes:–

(a) ICMR-NIF joint collaborative programme in traditional practices :

3.15 ICMR desires to enhance the rate of herbal drug discovery as the 21st century belongs tothis area. One of the ways that it can achieve this objective is to include outstanding traditionalpractices which can be validated through the research efforts of the individual researchers engagedin validating exercise in national laboratories as well as in various universities in the country. Inorder to reduce the cost of discovering leads ICMR felt that it can enter into a long termcollaboration with organizations like National Innovation Foundation (NIF). NIF is engaged in thescouting of traditional practices and grassroots innovations which has resulted in a database ofapproximately 80,000 traditional herbal practices from over 540 districts of India. It has beennoticed that sometimes traditional knowledge holders develop successful health solutions, whichmany times are not optimal. Thus, ICMR noticed that there is a gap between the world’s formaland informal knowledge production systems. In order to set the agenda, coordination andarrangements of formal scientific institutions and adequate resources are required to add value toor scale-up local knowledge after blending it with modern scientific technologies.

3.16 ICMR entered into a MoU with NIF for a period of five years on 23rd June, 2006. A taskforce discussed the plan and formulated the structure of the proposal to be submitted to ICMR sothat scientific validation and value addition in traditional knowledge can help solve many day-to-dayproblems of people. Under the scheme, value will be added by ICMR Labs and other scientificinstitutions recognized by it to outstanding traditional herbal knowledge and innovations to generateuseful leads and share the benefits. The promising leads among the noncodified herbal practices willbe developed as marketable products. The MoU was further extended for a period of next fiveyears by DG, ICMR and is operative till 23rd June, 2016. Under ICMR-NIF collaboration evaluationof anti-typhoid and anti-diarrheal activities of medicinal plants claimed by traditional healers havebeen undertaken. It is proposed to evaluate about 800 practices during Twelfth plan for which aproposal with an estimated cost of Rs. 17.0 crores has been submitted.

Meanwhile, ICMR has established following facilities at National Innovation Foundation,Ahmedabad:–

• Non-codified plant mini-repository of medicinal value practiced by traditional healers.The objectives of the repository are: (a) Phased manner collection of Noncodified

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plants for establishing herbarium; (b) Collection of Non-codified plants samples claimedto have theraupetic value for establishing repository; (c) Storage of crude drugs andplant extracts of therapeutic nature; (d) Establishment of exclusive herbarium andrepository for 5000 non-codified plants; e) fingerprinting at chemical and DNA levelfor elite materials through outsourcing to referral labs.

• Augmentation of SRISTI laboratory capacity by expanding the facilities for relevantmicrobial testing: Objectives are: (a) To expand the SRISTI Lab facilities for relevantpathogenic microbial strains culture and preservation; (b) To establish the facilities forhandling pathogenic microbial strains and their safe disposal; (c) To establish thefacility for herbal extraction and fractionation of extract; (d) To establish the facilityfor isolation and purification of herbal extract. SRISTI is the only lab in Indiadedicated to work on the practices of grassroots innovators and traditional knowledgewhere basic microbiological facilities exist. The facilities for relevant pathogenicmicrobial screening against different plants extract created.

(a) Collaboration with Department of AYUSH: This collaboration aims at scientificvalidation of traditional and other herbal formulations for HIV/AIDS cases. Under thiscollaboration following facilities have been set up:

• Standardisation and Quality Control of traditional formulations at National Instituteof Pharmaceutical Education and Research (NIPER), Mohali and SASTRA,Thanjavur.

• In-vitro screening of the formulations for their anti HIV activity at National AIDSResearch Institue (NARI), Pune.

• Preclinical Pharmacology and Safety testing of the formulations at NationalInstitute of Nutrition (NIN), Hyderabad.

• Monitoring of the clinical trials at Central Bio-statistical Monitoring Unit atNational Institute of Epidemiology (NIE), Chennai.

3.17 The Committee observes that no single system of health care has the capacity tosolve all of the country’s health care needs. It is in this context that promotion of researchin the area of traditional medicines including Ayurveda, Naturopathy, Tibbia, Sowa-Rigpa andHomoeopathy becomes vital for the public health care system. The Committee, therefore,recommends that the research projects on traditional medicines be pursued vigorously andthe innovations accruing therefrom be introduced into public health service within adesignated time-frame. The Committee desires to be kept apprised of the success achievedin this regard.

IV. Programmes for the North East

4.1 The Department in a written submission has informed that as per Government policy, it ismandatory to earmark 10% of total plan budget for the North Eastern Region. The provision ofRs.42.40 crores in RE 2012-13 and Rs.72.60 crores in BE 2012-13 for N.E. Region reflects the10% provision of the total budgetary provisions in these years.

4.2 In the Outcome Budget 2013-14, it has been informed that the projected outcomes of thehealth research projects for 2013-14 of the North East Region are as follows:–

Department of Health Research (DHR)

(i) To take up schemes for Human Resources Development for Health Research in theNorth East.

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(ii) To take up projects for Research including in coordination with other agencies.

(iii) To take up schemes for infrastructure development in Medical colleges and ModelRural/Health Research Units.

(iv) To take up the scheme for managing epidemics and natural calamities.

ICMR

(i) Ongoing intramural and extramural projects will be supported. Fifty one new proposalshave been received from Medical Colleges/Institutes in the NE States for funding.

(ii) Initiation of new research projects will be taken up as in the past.

(iii) Initiation of Construction of Research Units at Guwahati and Agartala.

(iv) A joint working Group meeting between ICMR and DBT to identify new proposals.

(v) Other new initiatives include new research centres on Communicable and Non-communicable diseases, health system research.

4.3 The Committee welcomes the initiatives taken by the Department to undertakestudies and projects specific to North Eastern Region and exhorts that focused attention bepaid to the implementation of the above projects by way of streamlined monitoring so thattangible outcomes could be achieved and benefits emerging therefrom percolate down to thepeople.

V. Human Resource Development for Health Research

5.1 The Committee has been informed by the Department that a major constraint in the currentscenario in the country is the lack of adequate and properly trained human resources for the healthresearch. The Department plans to strengthen human resource base of the country by organizingfocused training programs within and outside India, for midcareer professionals in medical collegesand other academic establishments. About 3500 personnel are proposed to be trained (in 5 years)in various programmes mentioned below. Improving the career path for young researchers,expanding the number of specialized researchers and then providing good initial support in the formof startup grants are planned as a part of this programme. Activities proposed in this regard are:–

(a) Fellowships for training: Researchers in identified advanced fields.

(b) Scholarships at PG level: Support for producing human resources in newer areas.

(c) Young researcher program: To encourage young students for research.

(d) Special training programs: In specified areas, this also includes support to selectedinstitutions for training.

(e) Mid-career research fellowships: Faculty development for medical colleges.

(f) Women Scientists who have had break in career.

5.2 During 2013-14, it is planned to train over 700 mid-career/other seniors and younginvestigators; 2/3 from medical colleges and provide start up grants for the faculty trained. Apartfrom these schemes, it is also proposed to establish an online teaching and learning facility forthe promotion of biomedical research, with components for supporting workshops. Much of thebiomedical research being carried out in the country today is confined to a few medical Colleges/institutions of the country. It is important that this research is encouraged in other parts of the

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country, especially rural and remote areas. One of the reasons for the limited reach has been thelack of knowledge and support for research. This programme will help prospective institutions andindividuals to access resources-both financial and technical on research and promote researchacross the country.

5.3 The Committee has also been informed that the EFC Note has been circulated for thecomments of the appraisal agencies and subject to the clearance of the Scheme by the EFC/Cabinet, it is expected to be rolled out in the early part of 2013-14.

5.4 An allocation of Rs. 45.00 crore (plan) has been made in BE 2013-14 for the above head,though the projected demand was to the tune of Rs. 123.00 crore. BE 2012-13 allocation wasRs. 44.00 crore which was drastically reduced to Rs. 4.02 crore at the RE stage but the actualexpenditure was nil due to the fact that the schemes could not take off for lack of necessaryapprovals.

5.5 The Committee observes that much delay has already taken place in implementingthe schemes pertaining to Human Resource Development which resulted in the surrenderof the entire budgeted funds for 2012-13. The Committee would expect the Department toavoid recurrence of such a situation and get the EFC clearance at the earliest. TheCommittee would also like the Department to complete other pre-project activities withinthe shortest possible time. The Committee desires to be kept apprised of the developmentsin this regard.

VI. Grant–in–Aid Schemes for Inter-Sectoral Convergence and Promotion and Guidanceon Research Governance Issues

6.1 An allocation of Rs. 40.00 crore has been made for the above scheme in BE 2013-14,though the actual expenditure for 2012-13 was Rs. .06 crore only vis-à-vis allocation of Rs. 34.00crore.

6.2 The Committee gathers from the information furnished that the Grant-in-AidScheme for Inter-Sectoral Convergence and Promotion and Guidance on ResearchGovernance Issues is yet to be cleared by the EFC/Cabinet. The Committee, in the earlierpart of the Report, has commented about proactively pursuing for approval of variousSchemes with the agencies concerned and completing all pre-project formalities well in time.The Committee recommends here also to take similar action in respect of the aboveScheme as well.

6.3 Grant-in-Aid scheme for projects requiring inter-sectoral coordination, translationspecially in PPP mode and IT enabled governance, trans-disciplinary as well asimplementation research. As per the information furnished by the Department this includes thebudget heads for Inter-sectoral co-ordination in medical, biomedical and health research, mattersrelating to scientific societies and associations, charitable and religious endowments in medicine andhealth research areas and Coordination with Government/organizations/institutions.

6.4 The Department has also informed that while several science departments are significantlycontributing to innovation related to different aspects of biomedical research, it is recognized thattranslation process and further implementation research is not as strong as is needed and DHRplans to focus on these aspects. In order to strengthen research effort in which the partnershipof different government agencies, NGOs and Industry is required, the Department has planned toprovide support in the form of grant-in-aid to selected projects; create awards, dedicated fundingfor translation of innovations and their implementation and support to professional associations etc.for developing guidelines and priority setting. Thus there will be special focus on encouraginginnovation, their translation and implementation by collaboration and cooperation with other

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agencies by laying special stress on implementation research so that there is a better utilization ofavailable knowledge.

6.5 The DHR proposes to fund activities/ projects identified by an Inter-DepartmentalCommittee on Biomedical and Health Research around medical/health priorities such as tuberculosis;Viral infections with potential for outbreaks; Zoonotic diseases; Maternal and Child Health includinggender issues in health; Nutrition and Food safety; diseases preventable through measures likevaccines, environmental interventions, public health education etc.; Diabetes, cardiovascular, mentaland chronic neurological disorders; Affordable health care technologies (diagnostics, therapeutics,devices etc.); Innovation in health care delivery; Rural healthcare; mental health and ageing-relateddiseases such as dementia, Parkinson’s Disease, etc.; Urban health; especially the emerging tripledisease burden due to communicable and non-communicable diseases and trauma; mechanisms toprovide information/guidance on healthy life style; Gender issues specially in the provision of healthservices, domestic and sexual violence against women, setting up of district research stations, etc.Projects will be identified and supported in partnerships with other science agencies/departments –those mainly involved in basic science and or innovation on one hand (e.g., DST, DBT, CSIR/DSIR, DRDO etc.) to those with major application on epidemiology, public health (e.g., ICMR).The focus would be on (i) establishing mechanisms to evaluate technologies for improving healthcare at individual and public health level; (ii) fostering academia-Industry link: creating processesand cell to link developers with industry for translation of leads into products/processes; and(iii) establishment of a rapid clearing house mechanism for evaluation of health researchtechnologies including the commercial applications In addition, agencies/departments havingcomplementary activities with DHR such as, DIT, ICAR/DARE, Social Justice, Environment andForests, Women and Children; Water resources; other user departments of Ministry of Health andFamily Welfare etc. are proposed to be engaged in the process. International collaborations ofscientific and strategic mutual interest will be a priority.

6.6 The Committee observes that very important activities are envisaged to beaccomplished under the Grant in Aid Scheme for Inter-Sectoral Convergence and Promotionand Guidance on Research Governance Issues. The Committee in its 56th Report onDemands for Grants (2012-13) of the Department of Health Research had observed that theaccomplishment of targets set under the Scheme would require involvement of a number ofagencies/organizations and recommended creation of an institutional coordinationmechanism for synergizing the core competencies of the different organizations/agencies.The Committee is not aware whether such a dispensation has come into existence or not.The Committee, therefore, would like to be updated in this regard.

6.7 (ii) Promotion and Guidance on Research Governance Issues

• A proposal for the enactment of an Ethics Bill and the establishment of the NationalBioethics Authority is under processing. The bill has been drafted and is beingprocessed.

• A Bill for Regulation of Assisted Reproductive Technology has been drafted.

• A Bill on Alternate systems of medicine has been drafted and is being process forintroduction in Parliament.

• Systems for establishing mechanisms for mapping of health research institutions,accreditation; Knowledge management policy, Health Research Policy etc. are beingfinalised.

6.8 The DHR plans to focus on programmes aimed at making health care affordable for thepoor/marginalized groups/communities. The DHR will set up Technology Assessment Board

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consisting of economists, social scientists, public health professionals and other specialists (similarto the Offices of Health./Medical Technology Assessment systems in some countries) whereby newtechnologies can be scientifically assessed for cost efficacy before introduction/procurement foraffordable health care. The Working Group of Twelfth Plan Document has recommended to set upa Medical Technology Development Board to promote development of indigenous medicaltechnologies.

6.9 The Committee recommends that early action be taken for setting up MTDB whichwill go a long way in promoting development of indigenous medical technologies.

VII. Development of Infrastructure for Promotion of Health Research

7.1 As per the information given in the Outcome Budget 2013-14, development of infrastructurefor research has been taken up as a major activity of Department of Health Research. During2013-14 it is proposed to establish about 60 Multidisciplinary Research Units (MRU) in medicalcolleges and 10 model Rural Health Research Units (MRHRU); 10-15 specialized researchlaboratories in cutting edge areas as well as trans-disciplinary aspects involving agencies likeAYUSH, NKN etc.

7.2 (i) Establishment of Multi-Disciplinary Research Units (MRUs)

• Medical colleges are the backbone of both teaching as well as providing specializedservices to patients in India. It is also expected that medical colleges will also set thetrends in thinking process and innovation to improve our understanding of thedisease(s) and their management.

• Over the years it has been seen that majority of our medical colleges are just confiningto routine patient care and also teaching based on conventional methods. This isthought to be basically because of lack of appropriate facilities and even lack ofadequate attempt to create such new facilities e.g. modern biology units in the medicalcolleges. As a result, medical colleges even do not think of including the new methodsof investigation for understanding the patho-biology, diagnosis, treatment and/ormonitoring the progress of cases for better management practices. The Department ofHealth Research plans to pay special attention to development of infrastructure inmedical colleges by establishing multi-disciplinary research units (around 150 units inTwelfth Plan) at least in all the Government medical colleges. These units will providethe modern technology infrastructure which will improve the quality of the specializedcare, training of doctors and other health care professionals and then research as perthe needs of the population. About sixty medical colleges have applied/been identifiedby State Governments and these Units are planned to be established in 2013-14 aftercompleting the formalities.

7.3 Development of infrastructure for research has been taken up as a major activity ofDepartment of Health Research. During 2013-14 it is proposed to establish about 60 Multi-disciplinary Research Units (MRU) in medical colleges. The Committee was given to understandthat the Department of Health Research’s Technical Committee has shortlisted 31 Medical Collegesin 14 different States for establishing Multi-Disciplinary Research Units (MRUs). However, not asingle MRU is being set up in Bihar, inspite of the fact that Darbhanga Medical College and Hospitalhad submitted a proposal for the same.

7.4 The Committee, therefore, recommends that the proposal of Darbhanga MedicalCollege and Hospital for establishing MRU may also be considered for approval and a MRUbe set up there at the earliest.

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(ii) Establishment of Model Rural Health Research Units (MRHRU):

7.5 There is a wide gap between the available specialized health care technology and thetechnology being developed vis-a-vis their utilization in the State health systems. This is particularlytrue for rural health settings. It is generally felt that technology application needs specializedinfrastructure and can be done only in urban settings. In order to develop models for transfer ofsuch technology to the end care users, the Department has planned to establish model rural healthresearch units in all the States (about 50); one in smaller States and more than one in larger States)where technology transfer and the research targeting health interventions will be done in partnershipwith the States. It has been planned to establish 10 units by the end of 2013-14.

7.6 The Committee observes that though first year of the Twelfth Plan has alreadyelapsed and the 2nd Year has started, no MRU or MRHRU has been set up till date. Fromthe information furnished by the Department, the Committee gathers that the EFC/Cabinetclearance for the above schemes is yet to be received, which would entail further delay.Considering the fact that around 150 MRUs and 50 MRHRUs are targeted to be set upduring the Twelfth Plan, the Committee apprehends that it would be difficult to achieve thetargets set, which would also lead to budgeted funds remaining unutilized and thereforeconcerted action may be taken in this regard. It is, therefore, imperative on the part of theDepartment to vigorously pursue the matter and get the necessary clearances in the rightearnest and well in time. The Committee desires to be kept apprised regularly of theprogress made towards setting up of MRUs and MRHRUs.

VIII. Managing Epidemics and National Calamities

Setting up a Laboratory Network for Research on Viral and other Infectious Diseases.

8.1 As per the information furnished by the Department, India continues to have outbreaks/epidemics due to various infectious pathogens. Currently national apex institutes like NCDC, NewDelhi and NIV, Pune are mandated to undertake the investigations that results in heavy burdenaffecting their real referral role. The resultant delay in diagnosis/detection and adequate/incompletedata about these outbreaks significantly impacts the response time for interventions. Significantly,avoidable delays in both short and long terms strategies for prevention, treatment through vaccineproduction/introduction and up-gradation of infra-structure etc. The Department has planned toestablish about 250 laboratories (total in 3-4 years) of three grades on infectious pathogens whichwill work under the overall guidance of apex institutions like NIV, NCDC through appropriatelinkages and networking. During 2013-14 it is planned to establish 2 regional BSL-III; 14 State levellabs and 70 district level labs.

8.2 The Committee observes that viral diagnosis has emerged as a major healthchallenge. The Committee, therefore, recommends that the Department should draw up anaction plan for timely implementation of the scheme for setting up of laboratory networkfor research on viral and other infections. Efforts may be made to achieve physical andfinancial targets.

IX. International Cooperation in Medical and Health Research

9.1 The Plan allocation for International Cooperation in Medical and Health Research wasRs. 5.00 crore in BE 2012-13 which was reduced to Rs. 1.02 crore in RE 2012-13. Asked aboutthe reasons for this reduction, the Department has informed that the reduction in allocation offunds in RE 2012-13 was because of non-approval of Grant-in-Aid scheme under whichInternational Cooperation in Medical and Health Research is also covered. On being asked about the

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number of international conferences held on medical and health research during 2012-13, theDepartment in a written submission has informed that an expenditure of Rs. 6.00 lakh has beenincurred on foreign travel expenses and no expenditure has been incurred on holding internationalconferences from this head. The Department has, however submitted that during 2013-14, theproposed activities under this head will be implemented.

9.2 The Committee observes that though adequate budgetary provisions had been madein BE 2012-13 for the above head, no international conference could be organised so far. TheCommittee is of the view that international conference involving eminent scientists anderudite scholars help in sharing and dissemination of knowledge. The Committee wouldtherefore, advise the Department to initiate action for organising international conferencesand symposia during 2013-14 and also ensure that sharing of knowledge and expertise couldlead to finding some solutions to health challenges of the country.

9.3 On being asked about the details of the projects likely to be funded with the allocation ofRs. 5.00 crore made in BE 2013-14, the Department has informed that the following activities areproposed to ensure utilization of the budgeted amount:–

(a) Contributions to international organisations – Besides the support to TDR, GFHR,contributions to other international organization like DNDi, NAM, SAARC, AfricaCouncil etc. will be made as a part of the scheme.

(b) Participation in conferences abroad (non-ICMR) : As a part of this activity financialassistance will be provided for presenting research papers, chairing the session ordelivering a keynote address in international scientific event (conferences/seminars/symposia/workshop) to non-ICMR biomedical scientists both young as well as seniorscientists.

(c) Organising international conferences in India – DHR will allocate money for supportinginternational conferences in India.

(d) DHR delegations to international bodies, WHO etc. : DHR officials will be included inIndian delegations to various bilateral/multilateral discussions and Joint Working Groups(JWGs)

(e) Supporting Indian component of research studies under bilateral and multilateralprogrammes.

(f) Hosting foreign delegations: The DHR will promote and host international delegationsfor sharing of the experiences to deal with various emerging and re-emergingchallenges. This will share the expertise with neighbouring and developing countries fortransfer of technology, training in cutting edge of science. Such deliberations/exchange will be focused on direct benefits to the health of the people of India/international agenda of Government of India.

9.4 The Committee is happy to note that one of the activities proposed for 2013-14 inter-alia talks of sharing the expertise of developed and developing countries for transfer oftechnology and training in cutting edge of science. The Committee also desires to beinformed of the achievements made so far.

X. Manpower Requirements of Department of Health Research

10.1 In reply to a query, the Department has informed that the latest status regarding sanctionedstrength of the Department and the number of posts filled are as under:–

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Sl. Name of Post No. of posts No. of Total No. of postsNo. transferred additional sanctioned filled

from posts strengthMoH&FW created

1. Joint Secretary 1 1 2 2

2. Director/DS 1 1 2 1

3. Scientist ‘E’ – 1 1 –

4. Under Secretary 1 1 2 1

5. Scientist ’C’ – 2 2 –

6. Section Officer 1 2 3 1

7. Assistant 1 4 5 2

8. Private Secretary – 2 2 1

9. Stenographer – 2 2 1

10. LDC 1 – 1 1

TOTAL: 6 16 22 10

10.2 The Department has further informed that after its creation as a separate Department in2007, the Department is still functioning with a very small complement of staff transferred fromthe Department of Health and Family Welfare. Most of the 16 additional posts in different gradescreated with the approval of Department of Expenditure. The position of filling up of posts asfollows:

1. Joint Secretary: An officer of Indian Forest Service has been selected by Departmentof Personnel and Training (DoPT). He will report for duty on 7th March, 2013.

2. Scientists: For the post of Scientist ‘C’ and Scientist ‘E’, the posts can be filled onlyafter the Recruitment Rules are approved by the DoPT and UPSC.

3. Secretariat Posts: The Central Secretariat posts have been encadered by the Departmentof Personnel and Training in July, 2012, against some posts, postings of which are yetto be made by the DoPT. Moreover, the cadre controlling authority for the DHR is theDepartment of Health and Family Welfare and, therefore, actual posting of officers arefirst made by the DoPT to that department thereafter the officers are posted by thatDepartment to the DHR. Department of Health and Family Welfare has been remindedin September, 2012 and January, 2013 for early posting of requisite staff in the DHRagainst the sanctioned posts. However, as a stop gap arrangement, two Consultants(one Retired Director and One Retired Under Secretary) have been engaged forhandling the important work, including the work relating to the schemes.

10.3 The Committee notes that despite coming into existence of DHR as a separateDepartment in 2007, the cadre-controlling authority for the DHR is the Department ofHealth and Family Welfare. The purpose being served by having such an arrangement isbeyond the comprehension of the Committee. The Committee feels that such anarrangement would only delay the process of filling up of vacant posts and should,therefore, be dispensed with. The Committee would therefore, like the Department ofHealth Research to bring the above observation to the notice of the authorities concerned

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for an appropriate decision. The Committee desires to be apprised of the response ofDepartment of Health and Family Welfare in this regard.

10.4 The Committee also expresses its concern over a large number of posts lying vacantvis-à-vis the sanctioned strength, which is certain to impinge on the smooth functioning ofthe Department. The Committee would recommend that the matter should be pursued atthe highest level with the concerned authorities for expeditious filling up of the vaccines atthe earliest. A Department cannot function with so many vacancies. If the government didnot create a separate Department, things would have been different. But now that theGovernment has created the Department, all the commitments should be fulfilled. An earlyaction may be taken in this regard.

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OBSERVATIONS/RECOMMENDATIONS — AT A GLANCE

II. Budgetary Allocation

The Committee observes that the five new schemes/projects of the Department ofHealth Research could not be made operational even during 2012-13 due to lack ofapprovals, though the Department had come into existence in 2007 and become functionalin 2008 with the appointment of its first Secretary. The Committee is unable to comprehendthe reasons for not getting the required approvals even after a lapse of five years since thecreation of the Department, which has resulted in massive financial under-performancevis-a-vis the approved outlay of Rs.4496.08 crore for the Eleventh Plan. The Committee hasbeen exhorting the Department to pay focused attention for completing all pre-projectformalities and obtaining necessary approvals on time so that the budgeted funds are notlocked up for want of approvals and surrendered later. The Committee is, however,constrained to note that little attention seems to have been paid to its advice in this regardwhich has resulted in persistent and substantial under-utilisation of budgeted funds. Thefirst year of the Twelfth Plan Period has already elapsed and the current year is the 2nd yearof the Twelfth Plan. The Committee notes that the EFC approval for the three new Schemeswere accorded, albeit belatedly, on 22.03.2013. Two of the five new schemes have not beenapproved as yet. The Committee, therefore, recommends to the Department to make morerigorous efforts and proactively pursue approval of the remaining two schemes with theagencies concerned. The Committee desires to be apprised of the updated status in thisregard. The Committee also recommends that a roadmap be chalked out to implement theSchemes and progress of their implementation be monitored at highest level in theDepartment so that the desired outcomes are achieved. The Committee desires that all theapproved schemes should be made operational at least during current financial year.Approvals to the remaining schemes may be accorded at the earliest so that they may alsobecome operational during the current year. (Para 2.6)

The Committee notes that there is significant variation between the BudgetEstimates and the actual expenditure incurred in respect of the five new schemes of theDepartment. Persistent mismatch between the Budget Estimates and the actual expenditureindicates that budget formulation is being done without applying proper financial yardsticks.The Committee feels that there is an imperative need to minimize the huge mismatchbetween the Budget Estimates and the actual expenditure so as to observe the fiscal normsin letter and spirit. The Committee, therefore, recommends that corrective measures beinitiated and implemented for realistic projection of fund requirements of the Departmentin future. (Para 2.7)

The Committee observes that scientific knowledge generated through health and bio-medical research is used to develop drugs, diagnostics, vaccines and devices that ultimatelyfind place in the health care systems of the country. It is also worth mentioning that healthresearch has a vital role to play in the discovery and development of indigenous healthproducts. Taking all these factors into account, the Committee apprehends that allowing thenew schemes to be plagued with under-funding from the very beginning would provedetrimental to generation of new knowledge in the area of health research. The Committee,therefore, lends its support for enhancement of funds for the schemes at the RE stage. The

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Committee, simultaneously, recommends to the Department to pay focused attention tomore efficient deployment of the available resources. (Para 2.10)

The Committee observes that the ICMR is the main technical wing of theDepartment of Health Research and is responsible for formulation, coordination andpromotion of bio-medical research in the country. The Committee, therefore, notes withserious concern the likely adverse impact of the funds crunch on the intramural andextramural research priorities of ICMR. The Committee desires that Planning Commission/Ministry of Finance may reconsider the allocation for ICMR for the Twelfth Plan aftermaking a fair assessment. (Para 2.13)

III. Indian Council of Medical Research

The Committee places on record its appreciation for the achievements of ICMRduring the Eleventh Plan. However, in view of the dynamic international health researchscenario and the current and future health challenges of the country, the ICMR has anuphill task to accomplish and milestones to achieve. The Committee would, therefore, likethe ICMR to collaborate with internationally acclaimed institutions in the field of Healthresearch in order to facilitate a vibrant and relevant health research system in the country.

(Para 3.3)

The Committee welcomes the on-going evaluation of the research activities of ICMRby an independent Committee. The Committee would Impress upon the Department toexpedite submission of the recommendations of the independent Committee and place themin the public domain. The Committee desires to be apprised of the composition, findings ofthe independent Committee and the follow-up action taken thereon. The Committee wouldalso like to know if it is possible to involve reputed scholars of developed countries in theevaluation of the research projects of ICMR. (Para 3.5)

The Committee notes that some very important research activities/projects in variedareas are targeted to be undertaken/continued during the year 2013-14. The Committeewould like to be apprised in due course of time, of the quantifiable and specificachievements made vis-à-vis targets set for the year 2013-14. (Para 3.7)

The Committee notes that a number of outcomes have been projected for the year2013-14. The Committee recommends that the desired outcomes be achieved within thetargeted time-frame. The Committee desires to be kept apprised of the achievements madevis-a-vis the targets set. The Committee observes that it takes time to translate theresearch leads into tangible health products or in application of the knowledge generatedthrough research and a lot of work remains to be done to bridge the gap between ‘what isknown’ and ‘what is done’. Concerted efforts are required to be made to bring researchoutcomes into application in the better interest of the public. The Committee would,therefore, like to be apprised of the finding of the Committee constituted to identify theleads from the completed extramural research projects. The Committee would also like tobe intimated of the specific health products/processes accruing from the above researchprojects. (Para 3.10)

ICMR – NIF joint collaborative programme in traditional practices

The Committee observes that no single system of health care has the capacity tosolve all of the country’s health care needs. It is in this context that promotion of researchin the area of traditional medicines including Ayurveda, Naturopathy, Tibbia, Sowa-Rigpa andHomoeopathy becomes vital for the public health care system. The Committee, therefore,

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recommends that the research projects on traditional medicines be pursued vigorously andthe innovations accruing therefrom be introduced into public health service within adesignated time-frame. The Committee desires to be kept apprised of the success achievedin this regard. (Para 3.17)

IV. Programmes for the North East

The Committee welcomes the initiatives taken by the Department to undertakestudies and projects specific to North Eastern Region and exhorts that focused attention bepaid to the implementation of the above projects by way of streamlined monitoring so thattangible outcomes could be achieved and benefits emerging therefrom percolate down to thepeople. (Para 4.3)

V. Human Resource Development for Health Research

The Committee observes that much delay has already taken place in implementingthe schemes pertaining to Human Resource Development which resulted in the surrenderof the entire budgeted funds for 2012-13. The Committee would expect the Department toavoid recurrence of such a situation and get the EFC clearance at the earliest. TheCommittee would also like the Department to complete other pre-project activities withinthe shortest possible time. The Committee desires to be kept apprised of the developmentin this regard. (Para 5.5)

VI. Grant-in-Aid Schemes for Inter-Sectoral Convergence and Promotion and Guidanceon Research Governance Issues

The Committee gathers from the information furnished that the Grant in AidScheme for Inter-Sectoral Convergence and Promotion and Guidance on ResearchGovernance Issues is yet to be cleared by the EFC/Cabinet. The Committee, in the earlierpart of the Report, has commented about proactively pursuing for approval of variousSchemes with the agencies concerned and completing all pre-project formalities well in time.The Committee recommends here also to take similar action in respect of the aboveScheme as well. (Para 6.2)

Grant-in-Aid scheme for projects requiring inter-sectoral coordination, translationspecially in PPP mode and IT enabled governance, trans-disciplinary as well asimplementation research.

The Committee observes that very important activities are envisaged to beaccomplished under the Grant in Aid Scheme for Inter-Sectoral Convergence and Promotionand Guidance on Research Governance Issues. The Committee in its 56th Report onDemands for Grants (2012-13) of the Department of Health Research had observed that theaccomplishment of targets set under the Scheme would require involvement of a number ofagencies/organizations and recommended creation of an institutional coordinationmechanism for synergizing the core competencies of the different organizations/agencies.The Committee is not aware whether such a dispensation has come into existence or not.The Committee, therefore, would like to be updated in this regard. (Para 6.6)

Promotion and Guidance on Research Governance Issues

The Committee recommends that early action be taken for setting up MTDB whichwill go a long way in promoting development of indigenous medical technologies. (Para 6.9)

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VII. Development of Infrastructure for Promotion of Health Research Establishment ofMulti-disciplinary Research Units (MRUs)

The Committee, therefore, recommends that the proposal of Darbhanga MedicalCollege and Hospital for establishing MRU may also be considered for approval and a MRUbe set up there at the earliest. (Para 7.4)

Establishment of Model Rural Health Research Units (MRHRUs)

The Committee observes that though first year of the Twelfth Plan has alreadyelapsed and the 2nd Year has started, no MRU or MRHRU has been set up till date. Fromthe information furnished by the Department, the Committee gathers that the EFC/Cabinetclearance for the above schemes is yet to be received, which would entail further delay.Considering the fact that around 150 MRUs and 50 MRHRUs are targeted to be set upduring the Twelfth Plan, the Committee apprehends that it would be difficult to achieve thetargets set, which would also lead to budgeted funds remaining unutilized and thereforeconcerted action may be taken in this regard. It is, therefore, imperative on the part of theDepartment to vigorously pursue the matter and get the necessary clearances in the rightearnest and well in time. The Committee desires to be kept apprised regularly of theprogress made towards setting up of MRUs and MRHRUs. (Para 7.6)

VIII. Managing Epidemics and National Calamities

Setting up a Laboratory Network for Research on Viral and other Infectious Diseases.

The Committee observes that viral diagnosis has emerged as a major healthchallenge. The Committee, therefore, recommends that the Department should draw up anaction plan for timely implementation of the scheme for setting up of laboratory networkfor research on viral and other infections. Efforts may be made to achieve physical andfinancial targets. (Para 8.2)

IX. International Cooperation in Medical and Health Research

The Committee observes that though adequate budgetary provisions had been madein BE 2012-13 for the above head, no international conference could be organised so far. TheCommittee is of the view that international conference involving eminent scientists anderudite scholars help in sharing and dissemination of knowledge. The Committee wouldtherefore, advise the Department to initiate action for organising international conferencesand symposia during 2013-14 and also ensure that sharing of knowledge and expertise couldlead to finding some solutions to health challenges of the country. (Para 9.2)

The Committee is happy to note that one of the activities proposed for 2013-14 inter-alia talks of sharing the expertise of developed and developing countries for transfer oftechnology and training in cutting edge of science. The Committee also desires to beinformed of the achievements made so far. (Para 9.4)

X. Manpower Requirements of Department of Health Research

The Committee notes that despite coming into existence of DHR as a separateDepartment in 2007, the cadre-controlling authority for the DHR is the Department ofHealth and Family Welfare. The purpose being served by having such an arrangement isbeyond the comprehension of the Committee. The Committee feels that such anarrangement would only delay the process of filling up of vacant posts and should,

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therefore, be dispensed with. The Committee would therefore, like the Department ofHealth Research to bring the above observation to the notice of the authorities concernedfor an appropriate decision. The Committee desires to be apprised of the response ofDepartment of Health and Family Welfare in this regard. (Para 10.3)

The Committee also expresses its concern over a large number of posts lying vacantvis-a-vis the sanctioned strength, which is certain to impinge on the smooth functioning ofthe Department. The Committee would recommend that the matter should be pursued atthe highest level with the concerned authorities for expeditious filling up of the vaccines atthe earliest. A Department cannot function with so many vacancies. If the Government didnot create a separate Department, things would have been different. But now that theGovernment has created the Department, all the commitments should be fulfilled. An earlyaction may be taken in this regard. (Para 10.4)

MINUTES

IXNINTH MEETING

(2012-13)

The Committee met at 10.30 A.M. on Friday, the 5th April, 2013 in Committee Room ‘A’,Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT


RAJYA SABHA2. Dr. Vijaylaxmi Sadho

3. Shri Rasheed Masood

4. Dr. Prabhakar Kore



7. Shri D. Raja

8. Shri H. K. Dua

LOK SABHA9. Shri Kirti Azad

10. Shrimati Sarika Devendra Singh Baghel



13. Dr. Monazir Hassan


15. Shri Mahabal Mishra


17. Shri Harin Pathak


19. Dr. Arvind Kumar Sharma


21. Shri P.T. Thomas

22. Shri Chowdhury Mohan Jatua

SECRETARIATShri P.P.K. Ramacharyulu, Joint Secretary





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Department of AYUSH

1. Dr. V.M. Katoch, Secretary and Director General, ICMR

2. Shri S.K. Srivastava, Additional Secretary and Financial Advisor

3. Shri S.K. Rao, Joint Secretary

4. Dr. H. Nagesh Prabhu, Joint Secretary

5. Shrimati Dharitri Panda, Sr. Financial Advisor, ICMR

6. Shri T.S. Jawahar, Sr. Deputy Director General, ICMR

7. Dr. Shakuntla, Chief Controller of Accounts

* * *

* * *

I. Opening Remarks

2. At the outset, the Chairman welcomed Members of the Committee and briefed them aboutthe agenda of the meeting i.e., examination of Demands for Grants (2013-14) of the * * *and taking of oral evidence of the Secretary of the Department of Health Research * * * inthe afternoon session.

II. Oral Evidence of the Secretary, Department of Health Research

3. The Secretary, Department of Health Research made a power-point presentation andacquainted the Committee with the various functions of the Department such as (i) Work relatedto ICMR viz. intramural and extramural programmes of ICMR; (ii) Work relating to Department ofHealth Research other than ICMR comprising Schemes viz. (a) Human Resources Development forHealth Research, (b) Grant-in-aid scheme for inter-sectoral convergence and promotion andguidance on research governance issues, (c) Managing epidemics and national calamities, and(d) Development of Infrastructure for promotion of Health Research-MRU&MRHRU; (iii) outlay ofEleventh Plan and actual expenditure incurred; (iv) Financial Performance (Non-Plan) in EleventhPlan; (v) Physical Achievements during the Eleventh Plan Period; (vi) Twelfth Plan outlay for theDepartment and Twelfth Plan schemes; (vii) Status of preparedness to roll out the new schemes(viii) Activities proposed to be taken up by ICMR in 2013-14 such as translational research,intramural and extramural research programmes and establishment of new centres for research;(ix) Proposed/approved budget 2013-14; (x) Summary of Budget (2013-14); (xi) Impact of reducedallocations on ongoing and new activities, etc. Members sought clarifications on the activities andachievements of the Department and deliberated on the adequacy or otherwise of the budgetaryallocation under different heads of the Department, reasons of under-utilization of funds, mainachievements of the Eleventh Plan vis-a-vis the targets set, on-going scheme of DHR and delayin approval of the five schemes proposed by the Department; on-going research projects ascompared to that planned; discovery of new TB drugs etc. The Secretary of the Department repliedto some of the queries raised by the Members. He was then directed by the Chairman to furnishdetailed written replies to the remaining queries, which remained unanswered, soon.

III. * * *

*** Relates to other matter.

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(The Committee then adjourned at 2.00 P.M. for lunch to meet again at 2.30 P.M.)

IV. * * *

5. A verbatim record of the proceedings of the meeting was kept.

6. The Committee then adjourned at 5.00 P.M.


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XIELEVENTH MEETING

(2012-13)

The Committee met at 3.00 P.M. on Tuesday, the 23rd April, 2013 in Room No. ‘67’, FirstFloor, Parliament House, New Delhi.

MEMBERS PRESENT


RAJYA SABHA



4. Shri D. Raja

LOK SABHA

5. Shri Kirti Azad







SECRETARIAT

Shri P.P.K. Ramacharyulu, Joint Secretary





I. Opening Remarks

2. At the outset, the Chairman welcomed Members of the Committee and apprised them of theagenda of the meeting, i.e., consideration and adoption of * * * and Draft 67th, 68th, 69th and70th Reports on Demands for Grants (2013-14) pertaining to Departments of Health and FamilyWelfare, AYUSH, Health Research and AIDS Control, respectively. He invited Members to sharetheir specific suggestions for improvements and incorporation in the Draft Reports.

II. Adoption of the Draft Reports

3. The Committee then considered and discussed the five draft Reports mentioned above. Afew changes were suggested by Members for incorporation in the Reports. After some discussion,the Committee adopted all the five Reports with some modifications. The Committee, thereafter,

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decided that the Reports may be presented to the Rajya Sabha and laid on the Table of the LokSabha on Friday, the 26th April, 2013. The Committee authorized its Chairman and in his absence,Shri D. Raja and Dr. Vijaylaxmi Sadho to present the Reports in Rajya Sabha, and Dr. SanjayJaiswal, and in his absence, Shrimati Jayshreeben Patel to lay the Reports on the Table of the LokSabha.

III. Study visit

4. * * *

5. The Committee adjourned at 3.35 P.M.


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